Psychosocial functioning of the patient with spinal cord and whiplash injury: A case report.

Whiplash is a soft tissue injury of the cervical spine that is generally caused by trauma from a motor vehicle accident or gunshot. It is associated with a wide range of clinical symptoms, including neck pain and stiffness, pain and restricted movement in the upper arms. We report the manifestations of this trauma within the beliefs and psychological functioning based on a comprehensive psychological assessment that include a review of hospital records, clinical examinations, a structured clinical interview, an inventory of psychosocial function, and a post-traumatic maladaptive belief scale. The results show that the patient's traumatic cervical syndrome manifested as moderate impairment in friendships and romantic relationships which reveal severe daily impairment in work, parenting, and self-care activities. The study further suggests that the injury is associated with maladaptive beliefs and significant impairment in psychosocial functioning.

Ruth Jackson, MD, 1902-1994.

This article commemorates Dr. Ruth Jackson for her contributions to orthopedic surgery and her status as a trailblazer for women in orthopedic surgery, becoming the first female member of the American Academy of Orthopedic Surgeons. She died on August 28, 1994, at the age of 91.

Focus on diagnosis, treatment, and problems of Barré-Lièou syndrome: Two case reports.

Barré-Lièou syndrome is a manifestation of various autonomic and secondary symptoms, such as muscle stiffness, tinnitus, dizziness, and pain in the head, neck, eyes, throat, ears, chest, and back. While thought to be caused by hyperactivation of the autonomic nervous system due to trauma, there is currently no firmly established etiology. This, and the nonspecific nature of many of its symptoms, presents a challenge both for clinicians, who must provide a correct diagnosis and patients, who are often misdiagnosed or faced with undue scrutiny from insurance companies. Here, we present two cases of Barré-Lièou syndrome, focusing on the processes leading to diagnosis, treatment, and problems encountered. Case 1 involves a 68-year-old woman whose head computed tomography (CT) scan revealed no abnormalities following a car accident. Approximately 10 months after her initial injury, Barré-Lièou syndrome was suspected because of autonomic symptoms that developed over time. She was prescribed an α-blocker, and 9 months later, her symptoms subsided. Case 2 was a 69-year-old woman who presented with bruising to the right chest and right knee after colliding with a car while riding her bicycle. One month later, Barré-Lièou syndrome was suspected because of her autonomic symptoms. She was prescribed an α-blocker, and 17 months later, her symptoms subsided. Because of the characteristic autonomic and secondary symptoms described above and a positive response to α-blockers, Barré-Lièou syndrome was suspected in both cases. We believe reporting cases will aid in the understanding of this disease and help patients obtain positive outcomes.

Clinical observation of stellate ganglion block combined buflomedil in vertebral artery type of cervical syndrome / 重庆医学

Objective To explore clinical effect of the stellate ganglion block combined buflomedil in the treatment of vertebral artery type of cervical syndrome (CSA).Methods One hundred and twenty cases of CSA were included in the study,and randomly divided into two groups.Study group (60 cases)patients were treated by stellate ganglion block therapy combined with buflomedil intravenous;the controlled group (60 cases)was treated with buflomedil intravenous therapy only.In the treatment,vertebral-basi-lar artery mean flow velocity (Vm)was measured before and after treatment and comparison of Vm difference was the clinical ba-sis.According to the CSA standard of clinical cure,the clinical curative effect was observed.Results After treatment,the total ef-fective rate of study group was 95.00%,total effective rate of control group was 71.67%,the difference statistically significant (χ2 =24.474,P <0.05).vertebral artery blood flow velocity of the two groups after treatment increased more obvious than that of before treatment,the difference was statistically significant (P <0.05),vertebral artery blood flow velocity after treatment of study group (38.44±2.20)cm/s was significantly higher than that of the control group (34.36±3.50)cm/s,the difference was statisti-cally significant (t=7.645,P <0.05).basilar artery blood flow velocity of the two groups after treatment increased more obvious than that of before treatment,the difference was statistically significant (P <0.05),basilar artery blood flow velocity after treat-ment of study group(56.34±4.10)cm/s was significantly higher than that of the control group (47.69±3.90)cm/s,the differ-ence was statistically significant (t= 11.841,P <0.05).Conclusion The clinical efficacy of stellate ganglion block combined bu-flomedil in treatment of vertebral artery type of cervical syndrome is obvious.The cure rate with respect to the drug treatment has significant advantages and the therapy is worthy of further promotion.

