The impact of generalized joint laxity (GJL) on the posterior neck pain, cervical disc herniation, and cervical disc degeneration in the cervical spine

Aim The impact of early degenerative changes of the cervical spine on pain in adulthood is unknown. The objective was to determine whether degeneration in adolescence predicts headache or neck pain in young adulthood. Methods As part of a follow-up of schoolchildren with and without headache, 17-year-old adolescents with headache at least three times a month ( N = 47) and adolescents with no headache ( N = 22) participated in a magnetic resonance imaging (MRI) study of the cervical spine. The same adolescents were re-examined by phone interview at the age of 22 years ( N = 60/69, 87%). Results Mild disc degeneration at the age of 17 years was common, but was not associated with either frequent or intensive headache or neck pain at the age of 22 years. Conclusion: Mild degenerative changes of the cervical spine in 17-year-old adolescents cannot be regarded as a cause of future headache or neck pain.

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Correlation between kinematic sagittal parameters of the cervical lordosis or head posture and disc degeneration in patients with posterior neck pain

Open Medicine ◽

10.1515/med-2021-0219 ◽

2021 ◽

Vol 16 (1) ◽

pp. 161-168

Author(s):

Hyo Jeong Lee ◽

Dae Geun Jeon ◽

Jung Hyun Park

Keyword(s):

Cervical Spine ◽

Neck Pain ◽

Disc Degeneration ◽

Cervical Disc ◽

Cervical Lordosis ◽

Sagittal Vertical Axis ◽

Cross Sectional ◽

Head Posture ◽

Posterior Neck ◽

Sagittal Parameters

Abstract The purpose of this retrospective cross-sectional study was to examine the degrees of the cervical disc degeneration and the parameters of cervical sagittal balance in plain radiographs, representing cervical lordosis or head posture in subjects with posterior neck pain. A total of 113 patients with posterior neck pain with or without radiating pain were analyzed. The kinematic sagittal parameters of cervical radiographs were obtained at the occipito–cervical (O–C2) angle, sagittal Cobb’s angles of C1–C2, C2–C7, and sagittal vertical axis (SVA) of C1–C7 and C2–C7. Cervical disc degeneration was evaluated using the sum of Pfirrmann grades and total modified Matsumoto scores calculated from MRI of the cervical spine. A significant positive correlation was found for the C2–C7 angle using the sum of the Pfirrmann grades and total modified Matsumoto scores, whereas the O–C2 angle and the C1–C2 angle were negatively correlated. The sagittal cervical parameters representing cervical kyphosis and jaw lifting posture were found to be significantly correlated with the degree of cervical disc degeneration. These findings suggest that the loss of the natural sagittal lordosis of the cervical spine may contribute to the progression of disc degeneration, rather than the forward head posture.

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Effects of Rehabilitation Exercise After Cervical Disc Herniation Reconstruction on Cervical Extension Strength, Flexion/Extension Strength Ratio and VAS in Female Patients with Neck Pain

Korean Journal of Sports Science ◽

10.35159/kjss.2020.10.29.5.965 ◽

2020 ◽

Vol 29 (5) ◽

pp. 965-976

Author(s):

Gun-Do Kim ◽

Gil-Soo Han

Keyword(s):

Neck Pain ◽

Disc Herniation ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Strength Ratio ◽

Female Patients ◽

Flexion Extension ◽

Rehabilitation Exercise

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Cervical Interlaminar Epidural Injections In The Treatment Of Cervical Disc Herniation, Post Surgery Syndrome, Or Discogenic Pain: Cost Utility Analysis From Randomized Trials

January 2018 - Pain Physician ◽

10.36076/ppj/2019.22.421 ◽

2019 ◽

Vol 5 (22;5) ◽

pp. 421-431

Author(s):

Laxmaiah Manchikanti

Keyword(s):

Neck Pain ◽

Disc Herniation ◽

Cost Utility ◽

Cost Utility Analysis ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Utility Analysis ◽

