scholarly journals Is the Severity of Cervical Foraminal Stenosis Related to the Severity and Sidedness of Symptoms?

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1743
Author(s):  
Han-Dong Lee ◽  
Chang-Hoon Jeon ◽  
Nam-Su Chung ◽  
Ha-Seung Yoon ◽  
Hee-Woong Chung
Keyword(s):  
Clinical Symptoms ◽  
Neck Disability Index ◽  
Total Count ◽  
Foraminal Stenosis ◽  
Arm Pain ◽  
Vas Scores ◽  
Left And Right ◽  
The Mean ◽  
Neck Disability ◽  
The Relationship

(1) Background: Cervical foraminal stenosis (CFS) is a common cause of axial neck and arm pain. The aim of this study was to determine the relationship between the severity of CFS and clinical symptoms in terms of severity and sidedness. (2) Methods: We retrospectively reviewed 75 consecutive patients with degenerative CFS. We graded 900 foramina from C3–4 to T1–2 using Park’s grading system. We collected visual analogue scale (VAS) and neck disability index (NDI) values from the neck and both arms. We analyzed the relationships with CFS grades and total number. We defined four types of left/right dominance of CFS (none, left-dominant, right-dominant, and both) by comparing left and right sides using total counts and maximal grade of CFS, respectively. We compared arm pain sidedness (no arm pain, left-only, right only, and bilateral) among different left and right CFS dominance types. (3) Results: Mean neck and left and right arm VAS scores were 4.4 ± 2.5, 4.9 ± 1.6, and 4.6 ± 2.0, respectively. The mean total NDI was 16.0 ± 8.0. The CFS grade at C3–4 and total count were correlated with neck VAS. Arm VAS was also correlated with CFS grade and total counts. Total NDI score was not correlated with radiological parameters. The presence and sidedness of arm pain were significantly different between left and right CFS dominance groups divided by total count of grade 2 and 3 CFS. (4) Conclusions: The CFS grade and total count were correlated with neck and arm VAS. Arm pain occurred more frequently on the side with more grade 2 and 3 CFS.

High prevalence of heterotopic ossification after cervical disc arthroplasty: outcome and intraoperative findings following explantation of 22 cervical disc prostheses

2012 ◽  
Vol 17 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Christopher Brenke ◽  
Johann Scharf ◽  
Kirsten Schmieder ◽  
Martin Barth
Keyword(s):  
Neck Disability Index ◽  
Adjacent Segment Degeneration ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Adjacent Segment ◽  
Analog Scale ◽  
Osteophyte Formation ◽  
High Prevalence ◽  
The Mean ◽  
Neck Disability

Object Cervical disc arthroplasty (CDA) has been increasingly used for the treatment of cervical disc herniations. However, the impact of CDA on adjacent-segment degeneration and the degree of heterotopic ossification (HO) of the treated segment remain a subject of controversy. Due to a product failure of the Galileo-type disc prosthesis, 22 of these devices were explanted. The radiological and clinical course in each case was investigated in detail with an emphasis on the incidence of HO and facet joint degeneration 18 months following the operation. Intraoperative findings regarding ossification and implant fixation were documented. Thus, the authors were able to describe the true rate of adjacent-segment degeneration and HO following CDA and the clinical relevance thereof. Methods In all 22 patients, functional radiographic imaging was performed prior to surgery, 3 and 12 months after surgery, and prior to disc prosthesis explantation. At all time points, the range of motion (ROM) in the operated and adjacent segments was determined. A motion index was calculated using the preoperative and all postoperative ROMs (preoperative ROM/postoperative ROM). Computed tomography was used preoperatively to measure the height of the index segment, extent of HO, and the degree of the progression of facet arthrosis, and was used postoperatively prior to prosthesis explantation. Patients completed clinical questionnaires that included a visual analog scale and the Neck Disability Index. Results The motion index of the index segment declined gradually from 1.4 at 3 months postoperative to 1.2 prior to explantation, while the motion index of the adjacent upper segment increased from 0.9 to 1.3. The mean ROM of the index segment was 10.4° ± 6.7°, and fusion was observed in 2 (9%) of the 22 patients. Prosthesis migration was present in 3 patients (13.6%). Severe HO (Grades 3 and 4) was present in 17.4%. Computed tomography showed a significant increase of segmental height of the index segment (1.6 ± 1.1 mm, p = 0.035), and a significant increase of left-sided lateral osteophytes (1.7 ± 2.1 mm, p = 0.009). The incidence of severe osteophyte formation (> 2 mm) occurred in 40%. Intraoperative findings reflected the results from CT, with primary lateral proliferation of osteophytes found in approximately 25% of patients. The mean visual analog scale scores were 3.8 ± 2.7 (neck) and 2.4 ± 2.5 (arms), and the mean Neck Disability Index score was 30 ± 22. No correlation was found between radiological and clinical parameters. Conclusions In this study, a higher incidence of HO after CDA could be demonstrated using CT, compared with studies using fluoroscopy only. However, patient selection and/or the operative technique might have contributed to the high prevalence of osteophyte formation. Thus, the exact indication for CDA has to be reconsidered. Because implant migration was detected, using fixation in the present CDA model appears suboptimal.

