Cervical Radiculopathy

Woods, Barrett I.; Hilibrand, Alan S.

doi:10.1097/bsd.0000000000000284

Cited by 234 publications

(136 citation statements)

References 45 publications

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“…The choices of approach and technique must take into consideration many anatomical and patient-related factors, such as the disc height, the extent of the degenerative fusion, the alignment of the vertebrae, the direction of the compression, the number of affected levels and possible instability as well as the age and the comorbidities of the patient [34, 35]. The evidence comparing the different surgical approaches and techniques is weak and conflicting, very likely reflecting the variability of the clinical scenarios [4–6, 9–13, 16, 28, 30].…”

Section: Discussionmentioning

confidence: 99%

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Surgical techniques for degenerative cervical spine in Finland from 1999 to 2015

et al. 2019

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PurposeThe purpose of this study is to assess the trends and regional variations in the operative techniques used for degenerative or rheumatoid cervical spine disease in Finland between 1999 and 2015.MethodsThe Finnish Hospital Discharge Register (FHDR) was searched for the data on all the primary operations for degenerative cervical spine disease (DCSD) or rheumatoid atlanto-axial subluxation (rAAS). Operative codes were used to identify the patients from the FHDR and combined with diagnosis codes to verify patient inclusion. The patients were classified into three groups: anterior cervical decompression and fusion (ACDF), posterior decompression and fusion (PDF) and decompression.ResultsA total of 19,701 primary operations were included. The adjusted incidence of ACDF rose from 6.5 to 27.3 operations/100,000 adults. ACDF became the favoured technique in all the diagnostic groups except AAS, and by 2015, ACDF comprised 84.5% of the operations. The incidence of PDF for DCSD increased from 0.2 to 0.7/100,000 people. Solely decompressive operations declined from 13.7 to 4.0 operations/100,000 people. The regional differences in the incidence of operations were most marked in the incidence of ACDF, with overall incidences ranging from 11.2 to 37.0 operations/100,000. The distribution of the operative techniques used varied as well.ConclusionsBetween 1999 and 2015, the operative techniques used for DCSD changed from prevalently decompressive to utilising ACDF in 68.8 to 91.0% of the operations, depending on the treating hospital. ACDF became the most commonly applied technique for all degenerative diagnoses except AAS.Electronic supplementary materialThe online version of this article (10.1007/s00701-019-04026-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…radicular/myelopathic/axial neck pain) cannot be determined from the administrative data. These are factors that strongly affect the choice of the operative approach and technique [34, 35]. …”

Section: Discussionmentioning

confidence: 99%

Surgical techniques for degenerative cervical spine in Finland from 1999 to 2015

et al. 2019

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“…In the absence of myelopathy or obvious muscle weakness all patients with cervical radicular pain should be treated conservatively [8]. At present, the use of conventional modalities for cervical radiculopathy remains debatable, primarily because most treatments had limited success in regard to decreasing levels of pain and disability, increasing function, and range of motion [9–16].…”

Section: Introductionmentioning

confidence: 99%

Clinical Evidence of Chinese Massage Therapy (Tui Na) for Cervical Radiculopathy: A Systematic Review and Meta‐Analysis

Wei

Wang

et al. 2017

Evidence-Based Complementary and Alternative Medicine

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Objective. The review is to assess the current evidence of Chinese massage therapy (Tui Na) for cervical radiculopathy. Methods. Seven databases were searched. Randomised controlled trials incorporating Tui Na alone or Tui Na combined with conventional treatment were enrolled. The authors in pairs independently assessed the risk of bias and extracted the data. Results. Five studies involving 448 patients were included. The pooled analysis from the 3 trials indicated that Tui Na alone showed a significant lowering immediate effects on pain score (SMD = −0.58; 95% CI: −0.96 to −0.21; Z = 3.08, P = 0.002) with moderate heterogeneity compared to cervical traction. The meta-analysis from 2 trials revealed significant immediate effects of Tui Na plus cervical traction in improving pain score (MD = −1.73; 95% CI: −2.01 to −1.44; Z = 11.98, P < 0.00001) with no heterogeneity compared to cervical traction alone. No adverse effect was reported. There was very low quality or low quality evidence to support the results. Conclusions. Tui Na alone or Tui Na plus cervical traction may be helpful to cervical radiculopathy patients, but supportive evidence seems generally weak. Future clinical studies with low risk of bias and adequate follow-up design are recommended.

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“…1-4 However, there are significant risks associated with undergoing cervical spine surgery. Some complications, such as mild dysphagia after an anterior cervical discectomy and fusion, are common, but rarely result in any long-term sequelae.…”

Section: Introductionmentioning

confidence: 99%

Epidural Hematoma Following Cervical Spine Surgery

Schroeder

Hilibrand

Arnold

et al. 2017

Global Spine Journal

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Study Design:A multicentered retrospective case series.Objective:To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine.Methods:Patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011, at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified.Results:A total of 16 582 cervical spine surgeries were identified, and 15 patients developed a postoperative epidural hematoma, for a total incidence of 0.090%. Substantial variation between institutions was noted, with 11 sites reporting no epidural hematomas, and 1 site reporting an incidence of 0.76%. All patients initially presented with a neurologic deficit. Nine patients had complete resolution of the neurologic deficit after hematoma evacuation; however 2 of the 3 patients (66%) who had a delay in the diagnosis of the epidural hematoma had residual neurologic deficits compared to only 4 of the 12 patients (33%) who had no delay in the diagnosis or treatment (P = .53). Additionally, the patients who experienced a postoperative epidural hematoma did not experience any significant improvement in health-related quality-of-life metrics as a result of the index procedure at final follow-up evaluation.Conclusion:This is the largest series to date to analyze the incidence of an epidural hematoma following cervical spine surgery, and this study suggest that an epidural hematoma occurs in approximately 1 out of 1000 cervical spine surgeries. Prompt diagnosis and treatment may improve the chance of making a complete neurologic recovery, but patients who develop this complication do not show improvements in the health-related quality-of-life measurements.

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Cervical Radiculopathy

Cited by 234 publications

References 45 publications

Surgical techniques for degenerative cervical spine in Finland from 1999 to 2015

Surgical techniques for degenerative cervical spine in Finland from 1999 to 2015

Clinical Evidence of Chinese Massage Therapy (Tui Na) for Cervical Radiculopathy: A Systematic Review and Meta‐Analysis

Epidural Hematoma Following Cervical Spine Surgery

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