scholarly journals Therapeutic Effects and Safety of Percutaneous Disc Decompression with Coblation Nucleoplasty in Cervical Vertigo: A Retrospective Outcome Study with 74 Consecutive Patients and Minimum 1-Year Follow-Up

2019 ◽  
Vol 3 (22;3) ◽  
pp. E205-E214
Author(s):  
Limin Rong
Keyword(s):  
Retrospective Study ◽  
Neck Pain ◽  
Pain Intensity ◽  
Clinical Outcomes ◽  
Clinical Efficacy ◽  
Rating Scale ◽  
Therapeutic Effects ◽  
Dizziness Handicap Inventory ◽  
Cervical Vertigo

Background: Surgical treatment of cervical vertigo has been rarely reported. This is the first retrospective study to evaluate the clinical outcomes of percutaneous disc decompression with coblation nucleoplasty (PDCN) for treatment of cervical vertigo. Objectives: To assess the clinical outcomes of patients with cervical vertigo who failed to improve with conservative care and who were subsequently treated with PDCN. Study Design: This study used a retrospective design. Setting: The research was conducted within an interventional vertigo management and spine practice. Methods: Seventy-four consecutive patients with cervical vertigo underwent PDCN and were followed for at least one year. Outcome measures included the dizziness intensity Visual Analog Scale (VAS), dizziness frequency, the Dizziness Handicap Inventory (DHI), and neck pain intensity. Clinical efficacy was assessed by rating scale and the modified MacNab evaluation criteria. Surgical complications during the operation and follow-up were also recorded. Results: The vertigo VAS score, frequency of dizziness, DHI, and neck pain intensity were all decreased significantly from evaluation before surgery to one week after surgery and to the last follow-up, giving a mean effective rate of 94.6% one week after surgery and 90.6% at the last follow-up. Good to excellent results were attained in 85.1% of these patients one week after PDCN and in 75.7% of the sufferers at the last follow-up (P < 0.001). There were 5 patients with transient adverse effects (6.25%) reported within the first month after surgery; they all recovered after conservative treatment. No neurological complications were found and no patient went on to spinal fusion surgery thereafter. Limitations: The rate of follow-up was 70% and a placebo effect cannot be excluded. There is no gold standard for the diagnosis and treatment of cervical vertigo so far. Conclusion: The clinical outcomes of PDCN for cervical vertigo were satisfactory in both the early and late postoperative period. PDCN is an effective, low-complication, minimally invasive procedure used to treat cervical vertigo. Further prospective randomized controlled trials are essential to verify this conclusion. Key words: Cervical vertigo, percutaneous disc decompression, coblation nucleoplasty, longterm outcome, dizziness intensity, dizziness frequency, dizziness handicap inventory, clinical efficacy, surgical complication, retrospective study

Is a combined programme of manual therapy and exercise more effective than usual care in patients with non-specific chronic neck pain? A randomized controlled trial

2019 ◽  
Vol 33 (12) ◽  
pp. 1908-1918 ◽  
Author(s):  
Lucia Domingues ◽  
Fernando Manuel Pimentel-Santos ◽  
Eduardo Brazete Cruz ◽  
Ana Cristina Sousa ◽  
Ana Santos ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Neck Pain ◽  
Usual Care ◽  
Pain Intensity ◽  
Manual Therapy ◽  
Rating Scale ◽  
Controlled Trial ◽  
Chronic Neck Pain ◽  
Randomized Controlled

Objective: The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP). Design: Randomized controlled trial. Setting: Outpatient care units. Subjects: Sixty-four non-specific CNP patients were randomly allocated to MET ( n = 32) or UC ( n = 32) groups. Interventions: Participants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy. Main measures: The primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment) and at a three-month follow-up. Results: Fifty-eight participants completed the study. No significant between-group difference was observed on disability and pain intensity at baseline. A significant between-group difference was observed on disability at three-week, six-week and three-month follow-up (median (P25–P75): 6 (3.25–9.81) vs. 15.5 (11.28–20.75); P < 0.001), favouring the MET group. Regarding pain intensity, a significant between-group difference was observed at six-week and three-month follow-up (median (P25–P75): 2 (1–2.51) vs. 5 (3.33–6); P < 0.001), with superiority of effect in MET group. Concerning the global perceived recovery, a significant between-group difference was observed only at the three-month follow-up ( P = 0.001), favouring the MET group. Conclusion: This study’s findings suggest that a combination of manual therapy and exercise is more effective than usual care on disability, pain intensity and global perceived recovery.

