scholarly journals A Young Boy with Neck Pain

2021 ◽  
Vol 2 (5) ◽  
pp. 253-254
Author(s):  
Hirofumi Ohno ◽  
Shinsuke Takeda ◽  
So Mitsuya ◽  
Hisatake Yoshihara ◽  
Ken-ichi Yamauchi
Keyword(s):  
Emergency Department ◽  
Cervical Spine ◽  
Neck Pain ◽  
Conservative Management ◽  
Rare Condition ◽  
Intervertebral Disk ◽  
Neck Movement ◽  
Case Presentation ◽  
Posterior Neck ◽  
Cervical Spine Radiography

Case Presentation: A five-year-old boy presented to our emergency department with severe posterior neck pain that was exacerbated upon neck movement. Cervical spine radiography revealed calcification in the cervical intervertebral disk 3-4. Discussion: Pediatric idiopathic intervertebral disk calcification is a benign, rare condition that might be complicated by associated severe neurological symptoms. In this case, the symptoms gradually subsided with conservative management alone.

What a Pain in the Neck!

2020 ◽  
pp. 13-22
Author(s):  
Walter Wiswell ◽  
Bryan McCarty
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Cervical Spine ◽  
Neck Pain ◽  
Pediatric Patient ◽  
Ct Scans ◽  
X Rays ◽  
Pros And Cons ◽  
Current Guidelines ◽  
Patient Presentation

The chapter on cervical spine controversies in children describes what initial steps need to be taken in assessing a pediatric patient with neck pain after trauma, and discusses the decision-making process that goes into further evaluation and testing. Clinical actions and assessments of the patient on-scene, whether to pursue imaging once in the emergency department setting, and what imaging is most appropriate depending on the patient presentation are discussed. Indications and contraindications for cervical spine immobilization and spinal positioning, including proper techniques based on a patient’s age and whether or not such steps are necessary. It also discusses the pros and cons of x-rays, CT scans, and MRIs in the context of pediatric neck trauma, and current guidelines that should be followed when deciding to order such studies.

Delayed presentation and conservative management of an odontoid basilar synchondrosis fracture in a child

2008 ◽  
Vol 1 (5) ◽  
pp. 402-405 ◽  
Author(s):  
Kenneth M. Crandall ◽  
Esperanza Pacheco-Jacome ◽  
David I. Sandberg
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Neck Pain ◽  
Conservative Management ◽  
Delayed Presentation ◽  
Imaging Studies ◽  
Bone Fusion ◽  
Cervical Orthosis ◽  
Computed Tomography Scans

✓ The authors report the case of a 3-year-old boy who presented with neck pain after falling from a low height and who was discharged from the emergency department after imaging studies were noted to be normal. He presented again 2 months later with continued neck pain, and repeated imaging demonstrated a fracture of the odontoid basilar synchondrosis that had not been shown on the initial studies. Based on the normal alignment of his spine and evidence of early bone fusion at the time of his second presentation, he underwent cervical orthosis therapy only. To the authors' knowledge, this is the first reported case of an odontoid synchondrosis fracture in which computed tomography scans were normal at presentation.

scholarly journals Spinal epidural hematoma in a patient on chronic anticoagulation therapy performing self-neck manipulation: a case report

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Jesse Cooper ◽  
Patrick Battaglia ◽  
Todd Reiter
Keyword(s):  
Cervical Spine ◽  
Epidural Hematoma ◽  
Anticoagulation Therapy ◽  
Rare Condition ◽  
Inpatient Rehabilitation ◽  
Spinal Epidural Hematoma ◽  
Case Presentation ◽  
First Case ◽  
Spinal Epidural ◽  
Neck Manipulation

Abstract Background Spinal epidural hematoma is a rare condition usually secondary to trauma and coagulopathy. To the best of our knowledge, we present the first case of a patient with an iatrogenic hypercoaguable state performing self-neck manipulation, which resulted in a spinal epidural hematoma and subsequent quadriparesis. Case presentation A 63-year-old man presented to the emergency department with worsening interscapular pain radiating to his neck 1 day after performing self-manipulation of his cervical spine. He was found to be coagulopathic upon admission, secondary to chronic warfarin therapy for the management of atrial fibrillation. Approximately 48 h after the manipulation, the patient became acutely quadriparetic and hypotensive. Urgent magnetic resonance imaging revealed a multilevel spinal epidural hematoma from the lower cervical to thoracic spine. Conclusions Partial C7, complete T1 and T2, and partial T3 bilateral laminectomy was performed for evacuation of the spinal epidural hematoma. Following a 2-week course of acute inpatient rehabilitation, the patient returned to his baseline functional status. This case highlights the risks of self-manipulation of the neck and potentially other activities that significantly stretch or apply torque to the cervical spine. It also presents a clinical scenario in which practitioners of spinal manipulation therapy should be aware of patients undergoing anticoagulation therapy.