Cervical syndrome - the effectiveness of physical therapy interventions.

INTRODUCTION: The cervical syndrome refers to a set of disorders caused by the changes in the cervical spine and the soft-tissue surrounding it, with pain as the predominant symptom. Sore neck has been a common problem among a large section of today`s population. The factors contributing to this issue include the modern lifestyle, prolonged sitting and incorrect, fixed or constrained working postures. The root of these difficulties is found in the mechanical disorders of the cervical spine structures, poor body posture and jerky body movements. In the Scandinavian countries neck pain is considered to be a public health problem. METHODS: The study evaluated 25 patients with an established diagnosis of cervical syndrome. The research was conducted at the PI Institute of Occupational and Sports Medicine of Zenica-Doboj Canton. Each patient received twenty physical therapy treatment sessions. RESULTS AND CONCLUSIONS: The study included 25 patients suffering from the cervical syndrome. The statistical analysis of gender distribution indicated that 36% of the patients were male, while 64% were female. The mean age of study participants was 46.76±4,23. The patients ranged in age from 39 to 54 years, with no statistically significant difference in the mean age of male and female patients, p=0.691. Analysing the types of occupational activities performed by the patients, the study found a positive relation between neck pain and prolonged sitting at work. The patients who performed office work made up 76% of the total number. Each method of physical therapy applied in the treatment of neck pain patients proved useful. However, the combination of electrotherapy, kinesiotherapy and manual massage proved to be most effective. CONCLUSION: The cervical syndrome is a common medical condition primarily affecting adult population, with prevalence being higher among women and office workers. The condition places a considerable socioeconomic burden on the afflicted. Cervical pain ranges greatly in severity - from moderate to unbearable, thus leading to high levels of work absence as well as to a decrease in the quality of life. Proper physical therapy program can help the patients with neck pain return to their normal everyday activities, improve their quality of life, as well as reduce the absence from work.

Clinical Experience of Traumatic Cervical Syndrome Treated with Daisaikoto / 日本東洋医学雑誌

We administered daisaikoto to 13 patients with traumatic cervical syndrome and observed complete responses in the following 2 patients. Patient 1 was a 40-year male. He was in the xiaoyang stage, and showed high abdominal tension and marked chest oppression. These findings were indications for daisaikoto. Patient 2 was a female in her 50 s. She was in the xiaoyang stage, showed moderate abdominal tension and chest oppression, and was aware of chest tension and constipation. Evaluation using the VAS in the 13 patients showed a complete response in 3 patients, partial response in 6, minor response in 1 and no response in 3. To clarify indications for daisaikoto in this disease, findings of Japanese Oriental Medicine in the 13 patients were evaluated. Of 9 patients with high abdominal tension, 8 showed partial or complete responses. Of 4 patients with moderate abdominal tension, a complete response, partial response, and no response were observed in 1, 1, and 2, respectively. In addition, objective abdominal coldness was present in both patients with moderate abdominal tension who showed no response but not in the patient showing a complete response.We confirmed the importance of therapy based on oriental medical syndromes when daisaikoto is used for traumatic cervical syndrome. However, patients with moderate abdominal tension without abdominal coldness can be differentiated from others for this therapy.

Assessing the Validity of a Novel Model of Vertebral Artery Type of Cervical Syndrome Induced by Injecting,Sclerosing Agent Next to Transverse Process of Cervical Vertebra / 华中科技大学学报（医学）（英德文版）

The efficacy of injecting sclerosing agent next to transverse process of cervical vertebra to induce vertebral artery type of cervical syndrome(CSA)was observed.Twenty rabbits were randomly divided into two groups: the model group and the control group.The rabbits in the model group were injected with sclerosing agent next to transverse process of cervical vertebray,on the contrary,the rabbits in the control group were injected with nothing.Transcranial Doppler(TCD)was used to detect the average speed of blood(Vm),pulsatility index(Pi)and the resistant index(Ri)of the vertebral artery,hematoxylin and eosin(HE)staining was used to observe the morphological changes,and immunohistochemistry was used to detect the expression of α-smooth muscle actin(α-SMA)and matrix metalloproteinase-2(MMP-2).TCD showed increased Pi,Ri and decreased Vm in the model group(P<0.05) compared with the control group.HE staining revealed hyperplasia and hypertrophied smooth muscle cells in the model group(P<0.05).Immunohistochemistry displayed up-regulation of α-SMA and MMP-2 in the model group(P<0.05).It was concluded that injecting sclerosing agent next to transverse process of cervical vertebra induces remodeling of vertebral artery in rabbits,suggesting it is a practical method to establish CSA animal model.