scholarly journals Motion-Preserving Navigated Primary Internal Fixation of Unstable C1 Fractures

2020 ◽  
Vol 14 (4) ◽  
pp. 466-474
Author(s):  
Shanmuganathan Rajasekaran ◽  
Dilip Chand Raja Soundararajan ◽  
Ajoy Prasad Shetty ◽  
Rishi Mugesh Kanna
Keyword(s):  
Neck Disability Index ◽  
Optimal Placement ◽  
Range Of Movement ◽  
Ct Guided ◽  
Duration Of Surgery ◽  
The Mean ◽  
The Right ◽  
Neck Disability ◽  
Displaced Fracture

Study Design: Prospective observational study.Purpose: To assess the safety, efficacy, and benefits of computed tomography (CT)-guided C1 fracture fixation.Overview of Literature: The surgical management of unstable C1 injuries by occipitocervical and atlantoaxial (AA) fusion compromises motion and function. Monosegmental C1 osteosynthesis negates these drawbacks and provides excellent functional outcomes.Methods: The patients were positioned in a prone position, and cranial traction was applied using Mayfield tongs to restore the C0–C2 height and obtain a reduction in the displaced fracture fragments. An intraoperative, CT-based navigation system was used to enable the optimal placement of C1 screws. A transverse rod was then placed connecting the two screws, and controlled compression was applied across the fixation. The patients were prospectively evaluated in terms of their clinical, functional, and radiological outcomes, with a minimal follow-up of 2 years.Results: A total of 10 screws were placed in five patients, with a mean follow-up of 40.8 months. The mean duration of surgery was 77±13.96 minutes, and the average blood loss was 84.4±8.04 mL. The mean combined lateral mass dislocation at presentation was 14.6±1.34 mm and following surgery, it was 5.2±1.64 mm, with a correction of 9.4±2.3 mm (<i>p</i> <0.001). The follow-up CT showed excellent placement of screws and sound healing. There were no complications and instances of AA instability. The clinical range of movement at 2 years in degrees was as follows: rotation to the right (73.6°±9.09°), rotation to the left (71.6°±5.59°), flexion (35.4°±4.5°), extension (43.8°±8.19°), and lateral bending on the right (28.4°±10.45°) and left (24.8°±11.77°). Significant improvement was observed in the functional Neck Disability Index from 78±4.4 to 1.6±1.6. All patients returned to their occupation within 3 months.Conclusions: Successful C1 reduction and fixation allows a motion-preserving option in unstable atlas fractures. CT navigation permits accurate and adequate monosegmental fixation with excellent clinical and radiological outcomes, and all patients in this study returned to their preoperative functional status.

Estimating EQ-5D values from the Neck Disability Index and numeric rating scales for neck and arm pain

2014 ◽  
Vol 21 (3) ◽  
pp. 394-399 ◽  
Author(s):  
Leah Y. Carreon ◽  
Kelly R. Bratcher ◽  
Nandita Das ◽  
Jacob B. Nienhuis ◽  
Steven D. Glassman
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Regression Model ◽  
Pain Score ◽  
Rating Scales ◽  
Neck Disability Index ◽  
Correlation Coefficients ◽  
Arm Pain ◽  
Pain Scores ◽  
Neck Disability

