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1.
Journal of Medical Biomechanics ; (6): E169-E173, 2022.
Article in Chinese | WPRIM | ID: wpr-920686

ABSTRACT

bjective To observe the changes of upper extremity sensory function in patients with radicular cervical spondylosis and evaluate the treatment effect, by using the method of suspension exercise therapy (SET) and soft tissue manipulation. Methods A total of 72 patients with cervical spondylosis were divided into observation group (treated by SET combined with manipulation)and control group (treated by purely cervical traction) by simple random method. Both groups received 4-week continuous treatment for 6 times per week. The somatosensory evoked potential(SEP), current perception threshold (CPT) before and after the treatment in two groups were separatedly tested, and changes in visual analogue scale (VAS) pain scores of the affected limbs were examined, so as to determine the effective rate of treatment. Results After treatment, the latency of SEP was shortened mainly in brachial plexus potential N9 and cervical spinal potential N13 in two groups (P<0.05). The CPT levels and the VAS pain scores of the affected limbs were reduced in two groups (P<0.01), and the treatment effect in observation group was better that in control group (P<0.01).Conclusion SET combined with soft tissue manipulation can effectively promote the repair of nerve sense function of cervical spondylotic radiculopathy.

2.
Article in Chinese | WPRIM | ID: wpr-928289

ABSTRACT

OBJECTIVE@#To explore the clinical efficacy and safety of manual therapy combined with posterior percutaneous endoscopic cervical decompression(PECD) in the treatment of intractable cervical spondylotic radiculopathy.@*METHODS@#From May 2016 to May 2018, 23 CSR patients who responded poorly to conservative treatment for at least 6 weeks underwent the combination management. Firstly, the patients received the posterior percutaneous endoscopic cervical decompression routine care for the following 4 weeks and manual therapy for another 4 weeks. A total of 23 patients were followed up, including 14 males and 9 females, the age ranged from 29 to 78 years old with an average of (50.30±12.28) years, the course of disease was 3 to 24 months with an average of (9.74±5.76) months. The lesion segment involved C4,5 in 4 cases, C5,6 in 13 cases, C6,7 in 6 cases. The visual analogue scale (VAS), neck disability index (NDI), changes of cervical physiological curvature and interbody stability, adverse events were observed before and after operation. The follow-up time points were before operation, 1 day after operation and 1, 3 and 6 months after operation.@*RESULTS@#All patients successfully completed the operation and manual treatment for 4 to 8 times. Among the 29 cases, 23 patients were followed up for more than 6 months. There was no spinal cord and nerve root injury during the treatment and follow-up. Operation time was from 80 to 120 min with a median of 90 min;intraoperative blood loss was from 35 to 80 ml with a median of 50 ml. NDI, VAS of neck, shoulder and arm each period after operation were significantly lower than those before PECD(P<0.05), while there were no significant improvement in cervical physiological curvature and target segment intervertebral space height(P>0.05);there was no significant change in interbody stability (P>0.05). After received the manual therapy, NDI significantly decreased (P<0.05), however, there was no significant difference in VAS of neck, shoulder and arm, physiological curvature of cervical spine and intervertebral space height of target segment compared with that before manual treatment (P>0.05);there was no significant change in interbody stability (P>0.05).@*CONCLUSION@#Manual therapy combined with PECD in the treatment of intractable cervical spondylotic radiculopathy can not only quickly improve the symptoms, but also alleviate the residual symptoms after PECD safely and effectively, and can not cause obvious signs of accelerated instability of cervical adjacent segments in the short term.


Subject(s)
Cervical Vertebrae/surgery , Child , Child, Preschool , Decompression/adverse effects , Female , Humans , Male , Musculoskeletal Manipulations , Radiculopathy/surgery , Retrospective Studies , Spondylosis/surgery , Treatment Outcome
3.
Article in Chinese | WPRIM | ID: wpr-923475

