Prevalence of Cervical Spondylosis in a General Practice

Irvine, Donald; Foster, John Burt; Newell, D. J.; Klukvin, B.N.

doi:10.1016/s0140-6736(65)92674-7

Cited by 90 publications

(54 citation statements)

References 6 publications

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“…Over 50% of the middle-aged population exhibits radiological or pathological evidence of cervical spondylosis [1][2][3]. This condition is often asymptomatic; however, in up to 15% of these cases the condition progresses to root or cord compression [4,5].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Evaluation of an Interfacet Joint Decompression and Stabilization System

Leasure

Buckley

2014

Journal of Biomechanical Engineering

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A majority of the middle-aged population exhibit cervical spondylosis that may require decompression and fusion of the affected level. Minimally invasive cervical fusion is an attractive option for decreasing operative time, morbidity, and mortality rates. A novel interfacet joint spacer (DTRAX facet screw system, Providence Medical) promises minimally invasive deployment resulting in decompression of the neuroforamen and interfacet fusion. The present study investigates the effectiveness of the device in minimizing intervertebral motion to promote fusion, decompression of the nerve root during bending activity, and performance of the implant to adhere to anatomy during repeated bending loads. We observed flexion, extension, lateral bending, and axial rotation resonant overshoot mode (ROM) in cadaver models of c-spine treated with the interfacet joint spacer (FJ spacer) as stand-alone and supplementing anterior plating. The FJ spacer was deployed bilaterally at single levels. Specimens were placed at the limit of ROM in flexion, extension, axial bending, and lateral bending. 3D images of the foramen were taken and postprocessed to quantify changes in foraminal area. Stand-alone spacer specimens were subjected to 30,000 cycles at 2 Hz of nonsimultaneous flexion-extension and lateral bending under compressive load and X-ray imaged at regular cycle intervals for quantitative measurements of device loosening. The stand-alone FJ spacer increased specimen stiffness in all directions except extension. 86% of all deployments resulted in some level of foraminal distraction. The rate of effective distraction was maintained in flexed, extended, and axially rotated postures. Two specimens demonstrated no detectable implant loosening (<0.25 mm). Three showed unilateral subclinical loosening (0.4 mm maximum), and one had subclinical loosening bilaterally (0.5 mm maximum). Results of our study are comparable to previous investigations into the stiffness of other standalone minimally invasive technologies. The FJ spacer system effectively increased stiffness of the affected level comparable to predicate systems. Results of this study indicate the FJ spacer increases foraminal area in the cervical spine, and decompression is maintained during bending activities. Clinical studies will be necessary to determine whether the magnitude of decompression observed in this cadaveric study will effectively treat cervical radiculopathy; however, results of this study, taken in context of successful decompression treatments in the lumbar spine, are promising for the continued development of this product. Results of this biomechanical study are encouraging for the continued investigation of this device in animal and clinical trials, as they suggest the device is well fixated and mechanically competent.

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Section: Introductionmentioning

confidence: 99%

Biomechanical Evaluation of an Interfacet Joint Decompression and Stabilization System

Leasure

Buckley

2014

Journal of Biomechanical Engineering

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“…Возрастные дегенеративные измене-ния костно-хрящевых структур шейного отдела позвоночника встречаются в 50% случаев среди населения средней возрастной группы. Хотя в большинстве случаев заболевание протекает бессимптомно, такие изменения, как грыжа межпозвонкового диска, образование краевых остеофитов, гипертрофированный суставно-связочный аппарат, являются причиной воз-никновения неврологической симптоматики, вызывая боль в шее, радикуло-и миелопатию [1,2].…”

Section: Modern Methods Of Radiology Diagnostics As a Basis For Timelunclassified

Modern Methods of Radiology Diagnostics as a Basis for Timely Detection and Successful Treatment of the Spinal Canal Degenerative Stenosis in the Cervical Spine

Meskhi¹,

Vorona²,

Zelyanin³

2017

Rejr

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ель исследования. Анализ роли современных методов лучевой диагностики, визуализации, контроля, а также их использования как в ходе предопераци-онной подготовки и оперативного лечения пациентов со стенозом позвоноч-ного канала шейного отдела позвоночника, так и в послеоперационном пери-оде.Материалы и методы. Проведено хирургическое лечение 25 пациентов со сте-нозом позвоночного канала шейного отдела позвоночника различной протяженности. Всем пациентам выполнялись рентгенологическое и МРТ-исследования на этапе доопе-рационного обследования, а также контрольные МРТ и КТ исследования в послеопера-ционном периоде. Оперативное лечение выполнялось из миниинвазивного переднебо-кового шейного парафарингеального доступа с установкой межтелового кейджа из ма-териала PEEK нулевого профиля с блокирующим механизмом, наполненного остеокон-дуктивной пастой на основе гидроксиапатита и β-трикальцийфосфата. На всех этапах оперативного пособия проводился рентгенологический контроль при помощи электрон-но-оптического преобразователя.Результаты. В результате тщательного предоперационного обследования, пла-нирования хирургического пособия и использования современных методов визуализа-ции в ходе оперативного вмешательства у 22 пациентов получен отличный ранний по-слеоперационный результат с выпиской на амбулаторное долечивание на 3-4 сутки по-сле оперативного лечения. У 3 пациентов в раннем послеоперационном периоде разви-лась симптоматика вторичного отека корешка, устраненная медикаментозным лечени-ем, пациенты выписаны из стационара на 9-10 сутки после операции. При последую-щих контрольных исследованиях через 6 и 12 месяцев у 17 (68,0%) из 25 пациентов на фоне отсутствия признаков дегенеративно-дистрофических изменений смежных уров-ней отмечались явления образования межтелового спондилодеза, дислокации имплан-тата зарегистрировано не было. Динамическое наблюдение за пациентами продолжено.Заключение. Применение современных методов лучевой диагностики на всех этапах (предоперационное обследование, планирование оперативного пособия, хирур-гическое вмешательство, наблюдение в послеоперационном периоде) лечения пациен-тов со стенозом позвоночного канала шейного отдела позвоночника позволяет получить отличные и хорошие результаты в абсолютном большинстве наблюдений и является за-логом успеха в лечении данной категории пациентов.Ключевые слова: стеноз позвоночного канала, шейный отдел позвоночника, ми-ниинвазивный спондилодез, дискэктомия, МРТ, КТ, спондилография.