Object The Neck Disability Index (NDI) and numeric rating scales (0 to 10) for neck pain and arm pain are widely used cervical spine disease–specific measures. Recent studies have shown that there is a strong relationship between the SF-6D and the NDI such that using a simple linear regression allows for the estimation of an SF-6D value from the NDI alone. Due to ease of administration and scoring, the EQ-5D is increasingly being used as a measure of utility in the clinical setting. The purpose of this study is to determine if the EQ-5D values can be estimated from commonly available cervical spine disease–specific health-related quality of life measures, much like the SF-6D. Methods The EQ-5D, NDI, neck pain score, and arm pain score were prospectively collected in 3732 patients who presented to the authors' clinic with degenerative cervical spine disorders. Correlation coefficients for paired observations from multiple time points between the NDI, neck pain and arm pain scores, and EQ-5D were determined. Regression models were built to estimate the EQ-5D values from the NDI, neck pain, and arm pain scores. Results The mean age of the 3732 patients was 53.3 ± 12.2 years, and 43% were male. Correlations between the EQ-5D and the NDI, neck pain score, and arm pain score were statistically significant (p < 0.0001), with correlation coefficients of −0.77, −0.62, and −0.50, respectively. The regression equation 0.98947 + (−0.00705 × NDI) + (−0.00875 × arm pain score) + (−0.00877 × neck pain score) to predict EQ-5D had an R-square of 0.62 and a root mean square error (RMSE) of 0.146. The model using NDI alone had an R-square of 0.59 and a RMSE of 0.150. The model using the individual NDI items had an R-square of 0.46 and an RMSE of 0.172. The correlation coefficient between the observed and estimated EQ-5D scores was 0.79. There was no statistically significant difference between the actual EQ-5D score (0.603 ± 0.235) and the estimated EQ-5D score (0.603 ± 0.185) using the NDI, neck pain score, and arm pain score regression model. However, rounding off the coefficients to fewer than 5 decimal places produced less accurate results. Conclusions The regression model estimating the EQ-5D from the NDI, neck pain score, and arm pain score accounted for 60% of the variability of the EQ-5D with a relatively large RMSE. This regression model may not be sufficient to accurately or reliably estimate actual EQ-5D values.

Postnatal Development of a Left-Right Atrial Pressure Gradient

1956 ◽  
Vol 186 (3) ◽  
pp. 521-524 ◽  
Author(s):  
A. van Harreveld ◽  
F. E. Russell
Keyword(s):  
Left Ventricle ◽  
Pressure Gradient ◽  
Left Atrium ◽  
Postnatal Development ◽  
Right Atrial ◽  
Left And Right ◽  
The Mean ◽  
The Right ◽  
The Relationship ◽  
Equal Thickness

The mean left and right atrial pressures were measured in six groups of 10 kittens each. One group was examined between the 12th and 24th hour after birth, one group after 3 days, after 1 week, 2 weeks, 1 month and 2 months. The left and right atrial pressures were almost equal in the first group. With age an increasing left to right pressure gradient developed. In the oldest group the pressure in the left atrium was almost twice as great as in the right. Parallel with the pressure gradient a difference developed in the wall thicknesses of the left and right ventricles. At birth the ventricular walls were of about equal thickness; at age 2 months the left ventricle wall was more than twice as thick as the right. The relationship between ventricle wall thicknesses and atrial pressures is discussed.

scholarly journals Can segmental mobility be increased by cervical arthroplasty?

2017 ◽  
Vol 42 (2) ◽  
pp. E3 ◽  
Author(s):  
Hsuan-Kan Chang ◽  
Chih-Chang Chang ◽  
Tsung-Hsi Tu ◽  
Jau-Ching Wu ◽  
Wen-Cheng Huang ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Range Of Motion ◽  
Clinical Outcomes ◽  
Japanese Orthopaedic Association ◽  
Neck Disability Index ◽  
Cervical Disc ◽  
Segmental Mobility ◽  
Arm Pain ◽  
The Mean ◽  
The Difference

