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Qu N, Jin J, Wang X, Deng Y, Zhang B, Qi Q. Quantitatively assessing the effect of cervical sagittal alignment on dynamic intervertebral kinematics by video-fluoroscopy technique. Musculoskelet Sci Pract 2024; 72:102959. [PMID: 38626497 DOI: 10.1016/j.msksp.2024.102959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 04/07/2024] [Accepted: 04/10/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Cervical sagittal alignment is crucial for distributing the head load to lower cervical segments and maintaining normal cervical spine function, but its biomechanical effect on the cervical spine was not fully elucidated. OBJECTIVE To investigate the effect of cervical sagittal alignment on dynamic intervertebral kinematics. DESIGN Cross-sectional study. METHODS Healthy participants without neck pain were recruited and divided into lordosis, straight and kyphosis groups according to the C2-C7 Cobb angle at the neutral position. The anti-directional and total joint motions were extracted across 10 epochs of dynamic cervical flexion and extension movements. RESULTS /findings: The overall anti-directional joint motion during flexion is larger in the kyphosis group when compared with the lordosis group (p = 0.021), while the range of flexion is smaller in the kyphosis group than that in the lordosis group (p = 0.017). The C2/C3 anti-directional joint motion during extension in the straight group is larger than that in the lordosis group (p = 0016). The range of extension in the kyphosis group (p < 0.001) and the straight group (p = 0.002) are larger than that in the lordosis group. The increased range of extension in the kyphosis and straight groups were mainly from the C3/C4, C4/C5, and C5/C6 joints(p < 0.05). CONCLUSION Changes in cervical sagittal alignment alter both the quality and quantity of the individual joint motions. More adjustments are required by the cervical joints to complete neck movements with the loss of lordosis. The lordotic curvature is a relatively effort-saving mode for the cervical spine from a biomechanical perspective.
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Affiliation(s)
- Ning Qu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - JiaHao Jin
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xu Wang
- Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - YanQun Deng
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Bin Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - QiHua Qi
- Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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Zhang Y, Lin W, Yi M, Song J, Ding L. Effect of long-term cervical extensor exercise program on functional disability, pain intensity, range of motion, cervical muscle mass, and cervical curvature in young adult population with chronic non-specific neck pain: a randomized controlled trial. J Orthop Surg Res 2024; 19:9. [PMID: 38169407 PMCID: PMC10763386 DOI: 10.1186/s13018-023-04487-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The prevalence of chronic non-specific neck pain (CNNP) is on the rise among the young adult population. We herein aimed to compare the effects of long-term specific cervical extensor training and stretching exercises on improving this chronic disorder in young adults. METHODS In this prospective, randomized, controlled study, 70 participants aged 18-35 years with CNNP and cervical lordosis loss were included. The participants were assigned to undergo either specific cervical extensor training (observation group) or perform usual stretching exercises (control group). The exercise duration was set at 12 months, with 9 months at the clinic and 3 months at home. The outcome assessments included changes in the neck disability index, visual analog scale from baseline, cervical range of motion (CROM), cross-sectional areas (CSAs) of cervical extensors, and cervical curvature from baseline. The outcome measures were compared between groups at 3, 6, and 12 months of follow-up. RESULTS All 70 participants underwent randomization, and no significant differences in demographics and baseline data were found between the two groups. The observation group showed a greater improvement in neck disability index and visual analog scale scores at the 12-month follow-up than the control group. Additionally, a more substantial increase in CROM and CSAs of cervical extensors was observed in the observation group at the 6-month and 12-month follow-ups (P < 0.05). Although more participants in the observation group achieved cervical lordosis at the 12-month follow-up, the difference was marginally nonsignificant (9% in the control group vs. 28% in the observation group, P = 0.075). CONCLUSIONS In young adults with CNNP, long-term specific cervical extensor training was associated with a more significant clinically meaningful improvement in disability, pain, and CROM than stretching exercises. The increased CSAs of cervical extensors may potentially contribute to the restoration of cervical lordosis. Trial registration The study is registered at the Chinese domestic clinical trial (ChiCTR2000040009) at Chictr.org. The date of registration: November 18, 2020.
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Affiliation(s)
- Yao Zhang
- Department of Spinal Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Yangfangdian, Haidian District, Beijing, 10038, People's Republic of China
| | - Wancheng Lin
- Department of Spinal Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Yangfangdian, Haidian District, Beijing, 10038, People's Republic of China
| | - Meng Yi
- Department of Spinal Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Yangfangdian, Haidian District, Beijing, 10038, People's Republic of China
| | - Jipeng Song
- Department of Spinal Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Yangfangdian, Haidian District, Beijing, 10038, People's Republic of China.
| | - Lixiang Ding
- Department of Spinal Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Road, Yangfangdian, Haidian District, Beijing, 10038, People's Republic of China.
