Spondylosis Patients Research Articles

Assessment of cranial blood flow in cervical spondylosis patients

Background: The effect of rotation of head movement on cerebral artery blood flow in normal subjects has been widely studied. Many factors effect blood flow through the vertebral artery such as rotation of head, variably sized arteries, atheroma, tortuous vertebral arteries, carotid sinus compression etc. Objective: To determine the effect of head and neck movement on the cranial blood flow in cervical spodylosis patients with reticulopathy. Material and methods: Fifty participants (23 male, 27female) with informed consent (20-70 years) participated in this study. Subjects with severe hypertension, cardiovascular, liver, kidney or other life threatening diseases were excluded. The changes in the Anterior, Middle, and Posterior cerebral arteries blood flow between the neutral (face to front) and rotated head positions (flexion and extension) was measured with Trans-cranial Doppler Method in healthy and Cervical Spondylosis with reticulopathy patients. Results: No significant differences in the afferent cerebral blood flow of the neutral and of the changed head positions in cervical spondylosis patient was found. In Cervical Spodylosis patients with reticulopathy, the mean values of cerebral blood flow were insignificantly different as compared to neutral position, however according to the data collected till now, the lowest blood inflow level was recorded during extension of the head. Flow changes were less than 10% considered to be normal. Conclusion: The flow changes in the afferent cerebral arteries of healthy subjects were insignificant. When a person has cervical spondylosis with reticulopathy, flexion and extension of head may diminish blood flow through the vertebral artery in its course through the cervical spine. Further studies and data are required to establish association. Keywords: Cervical spondylosis, Cranial blood flow, TCD

Overactive bladder and dysuria of the spondylosis patients

Overactive bladder and dysuria of the spondylosis patients

Kinematic characteristics of grip force in patients with cervical spondylosis

Objective: The aim of this study was to objectively evaluate sensory disturbance in cervical spondylosis using grip force and investigate the relationship between the grip force and upper extremity function. Design: Cross-sectional study. Methods: Eleven cervical spondylosis patients with paresthesia conducted grip and lift tasks using a precision grip with the tips of the thumb and index finger on either side. The sum of the grip force used during the first four seconds was calculated and defined as the total grip force. The cutaneous pressure threshold of the fingers, the pinch power, the grip power and three subtests of the Simple Test for Evaluating Hand Function (STEF) were also assessed. Correlations between the total grip force and cutaneous pressure threshold, pinch power, grip power, and STEF subtest times were evaluated. Results: We found that the total grip force correlated with the cutaneous pressure threshold (p

Analysis of the Clinical Chinese Medicine Nursing Countermeasures of Cervical Spondylosis

<strong>Objective: </strong>To explore the countermeasures and effects of the clinical Chinese medicine nursing of the cervical spondylosis. <strong>Method:</strong> The cervical spondylosis patients of arthralgia type as based on syndrome differentiation of Chinese medicine science are divided into two groups. The first group, which is the control group, is made up of 42 patients who are given routine nursing. Meanwhile, the second group which is the research group, is made up of 40 patients and are given integrated nursing. On the basis of the nursing as given to the control group, the research group is also given massage, fomentation, emotional nursing, diet nursing and functional exercise. The VDS scoring of the headache, neck pain and the tingling of the upper limbs of the two groups are compared after nursing.<strong> Result: </strong>The result of the research groups’ VDS scoring of the headache, neck pain and the tingling of the upper limbs of after nursing are obviously lower than those of the control group. After making the comparison between both groups, the data is proven to be statistically significant (<em>p</em> < 0.01). The integrated nursing given to 40 patients of the research group turns out to be effective and 3 patients of the research group recover with the total effective rate being 95%, which is much higher than that of the control group (76.2%) (<em>p</em> < 0.05). In addition, 38 of the patients of the research group feel satisfied with the nursing with the satisfaction rate being 95%，which is higher than that of the control group (61.9%) (<em>p </em>< 0.05). <strong>Conculsion: </strong>Integrating all kinds of nursing methods with emotional nursing and physiological nursing helps to cure cervical spondylosis and promotes recovery.

