RESUMEN
BACKGROUND: The prevalence of back and neck pain is common in children and adolescents, and in some series the numbers are alarming. Various risk factors have been identified, although some are controversial. OBJECTIVE: To determine the prevalence of neck and back pain in children and adolescents and to investigate the potential association with various risk factors identified in the literature. METHODS: We established a questionnaire targeting parents of children and adolescents aged between 6 and 18 years old in Tunisia. The recruitment of participants was done online using the Google Forms application. The questionnaire was divided into 2 parts: Part one collected the sociodemographics characteristics of the participants : age, gender, body mass index (BMI), exposure to passive smoking, the practice of a physical activity, puberty status and age at puberty if applicable, type and weight of the schoolbag, mean daily time spent on electronic devices, type of school the child attends (private/public), mode of transport from home to school, parental history of neck and/or back pain (mid or low back pain (LBP)), posture of the sitting position of the child, and finally whether the child reports neck/ back pain. The second part was aimed at parents whose child reported neck and/or back pain. We asked about the weekly frequency of neck/back pain, school absenteeism due to neck/back pain, whether it prevented the child from practicing physical activity and, finally, whether the child had ever seen a doctor/chiropractor/physiotherapist for their neck/back pain. RESULTS: Eighty-eight children (45 females, 43 males) were enrolled. Mean age was 11.9 ± 3.8 years [6-18]. Mean BMI was 18.8 ± 4.2 [15.8-35.5]. Thirty-four (38.6%) were pubescent. Twenty-five (28.4%) children were exposed to passive smoking. Parental history of spine pain was found in 58% of cases. A poor sitting position was noted in n = 49 (55.7%). Mean daily screen time was 88.3 ± 75.56 min [0-360]. Prevalence of spine pain was 44% (n = 39) distributed as follows: neck pain (n = 21, 23.8%), mid back pain (n = 15, 17%), LBP (n = 26, 29.5%), neck, mid back and low back pain (n = 4, 4.5%) Professional help seeking for spine pain in children was reported by 15 participants (25.3%). Among them, 20.3% visited a physician and 5% consulted a chiropractor or physiotherapist. A significant correlation was found between spine pain and age (p = 0.006) and BMI (p = 0.006). A significant association was found between LBP and exposure to passive smoking, puberty status, type of school bag and poor posture. A positive parental history of spine pain was significantly associated with the presence of spine pain in their children with p = 0.053 (neck pain), p = 0.013 (back pain) and p < 0.00 (LBP) respectively. A significant association was found between the presence of spine pain and school absenteeism, participation in sports, consultation with a doctor or physiotherapist/chiropractor (p < 0.0001 respectively). CONCLUSION: The prevalence of spinal pain was frequent in our series. A positive parental history of spinal pain, a bad posture while sitting, passive smoking, use of backpack, higher age and higher BMI were potential associated factors.
Asunto(s)
Dolor de Espalda , Dolor de Cuello , Humanos , Niño , Masculino , Adolescente , Femenino , Túnez/epidemiología , Prevalencia , Dolor de Cuello/epidemiología , Dolor de Cuello/etiología , Factores de Riesgo , Encuestas y Cuestionarios , Dolor de Espalda/epidemiología , Dolor de Espalda/etiología , Índice de Masa Corporal , Dolor de la Región Lumbar/epidemiología , Dolor de la Región Lumbar/etiologíaRESUMEN
BACKGROUND Eagle syndrome is an uncommon medical illness that can manifest as neck pain in primary care. It results from an abnormally unilateral or bilateral long styloid process that may compress and affect adjacent structures, which leads to the symptoms. Classical Eagle syndrome has been commonly reported, but this case highlights the uncommon involvement of autonomic nerve dysfunction. CASE REPORT This case report details a 43-year-old woman with chronic neck pain for 5 years who saw numerous medical professionals and underwent 8 physiotherapy sessions. Marginal improvement of her neck pain and recent development of imbalance and a floating sensation prompted escalation of radiological imaging that eventually led to the diagnosis of Eagle syndrome. She was subsequently subjected to tonsillectomy and styloidectomy to address the sources of her neck pain. CONCLUSIONS Neck pain is a common complaint in primary care, but Eagle syndrome is often overlooked due to its complex symptoms, which mimic other conditions resulting in missed diagnoses and prolonged diagnostic evaluations. To improve patient care and outcomes, primary care physicians should consider Eagle syndrome when evaluating neck pain. This involves taking a detailed clinical history, conducting a thorough physical examination, using appropriate imaging techniques, and knowing the treatment options. By considering this potential diagnosis, primary care physicians, other healthcare professionals, and physical therapists play an important role in referring these patients to an otorhinolaryngologist or a maxillofacial surgeon for a comprehensive evaluation and management.