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Chen K, Yang Y, Wang X, Zhu Y, Lyu F, Jiang J, Xia X, Zheng C. The role of leisure-time physical activity in maintaining cervical lordosis after anterior cervical fusion and its impact on the motor function in patients with hirayama disease: a retrospective cohort analysis. BMC Musculoskelet Disord 2023; 24:903. [PMID: 37990179 PMCID: PMC10662470 DOI: 10.1186/s12891-023-07038-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Surgical treatment has been increasingly performed in Hirayama disease (HD) patients to limit excessive neck flexion and restore cervical lordosis. However, postoperative recurrence of cervical lordosis loss may restart the progress of HD. Many studies have demonstrated a relationship between neck muscle strength and cervical lordosis, and it is widely accepted that leisure-time physical activity (LTPA) can increase muscle strength. However, there are few reports about the correlation between LTPA and maintenance of postoperative cervical curvature. OBJECTIVE To quantify the cervical lordosis and motor function before and after operation in HD patients and to analyze the impact of postoperative LTPA levels on the changes in these measurements. METHODS C2-7 Cobb were measured in 91 HD patients before, 2-5 days and approximately 2 years after operation. Motor unit number estimation (MUNE) and handgrip strength (HGS) were performed in all patients before and approximately 2 years after operation, and both cross-sectional area and fatty infiltration of posterior cervical muscles were measured in 62 patients. Long-form international Physical Activity Questionnaire and its different domains was administered to all patients at postoperative 2-year assessments. RESULTS The C2-7 Cobb was larger immediately and approximately 2 years after operation than that at preoperative assessment (P < 0.05). The preoperative to postoperative change in C2-7 Cobb was associated with postoperative changes in the symptomatic-side HGS and bilateral MUNE measurements (P < 0.05). Importantly, the patients performing LTPA had greater improvements in C2-7 Cobb from immediate to approximately 2 years after operation and greater C2-7 Cobb at last follow-up than those without LTPA, and postoperative improvements in both symptomatic-side MUNE measurements and symptomatic-side HGS were also greater in the former than in the latter (P < 0.05). CONCLUSIONS Postoperative LTPA has a positive effect on recovery/maintenance of cervical lordosis after operation, which may alleviate the motor unit loss of distal upper limbs in HD patients. Therefore, postoperative LTPA may be beneficial for postoperative rehabilitation or early conservative treatment of HD patients.
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Affiliation(s)
- Kaiwen Chen
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid- Wulumuqi Road, Shanghai, 200040, China
| | - Yang Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Xiaoqin Wang
- Department of Nursing, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Yu Zhu
- Department of Physical Medicine and Rehabilitation, Upstate Medical University, State University of New York at Syracuse, Syracuse, NY, 10212, USA
| | - Feizhou Lyu
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid- Wulumuqi Road, Shanghai, 200040, China
- Department of Orthopedics, The Fifth People's Hospital, Fudan University, Shanghai, 200240, China
| | - Jianyuan Jiang
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid- Wulumuqi Road, Shanghai, 200040, China
| | - Xinlei Xia
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid- Wulumuqi Road, Shanghai, 200040, China
| | - Chaojun Zheng
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid- Wulumuqi Road, Shanghai, 200040, China.
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Chen K, Gao T, Yang S, Zhu Y, Lyu F, Jiang J, Xia X, Zheng C. Changes in Self-Esteem in Patients with Hirayama Disease and its Association with Prognosis After Anterior Cervical Fusion Procedures. World Neurosurg 2023; 178:e802-e818. [PMID: 37572833 DOI: 10.1016/j.wneu.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE To quantify self-esteem in patients with Hirayama disease (HD) and investigate the impact of this psychosocial factor on surgical outcomes in HD. METHODS The Rosenberg Self-Esteem Scale (RSES) was measured in 58 patients with HD before anterior cervical fusion. These patients further underwent motor unit number estimation, handgrip strength, disabilities of the arm, shoulder and hand (DASH), Beck Anxiety Inventory (BAI) and Beck Depression Index (BDI) before and 18 months after operation. Furthermore, the International Physical Activity Questionnaire (IPAQ) was administered to all patients at postoperative 18-month assessments. RESULTS Compared with the general population, patients with HD showed a relatively lower RSES, and RSES was negatively associated with both postoperative DASH (r = -0.431, P < 0.05) and preoperative to postoperative changes (r = -0.295, P < 0.05) and positively associated with IPAQ (r = 0.472, P < 0.05). Similar to the difference in postoperative DASH scores, more patients with low self-esteem felt postoperative aggravated motor dysfunction than those with high/normal self-esteem (P < 0.05). Postoperative BDI exerted a partial mediating effect on the relationship between RSES and DASH scores (B = -0.30, P < 0.05), and postoperative BAI played a partial mediating effect on the relationship between RSES and IPAQ scores (B = 0.30, P < 0.05). CONCLUSIONS The self-esteem of HD patients may be below the population norms. Importantly, relatively low self-esteem in HD patients may cause/worsen postoperative depression and anxiety, thereby resulting in poor self-reported surgical prognosis and an inactive lifestyle after operation. Therefore, perioperative treatment and rehabilitation efforts in HD patients, especially those with low self-esteem, should account for both physiological and psychological symptoms.
