Endoscopic cervical foraminotomy is increasingly used for cervical spondylotic radiculopathy(CSR),but there is great concern about radiation exposure because of the heavy dependence of this surgical method on fluorosc...Endoscopic cervical foraminotomy is increasingly used for cervical spondylotic radiculopathy(CSR),but there is great concern about radiation exposure because of the heavy dependence of this surgical method on fluoroscopy.The objective of this study was to introduce in detail an advanced surgical technique of keyhole foraminotomy via a percutaneous posterior full-endoscopic approach as a treatment for CSR and investigate its clinical outcomes.We retrospectively reviewed 33 consecutive patients with CSR who underwent keyhole foraminotomy via a percutaneous posterior full-endoscopic approach from October 2015 to April 2017.The patients’general characteristics,including operative time,blood loss,hospital stay,complications,and recurrence,were obtained.Clinical outcomes were evaluated using the visual analogue scale(VAS)for radicular pain,the neck disability index(NDI)for functional assessment,and the modified MacNab criteria for patient satisfaction.All operations were successfully performed(mean operation time,62 min),with no measurable blood loss or severe related complications.The mean follow-up was 25 months.The VAS and NDI scores were significantly improved as compared with those in the preoperative period(preoperative vs.final follow-up:7.6±1.6 vs.3.83±7.34 for VAS,P<0.01;69.5%±10.5%vs.17.54%±13.40%for NDI,P<0.01).Of the 33 patients,32(97.0%)had good-to-excellent global outcomes and all patients obtained symptomatic improvement.In conclusion,keyhole foraminotomy via a percutaneous posterior full-endoscopic approach is an efficient,safe,and feasible procedure for the treatment of CSR.Its simplified single-step blunt incision for localization appears to decrease radiation exposure risks.展开更多
Introduction: Cervical radiculopathy is caused by either cervical disc herniation or bone spurs due to cervical spine degeneration. It is common in middle aged and elderly patients. Those patients who are refractory t...Introduction: Cervical radiculopathy is caused by either cervical disc herniation or bone spurs due to cervical spine degeneration. It is common in middle aged and elderly patients. Those patients who are refractory to conservative treatment are candidates for surgical management. The surgical approaches for cervical radiculopathy are either anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). In spite of many reports on ACDF and PCF, only a few studies directly compare the outcomes of both techniques. Purpose: To compare anterior cervical discectomy and fusion (ACDF) with posterior cervical foraminotomy (PCF) for the treatment of cervical radiculopathy, regarding the surgical, clinical and radiological outcomes. Patient and methods: This is a prospective randomized controlled clinical study carried on 44 patients with unilateral cervical radiculopathy. They are divided into 2 groups;group (A) included 23 patients who underwent ACDF and group (B) included 21 patients who underwent PCF, with 1 year follow up. The patient age, sex, clinical manifestations, surgical outcomes as number of cervical level, operative time, blood loss, complications and length of hospital stay were recorded. Visual analogus scale (VAS) and neck disability index (NDI) were used for evaluation of clinical outcomes. Postoperative imaging was done after 1 year to detect instability or adjacent level degeneration. Chi-square and unpaired T-test were used to compare the mean values of both groups. Results: The mean age was nearly 45 years for both groups. C5-6 ACDF was the most common level in group (A), while C6-7 PCF was the most frequent operated level in group (B). PCF group had less operative time, blood loss and length of hospital stay than ACDF group. Clinical improvement of the mean values of VAS and NDI were more pronounced in PCF group as compared to ACDF group with statistically significant difference. No cases of cervical instability were recorded during the period of follow up. Conclusion: Posterior cervical foraminotomy is a safe and effective technique for the treatment of cervical radiculopathy as compared to anterior cervical discectomy and fusion. PCF has a shorter operative time, less hospital stay and better clinical outcome.展开更多
OBJECTIVE: To evaluate the pain scores and rehabilitation of patientis with cervical spondylotic radiculopathy receiving massage therapy combined with traction and ultrashort wave therapy. METHODS: A total of 84 patie...OBJECTIVE: To evaluate the pain scores and rehabilitation of patientis with cervical spondylotic radiculopathy receiving massage therapy combined with traction and ultrashort wave therapy. METHODS: A total of 84 patients with cervical spondylotic radiculopathy treated in 105 Hospital of People's Liberation Army from June 2014 to June 2017 were included and divided into study group and control group according to different treatment regimens. A total of 42 patients in the study group was treated with cervical traction, ultrashort wave and massage therapy at the same time, whereas the other 42 patients in the