ABSTRACT

@#Objective To observe the effect sling exercise therapy (SET) and Tuina on radicular cervical spondylosis. Methods From August, 2015 to December, 2016, 72 patients with radicular cervical spondylosis were randomly divided into control group (n = 36) and trial group (n = 36), who accepted traction and SET+Tuina, respectively, for four weeks. They were measured F-wave conduction velocity with electromyogram from median nerve and ulnar nerve, somatosensory evoked potential (SEP), and current perception threshold (CPT) before and after treatment. The clinical ratio of improvement was calculated. Results The ratio of improvement was 83.33% in the trial group more than 58.33% in the control group (Z = 2.093, P < 0.05). F-wave conduction velocity increased in both groups after treatment (t > 12.059, P < 0.001), and increased more in the trial group than in the control group (t > 3.266, P < 0.01); while the latency of SEP decreased in N9 and N13 in both groups (t > 7.061, P < 0.001), and decreased more in the trial group than in the control group (t > 8.033, P < 0.001); the grade of CPT decreased in both groups (t > 8.895, P < 0.001), and decreased more in the trial group than in the control group (t = 8.913, P < 0.001). Conclusion The combination of SET and Tuina can promote the repair of nerve conduction of cervical spondylotic radiculopathy.

4.
Article in Chinese | WPRIM | ID: wpr-905926

ABSTRACT

Objective:To establish a model of cervical spondylosis of vertebral artery type (CSA) in rats by mixed modeling method, and observe the intervention effect of Panlongqi tablet (PLQT) on CSA rats. Method:SD rats were divided into a normal control group, a model group, low- (0.16 g·kg<sup>-1</sup>), medium- (0.32 g·kg<sup>-1</sup>), and high-dose (0.64 g·kg<sup>-1</sup>) PLQT groups, and a Jingfukang granule (JFK, 1.35 g·kg<sup>-1</sup>) group. The rats were treated correspondingly 24 hours after modeling for eight weeks, and those in the normal control group received an equal volume of normal saline by gavage. The limb movement was tested by the inclined plate assay, vertebral artery flow volume by multi-mode high-frequency sound wave for small animals, and microcirculatory blood flow in the pia mater by the laser Doppler. The imaging of the cervical spine was recorded and scored by X-ray micro-computed tomography (Micro CT). Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of endothelin-1 (ET-1), nitric oxide (NO), tissue plasminogen activator (t-PA), and plasminogen activator inhibitor (PAI). Result:Compared with the normal control group, the model group showed decreased limb movement, vertebral artery flow volume, and microcirculatory blood flow in the pia mater, and increased imaging of the cervical spine and score (<italic>P</italic><0.05,<italic>P</italic><0.01). PLQT could dose-dependently improve the motor function, increase the vertebral artery flow volume and microcirculatory blood flow in the pia mater, and reduce the degree and score of imaging of the cervical spine in CSA rats(<italic>P</italic><0.05,<italic>P</italic><0.01). The serum levels of NO and t-PA were decreased and those of ET-1 and PAI were increased in the model group as compared with those in the normal control group, while such changes were reversed by PLQT treatment(<italic>P</italic><0.05,<italic>P</italic><0.01). Conclusion:PLQT can enhance the limb movement, promote the vertebral artery flow volume and microcirculatory blood flow in the pia mater, improve the degree of imaging of the cervical spine, regulate the vasomotor function, and improve the coagulation and fibrinolysis system of CSA rats, which shows good potential for the treatment of CSA.

5.
Article in Chinese | WPRIM | ID: wpr-912892

ABSTRACT

Objective: To observe the clinical efficacy of warm needling moxibustion plus spine subtle adjusting manipulation for cervical radiculopathy. Methods: A total of 70 patients with cervical radiculopathy were randomized into an observation group and a control group, with 35 cases in each group. The observation group was treated with warm needling moxibustion plus spine subtle adjusting manipulation, while the control group was treated with warm needling moxibustion alone. The treatments were performed three times a week, and for four weeks in total. The visual analog scale (VAS) was scored before and after treatment. And the clinical efficacy of the two groups was compared after treatment. Results: The total effective rate was 97.1% in the observation group, versus 88.6% in the control group. The difference between the two groups was statistically significant (P<0.05). After treatment, the VAS scores in both groups significantly decreased (P<0.01), and the score in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: Warm needling moxibustion plus spine subtle adjusting manipulation has a better effect in the treatment of cervical radiculopathy than warm needling moxibustion alone.