Pathogenesis, Diagnosis, and Treatment of Cervical Vertigo

Cervical vertigo is characterized by vertigo from the cervical spine. However, whether cervical vertigo is an independent entity still remains controversial. In this narrative review, we outline the basic science and clinical evidence for cervical vertigo according to the current literature. So far, there are 4 different hypotheses explaining the vertigo of a cervical origin, including proprioceptive cervical vertigo, Barré-Lieou syndrome, rotational vertebral artery vertigo, and migraine-associated cervicogenic vertigo. Proprioceptive cervical vertigo and rotational vertebral artery vertigo have survived with time. Barré-Lieou syndrome once was discredited, but it has been resurrected recently by increased scientific evidence. Diagnosis depends mostly on patients’ subjective feelings, lacking positive signs, specific laboratory examinations and clinical trials, and often relies on limited clinical experiences of clinicians. Neurological, vestibular, and psychosomatic disorders must first be excluded before the dizziness and unsteadiness in cervical pain syndromes can be attributed to a cervical origin. Treatment for cervical vertigo is challenging. Manual therapy is recommended for treatment of proprioceptive cervical vertigo. Anterior cervical surgery and percutaneous laser disc decompression are effective for the cervical spondylosis patients accompanied with BarréLiéou syndrome. As to rotational vertebral artery vertigo, a rare entity, when the exact area of the arterial compression is identified through appropriate tests such as magnetic resonance angiography (MRA), computed tomography angiography (CTA) or digital subtraction angiography (DSA) decompressive surgery should be the chosen treatment. Key words: Cervical vertigo, dizziness, whiplash injury, neck pain, cervical spondylosis, manual therapy, vestibular rehabilitation, vertebrobasilar insufficiency

Acupuncture and cupping combined with chiropractic massage in the treatment of 36 cervical spondylosis patients

ObjectiveTo observe the clinical efficacy of treatment of cervical spondylosis with acupuncture and cupping combined with chiropractic massage. MethodsThirty-six patients with cervical spondylosis were treated with acupuncture, cupping, and massage. Body acupuncture was taken as the principle, combining with balance acupuncture. Acupuncture was mainly applied at C1–C7 Jiāj▪ with balance acupuncture at J▪ngtòng (▪) to stimulate them by needle sticking. When cupping was applied, flash cupping was applied first, then sliding-cupping, and retention cupping was applied finally. Eventually, chiropractic massage was applied. The treatment course lasted for 10 days, and the whole treatment lasted for one to three courses. ResultsTwenty patients were cured, 14 were improved, and ineffectiveness was seen in 2 cases. The total effective rate was 94.4%(34/36). ConclusionThe curative effect of cervical spondylosis treated with acupuncture and cupping combined with chiropractic massage was definite.

Lower vitamin D levels in knee arthroplasty candidates as compared with lumbar spondylosis patients

PurposeLow Vitamin D levels are common in adult Middle-Eastern populations as well as in patients with knee osteoarthritis. The current study was designed in order to assess whether vitamin D levels are different in patients with two types of osteoarthritis. MethodsA prospective, non-randomized observational study of two groups was performed. Patients with severe knee osteoarthritis requiring knee replacement (n=38) were compared to a control group of osteoarthritic patients suffering from lumbar spondylosis (n=24). KOOS pain subscale scores were used to evaluate knee related pain, and imaging studies were used to define the arthritic process of the knees. Lumbar CT scans were available for most patients. ResultsThe study results indicate that vitamin D insufficiency is common in both populations. However vitamin D levels were lower in the knee osteoarthritic patients than in the lumbar spondylosis patients. Low vitamin D levels correlate with worse pain in arthroplasty candidates but not in lumbar spine osteoarthritis patients. ConclusionsThe current study appears to indicate that vitamin D abnormalities are common in both types of osteoarthritis evaluated but are more severe in knee arthroplasty candidates and in this group are related to the pain severity levels.

Correlation between degree of subvoxel spinal cord compression measured with super-resolution tract density imaging and neurological impairment in cervical spondylotic myelopathy.

