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颈椎融合术后头部前移——手术疼痛和功能障碍的可能原因:1例CBP病例报告

Anterior head translation following cervical fusion-a probable cause of post-surgical pain and impairment: a CBP case report.

作者信息

Harrison Deed E, Oakley Paul A, Betz Joseph W

机构信息

CBP NonProfit, Inc., USA.

Private Practice: 11A-1100 Gorham Street, Newmarket, Ontario L3Y8Y8, Canada.

出版信息

J Phys Ther Sci. 2018 Feb;30(2):271-276. doi: 10.1589/jpts.30.271. Epub 2018 Feb 20.

Abstract

[Purpose] To present the case of the dramatic reduction in pain, disability, and neurologic symptoms following the reduction of forward head translation and increased cervical curvature in a patient suffering from post-surgical radiculopathy. [Subject and Methods] A 52-year-old male mechanic presented with chronic neck pain, unilateral paresthesia along the C5 and C6 dermatome distributions and diminished unilateral grip strength for 12 years following a C5-C6 cervical discectomy and fusion. Outcome measures included the neck disability index, the numerical pain rating scale, and the Zebris cervical range of motion system. Radiographs and computerized posture analysis revealed excessive forward head posture. Initial traditional 'symptom-relief' chiropractic rehabilitation was provided, followed by CBP structural rehabilitation of head and neck posture with a 2.5 year follow-up. [Results] The initial traditional chiropractic rehabilitation did not improve posture or disability scores. CBP methods resulted in radiograph-verified postural alignment improvements corresponding with clinically significant improvements in the patient's neurologic condition, pain and disability scores. These results were maintained at a 2.5 year follow-up with minimal treatment. [Conclusion] Patients with post-surgical axial symptoms and/or radicular complaints should be screened for altered cervical alignment and anterior head translation. Future studies should attempt to duplicate these positive results in a trial with long-term follow-up.

摘要

[目的] 介绍一例手术后神经根病患者在减少头部前伸和增加颈椎曲度后疼痛、功能障碍和神经症状显著减轻的病例。[对象与方法] 一名52岁男性机械师,在C5-C6颈椎间盘切除融合术后12年,出现慢性颈部疼痛、沿C5和C6皮节分布的单侧感觉异常以及单侧握力减弱。结果测量包括颈部功能障碍指数、数字疼痛评分量表和泽布里斯颈椎活动度系统。X线片和计算机姿势分析显示头部前伸姿势过度。最初进行了传统的“症状缓解”整脊康复治疗,随后进行了头部和颈部姿势的CBP结构康复治疗,并进行了2.5年的随访。[结果] 最初的传统整脊康复治疗并未改善姿势或功能障碍评分。CBP方法导致X线片证实的姿势排列改善,同时患者的神经状况、疼痛和功能障碍评分也有临床显著改善。在2.5年的随访中,经过最少的治疗,这些结果得以维持。[结论] 对于有手术后轴性症状和/或神经根性症状的患者,应筛查颈椎排列改变和头部前伸情况。未来的研究应尝试在长期随访试验中重现这些积极结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0a1/5851361/6ecef5b92515/jpts-30-271-g001.jpg

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