Discogenic Pain ◽

Epidural Injections ◽

Post Surgery

Background: Neck pain is one of the major conditions attributing to overall disability in the United States. There have been multiple publications assessing clinical and cost effectiveness of multiple modalities of interventions in managing chronic neck pain. Even then, the literature has been considered sparse in relation to cervical interlaminar epidural injections in managing chronic neck pain. In contrast, cost utility studies of lumbar interlaminar injections, caudal epidural injections, cervical and lumbar facet joint nerve blocks, percutaneous adhesiolysis demonstrated costs of less than $3,500 for quality-adjusted life year (QALY). Objectives: To assess the cost utility of cervical interlaminar epidural injections in managing chronic neck and/or upper extremity pain secondary to cervical disc herniation, post-surgery syndrome in neck, and axial or discogenic neck pain. Study Design: Analysis based on 3 previously published randomized trials of the effectiveness of cervical interlaminar epidural injections assessing their role in disc herniation, cervical post-surgery syndrome, and axial or discogenic pain. Setting: A contemporary, private, specialty referral interventional pain management center in the United States. Methods: Cost utility of cervical interlaminar epidural injections with or without steroids in managing cervical disc herniation, cervical post-surgery syndrome, and cervical discogenic or axial neck back pain was conducted with data derived from 3 randomized controlled trials (RCTs) that included a 2-year follow-up, with inclusion of 356 patients. The primary outcome was significant improvement defined as at least 50% in pain reduction and disability status. Direct payment data from all carriers from 2018 was utilized for the assessment of procedural costs. Overall costs, including drug costs, were determined by multiplication of direct procedural payment data by a factor of 1.67 to accommodate for indirect payments respectively for disc herniation, discogenic pain, and cervical post-surgery syndrome. Results: The results of the 3 RCTs showed direct cost utility for one year of QALY of $2,412.31 for axial or discogenic pain without disc herniation, $2,081.07 for disc herniation, and $2,309.20 for post surgery syndrome, with an average cost per one year QALY of $2,267.57, with total estimated overall costs with addition of indirect costs of $3,475.38, $4,028.55, $3,856.36, and $3,785.89 respectively. Limitations: The limitation of this cost utility analysis includes that it is a single center evaluation. Indirect costs were extrapolated. Conclusion: This cost utility analysis of cervical interlaminar epidural injections in patients nonresponsive to conservative management in the treatment of disc herniation, post surgery syndrome and axial or discogenic neck pain shows $2,267.57 for direct costs with a total cost of $3,785.89 per QALY. Key words: Cervical interlaminar epidural injections, chronic neck pain, cervical disc herniation, cervical discogenic pain, post surgery syndrome, cost utility analysis, cost effectiveness analysis, quality-adjusted life years

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Cervical disc herniation presenting with neck pain and contralateral symptoms: a case report

Journal of Medical Case Reports ◽

10.1186/1752-1947-6-166 ◽

2012 ◽

Vol 6 (1) ◽

Cited By ~ 5

Author(s):

Jacky T. Yeung ◽

John I. Johnson ◽

Aftab S. Karim

Keyword(s):

Case Report ◽

Neck Pain ◽

Disc Herniation ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Contralateral Symptoms

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Analysis of compliance and efficacy of integrated management of whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation

10.21203/rs.3.rs-31305/v2 ◽

2020 ◽

Author(s):

Zhongyan Jiang ◽

Ansu Wang ◽

Chong Wang ◽

Weijun Kong

Keyword(s):

Neck Pain ◽

Recurrence Rate ◽

Disc Herniation ◽

Integrated Management ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Control Group ◽

Efficacy Rate ◽

The Difference ◽

Experimental Group

Abstract Background: Percutaneous spinal endoscopy is a new type of surgery for the treatment of cervical disc herniation. It can avoid the complications of the classic anterior cervical discectomy and fusion (ACDF) approach and the risk of adjacent spondylosis. How can we effectively improve patients' awareness of spinal endoscopy and their election of endoscopic techniques?Objective: To analyze the compliance and clinical effect of the integrated management of the whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation.Methods: Retrospective analysis of 72 patients with cervical disc herniation undergoing surgery in our hospital from August 2015–August 2017 was performed. The whole-process integrated management model was used for all the patients. The 36 patients in the experimental group were treated by percutaneous full-endoscopic cervical discectomy, and the 36 patients in the control group were treated by ACDF. The postoperative feeding time, time to get out of bed, length of hospital stay, compliance, clinical efficacy, and recurrence rate of neck pain were observed. Changes between the preoperative and postoperative pain visual analog scale (VAS) scores and neurological function Japan Orthopaedic Association (JOA) scores were assessed.Results: The postoperative feeding time in the experimental group was 8.319 ± 1.374 hours, the postoperative time to get out of bed was 16.64 ± 3.728 hours, and the hospitalization time was 6.403 ± 0.735 days. The excellent and good clinical efficacy rate was 91.67%, the compliance rate was 88.89%, and the neck pain recurrence rate was 5.56%. The postoperative feeding time in the control group was 26.56 ± 9.512 hours, the postoperative time to get out of bed was 45.06 ± 9.027 hours, and the length of hospital stay was 8.208 ± 0.865 days. The excellent and good clinical efficacy rate was 88.89%, the compliance rate was 69.4%, and the neck pain recurrence rate was 8.33%. There was no significant difference between the two groups in the excellent efficacy rate and the neck pain recurrence rate, p>0.05. The compliance rate in the experimental group was better than that in the control group, and the difference was statistically significant, p<0.05. The hospitalization time of the experimental group was significantly lower than that of the control group, and the difference was statistically significant, p<0.05. The postoperative VAS scores and JOA scores of the two groups were significantly better than the preoperative scores, and the difference was statistically significant, p<0.05; there was no significant difference between the two groups, p>0.05.Conclusion: The integrated management of the whole course can effectively improve the compliance of patients with cervical disc herniation receiving endoscopic treatment, yield the same treatment effect as the classic operation, shorten the hospitalization time, speed up the turnover of hospital beds, and improve satisfaction with medical quality and is worthy of clinical application.