scholarly journals Shi’s Daoyin Therapy for Neck Pain: A Randomized Controlled Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Huihao Wang ◽  
Enyu Jiang ◽  
Kuan Wang ◽  
Zhen Deng ◽  
Hongsheng Zhan ◽  
...  
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Isometric Force ◽  
Controlled Trial ◽  
Neck Disability Index ◽  
Short Term ◽  
Significant Difference ◽  
Pain Patients

Objective. To compare the immediate and short term effectiveness of Shi’s Daoyin therapy (DT) rather than the Melbourne Protocol (MP) in terms of pain, mobility, and isometric strength of cervical muscles in nonacute nonspecific neck pain patients. Material and Methods. A total of 114 nonacute nonspecific neck pain patients aged 20~50 years were recruited and randomly assigned to be treated by either Shi’s DT or the MP. 56 cases and 54 cases received treatment for 3 weeks and were evaluated before and after intervention and at 3-week follow-up in Shi’s DT group and MP group, respectively. The outcome measures were Chinese version of the Neck Disability Index (NDI), cervical range of motion (ROM), maximal voluntary isometric force (MVIF), and pain intensity (Numeric Pain Rating Scale, NPRS). Results. All outcomes of both groups showed statistically significant improvements after the intervention and at 3-week follow-up (P < 0.05), while no statistically significant difference was found in NDI between groups. When followed up after 3 weeks, the ROM in axial rotation was significantly greater in the Shi’s DT group (P < 0.05), and the NPRS in the Shi’s DT group was significantly lower than the MP group (P < 0.05). At the end of the treatment period, the MVIF in lateral bending in the Shi’s DT group had a lower value (P = 0.044) than in the MP group, but there was no significant difference in flexion and extension between the two groups. Conclusions. Both Shi’s DT and MP groups demonstrated an obvious reduction in pain intensity and improvements in neck mobility after a short term follow-up period. The improvement of Shi’s DT in disability and pain during functional activities is generally similar to that of the MP for the treatment of nonacute nonspecific neck pain.

Radiographic and Clinical Outcomes of Surgical Treatment of Kümmell’s Disease With Thoracolumbar Kyphosis: A Minimal Two-Year Follow-Up

2021 ◽  
Author(s):  
Hao Cheng ◽  
Guo-dong Wang ◽  
Tao Li ◽  
Xiao-yang Liu ◽  
Jian-min Sun
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Sagittal Balance ◽  
Rating Scale ◽  
Clinical Results ◽  
Spinal Alignment ◽  
Thoracolumbar Kyphosis ◽  
Kummell’S Disease ◽  
Kümmell’S Disease

Abstract Background: To evaluate the short to mid-term radiographic and clinical outcomes of the restoration of normal spinal alignment and sagittal balance in the treatment of Kümmell’s disease with thoracolumbar kyphosis. Methods: Between February 2016 and May 2018,30 cases of Kümmell’s disease with thoracolumbar kyphosis were divided into two groups (A and B) according to whether the kyphosis was combined with neurological deficits.All of the cases underwent surgical treatment to regain the normal spinal alignment and sagittal balance.And the radiographic outcomes and clinical results of these 30 patients were retrospectively evaluated.The sagittal imaging parameters including sagittal vertebral axis (SVA),thoracic kyphosis (TK),thoracolumbar kyphosis (TLK),lumbar lordosis (LL),pelvic incidence (PI),pelvic tilt (PT),and sacral slope (SS)of the whole spine before operation,immediately after operation,and the last follow-up of each group were measured and evaluated.The clinical results included the Oswestry Disability Index (ODI) and the Numerical Rating Scale (NRS) of the two groups .Results: The average follow-up period of group A and B were 34.2 and 38.7 months respectively.The parameters of both groups such as SVA,TLK,and thoracolumbar Cobb angle after surgery and at the last follow-up were significantly improved compared with those before surgery.The ODI and the NRS of the two groups at the last follow-up were also significantly improved. Conclusion: In the treatment of Kümmell’s disease with thoracolumbar kyphosis,to restore the normal alignment and sagittal balance can obtain a satisfactory radiographic and clinical short and medium-term effects.