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Affiliation(s)
- Kaiwen Chen
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Tian Gao
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Shuo Yang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Yu Zhu
- Department of Physical Medicine and Rehabilitation, Upstate Medical University, State University of New York at Syracuse, Syracuse, New York, USA
| | - Feizhou Lyu
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China; Department of Orthopedics, The Fifth People's Hospital, Fudan University, Shanghai, China
| | - Jianyuan Jiang
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinlei Xia
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China
| | - Chaojun Zheng
- Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
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Guo W, Xing H, Gong X, He L, Zhang Z, Jia C. Effects of Yi Jin Jing on juvenile cervical spondylopathy in China: A parallel, randomized, assessor-blinded clinical trial. Niger J Clin Pract 2023; 26:1234-1241. [PMID: 37794534 DOI: 10.4103/njcp.njcp_410_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background Cervical spondylopathy is a common musculo-articular disorder, multiple exercises are recommended. Chinese fitness exercises are prevalent and used to treat various diseases. Aim To explore the efficacy of Chinese fitness exercise Yi Jin Jing exercise in intervening the cervical spondylopathy in adolescents. Patients and Methods The study was conducted in 60 adolescent patients with cervical spondylopathy, with 30 patients in each group. Methods The study was conducted in 60 adolescent patients with cervical spondylopathy, with 30 patients in each group. The observation group was required to take Yi Jin Jing exercise, and the control group took the brisk walking exercise. The first week was the preparatory period for the patients, and then the participants were required to do exercises three times a week for at least 30 minutes in the later 3 weeks. Before and after treatment, Neck Disability Index (NDI) scores, pain visual analog scale (VAS) scores, and cervical curvature in both groups were observed, and the incidence of adverse events in both groups was recorded during the trial. Results The NDI and VAS scores in both groups statistically decreased after intervention and mildly increased at follow-up, while the reduction in scores of the Yi Jin Jing group was more significant. Cervical curvature in both groups improved on day 28 compared to day 0. There were no adverse reactions during the evaluation period. Conclusion The Chinese health-care qigong Yi Jin Jing exercise is more effective than brisk walking in improving the cervical range of motion and relieving pain in adolescents with cervical spondylopathy. Trial registration/Protocol registration: Clinical Trial Registry (ChiCTR2000030723).
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Affiliation(s)
- W Guo
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - H Xing
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - X Gong
- Deparment of Acupuncture and Moxibustion, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - L He
- Deparment of Acupuncture and Moxibustion, Baiyun Hospital of The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Z Zhang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - C Jia
- Deparment of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Lim J, Lee D, Kim S, Lee S, Ryu JS. Analysis of abnormal muscle activities in patients with loss of cervical lordosis: a cross-sectional study. BMC Musculoskelet Disord 2023; 24:666. [PMID: 37608321 PMCID: PMC10464463 DOI: 10.1186/s12891-023-06782-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/04/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND This study aimed to detect the differences in cervical muscle activation patterns in people with versus without cervical lordosis and explore the possible mechanism of cervical pain originating therein. METHODS This cross-sectional design included 39 participants without and 18 with normal cervical lordosis. Muscular activation was measured for 5 s in both groups using surface electromyography. Subsequently, the root mean square (RMS) of muscle amplitude was obtained at the bilateral splenius capitis, upper and lower parts of the splenius cervicis, upper and lower parts of the semispinalis cervicis, sternocleidomastoid, upper trapezius, and rhomboid muscles in five cervical positions: 0° (resting), 30° of flexion, 30° of extension, 60° of extension, and upon a 1-kg load on the head in a resting posture. RESULTS The RMS values of the upper trapezius muscle at all postures and the rhomboid muscles at 60° of extension were significantly lower in the loss of lordosis than control group. Comparing the RMS ratio of each posture to the resting position, the ratio of the upper trapezius at flexion was significantly higher and that of the rhomboids at 60° of extension and upon loading was significantly lower in the loss of lordosis than control group. Moreover, the pattern changes in the RMS values according to posture showed a similar shape in these two muscles, and lower in the loss of lordosis than the normal group. CONCLUSIONS The loss of normal cervical alignment may correlate with predisposed conditions such as reduced muscle activation of the trapezius and rhomboid muscle, and may also provoke over-firing of the upper trapezius muscle, possibly increasing neck musculoskeletal pain. TRIAL REGISTRATION CLINICALTRIALS gov, registration number: NCT03710785.
