1.Observation on the Efficacy of Cervical Rotation and Lifting Manipulations on Pain and Cervical Sagittal Parameters in Patients with Neck Type Cervical Spondylopathy
Yuan-Li GU ; Zhuo-Heng MAI ; Hai-Ling WANG ; Sheng-Qiang ZHANG
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(8):2062-2068
Objective To observe the changes of cervical sagittal parameters of digital radiography(DR)at bilateral oblique position of cervical spine in patients with neck type cervical spondylopathy(NTCS)after cervical rotation and lifting manipulations,and to evaluate the clinical significance of cervical sagittal parameters in assessing the efficacy of NTCS by combining the pain score of visual analogue scale(VAS).Methods A retrospective analysis was carried out in 36 NTCS patients admitted to the outpatient clinic of the Tuina Department of Foshan Hospital of Traditional Chinese Medicine from November 2020 to May 2021.According to the treatment method,the patients were divided into the trial group and the control group,with 18 patients in each group.The trial group was treated with cervical rotation and lifting manipulations,and the control group was treated with cervical vertebra traction.The two groups were treated once every other day for 2 continuous weeks.The changes of VAS pain score and sagittal parameters of DR such as sagittal vertical axis of cervical vertebra 2-7(C2-7 SVA),the T1 slope(T1S),neck tilt(NT),and thoracic inlet angle(TIA)in the two groups were observed before and after treatment.Spearman correlation analysis was used to explore the correlation between VAS scores of pain level and cervical sagittal parameters.Results(1)Before treatment,there was no statistically significant difference in the VAS pain scores between the two groups(P>0.05).After treatment,the VAS pain scores in the two groups were significantly decreased compared with those before treatment(P<0.05),and the decrease of the scores in the trial group was significantly superior to that in the control group(P<0.01).(2)Before treatment,there was no statistically significant difference in the values of cervical sagittal parameters of C2-7 SVA,T1S,NT,and TIA between the two groups(P>0.05).After treatment,the C2-7 SVA,T1S,and TIA of the trial group were significantly improved compared with those before treatment(P<0.05),but the improvement of NT was not obvious(P>0.05);the cervical sagittal parameters of the control group were not significantly improved compared with those before treatment(P>0.05).The intergroup comparison showed that the improvement of C2-7 SVA,T1S,and TIA in the trial group was significantly superior to that in the control group(P<0.05 or P<0.01),while the difference in NT between the two groups after treatment was not statistically significant(P>0.05).(3)The results of Spearman correlation analysis showed that before treatment,VAS pain score had no correlation with C2-7 SVA,T1S,NT,and TIA(P>0.05),C2-7 SVA was negatively correlated with NT(r=-0.502,P<0.05),and T1S was positively correlated with NT(r=0.601,P<0.05).After treatment,VAS pain score was negatively correlated with C2-7 SVA(r=-0.362,P<0.05)and positively correlated with TIA(r=0.476,P<0.05),C2-7 SVA was positively correlated with NT(r=0.928,P<0.05),and T1S was positively correlated with TIA(r=0.623,P<0.05).Conclusion Both cervical rotation and lifting manipulations and cervical traction can relieve the pain and adjust cervical sagittal parameters in the patients with NTCS,but cervical rotation and lifting manipulations are more effective in treating NTCS.And there may be a correlation between the VAS scores of pain level and cervical sagittal parameters in patients with NTCS.