scholarly journals Effectiveness of Progressive Resisted Exercise along with Conventional Exercise and Conventional Exercise Program alone in Subjects with Text Neck Syndrome

2021 ◽  
pp. 536-542
Author(s):  
Divya Jain ◽  
Swapna Jawade ◽  
Neha Chitale
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Conventional Therapy ◽  
Rating Scale ◽  
Neck Disability Index ◽  
Exercise Program ◽  
Pain Rating ◽  
Numerical Pain Rating Scale ◽  
Neck Disability ◽  
Pain Rating Scale

Background: "Text neck" is a term coined to describe the posture created by leaning forward for lengthy periods of time, such as when reading and texting on a cellphone which has been linked to stress injuries. Neck pain, upper back discomfort, shoulder pain, frequent headaches, and greater curvature of the spine are all dangerous indications of text neck. According to a survey, 35% of smartphone users suffer from text neck syndrome. People between the ages of 15 and 18 are more likely to have neck pain. This protocol has been created that describes the design of comparative study to evaluate effectiveness of progressive resisted exercise along with conventional exercise and conventional exercise program alone in text neck syndrome. Methods: The participants (n=80) will be recruited in the study suffering from text neck syndrome and meeting the inclusion criteria. Two groups will be formed such that patients in group A will be treated with conventional therapy and group B will be treated with progressive resisted exercise (PRE) along with conventional therapy. The protocol will cover 4 weeks of treatment. In the rehabilitation period, we will evaluate the pain intensity, strength of neck muscles and functional activity. Our outcome measures will be- Numerical pain rating scale (NPRS) and Neck disability index (NDI). Discussion: Efficacy of the intervention will be evaluated by analyzing the pain intensity by using Numerical pain rating scale (NPRS) and level of functional disability by using Neck disability index (NDI). The result of the study will significantly provide affirmation on either using combination therapy of PRE with conventional exercise or conventional exercise alone.

Acupuncture for Chronic Neck Pain - a Cohort Study in An Nhs Pain Clinic

2004 ◽  
Vol 22 (3) ◽  
pp. 146-151 ◽  
Author(s):  
Patrick Blossfeldt
Keyword(s):  
Neck Pain ◽  
Rating Scale ◽  
Chronic Neck Pain ◽  
Pain Clinic ◽  
Patient Treatment ◽  
Successful Outcome ◽  
End Of Treatment ◽  
Long Term Follow Up ◽  
One Year

The study investigates the outcome of acupuncture for chronic neck pain in a cohort of patients referred to an NHS chronic pain clinic. One hundred and seventy two patients were selected for acupuncture over a period of 6.5 years. Treatment was given by a single acupuncturist and consisted of a course of needle acupuncture for an average of seven sessions per patient. Treatment outcome was measured by an oral rating scale of improvement at the end of treatment and at follow up six months and one year after treatment. Nineteen patients were withdrawn from treatment for various reasons, two for adverse events. One hundred and fifty three patients were evaluated, of whom 68% had a successful outcome from acupuncture, reporting an improvement in pain of at least 50%. The success rate was higher in patients with a short duration of pain: 85% in patients with pain for up to three months and 78% with pain for up to six months. Long-term follow up showed that 49% of the patients who completed treatment had maintained the benefit after six months, and 40% at one year. The results indicate that acupuncture can be an effective treatment for selected patients with chronic neck pain.

