Cervical Range Of Motion Research Articles

Effect of Respiratory Training on Pulmonary Functions and Cervical ROM in Non-Specific Chronic Neck Pain

Objectives: Non-Specific Chronic Neck (NS-CNP) is a multifactorial condition with excessive activity of accessory muscles of respiration in the neck. Studies have portrayed significant relationships between chronic neck pain and respiratory parameters. The study intends to find the impact of respiratory training on lung function and cervical ROM in NS CNP. Methods : The study recruited 64 subjects with pain who were advised to undergo conventional electrotherapy for a week. Pre-intervention measurements were taken, and subjects were divided into 2 groups. Group A received respiratory training and conventional therapy, while Group B received conventional therapy. Post-test measurements were recorded and statistically analyzed. Findings: The post-values of all the outcome measures were significant with an obtained p-value of 0.00, which is <0.05 in both Group A and Group B. Comparing all the outcome measures between the groups showed a significant difference in Cervical flexion along with FVC, SVC, and MVV with the obtained p values of <0.05 which is below the threshold chosen for the statistical analysis. Novelty: The novelty of this study is to implement respiratory training along with conventional neck exercises in the management of NS-CNP. Conclusion: This study concludes that respiratory training and conventional neck exercises significantly improved neck mobility and pulmonary function. Keywords: Cervical pain, Respiratory training, Neck range of motion, Pulmonary functions, Forced vital capacity

Effect of stabilizer pressure biofeedback on post-thyroidectomy neck pain in postmenopausal women: a randomized controlled trial

IntroductionTo investigate the effect of stabilizer pressure biofeedback on post-thyroidectomy neck pain, disability, endurance capacity of deep cervical flexors (DCFs), and cervical range of motion (ROM) in women after menopause.MethodsThirty-six women aged 50–65 years with post-thyroidectomy neck pain were incorporated in this study. Participants were assigned randomly into two groups. Each group was comprised of 18 women. Group A underwent active stretching exercises of the neck muscles. Group B underwent cranio- cervical flexion training using stabilizer pressure biofeedback in addition to active stretching exercises. Q1: The treatment interventions were administered 3 times per week for six weeks. A stabilizer pressure biofeedback device was utilized to evaluate the endurance capacity of the DCFs. A digital goniometer was used to measure the cervical spine ROM. The Neck Pain and Disability Scale (NPDS) was utilized to assess neck pain and disability levels prior to and following six weeks of treatment.ResultsGroup A had no significant improvement over group B in the endurance capacity of the DCFs. Both groups (A and B) showed significant increases in cervical ROM and decreases in NPDS. However, comparing the two groups post-treatment, group B showed a statistically significant improvement in all outcome measurements.ConclusionsStabilizer pressure biofeedback is efficacious in enhancing the endurance of DCFs and ROM, in addition to reducing neck pain and disability in postmenopausal women who experience neck pain after thyroidectomy.

Altered cervical proprioception and biomechanics in obstructive sleep apnea: a case-control study.

This study aimed to compare cervical proprioception and related biomechanical factors among patients with Obstructive Sleep Apnea (OSA) and asymptomatic controls. In this case-control study, polysomnography scores (apnea-hypopnea index-AHI) were examined to determine the disease severity of the OSA group. Also, we evaluated cervical proprioception by using a laser pointer to detect joint repositioning error sense in cervical rotational movements. Comparison statistics were also conducted for the cervical musculoskeletal variables such as range of motion (ROM) with bubble inclinometer, cranio-cervical (CVA), and thoracic posture (TKA) through photometric analysis, neck flexor muscle endurance test, and pain pressure thresholds of trapezius (PPT). This case-control study included 59 male participants: patients with OSA (n = 29; mean age = 49.10 years; mean BMI = 28.41kg/m2) and asymptomatic controls (n = 30; mean age = 49.73 years; mean BMI = 26.89 ± 3.60kg/m2). The mean AHI score was 26.06 events/hour, categorizing the severity of OSA as mild (31.03%), moderate (31.03%), and severe (37.94%). Patients with OSA demonstrated significantly poorer cervical proprioception compared to controls for both sides of cervical rotation with larger effect sizes (d:1.36-1.45; p < 0.05). Also, cervical ROM, CVA, TKA, neck flexor muscle endurance test, and PPT values were altered in the OSA group compared to the control group (p < 0.05). Impaired cervical proprioception may be a previously unrecognized factor associated with OSA. This finding has implications for understanding the mechanisms underlying cervical musculoskeletal changes in OSA and for developing potential new interventions or exercise designs targeting postural control.

