Short-term effects of an upper cervical spine traction-manipulation program in patients with cervicogenic dizziness: A case series study

BACKGROUND: Damage on the somatosensory system could cause sensation of dizziness, a condition known as cervicogenic dizziness (CD). Manual physical therapy has shown beneficial effects, relieving the symptoms of cervicogenic dizziness. However, the effect of upper cervical spine manipulation is unknown, as this is a technique that respects the International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT) safety criteria. OBJECTIVE: To assess the effects of upper cervical spine traction-manipulation in subjects with cervicogenic dizziness. METHODS: This was a descriptive case series study. Treatment focused on the upper cervical spine manipulation procedure. Evaluation was performed before and after the treatment. Variables recorded include upper and lower cervical range of motion, Cervical Flexion-Rotation Test (CFRT), dizziness intensity and cervical pain (VAS), self-perceived dizziness measured with Dizziness Handicap Inventory (DHI) and subjective perception of outcome (GROC-scale). RESULTS: Ten subjects were recruited. After the treatment protocol, there was an increased range of movement towards the most restricted side, as measured by the CFRT (p< 0.001), decreased intensity of dizziness (p< 0.001) and intensity of pain (p< 0.001). Functional capacity also improved after the intervention (p< 0.011). CONCLUSION: Upper cervical spine manipulation may decrease dizziness intensity and cervical pain and improve functional ability and upper cervical spine mobility in patients with cervicogenic dizziness.

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An upper cervical spine treatment protocol for cervicogenic dizziness: a randomized controlled trial

Physiotherapy Theory and Practice ◽

10.1080/09593985.2021.1972500 ◽

2021 ◽

pp. 1-10

Author(s):

Andoni Carrasco-Uribarren ◽

Jacobo Rodríguez-Sanz ◽

Carlos López-de-Celis ◽

Pablo Fanlo-Mazas ◽

Sara Cabanillas-Barea

Keyword(s):

Randomized Controlled Trial ◽

Cervical Spine ◽

Controlled Trial ◽

Treatment Protocol ◽

Upper Cervical Spine ◽

Randomized Controlled ◽

Upper Cervical ◽

Cervicogenic Dizziness

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Ventral C1 Fracture Combined with Congenital Posterior Cleft: What to Do?

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0037-1603636 ◽

2017 ◽

Vol 79 (01) ◽

pp. 066-072

Author(s):

Philipp Dammann ◽

Tobias Schoemberg ◽

Yahya Ahmadipour ◽

Michael Payer ◽

Ulrich Sure ◽

...

Keyword(s):

Cervical Spine ◽

Full Range ◽

Rare Condition ◽

Posterior Arch ◽

Upper Cervical Spine ◽

Spine Mobility ◽

Upper Cervical ◽

Congenital Cleft ◽

Transverse Atlantal Ligament

Background and Objective We present a treatment approach for a rare condition of patients with a ventral C1 fracture and a congenital cleft in the posterior arch (half-ring Jefferson fracture) with an intact transverse atlantal ligament. Our technique aims to achieve stability of the atlanto-occipital and atlantoaxial joints while preserving mobility of the upper cervical spine. Patients and Methods Two male patients, 43 years and 29 years of age, respectively, were admitted to our hospital due to a fracture of the ventral arch of the atlas with no damage of the transverse atlantal ligament. Both men also presented a congenital cleft of the posterior arch. Initial conservative management with a halo-thoracic vest was performed in one case and failed. As a result, surgical treatment was performed in both cases using bilateral C1 mass screws and a transverse connector. Results The patients showed no neurologic deficits on follow-up examination 4 weeks after surgery with a full range of head and neck motion. Computed tomography (CT) showed no dislocation of the implanted material with good dorsal alignment and a stable ventral fracture distance. Follow-up CT showed osseous stability in both cases with the beginning of bony ossification of the bone graft. Conclusion Isolated instable fractures of the ventral arch of the atlas with a congenital cleft of the posterior arch with no damage of the transverse atlantal ligament can be stabilized using bilateral C1 mass screws and a transverse connector preserving upper cervical spine mobility.

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The upper cervical spine tumor pathology C1-C2 - therapeutic attitude

Romanian Neurosurgery ◽

10.2478/v10282-012-0012-3 ◽

2012 ◽

Vol 19 (4) ◽

pp. 251-263 ◽

Cited By ~ 2

Author(s):

D. Serban ◽

N.A. Calina ◽

Fl. Exergian ◽

M. Podea ◽

C. Zamfir ◽

...

Keyword(s):

