scholarly journals Tropism of Sub-Axial Cervical Facet Joints Is Not Related to Segmental Movement during Active Movement or Therapist-Perceived Symptomatic Locations

Symmetry ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 739
Author(s):  
Neil Tuttle ◽  
Kerrie Evans ◽  
Clarice Sperotto dos Santos Rocha
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Active Movement ◽  
Facet Joints ◽  
Segmental Mobility ◽  
Limited Mobility ◽  
Translational Movement ◽  
The Difference ◽  
Cervical Facet ◽  
The Relationship

Tropism, or asymmetry, of facet joints in the cervical spine has been found to be related to degenerative changes of the joints and discs. Clinicians often assume that differences in segmental mobility are related to tropism. The aims of this study were to determine the relationship between asymmetry of facet joints in the sub-axial cervical spine and (1) segmental mobility and (2) spinal levels perceived by therapists to have limited mobility. Eighteen participants with idiopathic neck pain had MRIs of their cervical spine in neutral and at the end of active rotation. Angular movement and translational movement of each motion segment was calculated from 3D segmentations of the vertebrae. A plane was fitted to the facet on each side. Tropism was considered to be the difference in the orientation of the facet planes and ranged from 1 to 30° with a median of 7.7°. No relationships were found between the extent of tropism and either segmental movement or locations deemed to be symptomatic. Tropism in the sub-axial cervical spine does not appear to be related to segmental mobility in rotation or to levels deemed to be symptomatic.

Cervical facetectomy and its effect on spine strength

1985 ◽  
Vol 63 (2) ◽  
pp. 278-282 ◽  
Author(s):  
Richard B. Raynor ◽  
James Pugh ◽  
Ilan Shapiro
Keyword(s):  
Cervical Spine ◽  
Facet Joint ◽  
Fracture Load ◽  
Facet Joints ◽  
Shear Tests ◽  
Content Type ◽  
Spine Motion ◽  
Vertebral Bodies ◽  
The Difference ◽  
Anterior Posterior

✓ Fourteen cervical spine motion segments consisting of two adjacent vertebral bodies and their connecting ligaments were tested in shear. Five had intact facet joints, five had bilateral facetectomy of 50% or less, and four had bilateral 70% facetectomy. Three to 5 mm of root could be exposed in the specimens with 50% facetectomy, and 8 to 10 mm in those with 70% facetectomy. Anterior-posterior shear tests were run alternately in compression and distraction. Facetectomy was found to have no effect on compression and distraction stiffness. Failure in the 70% facetectomized specimens was due to fracture of the remaining joint at 159 lbs. In the specimens with 50% facetectomy, a fracture load could not be established since failure of the specimen mounting occurred at 208 lbs, as it did in two of the specimens without facetectomy that were tested to failure. The difference in bone fracture at 159 lbs and mounting failure at 208 lbs is significant at p < 0.05. Bilateral resection of more than 50% of the facet joint significantly compromises the shear strength of a cervical spine motion segment.

The relationship between capsule strain and neural response in cervical facet joints

2006 ◽  
Vol 39 ◽  
pp. S148
Author(s):  
Y. Lu ◽  
C. Chen ◽  
S. Kallakuri ◽  
J.M. Cavanaugh
Keyword(s):  
Neural Response ◽  
Facet Joints ◽  
Cervical Facet ◽  
The Relationship

The Benefit of Therapeutic Medial Branch Blocks after Cervical Operations

2010 ◽  
Vol 6;13 (6;12) ◽  
pp. 527-534
Author(s):  
Stephan Klessinger
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Joint Pain ◽  
Facet Joint ◽  
Medial Branch ◽  
Level Of Evidence ◽  
Nerve Blocks ◽  
Medial Branch Block ◽  
Cervical Facet ◽  
Cervical Facet Joint