6.
Article in Chinese | WPRIM | ID: wpr-888332

ABSTRACT

OBJECTIVE@#To study the changes of anterior soft tissue swelling after anterior cervical subtotal corpectomy, titanium mesh fusion and internal fixation.@*METHODS@#From November 2015 to July 2018, 151 patients with cervical spondylotic myelopathy were treated with anterior single corpectomy, titanium mesh fusion and internal fixation, including 109 males and 42 females, aged 44 to 81 (59.77±8.34) years. Through postoperative follow up observation, the C@*RESULTS@#All patients were followed up for 15 to 40(28.00±3.52) months. One week after the operation, the swelling of anterior soft tissue reached the peak, and then decreased. At 8 months after the operation, the swelling of anterior soft tissue on C@*CONCLUSION@#Anterior subtotal cervical corpectomy, titanium mesh bone graft fusion and internal fixation can cause swelling of the anterior soft tissue. One week after operation, we should pay more attention to the aggravation of the swelling of the anterior soft tissue to avoid the occurrence of dysphagia, respiratory obstruction, asphyxia and other complications.


Subject(s)
Cervical Vertebrae/surgery , Female , Humans , Male , Retrospective Studies , Spinal Cord Diseases , Spinal Fusion , Spondylosis , Treatment Outcome
7.
Article in Chinese | WPRIM | ID: wpr-887505

ABSTRACT

OBJECTIVE@#To observe the changes of functional connectivity of brain pain-emotion regulation region in patients with cervical spondylosis of cervical type by functional magnetic resonance imaging (fMRI).@*METHODS@#Thirty-two subjects were selected. Of them, 16 patients with cervical spondylosis of cervical type were divided into an observation group and 16 healthy subjects into a control group. The patients in the observation group were treated with acupuncture at Tianzhu (BL 10), Jingbailao (EX-HN 15), Jianzhongshu (SI 15) and @*RESULTS@#In the observation group, the VAS score was (1.94±1.12) after the treatment, which was lower than (5.62±1.20) before treatment (@*CONCLUSION@#Pain involves the formation and expression of "pain-emotion-cognition". Acupuncture can systematically regulate the brain functional connections between cognitive regions such as dorsal prefrontal lobe and anterior cingulate gyrus and emotional regions such as insula and VTA in patients with cervical spondylosis of cervical type, suggesting that acupuncture has a multi-dimensional and comprehensive regulation effect on pain.


Subject(s)
Acupuncture Therapy , Brain/diagnostic imaging , Emotions , Humans , Magnetic Resonance Imaging , Pain , Spondylosis/therapy
8.
Article in Chinese | WPRIM | ID: wpr-879408

ABSTRACT

OBJECTIVE@#To investigate the clinical efficacy of zero-profile anchored spacer (ROI-C) in treating cervical spondylosis with osteoporosis.@*METHODS@#From May 2013 to May 2018, a total of 145 patients with cervical spondylosis were treated by ROI-C through anterior cervical spine approach. Among them, 31 patients were aged ≥60 years and had osteoporosis by bone density measurement, and they were retrospectively analyzed. Including 9 males and 22 females, aged 60-84 years old with an average of (69.12±7.65) years. There were 23 cases of single-segment fusion, 6 cases of two-stage fusion, and 2 cases of three-stage fusion;and 41 devices of ROI-C fusion was placed in the patients. Operation time and intraoperative blood loss were recorded;Japanese Orthopaedic Association (JOA) scores and visual analogue scale(VAS) were respectively used to evaluate the neurological function and neck pain before and after operation. The cervical curvature (expressed as Cobb angle), the height of the intervertebral space at the surgical segment, and the intervertebral fusion were observed at postoperative and follow-up periods were observed by image data.@*RESULTS@#All patients were followed up for 12-24(15.6±4.4) months after operation. The operation time were from 75 to 113 (101.33±10.25) min and intraoperative blood loss were from 14 to 51 (33.18 ± 16.56) ml. Among these 23 patients with fusion of single segment, the operation time were 75 to 98 (85.47±8.70) min and intraoperative blood loss were 14 to 30(21.18±6.56) ml. JOA scores of all included patients were increased from 9.66±2.12 preoperatively to 14.36±1.24 at the final follow-up (@*CONCLUSION@#Anterior cervical approach with ROI-C for the treatment of elderly patients with cervical spondylosis and osteoporosis had reliable clinical effect, short operation time, less intraoperative blood loss, and can effectively restore cervical curvature and intervertebral space height, and has advantages of fewer complications and higher successful rate of fusion.


