Clinical Validity of the Smallest Oblique Sagittal Area of the Neural Foramen in Patients With Suspected Cervical Spondylotic Radiculopathy

Abstract Objective To evaluate the smallest oblique sagittal area of the neural foramen in detecting cervical spondylotic radiculopathy and to determine its potential significance for treatment decisions. Methods The subjects of the study were patients with cervical spondylotic radiculopathy who visited the spine surgery from 2016 to 2019. All patients were compared according to the minimum oblique sagittal area and the cut-off point value, and they were divided into positive and negative parameters. The changes in neck disability index (NDI), Japanese Orthopaedic Association score (JOA) and visual analog scale (VAS) during the two treatment groups from baseline to at least 24 months of follow-up were compared.Results In the surgery group, there was no significant difference in symptom improvement between patients with positive and negative parameters. In the non-surgical group, for patients with positive parameters, NDI decreased by 2.35, JOA increased by 0.88, and neck VAS score improved by 0.42. For patients with negative parameters, NDI decreased by 10.32, JOA increased by 2.86 on average, and neck VAS score improved by 2.46 points on average (both p＜0.01 on t test).Conclusions In patients undergoing surgery, the symptoms of the patients have been significantly improved after surgery, and the smallest oblique sagittal area of the neural foramen seems to be unable to predict the outcome of the surgery. However, in non-surgical patients, the improvement of symptoms in the stenosis group was more limited. This may imply that surgery may be effective for patients who had positive parameters.

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Anterior Controllable Antedisplacement and Fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS): a retrospective study of 45 cases

10.21203/rs.2.12543/v1 ◽

2019 ◽

Author(s):

Xi Luo ◽

Kaiqiang Sun ◽

Jingchuan Sun ◽

Shunmin Wang ◽

Yuan Wang ◽

...

Keyword(s):

Spinal Stenosis ◽

Cervical Spondylotic Myelopathy ◽

Japanese Orthopaedic Association ◽

Neck Disability Index ◽

Operation Time ◽

Significant Difference ◽

Csf Leakage ◽

One Year ◽

Neck Disability ◽

Multilevel Cervical Spondylotic Myelopathy

Abstract Background To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) technique for the treatment of multilevel cervical spondylotic myelopathy with spinal stenosis (MCSMSS), and compare ACAF with hybrid decompression fixation (HDF). Methods A retrospective analysis of 85 cases with MCSMSS was carried out. 45 patients were treated with ACAF, while 40 patients were treated with HDF. The operation time, intraoperative bleeding volume, postoperative complications, Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, Computed Tomography (CT) transverse measurement, cervical curvature and Kang's grade were compared between two groups. Results The patients were followed up for 12 to 17 months. Compared with HDF, ACAF group achieved better decompression according to CT measurement and Kang’s grade (P < 0.05), and recovered to a greater cervical Cobb’s angle (P < 0.05). However, JOA score and NDI index showed no significant difference one year after surgery (P＞0.05). Additionally, ACAF presented longer operation time and greater intraoperative blood loss (P < 0.05). As to complications, ACAF developed less incidences of cerebrospinal fluid examination (CSF) leakage, neurologic deterioration, epidural hematoma and C5 palsy by comparing with HDF. Conclusions ACAF is an effective method for the treatment of MCSMSS. Compared with HDF, ACAF has the advantages of significant decompression, increasing cervical curvature, and reducing the incidences of complications.

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

Neurosurgery ◽

10.1227/neu.0000000000001252 ◽

2016 ◽

Vol 79 (1) ◽

pp. 69-74 ◽

Cited By ~ 7

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.

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Establishing the minimum clinically important difference in Neck Disability Index and modified Japanese Orthopaedic Association scores for adult cervical deformity

Journal of Neurosurgery Spine ◽

10.3171/2020.3.spine191232 ◽

2020 ◽

Vol 33 (4) ◽

pp. 441-445

Author(s):

Alex Soroceanu ◽

Justin S. Smith ◽

Darryl Lau ◽

Michael P. Kelly ◽

Peter G. Passias ◽

...

