Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001, Japan.
Matsui Hospital, Kan-nonji 739, Kagawa, 768-0013, Japan.
Eur Spine J. 2020 May;29(5):1013-1021. doi: 10.1007/s00586-019-06233-5. Epub 2020 Jan 14.
Patients with various and indefinite symptoms in the whole body occasionally have coincident with stiffness or tenderness of the cervical muscles. This prospective case series examined the effect of local modulation of the cervical muscles in patients with cervical disorders reporting indefinite whole-body symptoms.
A total of 1863 hospitalized patients with cervical disorders accompanying three or more indefinite whole-body symptoms, who were resistant to outpatient care, were enrolled in this study for 12 years. All patients underwent daily physical therapies to the cervical muscles during hospitalization. Self-rated records on the medical interview sheets documenting 30 representative symptoms including cervical/shoulder pain or stiffness and 28 representative indefinite whole-body symptoms at admission and discharge were compared across the population.
The number of symptoms decreased significantly with the local modulation of the cervical muscles during hospitalization. All of the 28 indefinite whole-body symptoms at admission showed recovery rates greater than 50% at discharge. The mean number of symptoms decreased significantly from 17.8 at admission to 7.4 at discharge (p < 0.0001). The percentages of patients reporting 10 or more symptoms were 91.1% and 29.3% at admission and discharge, respectively. Moreover, 8.2% of patients reported no residual symptoms at discharge.
Cervical muscle lesions may contribute to indefinite whole-body symptoms, possibly through dysfunction of the parasympathetic nervous system in the muscles. Local modulation of cervical muscles could lead to a breakthrough in the management of patients with indefinite whole-body symptoms.
UMIN000035445. These slides can be retrieved under Electronic Supplementary Material.
各种全身不定症状的患者偶尔会伴有颈肌僵硬或压痛。本前瞻性病例系列研究检查了局部调节颈部肌肉对报告有不定全身症状的颈椎疾病患者的效果。
共纳入 1863 例因伴有三种或三种以上不定全身症状而对门诊治疗有抵抗的住院颈椎疾病患者,进行为期 12 年的研究。所有患者在住院期间均接受每日颈部肌肉物理治疗。将入院和出院时在医疗访谈表上记录的 30 种代表性症状(包括颈肩部疼痛或僵硬)和 28 种代表性不定全身症状的自我评估记录进行比较。
通过住院期间的颈部肌肉局部调节,症状数量显著减少。入院时的所有 28 种不定全身症状的恢复率均大于 50%。出院时的平均症状数从入院时的 17.8 显著减少至 7.4(p < 0.0001)。入院时报告有 10 种或更多症状的患者比例为 91.1%,出院时为 29.3%。此外,出院时有 8.2%的患者报告无残留症状。
颈肌病变可能导致不定全身症状,可能是通过肌肉副交感神经系统的功能障碍所致。局部调节颈部肌肉可能为治疗不定全身症状的患者提供突破。
UMIN000035445。这些幻灯片可在电子补充材料中检索。