Subject(s)
Aged , Aged, 80 and over , Cervical Vertebrae/surgery , Female , Humans , Male , Middle Aged , Osteoporosis , Retrospective Studies , Spinal Fusion , Spondylosis/surgery , Treatment Outcome
9.
Article in Chinese | WPRIM | ID: wpr-879402

ABSTRACT

OBJECTIVE@#To explore the short-term clinical efficacy of single-stage cervical spondylotic radiculopathy (CSR) between the minimally invasive Key-hole technique and anterior cervical Zero profile intervertebral fusion system (Zero-P).@*METHODS@#A retrospective analysis was performed on 45 patients who underwent surgical treatment for CSR from January 2017 to January 2020, including 21 in Key hole group (12 males and 9 females), followed up for 10-22(13.2±2.3) months;24 cases in Zero-P group (14 males and 10 females), and the follow up period was 10 to 23(12.7±1.9) months. Perioperative conditions (incision length, intraoperative blood loss, operation time, length of hospital stay, and complications) were compared between two groups, and X-rays of cervical spine before and after surgery and at the final follow-up were taken to analyzed curvature of the cervical spine, visual analogue scale(VAS) of pain before and after surgery, Oswestry Disability Index(ODI) and Japanese Orthopaedic Association (JOA) score of cervical spine were recorded to evaluate clinical efficacy.@*RESULTS@#In Key-hole group and Zero-P group, the surgical incision length, intraoperative blood loss, operation time, final follow-up Cobb angle and immediate postoperative VAS score respectively were (1.2±0.2) cm, (5.3±0.3) cm;(35.3±9.7) ml, (120.2±13.5) ml;(56.4±11.3) min, (90.6±12.6) min;(3.2±3.9)°, (7.3±3.8)°;(2.8±1.2)points, (3.8±1.1) points;the Zero-P group was larger than the Key hole group, with statistical significance(@*CONCLUSION@#The cervical spine Key-hole technology is similar to the anterior cervical Zero-P system in the treatment of CSR. The Key-hole technique has certain advantages in incision length, intraoperative blood loss, and operation time. It is a safe, effective and can be widely used cervical spine surgery method.


Subject(s)
Case-Control Studies , Cervical Vertebrae/surgery , Female , Humans , Male , Radiculopathy/surgery , Retrospective Studies , Spinal Fusion , Spondylosis/surgery , Treatment Outcome
10.
Article in Chinese | WPRIM | ID: wpr-907703

ABSTRACT

Acupuncture has achieved good effect in the treatment of various types of cervical spondylosis, which can alleviate the symptoms of neck pain and vertigo, and improve the blood supply to the brain. In terms of acupuncture location, treatment mainly selects acupoints according to meridians and syndrome differentiation, that is, identifying the diseased meridians and giving acupuncture treatment according to massage along meridians and pressing in the traditional meridian diagnosis method,or taking points according to location, including near and far ends based on meridian theory, acupuncture needlingcorresponding locations of hands and feet based on holographic theory, or taking points according to innervated areas or muscle fibers based on anatomical structure. Acupuncture methods mainly include warming and dredging acupuncture, short needling, fast needling and so on. In addition to filiform needles, floating needles, long needles, electroacupuncture and other special needles arealso usedin clinic.