OBJECTIVE Many reports have successfully demonstrated that cervical disc arthroplasty (CDA) can preserve range of motion after 1- or 2-level discectomy. However, few studies have addressed the extent of changes in segmental mobility after CDA or their clinical correlations. METHODS Data from consecutive patients who underwent 1-level CDA were retrospectively reviewed. Indications for surgery were medically intractable degenerative disc disease and spondylosis. Clinical outcomes, including visual analog scale (VAS)–measured neck and arm pain, Neck Disability Index (NDI), and Japanese Orthopaedic Association (JOA) scores, were analyzed. Radiographic outcomes, including C2–7 Cobb angle, the difference between pre- and postoperative C2–7 Cobb angle (ΔC2–7 Cobb angle), sagittal vertical axis (SVA), the difference between pre- and postoperative SVA (ΔSVA), segmental range of motion (ROM), and the difference between pre- and postoperative ROM (ΔROM), were assessed for their association with clinical outcomes. All patients underwent CT scanning, by which the presence and severity of heterotopic ossification (HO) were determined during the follow-up. RESULTS A total of 50 patients (mean age 45.6 ± 9.33 years) underwent a 1-level CDA (Prestige LP disc) and were followed up for a mean duration of 27.7 ± 8.76 months. All clinical outcomes, including VAS, NDI, and JOA scores, improved significantly after surgery. Preoperative and postoperative ROM values were similar (mean 9.5° vs 9.0°, p > 0.05) at each indexed level. The mean changes in segmental mobility (ΔROM) were −0.5° ± 6.13°. Patients with increased segmental mobility after surgery (ΔROM > 0°) had a lower incidence of HO and HO that was less severe (p = 0.048) than those whose ΔROM was < 0°. Segmental mobility (ROM) was significantly lower in patients with higher HO grade (p = 0.012), but it did not affect the clinical outcomes. The preoperative and postoperative C2–7 Cobb angles and SVA remained similar. The postoperative C2–7 Cobb angles, SVA, ΔC2–7 Cobb angles, and ΔSVA were not correlated to clinical outcomes after CDA. CONCLUSIONS Segmental mobility (as reflected by the mean ROM) and overall cervical alignment (i.e., mean SVA and C2–7 Cobb angle) had no significant impact on clinical outcomes after 1-level CDA. Patients with increased segmental mobility (ΔROM > 0°) had significantly less HO and similarly improved clinical outcomes than those with decreased segmental mobility (ΔROM < 0°).

Bioabsorbable instrumentation for single-level cervical degenerative disc disease: a radiological and clinical outcome study

2009 ◽  
Vol 11 (5) ◽  
pp. 529-537 ◽  
Author(s):  
Andre Tomasino ◽  
Harry Gebhard ◽  
Karishma Parikh ◽  
Christian Wess ◽  
Roger Härtl
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Neck Disability Index ◽  
Fusion Rate ◽  
Analog Scale ◽  
Single Level ◽  
Arm Pain ◽  
Neck Disability ◽  
Metallic Plates

Object The authors present the radiological and clinical outcome data obtained in patients who underwent single-level anterior cervical discectomy and fusion (ACDF) for cervical spondylosis and/or disc herniation; bioabsorbable plates were used for instrumentation. The use of metallic plates in ACDF has gained acceptance as a stabilizing part of the procedure to increase fusion rates, but when complications occur with these devices, the overall effectiveness of the procedure is compromised. As a possible solution, bioabsorbable implants for ACDF have been developed. This study investigates the feasibility and radiological and clinical outcomes of the bioabsorbable plates for ACDF. Methods The radiological and clinical outcomes of 30 patients were investigated retrospectively. All patients presented with cervical radiculopathy or myelopathy and underwent single-level ACDF in which a bioabsorbable anterior cervical plate and an allograft bone spacer were placed at a level between C-3 and C-7. Radiological outcome was assessed based on the fusion rate, subsidence, and Cobb angle of the surgical level. Clinical outcome was determined by using a visual analog scale, the Neck Disability Index, and the Odom criteria. Results There were no intraoperative complications, and no hardware failure was observed. No signs or symptoms of adverse tissue reaction caused by the implant were seen. Two reoperations were necessary due to postoperative blood collections. The overall complication rate was 16.7%. After 6 months, radiographic fusion was seen in 92.3% of patients. Subsidence at 11.3 ± 7.2 months was 3.1 ± 5.8 mm (an 8.2% change over the immediately postoperative results), and the change in the sagittal curvature was –2.7 ± 2.7°. The visual analog scale score for neck and arm pain and Neck Disability Index improved significantly after surgery (p < 0.001). Overall at 19.5 months postoperatively, 83% of the patients had favorable outcomes based on the Odom criteria. Conclusions Absorbable instrumentation provides better stability than the absence of a plate but graft subsidence and deformity rates may be higher than those associated with metal implants. There were no device-related complications, but adverse late effects cannot be excluded. The fusion rate and outcome are comparable to the results achieved with metallic plates. The authors were satisfied with the use of bioabsorbable plates as a reasonable alternative to metal, avoiding the need for lifelong metallic implants.

