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Feng X, Liu C, Hu DM, Zhang JF, Zheng N, Chi YY, Yu SB, Sui HJ, Xu Q. Magnetic resonance imaging-based classification of the myodural bridge complex and its influencing factors. Surg Radiol Anat 2024; 46:125-135. [PMID: 38194160 PMCID: PMC10861613 DOI: 10.1007/s00276-023-03279-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/05/2023] [Indexed: 01/10/2024]
Abstract
Cerebrospinal fluid (CSF) circulation is considered the third circulation of the human body. Recently, some scholars have proposed the myodural bridge (MDB) as a novel power source for CSF flow. Moreover, the suboccipital muscles can exert a driving force on the CSF via the MDB. This hypothesis is directly supported by head rotation and nodding movements, which can affect CSF circulation. The MDB has been validated as a normal structure in humans and mammals. In addition, the fusion of MDB fibers of different origins that act in concert with each other forms the MDB complex (MDBC). The MDBC may be associated with several CSF disorder-related neurological disorders in clinical practice. Therefore, the morphology of the MDBC and its influencing factors must be determined. In this study, T2-weighted imaging sagittal images of the cervical region were analyzed retrospectively in 1085 patients, and magnetic resonance imaging (MRI) typing of the MDBC was performed according to the imaging features of the MDBC in the posterior atlanto-occipital interspace (PAOiS) and posterior atlanto-axial interspace (PAAiS). The effects of age and age-related degenerative changes in the cervical spine on MRI staging of the MDBC were also determined. The results revealed four MRI types of the MDBC: type A (no MDBC hyposignal shadow connected to the dura mater in either the PAOiS or PAAiS), type B (MDBC hyposignal shadow connected to the dura mater in the PAOiS only), type C (MDBC hyposignal shadow connected to the dura mater in the PAAiS only), and type D (MDBC hyposignal shadow connected to the dura mater in both the PAOiS and PAAiS). The influencing factors for the MDBC typing were age (group), degree of intervertebral space stenosis, dorsal osteophytosis, and degenerative changes in the cervical spine (P < 0.05). With increasing age (10-year interval), the incidence of type B MDBC markedly decreased, whereas that of type A MDBC increased considerably. With the deepening of the degree of intervertebral space stenosis, the incidence of type C MDBC increased significantly, whereas that of type A MDBC decreased. In the presence of dorsal osteophytosis, the incidence of type C and D MDBCs significantly decreased, whereas that of type A increased. In the presence of protrusion of the intervertebral disc, the incidence of type B, C, and D MDBCs increased markedly, whereas that of type A MDBC decreased considerably, with cervical degenerative changes combined with spinal canal stenosis. Moreover, the incidence of both type C and D MDBCs increased, whereas that of type A MDBC decreased. Based on the MRI signal characteristics of the dural side of the MDBC, four types of the MDBC were identified. MDBC typing varies dynamically according to population distribution, depending on age and cervical degeneration (degree of intervertebral space stenosis, vertebral dorsal osteophytosis formation, simple protrusion of intervertebral disc, and cervical degeneration changes combined with spinal canal stenosis, except for the degree of protrusion of the intervertebral disc and the degree of spinal canal stenosis); however, it is not influenced by sex.
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Affiliation(s)
- Xiao Feng
- Postgraduate Training Base, The 967 Hospital of the Joint Logistics Support Force, Jinzhou Medical University, Dalian, 116021, China
| | - Cong Liu
- Department of Radiology, The 967 Hospital of the Joint Logistics Support Force, Dalian, 116021, China
| | - Dong-Mei Hu
- Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian, 116044, China
| | - Jian-Fei Zhang
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, 116044, China
| | - Nan Zheng
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, 116044, China
| | - Yan-Yan Chi
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, 116044, China
| | - Sheng-Bo Yu
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, 116044, China.
| | - Hong-Jin Sui
- Department of Anatomy, College of Basic Medicine, Dalian Medical University, Dalian, 116044, China.
| | - Qiang Xu
- Department of Radiology, The 967 Hospital of the Joint Logistics Support Force, Dalian, 116021, China.
- Postgraduate Training Base, The 967 Hospital of the Joint Logistics Support Force, Jinzhou Medical University, Dalian, 116021, China.