scholarly journals A distressingly painful neck

2019 ◽  
Vol 27 (4) ◽  
pp. 250-251
Author(s):  
James Siu Ki Lau ◽  
Pui Gay Kan
Keyword(s):  
Emergency Department ◽  
Cervical Spine ◽  
Neck Pain ◽  
Common Complaint ◽  
Sprain And Strain ◽  
Spine Degeneration ◽  
Painful Neck

Neck pain is a common complaint in the emergency department. It is often attributed to sprain and strain, and cervical spine degeneration. However, when the pain is prolonged, refractory to treatment and not improved after multiple consultations, an alternate diagnosis should be considered.

scholarly journals Correlation between kinematic sagittal parameters of the cervical lordosis or head posture and disc degeneration in patients with posterior neck pain

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 161-168
Author(s):  
Hyo Jeong Lee ◽  
Dae Geun Jeon ◽  
Jung Hyun Park
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Disc Degeneration ◽  
Cervical Disc ◽  
Cervical Lordosis ◽  
Sagittal Vertical Axis ◽  
Cross Sectional ◽  
Head Posture ◽  
Posterior Neck ◽  
Sagittal Parameters

Abstract The purpose of this retrospective cross-sectional study was to examine the degrees of the cervical disc degeneration and the parameters of cervical sagittal balance in plain radiographs, representing cervical lordosis or head posture in subjects with posterior neck pain. A total of 113 patients with posterior neck pain with or without radiating pain were analyzed. The kinematic sagittal parameters of cervical radiographs were obtained at the occipito–cervical (O–C2) angle, sagittal Cobb’s angles of C1–C2, C2–C7, and sagittal vertical axis (SVA) of C1–C7 and C2–C7. Cervical disc degeneration was evaluated using the sum of Pfirrmann grades and total modified Matsumoto scores calculated from MRI of the cervical spine. A significant positive correlation was found for the C2–C7 angle using the sum of the Pfirrmann grades and total modified Matsumoto scores, whereas the O–C2 angle and the C1–C2 angle were negatively correlated. The sagittal cervical parameters representing cervical kyphosis and jaw lifting posture were found to be significantly correlated with the degree of cervical disc degeneration. These findings suggest that the loss of the natural sagittal lordosis of the cervical spine may contribute to the progression of disc degeneration, rather than the forward head posture.

Motion Analysis of the Cervical Spine

2004 ◽  
Vol 9 (5) ◽  
pp. 1-11
Author(s):  
Patrick R. Luers
Keyword(s):  
Cervical Spine ◽  
Intervertebral Disk ◽  
Radiographic Evaluation ◽  
Ligamentous Injury ◽  
Pattern Of Injury ◽  
Motion Segment ◽  
Single Pattern ◽  
Compensatory Motion ◽  
Loss Of Motion ◽  
Flexion And Extension

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, defines a motion segment as “two adjacent vertebrae, the intervertebral disk, the apophyseal or facet joints, and ligamentous structures between the vertebrae.” The range of motion from segment to segment varies, and loss of motion segment integrity is defined as “an anteroposterior motion of one vertebra over another that is greater than 3.5 mm in the cervical spine, greater than 2.5 mm in the thoracic spine, and greater than 4.5 mm in the lumbar spine.” Multiple etiologies are associated with increased motion in the cervical spine; some are physiologic or compensatory and others are pathologic. The standard radiographic evaluation of instability and ligamentous injury in the cervical spine consists of lateral flexion and extension x-ray views, but no single pattern of injury is identified in whiplash injuries. Fluoroscopy or cineradiographic techniques may be more sensitive than other methods for evaluating subtle abnormal motion in the cervical spine. The increased motion thus detected then must be evaluated to determine whether it represents normal physiologic motion, normal compensatory motion, motion related to underlying degenerative disk and/or facet disease, or increased motion related to ligamentous injury. Imaging studies should be performed and interpreted as instructed in the AMA Guides.

Management of The Cervical Spine Tuberculosis

2018 ◽  
Vol 1 (2) ◽  
pp. 19
Author(s):  
Sabri Ibrahim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Spinal Tuberculosis ◽  
Intervertebral Disk ◽  
Posterior Fixation ◽  
Resonance Imaging ◽  
Vertebral Bodies ◽  
Intervertebral Disk Space ◽  
Developed Nations

Tuberculosis of the cervical spine is a rare clinical condition (10%), most commonly affected lower thoracic region (40-50% of the cases). Spinal tuberculosis is a destructive form of tuberculosis. It accounts for approximately half of all cases of musculoskeletal tuberculosis. Spinal tuberculosis is more common in children and young adults. The incidence of spinal tuberculosis is increasing in developed nations. Characteristically, there is a destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to kyphosis and gibbus formation. For the diagnosis of spinal tuberculosis, magnetic resonance imaging is more sensitive than x-ray and more specific than computed tomography. Magnetic resonance imaging frequently demonstrates an involvement of the vertebral bodies on either side of the disk, disk destruction, cold abscess, vertebral collapse, and presence of vertebral column deformities. Anti-tuberculous treatment remains the cornerstone of treatment. Surgery may be required in selected cases, e.g. large abscess formation, severe kyphosis, an evolving neurological deficit, or lack of response to medical treatment. The quality of debridement and bony fusion is optimal when the anterior approach is used. Posterior fixation is the best means of achieving reduction followed by stable sagittal alignment over time. With early diagnosis and early treatment, the prognosis is generally good.

