scholarly journals Impact of Myelopathy Severity and Degree of Deformity on Postoperative Outcomes in Cervical Spinal Deformity Patients

Neurospine ◽  
2021 ◽  
Vol 18 (3) ◽  
pp. 628-634
Author(s):  
Peter G. Passias ◽  
Katherine E. Pierce ◽  
Nicholas Kummer ◽  
Oscar Krol ◽  
Lara Passfall ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Cord Compression ◽  
Patient Reported ◽  
Numerical Rating ◽  
Euroqol 5D ◽  
Group 2 ◽  
Neck Disability

Objective: Malalignment of the cervical spine can result in cord compression, leading to a myelopathy diagnosis. Whether deformity or myelopathy severity is stronger predictors of surgical outcomes is understudied.Methods: Surgical cervical deformity (CD) patients with baseline (BL) and up to 1-year data were included. Modified Japanese Orthopaedic Association (mJOA) score categorized BL myelopathy (mJOA = 18 excluded), with moderate myelopathy mJOA being 12 to 17 and severe myelopathy being less than 12. BL deformity severity was categorized using the mismatch between T1 slope and cervical lordosis (TS-CL), with CL being the angle between the lower endplates of C2 and C7. Moderate deformity was TS-CL less than or equal to 25° and severe deformity was greater than 25°. Categorizations were combined into 4 groups: group 1 (G1), severe myelopathy and severe deformity; group 2 (G2), severe myelopathy and moderate deformity; group 3 (G3), moderate myelopathy and moderate deformity; group 4 (G4), moderate myelopathy and severe deformity. Univariate analyses determined whether myelopathy or deformity had greater impact on outcomes.Results: One hundred twenty-eight CD patients were included (mean age, 56.5 years; 46% female; body mass index, 30.4 kg/m2) with a BL mJOA score of 12.8 ± 2.7 and mean TS-CL of 25.9° ± 16.1°. G1 consisted of 11.1% of our CD population, with 21% in G2, 34.6% in G3, and 33.3% in G4. At BL, Neck Disability Index (NDI) was greatest in G2 (p = 0.011). G4 had the lowest EuroQol-5D (EQ-5D) (p < 0.001). Neurologic exam factors were greater in severe myelopathy (p < 0.050). At 1-year, severe deformity met minimum clinically important differences (MCIDs) for NDI more than moderate deformity (p = 0.002). G2 had significantly worse outcomes compared to G4 by 1-year NDI (p = 0.004), EQ-5D (p = 0.028), Numerical Rating Scale neck (p = 0.046), and MCID for NDI (p = 0.001).Conclusion: Addressing severe deformity had increased clinical weight in improving patient-reported outcomes compared to addressing severe myelopathy.

scholarly journals Clinical Efficacy of Scalene Injection for Thoracic Outlet Syndrome

2021 ◽  
Author(s):  
Samuel Baek ◽  
Seok Kim ◽  
Myung Ho Shin ◽  
Tae Min Kim ◽  
Seoung-Joon Lee ◽  
...  
Keyword(s):  
Side Effects ◽  
Clinical Efficacy ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Neck Disability Index ◽  
Vital Signs ◽  
Treatment Technique ◽  
The Novel ◽  
Numerical Rating ◽  
Neck Disability