Clinical evaluation of the efficacy of focused extracorporeal shock-wave therapy in patients with cervical spondylosis: A randomized control trial.

Extracorporeal shock wave therapy (ESWT) has emerged as a contemporary modality in physiotherapy, demonstrating efficacy in addressing musculoskeletal disorders. Despite its potential, the clinical efficacy of ESWT in the context of cervical spondylosis remains understudied, with a dearth of robust empirical evidence. To bridge this gap, the present study was designed to evaluate the therapeutic impact of focused ESWT (fESWT) on pain alleviation and functional improvement in individuals afflicted with cervical spondylosis. A multicenter, randomized controlled clinical study was conducted, collecting data from 5 clinical studies on the treatment of cervical spondylosis with fESWT from June 2021 to March 2024. The inclusion criteria were patients diagnosed with cervical spondylosis, aged 20 to 70, without severe underlying diseases such as heart disease, hypertension, diabetes, etc. The exclusion criteria included pregnant women, nursing women, patients with bleeding tendencies, or those with cardiac pacemakers. The control group underwent a sham fESWT, while the experimental group received fESWT administered via the Duolith SD1 Tower device. The main observation indicators included the Visual Analogue Scale (VAS) for pain scoring, Neck Disability Index (NDI) scoring, cervical range of motion (ROM) scoring, and the Short Form-36 (SF-36) quality of life survey scoring. A total of 320 subjects were included in the study, with 160 in the experimental group and 160 in the control group. Post-treatment, the VAS and NDI scores in the experimental group were significantly lower than those in the control group (P < .05), while the cervical range of motion (ROM) and SF-36 scores were significantly higher than in the control group (P < .05). The overall treatment efficacy rate in the experimental group exceeded 90%, markedly higher than the approximately 70% rate in the control group (P < .05). There was no significant difference in the incidence of adverse reactions between the 2 groups. The fESWT has shown promising therapeutic effects in the treatment of cervical spondylosis. It effectively reduces patient pain, improves cervical function, and enhances the quality of life, making it worthy of clinical promotion and application.

Variable Resistance Training Combined With Static Traction Computer Vision Applied in Neck and Shoulder Rehabilitation Training for College Students

This study evaluates the effectiveness of static traction combined with variable resistance training in rehabilitating college students with neck and shoulder diseases. Ninety students were randomly assigned to receive either static traction alone or combined therapy. Visual analogue scale (VAS), neck disability index (NDI), cervical range of motion, electromyography (EMG), and soft tissue parameters were assessed pre- and post-treatment. Both groups showed improved VAS and NDI scores post-treatment, with greater enhancements in the combined therapy group. Cervical range of motion, EMG values, and soft tissue parameters also favored the combined therapy. Statistical analysis revealed significant differences (P&amp;lt;0.05) between groups. Static traction combined with variable resistance training effectively improves neck and shoulder function, reduces pain, and enhances rehabilitation outcomes compared to static traction alone. This approach shows promise for optimizing rehabilitation in college students with similar musculoskeletal conditions.

Effectiveness of McKenzie exercises plus stabilization exercises versus McKenzie exercises alone on disability, pain, and range of motion in patients with nonspecific chronic neck pain: A randomized clinical trial.