Background: Persistent neck pain is a common problem after surgery of the cervical spine. No therapy recommendation exists for these patients. Objectives: The objective of this study was to determine if a therapeutic medial branch block is a rational treatment for patients with postoperative neck pain after cervical spine operations. Study Design: Retrospective practice audit. Setting: Review of charts of all patients who underwent cervical spine operations for degenerative reasons during a time period of 3 years. Methods: Patients with persistent postsurgical pain were treated with therapeutic medial branch blocks (local anesthetic and steroid). A positive treatment response was defined if at least 80% reduction of pain could be achieved or if the patient was sufficiently satisfied with the relief. All patients with a minimum follow up time of 6 month were included. Results: Of the 312 operations performed, 128 were artificial disc operations, 125 were stand alone cages, and 59 were fusions with cage and plate. Persistent neck pain occurred in 33.3 % of the patients. There was no difference between the patients with neck pain and the whole group of patients. More than half of the patients with neck pain—52.9%—were treated successfully with therapeutic medial branch blocks. Since no further treatment was necessary, the initial treatment was considered successful. Nearly a third—32.2%—of the patients were initially treated successfully, but their pain recurred and further diagnostics and treatments were necessary. In this group of patients, significantly more with double level operations were found (P = 0.003). Patients not responding to the medial branch block were 14.9%. Limitations: This audit is retrospective and observational, and therefore does not represent a high level of evidence. However, to our knowledge, since this information has not been previously reported and no recommendation for the treatment of post-operative zygapophysial joint pain exists, it appears to be the best available research upon which to recommend treatment and to plan higher quality studies. Conclusions: For persistent postsurgical neck pain only limited therapy recommendations exist. This study suggests treating these patients in a first instance with therapeutic medial branch blocks. The success rate is 52.9 %. Key words: Chronic neck pain, cervical zygapophysial pain, cervical facet joint pain, medial branch blocks, therapeutical cervical facet joint nerve blocks, postsurgery syndrome, pain therapy Pain Physician

Assessment of the occurrence of pain in the cervical spine and knowledge of physiotherapy and computer science students about Text Neck Syndrome

2019 ◽  
Vol XXIII (2) ◽  
pp. 15-24
Author(s):  
Joanna PIĘTA ◽  
Adrian KUŻDŻAŁ ◽  
Aleksander ZAGÓRSKI
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Computer Science ◽  
Neck Disability Index ◽  
Science Students ◽  
Spine Pain ◽  
Neck Disability ◽  
First Time ◽  
The Relationship ◽  
Cervical Spine Dysfunction

<b>Aim.</b> The aim of the study was to assess the frequency of cervical spine pain and students' knowledge about Text Neck Syndrome. <b>Material and research methodology.</b> The study covered 150 students of Physiotherapy and Computer Science, aged 18 - 26. The study used questionnaire consisting of 24 questions, as well as the NDI (Neck Disability Index) questionnaire. <b>Results.</b> The research have shown, that 69% of respondents have experienced cervical spine pain in their lives. Almost half of the students have heard about Text Neck Syndrome. A relationship between the frequency of neck pain and the age at which neck pain appeared for the first time, physical activity, the number of hours spent using the cell phone and the position taken while using the phone as well as the position taken at work were demonstrated . The relationship between the sum of points obtained in the NDI questionnaire and the number of hours allocated to using a mobile phone was also demonstrated. <b>Conclusions.</b> Most students have experienced cervical spine pain in their lives. Many factors affect the incidence of neck pain. Almost half of the respondents heard about Text Neck Syndrome. The use of cell phones affects the pain and level of cervical spine dysfunction.

scholarly journals A Review on Diagnosis and Management of Cervical Spondylosis

2021 ◽  
pp. 668-674
Author(s):  
Ahmed Abdulaziz G. Ibrahim ◽  
Ali Mohammed A. Alahmari ◽  
Abdullah Hassan F. Alsuayri ◽  
Abdullah Misfer M. Algomshah ◽  
Saeed Ghanem S. Almlfi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Cervical Spondylosis ◽  
Natural Aging ◽  
Posterior Longitudinal Ligament ◽  
Cervical Radiculopathy ◽  
Intervertebral Discs ◽  
Degenerative Changes ◽  
Facet Joints ◽  
Wide Range