Purpose: We introduce the novel treatment technique, scalene injection, and study its clinical efficacy for diagnosis, treatment, and pain control for patients with thoracic outlet syndrome.Methods: Between November 2001 and October 2018, 266 patients were studied retrospectively. To evaluate the efficacy and sustainability, we checked the numerical rating scale (NRS) for pain relief and neck disability index (NDI) for functional improvements, prior to and 1, 12 weeks after the injection. The safety was evaluated by examining side effects for at least 24 hours from the point of injection.Results: NRS was improved from 7.12 to 3.11 at 1 week, and to 3.05 at 12 weeks (p<0.05). NDI was improved from 15.87 to 6.15 at 1 week, and to 6.19 at 12 weeks (p<0.05). There were two cases of convulsion immediately after the injection and were treated with prompt oxygen supply and sedatives. Transient side effects included two cases of dyspnea and one case of nausea and were resolved within 1 hour after. All five cases showed symptoms of side effects on the day of injection and were resolved within a day. A total of 242 patients (91.0%) experienced immediate declines in NRS and 161 patients experienced persistent declines for more than 12 weeks. However, 24 patients (9.0%) showed no improvement and 20 patients (7.5%) experienced increases in NRS.Conclusion: Scalene injection is also effective as a therapeutic method. However, this study suggests that it must be done with monitoring of vital signs in an operating room for any possible complications and side effects.

scholarly journals Consumptive Disease and Chronic Fatigue Improved by Nokyonggunbi-tang and Other Korean Medical Treatments: A Case Report

2021 ◽  
Vol 42 (5) ◽  
pp. 738-745
Author(s):  
Mu-jin Park ◽  
So-ri Jin ◽  
Eun-jae Oh ◽  
Woo-sub Song ◽  
Hyun-seok Lee ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Neck Disability Index ◽  
Chronic Fatigue ◽  
Medical Treatments ◽  
Five Dimensions ◽  
Numerical Rating ◽  
Fatigue Severity ◽  
Neck Disability

Objective: This study investigated the efficacy of using Nokyonggunbi-tang and other Korean medical treatments for a patient with consumptive disease and chronic fatigue.Methods: A 59-year-old female patient with fatigue, headache, dizziness, and neck pain due to consumptive disease and chronic fatigue was treated with herbal medicine (Nokyonggunbi-tang), together with acupuncture, pharmacopuncture, cupping, and chuna manual therapy, for 22 days. The treatment effects on the pain were evaluated using the scores for the Fatigue Severity Scale (FSS), European Quality of Life Five Dimensions (EQ-5d) Scale, Neck Disability Index (NDI), and Numerical Rating Scale (NRS).Results: Following treatment, the patient showed a decrease in the FSS, NDI, and NRS scores and an improvement in the EQ-5d score.Conclusions: Nokyonggunbi-tang and Korean medical treatment significantly improved fatigue symptoms in a patient with no substrate disease.

scholarly journals Minimal Clinically Important Change of the Neck Disability Index and the Numerical Rating Scale for Patients With Neck Pain

Spine ◽  
2007 ◽  
Vol 32 (26) ◽  
pp. 3047-3051 ◽  
Author(s):  
Jan J. M. Pool ◽  
Raymond W. J. G. Ostelo ◽  
Jan L. Hoving ◽  
Lex M. Bouter ◽  
Henrica C. W. de Vet
Keyword(s):  
Neck Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Neck Disability Index ◽  
Important Change ◽  
Numerical Rating ◽  
Neck Disability ◽  
Clinically Important Change

scholarly journals Case Report on Headache (Suspected CPSP) Treated with Korean Medicine in a Hospitalized Patient with a History of Cerebral Infarction

2021 ◽  
Vol 42 (5) ◽  
pp. 893-903
Author(s):  
Jin-hun Park ◽  
Geon-sik Kong ◽  
Jin-young Song ◽  
So-won Kim ◽  
Yen-min Wang ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Neck Disability Index ◽  
Herbal Medicines ◽  
Korean Medicine ◽  
Five Dimensions ◽  
Numerical Rating ◽  
History Of ◽  
Neck Disability

Objectives: This study investigated the efficacy of Korean medical treatment for a headache (suspected CPSP) patient with a history of cerebral infarction.Methods: We treated the patient using Korean medical treatments (herbal medicines-Kamiseokyong-tang, acupuncture, pharmacopuncture, and chuna). The treatments were measured using the Numerical Rating Scale (NRS) and the Neck Disability Index (NDI) for headache and post neck pain. General health status was evaluated using the European Quality of Life Five Dimensions (EQ-5d) Scale.Results: We observed improvements in the NRS, NDI, and EQ-5d scores after the treatments.Conclusions: This study suggests that Korean medicine may effectively treat headaches (suspected CPSP) with accompanying cerebral infarction.