Chronic nonspecific neck pain is a common disorder that causes disability and reduced quality of life. Effective conservative treatment options are needed to manage this condition. This randomized trial compared the efficacy of McKenzie exercises alone versus McKenzie plus cervical and scapulothoracic stabilization training for patients with chronic nonspecific neck pain. A randomized controlled trial was conducted in an outpatient physical therapy clinic. 76 patients with chronic (> 3 months) neck pain were randomized to 6 weeks of either McKenzie exercises alone (n= 38) or McKenzie plus stabilization exercise (n= 38). The McKenzie protocol included posture correction, range of motion exercises, and lateral neck stretches. The stabilization program added targeted exercises for the neck and scapula. The combination of McKenzie plus stabilization exercises resulted in significantly greater reduction in current neck pain intensity compared to McKenzie alone at 6 weeks (mean difference: -1.2 points on 0-10 scale, 95% CI -1.8 to -0.6; p< 0.001). Neck disability improved in both groups. Cervical range of motion also improved more with the addition of stabilization, except for extension. Adding specific cervical and scapulothoracic stabilization exercises to a standard McKenzie protocol led to clinically meaningful reductions in neck pain compared to McKenzie therapy alone in patients with chronic nonspecific neck pain. This combined approach can improve outcomes.

EFFECT OF DRY NEEDLING ON PAIN AND CERVICAL RANGE OF MOTION IN PATIENTS WITH UPPER TRAPEZIUS TRIGGER POINTS: A SYSTEMATIC REVIEW

Objectives: This systematic review seeks to provide high-quality evidence on the effect of dry needling on cervical range of motion and pain in patients. The objective of this systematic review was to determine the evidence base for the effect of dry needling on cervical range of motion and pain in patients with upper trapezius trigger points. Material and methods: A systematic electronic literature search was undertaken utilizing keywords and medical subject heading search phrases in the PubMed/Medline, Cochrane Central, Scopus, and EBSCO databases, as well as Google Scholar. In addition, the reference lists of the systematic reviews included in the study were manually searched. Patient satisfaction and complications were collected from a range of motion prospective and experimental studies that provided the greatest degree of evidence. Articles were evaluated critically, and the methodological index for non-randomized studies scale was used to determine the risk of bias. Results: This systematic review suggested the use of dry needling to improve pain and functional capacity in patients with chronic neck pain at short- and mid-term intervals. To the interventions, dry needling combined with physical therapy was shown to be effective in decreasing pain, whereas isolated dry needling did not demonstrate significant improvements in the analyzed studies. Conclusion: Finally, as for pain, dry needling combined with physical therapy was the therapy that showed the most benefits in function in the analyzed studies

The comparison of Pilates with cognitive functional therapy in adults with chronic neck pain: a protocol for randomized controlled trial

Background Chronic Neck Pain is one of the main musculoskeletal problems in the general population that negatively affects the lives of patients. Its treatment can include various treatment methods, such as Pilates and Cognitive Functional Therapy. The purpose of this research was to investigate the effectiveness of Pilates in relation to Cognitive Functional Therapy in people with Chronic Neck Pain. Methods This single-blind randomized controlled study included 60 patients with Chronic Neck Pain who were randomly divided into two groups (Group 1: Pilates, Group 2: Cognitive Functional Therapy). All patients will undergo 16 sessions over 8 weeks. Outcome measures (pain, disability, fear perception, functionality, quality of life, cervical range of motion, and neck muscle isometric strength) will be evaluated at baseline, at the end of the treatment (week 8) and three months after randomization (week 12). Outcome measures will be analyzed via random effects at the three assessment time points, and the interactions of the treatment groups with the assessment points will be included in the results of the fixed model. Discussion This is the first Randomized Controlled Trial to compare the effectiveness of Pilates and Cognitive Functional Therapy in patients with chronic neck pain. The results of this research will provide information on the effectiveness of each intervention separately and whether one of the two can outperform the other.

