PubMed · 12485213
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D A Fishbain. 2002. Cervicogenic headache.. https://doi.org/10.1046/j.1468-2982.2002.00456.x
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STUDY DESIGN: Study of two cohorts with a differing severity of disease before and after treatment. OBJECTIVES: The aim of this study was to examine the validity and sensitivity to change of the German version of the cervical NASS patient questionnaire. SUMMARY OF BACKGROUND DATA: To the authors' best knowledge, there are no data revealing the psychometric properties of the cervical NASS patient questionnaire. PATIENTS AND METHODS: The validity and sensitivity in patients with cervical spine disorders who were referred by their physician either to an inpatient rehabilitation program or to an outpatient physiotherapy were examined. They were consecutively recruited. Their functioning and health status were assessed when entering the study and after the treatment by the NASS questionnaire and the Medical Outcome Survey Short Form-36 (SF-36). RESULTS: Criterion validity was demonstrated by the statistically significant correlations between the NASS subscores and all subscores of SF-36. As expected, the SF-36 subscores Physical Function and Pain showed the strongest associations to the NASS subscore Pain and Disability (rho = 0.75 and 0.65, respectively), demonstrating construct validity of the latter. Discriminative validity of NASS subscores was shown in two ways. First, a statistically significant difference was found between functional and health status of the two cohorts with better scores in the patients referred to outpatient physiotherapy as compared with those sent to an inpatient rehabilitation program. Second, statistically significant and clinically important improvements recorded by the NASS subscores were demonstrated in both patient groups after the treatment in accordance with improved SF-36 subscores. Moreover, the NASS subscores demonstrated good sensitivity to change (Pain and Disability with a standard response mean ranging from 0.64 to 1.24). CONCLUSIONS: The German version of the cervical NASS patient questionnaire (NASS) is a valid instrument for patients with cervical spine health problems. As this instrument is also sensitive to change, it is recommended for use. Moreover, the present study gives evidence for the validity of the original cervical NASS questionnaire in English.
STUDY DESIGN: Case report of a solitary fibrous tumor in the occipitocervical region. OBJECTIVE: To describe a rare clinical entity and successful management in a patient with solitary fibrous tumor in the occipitocervical region. SUMMARY OF BACKGROUND DATA: Solitary fibrous tumor is a rare spindle cell neoplasm of adults that arises most commonly in the pleura. Recently, this tumor has been reported in a number of other sites. However, its occurrence in the occipitocervical region is rare. METHODS: The patient presented with a painless mass in the left posterior neck. Resection of the tumor was performed. RESULTS: Histopathological study revealed features of a solitary fibrous tumor. Clinical follow-up review for 2.5 years shows no evidence of recurrence or metastasis. CONCLUSION: A case of extrapleural solitary fibrous tumor in the occipitocervical region was reported. Solitary fibrous tumor should be considered in the differential diagnosis in a tumoral mass of this region.
BACKGROUND: The number of surgical techniques for decompression and solid interbody fusion as a treatment for cervical spondylosis has increased rapidly, but the rationale for the choice between different techniques is unclear. OBJECTIVES: The goal of this study was to determine which method of anterior cervical interbody fusion at a single or double-level provides the best clinical and radiological outcome in patients with degenerative disc disease. SEARCH STRATEGY: Studies were identified with a computer-assisted search of electronic databases in the Cochrane Central Register of Controlled Trials (Issue 1, 2004), MEDLINE (1966 to 2004), EMBASE (1980 to 2004), and Current Contents (1996 to 2004). We also searched references of selected articles. SELECTION CRITERIA: With the aid of a checklist, two reviewers independently screened the identified references. Consensus was reached through negotiation. A third reviewer was consulted if consensus could not be reached. Inclusion criteria included: articles were reports of randomised comparative studies; treatments compared anterior cervical decompression and interbody fusion techniques, participants were individuals scheduled for surgery for a chronic (longer than 12 weeks) diagnosis of degenerative disc disease. DATA COLLECTION AND ANALYSIS: Methodological quality was assessed independently by two reviewers, using the van Tulder list of criteria. With the aid of a data extraction form, data was extracted independently by two reviewers on group characteristics, intervention details and outcome measures. MAIN RESULTS: Fourteen studies with 939 patients evaluated three comparisons of different fusion techniques. From these comparisons it appears that discectomy alone has a shorter operation time, hospital stay, and post-operative absence from work than discectomy with fusion, while there is no statistical difference for pain relief and rate of fusion. It also appears that fusion techniques that use autograft give a better chance for fusion than interbody fusion techniques that use a cage, but other outcome variables could not be combined. REVIEWERS' CONCLUSIONS: The low quality of the trials prohibits extensive conclusions from this review. More studies with better methodology and reporting are needed. There should be a more general agreement between researchers on which outcome parameters should be used in the evaluation of anterior cervical fusion procedures.