Cervical spondylosis is a term that encompasses a wide range of progressive degenerative changes that affect all components of the cervical spine (i.e., intervertebral discs, facet joints, Luschka joints, flava ligaments, and laminae). It is a natural aging process and occurs in most people after the age of five. Most people with radiographic spondylotic changes in the cervical spine  remain asymptomatic, and 25% of those under  40, 50% of those over  40, and 85% of those over  60 show some evidence of degenerative changes , including changes in  the environment. Uncovertebral joints, facet joints, posterior longitudinal ligament (PLL) and yellow ligament lead to  narrowing of the spinal canal and intervertebral foramina. As a result, the spinal cord, spinal vasculature, and nerve roots can become compressed, leading to the three clinical syndromes that occur with cervical spondylosis: axial neck pain, cervical myelopathy, and cervical radiculopathy. Cervical spondylosis is usually diagnosed for clinical reasons only, but imaging is also required. Treatment for cervical spondylosis can be medical or surgical, depending on whether the patient has symptoms of myelopathy, radicular pain, or neck pain.

scholarly journals Three-dimensional spiral CT observation of the facet joints of the lower cervical spine and its clinical significance

2021 ◽  
Author(s):  
Qiu An Wang ◽  
Chong Guo ◽  
Ma Ji Sun ◽  
Feng Yuan
Keyword(s):  
Cervical Spine ◽  
Clinical Significance ◽  
Facet Joint ◽  
Spiral Ct ◽  
Cervical Disc ◽  
Joint Interface ◽  
Facet Joints ◽  
Left And Right ◽  
Cervical Facet ◽  
Cervical Facet Joint

Abstract Objective By observing the 3D anatomy of normal adult cervical facet joints, using the picture archiving and communication system to measure its 3D parameters and discussing its clinical significance, the aim of this study was to provide a reliable morphological basis for the design and manufacture of lower cervical facet joint interface distractors. Methods We selected 200 patients who underwent cervical spine 3D spiral computed tomography (CT) examination in the imaging department of our hospital from September 2019 to May 2020 and whose spiral CT images showed no cervical spinal canal stenosis, cervical disc herniation, obvious bone hyperplasia, or infection. The anterior and posterior diameters of the facet joints on both sides of the cervical spine, the space between the joints, and the left and right diameters were measured on the sagittal, cross-sectional and coronal planes after reconstruction with 3D spiral CT. Results The anterior and posterior diameters of the facet joints of the cervical spine, the space between the joints, and the left and right diameters all increased from top to bottom along the cervical spine. The 3D parameters of the C2-3~C6-7 segments were significantly different between the male and female groups. Conclusion The anteroposterior diameter, joint space interval, and left and right diameter of cervical facet joints are different in each segment and between the sexes. The lower cervical facet joint interface fusion device designed according to the measurement results can fully meet the needs of most patients.

The utility of radionucleotide imaging in the surgical management of axial neck pain from cervical facet joint arthropathy

2020 ◽  
Vol 32 (2) ◽  
pp. 168-173
Author(s):  
Christopher D. Witiw ◽  
Nataliya Tsapenko ◽  
Vincent C. Traynelis
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Facet Joint ◽  
Case Series ◽  
Tracer Uptake ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Axial Neck Pain ◽  
Cervical Facet ◽  
Facet Arthropathy