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Javanshir K, Ghafouri-Rouzbehani P, Zohrehvand A, Naeimi A, Fernández-de-las-Peñas C, Nikbakht HA, Mousavi-Khatir SR, Valera-Calero JA. Cervical Multifidus and Longus Colli Ultrasound Differences among Patients with Cervical Disc Bulging, Protrusion and Extrusion and Asymptomatic Controls: A Cross-Sectional Study. J Clin Med 2024; 13:624. [PMID: 38276132 PMCID: PMC10816935 DOI: 10.3390/jcm13020624] [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: 11/08/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
The aim of this study was to analyze the differences in morphological and histological features of the cervical multifidus (CM) and longus colli (LC) muscles among patients with cervical disc bulging, protrusion, or extrusion. Fifteen patients with cervical disc bulging (20% male, mean age: 48.5, standard deviation (SD) 7.5 years), fifteen with cervical disc protrusion (6% male, mean age: 43, SD 7.8 years), and fifteen with cervical disc extrusion (40% male, mean age: 44, SD 8 years) diagnosed via clinical and imaging findings participated in this study. Additionally, fifteen asymptomatic controls (40% male, mean age: 40.4, SD 9.7 years) were also included. The following ultrasound measurements, cross-sectional area (CSA), anterior-posterior distance (APD), lateral dimension (LD), and mean echo-intensity (EI) of the CM and LC at C5-C6 level were examined by an assessor blinded to the subject's condition. The results revealed no group ×side significant differences among the groups (p > 0. 00625). However, group effects were found for APD and MEI of the CM (p = 0.006 and p < 0.001, respectively) and CSA, APD and MEI of the LC (all, p < 0.001). The LD of the LC muscle and the APD and LD of the CM were negatively associated with related disability (p < 0.01; p < 0.05 and p < 0.01, respectively), and pain intensity was negatively associated with LC APD and LD (both p < 0.05). These results suggest that US can be used to detect bilateral morphological changes in deep cervical flexors and extensors to discriminate patients with cervical disc alterations.
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Affiliation(s)
- Khodabakhsh Javanshir
- Department of Physical Therapy, School of Rehabilitation, Babol University of Medical Science, Babol 47176-47745, Iran; (K.J.); (P.G.-R.); (S.R.M.-K.)
| | - Payam Ghafouri-Rouzbehani
- Department of Physical Therapy, School of Rehabilitation, Babol University of Medical Science, Babol 47176-47745, Iran; (K.J.); (P.G.-R.); (S.R.M.-K.)
| | - Amirhossein Zohrehvand
- Department of Neurosurgery, School of Medicine, Babol University of Medical Sciences, Babol 47176-47745, Iran;
| | - Arvin Naeimi
- Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht 41446-66949, Iran;
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-47745, Iran;
| | - Seyedeh Roghayeh Mousavi-Khatir
- Department of Physical Therapy, School of Rehabilitation, Babol University of Medical Science, Babol 47176-47745, Iran; (K.J.); (P.G.-R.); (S.R.M.-K.)
| | - Juan Antonio Valera-Calero
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursery, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Hoseinyazdi M, Asadollahi S, Luna R, Rafiee F, Gong G, Yousem DM. Longitudinal assessment of annular fissures of the cervical spine: overlooked and static. NORTH AMERICAN SPINE SOCIETY JOURNAL 2023; 15:100238. [PMID: 37457394 PMCID: PMC10345478 DOI: 10.1016/j.xnsj.2023.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
Background Cervical annular fissures (AFs) have not been studied specifically as to their prevalence, imaging features, and persistence over time. We sought to determine the prevalence and natural history of cervical AFs. We hypothesized that these are static lesions that are not prevalent in the population. Methods This was a cross-sectional retrospective study of cervical MRI examinations performed between 2011-2021. We retrospectively reviewed the studies of 115 consecutive patients (63 female, 52 male) who had 2 or more MRI studies of the cervical spine to identify (1) imaging features of cervical AFs on various pulse sequences, (2) the concurrence of disc bulges/herniations, (3) changes in those imaging findings over time (mean follow-up 39.3 months) and (4) rate at which cervical AFs were mentioned in radiology reports. 620 initial and follow-up studies were reviewed. Results 50/115 (43.5%) patients had cervical AFs; 21 patients had a single AF and 29 patients had multi-level AFs (total 109 AFs). The most common levels affected were C4-C5 (28%, n = 31) and C5-C6 (27%, n = 30). All cervical AFs were hyperintense on T2WI and, over time, 95% (n = 104/109) of the AFs remained hyperintense; 22% (n = 25) showed less hyperintensity, 10% (n = 11) more hyperintensity, and 60% (n = 66) the same hyperintensity. 5 AFs (4%) resolved completely. Only 2 (8%) of 25 cervical AFs enhanced with gadolinium. The rate of concomitant disc bulges and herniations was 71% (n = 78) and 22% (n = 24) respectively. The presence of cervical AFs did not increase the risk of progression to bulges or herniations. None of the cervical AFs were mentioned in the radiology reports. Conclusions Cervical AFs occurred in 43.5% of patients but were rarely reported. They usually remained bright on T2W but their brightness could vary over time. Cervical AFs were often associated with disc bulges/herniations and enhanced less frequently (8%) than lumbar disk AFs.