scholarly journals Validation of the Nepali versions of the Neck Disability Index (NDI) and the Numerical Rating Scale (NRS) for Neck Pain

Spine ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Dipak Shrestha ◽  
Rohit Shrestha ◽  
Margreth Grotle ◽  
Øystein P. Nygaard ◽  
Tore K. Solberg
Keyword(s):  
Neck Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Neck Disability Index ◽  
Numerical Rating ◽  
Neck Disability

Does Obesity Correlate With Worse Patient-Reported Outcomes Following Elective Anterior Cervical Discectomy and Fusion?

Neurosurgery ◽  
2016 ◽  
Vol 79 (1) ◽  
pp. 69-74 ◽  
Author(s):  
John A. Sielatycki ◽  
Chotai Silky ◽  
Kay Harrison ◽  
David Stonko ◽  
Matthew McGirt ◽  
...  
Keyword(s):  
Scale Score ◽  
Patient Reported Outcomes ◽  
Minimal Clinically Important Difference ◽  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Japanese Orthopaedic Association Score ◽  
Association Score ◽  
Clinically Important Difference ◽  
Patient Reported ◽  
Neck Disability

Abstract BACKGROUND Studies have investigated the impact of obesity in thoracolumbar surgery; however, the effect of obesity on patient-reported outcomes (PROs) following anterior cervical discectomy and fusion (ACDF) is unknown. OBJECTIVE To examine the relationship between obesity and PROs following elective ACDF. METHODS Consecutive patients undergoing ACDF for degenerative conditions were evaluated. Patients were divided into groups with a body mass index ≥35. The EuroQol-5D, Short-Form 12 (SF-12), modified Japanese Orthopaedic Association score, and Neck Disability Index were used. Correlations between PROs and obesity were calculated at baseline and 1 year. RESULTS A total of 299 patients were included, with 80 obese (27%) and 219 nonobese (73%). patients At baseline, obesity was associated with worse myelopathy (modified Japanese Orthopaedic Association score: 10.7 vs 12.2, P = .01), general physical health (SF-12 physical component scale score: 28.7 vs 31.8, P = .02), and general mental health (SF-12 mental component scale score: 38.9 vs 42.3, P = .04). All PROs improved significantly following surgery in both groups. There was no difference in absolute scores and change scores for any PRO at 12 months following surgery. Furthermore, there was no difference in the percentage of patients achieving a minimal clinically important difference for the Neck Disability Index (52% vs 56%, P = .51) and no difference in patient satisfaction (85% vs 85%, P = .85) between groups. CONCLUSION Obesity was not associated with less improvement in PROs following ACDF. There was no difference in the proportion of patients satisfied with surgery and those achieving a minimal clinically important difference across all PROs. Obese patients may therefore achieve meaningful improvement following elective ACDF.

scholarly journals Comparison of Sustained Natural Apophyseal Glides and Maitland Manual Therapy in Non-Specific Neck Pain on Numeric Pain Rating Scale and Neck Disability Index

2018 ◽  
Vol 23 (4) ◽  
pp. 457-462
Author(s):  
Fahad Tanveer ◽  
Adnan Afzal ◽  
Muhammad Adeel ◽  
Sana Shahid ◽  
Maham Masood
Keyword(s):  
Neck Pain ◽  
Functional Status ◽  
Rating Scale ◽  
Neck Disability Index ◽  
Numeric Pain Rating Scale ◽  
Group 3 ◽  
Group 2 ◽  
Neck Disability ◽  
Pain Rating Scale ◽  
Group 1