Asunto(s)
Dolor Crónico , Dolor de Cuello , Osificación Heterotópica , Hueso Temporal , Humanos , Femenino , Adulto , Dolor de Cuello/etiología , Osificación Heterotópica/diagnóstico , Osificación Heterotópica/complicaciones , Osificación Heterotópica/diagnóstico por imagen , Hueso Temporal/anomalías , Hueso Temporal/diagnóstico por imagen , Dolor Crónico/etiología , Atención Primaria de SaludRESUMEN
The mobile phone is essential in daily life, especially during the pandemic. Prolonged use can cause postural issues, leading to common neck pain. This study aims to determine the correlation between mobile phone use duration, addiction, neck muscle endurance, and neck pain in university students. The study included 62 participants (30 female, 32 male) aged 18-35 years. Inclusion criteria required participants to have experienced neck pain at least twice in the past year and to have no other concomitant issues, as well as to volunteer for the study. Demographic information and daily mobile phone usage time were collected. Neck pain was assessed with the Visual Analogue Scale, smartphone addiction with the Smartphone Addiction Scale, and cervical muscle endurance was evaluated. Correlation analysis reveals a moderate relationship between neck pain severity (NPS) and cervical extensor muscle endurance (CEME), a strong relationship between NPS and cervical flexor muscle endurance (CFME), as well as a strong relationship among daily phone usage time (DPUT), CFME, and NPS, with a moderate relationship between DPUT and CEME. Participants were divided into two groups based on their DPUT, revealing that those who used their phone for four hours or more showed significantly higher levels of pain (p < 0.05) and reduced endurance in cervical flexor muscles. Our study found a strong correlation between neck pain, muscle endurance, and daily phone usage. Participants using their phones for more than four hours daily reported increased neck pain and decreased muscle endurance. We suggest integrating phone usage duration into neck pain assessments, promoting ergonomic practices, and offering detailed usage guidelines for users.
Asunto(s)
Músculos del Cuello , Dolor de Cuello , Estudiantes , Humanos , Dolor de Cuello/fisiopatología , Dolor de Cuello/epidemiología , Dolor de Cuello/etiología , Femenino , Masculino , Músculos del Cuello/fisiopatología , Músculos del Cuello/fisiología , Adulto , Adulto Joven , Adolescente , Universidades , Uso del Teléfono Celular/efectos adversos , Uso del Teléfono Celular/estadística & datos numéricos , Resistencia Física/fisiología , Teléfono CelularRESUMEN
The human neck is a unique mechanical structure, highly flexible but fatigue prone. The rising prevalence of neck pain and chronic injuries has been attributed to increasing exposure to fatigue loading in activities such as prolonged sedentary work and overuse of electronic devices. However, a causal relationship between fatigue and musculoskeletal mechanical changes remains elusive. This work aimed to establish this relationship through a unique experiment design, inspired by a cantilever beam mechanical model of the neck, and an orchestrated deployment of advanced motion-force measurement technologies including dynamic stereo-radiographic imaging. As a group of 24 subjects performed sustained-till-exhaustion neck exertions in varied positions-neutral, extended, and flexed, their cervical spine musculoskeletal responses were measured. Data verified the occurrence of fatigue and revealed fatigue-induced neck deflection which increased cervical lordosis or kyphosis by 4-5° to 11°, depending on the neck position. This finding and its interpretations render a renewed understanding of muscle fatigue from a more unified motor control perspective as well as profound implications on neck pain and injury prevention.
Asunto(s)
Fatiga Muscular , Dolor de Cuello , Cuello , Humanos , Masculino , Adulto , Femenino , Fatiga Muscular/fisiología , Dolor de Cuello/fisiopatología , Dolor de Cuello/etiología , Vértebras Cervicales/diagnóstico por imagen , Fenómenos Biomecánicos , Músculos del Cuello/fisiología , Rango del Movimiento Articular , Adulto Joven , Lordosis/fisiopatologíaRESUMEN
This is a case report of a patient who presented with neck pain and intermittent pyrexia as a manifestation of pseudogout of the neck.
Asunto(s)
Condrocalcinosis , Dolor de Cuello , Humanos , Condrocalcinosis/complicaciones , Condrocalcinosis/diagnóstico , Condrocalcinosis/diagnóstico por imagen , Dolor de Cuello/etiología , Fiebre/etiología , Tomografía Computarizada por Rayos X , Diagnóstico Diferencial , Masculino , Síndrome , Femenino , Apófisis Odontoides/diagnóstico por imagenRESUMEN
INTRODUCTION: Spinal cord infarction (SCI) is a rare disease representing nearly 1% of all strokes with a wide variety of symptoms at presentation. SCI diagnosis is very challenging owing to its low incidence and the variety of symptoms, and could be misdiagnosed with neuromyelitis optica spectrum disorders (NMOSD). CASE PRESENTATION: We describe the case of an 18-year-old girl who presented to the emergency department with acute neck pain and flaccid paralysis of the left upper and lower extremities. Few hours later, she developed apnea and was endotracheally intubated. Brain MRI was normal but spinal cord MRI revealed non-enhancing longitudinal abnormal high T2 signal intensity extending from C1 to C5. The patient underwent steroid therapy with methylprednisolone (1 g daily for 7 consecutive days) combined with physiotherapy. She was extubated after 3 weeks and discharged after 30 days of hospitalization with a muscle force of 4/5 in her left extremities. DISCUSSION: Idiopathic SCI in adolescence is a rare but often devastating disorder with unknown pathophysiology, however, some specific conditions in adolescent such as mechanical stresses on the immature spine can be considered as risk factors for SCI development. Early diagnosis and treatment can improve outcomes in SCI.
