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

A 33-year-old male developed stiffness of the left neck and pain of the left shoulder two years previously. Six months prior to admission, he noticed tingling sensation of the left 2nd, 3rd and 4th fingers and motor weakness of the left hand, both of which gradually progressed. On admission, positive neurological findings were neck pain on dorsal extension, left hemiparesis more advanced in the upper limb, diffuse muscle atrophy of the left upper limb, hyperreflexia of the left upper and lower limbs with positive Babinski sign and dysesthesia corresponding to the left C3-T5 sensory dermatomes. Enhanced CT and Metrizamide CT myelography showed a large extra- and intra-dural mass from the C1 segment to the medulla oblongata on the left. Angiography disclosed a fusiform aneurysm of the left vertebral artery. Proximal ligation of the left vertebral artery was performed. Postoperatively, clinical signs were markedly improved and shrinkage of the aneurysm was demonstrated on postoperative Metrizamide CT myelogram. Pathogenesis of diffuse muscle atrophy of the left upper limb was undetermined, but was probably not due to disturbance of the anterior spinal artery because of good visualization of the artery on the angiogram. Indication of the proximal ligation of the vertebral artery with an aneurysm was discussed.
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PMID:[Fusiform aneurysm of the vertebral artery presenting with foramen magnum syndrome: a case report]. 356 84

We report a rare case of myelopathy caused by compression of the upper cervical cord by the bilateral anomalous vertebral arteries. A 49-year-old man had dragged his right foot for 4 years. He also complained of a tingling sensation in his right arm and occipitalgia. Neurological examination disclosed right hemiparesis, hypalgesia in the right half of the body and hypertonicity of the lower extremities. MRIs showed a flow void area which compressed and distorted the spinal cord bilaterally at the level of the atlas. A vertebral angiogram showed that the bilateral vertebral arteries had pierced the dura matter under the posterior arch of the atlas, turned upward and laterally in the vertebral canal, making vascular loops at the level of the atlas. 3D CT angiography showed the loops convex medially in the anterior part of the vertebral canal. With these findings, we diagnosed the patient as suffering compression of the cervical cord by the bilateral anomalous vertebral arteries. Suboccipital craniectomy and C1 laminectomy were performed. When the dura mater was opened, the dorsolateral aspect of the spinal cord was found to be compressed and indented markedly by the vertebral arteries. To decompress the spinal cord, the vertebral arteries were retracted dorsolaterally by means of Gore-tex tape and anchored to the spinous process of the axis. Postoperatively, his neurological symptoms improved. Postoperative MRIs showed that the spinal cord was decompressed and had recovered its contour. A review of the literature revealed that only 3 such cases as this one have been reported. The clinical features of these rare cases are nonspecific myelopathy and concomitant occipitalgia or neck pain. The main cause of this rare entity seemed to be the compression of the vertebral artery through its course when it enters the vertebral canal between the atlas and the axis.
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PMID:[Cervical myelopathy caused by bilateral vertebral artery compression]. 948 91

Since no study to date has assessed the prevalence of scanning-related disorders amongst sonographers in Obstetrics and Gynecology, we distributed a survey to all trained personnel in our ultrasound division. We evaluated the correlation between injuries sustained in the workplace, and factors such as age, gender, work load and intensity, scanning techniques, previous medical problems, and physical activity. Injuries included one or more of the following: carpal tunnel syndrome; carpal instability; tendinitis; back, shoulder, and neck pain; tingling and/or numbness in the extremities; weakness; and motion restriction. Of the 44 respondents, 29 (65%) have experienced some type of injury or symptom over the course of their scanning career. Five (12%) reported having missed work because of their symptoms, 15 (34%) have received orthopedic treatment (medication or physiotherapy), two (4.5%) have been diagnosed with carpal tunnel syndrome, and one (2.3%) with carpal instability based on electrophysiological examinations. These results demonstrate that ultrasound scanning in Obstetrics and Gynecology may pose an occupational risk for doctors and technicians.
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PMID:Transducer user syndrome: an occupational hazard of the ultrasonographer. 1050 38