Incidence of neck pain is increasing day by day due to changed, sedentary, non-ergonomic environment and life style. This becomes the reason of an increased load of human resource and cost. To shed this load of resources and cost, it’s essential to sort out means which give real relief to this increasinglysignificant problem. To compare outcomes of sustained natural apophyseal glides (SNAGs) versus Maitland manual therapy in improving non-specific neck pain. It was a quasi-experimental study design. The study was conducted in Chaudhary Muhammad Akram, Teaching & Research Hospital, Lahore and SuriyaAzeem Teaching Hospital, Lahore within six months from June 2015 to December 2015. A total of 75 subjects with non-specific neck pain using non-probability convenience sampling technique who fulfilled the specific inclusion and exclusion criteria were randomly allocated to three groups; group 1 received SNAGs,group 2 Maitland mobilization and group 3 conventional treatment. Baseline, post-intervention and follow up readings were taken through numeric pain rating scale (NPRS) for pain intensity, neck disability index (NDI) for functional status,goniometer for range of motion and manual muscle testing for muscle strengthof neck. The subject in each group were given twelve sessions, with three sessions a week. Data were analyzed through statistical package of social sciences (SPSS) 21. The results of each group showed pre-treatment pain intensity for group 1 was 7.04+1.338 that changed to 3.52+0.714 and for group 2 it was changed from 7.52+0.872 to 5.16+0.850 and 7.16+0.943 to 5.12+0.781 for group 3. The NDI score for group 1, 2 and 3 were 31.56+5.560, 25.040+7.086 and 25.560+5.477 that were changed to 13.120+2.759, 16.360+2.899 and 12.600+2.020 respectively. The one way ANOVA test compared mean of three groups and p-value for painintensity after treatment was p=0.000 and for functional status p=0.000. The study showed that SNAGs mobilization was more effective in the management of non-specific neck pain and also conventional treatment improved functional status of neck than Maitland mobilization.

scholarly journals Comparing the visual analogue scale (VAS) and the numerical rating scale (NRS) in patient reported outcomes in psoriatic arthritis

2020 ◽  
pp. jrheum.200928
Author(s):  
Weiyu Ye ◽  
Simon Hackett ◽  
Claire Vandevelde ◽  
Sarah Twigg ◽  
Philip S. Helliwell ◽  
...  
Keyword(s):  
Disease Activity ◽  
Patient Reported Outcomes ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Correlation Coefficients ◽  
Patient Reported ◽  
Life Impact ◽  
Numerical Rating ◽  
Global Disease Activity ◽  
Test Retest Reliability

Objective Patient self-report scales are invaluable in psoriatic arthritis (PsA), as they allow physicians to rapidly assess patient perspectives of disease activity. We aimed to assess the agreement of the visual analogue scale (VAS), a 100 mm horizontal line, and the numerical rating scale (NRS), a 21-point scale ranging from 0 to 10 in increments of 0.5, in patients with PsA. Methods Data were collected prospectively across three UK hospital trusts from 2018-2019. All patients completed the VAS and NRS for pain, arthritis, skin psoriasis, and global disease activity. A subset completed an identical pack one week later. Demographic and clinical data were also collected. Agreement was assessed using medians and the Bland-Altman method. Intraclass correlation coefficients (ICC) were used to assess test-retest reliability. Spearman’s rank correlation coefficients were used to assess dependency between scale scores and clinical parameters. Results 210 patients completed the study; one withdrew consent, thus 209 were analysed. For pain, arthritis, skin psoriasis and global disease activity, the difference between the VAS and NRS mostly lay within 1.96 SD of the mean, suggesting reasonable agreement between the two scales. 64.1% patients preferred the NRS. The ICCs demonstrate excellent test-retest reliability for both VAS and NRS. Higher VAS and NRS scores were associated with increased tender/swollen joint count, poorer functional status and greater life impact. Conclusion The VAS and NRS show reasonable agreement in key patient reported outcomes in PsA. Results from both scales are correlated with disease severity and life impact.

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