scholarly journals Assessment of outcomes after surgical treatment of an isolated facet-syndrome in the cervical spine using facet joint laser denervation

2020 ◽  
Vol 24 (1) ◽  
pp. 26-33
Author(s):  
V. A. Byvaltsev ◽  
A. A. Kalinin ◽  
M. A. Aliyev ◽  
A. K. Okoneshnikova ◽  
V. V. Shepelev ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Facet Joint ◽  
Clinical Symptoms ◽  
Perioperative Complications ◽  
Neck Disability Index ◽  
Surgical Techniques ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Facet Syndrome

Chronic pain in the cervical spine is one of the relevant problems of modern vertebrology. This is due to the polyetiological formation of clinical symptoms and to the variety of surgical techniques, which are often used without taking into account the leading pathomorphological substrate of clinical symptoms. Purpose: To analyze clinical results of surgical treatment of an isolated facet-syndrome of the cervical spine using laser denervation of facet joints (FJ).Material and methods. The study included 234 patients aged in average 58 (53; 67). After provocative tests, an isolated facet-syndrome was diagnosed in them. FJ laser denervation was performed in 2013–2016. A visual analogue pain scale (VAS), neck disability index (NDI), Macnab subjective satisfaction scale and complications were used for analyzing treatment efficacy. The follow-up dynamic observation lasted for 36 months, in average, after the surgery. Results. It has been found out that the technique of laser denervation of cervical FJ is highly effective for treating patients with an isolated facet-syndrome caused by FJ degenerative diseases. Clinical efficacy is supported by a persistent positive dynamics in terms of pain syndrome and functional status at early and late postoperative periods with low risks of perioperative complications.

THE ROLE OF MANUAL THERAPY IN THE TREATMENT OF CHRONIC CERVICAL PAINS

2020 ◽  
pp. 1-4
Author(s):  
George-Sebastian Iacob ◽  
Constantin Munteanu
Keyword(s):  
Manual Therapy ◽  
Therapy Group ◽  
Neck Disability Index ◽  
Initial Assessment ◽  
Visual Analogue Pain Scale ◽  
Rehabilitation Protocol ◽  
Visual Analogue Pain ◽  
Therapeutic Exercises ◽  
Group A ◽  
Group B

Cervical back pain is one of the most important and common musculoskeletal disorders in medical recovery clinics and clinics. The main objective of the study was to highlight the effectiveness of an individualized therapeutic program adapted to the particularities of 22 subjects, which combines physical exercise with manual therapy. Subjects were randomly assigned to two equal groups. Group A - rehabilitation protocol consisting of therapeutic exercises (specific to the head, neck and upper limbs). Group B - rehabilitation protocol that included both therapeutic exercises and manual therapy (specific maneuvers of vertebral mobilization, massage, myofascial techniques, stretching and manipulations). The Visual Analogue Pain Scale (VAS) and the Neck Disability Index (NDI) were used to monitor the evolution of the research subjects, both of which have a specific applicability character to chronic pain. According to VAS (p <0.001), Group B showed mean values reduced to 2.2 ± 0.9 at week 12, compared to 7.3 ± 0.92, following the initial assessment. NDI values indicate better functional status after 12 weeks of treatment for both groups of subjects. NDI showed a beneficial decrease for Group B (13.2 ± 2.2 after 12 weeks, compared to 25.8 ± 2.3 in the first week). The mean results of VAS and NDI indicated a better evolution of symptoms in the case of the protocol that combined exercise and manual therapy (group B), but there were no statistically significant differences (compared to group A).

scholarly journals Effect of unicornuate uterus on women's reproductive health

2019 ◽  
Keyword(s):  
Quality Of Life ◽  
Reproductive Health ◽  
Clinical Symptoms ◽  
Normal Karyotype ◽  
Pain Scale ◽  
Control Group ◽  
Visual Analogue Pain Scale ◽  
Visual Analogue Pain ◽  
Unicornuate Uterus