The effects of photobiomodulation and transcutaneous electrical nerve stimulation on chronic neck pain: A double-blind, randomized, sham-controlled trial

BackgroundPhotobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) are used to reduce neck pain. ObjectiveTo investigate the immediate and 1-month post-treatment effects of 10 treatment sessions of PBM and TENS delivered over 2 weeks on pain intensity in individuals with neck pain. MethodsIndividuals with neck pain were randomized into four groups: PBM+TENS, PBM, TENS, and Sham. Primary outcome: pain intensity at rest. Secondary outcomes: pain intensity during movement, pressure pain threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM), cervical range of motion (ROM), psychosocial factors, drug intake for neck pain, and global perceived effect (GPE). All outcome assessments were made pre- and post-treatment. Mean differences and 95 % confidence intervals were calculated for between-group comparisons. ResultsA total of 144 participants were recruited. No significant between-group difference was observed for pain intensity at rest, TS, CPM, ROM, psychosocial factors, and drug intake. The PBM+TENS showed a reduction in pain intensity during movement and GPE compared to the PBM (MD: 1.0 points; 95 % CI: 0.0, 2.0; MD: 2.0 points; 95 % CI: 1.0, 3.0) and Sham (MD: 2.0 points; 95 % CI: 1.0, 3.0; MD: 2.0 points; 95 % CI: 1.0, 3.0) groups. PBM+TENS presented a medium effect size to increase local PPT compared to PBM and Sham groups. TENS presented a medium effect size to increase local PPT compared to PBM and Sham groups. TENS presented a medium effect size to increase distant PPT compared to other groups. ConclusionsThe use of PBM or TENS was not effective for reducing pain intensity at rest. The combination of PBM and TENS was effective in improving pain intensity during movement, local hyperalgesia, and the GPE. TENS reduced local and distant hyperalgesia.

Effects of Preoperative Cervical Range of Motion on Clinical Outcomes Following Posterior Decompression: A Multicenter Study of Patients With Cervical Ossification of the Posterior Longitudinal Ligament

Study Design Retrospective multicenter study. Objectives To investigate the impact of preoperative cervical range of motion (ROM) on clinical outcomes after posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL). Methods We analyzed data from 156 patients with cervical OPLL who underwent posterior decompression and were followed for at least 2 years. Patients were divided into two groups based on preoperative gap ROM, which was a novel indicator representing the difference between flexion and extension ROM: the gROM &lt;0° and &gt;0° groups, and their outcomes were compared. Results There were no significant differences in patient demographics or surgical details between the gROM &lt;0° and &gt;0° groups. The gROM &lt;0° group exhibited less lordosis in C2-7 angles before and after surgery compared to the gROM &gt;0° group. Cervical ROM significantly decreased following posterior decompression regardless of whether preoperative gROM was &lt;0° or &gt;0°. Meanwhile, the incidence of perioperative complications was similar between the two groups. Furthermore, both groups showed significant improvement in Japanese Orthopaedic Association (JOA) scores postoperatively; however, there were no significant group differences in JOA scores, recovery rates, or visual analog scale for neck pain between the two groups at the preoperation and final follow-up. Conclusions The incidence of perioperative complications and postoperative clinical outcomes were comparable regardless of the magnitude of preoperative cervical gROM. Although cervical ROM decrease postoperatively, posterior decompression for cervical OPLL can offer favorable clinical outcomes irrespective of the preoperative cervical ROM magnitude, consequently.

An investigation of machine learning algorithms for prediction of temporomandibular disorders by using clinical parameters.

This study aimed to predict temporomandibular disorder (TMD) using machine learning (ML) approaches based on measurement parameters that are practically acquired in clinical settings. 125 patients with TMD and 103 individuals without TMD were included in the study. Pain intensity (with visual analog scale), maximum mouth opening (MMO) and lateral excursion movements (with millimeter ruler), cervical range of motion (with goniometer), pressure pain threshold (PPT; with algometer), oral parafunctional behaviors (with Oral Behaviors Checklist), psychological status (with Hospital Anxiety and Depression Scale), and quality of life (with Oral Health Impact Profile) were evaluated. The measurements were analyzed via over 20 ML algorithms, taking into account an extensive parameter tuning and cross-validation process. Results of variable importance were also provided. Bagging algorithm using Multivariate Adaptive Regression Spline (MARS) algorithm (accuracy = 0.8966, area under receiver operating characteristic curve = 0.9387, F1-score = 0.9032) was the best performing model regarding the performance criteria. According to this model, the 5 most important variables for predicting TMD were pain intensity, MMO, lateral excursion and PPT values of masseter and temporalis anterior muscles, respectively. The Bagging algorithm using the MARS algorithm is a robust model that, in combination with clinical parameters, assists in the detection of patients with TMD in settings with limited capabilities. The clinical parameters and ML algorithm proposed in this study may assist clinicians inexperienced in TMD to make a preliminary detection of TMD in clinics where diagnostic imaging tools are limited.