OBJECT The purpose of this study was to explore the use of super-resolution tract density images derived from probabilistic diffusion tensor imaging (DTI) tractography of the spinal cord as an imaging surrogate for microstructural integrity and functional impairment in patients with cervical spondylosis. METHODS Structural MRI and DTI images were collected for 27 patients with cervical spondylosis with (n= 21) and without (n= 6) functional impairment as defined by the modified Japanese Orthopaedic Association Scale (mJOA). DTI was performed axially through the site of compression in a total of 20 directions with 10 averages. Probabilistic tractography was performed at 0.5-mm isotropic spatial resolution using the streamline technique combined with constrained spherical deconvolution. The following measurements were calculated for each patient: maximum tract density at the site of compression, average tract density in rostral normal-appearing spinal cord, and the ratio of maximum density to normal density. RESULTS Compared with normal tissue, the site of compression exhibited elevated fiber tract density in all patients, and a higher fiber tract density was also noted in focal areas at the site of compression in patients with functional impairment. There was a strong negative correlation between maximum tract density and mJOA score (R(2)= 0.6324, p < 0.0001) and the ratio of maximum tract density to normal tract density (R(2)= 0.6647, p < 0.0001). When grouped according to severity of neurological impairment (asymptomatic, mJOA score of 18; mild, mJOA score of 15-17; moderate, mJOA score of 11-14; and severe, mJOA score < 11), the results showed a significant difference in the ratio between severe and both no impairment (p= 0.0009) and any impairment (p= 0.036). A ratio of maximum fiber tract density at the site of compression to fiber tract density at C-2 greater than 1.45 had 82% sensitivity and 70% specificity for identifying patients with moderate to severe impairment (ROC AUC= 0.8882, p= 0.0009). CONCLUSIONS These results support the use of DTI as a surrogate for determining spinal cord integrity in patients with cervical spondylosis. Probabilistic tractography provides spinal cord microstructural information that can help discern clinical status in cervical spondylosis patients with varying degrees of neurological impairment.

Subaxial cervical spine involvement in symptomatic rheumatoid arthritis patients: Comparison with cervical spondylosis

ObjectiveTo investigate the frequency, location, characteristics, and clinical significance of subaxial involvement (below C1–C2) in a series of patients with rheumatoid arthritis (RA) and symptomatic involvement of the cervical spine. MethodsA total of 41 patients with RA were examined via cervical spine magnetic resonance imaging (MRI). A comparative analysis of the incidence of the different types of subaxial lesions was performed between these patients and 41 age- and sex-matched patients with symptomatic cervical spondylosis. ResultsStenosis of the spinal canal was found at the subaxial level in 85% of RA patients, and at the atlantoaxial level in 44%. Comparative analysis between these patients and the cervical spondylosis patients revealed significant differences in the types and frequencies of subaxial lesions. For both conditions, signs of discopathy and end-plate osteophytosis were the most common abnormalities observed on magnetic resonance imaging (MRI). However, in the RA patients these abnormalities coincided with subchondral bone and ligamentous acute inflammatory changes and with secondary destruction (vertebral instability) or repair (vertebral ankyloses).Only evidence of subaxial myelopathy was significantly associated with an increased risk of neurological dysfunction among the RA patients [Ranawat class II or III; P = 0.01; odds ratio (OR) = 11.43], although subaxial cord compression tended toward a significant association with the risk of neurological dysfunction (P = 0.06; OR = 3.95). ConclusionSubaxial stenosis seems to be the consequence of both the inflammatory process and mechanical-degenerative changes. Despite its frequency, it was not usually related to the occurrence of myelopathy symptoms, not even in cases with MRI evidence of spinal cord compression.