Effect of Comprehensive Rehabilitation on Cervical Syndrome / 中国康复理论与实践

@#Objective To evaluate the efficacy of comprehensive rehabilitation on cervical syndrome(CS).Methods 112 patients with CS were randomly divided into two groups.The cases in comprehensive rehabilitation group(n=56) were treated with traction,ultrashort wave and massage,while those in the control group(n=56) were treated with traction only.Results The efficient rate of comprehensive group were 91.1% 3 weeks after treatment,and the symptom scores improved significantly compared with the control group(P<0.01).Conclusion The comprehensive rehabilitation is efficient on cervical syndrome with few side-effects and complication.

Acupuncture Therapy Ameliorated Symptoms with Orthopaedics Therapy in a Case of Traumatic Cervical Syndrome / 日本東洋医学雑誌

We treated a 38-year-old woman with Traumatic Cervical Syndrome (TCS) due to a traffic accident, with orthopaedic therapy plus acupuncture. She was driving a light vehicle and was rear-ended. She reported finger numbness, and shoulder and back pain on the day following the accident. We treated her with acupoints of the superior and inferior limb and evaluated her pain using a Numerical Rating Scale (NRS). She felt an immediate effect after the treatment, and NRS changed for the better following her progress. Her most severe symptoms gradually improved with a course of 49 treatments over 7 months. These results suggest the effects of acupuncture appear useful in TCS. Patients with intractable TCS are troubled by long-term treatments. Therefore it is necessary to establish more evidence for acupuncture therapy in TCS cases.

Features of Atlantoepistrophic Imaging Examination in Patients with Vertigo of Cervical Syndrome / 中国康复理论与实践

@#ObjectiveTo investigate atlantoepistrophic imaging features of patients with vertigo of cervical syndrome.Methods74 patients with vertigo of cervical syndrome were checked by photographs of cervical vertebrae of A-P position, lateral position and mouth open position, some patients were checked by CT three-dimensional reconstruction and/or MRI vertebral arteriography.ResultsImaging examination of these patients showed that physiolgical curvature of cervical vertebrae became straightened, width of both lateral masses of atlas was inequality, space of both lateral masses of atlas to odontoid process of vertebra dentata was also inequality, and inferior articular surface of lateral mass was not parallel with superior articular surface of axis. The CT could display the side displacement and anterior or posterior rotation of lateral masses of atlas. The cervical MRI vertebral arteriography could display the effect of side displacement and rotation of lateral masses of atlas on vertebral artery. If side displacement or rotation of vertebral artery occurred, the diameter of artery decreased.ConclusionThe diseased region of vertigo of the cervical syndrome is the atlas and axis, especially the side displacement and anterior or posterior rotation of the atlas.

Degenerative instability in pathogensis of cervical syndrome / 中国矫形外科杂志

[Objective]To analyse the significance of degenerative instability in pathogensis of cervical syndrome.[Method]A total of 216 patients who underwent neck and shoulder pain and/or cervical spondylotic radiculopathy(CSR)were followed-up.There were 143 males and 73 females,aged from 29 to 41,with the average of 37.8.Number of patients with neck and shoulder pain were 173,with cervical spondylotic radiculopathy were 28,with neck and shoulder and CSR were 15.According to cervical degenerative instable radiology standard,instable group included 82 cases,stable group included 134 cases.All patients were treated by physiotherapy and/or local caging therapy.[Result]All the patients were followed-up for 2～7 years,with an average of 4.3 years.In the instable group,4 patients were found osteophyma at the instable vertebra,3 were intervertebral disk hernia,6 were intervertebral disk hernia and osteophyma,3 were T_2 high intensive sign(T_2 HIS)in spinal cord at the instable vertebra.In the stable group,2 were found intervertebral disk hernia at C_(4~5),2 were found osteophyma at C_5 vertebra.The incidence of cervical syndrome was 19.51% in instable group and 2.99% in stable group.There was significant statistical difference(P