Keyword(s):

Cobb Angle ◽

Japanese Orthopaedic Association ◽

Neck Disability Index ◽

Deformity Correction ◽

Minimum Clinically Important Difference ◽

Cervical Deformity ◽

Clinically Important Difference ◽

Significant Difference ◽

The Mean ◽

Neck Disability

OBJECTIVEIt is being increasingly recognized that adult cervical deformity (ACD) is correlated with significant pain, myelopathy, and disability, and that patients who undergo deformity correction gain significant benefit. However, there are no defined thresholds of minimum clinically important difference (MCID) in Neck Disability Index (NDI) and modified Japanese Orthopaedic Association (mJOA) scores.METHODSPatients of interest were consecutive patients with ACD who underwent cervical deformity correction. ACD was defined as C2–7 sagittal Cobb angle ≥ 10° (kyphosis), C2–7 coronal Cobb angle ≥ 10° (cervical scoliosis), C2–7 sagittal vertical axis ≥ 4 cm, and/or chin-brow vertical angle ≥ 25°. Data were obtained from a consecutive cohort of patients from a multiinstitutional prospective database maintained across 13 sites. Distribution-based MCID, anchor-based MCID, and minimally detectable measurement difference (MDMD) were calculated.RESULTSA total of 73 patients met inclusion criteria and had sufficient 1-year follow-up. In the cohort, 42 patients (57.5%) were female. The mean age at the time of surgery was 62.23 years, and average body mass index was 29.28. The mean preoperative NDI was 46.49 and mJOA was 13.17. There was significant improvement in NDI at 1 year (46.49 vs 37.04; p = 0.0001). There was no significant difference in preoperative and 1-year mJOA (13.17 vs 13.7; p = 0.12). Using multiple techniques to yield MCID thresholds specific to the ACD population, the authors obtained values of 5.42 to 7.48 for the NDI, and 1.00 to 1.39 for the mJOA. The MDMD was 6.4 for the NDI, and 1.8 for the mJOA. Therefore, based on their results, the authors recommend using an MCID threshold of 1.8 for the mJOA, and 7.0 for the NDI in patients with ACD.CONCLUSIONSThe ACD-specific MCID thresholds for NDI and mJOA are similar to the reported MCID following surgery for degenerative cervical disease. Additional studies are needed to verify these findings. Nonetheless, the findings here will be useful for future studies evaluating the success of surgery for patients with ACD undergoing deformity correction.

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Comparison of Two Reconstructive Techniques in the Surgical Management of Four-Level Cervical Spondylotic Myelopathy

BioMed Research International ◽

10.1155/2015/513906 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7

Author(s):

FengNing Li ◽

ZhongHai Li ◽

Xuan Huang ◽

Zhi Chen ◽

Fan Zhang ◽

...

Keyword(s):

Clinical Efficacy ◽

Cervical Spondylotic Myelopathy ◽

Japanese Orthopaedic Association ◽

Neck Disability Index ◽

Significant Difference ◽

Duration Of Surgery ◽

Group A ◽

Neck Disability ◽

Cervical Spine Alignment

To compare the clinical efficacy and radiological outcome of treating 4-level cervical spondylotic myelopathy (CSM) with either anterior cervical discectomy and fusion (ACDF) or “skip” corpectomy and fusion, 48 patients with 4-level CSM who had undergone ACDF or SCF at our hospital were analyzed retrospectively between January 2008 and June 2011. Twenty-seven patients received ACDF (Group A) and 21 patients received SCF. Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, and Cobb’s angles of the fused segments and C2-7 segments were compared in the two groups. The minimum patient follow-up was 2 years. No significant differences between the groups were found in demographic and baseline disease characteristics, duration of surgery, or follow-up time. Our study demonstrates that there was no significant difference in the clinical efficacy of ACDF and SCF, but ACDF involves less intraoperative blood loss, better cervical spine alignment, and fewer postoperative complications than SCF.