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Affiliation(s)
- Jiwoon Lim
- Department of Rehabilitation Medicine, Korea University Ansan Hospital, Ansan-si, South Korea
| | - Dajeong Lee
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Sangyoung Kim
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Seungeun Lee
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, South Korea
| | - Ju Seok Ryu
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, South Korea.
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, South Korea.
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Delen V, İlter S. Loss of cervical lordosis in chronic neck pain patients with fibromyalgia: A cross-sectional study. J Back Musculoskelet Rehabil 2023; 36:1429-1434. [PMID: 37545210 DOI: 10.3233/bmr-230019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
BACKGROUND Some interrelationships among fibromyalgia (FM), loss of cervical lordosis (LCL), and headache have been reported. Thus, it is sensible to examine LCL as a factor underlying FM and headache. OBJECTIVE In this study we aimed to assess LCL in chronic neck pain patients (CNPP) with FM and its association with headache features and FM severity. METHODS CNPP with (n= 55; mean age 40.0 ± 8.5; range 20 to 55 years) and without FM (n= 55; mean age 38.5 ± 8.9; range 20 to 55 years) were included in the study. Cervical lordosis was assessed by measuring the Cobb angle on the lateral cervical radiographs. The patients were asked about headache features within the last month. In addition, the CNPP with FM were evaluated by the Turkish version of the Revised Fibromyalgia Impact Questionnaire. RESULTS There were no statistically significant differences between the groups in terms of age, weight, height, body mass index, working status, and neck pain duration (p> 0.05 for each). The CNPP with FM had significantly reduced cervical lordosis angle compared with those without. The CNPP with FM had significantly higher headache frequency than those without (p= 0.008). There was statistically significant negative correlation between cervical lordosis angle and headache frequency in the CNPP with FM (r: -0.336; p= 0.012). CONCLUSION According to the results of this study, LCL may be associated with FM and headache frequency in the CNPP with FM.
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Affiliation(s)
- Veysel Delen
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Server İlter
- Department of Physical Medicine and Rehabilitation, Dursun Odabaş Medical Center, Van Yüzüncü Yıl University, Van, Turkey
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Giménez-Costa M, Schomacher J, Murillo C, Blanco-Hernández T, Falla D, Lluch E. Specific versus non-specific exercises for the neck extensor muscles in women with chronic idiopathic neck pain: A randomized controlled trial. Musculoskelet Sci Pract 2022; 60:102561. [PMID: 35421696 DOI: 10.1016/j.msksp.2022.102561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/19/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Structural and functional impairments of the cervical extensor muscles have been demonstrated in people with neck pain. A global exercise approach targeting all neck extensor muscles has shown positive effects in this population. However, to date, the efficacy of exercises specifically targeting the deep neck extensors has neither been tested nor compared to global exercises for the neck extensors. OBJECTIVES To compare the effects on pain and disability of a specific lower deep neck extensors (SLDNE) versus a general neck extensor (GNE) exercise program in women with chronic idiopathic neck pain. METHODS Fourty-three women with chronic idiopathic neck pain were randomly allocated to either a six-week SLDNE or a GNE exercise program. As primary outcome, neck disability was measured with the Neck Disability Index (NDI). Secondarily, pain intensity (VAS), cervical ROM, pressure pain thresholds (PPTs), cervical and thoracic posture and self-perceived benefit of treatment (GROC) were also measured. Every outcome was measured at baseline and immediately after treatment, except NDI, which was also measured at 6-months follow-up. The GROC was only assessed post-intervention. RESULTS Both exercise programs lead to reduced neck disability immediately post-intervention (within-group mean difference [MD] = -6.09; 95% Confidence Interval [CI]: 7.75, -4.42 and -4.73; 95%CI: 6.57, -2.91 respectively) and at the 6-months follow-up (-4.47; 95%CI: 6.41, -2.53 and -4.74; 95%CI: 6.50, -2.97), but with no between group differences. Similar results were found for pain intensity post-intervention, with no between group interaction (within-group MD = -20.87 mm; 95% CI: 28.55, -13.19 and -18.00 mm; 95%CI: (-26.24, -9.76) for SLDNE and GNE groups, respectively). GROC improved after both interventions without any between-group difference. CONCLUSIONS A six-week exercise program specifically targeting the lower deep neck extensors lead to comparable outcomes as a general neck extensor exercise program in women with chronic idiopathic neck pain.