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Affiliation(s)
- Meisam Hoseinyazdi
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 600 N. Wolfe Street, Phipps B-100, Baltimore, MD 21287
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street Boston, Boston MA
| | - Shadi Asadollahi
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 600 N. Wolfe Street, Phipps B-100, Baltimore, MD 21287
| | - Rodrigo Luna
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 600 N. Wolfe Street, Phipps B-100, Baltimore, MD 21287
| | - Faranak Rafiee
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street Boston, Boston MA
| | - Gary Gong
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 600 N. Wolfe Street, Phipps B-100, Baltimore, MD 21287
| | - David M. Yousem
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 600 N. Wolfe Street, Phipps B-100, Baltimore, MD 21287
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Hobby J, Ring D, Larson D. The mind and the hand. J Hand Surg Eur Vol 2023; 48:269-275. [PMID: 36638068 DOI: 10.1177/17531934221143502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Symptoms are determined in large part by mindsets. Feelings of distress and unhelpful thoughts (misinterpretations) of symptoms account for much of the variability in comfort and capability with the severity of the underlying pathophysiology making a more limited contribution. Incorporating this experimental evidence into the daily practice of hand surgery will help us find ways to develop healthy mindsets, to prioritize the alleviation of distress and the gentle redirection of unhelpful thoughts, to avoid unnecessary surgery, and to provide better psychological and social support for people recovering from injury and surgery.
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Affiliation(s)
- Jonathan Hobby
- Department of Trauma and Orthopaedics, North Hampshire Hospital, Basingstoke, UK
| | - David Ring
- University of Texas at Austin Dell Medical School, Austin, TX, USA
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Lee HR, Lee DH, Seok SY, Lee WS, Kim M, Cho JH, Hwang CJ, Lee CS. Predictable factors for aggravation of cervical alignment after posterior cervical foraminotomy. J Neurosurg Spine 2023; 38:174-181. [PMID: 36208429 DOI: 10.3171/2022.8.spine22462] [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] [Received: 04/27/2022] [Accepted: 08/19/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to investigate the risk factors for aggravation of cervical alignment after posterior cervical foraminotomy (PCF) and to identify their relationships with kyphotic changes in cervical curvature. METHODS Ninety-eight patients who underwent PCF for unilateral radiculopathy and received follow-up for more than 2 years were retrospectively reviewed. Segmental Cobb angle (SA), cervical Cobb angle (CA), Pfirrmann grade, foraminal stenosis, and clinical outcomes including neck pain, arm pain, and Neck Disability Index scores were assessed. Radiological and clinical outcomes were compared between groups C (control group with kyphotic change in CA < 5°) and K (kyphotic group with kyphotic change in CA ≥ 5°). Multivariate regression analysis was performed to determine the risk factors for kyphotic change ≥ 5° after PCF. RESULTS Group K was significantly older than group C (p = 0.002) and had a higher Pfirrmann grade (p = 0.025). In group K, neck pain had significantly increased at last follow-up (p < 0.001). Multivariate linear regression analysis revealed that kyphotic changes in CA were related to older age (p = 0.016, B = 0.420) and Pfirrmann grade of the operative levels (p = 0.032, B = 4.560). Preoperative hypolordosis was not an independent risk factor for kyphotic changes in CA. Receiver operating characteristic curve analysis showed that the cutoff value for kyphotic changes in patients with CA ≥ 5° was Pfirrmann grade 3.417 (p = 0.008). CONCLUSIONS Contrary to previous studies, preoperative hypolordosis was not a risk factor for kyphotic changes in CA after PCF. Older patients with disc degeneration of Pfirrmann grade IV or greater for should be carefully considered.
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Affiliation(s)
- Hyung Rae Lee
- 1Department of Orthopedic Surgery, Uijeongbu Eulji Medical Center, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | - Dong-Ho Lee
- 2Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and
| | - Sang Yun Seok
- 3Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Daejeon, Republic of Korea
| | - Woon Sang Lee
- 2Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and
| | - Minsoo Kim
- 2Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and
| | - Jae Hwan Cho
- 2Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and
| | - Chang Ju Hwang
- 2Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and
| | - Choon Sung Lee
- 2Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; and
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Nguyen AQ, Harada GK, Leverich KL, Khanna K, Louie PK, Basques BA, Tao Y, Galbusera F, Niemeyer F, Wilke HJ, An HS, Samartzis D. High-Intensity Zones on MRI of the Cervical Spine in Patients: Epidemiology and Association With Pain and Disability. Global Spine J 2022; 12:829-839. [PMID: 33203250 PMCID: PMC9344501 DOI: 10.1177/2192568220966328] [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] [Indexed: 12/02/2022] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVES This study aimed to address the prevalence, distribution, and clinical significance of cervical high-intensity zones (HIZs) on magnetic resonance imaging (MRI) with respect to pain and other patient-reported outcomes in the setting of patients that will undergo an anterior cervical discectomy and fusion (ACDF) procedure. METHODS A retrospective cohort study of ACDF patients surgically treated at a single center from 2008 to 2015. Based on preoperative MRI, HIZ subtypes were identified as either traditional T2-hyperintense, T1-hypointense ("single-HIZs"), or combined T1- and T2-hyperintense ("dual-HIZs"), and their level-specific prevalence was assessed. Preoperative symptoms, patient-reported outcomes, and disc degeneration pathology were assessed in relation to HIZs and HIZ subtypes. RESULTS Of 861 patients, 58 demonstrated evidence of HIZs in the cervical spine (6.7%). Single-HIZs and dual-HIZs comprised 63.8% and 36.2% of the overall HIZs, respectively. HIZs found outside of the planned fusion segment reported better preoperative Neck Disability Index (NDI; P = .049) and Visual Analogue Scale (VAS) Arm (P = .014) scores relative to patients without HIZs. Furthermore, patients with single-HIZs found inside the planned fusion segment had worse VAS Neck (P = .045) and VAS Arm (P = .010) scores. In general, dual-HIZ patients showed no significant differences across all clinical outcomes. CONCLUSIONS This is the first study to evaluate the clinical significance of HIZs in the cervical spine, noting level-specific and clinical outcome-specific variations. Single-HIZs were associated with significantly more pain when located inside the fusion segment, while dual-HIZs showed no associations with patient-reported outcomes. The presence of single-HIZs may correlate with concurrent spinal pathologies and should be more closely evaluated.
