Cervical spine disorders

2011 ◽  
Author(s):  
Howard An
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Clinical Symptoms ◽  
Exercise Program ◽  
Cervical Radiculopathy ◽  
Radicular Pain ◽  
Narcotic Analgesics ◽  
Advantages And Disadvantages ◽  
Degenerative Cervical Spine ◽  
Spine Disorders

♦ Degenerative cervical spine disorders may manifest clinically with axial neck pain, radiculopathy, myelopathy, or a combination of these clinical symptoms♦ The findings on radiographs and MRI are pertinent if they correlate with the clinical symptoms♦ The initial treatment for patients with degenerative cervical spine disorders is conservative, including non-narcotic analgesics, anti-inflammatory medications, exercise program, physiotherapy, and occasional injections♦ Surgical indications include significant radicular pain despite conservative treatment, profound neurologic deficits, and presence of significant myelopathy♦ Surgical treatment for cervical radiculopathy includes lamino-foraminotomy, anterior cervical discectomy and fusion (ACDF), and artificial disk replacement, and surgical treatment for myelopathy includes anterior discectomy and/or corpectomy with fusion, posterior laminoplasty, and posterior laminectomy and fusion. The surgeon should be familiar with the specific indications as well as advantages and disadvantages of each procedure.

Analysis of Reoperations after Surgical Treatment of Degenerative Cervical Spine Disorders: A Report on 900 Cases

2009 ◽  
Vol 70 (01) ◽  
pp. 3-8 ◽  
Author(s):  
R. Greiner-Perth ◽  
Y. Allam ◽  
H. El-Saghir ◽  
F. Röhl ◽  
J. Franke ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Degenerative Cervical Spine ◽  
Spine Disorders

scholarly journals Constitutional psychic human qualities influence on the clinical picture of reflex neurological cervical spine disorders

2020 ◽  
Keyword(s):  
Cervical Spine ◽  
Clinical Picture ◽  
Pain Sensitivity ◽  
Clinical Symptoms ◽  
Tactile Sensitivity ◽  
Treatment And Prevention ◽  
Diagnostic Approaches ◽  
Human Constitution ◽  
Human Quality ◽  
Spine Disorders

Objective - to study the constitutional psychic human qualities influence on the symptoms without pain in clinical picture of reflex neurological cervical spine disorders (RNCSD). Methods and subjects. 93 patients (18-44 years old) were examined by clinical-anamnestic, clinical-functional (vertebroneurological), clinical-neurological methods. A.M. Vein’s questionnaire was used and his others diagnostic approaches. Psychic functions of human constitution were studied by temperament type determining with using Eysenck’s EPQ questionnaire. All patients had RNCSD as cervicocranialgia, cervicalgia and cervicobrachialgia. Results and discussion. Muscle-tonic disturbances in the cervical spine segments were morpho-functional basis for RNCSD and clinical symptoms were formed for all sicks from this study. RNCSD characterized by symptoms without pain in clinical picture, except pain. There are pain sensitivity and tactile sensitivity disturbances in the cervical spine segments and dizziness and lack of coordination. Constitutional psychic human qualities were examined and pointed domination temperament types among ills with RNCSD. It are choleric and melancholic temperament types. Differentiation clinical pecularitіes were determined for every temperament type. Constitutional psychic human qualities influence on the forming, many symptoms, expression and hard course RNCSD. Worser being have ills with cervicalgia, cervicocranialgia, cervicobrachialgia whith melancholic and choleric temperament types. Better being and course of RNCSD have sicks with sanguine and phlegmatic temperament types. For treatment and preventions there disorders should considere temperament types. Studies about constitutional approach are relevant. Conclusions. Constitutional psychic human qualities which including in temperament influenced on the clinical picture of RNCSD. It create clinical structure and add different tints to sympthoms coloring. Constitutional psychic human quality can use as predictors of burden cource, choose criteries of treatment and prevention for patients with RNCSD.