Age-Related Incidences of Spondylosis of the Lower Cervical Spine Radiographic Study of 460 Jeju Islanders

Study design: Cervical spine radiograms of 460 Jeju islanders, taken at the Cheju Halla General Hospital, Jeju, were the study materials. Objectives: To investigate the age-matched incidences and severity of the cervical disc degeneration and associated pathologic findings. Summary of background data: There exist several previous studies on the incidences of disc and Luschka’s and facet joint degeneration in the Europeans and Asians which provided the basic data for the interested clinicians. Methods: Cervical radiographs of 460 (220 males and 240 females) patients of fourth to ninth decade were subjected to this prospective study. Ninety patients of third decade were excluded because none showed the spondylotic findings on radiograms. There were 76 patients (16.5%) in fourth decade, 107 patients (23.3%) in fifth decade, 112 patients (24.3%) in sixth decade, 85 patients (18.5%) in seventh decade, 64 patients (13.9%) in eighth decade, and 16 patients (3.5%) in ninth decade. Results: Overall incidences of cervical spondylosis were 47.8% (220 patients out of 460 patients). The percentile incidences of spondylosis in fourth, fifth, sixth, seventh, eighth and ninth decade were 13.2%(10 out of 76 patients), 34.6%(37 out of 107 patients), 58.9%(66 out of 112 patients), 58.8%(50 out of 85 patients), 70.3% (45 out of 64 patients), and 75.0%(12 out of 16 patients). The percentile incidences of one, two, three, four and five level spondylosis among 220 spondylosis patients were 45.5%(100 patients), 34.1%(75 patients), 15.0%(33 patients), 4.5%(10 patients), and 0.9%(2 patients). Severity of disc degeneration ranged from ± to ++++; ± in 6.0% (24 segments), + in 49.6% (198 segments), ++ in 35.3% (141 segments), +++ in 9.0% (36 segments) and ++++ in 0.25% (1 segment). Spurs and anterior ligament ossicle formed at the spondylotic segments, mostly at C4~6. Posterior corporal spurs formed in quite low rates. Olisthesis and OPLL rarely combined with spondylosis. Cervical sagittal lordotic curve decreased gradually according to the progress of spondylosis, particularly over + disc degeneration. Conclusion: It was evidently shown that the incidences of cervical spondylosis and numbers of spondylotic segments increased, and that degeneration became more severe gradually throughout the aging process.

The increased prevalence of cervical spondylosis in patients with adult thoracolumbar spinal deformity.

Retrospective cohort study. To assess the concomitance of cervical spondylosis and thoracolumbar spinal deformity. Patients with degenerative cervical spine disease have higher rates of degeneration in the lumbar spine. In addition, degenerative cervical spine changes have been observed in adult patients with thoracolumbar spinal deformities. However, to the best of our knowledge, there have been no studies quantifying the association between cervical spondylosis and thoracolumbar spinal deformity in adult patients. Patients seen by a spine surgeon or spine specialist at a single institution were assessed for cervical spondylosis and/or thoracolumbar spinal deformity using an administrative claims database. Spinal radiographic utilization and surgical intervention were used to infer severity of spinal disease. The relative prevalence of each spinal diagnosis was assessed in patients with and without the other diagnosis. A total of 47,560 patients were included in this study. Cervical spondylosis occurred in 13.1% overall, but was found in 31.0% of patients with thoracolumbar spinal deformity (OR=3.27, P<0.0001). Similarly, thoracolumbar spinal deformity was found in 10.7% of patients overall, but was increased at 23.5% in patients with cervical spondylosis (OR=3.26, P<0.0001). In addition, increasing severity of disease was associated with an increased likelihood of the other spinal diagnosis. Patients with both diagnoses were more likely to undergo both cervical (OR=3.23, P<0.0001) and thoracolumbar (OR=4.14, P<0.0001) spine fusion. Patients with cervical spondylosis or thoracolumbar spinal deformity had significantly higher rates of the other spinal diagnosis. This correlation was increased with increased severity of disease. Patients with both diagnoses were significantly more likely to have received a spine fusion. Further research is warranted to establish the cause of this correlation. Clinicians should use this information to both screen and counsel patients who present for cervical spondylosis or thoracolumbar spinal deformity.