Three dimensional-printed artificial disc replacement for single-level cervical spondylosis: a cohort study.

To compare the clinical efficacy of 3D-printed artificial discs with that of ACDF for treating cervical spondylosis. This was a retrospective analysis of 73 patients with single-level cervical spondylosis who met the inclusion criteria between January 2020 and December 2022 at XX Hospital. The patients were divided: 38 patients in the ACDF group and 35 patients in the CADR group. Patient general information, including operation time and intraoperative blood loss, was collected. The clinical effect of the combination therapy was evaluated by the VAS, JOA, and NDI. The radiological effect was evaluated using the ROM test. Ethics No. 201,606,009. The average follow-up times in the ACDF and CADR groups were 28.24 ± 4.65 and 29.11 ± 5.06 months, respectively (P = 0.443). Clinical symptoms (evaluated by VAS, NDI, and JOA) are significantly improved in both the ACDF and CADR groups with similar efficacy. The preoperative ROM of the ACDF group was 40.03 ± 8.79, while that of the CADR group was 42.11 ± 7.98 (P = 0.293). However, the postoperative ROM in the ACDF group was 35.29 ± 7.23, which was lower than that in the CADR group (40.43 ± 6.98) (P = 0.003). Furthermore, only one patient in the ACDF group experienced mild dysphagia after surgery, and the patient recovered within three days. ASD occurred in nine patients in the ACDF group and in two patients in the CADR group (Χ²=4.597, P = 0.032). Compared with ACDF, 3D-printed artificial discs for treating single-level cervical spondylosis have proven to be clinically effective; it associated with less blood loss and a lower incidence of ASD, and maintain a better cervical ROM.

The Effects of cervical mobilization and clinical pilates exercises in cervicogenic headache: randomized controlled trial.

To investigate the effects of Cervical Mobilization (CM) and Clinical Pilates Exercises (CPE) in Cervigogenic Headache (CHA). The 37 patients were randomized into the 3 groups. The CM for 1st group, CPE for 2nd group and CM+CPE for 3rd group were applied 3 days/a week for 6 weeks. Pain frequency, pain intensity, number of analgesic, were recorded. The posture was measured by Posture Screen application, the cervical range of motion by the CROM device, deep neck flexor muscle endurance by the pressurized biofeedback device. Evaluations were applied 2 times as pre-post treatment. In within-group comparison a decrease in pain parameters, neck-shoulder postural deviation and an increase DNFE and CROM were observed in all groups (p<0.05). In between-group comparison pain frequency, intensity and number of analgesics were significant changes in the CM and CM+CPE groups according to CPE (respectively p<0,001, p=0,001, p=0,018). Head and shoulder angulation were significant in the CPE and CM+CPE groups according to CM (respectively p=0.009, p=0,011). It was determined that the cervical right lateral flexion range of motion and right rotation were significant changes in the CM and CM+CPE groups according to CPE (respectively p=0,026, p=0,040). DNFE were significantly increased in CM+CPE according to CM and CPE (p=0.001). This study suggests that it would be beneficial to add CM and CPE to the treatment plans of patients with CHA.