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Affiliation(s)
- M Giménez-Costa
- Diputació de València, Valencia, Spain; University of Alcalá, Alcalá de Henares, Spain
| | | | - C Murillo
- Department of Rehabilitation Sciences, Faculty of Health Sciences and Medicine, Ghent University, Belgium; Pain in Motion International Research Group, Belgium(1)
| | | | - D Falla
- Center of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - E Lluch
- Pain in Motion International Research Group, Belgium(1); Department of Physical Therapy, University of Valencia, Spain.
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Wang XJ, Huang KK, He JB, Wu TK, Rong X, Liu H. Fatty infiltration in cervical extensor muscle: is there a relationship with cervical sagittal alignment after anterior cervical discectomy and fusion? BMC Musculoskelet Disord 2022; 23:641. [PMID: 35791024 PMCID: PMC9254416 DOI: 10.1186/s12891-022-05606-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/30/2022] [Indexed: 12/14/2022] Open
Abstract
Purpose To investigate the relationship between the preoperative paraspinal Goutalier grade of fatty infiltration and postoperative cervical sagittal alignment in patients undergoing anterior cervical discectomy and fusion (ACDF). Methods A total of 101 patients who underwent single-level ACDF with the Zero-profile implant system between March 2011 and April 2020 were included in this study. Cervical sagittal alignment parameters, including the C2-C7 Cobb angle, functional spinal unit (FSU) angle, cervical sagittal vertical axis (SVA), and T1 slope (T1S), were assessed. Preoperative magnetic resonance images were used to classify patients according to Goutalier grade. Clinical outcomes including Neck Disability Index (NDI) scores, Japanese Orthepaedic Association (JOA) scores and Visual Analogue Scale (VAS) scores were collected and analyzed. Results According to the Goutalier grade, 33 patients were classified as Goutalier 0–1 (Group A), 44 were classified as Goutalier 1.5–2 (Group B), and 24 were classified as Goutalier 2.5–4.0 (Group C). The mean age among the three groups showed significant differences (P = 0.007). At the last follow-up, the C2-C7 Cobb angle, FSU angle, and T1S improved after the surgery among the groups. Although there were varying degrees of loss of curvature among the different groups during the follow-up period, the postoperative cervical sagittal alignment parameters demonstrated no statistical differences among the three groups (P > 0.05). In addition, patients in all groups experienced significant relief of their symptoms, and the clinical scores were comparable among the groups (P > 0.05). Conclusion The complex nature of anterior cervical surgery requires surgical attention both in decompression and sagittal alignment. Our study demonstrates satisfactory postoperative cervical sagittal alignment of patients despite different grades of fatty infiltration of the multifidus muscle following single-level ACDF. Based on our results, the improvement and maintenance of cervical sagittal alignment after ACDF remains a complex problem that spine surgeons should consider before surgery.
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Wang L, Ibrahim Y, Tian Y, Yuan S, Liu X. Progressive Adolescent Idiopathic Cervical Kyphosis Secondary to Constant Postural Neck Flexion Reading Habit with a 10-year Follow-up: Case Report and Literature Review. Orthop Surg 2022; 14:1527-1532. [PMID: 35686521 PMCID: PMC9251296 DOI: 10.1111/os.13356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Although it has been established that adolescent idiopathic cervical kyphosis (AICK) has no known cause, there are associated risk factors. However, the underlying causes remain puzzling. This case report presents severe AICK linked to chronic neck flexion postural habit, treated with combined anterior and posterior correction surgery and review of the literature. CASE PRESENTATION A 16-year-old male with no history of trauma, surgery, or family history of spinal deformity complained of intolerable neck pain and rigidity. He developed an incessant reading of comic books at a very young age, and he preferred placing the book on the floor with his head flexed between his thighs. Acupuncture and massage therapy failed to relief symptoms. He had no neurological symptoms on examination and X-ray showed Cobb angle of 70.5°. MRI and CT scans showed no spinal cord compression or osteophyte formation. A combined anterior and posterior correction surgery was performed after a week of skull traction. The deformity was corrected, neck pain disappeared, and neck rotatory function maintained after posterior implant removal. The maximum follow-up was 10 years. CONCLUSIONS The potential underlying risk factor observed in this case is unusual. Chronic neck flexion postural habit is a potential risk factor of severe AICK in some individuals.
