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Query: UMLS:C0007859 (neck pain)
 3,931 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cervical radiculopathy is a condition encountered commonly in the evaluation of neck pain that may result in significant discomfort and functional deficits. Although the long-term prognosis of this condition is favorable, a standardized approach to therapy is important to minimize unnecessary tests and identify patients who require more urgent intervention. Patient education, pain control, and physical therapy are the first line of therapy. Patients who have protracted pain or significant functional deficits may require a more thorough evaluation, including imaging, electrodiagnostic testing, and, possibly, surgical referral. This article outlines the basic clinical, diagnostic, and therapy considerations in the evaluation of cervical radiculopathy.
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PMID:Cervical radiculopathy. 1744 34

The authors report the case of a 62-year-old woman who suffered an accidental fall and complained of severe neck pain and right C-7 radiculopathy. A right C6-7 facet fracture-subluxation was diagnosed. Bone fragments impinged on the right C-7 nerve root at the neural foramen. The bilateral vertebral arteries (VAs) ascended at the anterior aspect of C-6 and C-5 and entered the transverse foramen at the C-4 level. Based on findings of anomalous VAs, the authors applied a pedicle screw (PS)/rod system to effect surgical correction of the deformity. Intraoperatively, they successfully performed reduction of the subluxation, decompression of the impinged nerve root, and minimum single-segment fusion involving the placement of a PS/rod system. After surgery, the patient's neurological deficit dramatically improved and spinal fusion was completed without any loss of deformity correction. Prior to surgery for cervical injuries, the possible presence of an abnormal VA course should be considered. Preoperative detection of anomalous VAs will affect decisions on the appropriate corrective surgery option in cases of cervical spine injuries.
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PMID:Traumatic C6-7 subluxation with anomalous course of vertebral arteries treated with pedicle screw/rod fixation. Case report. 1763 90

We will discuss a potential role of percutaneous vertebroplasty (PVP) in the management of patients with severe fibrous dysplasia of the spine with multiple cervical lesions and C2-C3 pathologic fractures that may not be a good surgical candidate. Polyostotic fibrous dysplasia involvement of the cervical spine is rare. Review of literature indicates only few reported cases of surgical management with one case of mortality indicating increased risks associated with surgical intervention. While PVP is commonly used for the treatment of osteoporotic thoracolumbar vertebral compression fractures, its role in vertebral stabilization for fibrous dysplasia has not been reported. A 35-year-old man with McCune-Albright syndrome and severe polyostotic fibrous dysplasia of C2 and C3 vertebrae presented with severe neck pain, radiculopathy, quadriparesis and myelopathy. The lesion had pathologic fractures, and there was an os odontoideum with cervical cord atrophy at the C1 level. After discussing need for aggressive surgical management and potential complications, we offered PVP due to surgical risks involved. PVP was performed with a posterolateral transpedicular approach without complication. The patient had remarkable improvement in clinical relief of neck pain and improvement of myelopathic symptoms at 1-year follow-up. We present a case that illustrates a potential use of PVP in the management of a patient with symptomatic spinal fibrous dysplasia with associated pathologic fractures who was poor surgical candidate.
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PMID:C2/C3 pathologic fractures from polyostotic fibrous dysplasia of the cervical spine treated with percutaneous vertebroplasty. 1766 24

Anterior cervical discectomy (ACD) is standard practice for cervical radiculopathy. Irrespective of the precise method used, it involves more or less complete disc removal with resultant anatomical and biomechanical derangements, and frequently the insertion of a bone or prosthetic graft. Anterior cervical foramenotomy is an alternative procedure that allows effective anterior decompression of the nerve root and lateral spinal cord, whilst conserving the native disc, preserving normal anatomy and movement, and protecting against later degeneration at adjacent spaces as far as possible. The aim of the study was to determine the safety and efficacy of anterior cervical foramenotomy in the treatment of cervical radiculopathy and took the form of a prospective study of 21 cases under the care of a single surgeon. All patients had a single level or two level anterior cervical foramenotomy. All had pre- and postoperative visual analogue scores for arm and neck pain, arm strength, sensation and overall use. A comparison between patients' perceptions and surgeon's observations was also made. Patients were followed up for between 10 and 36 months. Sixty-eight per cent completed full pre- and postoperative assessments. Twenty-eight per cent of the responders had complete arm pain resolution. There were statistically significant reductions in arm and neck pain, and overall disability. The surgeon's impression of improvement paralleled that of the patients. There was one complication with discitis. Anterior cervical foramenotomy is a safe and effective treatment for cervical radiculopathy caused by posterolateral cervical disc prolapse or uncovertebral osteophyte, and might also reduce adjacent segment degeneration.
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PMID:Anterior cervical foramenotomy for cervical radiculopathy. 1767 57