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Effectiveness of sustained natural apophyseal glides in females with cervicogenic headache: A randomized controlled trial

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-210018 ◽

2021 ◽

pp. 1-7

Author(s):

Muhammad Kashif ◽

Nosheen Manzoor ◽

Rimsha Safdar ◽

Hafsa Khan ◽

Maryam Farooq ◽

...

Keyword(s):

Treatment Group ◽

Controlled Trial ◽

Neck Disability Index ◽

Placebo Treatment ◽

Cervicogenic Headache ◽

Control Group ◽

P Value ◽

Head Positioning ◽

Significant Difference ◽

Neck Disability

BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal gliders (SNAGs) as a manual therapy approach. However, only inconclusive short-term evidence exists for treating CGH with SNAGs. OBJECTIVE: The present study aims to investigate the effect of SNAGs in the treatment of CGH. METHODS: Fourty female patients ranging from 20 to 40 years with CGH were randomly assigned to two groups: 20 in a treatment group and 20 in a control group. SNAGs were applied to the treatment group while the control group received placebo treatment. Both groups received their respective treatment for 20 minutes, alternately three times per week, for a total of 12 times in four weeks. The outcome measures were the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). Participants were assessed at baseline and at the end of each week. The data was analyzed using SPSS version 20. Independent t-testing was used to reveal changes between groups. One-way ANOVA was used to determine changes within groups. The level of significance was P< 0.05. RESULTS: Twenty participants (100%) in the treatment group and 17 (85%) in the control group had a history of headache aggravation with active movements or passive head positioning. There was no significant difference at baseline (p> 0.05), indicating that both groups were homogeneous at the time of recruitment. The p value (p< 0.05) showed a significant difference in pain and level of disability at three and four weeks (p< 0.05) in patients treated with SNAGs. However, the cervical range of motion (ROM) showed a statistically significant improvement in flexion and extension in the treatment group (p< 0.05) while there was no significant improvement in side flexion and rotation ROM in both groups (p> 0.05). CONCLUSION: This study found that SNAGs were effective in reducing pain and neck disability and improved ROM in females with CGH.

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Effectiveness of Laser Therapy and Ultrasound Therapy along with Muscle Energy Technique in subjects with Trapezitis

Asian Journal of Pharmacy and Technology ◽

10.52711/2231-5713.2021.00019 ◽

2021 ◽

pp. 116-120

Author(s):

K. Kotteeswaran ◽

Syed Gaffar ◽

Krishna. R ◽

Keerthana Priya. R.

Keyword(s):

Laser Therapy ◽

Functional Disability ◽

Neck Disability Index ◽

Ultrasound Therapy ◽

Muscle Energy Technique ◽

Significant Difference ◽

Group A ◽

Muscle Energy ◽

Group B ◽

Neck Disability

Aim: To find the effectiveness of laser therapy and ultrasound therapy along with muscle energy technique in treatment of Trapezitis. Materials and Methods: Non-equivalent quasi experimental study design was used in this study. Total of 30 subjects with trapezitis were selected using non probability convenient sampling technique.30 Subjects was divided into two groups by lot system. Group A received laser therapy and Group B received ultrasound therapy and for both the group muscle energy technique was given. The outcome measures are Neck Disability Index (NDI) for measuring Functional Disability. Data collected and tabulated was statistically analyzed. Result: Statistical analysis of post-test, Neck Disability Index (NDI) revealed that there is statistically significant difference seen between Group A and Group B. Conclusion: From the result, it has been concluded that Laser therapy with muscle energy technique (Group A) was more effective than Ultrasound therapy with muscle energy technique (Group B) on improving functional ability in subjects with Trapezitis.