Asunto(s)
Médula Cervical , Infarto , Dolor de Cuello , Humanos , Femenino , Adolescente , Infarto/diagnóstico , Infarto/complicaciones , Infarto/diagnóstico por imagen , Médula Cervical/diagnóstico por imagen , Dolor de Cuello/etiología , Parálisis/etiología , Parálisis/diagnóstico , Metilprednisolona/uso terapéuticoRESUMEN
BACKGROUND: The foramen transversarium is a vital anatomical structure found in the cervical vertebrae of the spine. Typically, it serves as a passageway for important neurovascular structures, including the vertebral artery and vein, as well as the vertebral nerve. However, abnormal calcification or ossification of soft tissues in and around this area can lead to various clinical implications. Understanding the presence and implications of abnormal ossified structures in and around the foramen transversarium is crucial for clinicians involved in the diagnosis and management of cervical spine disorders. AIMS: Accordingly, this present study was designed to evaluate the abnormal ossified structures anatomically and radiologically within and around the foramen transversarium. MATERIALS AND METHODS: This study was conducted on 182 (26 sets of cervical vertebrae) dried human cervical vertebrae obtained from the respective departments of anatomy and on 190 (95 males and 95 females) adult patients who visited the radiology department for neck-related problems such as stiff neck, neck/shoulder pain, dizziness, vertigo, imbalance, visual disturbances, and cognitive impairment. RESULTS: Among 182 examined cervical vertebrae, unilateral complete accessory foramen transversarium was found in 23 vertebrae (12.63%), bilateral complete in 19 (10.44%), bilateral incomplete in 6 (3.29%), unilateral complete double in 4 (2.19%), and unilateral complete absence of foramen transversarium in 3 (1.64%). Stenosis due to aberrant osteophytes was noted in 9 vertebrae (4.9%). Out of 190 patients, three males presented with cervical kyphosis, severe spinal canal stenosis, and spinal cord compression due to ossification of the posterior longitudinal ligament and osteophyte complexes at C3-C6, with the most significant compression at C5-C6. CONCLUSION: A thorough understanding of abnormal ossifications in and around the foramen transversarium is crucial for the management of cervical spine disorders; imaging modalities such as X-ray, computed tomography, and magnetic resonance imaging are crucial for recognizing and intervening in these cases, which is essential to prevent adverse neurological outcomes associated with vertebral artery involvement.
Résumé Contexte:Le foramen transversarium est une structure anatomique vitale trouvée dans les vertèbres cervicales de la colonne vertébrale. Généralement, il sert de passage pour d'importantes structures neurovasculaires, notamment l'artère et la veine vertébrale, ainsi que le nerf vertébral. Cependant, anormal la calcification ou l'ossification des tissus mous dans et autour de cette zone peut entraîner diverses implications cliniques. Comprendre la présence et Les implications des structures ossifiées anormales dans et autour du foramen transversarium sont cruciales pour les cliniciens impliqués dans le diagnostic et prise en charge des troubles de la colonne cervicale.Objectifs:En conséquence, cette présente étude a été conçue pour évaluer les structures ossifiées anormales anatomiquement et radiologiquement à l'intérieur et autour du foramen transversarium.Matériels et méthodes:Cette étude a été menée sur 182 (26 ensembles de vertèbres cervicales) vertèbres cervicales humaines séchées obtenues auprès des départements d'anatomie respectifs et sur 190 (95 hommes et 95 femmes) patients adultes qui ont consulté le service de radiologie pour des problèmes liés au cou tels qu'une raideur de la nuque, des douleurs au cou/à l'épaule, des étourdissements, vertiges, déséquilibre, troubles visuels et troubles cognitifs.Résultats:Parmi 182 vertèbres cervicales examinées, unilatérales completes un foramen transversarium accessoire a été trouvé dans 23 vertèbres (12,63%), bilatéral complet dans 19 (10,44%), bilatéral incomplet dans 6 (3,29%), double complet unilatéral chez 4 (2,19 %) et absence complète unilatérale de foramen transversarium chez 3 (1,64 %). Sténose due à une aberration des ostéophytes ont été notés dans 9 vertèbres (4,9 %). Sur 190 patients, trois hommes présentaient une cyphose cervicale, une sténose sévère du canal rachidien, et compression de la moelle épinière due à l'ossification du ligament longitudinal postérieur et des complexes ostéophytes en C3C6, le plus compression importante en C5C6.Conclusion:Une compréhension approfondie des ossifications anormales dans et autour du foramen transversarium est crucial pour la gestion des troubles de la colonne cervicale; modalités d'imagerie telles que les rayons X, la tomodensitométrie et la résonance magnétique l'imagerie est cruciale pour reconnaître et intervenir dans ces cas, ce qui est essentiel pour prévenir les conséquences neurologiques indésirables associées avec atteinte de l'artère vertébrale.