To explore whether different distributions of numbness and tingling in the hand can be usefully distinguished in epidemiologic studies of disorders such as carpal tunnel syndrome, the authors used a postal questionnaire, an interview, and a physical examination to collect information about risk factors, symptoms, and signs from a general population sample of 2,142 adults in Southampton, England, during 1998-2000. The authors distinguished six distributions of numbness and tingling and compared their associations with other clinical findings and with known risk factors for upper limb disorders. Distinctive relations were found for symptoms that involved most of the palmar surface of the first three digits but not the dorsum of the hand or the little finger. Such symptoms were more often associated with positive Phalen's and Tinel's tests and, unlike other categories of sensory disturbance, were not related to neck pain or restriction of neck movement. They also differed in showing no association with lower vitality or poorer mental health but an association with repeated wrist and finger movements at work. These findings suggest that, in the classification of numbness and tingling of the hand, it may be useful to distinguish symptoms that involve most of the sensory distribution of the median nerve but not other parts of the hand.
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PMID:Anatomic distribution of sensory symptoms in the hand and their relation to neck pain, psychosocial variables, and occupational activities. 1263 42

Analysis of this survey of 244 responding cytotechnologists shows that a high percentage still suffer from musculoskeletal disorders commonly associated with poor ergonomic design in the workplace, despite the variety of ergonomically designed microscopes that have been introduced into the market. Although Kalavar and Hunting surveyed a small group of cytotechnologists in the Washington, DC, area in 1996, no broad-based study has focused specifically on these professionals. The landmark study of microscope ergonomics, published by Soderberg in 1980, documented widespread musculoskeletal complaints in the electronics industry. This article identifies and discusses the types of musculoskeletal discomforts experienced by cytotechnologists. We propose that both practicing and student cytotechnologists receive training in ergonomic principles and appropriate interventions, such as improved work practices, proper ergonomic aids, well-designed workstations, and ergonomically designed equipment. More than 85% of respondents reported some musculoskeletal discomfort. Among the symptoms presented are headache, neck pain and stiffness, pain of the lower and upper back, and upper-extremity discomfort. Neurological symptoms, such as numbness, tingling, and/or pain in the hand and fingers, are often associated with repetitive motion. More than one-third reported numbness, tingling, and/or pain in the left-hand fingers, usually used for the fine-focus control knob. Almost one-half of respondents reported such symptoms for the right hand and fingers, normally used to manipulate the mechanical stage controls. Only 9% of the respondents were left-handed. Most (91%) were right handed. Although just over one-third (34.4%) of respondents worked for an employer with an ergonomics program, ergonomic assessments had been performed for only about one-half (17.6%) of these. In addition, approximately 10% of respondents indicated that ergonomics assessments had been performed on their workstations, even though the employer did not have an ergonomics program. Because of the high prevalence of reported symptoms, we recommend that all cytologists be trained in basic ergonomic principles and the proper use of ergonomic aids. These interventions should reduce the prevalence of musculoskeletal discomfort in medical microscopists.
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PMID:Ergonomics and cytotechnologists: reported musculoskeletal discomfort. 1464 99

The purpose of this study was two-fold: first, to find out the musculoskeletal disorders between left- and right-handed dentists and second, to describe the prevalence and distribution of symptoms of musculoskeletal disorders among Turkish students who are practicing general dentistry. The investigation was carried out on 221 dental students; group I consisted of 24 left-handed students (18 male, 6 female), aged 24.2+/-2.24 years; group II comprised 24 right-handed students (14 male, 10 female), aged 25.1+/-3.14 years; and group III included 173 right-handed students (102 male, 71 female), aged 24.3+/-1.45 years. The study consists of a questionnaire to identify work tasks and working conditions, and a field study to assess the pain of the neck, shoulders, and other disorders during the dental practice. Data were analyzed through tests for the difference between two population proportion, percentage, and Chi-square. Left- and right-handed students had headaches (34%, 22%), pins and needles (35%, 22%), weakness (42%, 40%), numbness (23%, 19%), neck pain (67%, 43%), back pain (56%, 47%), upper limp pain (46%, 43%) and shoulder pain (78%, 58%), respectively (Table 3). Female students were not significantly different from males in musculoskeletal symptoms (p>.05). The position adopted by the student was significantly related to the intensity of pain. Left-handed students especially suffered from neck and shoulder pain when compared with right-handed students (p<.06). The authors think that a modification of work practices appears to be effective in decreasing the prevalence of symptoms. The best ergonomic working principles should be taught to the students, dental schools should provide a comfortable working environment, and further study is required to identify factors that will reduce the prevalence of symptoms among those practicing general dentistry.
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PMID:Musculoskeletal disorders in left- and right-handed Turkish dental students. 1576 5