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Affiliation(s)
- Lianlei Wang
- Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Yakubu Ibrahim
- Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Yonghao Tian
- Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Suomao Yuan
- Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Xinyu Liu
- Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
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Uehara T, Tsushima E, Yamada S, Kimura S, Satsukawa Y, Yoshihara A, Inada A, Hayakawa T. A Randomized Controlled Trial for the Intervention Effect of Early Exercise Therapy on Axial Pain after Cervical Laminoplasty. Spine Surg Relat Res 2022; 6:123-132. [PMID: 35478978 PMCID: PMC8995120 DOI: 10.22603/ssrr.2021-0110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/10/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Methods Results Conclusions
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Affiliation(s)
- Toru Uehara
- Department of Rehabilitation, Nagoya City University West Medical Center
| | - Eiki Tsushima
- Graduate School of Health Sciences, Hirosaki University
| | - Shota Yamada
- Department of Rehabilitation, Nagoya City University West Medical Center
| | - Shingo Kimura
- Department of Rehabilitation, Nagoya City University West Medical Center
| | - Yuya Satsukawa
- Department of Rehabilitation, Nagoya City University West Medical Center
| | - Akira Yoshihara
- Department of Rehabilitation, Nagoya City University West Medical Center
| | - Atsushi Inada
- Department of Orthopedic Surgery, Nagoya City University West Medical Center
| | - Takashi Hayakawa
- Department of Orthopedic Surgery, Nagoya City University West Medical Center
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12
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Tsang SMH, Szeto GPY, So BCL, Lau RWL, Tai JJ. Using cervical movement velocity to assist the prediction of pain and functional recovery for people with chronic mechanical neck pain. Clin Biomech (Bristol, Avon) 2022; 93:105607. [PMID: 35245780 DOI: 10.1016/j.clinbiomech.2022.105607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/16/2022] [Accepted: 02/22/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Impaired cervical kinematics particularly the movement velocity had been consistently found in people with neck pain. The recovery and potential of cervical movement velocity in assisting the prediction of recovery in individuals with chronic neck pain remained unknown. This study investigated the application of cervical movement velocity to predict the outcomes of pain intensity and functional disability for a cohort of participants with chronic mechanical pain after completion of a 12-week intervention program. METHODS Cervical movement velocity when performing neck motions in the anatomical planes, pain intensity and functional disability score were assessed before and after the physiotherapy program. Correlations between kinematic and clinical outcomes, and validity of applying the peak velocity values of the cervical spine measured at baseline for prediction of recovery of pain and function after the physiotherapy program were examined (n = 68). FINDINGS Significant improvements were found in the peak values of cervical velocity in all movement planes, pain intensity and functional disability score at post-program reassessment (p < 0.001). Significant negative correlations between peak values of cervical movement velocity and pain intensity (for specific directions, r = -0.163 to -0.191), and functional disability were found (for all directions, r = -0.158 to -0.282). Area under the Receiver Operating Characteristics curve was >0.6 for cervical extension, flexion and right rotation velocity for predicting functional recovery post-program. INTERPRETATION These findings suggest that cervical velocity of selected planes measured at baseline may inform the prediction of recovery of functional disability but not pain intensity in people with chronic mechanical neck pain.
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Affiliation(s)
- Sharon M H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Grace P Y Szeto
- School of Medical and Health Sciences, Tung Wah College, Hong Kong
| | - Billy C L So
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Rufina W L Lau
- School of Medical and Health Sciences, Tung Wah College, Hong Kong
| | - Jay J Tai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
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13
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Effects of a combination of scapular stabilization and thoracic extension exercises for office workers with forward head posture on the craniovertebral angle, respiration, pain, and disability: A randomized-controlled trial. Turk J Phys Med Rehabil 2021; 67:291-299. [PMID: 34870115 PMCID: PMC8606989 DOI: 10.5606/tftrd.2021.6397] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/23/2020] [Indexed: 11/27/2022] Open
Abstract
Objectives
This study aims to investigate how exercise programs not directly applied to the cervical spine affect office workers with forward head posture (FHP).
Patients and methods
Between March 2018 and June 2018, a total of 32 office workers with FHP (13 males, 19 females; mean age 36.63 years; range, 23 to 57 years) were randomized either to experimental (n=16) or control groups (n=16). Scapular stabilization and thoracic extension exercises were applied to the experimental group and cervical stabilization and stretching exercises to the control group. The results of the pre-intervention and after six weeks measurement of the craniovertebral angle (CVA), respiration, pain, and disability were compared and analyzed.
Results
For intra-group comparison, both groups showed significant differences (p<0.05) in CVA, forced expiratory volume at 1 sec (FEV1), Visual Analog Scale (VAS), and neck disability index at pre- and post-intervention, while only the experimental group showed a significant difference (p<0.05) in maximum inspiratory pressure, maximum expiratory pressure, and forced vital capacity. For inter-group comparison, a significant difference (p<0.05) between FEV1 and VAS was observed.
Conclusion
The combination of scapular stabilization and thoracic extension exercises, not directly applied to the cervical spine, has an effect on improving the posture, respiration, neck pain, and disability in office workers with FHP.