Asunto(s)
Vértebras Cervicales , Humanos , Masculino , Femenino , Vértebras Cervicales/diagnóstico por imagen , Adulto , Persona de Mediana Edad , Calcinosis/diagnóstico por imagen , Calcinosis/patología , Anciano , Dolor de Cuello/diagnóstico por imagen , Dolor de Cuello/etiología , Osificación Heterotópica/diagnóstico por imagen , Osificación Heterotópica/patología , RadiografíaRESUMEN
BACKGROUND: To develop a nursing program for the prevention and rehabilitation of shoulder and neck discomfort after thyroid cancer surgery based on the empowerment theory, and to evaluate the application effect of the program. METHODS: The prevention and rehabilitation nursing program for shoulder and neck discomfort after thyroid cancer surgery was established by literature review and the Delphi method. Between July 2022 and January 2023, a total of 62 postoperative thyroid cancer patients were recruited and randomly allocated to either the intervention group (nâ =â 31) or the control group (nâ =â 31) in this randomized controlled trial. Comparisons of shoulder and neck function, self-efficacy, and quality of life between the 2 groups were performed using a 2-sample independent t test, Wilcoxon rank-sum test, and repeated-measures analysis of variance. RESULTS: At the end of the study, the control group and intervention group were 30 cases each completed the study. After the intervention, the self-efficacy score of the intervention group was higher than the control group (Pâ <â .05), and the score of emotional function, cognitive function, and overall health dimension of the intervention group was higher than the control group (Pâ <â .05). The pain dimension score of the intervention group was lower than the control group (Pâ <â .05). There were significant differences in the group and time effects of the total shoulder joint scores between the 2 groups (Pâ <â .05). CONCLUSION: This study demonstrated that the shoulder and neck rehabilitation nursing program can alleviate the symptoms of shoulder and neck discomfort and improve patients' self-efficacy and quality of life.
Asunto(s)
Dolor de Cuello , Calidad de Vida , Neoplasias de la Tiroides , Humanos , Masculino , Femenino , Neoplasias de la Tiroides/cirugía , Neoplasias de la Tiroides/rehabilitación , Persona de Mediana Edad , Proyectos Piloto , Adulto , Dolor de Cuello/etiología , Dolor de Cuello/rehabilitación , Dolor de Cuello/prevención & control , Autoeficacia , Dolor de Hombro/etiología , Dolor de Hombro/rehabilitación , Dolor de Hombro/prevención & control , Complicaciones Posoperatorias/prevención & control , Complicaciones Posoperatorias/rehabilitaciónRESUMEN
BACKGROUND Crowned dens syndrome (CDS) is a rare condition characterized by deposition of calcium pyrophosphate crystals on the odontoid process of the second cervical vertebra, forming a calcified 'crown', with neck pain being a common symptom. The disorder exhibits unique clinical and radiological features, resembling manifestations of meningitis, such as acute headaches and cervical stiffness. There are few case reports and case series related to CDS. Patients generally respond well to treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), although there is a certain rate of recurrence. Since there are few reports of CDS, we sought to publish this case report, aiming of increasing clinicians' awareness and reducing misdiagnosis rates. CASE REPORT A 62-year-old man presented to the Emergency Department with "cutting-like" headaches and neck pain for 2 days, and was subsequently diagnosed with CDS by cervical computed tomography (CT) scan, and hematological tests revealed inflammatory manifestations. He was advised to take oral nonsteroidal anti-inflammatory drugs and to rest; his symptoms improved after 3 days and his neck pain had almost resolved after 2 months. CONCLUSIONS In older patients experiencing new headaches and neck pain, along with increased inflammatory markers, particularly those with a history of pseudogout, the possibility of CDS should be considered. Case reports suggest that oral NSAIDs and short courses of corticosteroids can generally alleviate symptoms. Further research is needed on CDS diagnosis and treatment.