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Affiliation(s)
| | | | | | | | | | | | - Youping Tao
- Rush University Medical
Center, Chicago, IL, USA
| | - Fabio Galbusera
- Rush University Medical
Center, Chicago, IL, USA,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Frank Niemeyer
- Rush University Medical
Center, Chicago, IL, USA,Ulm University Medical
Centre, Ulm, Germany
| | - Hans-Joachim Wilke
- Rush University Medical
Center, Chicago, IL, USA,Ulm University Medical
Centre, Ulm, Germany
| | - Howard S. An
- Rush University Medical
Center, Chicago, IL, USA
| | - Dino Samartzis
- Rush University Medical
Center, Chicago, IL, USA,Dino Samartzis, DSc, Department of
Orthopaedic Surgery, Rush University Medical Center, Orthopaedic Building, Suite
204-G, 1611W. Harrison Street, Chicago, IL 60612, USA.
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Dickson C, de Zoete RMJ, Stanton TR. From Where We've Come to Where We Need to Go: Physiotherapy Management of Chronic Whiplash-Associated Disorder. FRONTIERS IN PAIN RESEARCH 2022; 2:795369. [PMID: 35295440 PMCID: PMC8915571 DOI: 10.3389/fpain.2021.795369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/15/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Cameron Dickson
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, SA, Australia
- *Correspondence: Cameron Dickson
| | - Rutger M. J. de Zoete
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, SA, Australia
| | - Tasha R. Stanton
- Innovation, Implementation and Clinical Translation in Health, University of South Australia, Adelaide, SA, Australia
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Ehsanian R, Schneider BJ, Kennedy DJ, Koshkin E. Ultrasound-guided cervical selective nerve root injections: a narrative review of literature. Reg Anesth Pain Med 2021; 46:416-421. [PMID: 33441430 DOI: 10.1136/rapm-2020-102325] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND/IMPORTANCE Ultrasound (US)-guided cervical selective nerve root injections (CSNRI) have been proposed as an alternative to fluoroscopic (FL) -guided injections. When choosing US guidance, the proceduralist should be aware of potential issues confirming vertebral level, be clear regarding terminology, and up to date regarding the advantages and disadvantages of US-guided CSNRI. OBJECTIVE Review the accuracy and effectiveness of US guidance in avoiding vascular puncture (VP) and/or intravascular injection (IVI) during CSNRI. EVIDENCE REVIEW Queries included PubMed, CINAHL and Embase databases from 2005 to 2019. Three authors reviewed references for eligibility, abstracted data, and appraised quality. FINDINGS The literature demonstrates distinct safety considerations and limited evidence of the effectiveness of US guidance in detecting VP and/or IVI. As vascular flow and desired injectate spread cannot be visualized with US, the use of real-time fluoroscopy, and if needed digitial subraction imaging, is indicated in cervical transforaminal epidural injections (CTFEIs). Given the risk of VP and/or IVI, the ability to perform and to retain FL images to document that the procedure was safely conducted is valuable in CTFEIs. CONCLUSION US guidance remains to be proven as a non-inferior alternative to FL guidance or other imaging modalities in the prevention of VP and/or IVI with CTFEIs or cervical selective nerve root blocks. There is a paucity of adequately powered clinical studies evaluating the accuracy and effectiveness of US guidance in avoiding VP and/or IVI. US-guided procedures to treat cervical radicular pain has limitations in visualization of anatomy, and currently with the evidence available is best used in a combined approach with FL guidance.
