SURGERY FOR NECK PAIN

Neurosurgery ◽  
2007 ◽  
Vol 60 (suppl_1) ◽  
pp. S1-51-S1-56 ◽  
Author(s):  
Eric S. Wieser ◽  
Jeffrey C. Wang
Keyword(s):  
Cervical Spine ◽  
Los Angeles ◽  
Neck Pain ◽  
Cervical Spondylosis ◽  
Nonoperative Treatment ◽  
Common Finding ◽  
Cervical Fusion ◽  
Specific Level ◽  
Radicular Symptoms ◽  
Axial Neck Pain

Abstract AXIAL NECK PAIN is a common finding that typically represents a spectrum of clinical Arlington Orthopedic Associates, disorders affecting the cervical spine. Controversy exists concerning the ultimate treatment of the patient who presents with cervical spondylosis and primarily axial neck pain without radicular symptoms or myelopathy and who has failed to respond to extensive nonoperative treatment methods. Cervical discography has been used to assist in determining the specific level or levels causing the neck pain and, potentially, which levels to fuse; however, controversy regarding the specificity of cervical discograms has also been debated in the literature. Los Angeles, California We recommend exhausting all conservative means of treatment of axial neck pain. Surgery is offered only after conservative treatment fails and appropriate psychological testing is performed, as well as diagnostic imaging and discography that confirm a specific level or levels as the pain source. Cervical fusion may demonstrate good results in appropriately chosen patients with cervical spondylosis and axial neck pain.

Cervical Radiculopathy

2018 ◽  
pp. 101-108
Author(s):  
Michael Karsy ◽  
Ilyas Eli ◽  
Andrew Dailey
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Cervical Spondylosis ◽  
Cervical Radiculopathy ◽  
Surgical Approaches ◽  
Anatomical Landmarks ◽  
Cervical Fusion ◽  
Spine Mobility ◽  
Posterior Cervical Fusion ◽  
Spine Disease

Degenerative cervical spondylosis resulting in cervical radiculopathy or myelopathy can be a significant source of morbidity for patients. Traditional surgical approaches have involved anterior or posterior cervical fusion with decompression; however, these techniques may result in higher cost compared with noninstrumented cases, reduction of spine mobility, and adjacent level disease. Anterior microforaminotomy, first described by Jho in 1996, involves a microdiscectomy and decompression of the cervical spine without arthrodesis. Posterior approaches to the foramina can also be an option. In this chapter, the authors describe the use of lateral disc foraminotomies in the treatment of cervical spine disease. These techniques are mainly for the treatment of cervical radiculopathy without instability or mechanical neck pain. Techniques for both anterior and posterior approaches, including pitfalls and key anatomical landmarks, are described.

scholarly journals Cervical Spondylosis Management through the Spactacles of Homoeopathy

2021 ◽  
Vol 10 (1) ◽  
pp. 649-655
Author(s):  
Shashi Bhushan Singh ◽  
◽  
Ravi Prakash ◽  
Keyword(s):  
Risk Factor ◽  
Cervical Spine ◽  
Soft Tissue ◽  
Neck Pain ◽  
Intervertebral Disc ◽  
Cervical Spondylosis ◽  
Soft Tissues ◽  
Holistic Approach

Cervical spondylosis is one of the commonly seen diseases nowadays. Neck pain, which usually arises from diseases of the cervical spine & soft tissues of the neck, is common. “SPONDYLO” is a Greek term, meaning “Vertebra” & spondylosis generally mean changes in the vertrbral joint characterized by increasing degeneration of the intervertebral disc with subsequent changes in the bones & soft tissue. The management of cervical spondylosis is very much effective with Homoeopathic medicine. This article stress upon the risk factor, pathophysiology, symptomatology, investigation in concise manner as well as emphasises how homoeopathy can manage in such cases by its holistic approach of treatment.

