Treatment of Patients With Degenerative Cervical Radiculopathy Using a Multimodal Conservative Approach in a Geriatric Population: A Case Series
Treatment of Patients With Degenerative Cervical Radiculopathy Using a Multimodal Conservative Approach in a Geriatric Population: A Case Series
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DOI：
10.2519/jospt.2011.3592
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发表时间：
2011-10-01
影响因子：
6.1
通讯作者：
Wilson, Eric
中科院分区：
文献类型：
--
作者：
Forbush, Steven W.;Cox, Terry;Wilson, Eric
研究设计：回顾性临床病例系列研究：目的：描述10例晚期颈椎关节病伴神经根病患者的治疗，采用手法治疗，间歇性机械颈椎牵引和家庭exercises.Background：神经根型颈椎病的预测因素和短期预后已发表。这些预测因素尚未开发，或适用于老年患者的脊椎神经根病。病例描述：一系列的10例患者（年龄67至82岁）被称为物理治疗师的医学预先诊断颈椎关节病和神经根病，确定磁共振成像。颈部残疾指数（NDI），数字疼痛评定量表（NPRS），上肢张力测试，Spurling测试，颈椎牵引测试都完成了对每例患者在初始检查和出院。在治疗后6个月收集NDI和NPRS数据。干预措施包括手动治疗（包括高速低幅度推力操作）的上胸椎和颈椎，间歇性机械颈椎牵引，和一个家庭程序（包括深颈屈肌加强）6至12届在3至6 weeks.OUTCOMES：所有10例患者有显着改善NPRS和NDI评分。出院时平均NPRS评分小于1/10，平均NDI评分为6/50，而最初的平均NPRS和NDI评分分别为5.7和27.4。所有患者报告保持这些收益为6 months.Discussion：一个多模式的方法诊断为颈椎病与神经根症状的患者是有用的，在这个老年人口，以减少疼痛，最大限度地减少神经根症状，并改善功能outcomes. Level证据：治疗，4级。J Orthop Sports Phys Ther 2011;41（10）：723-733，Epub 2011年9月4日。doi：10.2519/jospt.2011.3592
STUDY DESIGN: Retrospective clinical case series.OBJECTIVE: To describe the management of 10 patients with advanced cervical spondyloarthrosis with radiculopathy, using manual therapy, intermittent mechanical cervical traction, and home exercises.BACKGROUND: 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.CASE DESCRIPTION: 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.OUTCOMES: 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.DISCUSSION: 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.LEVEL OF EVIDENCE: Therapy, level 4. J Orthop Sports Phys Ther 2011;41(10):723-733, Epub 4 September 2011. doi:10.2519/jospt.2011.3592