2.Clinical symptoms and imaging findings of cervical instability in young adult.
Guang-Qi LU ; Ming-Hui ZHUANG ; Xiao-Juan CHANG ; Li-Guo ZHU ; Jie YU
China Journal of Orthopaedics and Traumatology 2022;35(12):1148-1153
OBJECTIVE:
To explore clinical symptoms and X-ray imaging features of cervical instability in young adult represented by postgraduates with a master's degree in medicine.
METHODS:
Totally 91 postgraduates with a master's degree in medicine were investigated from September to December 2021, including 45 males and 46 females;aged from 22 to 30 years old with an average of (25.30±2.18) years old. The cervical spondylosis-related discomfort symptoms of the subjects were collected and examined by the examiner for neck and shoulder tenderness point examination and cervical vertebra positive and lateral and functional X-ray radiography. According to the results of X-ray examination, the subjects were divided into stable cervical group and unstable cervical group.
RESULTS:
Among 91 subjects, there were 50 patients with cervical instability, accounting for 54.90% of total number of subjects. The cervical curvature was abnormal in 78 patients, accounting for 85.70% of total number of subjects. Among 50 patients with cervical instability, 50 patients were diagnosed as cervical instability on the basis of angular displaxement(AD)≥ 11 °, including 13 cases of C3,4 instability, 30 cases of C4,5 instability and 7 cases of C5,6 instability;and 5 cases were diagnosed as cervical instability based on horizontal displacement(HD)≥ 3.5 mm, including 1 case of C3,4 instability and 4 cases of C4,5 instability. Compared with stable cervical group, the number of discomfort symptoms of neck pain, headache and shoulder pain in instability group was significantly higher than that of in stable cervical group(P<0.05);and the number of tenderness in spinous process space of C4,5 and C5,6, 2 cm adjacent to the spinous process of C2-C5 and the superior angle of the scapula (the stop point of levator scapulae) in the instability group was significantly higher than that in the stable cervical group (P<0.05);and the cervical curvature in the instability group was significantly lower than that in stable cervical group(P<0.05).
CONCLUSION
The incidence of cervical instability in young adult represented by postgraduates with a master's degree in medicine is high, they are mainly diagnosed as cervical instability on the basis of vertebral angular displacement ≥ 11°, and the instability segments are concentrated on C3,4, C4,5 and C5,6 segments, the occurrence of cervical instability is often accompanied by abnormalities of cervical curvature. Most of clinical manifestations are head, neck and shoulder pain, especially neck pain in unstable segment.
Male
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Female
;
Humans
;
Young Adult
;
Adult
;
Neck Pain/etiology*
;
Shoulder Pain
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Spinal Diseases
;
Radiography
;
Spondylosis/diagnostic imaging*
;
Joint Instability/diagnostic imaging*
;
Cervical Vertebrae/diagnostic imaging*
3.MRI pain matrix regional homogeneity in cervical spondylosis of neck type treated with acupuncture at multiple acupoints.
Weicui CHEN ; Xiaoyan HOU ; Jun CHEN ; Delong ZHANG ; Guoxi YE ; Chenlin LIN ; Xian LIU ; Jianhua LIU ; Bo LIU
Chinese Acupuncture & Moxibustion 2015;35(10):1005-1009
OBJECTIVETo observe the impacts on pain matrix (PM) brain area in the patients of cervical spondylosis of neck type treated with acupuncture at single point and the multiple points.
METHODSForty-nine patients of cervical spondylosis of neck type were randomized into a single-point group (25 cases) and a multiple-point group (24 cases), and treated with acupuncture at Bailao (EX-HN 15) singly or Bailao (EX-HN 15) and Hegu (LI 4) in combination correspondingly. At the same time, 19 healthy people were selected as a control group. The resting state functional magnetic resonance imaging (fMRI) was conducted in each group before and after treatment. The changes in the regional homogeneity (ReHo) of brain area PM were analyzed in terms of the different therapeutic programs. The relevant analysis was on the scores of the Northwick Park neck pain questionnaire (NPQ) and short form 36 questionnaire (SF-36) for life quality.
