颈椎病治疗成绩评分表

关于颈椎病疗效评定,目前尚缺乏客观标准,为了量化评定治疗前后颈椎功能改善状况,我们制定了“颈椎病颈椎功能评定表”,于2000年开始在临床试用,在临床应用中进行了多次修改和完善,制定了新的评分表。该表包括三部分：第一部分由临床症状、临床检查、日常生活动作、自我满意程度四大项目组成,可根据治疗前后评分,计算改善指数和／或改善率;第二部分为VAPS评定;第三部分为影像学资料,包括X线片、CT、MRI。我们认为该表具有较好的临床实用价值,值得推广应用。     

针刀配合颈部牵引治疗神经根型颈椎病52例

目的：观察针刀配合颈部牵引治疗神经根型颈椎病的临床疗效。方法：采用针刀疗法配合颈部牵引的方法治疗神经根型颈椎病52例为治疗组，同时设西药配合颈部牵引65例为对照组进行疗效分析。结果：参照疗效评定标准，治疗组治愈率61．5％，总有效率94．2％，对照组治愈率18．5％，总有效率81．5％，两组疗效差异具有显著性，治疗组明显优于对照组（P〈0．01）。结论：采用针刀配合颈部牵引治疗神经根型颈椎病临床疗效确切．值得临床推广。     

一指禅手法为主治疗椎动脉型颈椎病及其对脑血流速度的影响

目的探讨一指禅手法为主治疗椎动脉型颈椎病的临床意义和作用机制.方法将64例椎动脉型颈椎病患者随机分成手法治疗组和药物治疗组,于治疗前一两天、治疗后1、3周分别作经颅多普勒(TCD)检查,并作临床疗效对比.结果经治疗1周后,经颅多普勒检查、临床疗效评定之痊愈率、总有效率均无明显差异;治疗3周后,两组病例经颅多普勒检查及临床疗效评定有显著差异.结论一指禅手法为主治疗椎动脉型颈椎病疗效明显优于药物治疗组,是治疗椎动脉型颈椎病的有效方法之一.     

颈椎病疗效评定标准探讨

颈椎病疗效评定标准探讨孙文凤董莉范丽涛陈永芹颈椎病是中老年常见的一种疾病，长期以来均采用牵引、中药外敷、热疗等物理因子进行康复治疗，取得满意疗效。但以往疗效评定主要以治疗前后症状和体征改善程度为依据。这种判断标准，主观性较大，随着对颈椎病认识的深化，...     

星状神经节阻滞配合手法治疗椎动脉型颈椎病

目的观察星状神经节阻滞，配合手法治疗椎动脉型颈椎病的治疗效果。方法选择椎动脉型颈椎病患者204例，应用星状神经节阻滞，配合手法治疗，治疗后1-2mo进行随访，按照疗效评定标准进行评定。结果优97例，良74例，可33例，差0例，有效率100％，优良率83．82％。结论星状神经节阻滞配合手法治疗椎动脉型颈椎病，操作简单，经济实用，安全可靠，效果良好。     

分类治疗不同类型颈椎病的疗效观察

颈椎病在中老年人中发病率较高。临床袁现多样，治疗方甚多种，近年来我们采用牵引 中药热敷。牵引 电脑中频治疗神经根型颈椎病和椎动脉型颈椎病共160例，报告如下：     

颈椎病的非手术治疗及护理对策

目的：了解颈椎病非手术疗法及护理的临床效果。方法：分析32例颈椎病患者采取非手术治疗及护理的效果，并对治疗前后X线表现进行对比。结果：治疗后。临床症状明显减轻．部分消失，但x线变化不明显。结论：大多数颈椎患者通过非手术治疗和护理后，效果好，部分可达临床治愈。但x线改善与否不能作为评定非手术治疗效果的标准，但对选择治疗方法有较大的参考价值。     

牵引并电脑中频中药导入治疗颈椎病

颈椎病是中老年人的常见病、多发病。颈椎牵引是治疗颈椎病的有效方法，但单纯牵引治疗颈椎病，患者临床症状改善不太理想，我们采用电脑中药透人疗法治疗颈椎病130例，其中104例（80％）经随访1年以上无复发，现总结如下。     