Objectives. The effect of the unicornuate uterus on the reproductive health and quality of life of woman has been analyzed. Materials and methods. The study included 26 patients with unicornuate uterus aged 25 to 42 years and 20 women without gynecological pathology. Diagnosis of uterine abnomalies was based on patient complaints, medical history and life history, as well as clinical and laboratory and instrumental examinations. The severity of dysmenorrhea was determined using a visual analogue pain scale, women's quality of life was assessed using a short SF-12 health questionnaire. Results. The average age of the surveyed women was 30.2 ± 3.9 years. All patients with unicornuete uterus by subclasses were distributed as follows: subclass U4a (unicornuate uterus with rudimentary cavity) – 69.2% of patients, subclass U4b (unicornuate uterus without rudimentary cavity in the contralateral horn or with its aplasia) – 30.8%. In all patients was confirmed normal karyotype – 46XX. The combination of a unicornuate uterus with a defect of the urinary system (aplasia, doubling, or kidney dystopia) occurred in 23.1% of women. It has been found that in women with unicornuate uterus, clinical symptoms in 76.9% of cases are accompanied by dysmenorrhea. The unicornuate uterus in 69.2% of cases causes negative reproductive outcomes, among which 26.9% – early spontaneous abortions, 11.5% – ectopic pregnancy. In 46.2% of cases the unicornuate uterus is combined with other gynecological pathology, whereby the incidence of concomitant gynecologic pathology is significantly more frequent in U4a patients than in the U4b subclass (˂0.01). The severity of dysmenorrhea in the main group was 5.8 ± 1.8 points (the difference was significant compared with the control group, p = 0.0032). Conclusions. Due to the low physical subunit, the unicornuate uterus significantly impairs the quality of life of women, which was significantly lower in the group of patients with unicornuate uterus compared to the control group (total SF-12 score: 85.4 ± 11.2 vs. 95.8 ± 12.1; p = 0.002).

Cervical spine disorders

2011 ◽  
Author(s):  
Howard An
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Clinical Symptoms ◽  
Exercise Program ◽  
Cervical Radiculopathy ◽  
Radicular Pain ◽  
Narcotic Analgesics ◽  
Advantages And Disadvantages ◽  
Degenerative Cervical Spine ◽  
Spine Disorders

♦ Degenerative cervical spine disorders may manifest clinically with axial neck pain, radiculopathy, myelopathy, or a combination of these clinical symptoms♦ The findings on radiographs and MRI are pertinent if they correlate with the clinical symptoms♦ The initial treatment for patients with degenerative cervical spine disorders is conservative, including non-narcotic analgesics, anti-inflammatory medications, exercise program, physiotherapy, and occasional injections♦ Surgical indications include significant radicular pain despite conservative treatment, profound neurologic deficits, and presence of significant myelopathy♦ Surgical treatment for cervical radiculopathy includes lamino-foraminotomy, anterior cervical discectomy and fusion (ACDF), and artificial disk replacement, and surgical treatment for myelopathy includes anterior discectomy and/or corpectomy with fusion, posterior laminoplasty, and posterior laminectomy and fusion. The surgeon should be familiar with the specific indications as well as advantages and disadvantages of each procedure.

Relationship between facet joint distraction during anterior cervical discectomy and fusion for trauma and functional outcome

2018 ◽  
Vol 100-B (9) ◽  
pp. 1201-1207 ◽  
Author(s):  
N. Kirzner ◽  
G. Etherington ◽  
L. Ton ◽  
P. Chan ◽  
E. Paul ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Correlation Coefficient ◽  
Facet Joint ◽  
Neck Disability Index ◽  
Spine Injury ◽  
Spearman Correlation ◽  
Pain Scores ◽  
Joint Distraction ◽  
Vas Scores ◽  
Neck Disability

Aims The purpose of this retrospective study was to investigate the clinical relevance of increased facet joint distraction as a result of anterior cervical decompression and fusion (ACDF) for trauma. Patients and Methods A total of 155 patients (130 men, 25 women. Mean age 42.7 years; 16 to 87) who had undergone ACDF between 1 January 2001 and 1 January 2016 were included in the study. Outcome measures included the Neck Disability Index (NDI) and visual analogue scale (VAS) for pain. Lateral cervical spine radiographs taken in the immediate postoperative period were reviewed to compare the interfacet distance of the operated segment with those of the facet joints above and below. Results There was a statistically significant relationship between greater facet distraction and increased NDI and VAS pain scores. This was further confirmed by Spearman correlation, which showed evidence of a moderate correlation between both NDI score and facet joint distraction (Spearman correlation coefficient 0.34; p < 0.001) and VAS score and facet distraction (Spearman correlation coefficient 0.52; p < 0.001). Furthermore, there was a discernible transition point between outcome scores. Significantly worse outcomes, in terms of both NDI scores (17.8 vs 8.2; p < 0.001) and VAS scores (4.5 vs 1.3; p < 0.001), were seen with facet distraction of 3 mm or more. Patients who went on to have a posterior fusion also had increased NDI and VAS scores, independent of facet distraction. Conclusion After undergoing ACDF for the treatment of cervical spine injury, patients with facet joint distraction of 3 mm or more have worse NDI and VAS pain scores. Cite this article: Bone Joint J 2018;100-B:1201–7.

scholarly journals Facet syndrome. Minimally invasive surgical treatment. (Clinical case with a literature re-view).

