Treatment Of Cervical Spine Disorders Research Articles

Restoring cervical lordosis by cervical extension traction methods in the treatment of cervical spine disorders: a systematic review of controlled trials.

[Purpose] To systematically review the literature on the use of cervical extension traction methods for increasing cervical lordosis in those with hypolordosis and cervical spine disorders. [Methods] Literature searches for controlled clinical trials were performed in Pubmed, PEDro, Cochrane, and ICL databases. Search terms included iterations related to the cervical spine, neck pain and disorders, and extension traction rehabilitation. [Results] Of 1,001 initially located articles, 9 met the inclusion/exclusion criteria. The trials demonstrated increases in radiographically measured lordosis of 12–18°, over 5–15 weeks, after 15–60 treatment sessions. Untreated controls/comparison groups not receiving extension traction showed no increase in cervical lordosis. Several trials demonstrated that both traction and comparison treatment groups experienced immediate pain relief. Traction treatment groups maintained their pain and disability improvements up to 1.5 years later. Comparative groups not receiving lordosis improvement experienced regression of symptoms towards pre-treatment values by 1 years’ follow-up. [Conclusion] There are several high-quality controlled clinical trials substantiating that increasing cervical lordosis by extension traction as part of a spinal rehabilitation program reduces pain and disability and improves functional measures, and that these improvements are maintained long-term. Comparative groups who receive multimodal rehabilitation but not extension traction experience temporary relief that regresses after treatment cessation.

Halo-Gravity Traction for the Treatment of Cervical Spine Disorders

Halo-Gravity Traction for the Treatment of Cervical Spine Disorders

Evidence-based diagnosis and treatment of cervical spine disorders.

Neck pain from cervical spine disorders is the second-leading cause of musculoskeletal disorders. Neck pain can exist alone or with the presence of upper extremity symptoms. This review of evidence-based guidelines assists the provider in identifying and treating various cervical disorders.

Evidence-based diagnosis and treatment of cervical spine disorders

Evidence-based diagnosis and treatment of cervical spine disorders

Rheumatoid arthritis and ankylosing spondylitis with cervical involvement and characteristics

Rheumatoid Arthritis and Ankylosing Spondylitis are systemic, inflammatory and chronic diseases. Cervical vertebra involvement is common and may cause disability in patients. The aim of this study; to determine the clinical and radiological features of cervical vertebrae involvement in patients with Rheumatoid Arthritis and Ankylosing Spondylitis and to assess the disability and quality of life of patients with different measurement methods. Forty-two patients with Ankylosing Spondylitis (AS) were diagnosed according to Modified New York criteria and 54 Rheumatoid Arthritis (RA) patients meeting the American College of Rheumatology (ACR) criteria were included. Cervical vertebra joint range of motion and neurological examination of all patients were evaluated. Open odontoid radiographs, lateral cervical graphs in the flexion and extension positions and MRI images were taken. Values such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Rheumatoid factor (RF) were determined in all patients. Disease activity was assessed in patients with RA using DAS 28 and BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) in AS patients. In the evaluation of quality of life and disability for RA patients, the health assessment questionnaire (HAQ), the Rheumatoid Arthritis Quality of Life Scale (RAQOL), Short Form 36 (SF36), AS patients were interviewed for the Quality of Life Scale-SPA (SPA-QOL), Ankylosing Spondylitis Life Quality Scale (ASQOL), Short Form 36. 48 of the RA patients were female and 8 were female. The average age was 50.7 years Six patients with RA and AS had AAS identified by radiography. Pannus was detected on MRI of 5 patients with RA and 7 patients with AS. 80% of our patients with RA and 71% of our patients with AS who detected pannus formation by MRI were AA joint range was below 3 mm. There was no significant relationship between disease activity criteria and AAS. There was a significant relationship between AAS and age in RA patients (p < 0.05). Patients with RA had a worse quality of life. Cervical vertebral involvement can lead to deterioration of the quality of life of patients. For this reason, cervical spine involvement should be specifically investigated following the disease. Plain radiographs can provide reliable and practical measurements in determining cervical involvement MRI can be consulted if needed. Assessment of atlantoaxial joint integrity in patients with minimal cervical symptoms. Early diagnosis and treatment of cervical spine disorders is important.

The impact of mental health on patient-reported outcomes in cervical radiculopathy or myelopathy surgery