Asunto(s)
Condrocalcinosis , Dolor de Cuello , Apófisis Odontoides , Humanos , Masculino , Persona de Mediana Edad , Dolor de Cuello/etiología , Condrocalcinosis/complicaciones , Condrocalcinosis/diagnóstico , Apófisis Odontoides/diagnóstico por imagen , Antiinflamatorios no Esteroideos/uso terapéutico , Tomografía Computarizada por Rayos X , Vértebras Cervicales/diagnóstico por imagen , SíndromeRESUMEN
OBJECTIVE: To develop and internally validate a prognostic model to predict chronic pain after a new episode of acute or subacute non-specific idiopathic, non-traumatic neck pain in patients presenting to physiotherapy primary care, emphasising modifiable biomedical, psychological and social factors. DESIGN: A prospective cohort study with a 6-month follow-up between January 2020 and March 2023. SETTING: 30 physiotherapy primary care practices. PARTICIPANTS: Patients with a new presentation of non-specific idiopathic, non-traumatic neck pain, with a duration lasting no longer than 12 weeks from onset. BASELINE MEASURES: Candidate prognostic variables collected from participants included age and sex, neck pain symptoms, work-related factors, general factors, psychological and behavioural factors and the remaining factors: therapeutic relation and healthcare provider attitude. OUTCOME MEASURES: Pain intensity at 6 weeks, 3 months and 6 months on a Numeric Pain Rating Scale (NPRS) after inclusion. An NPRS score of ≥3 at each time point was used to define chronic neck pain. RESULTS: 62 (10%) of the 603 participants developed chronic neck pain. The prognostic factors in the final model were sex, pain intensity, reported pain in different body regions, headache since and before the neck pain, posture during work, employment status, illness beliefs about pain identity and recovery, treatment beliefs, distress and self-efficacy. The model demonstrated an optimism-corrected area under the curve of 0.83 and a corrected R2 of 0.24. Calibration was deemed acceptable to good, as indicated by the calibration curve. The Hosmer-Lemeshow test yielded a p-value of 0.7167, indicating a good model fit. CONCLUSION: This model has the potential to obtain a valid prognosis for developing chronic pain after a new episode of acute and subacute non-specific idiopathic, non-traumatic neck pain. It includes mostly potentially modifiable factors for physiotherapy practice. External validation of this model is recommended.
Asunto(s)
Dolor Crónico , Dolor de Cuello , Modalidades de Fisioterapia , Atención Primaria de Salud , Humanos , Dolor de Cuello/terapia , Dolor de Cuello/etiología , Femenino , Masculino , Dolor Crónico/etiología , Dolor Crónico/terapia , Dolor Crónico/psicología , Pronóstico , Persona de Mediana Edad , Estudios Prospectivos , Adulto , Dimensión del DolorRESUMEN
Hyoid bone-related carotid injury is a rare cause of neurovascular events. This report describes a case of a young, healthy male presenting with neck pain followed by left-sided hemiparesis. The patient was diagnosed with a transient ischaemic attack attributed to structural damage of the vascular surface of the right internal carotid artery as a direct result of continuous compression by an elongated hyoid bone. We describe a successful diagnosis using a series of manoeuvres during a six-vessel cerebral angiogram. Genetic testing later confirmed the diagnosis of vascular Ehlers-Danlos syndrome.
Asunto(s)
Disección de la Arteria Carótida Interna , Síndrome de Ehlers-Danlos , Hueso Hioides , Humanos , Masculino , Síndrome de Ehlers-Danlos/complicaciones , Síndrome de Ehlers-Danlos/diagnóstico , Disección de la Arteria Carótida Interna/etiología , Disección de la Arteria Carótida Interna/diagnóstico por imagen , Disección de la Arteria Carótida Interna/complicaciones , Hueso Hioides/diagnóstico por imagen , Adulto , Ataque Isquémico Transitorio/etiología , Angiografía Cerebral , Arteria Carótida Interna/diagnóstico por imagen , Dolor de Cuello/etiología , Síndrome de Ehlers-Danlos Tipo IVRESUMEN
A whiplash injury can alter neck muscle function, which remains years after the injury and may explain why symptoms such as persistent pain and disability occur. There is currently limited knowledge about dynamic neck muscle function in chronic whiplash-associated disorders (WAD), and about the extent to which altered muscle function can improve after rehabilitation. Ultrasound can detect mechanical neck muscle function by measuring real-time deformation and deformation rate in the muscles. This method was used for five dorsal neck muscles in participants with chronic WAD versus matched controls in resistant neck rotation. We obtained real-time, non-invasive ultrasound measurements using speckle tracking, multivariate analyses, and mixed-design ANOVA analyses. The results showed altered deformation in the three deepest neck muscle layers, with less deformation area in the WAD group compared to controls in rotation to the most painful side at baseline. Participants in the WAD group performed three months of neck-specific exercises, resulting in improved deformation in the deep neck muscles in WAD and with a similar deformation pattern to controls, and the significant group differences ceased. We reveal new and important insights into the capability of ultrasound to diagnose altered neck muscle function and evaluate an exercise intervention.