11.
Article | IMSEAR | ID: sea-215108

ABSTRACT

So far, evaluation of vertebral arteries has been done by angiography with a limited data on evaluation with duplex scanning of the vertebral arteries. We wanted to study the radiological features and vertebral artery Doppler characteristics, in patients aged above 35 years with a clinical diagnosis of cervical spondylosis. METHODSThis is a case control study with a total of 120 subjects aged over 35 years (60 subjects were cases with the clinical diagnosis of cervical spondylosis and the remaining 60 subjects were age matched controls). Vertebral artery colour Doppler was performed to record peak systolic velocity, time averaged maximum velocity, diameter of the segment in grey scale in millimetres and flow volume of the vertebral artery. Statistical analysis was done using chi square test, student t test and z test with p values < 0.05 being considered statistically significant. RESULTSMajority of patients in both groups were in the age group 41 - 50 years. Among cases 39 (65%) were males and 21 (35%) were females. Most of cases had vertebral artery diameters in the range of 3.0 - 3.5 mm seen both on right [21{35%}] as well as on left side [17 {28.3%}], and a similar finding was observed in controls as well. No statistical significance was observed amongst cases and control on either right or left side. Most of the cases had vertebral artery blood flow in the range of 51-100 mL/min both on right side [26 (43.3%)] and left side [22 (36.7%). On comparing vertebral artery blood flow in the range of ≤100 mL/min and >100 mL/min, the difference was statistically significant on the left side. On comparing the number of cases and controls according to the vertebral artery blood flow velocity ≤30 cm/s and >30 cm/sec on right side, p value was 0.009 and that on the left was 0.001, both of which are statistically significant. CONCLUSIONSVertebral artery diameter is not a very reliable sign in this degenerative condition. Vertebral artery flow volume is decreased at least in one vertebral artery. Vertebral artery blood flow velocity was significantly reduced in cervical spondylosis cases compared to controls both on right side (p=0.009) and left side (p= 0.001). This makes reduced vertebral artery blood flow velocity as a very strong sign in this condition. To conclude vertebral artery ultrasound is a very useful and reliable tool in evaluation of vertebrobasilar insufficiency cases.

12.
Article | IMSEAR | ID: sea-205356

ABSTRACT

Background: Neuroimaging is indicated in most instances of new-onset myelopathy for clinico-radiological correlation in terms of diagnosis, recovery, and prediction of recurrence. Aim: This study was conducted to study the clinical profile of cases of Compressive Myelopathy and the pattern of spinal cord involvement, also to compare the sites of localisation of clinical diagnosis with MRI diagnosis. Methodology: The present study was a prospective study involving 30 patients. Patients with clinical suspicion of spinal cord disease of age group 20-80 years were included as study participants. The primary pulse sequences included T1 and T2 weighted images on MRI, the location of the lesion, its margins, signal intensity on both T1 and T2 weighted images was noted. Results: The majority of 53.33% of participants were aged between 51 to 60 years. Difficulty in walking was observed in 97% of participants. Men were more often affected than women. Cervical spondylosis was the commonest cause of compressive myelopathy in 57%. A most common pattern of spinal cord involvement was combined Anterior + Posterior cord involvement. The cervical site of localisation (54%) was the commonest followed by the thoracic and lumbar spinal cord. Conclusion: Myelopathies have male preponderance. The commonest cause of compressive myelopathy was Cervical spondylosis. Anterior plus posterior cord syndrome was the commonest pattern seen, followed by posterior cord syndrome, anterior cord syndrome being the least observed. MRI correlates well with a clinical diagnosis and is useful in suggesting the location of the lesion.

13.
Article in Chinese | WPRIM | ID: wpr-856379

ABSTRACT

Objective: To compare differences in the maintenance of cervical curvature after anterior cervical surgery between zero-profile and self-locking intervertebral cage and plate-cage construct (PCC). Methods: A clinical data of 100 patients with single-segment cervical disc herniation who were treated with anterior cervical discectomy and fusion were retrospectively analyzed between January 2015 and January 2016. Among them, 50 patients were treated with the zero-profile and self-locking intervertebral cage (group A) and 50 patients with the PCC (group B). There was no significant difference between the two groups in age, gender, bone mineral density, disease duration, operative segment, and preoperative visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, C 2-7 cervical curvature, segmental Cobb angle, and adjacent vertebral height ( P>0.05). The operation time and intraoperative blood loss were recorded. The postoperative VAS and JOA scores were used to evaluate the clinical efficacy. The C 2-7 cervical curvature, segmental Cobb angle, and adjacent vertebral height were measured on lateral X-ray films, and the interbody fusion was evaluated according to Pitzen's criteria. Results: The operation time in group A was significantly shorter than that in group B ( t=2.442, P=0.021), but there was no significant difference in the intraoperative blood loss between the two groups ( t=0.812, P=0.403). All patients were followed up 24-36 months, with an average of 28.5 months. According to Pitzen's criteria for cervical interbody fusion, bone fusion achieved in both groups. The VAS score, JOA score, C 2-7 cervical curvature, segmental Cobb angle, and adjacent vertebral height of the two groups at 1 and 24 months after operation were significantly improved when compared with those before operation ( P0.05). There were significant differences in C 2-7 cervical curvature, segmental Cobb angle, and adjacent vertebral height between the two groups at 24 months after operation ( P0.05). Conclusion: Compared with the PCC, the zero-profile and self-locking intervertebral cage can significantly shorten the operation time and obtain the same clinical efficacy, but the intervertebral height loss and secondary cervical curvature change after operation is more serious.