Efficacy analysis of small needle knife treatment of cervical spondylosis

Objective To compare the clinical effect of needle knife therapy and traction for treatment of cervical spondylosis .Methods 156 patients with nerve root type of cervical spondylosis patients definitely diag -nosed,randomly divided into two groups ,the treatment group of 78 cases,with small needle knife therapy;the control group of 78 cases,the cervical traction therapy ,combined with traditional Chinese medicine .The clinical efficacy was compared between the two groups .Results The treatment group 70 cases were cured（89.6%）,the total efficiency of 96.9%;control group 44 cases were cured（56.7%）,the total efficiency of 83.3%.The cure rate and total effective rate was significantly better than the control group （χ2 =22.02,11.57,all P<0.05）.Conclusion The needle knife therapy to treat cervical vertebra disease is better than that of cervical traction ,has good clinical curative effect . Key words: Cervical spondylosis; Small needle knife therapy; Traction

Diffusion tensor imaging predicts functional impairment in mild-to-moderate cervical spondylotic myelopathy

Background contextMagnetic resonance imaging (MRI) is the standard imaging modality for the assessment of cervical spinal cord; however, MRI assessment of the spinal cord in cervical spondylotic myelopathy patients has not demonstrated a consistent association with neurologic function or outcome after surgical or medical intervention. Thus, there is a need for sensitive imaging biomarkers that can predict functional impairment in patients with advanced cervical spondylosis. PurposeTo implement diffusion tensor imaging (DTI) as an imaging biomarker for microstructural integrity and functional impairment in patients with cervical spondylosis. Study designNonrandomized, single institution study. Patient sampleForty-eight cervical spondylosis patients with or without spinal cord signal change underwent DTI of the spinal cord along with functional assessment. Outcome measuresFunctional measures of neurologic function via modified Japanese Orthopedic Association (mJOA) score. MethodsA zoomed-echoplanar imaging technique and two-dimensional spatially selective radiofrequency excitation pulse were used for DTI measurement. Fractional anisotropy (FA), mean diffusivity (MD), radial and axial diffusion (AD) coefficient, AD anisotropy, ψ, defined as AD-MD, and the standard deviation (SD) of primary eigenvector orientation were evaluated at the site of compression. ResultsResults suggest average FA, transverse apparent diffusion coefficient, ψ, and SD of primary eigenvector orientation at the spinal level of highest compression were linearly correlated with mJOA score. Receiver-operator characteristic analysis suggested FA and ψ could identify stenosis patients with mild-to-moderate symptoms with a relatively high sensitivity and specificity. ConclusionsThe results of this study support the potential use of DTI as a biomarker for predicting functional impairment in patients with cervical spondylosis.

An Outpatient-based Survey about the Recognition of Locomotive Syndrome and the Results of the Loco-check at a University Hospital in Tokyo

Background: To prevent locomotor dysfunction, the Japanese Orthopaedic Association (JOA) proposed the concept of locomotive syndrome (LS) in 2007, and has carried out many campaigns to increase the awareness of LS. Recently, the JOA reported that 26.6% of people recognized LS in internet based surveys. However, a survey of the recognition of LS using outpatient (hospital-based) cohorts has never been performed. Therefore, we surveyed the recognition of LS, the prevalence of LS and any correlations between LS and Original Research Article British Journal of Medicine & Medical Research, 4(17): 3255-3268, 2014 3256 the clinical data in the outpatient cohort. Methods: To investigate the recognition of LS and prevalence of LS, we conducted a questionnaire survey including the “loco-check” in 1010 (429 male and 581 female) orthopaedic outpatients at Juntendo University Hospital (Tokyo, Japan) from April to June 2013. Results: Only 24.6% of the patients knew about the concept of LS. In terms of the media sources from which the patients had received information about LS, 49.5% received LS information from TV. With regard to the prevalence of LS, 43.8% was classified into the LS group. The prevalence of LS was 32.9% in males and 51.8% in females. When the relationship between LS and orthopaedic disease was examined, 50 of 55 (90.9%) knee osteoarthritis (OA) patients, 21 of 26 (80.8%) hip OA patients and 98 of 151 (64.9%) lumbar spondylosis patients had statistically significant correlations with LS (p<0.0001). Conclusion: This study confirmed the rate of recognition of LS indicated by the JOA survey. Our studies also revealed that LS score was related to orthopaedic disorders. Our outpatient-based surveys may help provide a better understanding of the effects and trends of the campaigns to promote the recognition of LS.

