Predictive factors associated with neck pain in patients with cervical disc degeneration

Background: Epidural neuroplasty using the Racz catheter has a therapeutic effect in patients with cervical disc herniation and central stenosis who do not respond to fluoroscopically guided epidural injections. Objective: To evaluate the clinical outcomes of cervical epidural neuroplasty in patients with posterior neck and upper extremity pain and to demonstrate correlations between predictive factors and unsuccessful results of cervical epidural neuroplasty. Study Design: Observational study. Setting: An interventional pain management practice in a university hospital. Methods: Outcome measures were obtained using the numeric rating scale (NRS) for total pain, neck pain, arm pain, and sleep disturbance; and the neck pain and disability scale (NPDS); as well as opioid consumption at preprocedure, one month, 3, 6, and 12 months after procedure. Successful epidural neuroplasty was defined as 50% or greater reduction from the preprocedure NRS for total pain, and at least a 40% reduction in the NPDS. We obtained clinical data and radiologic findings to evaluate correlations between predictive factors and efficacy of epidural neuroplasty. Results: Of the 169 patients, successful outcomes were observed in 108 patients (63.9%) at one month following the procedure, in 109 patients (64.5%) at 3 months, in 96 patients (56.8%) at 6 months, and in 89 patients (52.7%) at 12 months. Previous surgery, spondylolisthesis, and ossification of the posterior longitudinal ligament were significantly associated with unsuccessful outcomes as measured by NRS and NPDS (P < 0.05). Limitations: Limitations of this evaluation include the lack of a placebo group. Conclusions: Cervical epidural neuroplasty may be an effective treatment for pain reduction and functional improvement in patients with cervical spinal pain who did not respond to conservative treatment, and may decrease surgical demand. Previous surgery, spondylolisthesis, and ossification of the posterior longitudinal ligament are associated with unsuccesful outcomes of epidural neuroplasty. Key words: Cervical spinal pain, epidural neuroplasty, percutaneous adhesiolysis, predictive factor, racz catheter

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

The Spine Journal ◽

10.1016/j.spinee.2016.08.009 ◽

2016 ◽

Vol 16 (12) ◽

pp. 1453-1458 ◽

Cited By ~ 1

Author(s):

Sun-Mi Lee ◽

Su Chan Oh ◽

Jin S. Yeom ◽

Ji-Hoon Shin ◽

Sam-Guk Park ◽

...

Keyword(s):

Cervical Spine ◽

Neck Pain ◽

Disc Degeneration ◽

Disc Herniation ◽

Joint Laxity ◽

Cervical Disc Herniation ◽

Cervical Disc ◽

Generalized Joint Laxity ◽

Posterior Neck ◽

The Impact

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Adolescent cervical disc degeneration in MRI does not predict adult headache or neck pain: A 5-year follow-up of adolescents with and without headache

Cephalalgia ◽

10.1177/0333102414521509 ◽

2014 ◽

Vol 34 (9) ◽

pp. 679-685 ◽

Cited By ~ 2

Author(s):

Katri Laimi ◽

Johanna Pitkänen ◽

Liisa Metsähonkala ◽

Tero Vahlberg ◽

Marja Mikkelsson ◽

...

Keyword(s):

Cervical Spine ◽

Neck Pain ◽

Disc Degeneration ◽

Degenerative Changes ◽

Cervical Disc ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri ◽

Mri Study ◽

The Impact

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: retrospective cross-sectional study

10.21203/rs.3.rs-26105/v1 ◽

2020 ◽

Author(s):

Hyo Jeong Lee ◽

Dae Geun Jeon ◽

Jinyoung Park ◽

Jung Hyun Park

Keyword(s):

Neck Pain ◽

Disc Degeneration ◽

Cross Sectional Study ◽

Cervical Disc ◽

Cervical Lordosis ◽

Sectional Study ◽

Cross Sectional ◽

Head Posture ◽

Posterior Neck ◽

Sagittal Parameters

Abstract Background The aim of this study was to examine 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. Methods This study was a retrospective cross-sectional study that analyzed 113 patients with posterior neck pain with or without radiating pain. 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 magnetic resonance images (MRI) of the cervical spine. Pearson’s correlation analysis was conducted to evaluate the relationship of these parameters and a linear regression method was used to determine associations between sagittal cervical alignment and disc degeneration. Results A significant positive correlation was found for the C2-C7 angle using the sum of the Pfirrmann grades and total modified Matsumoto scores. The O-C2 angle was negatively correlated with the sum of the Pfirrmann grades and total modified Matsumoto scores. The C1-C2 angle was also negatively correlated with the sum of the Pfirrmann grades. No significant relationship was found between the cervical SVA and cervical disc degeneration. Conclusions 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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The Relationship Between Generalized Joint Hypermobility and Cervical Disc Degeneration, Neck Pain: A Multidisciplinary Clinical Study

Southern Clinics of Istanbul Eurasia ◽

10.14744/scie.2019.49469 ◽

2019 ◽

Author(s):

Neşe Keser

Keyword(s):

Clinical Study ◽

Neck Pain ◽

Disc Degeneration ◽

Joint Hypermobility ◽

Cervical Disc ◽

Generalized Joint Hypermobility ◽

The Relationship

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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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