Changes in the Centers of Rotation in Different Prosthetic Segments Following Continuous Two-Level Cervical Disc Replacement: A Retrospective Study

To observe the short-term to medium-term therapeutic effects and radiological outcomes of adjacent 2-level cervical spondylosis treated with artificial cervical disc replacement (ACDR) using Mobi-C and Bryan discs. To observe changes and discrepancies in the flexion-extension centers of rotation (FE-COR) of different ACDR segments. Twenty-four patients undergoing 2-level (C4/5 and C5/6) ACDR were analyzed retrospectively (11 patients in the Mobi-C group and 13 patients in the Bryan group). Clinical outcomes were assessed using modified Japanese Orthopedic Association score, Neck Disability Index, and visual analog scale. Preoperative and 2years' follow-up radiographs were collected to compare total cervical spine curvature (C2-C7) range of motion (ROM), upper and lower ACDR segmental ROM, and the operated adjacent segmental ROM. The FE-COR of the ACDR segment was measured using the mid-plumb line method. The degree of disc degeneration in the adjacent segment was observed. At the 2years' follow-up, in both group, the modified Japanese Orthopedic Association score increased significantly, and the Neck Disability Index and neck and upper extremity visual analog scale scores decreased significantly compared with preoperative (P<0.05). There were no significant statistical differences in postoperative scores between the 2 groups (P > 0.05). The overall cervical ROM, the upper and lower segmental ROM at the 2years' follow-up showed no significant statistical differences compared with the preoperative period (P > 0.05). There was no statistically significant difference in the adjacent segmental ROMs compared with the preoperative period (P > 0.05). Furthermore, the statistical analysis revealed no significant differences in the measurements of the ROM at each time points between the Mobi-C Group and the Bryan Group (P > 0.05). There was no significant difference in the preoperative FE-COR-X (indicating the horizontal position of the point in the coordinate system) and FE-COR-Y (indicating the vertical position of the point in the coordinate system) of upper or lower ACDR segments between the 2 groups (P > 0.05). At the 2years' follow-up, there were significant differences both in FE-COR-X and FE-COR-Y between the 2 groups (P < 0.05). For the Mobi-C group, in both the upper and lower segment, the FE-COR-X significantly increased compared with preoperative (P < 0.05), while the FE-COR-Y decreased compared with preoperative (P < 0.05). For the Bryan group, no significant changes were observed in the upper or lower segment in both FE-COR-X and FE-COR-Y compared with preoperative (P > 0.05). Fourty-eight adjacent segments (24 superior and 24 inferior segments) were included in the studies of adjacent segment disease. Four segments showed imaging adjacent segment disease (4/48, 8.33%) in 4 patients, of which 2 were mild and 2 were moderate according to the grading criteria. Among them, 2 were from the Mobi-C group and 2 were from the Bryan group. No severe imaging degeneration was observed. In continuous 2-level cervical ACDR surgery, both Mobi-C and Bryan artificial cervical discs achieved satisfactory clinical outcomes in the short to medium term postoperatively. The FE-COR exhibited different trends of change. In the Mobi-C group, the FE-COR for both upper and lower segments shifted anteriorly and inferiorly, whereas in the Bryan group, whether upper or lower, the FE-COR remained closer to the preoperative state. The changes in FE-COR did not significantly affect the short-term to medium-term clinical outcomes postoperatively.

Efficacy and safety of laminoplasty combined with C3 laminectomy for patients with multilevel degenerative cervical myelopathy: a systematic review and meta-analysis.

Laminoplasty (LP) combined with C3 laminectomy (LN) can effectively achieve spinal cord decompression while maintaining the integrity of the posterior ligament-muscle complex, thereby minimizing cervical muscle damage. However, its necessity and safety remain controversial. This study aimed to compare the safety and efficacy of LP and LP combined with C3 LN in the treatment of patients with multilevel degenerative cervical spondylotic myelopathy (DCM). A systematic review and meta-analysis of the literature was performed. A search of PubMed, Web of Science, Embase, and the Cochrane Library databases was conducted from inception through December 2023 and updated in February 2024. Search terms included laminoplasty, laminectomy, C3 and degenerative cervical spondylosis. The literature search yielded 14 studies that met our inclusion criteria. Outcomes included radiographic results, neck pain, neurologic function, surgical parameters, and postoperative complications. We also assessed methodologic quality, publication bias, and quality of evidence. Fourteen studies were identified, including 590 patients who underwent LP combined with C3 LN (modified group, MG) compared to 669 patients who underwent LP (traditional group, TG). The results of the study indicated a statistically significant improvement in cervical range of motion (WMD = 3.62, 95% CI: 0.39 to 6.85) and cervical sagittal angle (WMD = 2.07, 95% CI: 0.40 to 3.74) in the MG compared to the TG at the last follow-up (very low-level evidence). The TG had a higher number of patients with complications, especially C2-3 bone fusion. There was no significant difference found in improvement of neck pain, JOA, NDI, cSVA, T1 slope at latest follow-up. LP combined with C3 LN is an effective and necessary surgical method for multilevel DCM patients to maintain cervical sagittal balance. However, due to the low quality of evidence in existing studies, more and higher quality research on the technology is needed in the future.