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Self Manipulated Cervical Spine Leads to Posterior Disc Herniation and Spinal Stenosis

Brain Sciences ◽

10.3390/brainsci9060125 ◽

2019 ◽

Vol 9 (6) ◽

pp. 125 ◽

Cited By ~ 1

Author(s):

Wyatt McGilvery ◽

Marc Eastin ◽

Anish Sen ◽

Maciej Witkos

Keyword(s):

Emergency Department ◽

Neck Pain ◽

Spinal Stenosis ◽

Disc Herniation ◽

Spinal Manipulation ◽

Cervical Spinal Cord ◽

Cervical Vertebrae ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Manipulation Therapy

The authors report a case in which a 38-year-old male who presented himself to the emergency department with a chief complaint of cervical neck pain and paresthesia radiating from the right pectoral region down his distal right arm following self-manipulation of the patient’s own cervical vertebrae. Initial emergency department imaging via cervical x-ray and magnetic resonance imaging (MRI) without contrast revealed no cervical fractures; however, there was evidence of an acute cervical disc herniation (C3–C7) with severe herniation and spinal stenosis located at C5–C6. Immediate discectomy at C5–C6 and anterior arthrodesis was conducted in order to decompress the cervical spinal cord. Acute traumatic cervical disc herniation is rare in comparison to disc herniation due to the chronic degradation of the posterior annulus fibrosus and nucleus pulposus. Traumatic cervical hernias usually arise due to a very large external force causing hyperflexion or hyperextension of the cervical vertebrae. However, there have been reports of cervical injury arising from cervical spinal manipulation therapy (SMT) where a licensed professional applies a rotary force component. This can be concerning, considering that 12 million Americans receive SMT annually (Powell, F.C.; Hanigan, W.C.; Olivero, W.C. A risk/benefit analysis of spinal manipulation therapy for relief of lumbar or cervical pain. Neurosurgery 1993, 33, 73–79.). This case study involved an individual who was able to apply enough rotary force to his own cervical vertebrae, causing severe neurological damage requiring surgical intervention. Individuals with neck pain should be advised of the complications of SMT, and provided with alternative treatment methods, especially if one is willing to self manipulate.

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Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain

Medicine ◽

10.1097/md.0000000000016545 ◽

2019 ◽

Vol 98 (31) ◽

pp. e16545 ◽

Cited By ~ 1

Author(s):

Kun Gao ◽

Jiliang Zhang ◽

Jinquan Lai ◽

Weidong Liu ◽

Hanqing Lyu ◽

...

Keyword(s):

Neck Pain ◽

Disc Herniation ◽

Young Patients ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Cervical Lordosis

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Mild Cervical Spine Trauma Showing Symptomatic Calcified Cervical Disc Herniation in a Child

Spine ◽

10.1097/01.brs.0000048655.43106.08 ◽

2003 ◽

Vol 28 (5) ◽

pp. E93-E94 ◽

Cited By ~ 3

Author(s):

Klaus-D. Schaser ◽

John F. Stover ◽

Max J. Kaeaeb ◽

N. P. Haas ◽

Thomas Mittlmeier

Keyword(s):

Cervical Spine ◽

Disc Herniation ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Cervical Spine Trauma ◽

Spine Trauma

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Cervical spine surgery in professional athletes: a systematic review

Neurosurgical FOCUS ◽

10.3171/2016.1.focus15560 ◽

2016 ◽

Vol 40 (4) ◽

pp. E10 ◽

Cited By ~ 7

Author(s):

Andrei F. Joaquim ◽

Wellington K. Hsu ◽

Alpesh A. Patel

Keyword(s):

Systematic Review ◽

Cervical Spine ◽

Spine Surgery ◽

Disc Herniation ◽

Cervical Disc Herniation ◽

Return To Play ◽

Cervical Disc ◽

Cervical Spine Surgery ◽

Spine Pathology ◽

High Level

Cervical surgery is one of the most common surgical spinal procedures performed around the world. The authors performed a systematic review of the literature reporting the outcomes of cervical spine surgery in high-level athletes in order to better understand the nuances of cervical spine pathology in this population. A search of the MEDLINE database using the search terms “cervical spine” AND “surgery” AND “athletes” yielded 54 abstracts. After exclusion of publications that did not meet the criteria for inclusion, a total of 8 papers reporting the outcome of cervical spine surgery in professional or elite athletes treated for symptoms secondary to cervical spine pathology (focusing in degenerative conditions) remained for analysis. Five of these involved the management of cervical disc herniation, 3 were specifically about traumatic neurapraxia. The majority of the patients included in this review were American football players. Anterior cervical discectomy and fusion (ACDF) was commonly performed in high-level athletes for the treatment of cervical disc herniation. Most of the studies suggested that return to play is safe for athletes who are asymptomatic after ACDF for cervical radiculopathy due to disc herniation. Surgical treatment may provide a higher rate of return to play for these athletes than nonsurgical treatment. Return to play after cervical spinal cord contusion may be possible in asymptomatic patients. Cervical cord signal changes on MRI may not be an absolute contraindication for return to play in neurologically intact patients, according to some authors. Cervical contusions secondary to cervical stenosis may be associated with a worse outcome and a higher recurrence rate than those those secondary to disc herniation. The evidence is low (Level IV) and individualized treatment must be recommended.

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