Cervical Spine Research Papers - Academia.edu (original) (raw)

This study was undertaken to investigate any relationship between sensory features and neck pain in female office workers using quantitative sensory measures to better understand neck pain in this group. Office workers who used a visual... more

This study was undertaken to investigate any relationship between sensory features and neck pain in female office workers using quantitative sensory measures to better understand neck pain in this group. Office workers who used a visual display monitor for more than four hours per day with varying levels of neck pain and disability were eligible for inclusion. There were 85 participants categorized according to their scores on the neck disability index (NDI): 33 with no pain (NDI < 8); 38 with mild levels of pain and disability (NDI 9–29); 14 with moderate levels of pain (NDI ⩾ 30). A fourth group of women without neck pain (n = 22) who did not work formed the control group. Measures included: thermal pain thresholds over the posterior cervical spine; pressure pain thresholds over the posterior neck, trapezius, levator scapulae and tibialis anterior muscles, and the median nerve trunk; sensitivity to vibrotactile stimulus over areas of the hand innervated by the median, ulnar and radial nerves; sympathetic vasoconstrictor response. All tests were conducted bilaterally. ANCOVA models were used to determine group differences between the means for each sensory measure. Office workers with greater self-reported neck pain demonstrated hyperalgesia to thermal stimuli over the neck, hyperalgesia to pressure stimulation over several sites tested; hypoaesthesia to vibration stimulation but no changes in the sympathetic vasoconstrictor response. There is evidence of multiple peripheral nerve dysfunction with widespread sensitivity most likely due to altered central nociceptive processing initiated and sustained by nociceptive input from the periphery.

Diffuse idiopathic skeletal hyperostosis is a common but poorly recognised condition that may have important and occasionally life-threatening clinical outcomes. We report the case of a 71-year-old man with giant osteophytes in his... more

Diffuse idiopathic skeletal hyperostosis is a common but poorly recognised condition that may have important and occasionally life-threatening clinical outcomes. We report the case of a 71-year-old man with giant osteophytes in his cervical spine which caused dysphagia and silent aspiration, leading to pneumonia, septicaemia, aortic wall infection and septic arthritis. Early recognition of the cause of his neck pain may have averted the subsequent clinical course.

Manipulative therapy is frequently used in the management of musculoskeletal pain. A frequently reported clinical feature of this treatment is the immediacy with which it appears to initiate improvement in pain and function. A randomised,... more

Manipulative therapy is frequently used in the management of musculoskeletal pain. A frequently reported clinical feature of this treatment is the immediacy with which it appears to initiate improvement in pain and function. A randomised, double blind, placebo controlled, repeated measures design was employed to study the initial effects of a cervical spine treatment technique in a group of 15 patients with lateral epicondylalgia. Pressure pain threshold, pain-free grip strength, upper limb neurodynamics, pain and function were assessed prior to and following application of either a treatment, placebo or control condition. All subjects received all three conditions. Differences between the pre-post measures were used as indicators of change in subject's symptom profiles. The treatment condition produced significant improvement in pressure pain threshold, pain-free grip strength, neurodynamics and pain scores relative to placebo and control conditions (P < 0.05). In summary, this study demonstrates that manipulative therapy is capable of eliciting a rapid hypoalgesic effect.

An abundance of literature has attempted to provide insight into the association between cervical spine manual therapy and cervical artery dysfunction leading to cerebral ischaemic events. Additionally, specific guidelines have been... more

An abundance of literature has attempted to provide insight into the association between cervical spine manual therapy and cervical artery dysfunction leading to cerebral ischaemic events. Additionally, specific guidelines have been developed to assist manual therapists in clinical decision-making. Despite this, there remains a lack of agreement within the profession on many issues.This paper presents a critical, re-examination of relevant literature with the aim of providing a contemporary, evidence-informed review of key areas regarding the neurovascular risks of cervical spine manual therapy.From a consideration of case reviews and surveys, haemodynamic principles, and blood flow studies, the authors suggest that: (1) it is currently impossible to meaningfully estimate the size of the risk of post-treatment complications; (2) existing testing procedures have limited clinical utility; and (3) a consideration of the association between pre-existing vascular risk factors, combined with a system based approach to cervical arterial haemodynamics (inclusive of the carotid system), may assist manual therapists in identifying at-risk patients.

