scholarly journals Effect of Auricular Point Acupressure on Axial Neck Pain After Anterior Cervical Discectomy and Fusion: A Randomized Controlled Trial

Pain Medicine ◽  
2017 ◽  
Vol 19 (1) ◽  
pp. 193-201 ◽  
Author(s):  
Bingjiang Xia ◽  
Yiping Xie ◽  
Songfeng Hu ◽  
Taotao Xu ◽  
Peijian Tong
Keyword(s):  
Randomized Controlled Trial ◽  
Neck Pain ◽  
Controlled Trial ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Randomized Controlled ◽  
Auricular Point ◽  
Axial Neck Pain

Postoperative Rigid Cervical Collar Leads to Less Axial Neck Pain in the Early Stage After Open-Door Laminoplasty—A Single-Blinded Randomized Controlled Trial

Neurosurgery ◽  
2018 ◽  
Vol 85 (3) ◽  
pp. 325-334 ◽  
Author(s):  
Jason Pui Yin Cheung ◽  
Prudence Wing Hang Cheung ◽  
Karlen Law ◽  
Vishal Borse ◽  
Yuk Ming Lau ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Neck Pain ◽  
Range Of Motion ◽  
Short Form ◽  
Controlled Trial ◽  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Randomized Controlled ◽  
Complication Risk ◽  
Axial Neck Pain

AbstractBACKGROUNDCervical collars are used after laminoplasty to protect the hinge opening, reduce risks of hinge fractures, and avoid spring-back phenomena. However, their use may lead to reduced range of motion and worse neck pain.OBJECTIVETo investigate the clinical, radiological, and functional outcomes of patients undergoing single-door laminoplasty with or without collar immobilization.METHODSThis was a prospective, parallel, single-blinded randomized controlled trial. Patients underwent standardized single-door laminoplasty with mini-plates for cervical myelopathy and were randomly allocated into 2 groups based on the use of collar postoperatively. Clinical assessments included cervical range of motion, axial neck pain (VAS [visual analogue scale]), and objective scores (short-form 36-item, neck disability index, and modified Japanese Orthopaedic Association). All assessments were performed preoperatively and at postoperative 1, 2, 3, and 6 wk, and 3, 6, and 12 mo. Comparative analysis was performed via analysis of variance adjusted by baseline scores, sex, and age as covariates.RESULTSA total of 35 patients were recruited and randomized to collar use (n = 16) and without (n = 19). There were no dropouts or complications. There were no differences between groups at baseline. Subjects had comparable objective scores and range of motion at postoperative time-points. Patients without collar use had higher VAS at postoperative 1 wk (5.4 vs 3.5; P = .038) and 2 wk (3.5 vs 1.5; P = .028) but subsequently follow-up revealed no differences between the 2 groups.CONCLUSIONThe use of a rigid collar after laminoplasty leads to less axial neck pain in the first 2 wk after surgery. However, there is no additional benefit with regards to range of motion, quality of life, and complication risk.

scholarly journals RESEARCH PROTOCOL: Cervical Arthroplasty Cost Effectiveness Study (CACES) Economic Evaluation of Anterior Cervical Discectomy With Arthroplasty Versus Anterior Cervical Discectomy With Fusion in the Surgical Treatment of Cervical Degenerative Disc Disease, a Randomized Controlled Trial.

2022 ◽  
Author(s):  
Valérie N.E. Schuermans ◽  
Anouk Y.J.M. Smeets ◽  
Toon F.M. Boselie ◽  
Math M.J.J. Candel ◽  
Inez Curfs ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cost Effectiveness ◽  
Surgical Treatment ◽  
Controlled Trial ◽  
Cost Effective ◽  
Anterior Cervical Discectomy ◽  
Disc Disease ◽  
Cervical Discectomy ◽  
Randomized Controlled ◽  
Multi Level

Abstract IntroductionTo date, there is no consensus on which anterior surgical technique is more cost-effective in treating cervical degenerative disc disease (CDDD). The most commonly used surgical treatment for patients with single- or multi-level symptomatic CDDD is anterior cervical discectomy with fusion (ACDF). However, new complaints of radiculopathy and/or myelopathy commonly develop at adjacent levels, also known as clinical adjacent segment pathology (CASP). The extent to which kinematics, surgery-induced fusion, natural history and progression of disease play a role in the development of CASP remain unclear. Anterior cervical discectomy with arthroplasty (ACDA) is another treatment option that is thought to reduce the incidence of CASP by preserving motion in the operated segment. While ACDA is often discouraged, as the implant costs are higher while the clinical outcomes are similar to ACDF, preventing CASP might be a reason for ACDA to be a more cost-effective technique in the long-term.Methods and analysisIn this randomized controlled trial, patients will be randomized to receive ACDF or ACDA in a 1:1 ratio. Adult patients with single- or multi-level CDDD and symptoms of radiculopathy and/or myelopathy will be included. The primary outcome is cost-effectiveness and cost-utility of both techniques from a healthcare and societal perspective. Secondary objectives are the differences in clinical and radiological outcomes between the two techniques, as well as the qualitative process surrounding anterior decompression surgery. All outcomes will be measured at baseline, and every six months until four years post-surgery.DiscussionHigh-quality evidence regarding the cost-effectiveness of both ACDA and ACDF is lacking; to date, there are no prospective trials from a societal perspective. Considering the ageing of the population and the rising healthcare costs, there is an urgent need for a solid clinical cost-effectiveness trial addressing this question.

scholarly journals Prospective Randomized Controlled Trial to Study the Effect of Local Steroids in the Retropharyngeal Space After Anterior Cervical Discectomy and Fusion

2020 ◽  
pp. 219256822092578
Author(s):  
Aditya Dahapute ◽  
Sandeep Sonone ◽  
Shubhanshu Bhaladhare ◽  
Kuber Sakhare ◽  
Nandan Marathe ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Anterior Cervical Discectomy ◽  
Control Group ◽  
Retropharyngeal Space ◽  
Cervical Discectomy ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference

Study Design: Prospective randomized controlled trial. Objective: To study the effect of local steroids in the retropharyngeal space after anterior cervical discectomy and fusion (ACDF) in reducing prevertebral soft-tissue swelling (PSTS) and complications associated with it. Methods: A total of 50 consecutive patients operated with ACDF were double-blinded randomized into 2 groups: steroids (25) and control (25). Triamcinolone in collagen sponge was used in the steroid group and normal saline in gelatin sponge in the control group. Patients’ lateral radiographs were taken on the immediate postoperative day; days 2, 4, and 6; at 2 weeks; and 2 and 6 months postoperatively. The PSTS ratio at C3 to C7 and PSTS index were calculated. Patients were clinically evaluated using the Visual Analogue Scale (VAS) score for odynophagia and radiating pain, modified Japanese Orthopedic Association Score (mJOA), and Neck Disability Index (NDI). Results: PSTS showed a significant reduction in the steroid group as compared with the control group on the immediate postoperative day; days 2, 4, and 6; and at 2 weeks. However, at 2 and 6 months, PSTS remained the same. VAS score for odynophagia also showed a significant difference between the 2 groups on the immediate postoperative day; days 2, 4, and 6; and 2 weeks postoperatively, with no significant difference at the 2- and 6-month follow-up. mJOA and NDI showed no significant difference between the 2 groups at the 2- and 6-month follow-up. Conclusion: Use of retropharyngeal steroids helps in reducing the postoperative odynophagia on a short-term basis without any complication.

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