scholarly journals P.229 Epidemiology and Outcomes of Neck Pain Following Surgery for Degenerative Cervical Radiculopathy

2021 ◽  
Vol 48 (s3) ◽  
pp. S86-S86
Author(s):  
MA MacLean ◽  
A Dakson ◽  
F Xavier ◽  
SD Christie ◽  
C Investigators
Keyword(s):  
Neck Pain ◽  
Short Form ◽  
Neck Disability Index ◽  
Cervical Radiculopathy ◽  
Research Network ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Arm Pain ◽  
Composite Scale ◽  
Neck Disability

Background: Many studies have demonstrated improved arm pain (AP) following surgery for degenerative cervical radiculopathy (DCR); however, axial neck pain (NP) is generally not felt to improve. The purpose of this study was to determine whether surgery for DCR improves NP. Methods: A ambispective cohort study of the Canadian Spine Outcomes Research Network (CSORN) registry for patients who received 1-level, 2-level, 3-level ADCF (anterior cervical discectomy and fusion) or cervical disc arthroplasty (CDA) for DCR. Outcomes: 12-month post-operative Visual Analogue Scale for NP (VAS-NP), Neck Disability Index (NDI), VAS for AP (VAS-AP), Short-Form Physical Health Composite Scale (SF36-PCS), and Mental Health Composite Scale (SF36-MCS). Results: We identified 603 patients with DCR. CDA patients were the youngest (ANOVA; p<0.001). Patients reported similar pre-operative AP, NP, disability, and health-related quality of life, regardless of procedure (ANOVA; all P>0.05). All procedures offered a statistically significant reduction in VAS-NP, VAS-AP, and NDI (ANOVA; all P<0.001). Mean change from baseline in NP, AP, and disability, were similar across procedures. At 12 months, mean reduction in VAS-AP, VAS-NP, and NDI exceeded minimal clinically important differences for nearly all procedures. Conclusions: Patients undergoing surgery for DCR can expect a clinically significant, approximate 50% reduction in NP, AP, and neck-related disability.

scholarly journals Agreement between Original and Rasch-Approved Neck Disability Index

2020 ◽  
Author(s):  
ZE LU ◽  
Joy C. MacDermid ◽  
Goris Nazari
Keyword(s):  
Neck Pain ◽  
Neck Disability Index ◽  
Secondary Data ◽  
Study Data ◽  
Mean Difference ◽  
Patient Status ◽  
Alternate Forms ◽  
The Mean ◽  
Mean Differences ◽  
Neck Disability

Abstract Background: Given the high prevalence of neck pain, the neck disability index (NDI) has been used to evaluate patient status and treatment outcomes. Modified versions were proposed as solutions to measurement deficits in the NDI. However, the original 10-item NDI was scored out of 50 and is still the most frequently administered version. Examining the extent of agreement between traditional and Rasch-based versions using Bland-Altman (B&A) plots will inform our understanding of score differences that might rise from using different versions. Therefore, the objective of current study was to describe the extent of agreement between different versions of NDI.Methods: The current study was a secondary data analysis. The study data was compiled from two prospectively collected data sources. We performed a comprehensive literature search to identify Rasch approved NDI within four databases including Embase, Medline, PubMed, and Google Scholar. Alternate forms and scorings were compared to each other and to the standard NDI. We graphed B&A plots and calculated the mean difference and the 95% limits of agreement (LoA; ±1.96 times the standard deviation).Results: Two Rasch approved alternative versions (8 vs 5 items) were identified from 303 screened publications. We analyzed data from 201 (43 males and 158 females) patients attending community clinics for neck pain. We found that the mean difference was approximately 10% of the total score between the 10-item and 5-item (-4.6 points), whereas the 10-item versus 8-item and 8-item versus 5-item had smaller mean differences (-2.3 points). The B&A plots displayed wider 95% LoA for the agreement between 10-item and 8-item (LoA: -12.0, 7.4) and 5-item (LoA: -14.9, 5.8) compared with the LoA for the 8-item and 5-item (LoA: -7.8, 3.3). Conclusion: Two Rasch-based NDI solutions (8 vs 5 items) which differ in number of items and conceptual construction are available to provide interval level scoring. They both provide scores that are substantially different from the ordinal NDI, which does not provide interval level scoring. Smaller differences between the two Rasch solutions exist and may relate to the items included. Due to the size and unpredictable nature of the bias between measures, they should not be used interchangeably.