Optimizing functional outcomes and disability status are essential for effective surgical treatment of cervical spine disorders. Mental impairment is common among patients with cervical spine complaints; yet little is known about the impact of baseline mental status with respect to overall patient-reported outcomes. This was a retrospective analysis of patients with cervical spondylosis with myelopathy(CM) or radiculopathy(CR: cervical disc herniation, stenosis, or spondylosis without myelopathy) at 2-year follow-ups. Patients were assessed for several health-related quality of life HRQOL) measures at baseline and 24-months post-operatively: Neck Disability Index (NDI), Visual Analog Scale(VAS), Short Form-36(SF) Physical(PCS) and Mental(MCS) Components. Patients were dichotomized by MCS score: LOW-MCS(SF-MCS < 40th percentile) vs. HIGH-MCS(SF-MCS > 60th percentile). Independent and paired t-tests compared improvement in each group for HIGH-MCS and LOW-MCS cohorts. 375 patients were analyzed(65.4yrs, 67.6%F). LOW-MCS radiculopathy patients showed significant improvement in NDI, VAS Neck and Arm Pain(p < 0.05). HIGH-MCS radiculopathy patients showed greater improvement in NDI score, VAS Neck and Arm Pain, and improvement in PCS(all p < 0.05). Comparing baseline and 2-year follow-up, LOW-MCS CM patients showed significant improvement in PCS, NDI, VAS Neck and Arm Pain(p < 0.05). HIGH-MCS myelopathy patients group showed marked improvement in NDI scores, VAS Neck and Arm Pain(p < 0.05). LOW-MCS CR patients were more likely to be less satisfied 2-years post-op(p < 0.001). Postoperative CR patients with lower baseline mental status saw less improvement and significantly worse outcomes than patients with higher baseline mental status. Improving baseline mental health may improve post-operative recovery. Implementing additional screening and care can optimize functional outcomes and disability status for patients with CR.

History of cervical spine surgery: from nihilism to advanced reconstructive surgery

Review of literature. To review and analyze the evolution of cervical spine surgery from ancient times to current practice. The aim is to present an accessible overview, primarily intended for a broad readership. Descriptive literature review and analysis of the development of cervical spine surgery from the prehistoric era until today. The first evidence for surgical treatment of spinal disorders dates back to approximately 1500 BC. Conservative approaches to treatment have been the hallmark for thousands of years, but over the past 50 years progress has been rapid. We illustrate how nations have added elements to this complex subject and how knowledge has surpassed borders and language barriers. Transferral of knowledge occurred from Babylon (Bagdad) to Old Egypt, to the Greek and Roman empires and finally via the Middle East (Bagdad and Damascus) back to Europe. Recent advances in the field of anesthesia, imaging and spinal instrumentation have changed long-standing nihilism in the treatment of cervical spine pathologies to the current practice of advanced reconstructive surgery of the cervical spine. A critical approach to the evaluation of benefits and complications of these advanced surgical techniques for treatment of cervical spine disorders is required. Advances in surgery now permit full mechanical reconstruction of the cervical spine. However, despite substantial experimental progress, spinal cord repair and restoration of lost functions remain a challenge. Modern surgeons are still looking for the best way to manage spine disorders.

Avoiding Complications in Patients With Ankylosing Spondylitis Undergoing Spine Surgery

Dr. Bono is Assistant Professor of Orthopaedic Surgery, Harvard Medical School, and Chief of Orthopaedic Spine Service, Brigham and Women's Hospital, Department of Orthopaedic Surgery, 75 Francis Street, Boston, MA 02115, E-mail: [email protected]; and Dr. Min is Orthopaedic Resident, NYU Hospital for Joint Diseases, New York, NY. The authors have disclosed that they have no significant relationships with or financial interests in any commercial organizations pertaining to this educational activity. They also have disclosed that the use of lateral mass screws for treatment of cervical spine disorders as discussed in this article has not been approved by the U.S. Food and Drug Administration. Lippincott CME Institute, Inc., has identified and resolved all faculty conflicts of interest regarding this educational activity. This article was published originally in Current Opinion in Orthopaedics 16:178–183, 2005.

Preliminary experience of carbon fibre cage prostheses for treatment of cervical spine disorders

The objective of this study was to assess the technical feasibility, and the clinical and radiological results of interbody fusion with a carbon fibre cage following anterior cervical discectomy. Nineteen consecutive patients, eight male and 11 female, with an age range from 28 to 75 years (mean 45) underwent anterior cervical discectomy and interbody fusion with a carbon fibre cage at one or two levels. Subjective assessment of symptomatic improvement and radiological assessment of cervical spine alignment and stability was made. All complications were recorded. The procedure was technically feasible. There was no increased morbidity and the length of procedure was no longer when compared with the similar operation but using tricorticate bone graft. All patients initially lost their radicular symptoms and the patients with myelopathy had subjective improvements of their symptoms. Fourteen of the 17 patients with neck pain showed some improvement. Bony fusion was achieved in all cases.

The functional treatment of cervical spine disorders and trauma

The functional treatment of cervical spine disorders and trauma

Cervical Spine Disorders

A randomized clinical trial was conducted to evaluate the efficacy of three commonly employed forms of traction in the treatment of cervical spine disorders. One hundred consenting men and women with disorders of the cervical spine were randomly assigned to one of four treatment groups, static traction, intermittent traction, manual traction, or no traction. All patients, regardless of group assignment, were seen twice weekly. The four groups were shown to be similar with regard to age, sex, diagnosis, chronicity, and prescores on the seven outcome measures. Although the entire cohort of neck patients, regardless of group assignment, improved significantly on all the outcome variables over the 6-week period, patients receiving intermittent traction performed significantly better than those assigned to the no traction group in terms of pain (P = 0.03), forward flexion (P = 0.01), right rotation (P = 0.004) and left rotation (P = 0.05).