Comparison of Staggered and Conventional Posterior Single-Door Laminoplasty

ObjectiveThis study aimed to delineate the clinical and radiological outcomes between two different single-door laminoplasty techniques, the staggered approach and the conventional one-sided approach, in treating cervical spondylotic myelopathy (CSM). MethodsThis is a retrospective chart review that involved 67 patients who had CSM with symptoms lasting for ≥3 months, and underwent staggered laminoplasty (Group A, n=35) or conventional laminoplasty (Group B, n=32). Outcomes measures included intraoperative parameters, the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) for pain, cervical curvature, cervical range of motion (ROM), and radiographic parameters that reflected the level of post-operative muscle atrophy. Follow-up assessments were available at 3-, 6-, and 12-months post-operation. ResultsThe mean ages in Group A and Group B were 57.11 (SD, 8.02) and 55.28 (SD, 8.47) years, respectively, with a gender distribution of 40.00% female in Group A and 40.63% in Group B (P>0.05). The average operative times were 130.86 (SD, 11.80) and 129.84 (SD, 10.51) minutes, respectively (P>0.05). However, intraoperative blood loss in milliliters was significantly higher in Group A (196.06; SD, 32.69) compared to Group B (155.03; SD, 37.80) (P<0.001). JOA scores revealed no significant post-operative differences between the two groups. Nevertheless, Group A exhibited less VAS pain, reduced post-operative ROM loss at 6 and 12 months, and less alteration in cervical curvature and decreased severity in muscle atrophy at 3-, 6-, and 12-months post-surgery. ConclusionPatients who underwent staggered single-door laminoplasty experienced more favorable outcomes in some metrics than those who received the conventional technique.

Evaluating the Impact of Posterior Edentulism on Temporomandibular Disorder-Related Bruxism, Tinnitus, and Depression

Purpose: The impact of posterior edentulism on the management of temporomandibular disorders (TMD) remains unclear, with a paucity of studies examining the influence of posterior edentulism on TMD symptoms. The objective of this study is to investigate the relationship between posterior edentulism and bruxism, tinnitus, and depression in TMD patients and to compare treatment outcomes in two groups with and without posterior edentulism. Material and methods: In a quasi-experimental controlled trial, 26 patients with TMD participated in a six-week intervention, including manual therapy, massage, postural exercises and kinesio taping. The patients were divided into 13 in the posterior edentulous group and 13 in the full dentate group. The participants attended 12 physiotherapy sessions, twice a week, over six weeks. Outcome measures, including bruxism, tinnitus, joint clicking, Beck Depression Inventory, and cervical range of motion, were evaluated at baseline and the end of the six weeks. Results: The six-week physiotherapy program significantly improved bruxism, tinnitus, cervical range of motion, and depression (p

Laminoplasty with foraminotomy versus anterior cervical discectomy and fusion for cervical myeloradiculopathy