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“…Osteophytes can form around the vertebral bodies, as well as around the uncovertebral joints anteriorly; and the facet joints posteriorly [22,34]. Interestingly, more than half of the middle age population has radiologic evidence of asymptomatic cervical spondylosis, and spondylosis is regarded as an integral part of physiological ageing [35]. However, spondylosis is associated with symptoms of nerve root(s) or spinal cord compression (myelopathy) in 10% -15% of the population [36].…”

Section: Neurological Symptomsmentioning

confidence: 99%

“…However, the origin of the neck pain remains controversial, since there are numerous structures in the cervical spine that can generate pain in the neck area [22]. The direct attribution of axial neck pain to degenerative changes in the cervical spine is questionable considering the high prevalence of degenerative changes in an asymptomatic population [35]. Nevertheless, the presence of nerve fibres and nerve endings in the peripheral portion of intervertebral discs [40], and in the facet joints [41] suggests that these structures may be involved and directly responsible for the development of axial neck pain in patients with cervical degenerative changes [22].…”

Section: Neck Painmentioning

confidence: 99%

Neck disability in patients with cervical radiculopathy and evaluation of structured postoperative physiotherapy

Wibault¹

2015

Linköping University Medical Dissertations

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Non-surgical and surgical approaches to treatment are used in patients with cervical radiculopathy (CR) due to disc disease. Overall, good effects of surgery have been reported on arm pain and neurological symptoms. However, the effects on neck functioning are more uncertain. Studies have shown persistent activity limitations; participation restrictions; and impairments in neck-related body functions after surgery. Structured physiotherapy combining neck-specific exercises with a behavioural approach has been suggested as treatment before as well as after surgery to improve clinical outcomes in patients with CR. Randomized clinical trials of postoperative physiotherapy to inform evidence-based clinical guidelines for the treatment of patients with CR are lacking. The overall aim of the thesis was to investigate the additional benefit of structured postoperative physiotherapy combining neck-specific exercises with a behavioural approach compared to standard postoperative approach in patients with CR. A further aim was to evaluate the contribution of different aspects of neck-related body functions and mental functions on preoperative neck disability in these patients. A total of 202 patients with CR who were scheduled for surgery were recruited, and randomized preoperatively to either structured postoperative physiotherapy, or standard postoperative approach. Standard postoperative approach was in accordance with Swedish postoperative care, and may have included pragmatic physiotherapy after surgery when needed. Patients were evaluated with a set of questionnaires and clinical examinations before surgery and at 3 and 6 months after surgery. Outcomes included patient-reported measures of pain, neck functioning, global outcome, clinical evaluation of neckrelated body functions, self-efficacy and coping strategies, as well as expectation fulfilment and enablement. Differences between treatment groups were investigated in complete case and per-protocol approaches (Paper III & IV). A sub-sample of patients with CR who were scheduled for surgery were also compared with neck-healthy individuals for assessment of head repositioning accuracy with a cervical range of motion device (Paper I). In patients with CR who were scheduled for surgery, associations between preoperative measures of neck-related body functions, mental functions, and other contextual factors with patientreported neck disability were studied (Paper II). With the exception of greater expectation fulfilment in patients who received structured postoperative physiotherapy (p = 0.01), there were no differences between the treatment groups in outcomes at 6 months after surgery. There were no differences reported for changes in outcomes from before surgery to 6 months after surgery between the groups, but all outcomes significantly improved from baseline in both groups (p<0.001) (Paper III & IV). However, global outcome and frequency of neck pain improved during the postoperative period only in patients who received structured postoperative physiot...

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Prevalence of Cervical Spondylosis in a General Practice

Cited by 90 publications

References 6 publications

Biomechanical Evaluation of an Interfacet Joint Decompression and Stabilization System

Biomechanical Evaluation of an Interfacet Joint Decompression and Stabilization System

Modern Methods of Radiology Diagnostics as a Basis for Timely Detection and Successful Treatment of the Spinal Canal Degenerative Stenosis in the Cervical Spine

Neck disability in patients with cervical radiculopathy and evaluation of structured postoperative physiotherapy

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