Applied microanatomy of cervical nerve and its related structure / 第三军医大学学报

Objective To study the course of different cervical nerve segments and their related intervertebral foramen’s size so as to increase safety and decrease complications in microinvasive surgery for cervical syndrome. Methods Fifteen human cervical specimens (30 sides) were anatomically observed for the course, branches and distribution of cervical nerves. Results The diameter of intervertebral foramen ranges from 0.54 to 0.65 cm, and increases gradually from top to bottom. The vertical diameter and anteroposterior diameter between C4, C5 and C6 vertebrae are smaller, and those between C3 and C7 are larger, but the diameter line of nerve root in intervertebral foramen from up to down gradually increases. The anteversion angle between nerve root and spine cord on horizontal plane is from 15? to 19?, within a small variation, while the declination angle on coronal plane gradually decreases from C3 to C7. There exist plenty of anastomosis branches among the cervical dorsal rami. Conclusion In the range of 0.6 cm around articular process at the entrance of intervertebral foramen, it is the narrowest part, the removal of which may alleviate the pressure on nerve root and benefit spinal stability. Because of the general existence of anastomosis branches of cervical nerve, the symptoms of cervical syndrome are not completely consistent to innervation. The intervertebral foramen between C4, C5, C6 is relatively small and the diameter line of nerve root is comparatively large, so the nerve root at C4, C5, C6 is most likely to be pressed.

Application of McKenzie technique in the treatment of cervical spondylotic radiculopathy / 中华物理医学与康复杂志

Objective To compare the effect of the McKenzie method and traditional manipulation in the treatment of patient with cervical spondylotic radiculopathy. Methods Seventy-two patients (42 women and 30 men with an average age of 42.60?13.73 years ) were randomly divided into 2 groups: an observation group and a control group. Both groups were given cervical traction, medium frequency electrotherapy and ultrasound therapy. In addition, the observation group was also treated with the McKenzie techniques, while the control group was treated by traditional manipulation. All the subjects were evaluated in terms of the clinical effect, VAS(Visual analog scale), McKenzie′s movement loss. The 1-year follow-up results were obtained. Results Both groups got a good therapeutic effect( the cure rate was 69% and 55.5%, respectively) and significant pain relief (P0.05). Range of motion of the cervical spine of the observation group was significantly improved after the treatment(P

Clinical Research of Neck-type Cervical Syndrome Treated with Isometric Neck Strength Training / 广州中医药大学学报

Objective To evaluate the effectiveness and safety of isometric neck strength training for the treatment of neck-type cervical syndrome.Methods The qualified patients with neck-type cervical syndrome were divided into two groups by stratified randomization: the treatment group(N=55)received isometric neck strength training,and the control group(N=40) received manipulation treatment.Two weeks constituted one treatmeat course.Visual Analog Scale(VAS) and Vernon Cervical Disability Index(VCDI) were used to evaluate the efficacy,and the safety was also monitored.Results All of the 95 enrolled patients were followed up for 3~11.4 months.No aggravation was found in the treatment group,but in the control group one patient developed into cervical spondylotic radiculopathy and one patient developed into sympathetic cervical spondylosis.The frequency of serious neck pain attack within 3 months was 6.65?2.62 times in the control group and 2.27?1.50 times in the treatment group,the difference being significant(P0.05);the result of follow-up on the 3rd month after treatment showed that the difference of VCDI score was significant between the two groups(P

[Osteoarthritis of the atlanto-axial joints]. / Die posttraumatische atlantoaxiale Arthrose.

Eight patients with post-traumatic chronic cervical syndrome and degenerative changes of the upper cervical spine, were treated with suboccipital fusion. After a mean follow up of 60 months (58-64), the patients were examined. Three patients had died during the follow-up period. A solid fusion was achieved in all cases. Significant reduction of pain and increased quality of life were established.

Observation on The Plethysmogramm of The Allen Test and its Clinical Significance in Cervical Syndrome / 全日本鍼灸学会雑誌

Among several manual examinations in cervical syndrome, there is a typical test called ‘Allen Test’ connected with hypertonus in the scalene muscles. We evaluated the clinical effectiveness of this test in cervical syndrome.<br>Both the positive group in the Allen test and the healthy group were examined with the plethysmogramm at the finger tips. As a result, in comparison with the healthy group, the positive group showed a low pulse wave. As their syndrome was improved clinically, their pulse wave heights were also improved.<br>It was thought that the Allen test was valuable to both the clinical test in cervical syndrome and the decisive test in a recovery from this syndrome.