14.
Article in Chinese | WPRIM | ID: wpr-848038

ABSTRACT

BACKGROUND: In degenerative cervical spondylosis associated with cervical curvature straightening or segmental instability, ossification of the nuchal ligament caused by chronic injury of the nuchal ligament is very common. OBJECTIVE: To investigate the correlation between ossification of the nuchal ligament and cervical curvature and segmental stability of the cervical spine. METHODS: Data of 109 patients with degenerative cervical spondylosis, who were treated in Department of Spinal Surgery of Affiliated Hospital of Xuzhou Medical University from October 1, 2017 to October 31, 2018, were retrospectively analyzed. There were 61 male patients and 48 female patients, who aged 30 to 81 years old at a mean age of (55. 8±11. 1) years. All patients signed the informed consent. This study was approved by the Ethics Committee of Affiliated Hospital of Xuzhou Medical University. The patients underwent the X-ray examinations of cervical spine. The imaging observation included the distribution and degree of ossification of the nuchal ligament and the change of cervical physiological curvature and segment stability. The patients were divided into ossification group and non-ossification group according to whether or not the patients had ossification of the nuchal ligament. Gender, age, cervical curvature and lower cervical stability were compared between the two groups. Pearson correlation analysis was used to compare the relationship between the degree of ossification of the nuchal ligament and cervical curvature and cervical stability. Binary Logistic regression analysis was applied to evaluate the significant risk factors for the development of ossification of the nuchal ligament. RESULTS AND CONCLUSION: (1) Of 109 patients with degenerative cervical spondylosis, 56 patients with ossification of the nuchal ligament and ossification involved 83 cervical segments in ossification of the nuchal ligament patients, most of which were C4-5 (39. 8%) and Cm (42. 2%). (2) There was significant difference in age, C2-C7 Cobb angle, Jackson physiological stress curve, parameter angular displacement and horizontal displacement between the ossification group and non-ossification group (P < 0. 05). The degree of ossification of the nuchal ligament was positively correlated with angular displacement (f=0. 486, P < 0. 05). (3) The incidence of ossification of the nuchal ligament was significantly higher in patients with lower cervical instability (P < 0. 05). Age and lower cervical instability parameter angular displacement were significant risk factors for the development of ossification of the nuchal ligament. (4) Patients with ossification of the nuchal ligament are more likely to have cervical curvature straightening and lower cervical instability, especially in the segment instability. In the diagnosis and treatment of degenerative cervical spondylosis, the existence of ossification of the nuchal ligament causes corresponding attention.

15.
Article in Chinese | WPRIM | ID: wpr-848012

ABSTRACT

BACKGROUND: Anterior cervical discectomy and fusion is a classic surgical procedure for the treatment of cervical spondylosis. At present, we can use a Zero-P interbody fusion fixture and a traditional cervical anterior plate plus cage as an internal fixation material. The Zero-P has less postoperative esophageal interference and lower incidence of postoperative dysphagia compared with traditional anterior cervical plate fixation. Besides, the Zero-P could avoid the risk of excessively long or pooriy placed plate injury to adjacent segmental intervertebral discs. OBJECTIVE: To compare the safety and effectiveness between two-level anterior cervical discectomy and fusion using Zero-P and using traditional anterior cervical plate plus cage. METHODS: Clinical data of sixty patients who underwent two-level anterior cervical discectomy and fusion in the Chengdu Third People’s Hospital from May 2016 to May 2018 were retrospectively analyzed. The patients were divided into Zero-P group (Zero-P fusion, n=30) and plate group (anterior cervical plate fixation combined with cage implantation, n=30). All patients in the two groups had informed consent to the treatment plan. This study was approved by the hospital ethics committee. The Japanese orthopedic association score, neck disability index score and Bazaz swallowing function score were used to evaluate the clinical efficacy. Cervical X-ray and cervical CT scans were performed to assess cervical curvature, observe bone graft fusion, and implant displacement, loosening and breakage. RESULTS AND CONCLUSION: (1) All surgeries were successfully completed in 60 patients. The wounds healed in stage I after operation. There were no serious complications such as nerve injury, esophageal fistula, and cerebrospinal fluid leakage. (2) During the follow-up, there was no significant difference in neck disability index, Japanese orthopedic association score and bone graft fusion rates between the two groups (P > 0.05). (3) The incidence and severity of dysphagia in the Zero-P group were lower than those in the plate group at various time points after operation (all P < 0.05). (4) The overall curvature and operative segments curvature were better in the plate group than in the Zero-P group 6 months after surgery and in final follow-up (P < 0.05). (5) Two-level anterior cervical discectomy and fusion using Zero-P is a safe and effective operative method. The operation time, bleeding volume, number of fluoroscopy and postoperative dysphagia incidence were better than the traditional anterior cervical plate plus cage fixation system, but it is not as good as the traditional anterior cervical plate plus cage system in the curvature of the cervical spine. Zero-P is not recommended for patients with obvious abnormal cervical curvature before operation.