Degenerative Conditions of the Cervical Spine

2018 ◽  
Author(s):  
Samuel C. Overley ◽  
Dante Leven ◽  
Abhishek Kumar ◽  
Sheeraz A. Qureshi
Keyword(s):  
Cervical Spine ◽  
Cervical Spondylosis ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Disease Process ◽  
Natural Aging ◽  
Patient Characteristics ◽  
Axial Neck Pain ◽  
Degenerative Cervical Spine ◽  
Patient Presentation

Degenerative disease of the cervical spine, also referred to as cervical spondylosis, is one of the most common pathologies encountered by spine specialists. This degenerative condition is primarily attributed to the natural aging process. However, a subset of patients may exhibit symptoms ranging from axial neck pain to radiculopathy to florid signs of myelopathy. A sound understanding of the spinal anatomy, pathology, patient presentation and treatment options, including surgical intervention, is paramount to evaluating and treating a patient with cervical spondylosis. This chapter focuses on the disease process, its natural history, patient characteristics, and treatment options for one of the most prevalent and potentially problematic spinal pathologies: the degenerative cervical spine.

scholarly journals The Biomechanics of Cervical Spondylosis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Lisa A. Ferrara
Keyword(s):  
Risk Factor ◽  
Cervical Spine ◽  
Neck Pain ◽  
Load Balance ◽  
Cervical Spondylosis ◽  
Cervical Radiculopathy ◽  
Height Loss ◽  
Ventral Margin ◽  
Vascular Structures ◽  
Eventual Loss

Aging is the major risk factor that contributes to the onset of cervical spondylosis. Several acute and chronic symptoms can occur that start with neck pain and may progress into cervical radiculopathy. Eventually, the degenerative cascade causes desiccation of the intervertebral disc resulting in height loss along the ventral margin of the cervical spine. This causes ventral angulation and eventual loss of lordosis, with compression of the neural and vascular structures. The altered posture of the cervical spine will progress into kyphosis and continue if the load balance and lordosis is not restored. The content of this paper will address the physiological and biomechanical pathways leading to cervical spondylosis and the biomechanical principles related to the surgical correction and treatment of kyphotic progression.

scholarly journals A Review on Diagnosis and Management of Cervical Spondylosis

2021 ◽  
pp. 668-674
Author(s):  
Ahmed Abdulaziz G. Ibrahim ◽  
Ali Mohammed A. Alahmari ◽  
Abdullah Hassan F. Alsuayri ◽  
Abdullah Misfer M. Algomshah ◽  
Saeed Ghanem S. Almlfi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Cervical Spondylosis ◽  
Natural Aging ◽  
Posterior Longitudinal Ligament ◽  
Cervical Radiculopathy ◽  
Intervertebral Discs ◽  
Degenerative Changes ◽  
Facet Joints ◽  
Wide Range

Cervical spondylosis is a term that encompasses a wide range of progressive degenerative changes that affect all components of the cervical spine (i.e., intervertebral discs, facet joints, Luschka joints, flava ligaments, and laminae). It is a natural aging process and occurs in most people after the age of five. Most people with radiographic spondylotic changes in the cervical spine  remain asymptomatic, and 25% of those under  40, 50% of those over  40, and 85% of those over  60 show some evidence of degenerative changes , including changes in  the environment. Uncovertebral joints, facet joints, posterior longitudinal ligament (PLL) and yellow ligament lead to  narrowing of the spinal canal and intervertebral foramina. As a result, the spinal cord, spinal vasculature, and nerve roots can become compressed, leading to the three clinical syndromes that occur with cervical spondylosis: axial neck pain, cervical myelopathy, and cervical radiculopathy. Cervical spondylosis is usually diagnosed for clinical reasons only, but imaging is also required. Treatment for cervical spondylosis can be medical or surgical, depending on whether the patient has symptoms of myelopathy, radicular pain, or neck pain.

scholarly journals Cervical Spondylosis in Nepalese Porters

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Prakash Bista ◽  
YB Roka
Keyword(s):  
Cervical Spine ◽  
Head Injury ◽  
Confidence Interval ◽  
Neck Pain ◽  
Odds Ratio ◽  
Cervical Spondylosis ◽  
Case Control ◽  
X Rays ◽  
Age Group

Neck pain with or without radiculopathy and myelopathy is a very common problem in clinicalpractice. The incidence is believed to be higher in subgroups carrying load on their head. It has beenreported in literature that radiographic spondylosis is appreciable in 25% to 50% of population by theage of 50 years and 75% to 85% by the age of 65 years.One hundred and nineteen lateral X-rays of cervical spine were analyzed as case-control studyin patients between 40 and 50 years age with the objective of finding out proportion of cervicalspondylosis in this age group and difference in the prevalence between porters and non-porters.Out of the 119 cases 54 (45.4.2%) were porters and 65 (54.6%) were non-porters. There were 98(82.4%) males and 21 (17.6%) females. The overall prevalence of radiological cervical spondylosiswas 69 (58%). The prevalence of cervical spondylosis was significantly lower (x2 = 14.795, p=0.0001)in porters in comparison to non-porters. The odds ratio was found to be 0.23 (0.10, 0.53) at 95%confidence interval indicating that portering significantly prohibited development of spondylosis.This study concludes that the overall prevalence of cervical spondylosis in the Nepalese populationis slightly higher than in the Caucasian and contrary to other studies there is significantly lowerprevalence of such degeneration among the Nepalese porters.Key words: cervical Spine, cervical spondylosis, head Injury, Nepalese porters