Asunto(s)
Terapia por Ejercicio , Músculos del Cuello , Ultrasonografía , Lesiones por Latigazo Cervical , Humanos , Lesiones por Latigazo Cervical/diagnóstico por imagen , Lesiones por Latigazo Cervical/fisiopatología , Músculos del Cuello/diagnóstico por imagen , Músculos del Cuello/fisiopatología , Masculino , Ultrasonografía/métodos , Femenino , Adulto , Estudios de Casos y Controles , Terapia por Ejercicio/métodos , Persona de Mediana Edad , Dolor de Cuello/diagnóstico por imagen , Dolor de Cuello/fisiopatología , Dolor de Cuello/etiología , Adulto JovenRESUMEN
STUDY DESIGN: Retrospective Cohort Study. OBJECTIVES: This study measures the subcutaneous fat index (SFI) of the cervical spine in patients with spinal cervical spondylosis using cervical magnetic resonance imaging and explores its relationship with neck pain in patients with spinal cervical spondylosis. METHODS: In this single-center retrospective study, 298 patients hospitalized for spinal cervical spondylosis between January and June 2021 were initially considered. After applying inclusion and exclusion criteria, 93 patients were enrolled. The cervical magnetic resonance imaging data for these patients were analyzed using A-Site software. The SFI was measured at the median sagittal plane on T2-weighted images. Patients were categorized into 2 groups based on their admission complaints: those with cervical pain and those without it. Differences between these groups were then statistically analyzed. RESULTS: The mean SFIs with standard deviations for the neck and non-neck pain groups were 36.4% ± 7.7% and 27.0% ± 7.9%, respectively, with a significant difference (P < 0.0001). The SFI was consistently higher across all neck segments in the neck pain group compared to the nonneck pain group (P < 0.05). The 2 groups had no statistically significant difference in the body mass index. CONCLUSIONS: The SFI provides a more precise assessment of muscle and fat distribution in the posterior cervical region than body mass index and is generally higher in patients with spinal cervical spondylosis who experience neck pain. These findings suggest the importance of early functional exercises postsurgery for potentially improving surgical outcomes in this patient population.
Asunto(s)
Vértebras Cervicales , Imagen por Resonancia Magnética , Dolor de Cuello , Espondilosis , Grasa Subcutánea , Humanos , Espondilosis/cirugía , Espondilosis/complicaciones , Espondilosis/diagnóstico por imagen , Femenino , Masculino , Estudios Retrospectivos , Dolor de Cuello/etiología , Dolor de Cuello/diagnóstico por imagen , Persona de Mediana Edad , Grasa Subcutánea/diagnóstico por imagen , Vértebras Cervicales/diagnóstico por imagen , Vértebras Cervicales/cirugía , Anciano , Adulto , Estudios de Cohortes , Índice de Masa CorporalRESUMEN
OBJECTIVE: To compare the effects of a neck-specific exercise programme with internet support and 4 physiotherapist sessions (NSEIT) and the same neck-specific exercises supervised by a physiotherapist (NSE) on neck muscle endurance and cervical range of motion. DESIGN: Randomized controlled trial. PATIENTS: A total of 140 participants with chronic whiplash-associated disorders grade II or grade III were randomly assigned to the NSEIT or NSE groups. METHODS: Outcomes were changes in active cervical range of motion, cranio-cervical flexion test, neck muscle endurance, and neck pain, at 3- and 15-month follow-ups. RESULTS: There were no significant differences between the NSEIT and NSE groups. There was a significant group-by-time inter-action effect in active cervical range of motion flexion/extension where the NSEIT group improved to 3-month follow-up, but the NSE group did not. Both groups were significantly improved over time in all other outcomes (p < 0.001) at 3- and 15-month follow-ups, with effect size between 0.64 and 1.35 in active cervical range of motion, cranio-cervical flexion test, dorsal neck muscle endurance, and neck pain, and effect size between 0.22 and 0.42 in ventral neck muscle endurance. CONCLUSION: Both NSE and NSEIT led to improved neck function. Depending on the patients' needs, either NSE or NSEIT could be used as treatment for patients with chronic whiplash-associated disorders.
Asunto(s)
Terapia por Ejercicio , Músculos del Cuello , Dolor de Cuello , Rango del Movimiento Articular , Lesiones por Latigazo Cervical , Humanos , Lesiones por Latigazo Cervical/fisiopatología , Lesiones por Latigazo Cervical/rehabilitación , Rango del Movimiento Articular/fisiología , Masculino , Femenino , Adulto , Terapia por Ejercicio/métodos , Músculos del Cuello/fisiopatología , Dolor de Cuello/fisiopatología , Dolor de Cuello/rehabilitación , Dolor de Cuello/etiología , Dolor de Cuello/terapia , Persona de Mediana Edad , Resultado del Tratamiento , Internet , Enfermedad Crónica , Resistencia Física/fisiologíaRESUMEN
AIMS: This study aimed to describe clinical characteristics and sleep quality of Parkinson's Diseases (PD) patients and identify associated factors with sleep quality. METHODS: A cross-sectional study was conducted at the National Geriatric Hospital, Hanoi, Vietnam, from December 2022 to April 2023. A total of 130 Parkinson's disease patients undergoing treatment at the hospital were invited. Demographic and clinical characteristics were obtained. The diagnosis of sleep disorders was based on the standards outlined in the DSM-V. A multivariate logistic regression model was employed. RESULTS: 90.9â¯% experienced sleep disorder, with the significant types including insomnia (76.2â¯%) and restless legs syndrome (56.2â¯%). The majority of patients suffered two (33.1â¯%) and one kind of sleep disorder (32.3â¯%). Most patients experienced sleep disorders after diagnosis of PD (80.0â¯%). Only having shoulder and neck pain was positively associated with a likelihood of having sleep disturbances (OR=4.87, 95â¯%CI=1.18-20.15). CONCLUSION: This study found a high rate of sleep disorders among PD patients in our sample. Shoulder and neck pain was found to be associated with a risk of sleep disorders. Pain management should be performed to improve the sleep quality of PD patients.