16.
Article in Chinese | WPRIM | ID: wpr-847268

ABSTRACT

BACKGROUND: There is limited anterior cervical spine space. Incomplete hemostasis or drainage during artificial cervical total disc replacement can incur a series of complications. Preoperative factors can directly affect the amount of bleeding during spine surgery, while there are no publications aiming at cervical artificial disc replacement. OBJECTIVE: To analyze influencing factors on operation time and hemorrhage in patients undergoing single cervical total disc replacement. METHODS: Fifty-six patients with cervical spondylosis who underwent cervical total disc replacement from October 2012 to December 2017 in Department of Spine Surgery, Peking University People’s Hospital, were retrospectively enrolled. Pre- and intra-operative related parameters were measured. Primary outcomes included operation time, intraoperative blood loss and postoperative drainage. The secondary outcomes included demographic data such as sex, male and hypertension; surgery-related information such as operated segment, types of cervical spondylosis and artificial prosthesis; parameters in X-ray plain films such as the motion range and cervical lordosis of C2-C7 and index segment, the height of intervertebral disc, MRI classification (Modic classification and Pfirrmann classification) and preoperative functional score. The analysis was performed between primary and secondary outcomes as well as among primary outcomes. RESULTS AND CONCLUSION: (1) The average age of 56 patients (30 males and 26 females) was 48.2±9.8 years; operation time, intraoperative bleeding and postoperative drainage were 73.2±13.4 minutes, 51.8±41.2 mL and 7.8±5.3 mL, respectively. (2) There were no differences both in operation time and intraoperative blood loss in terms of demographics, while the drainage was statistically different in various ages (P=0.030). (3) The operation time of Prestige-LP implantation was statistically shorter than that of Mobi-C and Prodisc-C (P < 0.05). There was a positive correlation between the intermittent on taking (nonsteroidal anti-inflammatory drugs) and intraoperative blood loss (r=0.310, P=0.020). The higher intervertebral disc of the operation segment was, the longer operation time was (P=0.028). (4) There was a significant difference in more intraoperative blood loss with osteoporosis compared to the normal ones (P=0.039); while the rest radiological parameters in X-ray were in no relation to primary outcomes, neither were in MRI degree, Modic change and Pfirrmann classification. (5) There was a positive correlation between operation time and intraoperative blood loss (P=0.010) and postoperative drainage (P=0.001). (6) These indicate that the height of intervertebral space can prolong operation time. Osteoporosis is a risk factor for intraoperative blood loss. The longer the operation time is, the more intraoperative blood loss and postoperative drainage will be.