control group were only treated with cervical traction and ultrashort wave. Comparison of the clinical efficacy and adverse reactions of the 2 groups was made and the Visual Analogue Scale (VAS) scores before and after treatment were observed to assess the patient's pain. Comparison of rehabilitation in the 2 groups was made by applying the Clinical Assessment Scale for Cervical Spondylosis (CASCS). RESULTS: After comparing the therapeutic effect between the study group and the control group, it showed that the total effective rate (90.48%) in the study group was significantly higher than that in the control group (73.81%), the difference was statistically significant (P < 0.05). By comparing the incidence of adverse reactions in the study group and the control group, results showed that the incidence of adverse reactions such as nausea, palpitations, vomiting, sweating, dizziness and colorless complexion in the study group (9.52%) was significantly lower than that in the control group (21.43%), the difference was statistically significant (P < 0.05). After the treatment, the VAS pain scores of the study group and the control group were both significantly improved (P < 0.05), but the improvement of the patients in the study group was more significantly (P < 0.05), and the difference was statistically significant. After treatment, the CASCS scores of the patients in the study group and the control group were significantly improved (P < 0.05), but the improvement of the study group was more (P < 0.05), and there was statistically significant difference. CONCLUSION: The combination of massage, traction and ultrashort wave therapy can significantly reduce the pain and reduce the incidence of adverse reactions in patients with cervical spondylotic radiculopathy, which is of great clinical significance to the rehabilitation of patients.展开更多
Tandem spinal stenosis is described as concurrent symptomatic cervical and lumbar spinal stenosis. The clinical presentation includes neurogenic claudication, gait disturbance, myelopathy and polyradicuopathy in both ...Tandem spinal stenosis is described as concurrent symptomatic cervical and lumbar spinal stenosis. The clinical presentation includes neurogenic claudication, gait disturbance, myelopathy and polyradicuopathy in both upper and lower limbs. A 43-year-old female presented with predominant low back pain with right S1 radiculopathy leading to diagnosis of synovial facet cyst of lumbar spine. She was managed surgically after medical treatment failed. After 1 week post operatively, she presented with severe neck pain with left radiculopathy. MRI revealed acute on chronic cervical prolapsed intervertebral disc, cervical decompression surgery proceeded. Post operative improvement was noted on follow up. We report a case of tandem spinal stenosis, which both of the pathologies were managed with endoscopic approach.展开更多
By means of cervical nerve root stimulation(CRS) method, the amplitudes and latencies of compound motor action potential(CMAP) of brachial biceps and brachial triceps muscles in 41 patients with clinical symptoms and ...By means of cervical nerve root stimulation(CRS) method, the amplitudes and latencies of compound motor action potential(CMAP) of brachial biceps and brachial triceps muscles in 41 patients with clinical symptoms and signs of cervical radiculopathy were observed. The amplitudes of CMAPs on the affected side in the patients were obviously lower than on the healthy side and control group, latencies of CMAPs on the affected side were also significantly prolonged. The results showed that CRS was a sensitive method for making a direct determination of proximal nerve roit cinductiin function, and a good aid for diagnosing cervical radiculopathy.展开更多
Objective: On the basis of a brief description of the current research status of modern Chinese medicine on the name, etiology, pathogenesis and classification of cervical spondylotic radiculopathy, this paper summari...Objective: On the basis of a brief description of the current research status of modern Chinese medicine on the name, etiology, pathogenesis and classification of cervical spondylotic radiculopathy, this paper summarizes the research progress of modern Chinese medicine treatment of cervical spondylotic radiculopathy from the perspective of modern Chinese medicine treatment. This article mainly summarizes the following aspects: modern Chinese medicine for internal and external use;Chinese medicine acupuncture with filiform needle, electro-acupuncture and warm moxibustion;Chinese medicine massage and acupoint therapy;moxibustion, cupping, scraping and other comprehensive treatment;and Chinese medicine comprehensive therapy. The purpose of this article is to provide references for modern Chinese medicine treatment of cervical spondylotic radiculopathy.展开更多