Time to recovery predicted by the severity of postoperative C5 palsy

2020 ◽  
Vol 32 (2) ◽  
pp. 191-199 ◽  
Author(s):  
Zach Pennington ◽  
Daniel Lubelski ◽  
Erick M. Westbroek ◽  
A. Karim Ahmed ◽  
Jeff Ehresman ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Complete Recovery ◽  
Radicular Pain ◽  
Tertiary Referral Center ◽  
C5 Palsy ◽  
Kaplan Meier ◽  
History Of ◽  
The Mean ◽  
Grade 3 ◽  
Degenerative Cervical Spine

OBJECTIVEPostoperative C5 palsy affects 7%–12% of patients who undergo posterior cervical decompression for degenerative cervical spine pathologies. Minimal evidence exists regarding the natural history of expected recovery and variables that affect palsy recovery. The authors investigated pre- and postoperative variables that predict recovery and recovery time among patients with postoperative C5 palsy.METHODSThe authors included patients who underwent posterior cervical decompression at a tertiary referral center between 2004 and 2018 and who experienced postoperative C5 palsy. All patients had preoperative MR images and full records, including operative note, postoperative course, and clinical presentation. Kaplan-Meier survival analysis was used to evaluate both times to complete recovery and to new neurological baseline—defined by deltoid strength on manual motor testing of the affected side—as a function of clinical symptoms, surgical maneuvers, and the severity of postoperative deficits.RESULTSSeventy-seven patients were included, with an average age of 64 years. The mean follow-up period was 17.7 months. The mean postoperative C5 strength was grade 2.7/5, and the mean time to first motor examination with documented C5 palsy was 3.5 days. Sixteen patients (21%) had bilateral deficits, and 9 (12%) had new-onset biceps weakness; 36% of patients had undergone C4–5 foraminotomy of the affected root, and 17% had presented with radicular pain in the dermatome of the affected root. On univariable analysis, patients’ reporting of numbness or tingling (p = 0.02) and a baseline deficit (p < 0.001) were the only predictors of time to recovery. Patients with grade 4+/5 weakness had significantly shorter times to recovery than patients with grade 4/5 weakness (p = 0.001) or ≤ grade 3/5 weakness (p < 0.001). There was no difference between those with grade 4/5 weakness and those with ≤ grade 3/5 weakness. Patients with postoperative strength < grade 3/5 had a < 50% chance of achieving complete recovery.CONCLUSIONSThe timing and odds of recovery following C5 palsy were best predicted by the magnitude of the postoperative deficit. The use of C4–5 foraminotomy did not predict the time to or likelihood of recovery.

scholarly journals Our Experience in the Treatment of Vertebrobasilar Insufficiency Due to Cervical Spine Disorders

2021 ◽  
Vol 15 ◽  
pp. 318-324
Author(s):  
Beslan S. Dzhilkashiev ◽  
Gennadiy I. Antonov ◽  
Gennadiy E. Chmutin ◽  
Keith Simfukwe ◽  
Edward R. Miklashevich
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Clinical Results ◽  
Early Postoperative Period ◽  
Vertebrobasilar Insufficiency ◽  
Vertebrobasilar System ◽  
Circulatory Insufficiency ◽  
Basilar Arteries ◽  
Spine Disorders

This article defines vertebra-related causes of vertebrobasilar insufficiency in patients with the signs of tortuosity of segment VI of the VA. The aim of this study is to present the results of diagnostics of discirculatory phenomena in the vertebrobasilar system and to show their importance for differentiated surgical treatment of stenotic lesions of segment V1 of VA in pathological disorders of cerebral circulation in the VBS caused by osteochondrosis of the cervical spine. The following traditional methods are used in diagnostics: Doppler ultrasonography, multispiral computed tomography with contrast enhancement. Also using developed by the author method for determining VA reactivity and circulatory insufficiency in the vertebrobasilar system (VBS). Based on our methodology and criteria, patients were selected for different types of surgical treatment with clinical outcome prediction following interventions on the arteries of the VBS. To determine the pathologies of the intracranial segments of the vertebral and basilar arteries, taking into account the pathways of collateral compensation in the VBS, cerebral angiography is recommended before surgery on the arteries of the VBS. Reconstructive techniques used on segment VI of the VA will predictably show the best long-term clinical results. The excision of a tortuous segment VI of the VA may be effective in obtaining reliable results of successful interventions in the early postoperative period. The conservative treatment of the patients with multiple VBD lesions is possible. early outcomes of their use are satisfactory.

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