Department of Physical Therapy, University of Central Arkansas, Conway, AR 72035, USA.
J Orthop Sports Phys Ther. 2011 Oct;41(10):723-33. doi: 10.2519/jospt.2011.3592. Epub 2011 Sep 4.
Retrospective clinical case series.
To describe the management of 10 patients with advanced cervical spondyloarthrosis with radiculopathy, using manual therapy, intermittent mechanical cervical traction, and home exercises.
Predictors and short-term outcomes of cervical radiculopathy have been published. These predictors have not been developed for, or applied to, geriatric patients with spondylitic radiculopathy.
A series of 10 patients (aged 67 to 82 years) were referred to a physical therapist for medically prediagnosed cervical spondyloarthrosis and radiculopathy, as determined by magnetic resonance imaging. Neck Disability Index (NDI), numeric pain rating scale (NPRS), upper limb tension testing, Spurling's test, and the cervical distraction test were all completed on each patient at initial examination and at discharge. NDI and NPRS data were also collected at 6 months posttreatment. Intervention included manual therapy (including high-velocity low-amplitude thrust manipulation) of the upper thoracic and cervical spine, intermittent mechanical cervical traction, and a home program (including deep cervical flexor strengthening) for 6 to 12 sessions over a period of 3 to 6 weeks.
All 10 patients had substantial improvement in NPRS and NDI scores. The mean NPRS score was less than 1/10, and the mean NDI score was 6/50 at discharge, compared to the original mean NPRS and NDI scores of 5.7 and 27.4, respectively. All patients reported maintaining those gains for 6 months.
A multimodal approach for patients diagnosed with cervical spondyloarthrosis with radicular symptoms was useful in this geriatric population to reduce pain, minimize radicular symptoms, and improve functional outcomes.
Therapy, level 4.
回顾性临床病例系列。
描述 10 例颈椎退变性关节病伴根性颈椎病患者的治疗方法，采用手法治疗、间歇性机械颈椎牵引和家庭锻炼。
颈椎神经根病的预测因素和短期结果已经公布。这些预测因素尚未针对或应用于患有脊柱关节炎性神经根病的老年患者。
10 例患者（年龄 67 至 82 岁）因医学诊断为颈椎退变性关节病和神经根病，经磁共振成像（MRI）检查后，被转介给物理治疗师。每位患者在初次就诊和出院时均进行颈椎功能障碍指数（NDI）、数字疼痛评分量表（NPRS）、上肢张力测试、斯伯林氏试验和颈椎牵伸试验。NDI 和 NPRS 数据也在治疗后 6 个月进行了收集。干预措施包括对胸椎和颈椎上段进行手法治疗（包括高速度低幅度推力手法）、间歇性机械颈椎牵引和家庭锻炼（包括深层颈屈肌强化），持续 6 至 12 次，为期 3 至 6 周。
所有 10 例患者的 NPRS 和 NDI 评分均有显著改善。出院时，平均 NPRS 评分小于 1/10，平均 NDI 评分为 6/50，而原始平均 NPRS 和 NDI 评分为 5.7 和 27.4。所有患者报告在 6 个月内保持这些改善。
针对诊断为颈椎退变性关节病伴根性症状的患者，采用多模式方法有助于减轻疼痛、最小化根性症状并改善功能结局。
治疗，4 级。