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14
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Siasios I, Samara E, Fotiadou A, Tsoleka K, Vadikolias K, Mantatzis M, Birbilis T. The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies. J Clin Med Res 2021; 13:367-376. [PMID: 34394779 PMCID: PMC8336945 DOI: 10.14740/jocmr4551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/16/2021] [Indexed: 12/03/2022] Open
Abstract
Cervical spine musculature still remains a less studied component of the cervical spine anatomical compartments, although it plays a significant role in the mobility of the head and the preservation of cervical spine alignment. The goal of this study was to extract any significant information from the literature regarding the role of cervical spine muscles morphology in the outcome of surgically treated patients for degenerative disc disease (DDD) based on preoperative magnetic resonance imaging (MRI) studies. Eleven clinical case series were found, from which four were prospective and seven were retrospective. Six studies were concentrated on anterior approaches and five studies on posterior approaches in the cervical spine. In posterior approaches aiming at the preservation of muscles attachments and overall less surgical manipulations, results on cervical lordosis, axial pain and patient’s functionality were found superior to traditional laminectomies. The study of cross-sectional areas (CSAs) of deep paraspinal muscles in the cervical spine could add significant information for the spine surgeon such as the prediction of adjacent level disease (ALD), fusion failure, axial pain persistence, postoperative cervical alignment and patient’s postoperative functionality. It seems that MRI studies focusing on muscle layers of the cervical spine could add significant information for the spinal surgeon regarding the final surgical outcome in terms of pain and function expression. Larger multicenter clinical studies are a necessity in defining the role of the muscle component of the cervical spine in the surgical treatment of DDD.
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Affiliation(s)
- Ioannis Siasios
- Department of Neurosurgery, General Hospital of Papageorgiou, Thessaloniki, Greece.,Department of Neurosurgery, General University Hospital of Alexandroupolis, Alexandroupoli, Greece
| | - Ethymia Samara
- Department of Neurology, General Hospital of Papageorgiou, Thessaloniki, Greece
| | - Aggeliki Fotiadou
- Department of Neurology, General University Hospital of Alexandroupolis, Alexandroupoli, Greece
| | - Kalliopi Tsoleka
- Department of Neurosurgery, General Hospital of Papageorgiou, Thessaloniki, Greece
| | - Konstantinos Vadikolias
- Department of Neurology, General University Hospital of Alexandroupolis, Alexandroupoli, Greece
| | - Michael Mantatzis
- Department of Radiology, General University Hospital of Alexandroupolis, Alexandroupoli, Greece
| | - Theodosis Birbilis
- Department of Neurosurgery, General University Hospital of Alexandroupolis, Alexandroupoli, Greece
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15
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Romero-Franco N, Jiménez-Reyes P, Fernández-Domínguez JC. Concurrent Validity and Reliability of a Low-Cost Dynamometer to Assess Maximal Isometric Strength in Neck Movements. J Manipulative Physiol Ther 2021; 44:229-235. [PMID: 33461749 DOI: 10.1016/j.jmpt.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 02/18/2020] [Accepted: 08/03/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to evaluate the concurrent validity and reliability of a low-cost digital dynamometer to assess maximal isometric strength in neck movements. METHODS Twelve recreationally active participants (6 women, 6 men; age: 24.1 ± 3.4 years; height: 1.71 ± 0.06 m; weight: 64.6 ± 11.7 kg) performed neck flexion, extension, and lateral flexion, and maximal isometric strength was simultaneously measured using an isokinetic dynamometer (gold standard) and a digital dynamometer to evaluate the concurrent validity of the latter. One week later, all the participants repeated 3 trials of each neck movement (3 minutes apart) registered only with the digital dynamometer. The first and second trial were guided by tester 1 and the third trial was guided by tester 2. RESULTS The concurrent validity of the digital dynamometer showed a nearly perfect correlation between both devices (r > 0.986, P < .001), with Bland-Altman plots showing absolute agreement. Intertester and intratester reliability were nearly perfect for all neck movements (intraclass correlation coefficient > 0.86). CONCLUSION The low-cost digital dynamometer showed valid and reliable measurements of maximal isometric strength in neck movements.
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Affiliation(s)
- Natalia Romero-Franco
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Spain..