Objective:To review and evaluate the quality of the randomized controlled trials of exercise for the treatment of cervical radiculopathy with the present internationally recognized CONSORT statement, which provides re...Objective:To review and evaluate the quality of the randomized controlled trials of exercise for the treatment of cervical radiculopathy with the present internationally recognized CONSORT statement, which provides reference and basis for the improvement of clinical research on exercise for intervening cervical radiculopathy in the future.Methods: A computer-based search of large domestic databases, including CNKI, Wanfang database and VIP database screened out literature that meet the requirements and used CONSORT statement for quality assessment.Results: According to the prescribed inclusion and exclusion criteria, 30 articles were retrieved in accordance with the standard. No literature was referred to the randomized controlled trial, 2 documents clearly defined the type of test design, 1 documents carried out the calculation of sample size, 13 documents clearly randomly assigned, 1 literature implemented the blind method, in the 7 literature, baseline information was shown in tabular form, and no reference was made to trial registration, trial protocol and funding.Conclusion:There are some aspects of randomized controlled trials on exercise for the treatment of cervical radiculopathy. However, there are some aspects that need to be improved. In the future randomized controlled trial report, the CONSORT statement should be highly valued and carefully considered to improve the accuracy and credibility of the research.展开更多
文摘Endoscopic cervical foraminotomy is increasingly used for cervical spondylotic radiculopathy(CSR),but there is great concern about radiation exposure because of the heavy dependence of this surgical method on fluoroscopy.The objective of this study was to introduce in detail an advanced surgical technique of keyhole foraminotomy via a percutaneous posterior full-endoscopic approach as a treatment for CSR and investigate its clinical outcomes.We retrospectively reviewed 33 consecutive patients with CSR who underwent keyhole foraminotomy via a percutaneous posterior full-endoscopic approach from October 2015 to April 2017.The patients’general characteristics,including operative time,blood loss,hospital stay,complications,and recurrence,were obtained.Clinical outcomes were evaluated using the visual analogue scale(VAS)for radicular pain,the neck disability index(NDI)for functional assessment,and the modified MacNab criteria for patient satisfaction.All operations were successfully performed(mean operation time,62 min),with no measurable blood loss or severe related complications.The mean follow-up was 25 months.The VAS and NDI scores were significantly improved as compared with those in the preoperative period(preoperative vs.final follow-up:7.6±1.6 vs.3.83±7.34 for VAS,P<0.01;69.5%±10.5%vs.17.54%±13.40%for NDI,P<0.01).Of the 33 patients,32(97.0%)had good-to-excellent global outcomes and all patients obtained symptomatic improvement.In conclusion,keyhole foraminotomy via a percutaneous posterior full-endoscopic approach is an efficient,safe,and feasible procedure for the treatment of CSR.Its simplified single-step blunt incision for localization appears to decrease radiation exposure risks.
文摘Introduction: Cervical radiculopathy is caused by either cervical disc herniation or bone spurs due to cervical spine degeneration. It is common in middle aged and elderly patients. Those patients who are refractory to conservative treatment are candidates for surgical management. The surgical approaches for cervical radiculopathy are either anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). In spite of many reports on ACDF and PCF, only a few studies directly compare the outcomes of both techniques. Purpose: To compare anterior cervical discectomy and fusion (ACDF) with posterior cervical foraminotomy (PCF) for the treatment of cervical radiculopathy, regarding the surgical, clinical and radiological outcomes. Patient and methods: This is a prospective randomized controlled clinical study carried on 44 patients with unilateral cervical radiculopathy. They are divided into 2 groups;group (A) included 23 patients who underwent ACDF and group (B) included 21 patients who underwent PCF, with 1 year follow up. The patient age, sex, clinical manifestations, surgical outcomes as number of cervical level, operative time, blood loss, complications and length of hospital stay were recorded. Visual analogus scale (VAS) and neck disability index (NDI) were used for evaluation of clinical outcomes. Postoperative imaging was done after 1 year to detect instability or adjacent level degeneration. Chi-square and unpaired T-test were used to compare the mean values of both groups. Results: The mean age was nearly 45 years for both groups. C5-6 ACDF was the most common level in group (A), while C6-7 PCF was the most frequent operated level in group (B). PCF group had less operative time, blood loss and length of hospital stay than ACDF group. Clinical improvement of the mean values of VAS and NDI were more pronounced in PCF group as compared to ACDF group with statistically significant difference. No cases of cervical instability were recorded during the period of follow up. Conclusion: Posterior cervical foraminotomy is a safe and effective technique for the treatment of cervical radiculopathy as compared to anterior cervical discectomy and fusion. PCF has a shorter operative time, less hospital stay and better clinical outcome.