scholarly journals Patient-Reported Allergies, a Marker of Preoperative Pain and Disability in Elective Spine Surgery

2019 ◽  
Vol 10 (5) ◽  
pp. 592-597
Author(s):  
Keith W. Lyons ◽  
Tracy M. Borsinger ◽  
Adriana P. Lucas ◽  
Kevin J. McGuire ◽  
Adam M. Pearson ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Neck Disability Index ◽  
Negative Relationship ◽  
Preoperative Pain ◽  
Significant Negative Relationship ◽  
Patient Reported ◽  
The Mean ◽  
And Function ◽  
The Relationship

Study Design: Retrospective review. Objective: Previous literature demonstrates mixed results regarding the relationship between patient-reported allergies and pain, function, and satisfaction scores. The objective of this study was to investigate the correlation between patient-reported allergies and preoperative Oswestry Disability Index (ODI), Neck Disability Index (NDI), and Patient-Reported Outcomes Measurement System (PROMIS) scores. Methods: All patients undergoing elective cervical, lumbar procedures between May 2017 and October 2018 were included. Baseline demographic information was recorded, as well as all reported allergies or adverse reactions. Preoperative PROMIS, ODI, and NDI scores were recorded. Hierarchical multiple linear regressions were used to assess the relationship between total number of allergies and the preoperative pain and function scores. Results: A total of 570 patients were included (476 lumbar, 94 cervical). The mean number of allergies reported was 1.89 ± 2.32. The mean preoperative ODI and NDI scores were 46.39 ± 17.67 and 43.47 ± 16.51, respectively. The mean preoperative PROMIS Physical Health and PROMIS Mental Health scores were 37.21 ± 6.54 and 43.89 ± 9.26, respectively. Hierarchical multiple linear regression showed that total number of reported allergies shared a statistically significant negative relationship with all of the following scores: ODI ( B = 0.83, P = .02), NDI ( B = 1.45, P = .02), PROMIS Physical Health ( B = −0.29, P = .013), and PROMIS Mental Health ( B = −0.38, P = .024). Conclusions: Patient-reported allergies share a statistically significant negative relationship with preoperative pain and function scores; as patients have increasing total number of allergies, the ODI/NDI scores become worse (increase) and the PROMIS scores become worse (decrease).

Comparison of effectiveness of muscle energy technique with Mulligan mobilization in patients with non-specific neck pain

2021 ◽  
pp. 1-10
Author(s):  
Anam Manzoor ◽  
Naveed Anwar ◽  
Kehkshan khalid ◽  
Rizwan Haider ◽  
Mehwish Saghir ◽  
...  
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Functional Status ◽  
Group Analysis ◽  
Neck Disability Index ◽  
Muscle Energy Technique ◽  
The Mean ◽  
Muscle Energy ◽  
Neck Disability ◽  
Group 1

Abstract Background: Neck pain is very common in general population. The onset of pain may be sudden or insidious, recurrent or persistent in nature. The prevalence of neck pain in Pakistan is not known. The neck pain that persists for more than 3 months is called chronic neck pain. There are different physiotherapy techniques to manage nonspecific neck pain including Mulligan mobilization and muscle energy technique. Objective: to compare the efficacy of muscle energy technique with Mulligan mobilization in patients having non-specific neck pain. Methodology: This quasi-experimental study was conducted at Mayo hospital physiotherapy department, Lahore. The study duration was six months from March 2017 to September 2017. Sample size calculated was 56 by using g power software. Random sampling technique was used. Subjects were divided into two groups. In the group 1 patients; muscle energy technique was used and in group 2; Mulligan mobilization as natural apophyseal glides (NAGs) and sustained natural apophyseal glides (SNAGs) were used. The pain intensity, functional status of neck and cervical range of motion (ROM) were measured before and after treatment session by using visual analogue (VAS), neck disability index (NDI) and goniometer. Independent t-test was applied for between group analysis. Results: The mean age of participants is 36.89±9.28. The mean improvement in pain intensity was 3.61 for the Muscle energy technique group and for Mulligan group it was 4.86 after three weeks’ treatment. The functional status score according to neck disability index (NDI) pre-treatment mean for the group 1 was 12.04±4.69 and Continuous....

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