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de Zoete RM, Armfield NR, McAuley JH, Chen K, Sterling M. Comparative effectiveness of physical exercise interventions for chronic non-specific neck pain: a systematic review with network meta-analysis of 40 randomised controlled trials. Br J Sports Med 2020; 55:bjsports-2020-102664. [PMID: 33139256 DOI: 10.1136/bjsports-2020-102664] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To compare the effectiveness of different physical exercise interventions for chronic non-specific neck pain. DESIGN Systematic review and network meta-analysis. DATA SOURCES Electronic databases: AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Physiotherapy Evidence Database, PsycINFO, Scopus and SPORTDiscus. ELIGIBILITY CRITERIA Randomised controlled trials (RCTs) describing the effects of any physical exercise intervention in adults with chronic non-specific neck pain. RESULTS The search returned 6549 records, 40 studies were included. Two networks of pairwise comparisons were constructed, one for pain intensity (n=38 RCTs, n=3151 participants) and one for disability (n=29 RCTs, n=2336 participants), and direct and indirect evidence was obtained. Compared with no treatment, three exercise interventions were found to be effective for pain and disability: motor control (Hedges' g, pain -1.32, 95% CI: -1.99 to -0.65; disability -0.87, 95% CI: -1.45 o -0.29), yoga/Pilates/Tai Chi/Qigong (pain -1.25, 95% CI: -1.85 to -0.65; disability -1.16, 95% CI: -1.75 to -0.57) and strengthening (pain -1.21, 95% CI: -1.63 to -0.78; disability -0.75, 95% CI: -1.28 to -0.22). Other interventions, including range of motion (pain -0.98 CI: -2.51 to 0.56), balance (pain -0.38, 95% CI: -2.10 to 1.33) and multimodal (three or more exercises types combined) (pain -0.08, 95% CI: -1.70 to 1.53) exercises showed uncertain or negligible effects. The quality of evidence was very low according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. CONCLUSION There is not one superior type of physical exercise for people with chronic non-specific neck pain. Rather, there is very low quality evidence that motor control, yoga/Pilates/Tai Chi/Qigong and strengthening exercises are equally effective. These findings may assist clinicians to select exercises for people with chronic non-specific neck pain. PROSPERO REGISTRATION NUMBER CRD42019126523.
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Affiliation(s)
- Rutger Mj de Zoete
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia
| | - Nigel R Armfield
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
| | - James H McAuley
- Neuroscience Research Australia and School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Kenneth Chen
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
- Geriatric Education and Research Institute, Singapore
| | - Michele Sterling
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Queensland, Australia
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Lee MY, Jeon H, Choi JS, Park Y, Ryu JS. Efficacy of Modified Cervical and Shoulder Retraction Exercise in Patients With Loss of Cervical Lordosis and Neck Pain. Ann Rehabil Med 2020; 44:210-217. [PMID: 32475094 PMCID: PMC7349041 DOI: 10.5535/arm.19117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/18/2019] [Indexed: 12/20/2022] Open
Abstract
Objective To explore if the modified cervical and shoulder retraction exercise program restores cervical lordosis and reduces neck pain in patients with loss of cervical lordosis. Methods This study was a retrospective analysis of prospectively collected data. Eighty-three patients with loss of cervical lordosis were eligible. The eligible patients were trained to perform the modified cervical and shoulder retraction exercise program by a physiatrist, and were scheduled for a follow-up 6 to 8 weeks later to check the post-exercise pain intensity and lateral radiograph of the cervical spine in a comfortable position. The parameters of cervical alignment (4-line Cobb’s angle, posterior tangent method, and sagittal vertical axis) were measured from the lateral radiograph. Results Forty-seven patients were included. The mean age was 48.29±14.47 years. Cervical alignment and neck pain significantly improved after undergoing the modified cervical and shoulder retraction exercise program (p≤0.001). The upper cervical lordotic angle also significantly improved (p=0.001). In a subgroup analysis, which involved dividing the patients into two age groups (<50 years and ≥50 years), the change of the sagittal vertical axis was significantly greater in the <50 years group (p=0.021). Conclusion The modified cervical and shoulder retraction exercise program tends to improve cervical lordosis and neck pain in patients with loss of cervical lordosis.
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Affiliation(s)
- Min Yong Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Heewon Jeon
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ji Soo Choi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yulhyun Park
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Bundang, Korea
| | - Ju Seok Ryu
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Bundang, Korea.,Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
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Yoon SY, Moon HI, Lee SC, Eun NL, Kim YW. Association between cervical lordotic curvature and cervical muscle cross-sectional area in patients with loss of cervical lordosis. Clin Anat 2018; 31:710-715. [DOI: 10.1002/ca.23074] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 02/20/2018] [Accepted: 03/13/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Seo Yeon Yoon
- Department of Rehabilitation Medicine; Bundang Jesaeng General Hospital; Gyeonggi-do Republic of Korea
| | - Hyun Im Moon
- Department of Rehabilitation Medicine; Bundang Jesaeng General Hospital; Gyeonggi-do Republic of Korea
| | - Sang Chul Lee
- Department and Research Institute of Rehabilitation Medicine; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Na Lae Eun
- Department of Radiology and Research Institute of Radiological Science; Gangnam Severance Hospital, Yonsei University College of Medicine; Seoul Republic of Korea
| | - Yong Wook Kim
- Department and Research Institute of Rehabilitation Medicine; Yonsei University College of Medicine; Seoul Republic of Korea
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