scholarly journals Cervicovestibular rehabilitation in adult with mild traumatic brain injury: a randomised controlled trial protocol

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Pierre Langevin ◽  
Philippe Fait ◽  
Pierre Frémont ◽  
Jean-Sébastien Roy
Keyword(s):  
Traumatic Brain Injury ◽  
Cervical Spine ◽  
Brain Injury ◽  
Neck Pain ◽  
Mild Traumatic Brain Injury ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Conventional Approach ◽  
Persistent Symptoms ◽  
Link Type

Abstract Background Mild traumatic brain injury (mTBI) is an acknowledged public health problem. Up to 25% of adult with mTBI present persistent symptoms. Headache, dizziness, nausea and neck pain are the most commonly reported symptoms and are frequently associated with cervical spine and vestibular impairments. The most recent international consensus statement (2017 Berlin consensus) recommends the addition of an individualized rehabilitation approach for mTBI with persistent symptoms. The addition of an individualized rehabilitation approach including the evaluation and treatment of cervical and vestibular impairments leading to symptoms such as neck pain, headache and dizziness is, however, recommended based only on limited scientific evidence. The benefit of such intervention should therefore be further investigated. Objective To compare the addition of a 6-week individualized cervicovestibular rehabilitation program to a conventional approach of gradual sub-threshold physical activation (SPA) alone in adults with persistent headache, neck pain and/or dizziness-related following a mTBI on the severity of symptoms and on other indicators of clinical recovery. We hypothesize that such a program will improve all outcomes faster than a conventional approach (between-group differences at 6-week and 12-week). Methods In this single-blind, parallel-group randomized controlled trial, 46 adults with subacute (3 to12 weeks post-injury) persistent mTBI symptoms will be randomly assigned to: 1) a 6-week SPA program or 2) SPA combined with a cervicovestibular rehabilitation program. The cervicovestibular rehabilitation program will include education, cervical spine manual therapy and exercises, vestibular rehabilitation and home exercises. All participants will take part in 4 evaluation sessions (baseline, week 6, 12 and 26) performed by a blinded evaluator. The primary outcome will be the Post-Concussion Symptoms Scale. The secondary outcomes will be time to clearance to return to function, number of recurrent episodes, Global Rating of Change, Numerical Pain Rating Scale, Neck Disability Index, Headache Disability Inventory and Dizziness Handicap Inventory. A 2-way ANOVA and an intention-to-treat analysis will be used. Discussion Controlled trials are needed to determine the best rehabilitation approach for mTBI with persistent symptoms such as neck pain, headache and dizziness. This RCT will be crucial to guide future clinical management recommendations. Trial registration ClinicalTrials.gov Identifier - NCT03677661, Registered on September, 15th 2018.

Immediate effects of static and proprioceptive neuromuscular facilitation stretching of hamstring muscles on straight leg raise, craniovertebral angle, and cervical spine range of motion in neck pain patients with hamstring tightness: A prospective randomized controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Eun-Dong Jeong ◽  
Chang-Yong Kim ◽  
Nack-Hwan Kim ◽  
Hyeong-Dong Kim
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Range Of Motion ◽  
T Test ◽  
Static Stretching ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Before And After ◽  
Straight Leg Raise ◽  
Pain Patients ◽  
Group Effects

BACKGROUND: The cranio-cervical flexion exercise and sub-occipital muscle inhibition technique have been used to improve a forward head posture among neck pain patients with straight leg raise (SLR) limitation. However, little is known about the cranio-vertebral angle (CVA) and cervical spine range of motion (CROM) after applying stretching methods to the hamstring muscle. OBJECTIVE: To compare the immediate effects of static stretching and proprioceptive neuromuscular facilitation stretching on SLR, CVA, and CROM in neck pain patients with hamstring tightness. METHODS: 64 subjects were randomly allocated to the static stretching (n1= 32) or proprioceptive neuromuscular facilitation (n2= 32) stretching group. The SLR test was performed to measure the hamstring muscle’s flexibility and tightness between the two groups, with CROM and CVA also being measured. The paired t-test was used to compare all the variables within each group before and after the intervention. The independent t-test was used to compare the two groups before and after the stretching exercise. RESULTS: There were no between-group effects for any outcome variables (P> 0.05). However, all SLR, CVA, and CROM outcome variables were significantly improved within-group (P< 0.05). CONCLUSIONS: There were no between-group effects for any outcome variable; however, SLR, CVA, and CROM significantly improved within-group after the one-session intervention in neck pain patients with hamstring tightness.

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