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Affiliation(s)
- Reza Ehsanian
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedics & Rehabilitation, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Byron J Schneider
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David J Kennedy
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eugene Koshkin
- Department of Anesthesia & Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
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Katschnig-Winter P, Enzinger C, Bohlsen D, Magyar M, Seiler S, Hofer E, Franthal S, Homayoon N, Kögl M, Wenzel K, Deutschmann H, Fazekas F, Schmidt R, Schwingenschuh P. Minor Structural Differences in the Cervical Spine Between Patients With Cervical Dystonia and Age-Matched Healthy Controls. Front Neurol 2020; 11:472. [PMID: 32547481 PMCID: PMC7272577 DOI: 10.3389/fneur.2020.00472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/29/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Cervical dystonia is the most common form of focal dystonia. The frequency and pattern of degenerative changes of the cervical spine in patients with cervical dystonia and their relation to clinical symptoms remain unclear as no direct comparison to healthy controls has been performed yet. Here, we used magnetic resonance imaging (MRI) to investigate (1) whether structural abnormalities of the cervical spine are more common in patients with cervical dystonia compared to age-matched healthy controls, (2) if there are clinical predictors for abnormalities on MRI, and (3) to calculate the inter-rater reliability of the respective radiological scales. Methods: Twenty-five consecutive patients with cervical dystonia and 20 age-matched healthy controls were included in the study. MRI scans of the cervical spine were analyzed separately by three experienced raters blinded to clinical information, applying different MRI rating scales. Structural abnormalities were compared between groups for upper, middle, and lower cervical spine segments. The associations between scores differentiating both groups and clinical parameters were assessed in dystonia patients. Additionally, inter-rater reliability of the MRI scales was calculated. Results: Comparing structural abnormalities, we found minor differences in the middle cervical spine, indicated by a higher MRI total score in patients but no significant correlation between clinical parameters and MRI changes. Inter-rater reliability was satisfying for most of the MRI rating scales. Conclusion: Our results do not provide evidence for a role of MRI of the cervical spine in the routine work-up of patients with cervical dystonia in the absence of specific clinical signs or symptoms.
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Affiliation(s)
| | - Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz, Austria
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Dennis Bohlsen
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Marton Magyar
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Stephan Seiler
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Edith Hofer
- Department of Neurology, Medical University of Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | | | - Nina Homayoon
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Mariella Kögl
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Karoline Wenzel
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Hannes Deutschmann
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Petra Schwingenschuh
- Department of Neurology, Medical University of Graz, Graz, Austria
- *Correspondence: Petra Schwingenschuh
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Cervical Ultrasound Utilization in Selective Cervical Nerve Root Injection for the Treatment of Cervical Radicular Pain: a Review. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2019. [DOI: 10.1007/s40141-019-00248-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Wang XR, Kwok TCY, Griffith JF, Man Yu BW, Leung JCS, Wáng YXJ. Prevalence of cervical spine degenerative changes in elderly population and its weak association with aging, neck pain, and osteoporosis. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:486. [PMID: 31700922 DOI: 10.21037/atm.2019.07.80] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background To investigate the prevalence of MRI degenerative findings of cervical spine in elderly Chinese males and females. Methods From a general population sample, cervical spine T2 weighted sagittal MR images were acquired in 272 males (mean age: 82.9±3.83) and 150 females (mean age: 81.5±4.27). Images were interpreted and degenerative changes were classified. Study subjects were divided into younger group (group A, ≤81 years) and older group (group B, >81 years). For neck pain, question was structured as 'during the past 12 months, have you had any neck pain?'. Two hundred and fifty-two males and 134 females also had hip bone mineral density (BMD) measured. Results 98.1% subjects exhibited at least one degenerative change at one or more vertebral levels. The C5/6 level had the highest overall frequency for degenerative changes. Most of the degenerative changes were more common in females. The older female group had higher prevalence or higher severity of degenerative findings than the younger group. Eleven point four percent of the males and 20.6% of the females reported neck pain, and male subjects with neck pain tended to have slightly higher prevalence of cervical degenerative changes. There was a weak trend that osteoporosis was associated with a higher prevalence of spinal cord high signal and a higher prevalence of spinal canal stenosis. Conclusions The age-dependence of cervical spine degenerative changes was more notable in females. Subjects with neck pain and subjects with osteoporosis were weakly associated with higher prevalence of cervical degenerative changes.