Management of Complete Talocrural Luxations by Selective Talocrural Arthrodesis using Hybrid Transarticular External Skeletal Fixation in Dogs

2018 ◽  
Vol 31 (04) ◽  
pp. 291-297
Author(s):  
Taylan Önyay ◽  
Kamil İnal ◽  
Deniz Özbakır ◽  
Ahmet Özak ◽  
Cenk Yardımcı
Keyword(s):  
Retrospective Study ◽  
Clinical Outcomes ◽  
Injured Limb ◽  
Clinical Utilization ◽  
Removal Time ◽  
Hybrid External Fixator ◽  
Early Use ◽  
Clinical Benefits ◽  
Age And Sex

Objective This article presents a novel surgical technique in the management of open complete talocrural luxations and evaluates the results, and clinical benefits with its routine clinical utilization. Study Design Retrospective study. Animals Seventeen medium- or large-breed client-owned dogs of different breed, age and sex with complete talocrural luxations and radiographic follow-up of at least 24 weeks duration. Method Selective talocrural arthrodesis was performed by using a hybrid transarticular external skeletal fixator frame. Clinical and radiographical evaluation was performed regarding the lesion, concomitant injury, duration of the surgery, time to first use of the limb, fixator removal time, complications and clinical outcomes. Results Dogs started to use the injured limb between postoperative days 1 to 11. Pin or wire tract related complications were observed in all dogs. Time to fixator removal ranged from 57 to 90 days with a median of 73 days. All of the operated joints with an exception of one dog resulted in talocrural fusion. Mid-term clinical outcomes score was regarded as excellent in 13/17 dogs, good in 3/17 dogs and poor in 1/17 dogs subject to authors' evaluation. Conclusion A transarticular hybrid external fixator may allow early use of postoperative limb with an excellent patient compliance and is well tolerated as well. The technique showed a promising opportunity of providing favourable limb use.

Long-Term Clinical Outcomes of Percutaneous Cervical Nucleoplasty for Cervical Degenerative Diseases with Neck Pain and Cervical Vertigo

2020 ◽  
Vol 133 ◽  
pp. e205-e210
Author(s):  
Chungen Li ◽  
Yingna Qi ◽  
Genzhe Liu ◽  
Xincheng Yin ◽  
Yi Jin ◽  
...  
Keyword(s):  
Neck Pain ◽  
Clinical Outcomes ◽  
Degenerative Diseases ◽  
Cervical Vertigo

scholarly journals Comparison of Gastrocnemius Turn Flap and Hamstring Graft for the Treatment of Kuwada Type 3 Chronic Ruptures of the Achilles Tendon: A Retrospective Study

2019 ◽  
Vol 7 (12) ◽  
pp. 232596711988767
Author(s):  
Lu Bai ◽  
Siyao Guan ◽  
Tian You ◽  
Wentao Zhang ◽  
Peng Chen
Keyword(s):  
Retrospective Study ◽  
Achilles Tendon ◽  
Clinical Outcomes ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Hamstring Graft ◽  
Early Recovery ◽  
Level Of Evidence ◽  
Type 3

Background: Chronic Achilles tendon rupture is challenging to repair, and many procedures have been suggested to fill the gap that separates the distal and proximal ends of the ruptured tendon. Purpose: To compare clinical outcomes between the free hamstring graft (HG) and gastrocnemius turn flap (GTF) procedures in the treatment of chronic Achilles tendon rupture. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study included 26 patients (25 males, 1 female; mean age, 36.7 years; range, 22-53 years) with Kuwada type 3 chronic rupture of the Achilles tendon. A total of 11 patients underwent GTF surgery, whereas 15 patients underwent HG surgery. Follow-up assessments were conducted at 3, 6, and 12 months postoperatively. Results: The complication rate was significantly higher in the GTF group compared with the HG group (27.2% vs 6.6%, respectively; χ2 = 12.462; P = .001). At the 3-month follow-up, the degree of ankle dorsiflexion was significantly higher in the HG group than in the GTF group ( t = 3.144; P = .004). At 6-month and 1-year follow-up, no significant differences in ankle function were seen between the 2 groups. Conclusion: Hamstring tendon graft is associated with better early recovery of dorsiflexion compared with GTF. The long-term clinical outcomes of these 2 procedures are similar.

