Hubka M J, Phelan S P, Delaney P M, Robertson V L
Los Angeles College of Chiropractic, Whittier, CA, USA.
J Manipulative Physiol Ther. 1997 Nov-Dec;20(9):622-7.
To describe the clinical presentation of eight patients with cervical spine radiculopathy, the manipulation technique used for each patient and the outcomes of treatment.
The cause of radiculopathy in four patients was disc herniation. The other four patients had a combination of spondylosis, disc herniation and sprain injury.
Six of eight patients had a good outcome associated with receiving manipulation performed by contacting the cervical spine at the level of the radiculopathy, laterally flexing toward the side of radiculopathy, rotating the neck away from the side of the radiculopathy and applying a gentle high-velocity, low-amplitude thrust. Two patients had an exacerbation of arm pain and increased neurological deficit associated with manipulation performed with the neck rotated toward the side of radiculopathy.
There is little compelling evidence supporting or disputing the use of manipulation for patients with cervical spine radiculopathy. In our patients, rotary manipulation was associated with a different outcome depending on the direction of neck rotation. Prospective time-series studies and randomized, blind trials are needed to identify the efficacy and effectiveness of different manipulation techniques for this condition.
描述8例颈椎神经根病患者的临床表现、对每位患者采用的手法治疗技术及治疗结果。
4例患者神经根病的病因是椎间盘突出。另外4例患者合并有颈椎病、椎间盘突出和扭伤。
8例患者中有6例通过在神经根病水平接触颈椎、向神经根病侧侧屈、将颈部向远离神经根病侧旋转并施加轻柔的高速度、低幅度推力进行手法治疗后取得了良好效果。2例患者在颈部向神经根病侧旋转进行手法治疗后出现手臂疼痛加重和神经功能缺损增加。
几乎没有确凿证据支持或反对对颈椎神经根病患者使用手法治疗。在我们的患者中，旋转手法根据颈部旋转方向产生了不同的结果。需要进行前瞻性时间序列研究和随机双盲试验来确定不同手法治疗技术对这种疾病的疗效和有效性。