Asunto(s)
Enfermedad de Parkinson , Trastornos del Sueño-Vigilia , Humanos , Enfermedad de Parkinson/complicaciones , Masculino , Femenino , Anciano , Estudios Transversales , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/epidemiología , Persona de Mediana Edad , Síndrome de las Piernas Inquietas/epidemiología , Anciano de 80 o más Años , Factores de Riesgo , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Dolor de Cuello/etiología , Dolor de Cuello/epidemiología , Calidad del Sueño , Dolor de Hombro/epidemiología , Dolor de Hombro/etiologíaRESUMEN
OBJECTIVE: The purpose of this study is to compare radiological and clinical outcomes between alternate levels (C4 and C6) and all levels mini-plate fixation in C3-6 unilateral open-door laminoplasty. METHODS: Ninety-six patients who underwent C3-6 unilateral open-door laminoplasty with alternate levels mini-plate fixation (54 patients in group A) or all levels mini-plate fixation (42 patients in group B) between September 2014 and September 2019 were reviewed in this study. Radiologic and clinical outcomes were assessed. Clinical results included Visual Analogue Scale (VAS) of axial neck pain and Japanese Orthopedic Association (JOA) score. Radiographic results included cervical range of motion (ROM), cervical curvature index (CCI), and the spinal canal expansive parameters including open angle, anteroposterior diameter (APD), and Pavlov`s ratio. RESULTS: There was no significant difference in VAS, JOA score, ROM, and CCI between two groups. There was no significant difference in canal expansion postoperatively between two groups. However, open angle, APD, and Pavlov`s ratio in group A decreased significantly during the follow-up. In group B, APD, Pavlov`s ratio, and open angle were maintained until the final follow-up. There was no hardware failure or lamina reclosure occurred in both groups during the follow-up. The mean cost of group B was higher than that of group A. CONCLUSIONS: Despite the differences in the maintenance of canal expansion, alternate levels mini-plate fixation can achieve similar clinical outcomes as all levels mini-plate fixation in C3-6 unilateral open-door laminoplasty. As evidenced in this study, we believe C3-6 laminoplasty with alternate levels (C4 and C6) mini-plate fixation is an economical, effective, and safe treatment method.
Asunto(s)
Placas Óseas , Vértebras Cervicales , Laminoplastia , Humanos , Vértebras Cervicales/cirugía , Vértebras Cervicales/diagnóstico por imagen , Laminoplastia/métodos , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Masculino , Anciano , Resultado del Tratamiento , Rango del Movimiento Articular , Adulto , Dolor de Cuello/etiología , Dolor de Cuello/cirugíaRESUMEN
BACKGROUND: Low back pain is an important disability problem frequently encountered in the clinic. In the literature, it has been shown that neuropathic pain in chronic low back pain is quite common in patients. Although superior cluneal nerve entrapment syndrome is an underdiagnosed cause of low back and leg pain, differential diagnosis is very important anatomically and clinically. The superior cluneal nerves are pure sensory nerves that innervate the skin of the upper part of the buttocks. In the literature, methods such as surgery, nerve blockade, prolotherapy, and acupuncture have been used in the treatment of cluneal nerve entrapment syndrome, but there are no studies on exercise. In this case report, our aim is to explain the importance of differential diagnosis in cluneal nerve entrapment syndrome, which is one of the common causes of low back pain in the clinic, and the effects of exercise in this disease. CASE PRESENTATION: A 22-year-old, Turkish-ethnicity, male patient with complaints of low back pain, neck-back pain, and weakness did not use alcohol or cigarettes. In his family history, there was a history of diabetes in the mother and diabetes and heart failure in the father. He had a history of osteoporosis, epilepsy, asthma, sarcoidosis, and cardiac arrhythmia. The patient reported that he suffered from constipation three to four times a month. As a result of the detailed evaluation, the planned exercise prescription was taught to the patient, and after it was confirmed that the patient did the exercises correctly for 3 days, the exercise brochure was given and followed as a home exercise program for 8 weeks. CONCLUSIONS: Lumbar stabilization exercises, gluteal muscle strengthening exercises, thoracolumbar fascia mobilization, and stretching exercises, which will be given in accordance with the clinical anatomy of the disease after the correct diagnosis in cluneal nerve entrapment syndrome, have been beneficial for the patient. However, we think that randomized controlled studies with a large sample will contribute to the literature.