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Affiliation(s)
- Xiao-Rong Wang
- Department of Imaging and Interventional Radiology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.,Department of Radiology, Ningbo First Hospital, Ningbo 315000, China
| | - Timothy C Y Kwok
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine and Therapeutics, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - James F Griffith
- Department of Imaging and Interventional Radiology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Blanche Wai Man Yu
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason C S Leung
- JC Centre for Osteoporosis Care and Control, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
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12
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Ravindra VM, Senglaub SS, Rattani A, Dewan MC, Härtl R, Bisson E, Park KB, Shrime MG. Degenerative Lumbar Spine Disease: Estimating Global Incidence and Worldwide Volume. Global Spine J 2018; 8:784-794. [PMID: 30560029 PMCID: PMC6293435 DOI: 10.1177/2192568218770769] [Citation(s) in RCA: 227] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
STUDY DESIGN Meta-analysis-based calculation. OBJECTIVES Lumbar degenerative spine disease (DSD) is a common cause of disability, yet a reliable measure of its global burden does not exist. We sought to quantify the incidence of lumbar DSD to determine the overall worldwide burden of symptomatic lumbar DSD across World Health Organization regions and World Bank income groups. METHODS We used a meta-analysis to create a single proportion of cases of DSD in patients with low back pain (LBP). Using this information in conjunction with LBP incidence rates, we calculated the global incidence of individuals who have DSD and LBP (ie, their DSD has neurosurgical relevance) based on the Global Burden of Disease 2015 database. RESULTS We found that 266 million individuals (3.63%) worldwide have DSD and LBP each year; the highest and lowest estimated incidences were found in Europe (5.7%) and Africa (2.4%), respectively. Based on population sizes, low- and middle-income countries have 4 times as many cases as high-income countries. Thirty-nine million individuals (0.53%) worldwide were found to have spondylolisthesis, 403 million (5.5%) individuals worldwide with symptomatic disc degeneration, and 103 million (1.41%) individuals worldwide with spinal stenosis annually. CONCLUSIONS A total of 266 million individuals (3.63%) worldwide were found to have DSD and LBP annually. Significantly, data quality is higher in high-income countries, making overall quantification in low- and middle-income countries less complete. A global effort to address degenerative conditions of the lumbar spine in regions with high demand is important to reduce disability.
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Affiliation(s)
| | | | - Abbas Rattani
- Harvard Medical School, Boston, MA, USA
- Meharry Medical College, Nashville, TN, USA
| | - Michael C. Dewan
- Harvard Medical School, Boston, MA, USA
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Roger Härtl
- Weill Cornell Medical College, New York–Presbyterian Hospital, New York, NY,
USA
| | | | | | - Mark G. Shrime
- Harvard Medical School, Boston, MA, USA
- Massachusetts Eye and Ear Infirmary, Boston, MA, USA
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13
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Meziat-Filho N, Ferreira AS, Nogueira LAC, Reis FJJ. "Text-neck": an epidemic of the modern era of cell phones? Spine J 2018; 18:714-715. [PMID: 29685297 DOI: 10.1016/j.spinee.2017.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 11/22/2017] [Indexed: 02/03/2023]
Affiliation(s)
- Ney Meziat-Filho
- Postgratuate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, UNISUAM, Praça das Nações 34, Bonsucesso, 21041-010, Rio de Janeiro, Brazil
| | - Arthur Sá Ferreira
- Postgratuate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, UNISUAM, Praça das Nações 34, Bonsucesso, 21041-010, Rio de Janeiro, Brazil
| | - Leandro Alberto Calazans Nogueira
- Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta, UNISUAM; Instituto Federal do Rio de Janeiro, Rua Professor Carlos Wenceslau, Realengo, 21710-240, Rio de Janeiro, Brazil
| | - Felipe José Jandre Reis
- Instituto Federal do Rio de Janeiro, Department of Clinical Medicine, Universidade Federal do Rio de Janeiro, Av Brigadeiro Trompowsky s/n, andar 11, 21941-590, Ilha do Fundão, Rio de Janeiro, Brazil
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14
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Meziat-Filho N, Lima M, Fernandez J, Reis FJ. Cognitive Functional Therapy (CFT) for chronic non-specific neck pain. J Bodyw Mov Ther 2018; 22:32-36. [DOI: 10.1016/j.jbmt.2017.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/18/2017] [Accepted: 02/22/2017] [Indexed: 11/25/2022]
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15
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Oh CH, Yoon SH. Whole Spine Disc Degeneration Survey according to the Ages and Sex Using Pfirrmann Disc Degeneration Grades. KOREAN JOURNAL OF SPINE 2017; 14:148-154. [PMID: 29301175 PMCID: PMC5769942 DOI: 10.14245/kjs.2017.14.4.148] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 12/19/2017] [Accepted: 12/26/2017] [Indexed: 01/07/2023]
Abstract
Objective Pfirrmann disc grade is a useful scoring tool for evaluating disc degeneration, but normal values according to aging process has not been elucidated. This study was conducted to identify the prevalence and pattern of whole spine disc degeneration according to ages and gender differences. Methods Total 653 patients (336 male and 317 female patients, 48.1±58.7 years old) who took whole spine magnetic resonance images were enrolled in this study. There were 19 cases in their 2nd decades and 74 cases in 3rd decades, 141 cases in 4th decades, 129 cases in 5th decades, 139 cases in 6th decades, and 93 cases in 7th decades, 58 cases in over 8th decades. Pfirrmann disc grades were measured according to sex and ages by 2 neurosurgeons that were blind to this study. Results All spinal disc degeneration grades were correlated with ageing. The Pfirrmann disc grades of degeneration in all spine levels showed the statistically significant difference according to the ages (p<0.001). The common Pfirrmann disc grades according to the ages were grade 3 among 2nd to 5th decades, and grade 4 was more common than 6th decades. The lower cervical level (C2–3 to C4–5) and lumbar level (L1–2 to L5–S1) were happened relatively early severe disc degeneration compared to other levels. The intersexual differences were increased after 6th decades. Conclusion Disc degeneration is natural course after one’s 2nd decades. And its incidence and grade were increased with age, and more affected by sexual difference after 6th decades.