The utility of radionucleotide imaging in the surgical management of axial neck pain from cervical facet joint arthropathy

2020 ◽  
Vol 32 (2) ◽  
pp. 168-173
Author(s):  
Christopher D. Witiw ◽  
Nataliya Tsapenko ◽  
Vincent C. Traynelis
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Facet Joint ◽  
Case Series ◽  
Tracer Uptake ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Axial Neck Pain ◽  
Cervical Facet ◽  
Facet Arthropathy

OBJECTIVEAxial neck pain is common and often debilitating. Diagnosis of the specific pain source can be a challenge, and this confounds effective treatment. Cervical facet arthropathy is implicated in many of these cases. The diagnosis is readily made on conventional cross-sectional imaging modalities, particularly CT imaging. However, this modality falls short in determining if an osteoarthritic facet joint is truly the source of symptoms. Radionucleotide imaging presents a noninvasive radiological adjunct to conventional cross-sectional imaging in the workup of patients with suspected facetogenic pain. Herein, the authors present the patient-reported outcomes (PROs) following posterior instrumented arthrodesis of the subaxial cervical spine from a consecutive case series of patients with a diagnosis of cervical facet joint arthropathy and a concordant positive radionucleotide tracer uptake.METHODSThe clinical case series of patients treated by the senior author at a single tertiary care institution between September 2014 and April 2018 was reviewed. Patients were selected for inclusion if their primary symptom at presentation was axial neck pain without neurological deficits and if CT imaging revealed facet arthropathy of the cervical spine. These patients underwent radionucleotide imaging in the form of a planar 99mTc methylene diphosphonate (99mTc MDP) bone scintigraphy study. Those with a finding of radionucleotide tracer uptake at a location concordant with the facet arthropathy were selected to undergo posterior cervical instrumented arthrodesis of the affected levels. PROs were recorded at the time of surgical consultation (i.e., after nonoperative treatment) and at 6 weeks, 3 months, 6 months, and 1 year following surgery. These included neck and arm pain, the Neck Disability Index (NDI) and the 12-Item Short Form Health Survey responses.RESULTSA total of 11 patients were included in this retrospective case series. The average reported neck pain and NDI scores were high at baseline; 7.6 ± 2.3 and 37.1 ± 13.9 respectively. Twelve months after surgical intervention, a significant decrease in reported neck pain of −4.5 (95% CI −6.9, −2.1; p = 0.015) and a significant decrease in NDI of −20.0 (95% CI −29.4, −10.6; p = 0.014) was observed.CONCLUSIONSThis case series represents the largest to date of patients undergoing surgical arthrodesis following a finding of facet arthropathy with a concordant positive radioisotope image study. These observations add support to a growing body of evidence that suggests the utility of radioisotope imaging for identification of a facetogenic pain generator in patients with primary axial neck pain and a finding of cervical facet arthropathy. These preliminary data should serve to promote future prospective, controlled studies on the incorporation of radionucleotide imaging into the workup of patients with suspected facetogenic pain of the cervical spine.

MECHANICAL NECK PAIN ANDCERVICOGENIC HEADACHE

Neurosurgery ◽  
2007 ◽  
Vol 60 (suppl_1) ◽  
pp. S1-21-S1-27 ◽  
Author(s):  
Nicholas U. Ahn ◽  
Uri M. Ahn ◽  
Brian Ipsen ◽  
Howard S. An
Keyword(s):  
Differential Diagnosis ◽  
Neck Pain ◽  
Cervical Spondylosis ◽  
Cervical Radiculopathy ◽  
Common Symptom ◽  
Axial Neck Pain ◽  
Work Up

Abstract MECHANICAL NECK PAIN is a very common symptom that may occur with cervical spondylosis. It can be associated with cervical radiculopathy and myelopathy or can occur in isolation. Neck pain can result from a variety of causes, including trauma, tumor, infection, and degeneration. The presentation of axial neck pain varies. This article highlights the presentation, differential diagnosis, and appropriate work-up for the patient who presents with mechanical neck pain.

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