Every pain syndrome has an inflammatory profile consisting of the inflammatory mediators that are present in the pain syndrome. The inflammatory profile may have variations from one person to another and may have variations in the same person at different times. The key to treatment of Pain Syndromes is an understanding of their inflammatory profile. Pain syndromes may be treated medically or surgically. The goal should be inhibition or suppression of production of the inflammatory mediators and inhibition, suppression or modulation of neuronal afferent and efferent (motor) transmission. A successful outcome is one that results in less inflammation and thus less pain. We hereby briefly describe the inflammatory profile for several pain syndromes including arthritis, back pain, neck pain, fibromyalgia, interstitial cystitis, migraine, neuropathic pain, complex regional pain syndrome/reflex sympathetic dystrophy (CRPS/RSD), bursitis, shoulder pain and vulvodynia. These profiles are derived from basic science and clinical research performed in the past by numerous investigators and serve as a foundation to be built upon by other researchers and will be updated in the future by new technologies such as magnetic resonance spectroscopy. Our unifying theory or law of pain states: the origin of all pain is inflammation and the inflammatory response. The biochemical mediators of inflammation include cytokines, neuropeptides, growth factors and neurotransmitters. Irrespective of the type of pain whether it is acute or chronic pain, peripheral or central pain, nociceptive or neuropathic pain, the underlying origin is inflammation and the inflammatory response. Activation of pain receptors, transmission and modulation of pain signals, neuro plasticity and central sensitization are all one continuum of inflammation and the inflammatory response. Irrespective of the characteristic of the pain, whether it is sharp, dull, aching, burning, stabbing, numbing or tingling, all pain arise from inflammation and the inflammatory response. We are proposing a re-classification and treatment of pain syndromes based upon their inflammatory profile.
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PMID:The biochemical origin of pain: the origin of all pain is inflammation and the inflammatory response. Part 2 of 3 - inflammatory profile of pain syndromes. 1772 71

The use of somatosensory evoked potentials (SSEPs) to monitor upper extremity nerves during surgery is becoming more accepted as a valid and useful technique to minimize intraoperative nerve injuries. We present a case illustrating the benefit of utilizing both SSEPs and transcranial electrical motor evoked potentials (TCeMEPs) for preventing position-related injury during surgery. The patient was a 43-year-old male with a history of neck pain, along with numbness and tingling of the upper extremities. While the patient was being draped, upper extremity SSEPs diminished significantly TCeMEP responses in the hands (abductor pollicus brevis-abductor digiti minimi; APB-ADM) vanished shortly after that, followed by the biceps and left deltoid. The surgeons were notified, and the tape on the shoulders was loosened. No improvements were noted in SSEPs nor TCeMEPs due to this intervention, so all tape was removed and the patient's arms were allowed to rest naturally upon the arm boards. Upper extremity TCeMEP responses could then be elicited and SSEPs improved shortly afterward. Surgery was completed with the arms on the arm boards. All signals remained stable for the remaining three hours of the procedure. At two months follow-up, the patient was well with total pain relief and normal upper extremity function when neurological examination was performed. This report demonstrates a case in which intraoperative neurophysiological monitoring was useful in identifying and reversing impending nerve injury during cervical spine surgery. Significant changes were seen in SSEPs as well as TCeMEPs, so we recommend that TCeMEP monitoring be considered as an adjunct to SSEPs for prevention of injury to the brachial plexus.
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PMID:Preventing position-related brachial plexus injury with intraoperative somatosensory evoked potentials and transcranial electrical motor evoked potentials during anterior cervical spine surgery. 2198 38

Mesenchymal chondrosarcoma (MCS) is a rare tumour accounting for less than 1% of all chondrosarcomas. We report here, the case of a 30-year-old female who presented with neck pain, weakness and tingling and numbness starting on the right side and later involving all four limbs. MRI revealed an ill-defined neoplastic lesion showing specks of calcification and arising from the right half of C2 and C3 cervical vertebrae. Microscopy showed an admixture of well differentiated cartilage showing focal calcification and spindly cell areas having a hemangiopericytomatous pattern.
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PMID:Mesenchymal chondrosarcoma of the cervical spine: A case report. 2339 33

Cervical spinal cord injury is a rare but serious complication after general anesthesia. The risk factors include traumatic cervical injury, cervical spine instability, and difficult airway management. It has also occurred in the absence of cervical instability. Here we report a patient who had a history of intermittent neck pain without numbness. Preoperative radiologic examinations showed degenerative changes in the cervical spine. She developed progressive tingling and numbness in her limbs after thyroidectomy under general anesthesia. Magnetic resonance imaging showed a cervical disc protruding into the canal at C5-C6, which was considered to be induced by surgical positioning. She recovered after anterior cervical decompression and internal fixation surgery.
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PMID:Cervical spinal cord compression after thyroidectomy under general anesthesia. 2382 50


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