Shoulder pain is a common complaint seen at the primary physician's clinic, and it is the third most common musculoskeletal complaint after back and neck pain. Shoulder pain can have a wide range of etiologies: trauma caused from a sprain or a simple muscle strain to a large tear of one of the shoulder stabilizer muscles. Some shoulder pathologies can cause chronic pain and limitation in shoulder range of motion such as impingement syndrome, adhesive capsulitis, calcified tendonitis, cervical radiculopathy, glenohumeral osteoarthritis, and biceps tendonitis. The physician who attempts to diagnose the cause for his patient's shoulder pain faces a great challenge due to the large number of etiologies that can lead to such a complaint. The physician has a large number of tools at his disposal starting from a thorough history emphasizing the time and character of the shoulder pain, range of motion and the ability to do everyday activities, to a wide range of imaging modalities such as X-ray, ultrasound and magnetic resonance imaging. Most of the causes of shoulder pain are adequately treated non-surgically with treatments such as physiotherapy, antiinflammatory medication and local corticosteroid injections. However, some situations necessitate surgical intervention in order to correct and restore the patient's prior level of shoulder function. The physician's ability to correctly diagnose and recommend appropriate lines of treatment, taking into consideration the patient's problem, age, medical condition and prior level of function is the secret to successful treatment, recovery of the patient's shoulder function and most important, patient satisfaction.
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PMID:[Shoulder pain: assessment, diagnosis and treatment of common problems]. 1830 Jun 28

Degenerative changes in the cervical spinal column are ubiquitous in the adult population, but infrequently symptomatic. The evaluation of patients with symptoms is facilitated by classifying the resulting clinical syndromes into axial neck pain, cervical radiculopathy, cervical myelopathy, or a combination of these conditions. Although most patients with axial neck pain, cervical radiculopathy, or mild cervical myelopathy respond well to initial nonsurgical treatment, those who continue to have symptoms or patients with clinically evident myelopathy are candidates for surgical intervention.
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PMID:Degenerative cervical spondylosis: clinical syndromes, pathogenesis, and management. 1839 2

As the principles of joint arthroplasty become increasingly refined and more widely established, new designs are being developed that require careful evaluation for their propensity to generate wear debris in vivo. In the past several years, new designs intended to improve clinical performance have emerged in both total knee replacement and total spinal disk replacement. Advances in these types of implants have the potential for major clinical impact in the coming decade, due to the large number of patients seeking treatment of knee arthritis as well as back pain, neck pain, and radiculopathy.
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PMID:How have new designs and new types of joint replacement influenced wear behavior? 1861 4

Spinal manifestations of vertebral artery dissection (VAD) are rare events and are typically symptomatic with neck pain and ischemic brain injury. We report a patient presenting with unusual peripheral paresis of the right upper limb due to an intramural hematoma of the right vertebral artery with local compression of C5 and C6 as the cause of cervical radiculopathy. These symptoms completely resolved after anticoagulation and physical therapy.
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PMID:Vertebral artery dissection presenting with ispilateral acute C5 and C6 sensorimotor radiculopathy: A case report. 1876 83

Anterior cervical discectomy without fusion is an effective treatment for myeloradiculopathy arising from a medial disc prolapse. However, the long-term clinical results are not well known. Between 2000 and 2006, 38 patients with persistent radiculopathy and medial disc prolapse or myelopathy due to acute disc prolapse underwent subtotal anterior cervical discectomy without fusion. Patients were evaluated with respect to pain, myelopathy and functional outcome. Thirty-four patients were followed up for an average of 48.6 months. Following surgery, neck pain improved by 69% in 88% of patients, arm pain improved by 76% in 91% of patients and 76% of the patients were able to resume working in their previous occupation. We conclude anterior cervical decompression without fusion can be associated with good clinical results that are sustained in patients with predominant acute soft disc prolapse generating medial nerve root compression or cord compression.
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PMID:Clinical and functional outcomes of anterior cervical discectomy without fusion. 1897 23

Idiopathic calcification of the intervertebral disc is a rare condition in childhood, of unknown etiology. Calcifications are occasionally discovered on routine radiological examination, or on investigation of nonspecific symptoms such as neck pain, torticollis, fever, and radiculopathy. We report a case of a 7-year-old boy with intervertebral disc calcification. Clinical and radiological signs are discussed.
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PMID:Pediatric intervertebral disc calcification. 1906 Nov 69


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