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Physical function measurements in neck pain.

Abstract

The literature on physical and functional measurements for the cervical spine is more limited than for the lumbar spine. Most of the studies so far have dealt with the methods for range-of-motion measurements in the cervical spine. These studies indicate that newer computer-guided, three-dimensional measurements systems may provide more precise and reliable data than inclinometer-based techniques and visual estimation methods. The research available also shows a correlation between training and strength improvement in the cervical spine. In addition to physical measurements, several tests have been developed to measure pain level, psychologic factors, disability from neck pain, and generic health, which can assist the clinician in choosing the most appropriate treatment for patients with neck pain. Furthermore, functional measurement systems, such as FCEs, have been developed to describe the functional limitations that a patient may have as a result of a spinal injury. Except for the range-of-motion measurement methods, much more research is required to determine which measurement systems provide the optimal balance between reliability and validity and pragmatic considerations such as time and expense.

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BibTeXRIS

Michael K Schaufele, Scott D Boden. 2003. Physical function measurements in neck pain.. https://doi.org/10.1016/s1047-9651(03)00030-5

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Surgical treatment of cervical kyphosis in Larsen syndrome: report of 3 cases and review of the literature.

STUDY DESIGN: A retrospective case series. OBJECTIVE: To review the surgical results for midcervical kyphosis in 3 cases with Larsen syndrome, and to discuss the choice of surgical treatments. SUMMARY OF BACKGROUND DATA: Cervical kyphosis is the most hazardous and serious manifestation of Larsen syndrome due to the risk of life-threatening paralysis, and thus usually requires surgical treatment. However, little information has been reported concerning surgical treatments for this challenging condition. METHODS: Three patients with Larsen syndrome were surgically treated for midcervical kyphosis at our institution. RESULTS: An infant with mild cervical kyphosis was successfully treated with posterior arthrodesis using a halo immobilization, and anterior vertebral growth with a mature posterior fusion mass resulted in spontaneous correction of the kyphosis. In the remaining 2 infants with myelopathic symptoms due to severe and structural kyphosis, anterior decompression and fusion via a lateral approach followed by posterior fusion with segmental spinal instrumentation and halo immobilization resulted in improved neurologic symptoms and solid fusion. CONCLUSIONS: Posterior spinal fusion is only indicated for patients with mild and flexible cervical kyphosis, and anterior decompression and circumferential arthrodesis is required for patients with severe kyphotic deformity, who usually develop myelopathic symptoms. Anterior surgery for such a small patient with severe kyphosis involves much higher risk of spinal cord injury during decompression maneuvers and difficulty in stabilization of the reconstructed cervical spine. Therefore, all patients with Larsen syndrome should be screened with radiographs at the first visit to detect cervical kyphosis early so that posterior alone fusion is possible.

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