文摘OBJECTIVE: To evaluate the pain scores and rehabilitation of patientis with cervical spondylotic radiculopathy receiving massage therapy combined with traction and ultrashort wave therapy. METHODS: A total of 84 patients with cervical spondylotic radiculopathy treated in 105 Hospital of People's Liberation Army from June 2014 to June 2017 were included and divided into study group and control group according to different treatment regimens. A total of 42 patients in the study group was treated with cervical traction, ultrashort wave and massage therapy at the same time, whereas the other 42 patients in the control group were only treated with cervical traction and ultrashort wave. Comparison of the clinical efficacy and adverse reactions of the 2 groups was made and the Visual Analogue Scale (VAS) scores before and after treatment were observed to assess the patient's pain. Comparison of rehabilitation in the 2 groups was made by applying the Clinical Assessment Scale for Cervical Spondylosis (CASCS). RESULTS: After comparing the therapeutic effect between the study group and the control group, it showed that the total effective rate (90.48%) in the study group was significantly higher than that in the control group (73.81%), the difference was statistically significant (P < 0.05). By comparing the incidence of adverse reactions in the study group and the control group, results showed that the incidence of adverse reactions such as nausea, palpitations, vomiting, sweating, dizziness and colorless complexion in the study group (9.52%) was significantly lower than that in the control group (21.43%), the difference was statistically significant (P < 0.05). After the treatment, the VAS pain scores of the study group and the control group were both significantly improved (P < 0.05), but the improvement of the patients in the study group was more significantly (P < 0.05), and the difference was statistically significant. After treatment, the CASCS scores of the patients in the study group and the control group were significantly improved (P < 0.05), but the improvement of the study group was more (P < 0.05), and there was statistically significant difference. CONCLUSION: The combination of massage, traction and ultrashort wave therapy can significantly reduce the pain and reduce the incidence of adverse reactions in patients with cervical spondylotic radiculopathy, which is of great clinical significance to the rehabilitation of patients.
文摘Tandem spinal stenosis is described as concurrent symptomatic cervical and lumbar spinal stenosis. The clinical presentation includes neurogenic claudication, gait disturbance, myelopathy and polyradicuopathy in both upper and lower limbs. A 43-year-old female presented with predominant low back pain with right S1 radiculopathy leading to diagnosis of synovial facet cyst of lumbar spine. She was managed surgically after medical treatment failed. After 1 week post operatively, she presented with severe neck pain with left radiculopathy. MRI revealed acute on chronic cervical prolapsed intervertebral disc, cervical decompression surgery proceeded. Post operative improvement was noted on follow up. We report a case of tandem spinal stenosis, which both of the pathologies were managed with endoscopic approach.
文摘By means of cervical nerve root stimulation(CRS) method, the amplitudes and latencies of compound motor action potential(CMAP) of brachial biceps and brachial triceps muscles in 41 patients with clinical symptoms and signs of cervical radiculopathy were observed. The amplitudes of CMAPs on the affected side in the patients were obviously lower than on the healthy side and control group, latencies of CMAPs on the affected side were also significantly prolonged. The results showed that CRS was a sensitive method for making a direct determination of proximal nerve roit cinductiin function, and a good aid for diagnosing cervical radiculopathy.
基金supported by the 12th Five-Year National Science and Technology Support Plan(Grant No.2014BAI08B06)the National Natural Science Foundation of China(Grant No.81674005,81774330)the Special Research Project of Traditional Chinese Medicine Industry(Grant No.201407001).
文摘Objective: On the basis of a brief description of the current research status of modern Chinese medicine on the name, etiology, pathogenesis and classification of cervical spondylotic radiculopathy, this paper summarizes the research progress of modern Chinese medicine treatment of cervical spondylotic radiculopathy from the perspective of modern Chinese medicine treatment. This article mainly summarizes the following aspects: modern Chinese medicine for internal and external use;Chinese medicine acupuncture with filiform needle, electro-acupuncture and warm moxibustion;Chinese medicine massage and acupoint therapy;moxibustion, cupping, scraping and other comprehensive treatment;and Chinese medicine comprehensive therapy. The purpose of this article is to provide references for modern Chinese medicine treatment of cervical spondylotic radiculopathy.
文摘Objective:To review and evaluate the quality of the randomized controlled trials of exercise for the treatment of cervical radiculopathy with the present internationally recognized CONSORT statement, which provides reference and basis for the improvement of clinical research on exercise for intervening cervical radiculopathy in the future.Methods: A computer-based search of large domestic databases, including CNKI, Wanfang database and VIP database screened out literature that meet the requirements and used CONSORT statement for quality assessment.Results: According to the prescribed inclusion and exclusion criteria, 30 articles were retrieved in accordance with the standard. No literature was referred to the randomized controlled trial, 2 documents clearly defined the type of test design, 1 documents carried out the calculation of sample size, 13 documents clearly randomly assigned, 1 literature implemented the blind method, in the 7 literature, baseline information was shown in tabular form, and no reference was made to trial registration, trial protocol and funding.Conclusion:There are some aspects of randomized controlled trials on exercise for the treatment of cervical radiculopathy. However, there are some aspects that need to be improved. In the future randomized controlled trial report, the CONSORT statement should be highly valued and carefully considered to improve the accuracy and credibility of the research.