2021 ◽  
Author(s):  
Vitaliy E. Potapov ◽  
Vladimir Alekseevich Sorokovikov ◽  
Sergey Nikolaevich Larionov ◽  
Aleksandr Petrovich Zhivotenko
Keyword(s):  
Surgical Treatment ◽  
Facet Joint ◽  
Pain Syndrome ◽  
Intervertebral Discs ◽  
Facet Joints ◽  
Spinal Motion ◽  
Minimally Invasive Surgical ◽  
High Incidence ◽  
Facet Syndrome ◽  
Minimally Invasive Surgical Treatment

The problem of the pathology of the facet joints of the lumbar spine remains significant and is medical and social due to persistent pain syndrome, high incidence of morbidity and frequent disability outcomes. The complex anatomical and topographic relationships of the facet joints, intervertebral discs and radicular nerves force clinicians to pay attention to the pathology of facet syndrome. A pair of facet joints and an intervertebral disc constitute a functional unit - a "three-component complex" and are interconnected with each other. The article examines the anatomical and morphological features and radiological classifications of degenerative changes in the facet joints, which are currently used in clinical practice. Facet joint pathologies are the most common nosological form of degenerative-dystrophic process (spondyloarthrosis) and a potential source of pain with the formation of instability of the spinal motion segment and the formation of chronic pain syndrome. The features of facet syndrome diagnostics are presented on a clinical example of surgical treatment by means of laser dereception of facet joints.

scholarly journals A meta-analysis of prospective studies comparing the results of laminoplasty and laminectomy with instrumental fixation in the surgical treatment of patients with multilevel degenerative cervical spine diseases

2020 ◽  
Vol 75 (1) ◽  
pp. 54-68
Author(s):  
Vadim A. Byvaltsev ◽  
Andrey A. Kalinin ◽  
Marat A. Aliev ◽  
Valeriy V. Shepelev ◽  
Bobur R. Yusupov ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cervical Spine ◽  
Surgical Treatment ◽  
Perioperative Complications ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Library ◽  
Continuous Variables ◽  
Degenerative Diseases

Background: Dorsal decompressive-stabilizing techniques laminotomy with laminoplasty (LP) and laminectomy with instrumental fixation (LF) are effective methods for surgical treatment of patients with multi-level degenerative diseases of the cervical spine. At the same time, there is currently no priority in determining the optimal method for posterior decompression and stabilization. Aim: conduct a comparative analysis of intraoperative parameters, clinical outcomes, radiological results and complications of LP and LF in the treatment of patients with multilevel degenerative diseases of the cervical spine. Methods: A meta-analysis of prospective cohort clinical trials was carried out, the primary sources were searched using the databases PubMed, CNKI, eLibrary and the Cochrane Library, published until March 2019, which compared the results of applying the LP and LF methods in the treatment of patients with multilevel degenerative diseases of the cervical spine. For dichotomous variables, the relative risk and the 95% confidence interval were calculated; in turn, for the continuous variables, the standardized difference of the mean values and their 95% confidence intervals were used, using random effect models and a fixed effect. Resuts: The meta-analysis included 6 prospective clinical trials, one of which was a randomized controlled trial. In total, the results of surgical treatment of 493 patients with multilevel degenerative diseases of the cervical spine were evaluated. In the group of drugs, statistically significantly smaller parameters of the duration of surgical intervention were verified (p 0.00001). At the same time, comparable parameters of cervical lordosis after surgery, the level of pain in the cervical spine, functional status according to NDI and JOA after surgery, the frequency of perioperative complications (p = 0.17, p = 0.05, p = 0.94, p = 0.96, p = 0.24, respectively). Conclusions: A meta-analysis showed that the functional outcomes of LP and LF, as well as instrumental results in the treatment of multilevel degenerative diseases of the cervical spine, are not clinically significant. In this case, the LP technique can be performed in a shorter period of time compared with LF.

scholarly journals Spondyloarthrosis: pathogenesis, clinic, diagnosis and treatment (literature review and own experience)

2020 ◽  
Vol 10 (4) ◽  
pp. 61-73
Author(s):  
Anton V. Yarikov ◽  
A. A. Denisov ◽  
O. A. Perlmutter ◽  
M. Yu. Dokish ◽  
A. G. Sosnin ◽  
...  
Keyword(s):  
Facet Joint ◽  
Perioperative Complications ◽  
Pain Syndrome ◽  
Clinical Work ◽  
The Elderly ◽  
Advantages And Disadvantages ◽  
Surgical Methods ◽  
Facet Syndrome ◽  
Frequency Laser ◽  
Intraarticular Administration