RESULTSCompared with the control group, ReHo value was increased in supplementary motor area (SMA) of PM in the patients, of cervical spondylosis of neck type. In the single-point group, after treatment, ReHo value was reduced in the bilateral medial superior frontal gyri of patients. In the multiple-point group, ReHo values were reduced in the left medial superior frontal gyrus and right SMA in PM area after treatment. In the single-point group, ReHo value in each brain area of PM was not significantly correlated with NPQ and SF-36 scores. In the multiple-point group, the changes of ReHo value in superior frontal gyrus were positively correlated with those of NPQ scores.
CONCLUSIONConsidering the clinical efficacy of acupunctrue for cervical spondylosis of neck type, the overall result in the multiple-point group is better than that in the single-point group. It is deduced that the advantages of the therapeutic program in the multiple-point group is relevant with the cooperative integration of the stimulation at multiple points in cerebral analgesic center.
Acupuncture Points ; Acupuncture Therapy ; Adult ; Brain ; diagnostic imaging ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Neck Pain ; diagnostic imaging ; therapy ; Radiography ; Spondylosis ; diagnostic imaging ; therapy ; Treatment Outcome ; Young Adult
4.Correlation between cervical curvature and cervical disc bulging in young patients with neck pain.
Xue-Jun HE ; Xin JIN ; Quan-Wen HU ; Zhao-Ming FAN ; Jin-le WANG ; Yong-Wei SUN ; Kai GUAN
China Journal of Orthopaedics and Traumatology 2021;34(4):360-362
OBJECTIVE:
To explore the correlation between the curvature of the cervical spine and the degree of cervical disc bulging in young patients with cervical pain.
METHODS:
The clinical data of 539 young patients with neck pain from January 2015 to December 2018 were retrospectively analyzed. There were 251 males and 288 females, aged 18 to 40 (32.2±6.3) years old. The cervical curvature and cervical disc bulging were measured by cervical X-ray and MRI. According to cervical curvature, the patients were divided into 175 cases of cervical lordosis group (cervical curvature > 7 mm), 163 cases of cervical erection group (0
Adolescent
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Adult
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Cervical Vertebrae/diagnostic imaging*
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Female
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Humans
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Kyphosis
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Lordosis
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Male
;
Neck Pain/diagnostic imaging*
;
Retrospective Studies
;
Young Adult
6.Kinematic effect of Chinese herbal fomentation on patients with chronic neck pain.
Zhen-Yu LIU ; Bao-Ge LIU ; Xin LIN
Chinese journal of integrative medicine 2014;20(12):917-922
OBJECTIVETo clarify the effectiveness of Chinese herbal fomentation in treating chronic neck pain by means of changes in cervical kinematics.
METHODSSeventy-six patients with chronic neck pain were included in the study and were randomized into two groups based on the random number generator of the SPSS software: fomentation combined with Chinese herbal (Group 1) and fomentation without any medicine (Group 2). In both groups, the fomentation lasted for 60 min and heated to 35 °C, once a day for 28 consecutive days. Standard lateral radiographs of the cervical spine were obtained including the neutral, full flexion, and full extension positions. Before and after intervention, the following parameters were used to evaluate the changes in kinematics: range of motion (ROM), sagittal alignment and instantaneous center of rotation (ICR).
RESULTSAfter treatment, the ROM was signifcantly higher than that of before treatment in Group 1 (51.5, 95% CI: 49.8-55.9; P<0.05). There was no significant difference between before and after treatment in Group 2 (P>0.05). Although C2-C7 cervical alignment was increased in both groups after treatment, no significant difference was detected between before and after treatment (P>0.05). For Group 1, the significant X coordinate variation was only observed at C5/C6 level (38.1; 95% CI: 34.0, 42.1; P<0.05). There was a significant upward trend in the Y coordinate of the ICR at C5/C6 (-30.5; 95% CI: -34.3, -26.8; P<0.05) and C6/C7 after treatment (-6.1; 95% CI: -6.7, -5.4; P<0.05). For Group 2, the ICR location of each level was not statistically different between the pre- and post-treatment (P>0.05).
CONCLUSIONSChinese herbal fomentation could improve abnormal mobility in terms of ROM and ICR. Chinese herbal fomentation might be an effective treatment for chronic neck pain.
Adult ; Biomechanical Phenomena ; Cervical Vertebrae ; diagnostic imaging ; physiopathology ; Chronic Pain ; diagnostic imaging ; drug therapy ; physiopathology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Neck Pain ; diagnostic imaging ; drug therapy ; physiopathology ; Radiography ; Range of Motion, Articular
8.Clinics in diagnostic imaging (192). Flexion teardrop fracture.