CORR Insights®: Coexisting Lumbar Spondylosis in Patients Undergoing TKA: How Common and How Serious?

This CORR Insights® is a commentary on the article “Coexisting Lumbar Spondylosis in Patients Undergoing TKA: How Common and How Serious?” by Chang and colleagues available at: DOI: 10.1007/s11999-013-3298-7. The author certifies that he, or a member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research ® editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR ® or the Association of Bone and Joint Surgeons®. This CORR Insights® comment refers to the article available at DOI: 10.1007/s11999-013-3298-7.

Coexisting Lumbar Spondylosis in Patients Undergoing TKA: How Common and How Serious?

Information on the coexistence of lumbar spondylosis and its influence on overall levels of pain and function in patients with advanced knee osteoarthritis (OA) undergoing total knee arthroplasty (TKA) would be valuable for patient consultation and management. The purposes of this study were to document the prevalence and severity of coexisting lumbar spondylosis in patients with advanced knee OA undergoing TKA and to determine whether the coexisting lumbar spondylosis at the time of TKA adversely affects clinical scores in affected patients before and 2 years after TKA. Radiographic lumbar spine degeneration and lumbar spine symptoms including lower back pain, radiating pain at rest, and radiating pain with activity were assessed in 225 patients undergoing TKA. In addition, the WOMAC score and the SF-36 scores were evaluated before and 2 years after TKA. Potential associations of radiographic lumbar spine degeneration and lumbar spine symptom severities with pre- and postoperative WOMAC subscales and SF-36 scores were examined. All 225 patients had radiographic degeneration of the lumbar spine, and the large majority (89% [200 of 225]) had either moderate or severe spondylosis (72% and 17%, respectively). A total of 114 patients (51%) had at least one moderate or severe lumbar spine symptom. No association was found between radiographic severity of lumbar spine degeneration and pre- and postoperative clinical scores. In terms of lumbar spine symptoms, more severe symptoms were likely to adversely affect the preoperative WOMAC and SF-36 physical component summary (PCS) scores, but most of these adverse effects improved by 2 years after TKA with the exception of the association between severe radiating pain during activity and a poorer postoperative SF-36 PCS score (regression coefficient = -5.41, p = 0.015). Radiographic lumbar spine degeneration and lumbar spine symptoms are common among patients with advanced knee OA undergoing TKA. Severe lumbar spine symptoms (visual analog scale score of ≥ 7) were likely to adversely affect the preoperative clinical scores of patients undergoing TKA; however, most of the adverse effects were not found 2 years after TKA. Nevertheless, because preexisting severe radiating pain during activity may be a source of a poorer outcome after TKA, careful patient consultation regarding this potential poorer prognosis after TKA needs to be provided to the patient with this symptom.

Proton magnetic resonance spectroscopy of human cervical spondylosis at 3T

Study DesignA single center magnetic resonance imaging and spectroscopic study involving twenty-one patients with advanced cervical spondylosis and eleven healthy controls.ObjectiveWe assessed the utility of MR spectroscopy to quantify biochemical changes within the spinal cord and serve as a potential biomarker in patients with cervical spondylosis with or without T2 hyperintensity within the cord.SettingLos Angeles, California, USAMethodsTwenty-one patients with cervical spondylosis and eleven healthy controls were evaluated. Single voxel MR spectroscopy was performed in the cervical cord. Morphometry of the spinal canal space was measured. NAA, choline, myo-inositol, glutamine-glutamate complex and lactate metabolite concentration ratios with respect to total creatine were quantified using an LC model algorithm and compared between healthy controls and spondylosis patients. Correlation of MRS metabolites with mJOA score was also performed.ResultsThe spinal canal space was significantly different between patients and controls (ANOVA, P<0.0001). Total choline-to creatine-ratio was significantly elevated in patients with spondylosis and T2-hyperintensity compared with healthy controls (ANOVA, P<0.01). A significantly higher choline-to-NAA ratio was observed in spondylosis patients compared with healthy controls (ANOVA, P<0.01). Slightly elevated glutamine-glutamate complex and myo-inositol was encountered in patients with stenosis without T2 hyperintensity. A linear correlation between Cho-NAA ratio and mJOA was also observed (P<0.01).ConclusionMRS appears sensitive to biochemical changes occurring in advanced cervical spondylosis patients. The choline/NAA ratio was significantly correlated with the mJOA score, providing a potentially clinical useful radiographical biomarker for the management of advanced cervical spondylosis patients.