scholarly journals A Higher-Order Analysis Supports Use of the 11-Item Version of the Tampa Scale for Kinesiophobia in People With Neck Pain

2013 ◽  
Vol 93 (1) ◽  
pp. 60-68 ◽  
Author(s):  
David Walton ◽  
James M. Elliott
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Convergent Validity ◽  
Rasch Analysis ◽  
Rating Scale ◽  
Neck Disability Index ◽  
Measurement Properties ◽  
Symptom Duration ◽  
Cross Sectional ◽  
Tampa Scale For Kinesiophobia

Background Despite increasing clinical and research use of the 11-item version of the Tampa Scale for Kinesiophobia (TSK-11) in people with neck pain, little is known about its measurement properties in this population. Objective The purpose of this study was to rigorously evaluate the measurement properties of the TSK-11 when used in people with mechanical neck pain. Design This study was a secondary analysis of 2 independent databases (N=235) of people with mechanical neck pain of primarily traumatic origin. Methods The TSK-11 was subjected to Rasch analysis and subsequent evaluation of concurrent associations with the Neck Disability Index and a numeric rating scale for pain intensity. Results The TSK-11 conformed well to the Rasch model for interval-level measurement, but less so for acute or nontraumatic etiologies. A transformation matrix suggested that small changes at the extremes of the scale are more meaningful than in the middle. Cross-sectional convergent validity testing suggested relationships of expected magnitude and direction compared with pain intensity and neck-related disability. The use of the linearly transformed TSK-11 led to potentially important differences in distribution of data compared with use of the raw scores. Limitations The sample size was slightly smaller than desired for Rasch analysis. The 2 databases were similar in terms of symptom duration, but differed in pain intensity and age. Conclusions The TSK-11 can be considered an interval-level measure when used in people with neck pain. It provides potentially important information regarding the nature of neck-related disability. Clinically important difference may not be consistent across the range of the scale.

Heterotopic ossification following total elbow arthroplasty

2018 ◽  
Vol 100-B (6) ◽  
pp. 767-771 ◽  
Author(s):  
P. M. Robinson ◽  
S. J. MacInnes ◽  
D. Stanley ◽  
A. A. Ali
Keyword(s):  
Retrospective Study ◽  
Heterotopic Ossification ◽  
Clinical Outcomes ◽  
Total Elbow Arthroplasty ◽  
Range Of Movement ◽  
Exact Test ◽  
Elbow Arthroplasty ◽  
Fisher’S Exact Test ◽  
Trauma Group

Aim The primary aim of this retrospective study was to identify the incidence of heterotopic ossification (HO) following elective and trauma elbow arthroplasty. The secondary aim was to determine clinical outcomes with respect to the formation of heterotopic ossification. Patients and Methods A total of 55 total elbow arthroplasties (TEAs) (52 patients) performed between June 2007 and December 2015 were eligible for inclusion in the study (29 TEAs for primary elective arthroplasty and 26 TEAs for trauma). At review, 15 patients (17 total elbow arthroplasties) had died from unrelated causes. There were 14 men and 38 women with a mean age of 70 years (42 to 90). The median clinical follow-up was 3.6 years (1.2 to 6) and the median radiological follow-up was 3.1 years (0.5 to 7.5). Results The overall incidence of HO was 84% (46/55). This was higher in the trauma group (96%, 25/26) compared with the elective arthroplasty group (72%, 21/29) (p = 0.027, Fisher’s exact test). Patients in the trauma group had HO of higher Brooker class. The presence of HO did not significantly affect elbow range of movement within the trauma or elective groups (elective arthroplasty, Mann–Whitney U test, p = 0.070; trauma arthroplasty, p = 0.370, Mann–Whitney U test). Conclusion HO after total elbow arthroplasty is seen more commonly than previously reported. We have reported a significantly higher rate of HO in TEAs performed for trauma than those performed electively. Cite this article: Bone Joint J 2018;100-B:767–71.

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