Nicola Yan Ying LEE ; Bak Siew Steven WONG
Singapore medical journal 2018;59(11):562-566
An 82-year-old woman presented with neck pain and bilateral upper limb paraesthesia after sustaining an unwitnessed fall at home the day before. Physical examination revealed tenderness over the C4-6 region but no evidence of step deformity or neurological deficit. Magnetic resonance imaging of the cervical spine revealed multiple small fractures at the anteroinferior endplate corners of the C3, C5 and C6 vertebrae with focal kyphosis and marrow oedema at these levels, as well as associated disruption of the anterior longitudinal ligament and central spinal canal stenosis. The diagnosis of multiple flexion teardrop fractures was made based on these imaging findings, and the patient subsequently received conservative management. This paper illustrates the radiological features of flexion teardrop fractures and highlights the importance of prompt diagnosis and management of such cases.
Accidental Falls
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Aged, 80 and over
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Cervical Vertebrae
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diagnostic imaging
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Female
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Fracture Fixation, Internal
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methods
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Fractures, Bone
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diagnostic imaging
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Humans
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Neck Pain
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Radiography
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Range of Motion, Articular
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Spinal Fractures
;
diagnostic imaging
;
Treatment Outcome
9.A guide to requesting outpatient and emergency radiographs.
Gerald Jit Shen TAN ; Er Luen LIM ; Choon How HOW
Singapore medical journal 2012;53(7):423-quiz 427
Radiology is an important adjunct to clinical practice, but for many clinicians, requesting X-rays was something that was learnt on the job. This article provides guidelines on when and how to request X-rays for acute conditions such as head and cervical spine trauma, suspected rib and extremity fractures, low back pain and acute abdominal pain. We also highlight what to write in the request form, in order to obtain maximum value from the examination and allow the radiologist to generate a useful, accurate report.
Ankle Injuries
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diagnostic imaging
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Cervical Vertebrae
;
diagnostic imaging
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Emergency Service, Hospital
;
standards
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Fractures, Bone
;
diagnostic imaging
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Health Care Costs
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Hospitals
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Humans
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Medical Errors
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prevention & control
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Neck Pain
;
diagnostic imaging
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Radiology
;
methods
;
organization & administration
;
standards
;
Spinal Injuries
;
diagnostic imaging
;
Tomography, X-Ray Computed
;
X-Rays
10.Ultrasound-guided percutaneous laser ablation for benign solid thyroid nodule: a pilot study.
Juan LIU ; Fenglin WU ; Yang SUI ; Jie HU
Journal of Southern Medical University 2013;33(10):1529-1532
OBJECTIVETo evaluate the method, safety and short-term efficacy of ultrasound-guided percutaneous laser ablation (PLA) for benign solid thyroid nodule (BSTN).
METHODSThe treatment group consisting of 12 patients with single BSTN were treated with ultrasound-guided PLA. After treatment, the size and blood flow signals in conventional ultrasonography, the ablation extent of lesions in contrast-enhanced ultrasonography (CEUS), and the related complications and thyroid function were assessed in comparison with the the baseline. A control group including 12 untreated patients with single BSTN was followed-up in the same manner as in the treatment group.
RESULTSIn the treatment group, all the 12 patients completed the treatment successfully. During the follow-up, the volume of the nodules was reduced gradually (P<0.05), and blood flow signals in the nodules disappeared. Eleven nodules were non-enhanced in CEUS immediately after the treatment, and the complete ablation rate was 91.7%. During the operation, 3 patients complained of intolerable pain, which was ameliorated or totally relieved after appropriate treatment. The thyroid function showed no significant changes after the treatment (P>0.05). The control group followed up for 6 months showed no significant changes in the nodule volume or thyroid function in comparison with the baseline (P>0.05).
CONCLUSIONUltrasound-guided PLA is a safe and effective minimally invasive treatment of BSTN without obvious adverse effect on thyroid function.
Adult ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; adverse effects ; methods ; Male ; Middle Aged ; Neck Pain ; etiology ; Pilot Projects ; Thyroid Gland ; diagnostic imaging ; pathology ; surgery ; Thyroid Nodule ; diagnostic imaging ; pathology ; surgery ; Treatment Outcome ; Ultrasonography, Doppler, Color ; Ultrasonography, Interventional