Contextualization Cough is an important defensive reflex, which ensures that airway clearance is kept. The tracheal stimulus of the sternal furculum (SF) is a way to trigger cough reflex. However, a recent study considered it as an... more

Contextualization
Cough is an important defensive reflex, which ensures that airway clearance is kept. The tracheal stimulus of the sternal
furculum (SF) is a way to trigger cough reflex. However, a recent study considered it as an uncomfortable resource in which
patients pictured lack of care.
Aim
Evaluating the effectiveness of Tracheal Clamping (TC) maneuver in cough reflex stimulation.
Methods
A randomized crossover clinical trial was conducted with 188 healthy adult individuals. First, the following measurements
were taken: weight, height, body mass index (BMI), height and neck circumference. Then, the sequence of maneuvers (TC or
SF) was randomized. The maneuvers were performed within an interval of 24 hours and cough was quantified by means of
Peak Flow meter coupled to an EPAP mask. Finally, participants were asked about their degree of discomfort.
Results
At peak cough flow (PCF), TC showed statistical significance with an average of 204.9 (77.1) L/min, whereas SF showed an
average value of 166.5 (78.4) L/min (p = 0.001). The degree of discomfort also showed difference, according to the Visual
Analog Scale (VAS).
Conclusion
We concluded that TC maneuver was effective in producing a higher PCF when it was compared with the SF maneuver.
Moreover, it achieved a lesser degree of discomfort, thus suggesting to be a suitable and tolerable method for the mechanical
stimulation of coughing.

Retrospective comparative study of 80 consecutive patients treated with either anterior cervical discectomy fusion (ACDF) or anterior cervical corpectomy fusion (ACCF) for multi-level cervical spondylosis. To compare clinical outcome,... more

Retrospective comparative study of 80 consecutive patients treated with either anterior cervical discectomy fusion (ACDF) or anterior cervical corpectomy fusion (ACCF) for multi-level cervical spondylosis. To compare clinical outcome, fusion rates, and complications of anterior cervical reconstruction of multi-level ACDF and single-/multi-level ACCF performed using titanium mesh cages (TMCs) filled with autograft and anterior cervical plates (ACPs). Reconstruction of the cervical spine after discectomy or corpectomy with titanium cages filled with autograft has become an acceptable alternative to both allograft and autograft; however, there is no data comparing the outcome of multi-level ACDF and single-/multi-level ACCF using this reconstruction. We evaluated 80 consecutive patients who underwent surgery for the treatment of multi-level cervical spondylosis at our institution from 1998 to 2001. In this series, 42 patients underwent multi-level ACDF (Group 1) and 38 patients underwent ACCF (Group 2). Interbody TMCs and local autograft bone with ACPs were used in both procedures. Medical records were reviewed to assess outcome. Clinical outcome was measured by Odom’s criteria. Operative time and blood loss were noted. Radiographs were obtained at 6 and 12 weeks, 6 months, 1 year, and 2 years (if necessary). Early hardware failures and pseudarthroses were noted. Cervical sagittal curvature was measured by Ishihara’s index at 1 year. Group 1 had a mean age 46.2 years (range 35–60 years). Group 2 had a mean age 50.1 years (range 35–70 years).The operative time was significantly lower (P < 0.001) and blood loss significantly higher (P < 0.001) in Group 2 than in Group 1. At a minimum of 1 year follow up, patients in both groups had equivalent improvement in their clinical symptoms. The fusion rates for Group 1 were 97.6 and 92.1% for Group 2. The rates of early hardware failure were higher in Group 2 (2.6%) than in Group 1 (0%). The fusion rates for Group 1 were not significantly higher than Group 2 (P > 0.28). There was one patient in Group 1 and 2 patients in Group 2 with pseudarthroses. Complication rates in Group 2 were not significantly higher (P > 0.341). Cervical lordosis was well-maintained (80%) in both groups. Both multi-level ACDF and ACCF with anterior cervical reconstruction using TMC filled with autograft and ACP for treatment of multi-level cervical spondylosis have high fusion rates and good clinical outcome. However, there is a higher rate of early hardware failure and pseudarthroses after ACCF than ACDF. Hence, in the absence of specific pathology requiring removal of vertebral body, multi-level ACDF using interbody cages and autologous bone graft could result in lower morbidity.

Although soccer has a lower injury rate than does American football, injuries to the head and neck do occur. Indeed, soccer is classified as a contact sport. The potential for cervical injuries from the maneuver known as... more

Although soccer has a lower injury rate than does American football, injuries to the head and neck do occur. Indeed, soccer is classified as a contact sport. The potential for cervical injuries from the maneuver known as "heading" are of particular concern. This review provides a synopsis of soccer-related head and neck injuries, an overview of the biomechanics of trauma, and a rational approach to evaluating patients. This review was conducted to assess and evaluate existing literature on the biomechanics of the act of heading in soccer and the potential for acute and long-term injury to the head and neck. The resulting work is based on literature searches of the PubMed and Medline databases, textbook reviews, and bibliographies of articles and textbooks obtained during the search. Findings from several studies were summarized and critiqued. Biomechanics, anatomy, pathophysiology, and their relation to the act of heading in soccer were also synthesized into the discussion...