17.
Article in Chinese | WPRIM | ID: wpr-828258

ABSTRACT

OBJECTIVE@#To study the therapeutic effects of the ultramicro needle-knife combine with cervical spine fine adjusting on youth cervical curvature abnormality case.@*METHODS@#From November 2016 to October 2018, 88 young patients with abnormal curvature of cervical spine were treated. Due to loss of follow up, 86 cases were actually completely including 37 males and 49 females, ranging in age from 20 to 40 years old, with an average of (30.55±5.21) years old, and the course of disease ranged from 1 to 42 months, with a mean of (14.21±7.38) months. All the patients were divided into two groups:treatment group (44 cases) and control group (42 cases). The patients in the treatment group were treated with ultramicro needle-knife and cervical spine fine adjusting, and the patients in the control group were treated with conventional acupuncture and manipulation. The treatments were done 1 time per week in the treatment group while 3 times per week in control group every week, with a duration of 3 weeks for both groups. Before treatment, 3 weeks after treatment, and at the end of 1 month follow-up, the score of neck pain questionnaire(NPQ), range of the motion(ROM) in the cervical region and the D values of cervical physiological curvature were recorded. The efficacy at the end of treatment and in the follow up was evaluated. During the treatment, the patients were also required to correct the bad posture in daily life, to sleep in a low pillow position, and put a moderately columnar pillow behind the neck for 0.5 hours every morning and evening.@*RESULTS@#Two patients in the control group were dropped out after 3 weeks treatment. No adverse reactions were found in the 2 groups during the treatment period. Compared with those before treatment, all scores at all the observation time points were significantly improved between two groups after treatment(all 0.05). There was statistical difference in ROM scores between different time points, there was time effect (=240.32), =0.000). There was no interaction between time factor and group factor (=0.311, =0.734). The effective rate of the treatment group and control group were 90.91%(40 / 44) and 80.95%(34 / 42) respectively, the treatment group was more effective than the control group (0.05) in the follow-up duration.@*CONCLUSION@#The method of needle knife combined with cervical spine fine adjusting has a better therapeutic efficiency than conventional acupuncturecombined with manipulation in treating youth cervical curvature abnormality patients. Because this novel method can recover the cervical curvature, relieve the neck pain, and improve cervical mobility.


Subject(s)
Acupuncture Therapy , Adolescent , Adult , Cervical Vertebrae , Female , Humans , Male , Neck , Spondylosis , Treatment Outcome , Young Adult
19.
Chinese Acupuncture & Moxibustion ; (12): 1299-1303, 2020.
Article in Chinese | WPRIM | ID: wpr-877531

ABSTRACT

OBJECTIVE@#To compare the clinical efficacy between rolling needle pricking-cupping (RNP-C) and traditional pricking-cupping (TP-C) for cervical spondylosis of neck type.@*METHODS@#A total of 96 patients with cervical spondylosis of neck type were randomly divided into an RNP-C group, a TP-C group and an electroacupuncture (EA) group, 32 cases in each group. Each group was treated with EA at Jingbailao (EX-HN 15), Fengchi (GB 20), Dazhui (GV 14), Jianjing (GB 21) and @*RESULTS@#Compared before treatment, the scores of NPQ and VAS in each group were all reduced at 2 and 4 weeks into treatment and follow-up (@*CONCLUSION@#TP-C and RNP-C could both improve the cervical pain symptoms in patients with cervical spondylosis of neck type, and improve the overall function of the cervical spine, and the curative effect is similar.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Cervical Vertebrae , Cupping Therapy , Humans , Spondylosis/therapy , Treatment Outcome
20.
Article | IMSEAR | ID: sea-194958

ABSTRACT

Cervical Spondylosis is a common spinal problem now days. It is a general term for age related wear and tear affecting spinal disc of the neck. Normally soft disc between vertebras provides cushioning, with Cervical Spondylosis the disc becomes compressed, when this happens the cartilage can wear away. Once this protective cartilage is gone, spur may develop on your vertebrae where they rub together and the nerves attached to spinal cord will have less room to pass between the vertebras. Cervical Spondylosis usually starts earlier in men than women. Usually it doesn’t lead to disability but sometimes these changes in the spine can cause compression which makes the finger clumsy. In Karnataka incidence and prevalence is 7.25 cases per 1000 populations and in Bangalore prevalence of Cervical Spondylosis is 23.25 per 10000 populations. Cervical Spondylosis can be compared to Manyasthambha mentioned in the classics. Divaswapna, Asamasthana, Vivrutho Urva nirikshana are the main causes leading to Manyasthambha. Ruk and Sthambha are the main Lakshanas of Manyasthambha. Considering these Lakshanas along with radiation of pain and Motor activity as the assessment parameters, Nasya Karma and Swedana were adopted in the study, which showed highly significant result in almost all parameters with p value < 0.001 taken for assessment in the group.

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