BACKGROUND CONTEXTAnterior cervical discectomy and fusion (ACDF) combined with uncinate process resection and laminoplasty combined with foraminotomy (LPF) have been used to achieve cervical cord and root decompression in patients with combined cervical myeloradiculopathy (CMR). PURPOSETo compare the clinical and radiographic outcomes of ACDF with those of LPF for the treatment of CMR. STUDY DESIGN/SETTINGPropensity score-matched retrospective cohort study. PATIENT SAMPLEPatients with CMR who underwent ACDF or LPF and were followed up for at least 2 years. OUTCOME MEASURESC2–C7 lordosis, C2–C7 sagittal vertical axis, and cervical range of motion (ROM) were determined. The visual analog scale (VAS) scores for neck and arm pain, neck disability index (NDI), and Japanese Orthopedic Association (JOA) scores were analyzed. METHODSThe radiographic and clinical outcomes of the 2 groups were compared. RESULTSEighty-four patients were included (n=42 in each group) after application of the inclusion criteria and propensity score matching. A significant decrease in C2–C7 lordosis (p<.001) and ROM (p<.001) was observed in the LPF and ACDF groups, respectively. LPF was associated with a significant decrease in C2 to C7 lordosis (p<.001), while ACDF caused a significant decrease in cervical ROM (p<.001). ACDF effectively improved neck pain VAS (p<.001) and NDI (p<.001), while neck pain did not significantly improve after LPF (p=.103). Furthermore, neck pain VAS (p=0.026) and NDI (p=.021) at postoperative 6 months, were significantly greater in the LPF group than in the ACDF group, while the difference was not statistically significant at 2 years postoperatively (neck pain VAS, p=.502; NDI, p=.085). Arm pain VAS and JOA score both significantly improved after LPF (p=0.003 and 0.043, respectively) or ACDF (p<.001 and 0.039, respectively), and postoperative results were not significantly different between the 2 groups. CONCLUSIONLPF and ACDF yielded similar outcomes for arm pain and neurological recovery. More immediate neck pain improvement was observed with ACDF, while neck pain after 2 years postoperatively was similar between the LPF and ACDF groups. Furthermore, increased postoperative loss of lordosis was observed in the LPF group, whereas decreased postoperative ROM was observed in the ACDF group. These findings should be considered when deciding the surgical method for patients with CMR. LEVEL Of EVIDENCEIII.

Effectiveness of adding dry needling of the upper trapezius muscle to the usual physiotherapy for managing chronic neck pain: A randomized controlled trial with a 7-week follow-up

BackgroundMyofascial pain syndrome (MPS) is a chronic condition caused by sensitive pressure regions within the muscles known as myofascial trigger points (MTrPs). ObjectiveThe purpose of this randomized controlled trial (RCT) was to assess the effectiveness of adding dry needling (DN) to activate MTrPs in the upper trapezius muscle compared with usual physiotherapy among individuals with chronic neck pain. MethodsThirty participants were recruited from a private clinic in Saudi Arabia. Their mean age was 29.7 ± 4.4 years. The subjects were randomized into two groups: the experimental group (application of DN to the MTrPs coupled with usual physiotherapy (n = 15)) and the control group (usual physiotherapy alone (n = 15)). The primary outcomes were pain (assessed using the visual analog scale) and disability (Neck Disability Index), and the secondary outcomes were neck active range of motion (AROM; assessed using cervical ROM) and depression (Beck's Depression Inventory). ResultsSignificant between-group difference in pain intensity was observed immediately post-intervention. Participants in the experimental group had significantly higher pain (mean difference = 1.27, 95% confidence interval [CI] 0.20, 2.33, p = 0.022, Cohen's d = 0.889) than those in the control group. There was no significant difference between both groups in pain intensity during the follow-up. There were no between-group differences in disability immediately post-intervention. However, there was a between-group difference in disability at follow-up; participants in the experimental group had significantly lower disability (mean difference = −3.13, 95%CI -5.07, −1.20, p = 0.003, Cohen's d = 1.211) than those in the control group. Immediately post-intervention, the experimental group showed greater flexion AROM compared to the control group, with no differences in other AROM measures. At follow-up, the experimental group exhibited significantly higher neck AROM in extension, flexion, right and left side bending, and lower depression, while no differences were observed in right- and left-rotation AROMs between groups. ConclusionsThe addition of DN to standard physiotherapy effectively improved disability, AROM (extension, flexion, and side bending), and depression among patients with chronic neck pain.

P112. Worse baseline neck pain is associated with worse postoperative mental health, physical function and cervical range of motion following cervical disc replacement

P112. Worse baseline neck pain is associated with worse postoperative mental health, physical function and cervical range of motion following cervical disc replacement