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Affiliation(s)
- Chang Hyun Oh
- Department of Neurosurgery, Guri Cham Teun Teun Hospital, Guri, Korea
| | - Seung Hwan Yoon
- Department of Neurosurgery, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
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16
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Markotić V, Zubac D, Miljko M, Šimić G, Zalihić A, Bogdan G, Radančević D, Šimić AD, Mašković J. Level of Education as a Risk Factor for Extensive Prevalence of Cervical Intervertebral Disc Degenerative Changes and Chronic Neck Pain. Cent Eur J Public Health 2017; 25:245-250. [PMID: 29022686 DOI: 10.21101/cejph.a4897] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 11/23/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to document the prevalence of degenerative intervertebral disc changes in the patients who previously reported symptoms of neck pain and to determine the influence of education level on degenerative intervertebral disc changes and subsequent chronic neck pain. METHODS One hundred and twelve patients were randomly selected from the University Hospital in Mostar, Bosna and Herzegovina, (aged 48.5±12.7 years) and submitted to magnetic resonance imaging (MRI) of the cervical spine. MRI of 3.0 T (Siemens, Skyrim, Erlangen, Germany) was used to obtain cervical spine images. Patients were separated into two groups based on their education level: low education level (LLE) and high education level (HLE). Pfirrmann classification was used to document intervertebral disc degeneration, while self-reported chronic neck pain was evaluated using the previously validated Oswestry questionnaire. RESULTS The entire logistic regression model containing all predictors was statistically significant, (χ2(3)=12.2, p=0.02), and was able to distinguish between respondents who had chronic neck pain and vice versa. The model explained between 10.0% (Cox-Snell R2) and 13.8% (Nagelkerke R2) of common variance with Pfirrmann classification, and it had the strength to discriminate and correctly classify 69.6% of patients. The probability of a patient being classified in the high or low group of degenerative disc changes according to the Pfirrmann scale was associated with the education level (Wald test: 5.5, p=0.02). Based on the Pfirrmann assessment scale, the HLE group was significantly different from the LLE group in the degree of degenerative changes of the cervical intervertebral discs (U=1,077.5, p=0.001). CONCLUSION A moderate level of intervertebral disc degenerative changes (grade II and III) was equally matched among all patients, while the overall results suggest a higher level of education as a risk factor leading to cervical disc degenerative changes, regardless of age differences among respondents.
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Affiliation(s)
- Vedran Markotić
- Department of Clinical Radiology, University Hospital, Mostar, Bosnia and Herzegovina
| | - Damir Zubac
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Miro Miljko
- School of Medicine, University Hospital in Mostar, Mostar, Bosnia and Herzegovina
| | - Goran Šimić
- University Hospital, Mostar, Bosnia and Herzegovina
| | - Amra Zalihić
- School of Medicine, University Hospital in Mostar, Mostar, Bosnia and Herzegovina
| | - Gojko Bogdan
- Department of Clinical Radiology, University Hospital, Mostar, Bosnia and Herzegovina
| | - Dorijan Radančević
- Department of Clinical Radiology, University Hospital, Mostar, Bosnia and Herzegovina
| | | | - Josip Mašković
- Department of Clinical Radiology, University Hospital, Mostar, Bosnia and Herzegovina
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17
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Kjaer P, Kongsted A, Hartvigsen J, Isenberg-Jørgensen A, Schiøttz-Christensen B, Søborg B, Krog C, Møller CM, Halling CMB, Lauridsen HH, Hansen IR, Nørregaard J, Jørgensen KJ, Hansen LV, Jakobsen M, Jensen MB, Melbye M, Duel P, Christensen SW, Povlsen TM. National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 26:2242-2257. [PMID: 28523381 DOI: 10.1007/s00586-017-5121-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/27/2017] [Accepted: 05/02/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE To summarise recommendations about 21 selected non-surgical interventions for recent onset (<12 weeks) non-specific neck pain (NP) and cervical radiculopathy (CR) based on two guidelines from the Danish Health Authority. METHODS Two multidisciplinary working groups formulated recommendations based on the GRADE approach. RESULTS Twelve recommendations were based on evidence and nine on consensus. Management should include information about prognosis, warning signs, and advise to remain active. For treatment, guidelines suggest different types of supervised exercise and manual therapy; combinations of exercise and manual therapy before medicine for NP; acupuncture for NP but not CR; traction for CR; and oral NSAID (oral or topical) and Tramadol after careful consideration for NP and CR. CONCLUSION Recommendations are based on low-quality evidence or on consensus, but are well aligned with recommendations from guidelines from North America. The working groups recommend intensifying research relating to all aspects of management of NP and CR.