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Reliability and validity of the Mizo-version of neck disability index for non-specific neck pain in the rural North-East Indian population

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195929 ◽

2019 ◽

Vol 8 (1) ◽

pp. 317

Author(s):

Andrew Lalchhuanawma ◽

Divya Sanghi

Keyword(s):

Neck Pain ◽

Correlation Coefficient ◽

Rating Scale ◽

Neck Disability Index ◽

Reliability And Validity ◽

East Indian ◽

North East ◽

Study Results ◽

Significant Difference ◽

Neck Disability

Background: The Neck Disability Index (NDI) is an important self-assessment tool used extensively worldwide, in clinical practice with implications into scientific research fields. It is used to assess the extent of pain and levels of functional disability associated with neck pain. The NDI consists of 10 items where each item was scored from a scale of 0 to 5 giving the maximum score possible to 50. Though proven to be a reliable instrument in the English-speaking population, the NDI has never been validated and culturally adapted in the Mizo language among the rural north-east Indian region where English is not spoken as means of communication. The aim is to translate and cross culturally adapt the NDI into Mizo tawng (official language of Mizoram) with the objective of establishing reliability and validity of the M-NDI in patients with non-specific neck pain.Methods: A total of 49 subjects participated voluntarily from the rural primary health care, Lunglei district, Mizoram. Subject having chronic non-specific neck pain lasting more than 3 months were included after taking a written formal consent.Results: The internal consistency determined by Cronbach alpha, and the Intraclass Correlation Coefficient (ICC) using the test-retest reliability showed a good and an excellent reliability respectively (α=0.82, ICC=0.97, 95% CI= 0.95-0.98). Construct validity was determined between the variables-Numerical Pain Rating Scale (NPRS) and NDI by Pearson’s correlation coefficient and found to have a good correlation r=0.89 and significant difference at p<0.001.Conclusions: The study results concluded the Mizo version of NDI to be easy to understand, reliable and valid instrument for measuring disability and functional limitations of daily activities in non-specific neck pain in the Mizo speaking population.

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Effect of Mechanical Neck pain on Neck Disability and Scapula position among School Teachers in Delhi and NCR

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i2.4672 ◽

2021 ◽

Vol 12 (2) ◽

pp. 1260-1265

Author(s):

Jyoti Kataria ◽

Bijender Sindhu ◽

Sonia Pawaria

Keyword(s):

Neck Pain ◽

Research Work ◽

Neck Disability Index ◽

Cervicogenic Headache ◽

Control Group ◽

School Teachers ◽

Significant Difference ◽

Slide Test ◽

Neck Disability ◽

Senior Secondary

Neck pain found to be most common musculoskeletal condition in office workers with 12-month prevalence. Mechanical neck pain can be classified into two categories in clinical studies mechanical neck pain which has patients without any identifiable anatomic cause and leaves patients having neurological dysfunctions cervicogenic headache and inflammatory disorders. Current research work has total of 150 participants out of which there were 100 females school teachers having mean age of 37.8 years(median 38 years) and 50 male school teachers having mean age 40 years (median 39 years). Participants included in the study were professionally active school teachers of primary, secondary and senior secondary. Scapula position and neck disability was examined as per keiblers lateral scapular slide test and Neck disability index. Total 150 teachers were included in the study 80 teachers having mechanical neck pain (study group) and 70 teachers not having mechanical neck pain (control group) statistically significant difference found in scapula position and neck disability. In the present research, it is found that there is statistically significant difference in scapula position protraction and upward rotation at three different levels as well as there are statistically significant changes observed in neck disability.