The Correlation Study of C5 Nerve Root Palsy and Common Body Position in Posterior Total Laminectomy Decompression and Instrumentation.

To compare both the clinical characteristics and incidence of postoperative cervical nerve root palsy in cervical spondylosis patients treated by posterior total laminectomy, decompression and instrumentation with two different common body positions, traction bed and plaster bed. One hundred and thirty-three patients, with a mean age of 49.5 years suffering from multilevel cervical spondylosis and treated by laminectomy from 2007 to 2009, were reviewed. Overall 30 of 133 (22.56%) patients had C5 palsy, of which 14 (19.44%) out of 72 patients were in the plaster bed group, while 16 of 61 (26.23%) patients were in the traction bed group. The difference was statistically significant (P < 0.05). The cervical curvature index (CCI) reflected both the change of cervical height and the change of the overall cervical curvature. CCI was related with the incidence of C5 nerve root palsy postoperatively. The patients in the traction bed group had a higher nerve root palsy rate and change in cervical alignment because of over traction.

Effect of tailored cervical pillow on the neck muscle strength balance of cervical spondylosis patients

Objective To study the effect of tailored cervical pillow on the neck muscle strength balance of patients with cervical spondylosis.Methods Totals of 60 cases of cervical spondylosis patients were randomly divided into experimental group and control group,with 30 cases each group,the patients of the two groups were treated with conventional treatment and nursing,while experimental group used the tailored cervical pillow for 8 hours every day and one month (1 course ). Two groups were being respectively received the isometric muscle strength and movement of the cervical spine assessment with the symptoms and functional assessment scales,clinical assessment and multifunctional cervical vertebra rehabilitation system (MCU).Results Experimental group were significantly improved than that of the control group in symptoms and functional assessment scale score[ (24.84 ± 2.341 ) vs ( 20.65 ± 2.134 ) ; t =3.024,P ＜0.05 ],The overall clinical curative effect,difference has statistical significance [ 60.0％ vs 30.0％ ; x2=5.455,P ＜ 0.05 ] ; the position of each isometric muscle strength and movement of the cervical spine were statistically significant( P ＜0.05).Conclusions The tailored cervical pillow can promote the neck muscle balance of patients with cervical spondylosis,strengthen the stability of cervical spine and improve symptoms,which is one of value auxiliary treatment for cervical spondylosis. Key words: Cervical spondylosis; Tailored cervical pillow; Neck muscles; Balance

Clinical effects of innovative tuina manipulations on treating cervical spondylosis of vertebral artery type and changes in cerebral blood flow

ObjectiveTo determine the clinical effect, treatment times, and rheoencephalogram changes in vertebral artery type cervical spondylosis patients treated with innovative Tuina manipulations. MethodsOne hundred and twenty six cervical spondylosis patients (vertebral artery type) were randomly divided into test and control groups. Patients in the test group were treated with innovative Tuina manipulations, while those in the control group were treated with the routine Tuina manipulations according to the textbook of Chinese Massage for Acupuncture and Moxibustion majors. The clinical effects, treatment times, clinical symptoms, and cerebral blood flow were measured. ResultsThe response to the treatment was 100% in the test group and 88.71% in the control group. Patients in the test group required (7 ± 4) treatments before recovery, while those in the control group required (15 ± 7) treatments before recovery (P<0.05). The clinical symptoms exhibited greater improvement in the test group compared to the control group (P<0.05). There were no differences in cerebral blood flow between the two groups. ConclusionBoth innovative Tuina manipulations and routine Tuina manipulations produced satisfactory therapeutic results in vertebral artery type cervical spondylosis patients. However, the innovative manipulation was more effective in improving the functional symptoms, although there were no changes in the cerebral blood flow.