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Affiliation(s)
- Per Kjaer
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. .,Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark.
| | - Alice Kongsted
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Alexander Isenberg-Jørgensen
- Centre for Spine Surgery and Research, Spine Centre of Southern Denmark, Hospital Lillebaelt, Østre Houghvej 55, 5500, Middelfart, Denmark
| | - Berit Schiøttz-Christensen
- Spine Centre of Southern Denmark, Hospital Lillebaelt, Østre Houghvej 55, 5500, Middelfart, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Campusvej 55, Odense M, Denmark
| | - Bolette Søborg
- Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark
| | - Charlotte Krog
- Københavns Fysioterapi I/S, J. E. Ohlsens Gade 2, 1, th, 2100, København Ø, Denmark
| | | | - Christine Marie Bækø Halling
- Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark.,KORA, the Danish Institute for Local and Regional Government Research, Købmagergade 22, 1150, Copenhagen K, Denmark
| | - Henrik Hein Lauridsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Inge Ris Hansen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jesper Nørregaard
- Centre for Rheumatology and Spine Diseases, Dyrehavevej 29, 3400, Hillerød, Denmark
| | - Karsten Juhl Jørgensen
- Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark.,The Nordic Cochrane Centre, Rigshospitalet, 7811, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| | - Lars Valentin Hansen
- Spine Unit, Department of Ortopaedic Surgery, Rigshospitalet, Copenhagen, Denmark
| | - Marie Jakobsen
- Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark.,KORA, the Danish Institute for Local and Regional Government Research, Købmagergade 22, 1150, Copenhagen K, Denmark
| | - Martin Bach Jensen
- Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Fyrkildevej 7,1, 9220, Aalborg Ø, Denmark
| | - Martin Melbye
- Aalborg Spine Clinic, Aalborg Rygklinik, Vingaardsgade 9, 9000, Aalborg, Denmark
| | - Peter Duel
- Neurosurgical Department, Aarhus University Hospital, Nørrebrogade, 8000, Aarhus C, Denmark
| | - Steffan W Christensen
- Department of Health Science and Technology, SMI®, Aalborg University, Aalborg, Denmark.,Department of Physiotherapy, University College of Northern Denmark (UCN), Aalborg, Denmark
| | - Tina Myung Povlsen
- Evidence, Education and Emergency Services, The Danish Health Authority, Islands Brygge 67, 2300, Copenhagen S, Denmark.,Research and Test Center for Health Technologies. Rigshospitalet, Nordre Ringvej 57. Opgang 8, 5.sal., 2600, Glostrup, Denmark
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18
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Role of Diffusion Tensor MR Imaging in Degenerative Cervical Spine Disease: a Review of the Literature. Clin Neuroradiol 2015; 26:265-76. [DOI: 10.1007/s00062-015-0467-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/10/2015] [Indexed: 12/13/2022]
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19
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Shin DA, Kim HI. Nonoperative interventions for spinal pain. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2014. [DOI: 10.5124/jkma.2014.57.4.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Dong Ah Shin
- Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Medical System Engineering, Gwangju Institute of Science & Technology, Gwnagju, Korea
| | - Hyoung Ihl Kim
- Department of Medical System Engineering, Gwangju Institute of Science & Technology, Gwnagju, Korea
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20
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Kim SJ, Lee TH, Yi S. Prevalence of disc degeneration in asymptomatic korean subjects. Part 3 : cervical and lumbar relationship. J Korean Neurosurg Soc 2013; 53:167-73. [PMID: 23634267 PMCID: PMC3638270 DOI: 10.3340/jkns.2013.53.3.167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 11/22/2012] [Accepted: 02/25/2013] [Indexed: 12/01/2022] Open
Abstract
Objective There are many cases in which degenerative changes are prevalent in both the cervical and lumbar spine, and the relation between both spinal degenerative findings of MRI is controversial. The authors analyzed the prevalence of abnormal findings on MRI, and suggested a model to explain the relationship between cervical and lumbar disc in asymptomatic Korean subjects. Methods We performed 3 T MRI sagittal scans on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). Scores pertaining to herniation (HN), annular fissure (AF), and nucleus degeneration (ND) were analyzed. The total scores for the cervical and lumbar spine were analyzed using correlation coefficients and multiple linear regression with various predictive parameters, including weight, height, sex, age, smoking, occupation, and sedentary fashion. Results The correlation coefficients of HN, AF, and ND were 0.44, 0.50, and 0.59, respectively. We made the best model for relationship by using multiple linear regression. Conclusion The results of the current study showed that there was a close relationship between the cervical score (CS) and lumbar score (LS). In addition, the correlation between CS and LS, as well as the LS value itself, can be altered by other explanatory variables. Although not absolute, there was also a linear relationship between degenerative changes of the cervical and lumbar spine. Based on these results, it can be inferred that degenerative changes of the lumbar spine will be useful in predicting the degree of cervical spine degeneration in an actual clinical setting.
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Affiliation(s)
- Sang Jin Kim
- Department of Neurosurgery, Ewha Womans University School of Medicine, Mokdong Hospital, Seoul, Korea
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