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A Study to find the effectiveness of Scapular Strengthening Exercise in patients with Cervical Dysfunction

Research Journal of Pharmacy and Technology ◽

10.52711/0974-360x.2021.00621 ◽

2021 ◽

pp. 3591-3594

Author(s):

Kotteeswaran. K ◽

Chiranjibi Kumar Nayak

Keyword(s):

Cervical Spine ◽

Neck Pain ◽

Neck Disability Index ◽

T Test ◽

Strengthening Exercise ◽

Significant Difference ◽

Group A ◽

Group B ◽

Neck Disability ◽

Cervical Spine Dysfunction

Background: Cervical spine dysfunction is a cause of neck pain. The cause for it is believed to be a disorder (most likely malalignment) of the pain-sensitive facet joints (which may also be due to disc disruption). Dysfunction can also cause secondary muscle spasm, which can may lead to more pain and stiffness. Objective: To find the effectiveness of SNAGs and scapular strengthening exercises in the patients with chronic cervical dysfunction. To find the Neck disability index (NDI) score difference between the functional activities of experimental group and conventional treatment group. Methodology: According to inclusion and exclusion criteria a prior to the study, the principal researcher explained the procedures to all the subjects and inform consent obtained, 30 subjects taken through Random block design and numbering was done for all the subjects. All the odd numbers in one group and all the even numbers in another group are allocated by random table where each group had 15 subjects. The collected data was tabulated and analyzed using descriptive and inferential statistics. To all parameters mean and standard deviation (SD) were used. Paired t-test was used to analyze significant changes between pre-test and post-test measurements. Unpaired t-test was used to analyze significant changes between two groups. Result: rom statistical analysis made with the quantitative data revealed statistically significant difference between the Group A and Group B, and also within the group. The Posttest mean value of Neck Disability Index (NDI) in group A is 12.00 and in group B is 13.80. This shows that Neck Disability Index (NDI) in Group B disability value were comparatively more than Group A disability value, P<0.0001. Conclusion: This study shows better improvement in reducing cervical spine dysfunction (neck pain) by scapular strengthening exercise than resisted neck isometrics. Both the techniques can be used in clinical practice.

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Effect of neck range of motion exercises on neck disability and pain among patients undergoing thyroidectomy

Clinical Nursing Studies ◽

10.5430/cns.v8n4p1 ◽

2020 ◽

Vol 8 (4) ◽

pp. 1

Author(s):

Om Elhana Kamel Abo Shehata ◽

Omima Said M.H. Shehata ◽

Seham Mohamed Abd elalem

Keyword(s):

Neck Pain ◽

Range Of Motion ◽

Neck Disability Index ◽

Pain Scale ◽

Control Group ◽

Surgical Performance ◽

Surgical Department ◽

Significant Difference ◽

Neck Disability ◽

And Control

Objective: Thyroidectomy is a surgery in which head and neck became extended during operation to facilitate surgical performance. Patients experience neck pain and limitation to the range of motion following surgery. The study’s aim was to assess the effect of neck range of motion exercises on neck disability and pain among patients undergoing thyroidectomy.Methods: A quasi-experimental research design was utilized, the research was carried out at the surgical department in Shebin Emergency Hospital, at Shebin El-Kom District, Menoufia Governorate, Egypt. Sample; 90 adult subjects undergoing thyroidectomy and are welcoming to participate in the current research. Four Instruments for data collection: Instrument (1): Interview questionnaire sheet consists of two parts to assess subjects’ socio-demographic and medical data. Instrument (2): Visual analog pain scale to rate the patients’ level of pain intensity. Instrument (3): Neck disability index to assess neck pain and its effect on patients’ ability to perform daily activities. Instrument (4): Compliance assessment sheet to follow the patient’s adherence with neck range of motion exercise.Results: There was no statistically significant difference found between study and control group socio-demographic characteristics and medical history while there was a statistically significant difference between study and control group concerning neck disability and pain after one week and four weeks post-operative thyroidectomy.Conclusions: Patient compliance with a range of motion exercises significantly improves neck movement in order to be able to carry out daily life activities and reducing pain for the study group in comparison with the control group.Recommendation: Nurses who work in the general surgery department should include a neck range of motion exercises in providing the care and follow up protocol for the patients undergoing thyroidectomy.

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