8590% of the elderly people are diagnosed with spondyloarthrosis There are various synonyms for this disease in the literature: facet syndrome, facet pain syndrome, arthrosis of the intervertebral joints, zygapophysial joint arthrosis and spondyloarthropathy. The article analyzes the pathogenesis, clinical picture and methods of diagnosis of this disease. Modern types of conservative and surgical treatment are presented. The advantages and disadvantages of the surgical methods for the facet syndrome treatment are analyzed: instrumental denervation (radio frequency, laser, etc.), chemical denervaion and intraarticular administration of drugs. The results of our own clinical work are presented. The facet joint denervation appears to be a productive minimally invasive method of treatment of the reflex forms of spondyloarthrosis. In the early and long-term postoperative period, it leads to a persistent decrease in the intensity of pain and improvement of the quality of life with a low risk of perioperative complications.

scholarly journals Open vertebroplasty for cervical spine aggressive hemangioma

2021 ◽  
Vol 18 (1) ◽  
pp. 53-60
Author(s):  
V. B. Arsenievich ◽  
S. V. Likhachev ◽  
V. V. Zaretskov ◽  
V. V. Ostrovskij ◽  
S. P. Bazhanov ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Treatment Effectiveness ◽  
Neck Disability Index ◽  
Image Intensifier ◽  
Anterolateral Approach ◽  
Open Approach ◽  
Pmma Bone Cement ◽  
Iatrogenic Complications ◽  
Neck Disability

Objective.To analyze results of open vertebroplasty for aggressive hemangioma of the cervical spine.Material and Methods. Surgical treatment was performed in 12 patients with aggressive hemangioma of the cervical spine. Vertebroplasty was performed through an open anterolateral approach under the control of an image intensifier.Results. Pain intensity was 7.0 ± 1.0 on VAS before surgery and 1.8 ± 1.2 immediately after surgery. Neck disability index (NDI) was 17.5 ± 6.5 before surgery and 4.3 ± 1.7 after surgery. One month after surgery VAS and NDI scores were 0. There were no complications in the postoperative period. A control study visualized from 82 % to 98 % completeness of filling the bone defect with polymethyl methacrylate. Bone composite migration outside the vertebral body was not detected in any of the operated patients. Control images taken 6 and 12 months after surgical treatment did not reveal continued tumor growth and signs of any osteonecrotic processes in bone tissue as a response to PMMA bone cement in any case.Conclusion. Despite the widespread and rather long period of using vertebroplasty, the issues of the choice of approaches when performing it on the cervical spine are still debatable. In order to reduce the risk of iatrogenic complications in cervical vertebroplasty, the open approach can be used which increases the treatment effectiveness.

scholarly journals Degenerative scoliosis of the ventricle: diagnosis, classification and surgical approach in older patients

2021 ◽  
Author(s):  
Anton Yarikov
Keyword(s):  
Surgical Treatment ◽  
Physical Therapy ◽  
Conservative Therapy ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Surgical Techniques ◽  
Neurological Status ◽  
Point Of View ◽  
Degenerative Scoliosis ◽  
Instrumental Methods

Adult scoliosis is a deformity of the spine with an angle of more than 10 (according to Cobb) in people with a fully formed bone system. Due to the aging of the population, the improvement of surgical techniques, the appearance of new implants and the improvement of anesthetic aids, the problem of degenerative scoliosis is increasingly being considered from the point of view of the possibilities of surgery. There are many theories that contribute to the formation of degenerative scoliosis. Conservative therapy of degenerative scoliosis includes non-steroidal anti-inflammatory drugs, corset therapy, epidural and paravertebral injections with glucocorticosteroids, physical therapy, and physical therapy. With complete ineffectiveness of conservative therapy and with a significant decrease in the quality of life of the patient, the question of performing surgical intervention is individually decided. Currently, the question of the role and scope of surgical intervention in individuals with this pathology remains debatable. The choice of surgical intervention depends on a thorough assessment of clinical symptoms, neurological status, data of instrumental methods of examination and mandatory consideration of the parameters of the global vertebral-pelvic balance. Therefore, in this article, special attention is paid to the algorithms of surgical treatment based on the choice of the type of decompression and the length of the fusion. The paper describes the generally accepted criteria for selecting the level of spondylosynthesis. Special attention is paid to the risk factors for surgical treatment. As well as the complications associated with surgical treatment are described.

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