OBJECTIVEAxial neck pain is common and often debilitating. Diagnosis of the specific pain source can be a challenge, and this confounds effective treatment. Cervical facet arthropathy is implicated in many of these cases. The diagnosis is readily made on conventional cross-sectional imaging modalities, particularly CT imaging. However, this modality falls short in determining if an osteoarthritic facet joint is truly the source of symptoms. Radionucleotide imaging presents a noninvasive radiological adjunct to conventional cross-sectional imaging in the workup of patients with suspected facetogenic pain. Herein, the authors present the patient-reported outcomes (PROs) following posterior instrumented arthrodesis of the subaxial cervical spine from a consecutive case series of patients with a diagnosis of cervical facet joint arthropathy and a concordant positive radionucleotide tracer uptake.METHODSThe clinical case series of patients treated by the senior author at a single tertiary care institution between September 2014 and April 2018 was reviewed. Patients were selected for inclusion if their primary symptom at presentation was axial neck pain without neurological deficits and if CT imaging revealed facet arthropathy of the cervical spine. These patients underwent radionucleotide imaging in the form of a planar 99mTc methylene diphosphonate (99mTc MDP) bone scintigraphy study. Those with a finding of radionucleotide tracer uptake at a location concordant with the facet arthropathy were selected to undergo posterior cervical instrumented arthrodesis of the affected levels. PROs were recorded at the time of surgical consultation (i.e., after nonoperative treatment) and at 6 weeks, 3 months, 6 months, and 1 year following surgery. These included neck and arm pain, the Neck Disability Index (NDI) and the 12-Item Short Form Health Survey responses.RESULTSA total of 11 patients were included in this retrospective case series. The average reported neck pain and NDI scores were high at baseline; 7.6 ± 2.3 and 37.1 ± 13.9 respectively. Twelve months after surgical intervention, a significant decrease in reported neck pain of −4.5 (95% CI −6.9, −2.1; p = 0.015) and a significant decrease in NDI of −20.0 (95% CI −29.4, −10.6; p = 0.014) was observed.CONCLUSIONSThis case series represents the largest to date of patients undergoing surgical arthrodesis following a finding of facet arthropathy with a concordant positive radioisotope image study. These observations add support to a growing body of evidence that suggests the utility of radioisotope imaging for identification of a facetogenic pain generator in patients with primary axial neck pain and a finding of cervical facet arthropathy. These preliminary data should serve to promote future prospective, controlled studies on the incorporation of radionucleotide imaging into the workup of patients with suspected facetogenic pain of the cervical spine.

Intraoperative Reduction of Locked Facets in the Cervical Spine by Use of a Modified Interlaminar Spreader: Technical Note

Neurosurgery ◽  
2001 ◽  
Vol 48 (2) ◽  
pp. 444-446 ◽  
Author(s):  
Mahmood Fazl ◽  
Farhad Pirouzmand
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Open Reduction ◽  
Posterior Approach ◽  
Technical Note ◽  
Facet Joints ◽  
Bone Removal ◽  
A New Technique ◽  
The Stability ◽  
Cervical Facet

Abstract OBJECTIVE Facet dislocations commonly require intraoperative reduction after closed reduction with traction has failed. Reduction should be performed in a gradual, controlled fashion to prevent additional inadvertent spinal cord compromise. METHODS We describe a new technique for safe and simple dorsal reduction of facet dislocations by use of a modified interlaminar spreader. This technique requires only minimal controlled manipulation of the spine. RESULTS We have used this technique in 52 consecutive patients with no complications or failures related to its use in open reduction. This technique increases the stability of the cervical spine after reduction because it limits bone removal from the facet joints. CONCLUSION This technique provides a feasible and reliable approach to open reduction of cervical facet dislocations via the posterior approach.

Comparison of In-the-Ear and Over-the-Ear Hearing Aid Fittings

1986 ◽  
Vol 51 (4) ◽  
pp. 362-369 ◽  
Author(s):  
Donna M. Risberg ◽  
Robyn M. Cox
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Comparative Evaluation ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
The Difference ◽  
Functional Gain ◽  
The Relationship

A custom in-the-ear (ITE) hearing aid fitting was compared to two over-the-ear (OTE) hearing aid fittings for each of 9 subjects with mild to moderately severe hearing losses. Speech intelligibility via the three instruments was compared using the Speech Intelligibility Rating (SIR) test. The relationship between functional gain and coupler gain was compared for the ITE and the higher rated OTE instruments. The difference in input received at the microphone locations of the two types of hearing aids was measured for 10 different subjects and compared to the functional gain data. It was concluded that (a) for persons with mild to moderately severe hearing losses, appropriately adjusted custom ITE fittings typically yield speech intelligibility that is equal to the better OTE fitting identified in a comparative evaluation; and (b) gain prescriptions for ITE hearing aids should be adjusted to account for the high-frequency emphasis associated with in-the-concha microphone placement.

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