Asunto(s)
Dolor de la Región Lumbar , Síndromes de Compresión Nerviosa , Humanos , Masculino , Dolor de la Región Lumbar/terapia , Síndromes de Compresión Nerviosa/terapia , Síndromes de Compresión Nerviosa/fisiopatología , Adulto Joven , Terapia por Ejercicio/métodos , Resultado del Tratamiento , Ejercicio Físico , Dolor de Cuello/terapia , Dolor de Cuello/etiología , Nalgas/inervación , Diagnóstico DiferencialRESUMEN
OBJECTIVE: Define the prevalence and location of inflammatory and structural lesions on magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA) and radiographic axial spondyloarthritis (r-axSpA) with neck pain as leading clinical symptom. METHODS: Patients with diagnosis of RA and r-axSpA were consecutively included if they had chronic (> 3 months) neck pain. Clinical assessment, neck pain questionnaires and MRIs of the cervical spine (CS) were performed. RESULTS: 107 patients (59 RA and 48 r-axSpA) were included. While there was no difference in the Northwick-Park-Neck-Pain-questionnaire, patients with RA reported higher neck pain compared to r-axSpA on a numeric rating scale (5.0 ± 3.6 vs. 3.0 ± 3.1; p = 0.003). Inflammatory lesions occurred predominantly in the craniocervical area in RA and in the lower CS segments in r-axSpA. Bone marrow edema (BME) was more frequent in axSpA (BME-score axSpA/RA: 0.35vs0.17; p < 0.001) while synovitis was visible in both but was more prevalent in RA (synovitis-score axSpA/RA: 0.02vs0.1; p < 0.001). BME was found in 8 (13.6%) vertebral corner vs. 9 (18.8%), in 2 (3.4%) facet joints vs. 7 (14.6%) and in 1 (1.7%) spinous processes vs. 9 (18.8%) in patients with RA/r-axSpA. In contrast, more patients with RA (30.5% vs6.3%) showed erosive osteochondrosis with endplate BME (p = 0.002). CONCLUSION: While involvement of upper cervical inflammation was typically present in RA, r-axSpA patients showed more BME in lower CS segments, vertebral corners, facet joints and spinous processes. Neck pain is linked to upper and lower inflammatory and structural lesions of the CS in both diseases.
Asunto(s)
Artritis Reumatoide , Espondiloartritis Axial , Dolor Crónico , Imagen por Resonancia Magnética , Dolor de Cuello , Humanos , Femenino , Masculino , Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/complicaciones , Imagen por Resonancia Magnética/métodos , Dolor de Cuello/diagnóstico por imagen , Dolor de Cuello/epidemiología , Dolor de Cuello/etiología , Persona de Mediana Edad , Prevalencia , Adulto , Dolor Crónico/diagnóstico por imagen , Dolor Crónico/etiología , Dolor Crónico/epidemiología , Espondiloartritis Axial/diagnóstico por imagen , Espondiloartritis Axial/epidemiología , Vértebras Cervicales/diagnóstico por imagen , Radiografía/métodos , Anciano , Inflamación/diagnóstico por imagen , Espondiloartritis/diagnóstico por imagen , Espondiloartritis/complicacionesRESUMEN
BACKGROUND: Idiopathic carotidynia, also known as transient perivascular inflammation of the carotid artery (TIPIC) syndrome, is a rare, self-limited, clinical-radiologic entity. Over the years, the diagnosis of carotidynia has been controversial, but recent pathologic, radiologic, clinical, and laboratory findings support an inflammatory etiology. CASE REPORT: A 61-year-old woman with a history of hypertension, left lower extremity liposarcoma, and right internal jugular port placement 2 weeks prior with initiation of chemotherapy presented to the emergency department with right neck pain and swelling of the lateral neck and lower face for the past 3 days. Computed tomography-neck with IV contrast revealed marked mural thickening of the right common carotid artery, which can be seen with carotidynia (Fay syndrome and TIPIC syndrome) and vasculitis. The patient had elevated inflammatory markers and was treated clinically for carotidynia with ibuprofen, evaluated by vascular surgery, and discharged home. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The causes of acute neck pain are diverse, ranging from nonemergent to surgically emergent etiologies. As radiologists and emergency physicians, we believe TIPIC syndrome is a rare entity with important clinical impact deserving attention, as it is not typically included in medical training and is usually learned only through years of clinical experience and practice. TIPIC syndrome requires a unique combination of both clinical and radiologic findings to diagnose accurately and appropriately. It is important to be familiar with this diagnosis because treatment is focused on symptomatic relief without the need for invasive procedures. Our goal was to increase awareness of this uncommon diagnosis to improve patient care by preventing unnecessary invasive procedures and aid in timely and accurate diagnosis.