Cervical Spine ◽

Posterior Approach ◽

Surgical Techniques ◽

Neurological Deficits ◽

Upper Cervical Spine ◽

Cervical Pain ◽

Presenting Symptoms ◽

Spine Tumors ◽

Tumor Pathology ◽

Upper Cervical

Abstract Surgical treatment of upper cervical spine tumors, whether they are vertebral, epidural, subdural or intramedullary, raises technical and decisional difficulties regarding the approach of the region as well as in maintaining its stability. The authors performed a retrospective study on C1, C2 spinal tumor pathology, managed surgically in the Spinal Surgery Department of Bagdasar Arseni Clinical Hospital, between January 2007 and December 2011. We included in the study 44 patients, operated for C1, C2 cervical spine tumors, 23 men and 21 women with ages between 13 and 71 years. The pathology included 24 C1-C2 vertebral tumors, 11 subdural tumors, 2 epidural tumors and 7 intramedullary tumors. Presenting symptoms were cervical pain, occipital neuralgia, medullary compression syndrome, and/or cranio-spinal junction instability. The purpose of surgery was to establish a histopathologic diagnosis and to decompress the neural elements by attempting a total tumor removal as well as to stabilize the cranio - cervical junction in order to improve the patient's quality of life. The approach was chosen based on tumor location, prognosis and the need for fixation. For 6 patients an anterior approach was used, for 31 pacients we used a posterior approach and 7 patients required a combined anterior and posterior approach. Neurological improvement was observed in 17 patients, with a mean increase of 8 points on ASIA scale, 7 patients worsened immediately postoperatively with a mean decrease of 10 points on ASIA scale, (2 patients died), and 20 patients without neurological deficits preoperatively remained unchanged. In all cases where the craniospinal junction instability was the cause of occipito-cervical pain we noted the disappearence of pain after surgery. The development of new surgical techniques and fixation systems paved the way to a successful treatment for these difficult tumors, some of them considered inoperable in the past.

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Global and regional kinematics of the cervical spine during upper cervical spine manipulation: A reliability analysis of 3D motion data

Manual Therapy ◽

10.1016/j.math.2014.04.017 ◽

2014 ◽

Vol 19 (5) ◽

pp. 472-477 ◽

Cited By ~ 6

Author(s):

Pierre-Michel Dugailly ◽

Benoît Beyer ◽

Stéphane Sobczak ◽

Patrick Salvia ◽

Véronique Feipel

Keyword(s):

Cervical Spine ◽

Reliability Analysis ◽

Upper Cervical Spine ◽

3D Motion ◽

Motion Data ◽

Upper Cervical ◽

Cervical Spine Manipulation

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Does routine pin re-torquing of patients wearing a halo-thoracic orthosis reduce the need for pin replacement?

Prosthetics and Orthotics International ◽

10.1177/0309364614531279 ◽

2014 ◽

Vol 39 (4) ◽

pp. 338-341 ◽

Cited By ~ 1

Author(s):

Sue Fraser ◽

John P Coffey

Keyword(s):

Cervical Spine ◽

Case Series ◽

Case Description ◽

Common Complication ◽

Retrospective Case ◽

Initial Application ◽

Case Series Study ◽

Potential Improvement ◽

Series Study ◽

Halo Orthosis

Background: The halo orthosis is a treatment option currently used in Australia for cervical spine immobilisation following trauma, fracture and post surgical stabilisation. In a previous study, the authors reported halo pin replacement to be a common complication. The aim of this study was to investigate the potential correlation between routine halo pin re-torquing and the incidence of pin replacement. Case description and methods: A retrospective case series study was undertaken. A total of 258 charts were reviewed, with 170 patients included in the study. Patients were fitted with a Bremer HALO System with the initial application torque maintained by routine re-torquing throughout the duration of wear. Findings and outcomes: A total of 680 pins (4 per patient) were inserted during the initial application of the halo orthoses, with only six pins replaced (0.88%) throughout the duration of the study. Conclusion: The findings from this study demonstrate a potential correlation between routinely re-torquing halo pins and decreasing the incidence of pin replacement. Clinical relevance This case series study has identified a potential improvement in clinical management of patients wearing a halo-thoracic orthosis.

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Validity and reliability of two Smartphone applications to measure the lower and upper cervical spine range of motion in subjects with chronic cervical pain

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-181260 ◽

2019 ◽

Vol 32 (4) ◽

pp. 619-627 ◽

Cited By ~ 3

Author(s):

Jacobo Rodríguez-Sanz ◽

Andoni Carrasco-Uribarren ◽

Sara Cabanillas-Barea ◽

César Hidalgo-García ◽

Pablo Fanlo-Mazas ◽

...

Keyword(s):

Cervical Spine ◽

Range Of Motion ◽

Upper Cervical Spine ◽

Cervical Pain ◽

Smartphone Applications ◽

Validity And Reliability ◽

Upper Cervical

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Cervicogenic Headache: Results of Computer-Based Measurements of Cervical Spine Mobility in 15 Patients

Cephalalgia ◽

10.1046/j.1468-2982.1988.0801045.x ◽

1988 ◽

Vol 8 (1) ◽

pp. 45-48 ◽

Cited By ~ 30

Author(s):

V Pfaffenrath ◽

R Dandekar ◽

ETh Mayer ◽

G Hermann ◽

W Pöllmann

Keyword(s):

Cervical Spine ◽

Cervicogenic Headache ◽

Upper Cervical Spine ◽

Impaired Mobility ◽

Radiologic Evaluation ◽

Spine Mobility ◽

Upper Cervical ◽

Group A ◽

Computer Based ◽

Dorsal Flexion

Head and neck pain are often attributed to impaired mobility of the cervical spine. No established methods exist to examine such an impaired mobility objectively in patients with cervicogenic headache. Therefore, functional roentgenograms of the cervical spine in maximum ventral and dorsal flexion were analyzed in 15 patients with cervicogenic headache and in 18 controls. Qualitative radiologic evaluation showed no significant differences in either group. A computer-based technique to assess the mobility of the cervical spine demonstrated a statistically pronounced hypomobility of the craniocervical joints C0/C2 and an impaired overall mobility of the upper cervical spine (C0-C5) in the cervicogenic headache group. The most evident hypomotility was found in segment C0/C1. Interesting was, furthermore. a probably compensatory hypermotility in segment C6/C7. These findings did not correlate with the results of the qualitative radiologic evaluation.

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