火针加星状神经节阻滞综合治疗颈椎病

目的以火针加星状神经节阻滞为主要治疗手段，并根据颈椎病的临床分型结合手法和颈椎牵引进行治疗，通过对其治疗效果的观察，总结出一套以火针加星状神经节阻滞治疗颈椎病的高效综合疗法。方法收集2000—03／2003—03确诊为颈椎病的患者108例，根据患者的症状、体征进行临床分型，对治疗前后的症状、体征、影像学检查进行观察评定。结果在108例患者中治愈98例，治愈率达90．7％，显效10例，有效率为100％。结论临床实践证明，采用火针加星状神经节阻滞综合治疗颈椎病有显效快、疗程短、治愈率高、不易复发的优点。     

大剂量中西药物硬膜外腔灌注治疗椎动脉型颈椎病的临床研究

目的观察大剂量中西药物硬膜外腔灌注治疗椎动脉型颈椎病的临床效果。方法以2005-01—2006-10中西药物硬膜外腔灌注治疗椎动脉型颈椎病119例为研究对象，随机分为大剂量中西药物硬膜外腔灌注治疗组（89例）和单纯静脉注射用药治疗对照组（30例），分别观察和记录治疗前后临床主要自觉症状的模拟评分，评定治疗效果。结果大剂量硬膜外腔灌注结束时即刻开始观察，治疗后所有临床主要自觉症状的模拟评分较治疗前均显著降低（P〈0．01）；与对照组比较，各观察阶段均有显著疗效。结论大剂量中西药物硬膜外腔灌注治疗颈椎病有令人满意的的疗效。     

温针灸在寒湿痹阻证神经根型颈椎病急性期患者中的应用价值探讨

目的 分析温针灸在寒湿痹阻证神经根型颈椎病急性期患者中的应用价值。方法 选取我院在2019年1月至2021年1月期间收治并被中医辨证为寒湿痹阻证神经根型颈椎病急性期患者80例,按随机数字法分为两组,即对照组40例,给予常规西医治疗;观察组40例,基于对照组治疗方法给予温针灸治疗;比较两组治疗效果、颈椎功能恢复情况。结果 观察组治疗效果优于对照组（94.50% VS 80.0%）,治疗后颈肩部疼痛、上肢疼痛麻木、遇寒加重评分与颈部残障指数（NDI）、Northwick Park颈痛量表（NPQ）评分均低于对照组（P<0.05）。结论 温针灸治疗寒湿痹阻证神经根型颈椎病急性期取得显著效果,颈椎功能改善明显。     

Intracranial hypotension syndrome following chiropractic manipulation of the cervical spine

Cervical spine manipulation has been associated with several disorders such as cervical arteries dissection, but rarely has a relationship with intracranial hypotension been reported. We describe a patient showing intracranial hypotension syndrome following chiropractic cervical spine treatment. Magnetic resonance showed the presence of dural leakage at cervical level, suggesting the pathogenesis of the syndrome. We state that cervical spine manipulation should be considered a treatment with risk of neurological complications, including the occurrence of intracranial hypotension.     

颈椎荣通方联合旋提手法治疗神经根型（气滞血瘀型）颈椎病的临床疗效观察

摘要：目的：观察和评价中药颈椎荣通方联合旋提手法在治疗气滞血瘀型神经根型颈椎病的临床治疗效果。方法：选取2018年10月至2020年01月江西中医药大学附属医院门诊收治符合神经根型颈椎病诊断,中医辩证分型为气滞血瘀证的80例患者,采用单盲、随机数字表法、按就诊顺序分为观察组40例、对照组40例。观察组采用自拟颈椎荣通方结合旋提手法治疗,对照组仅采用旋提手法治疗,疗程均为两周。比较两组治疗两周后的临床疗效、视觉疼痛模拟评分（VAS）、颈椎弓弦距。结果：经两周治疗后,观察组总有效率（92.50%）明显高于对照组（75.00）%,P<0.05,差异均具有统计学意义;治疗后视觉疼痛模拟评分（VAS）观察组（1.22±1.54)明显低于对照组（2.52±1.76）,P<0.05,差异均具有统计学意义;观察组治疗前后颈椎弓弦距差值（1.03±0.24）高于对照组（0.52±0.14）,P<0.05,差异均具有统计学意义。结论：颈椎荣通方结合旋提手法治疗神经根型（气滞血瘀证型）颈椎病较单纯应用旋提手法治疗疗效更优,值得临床推广应用。     

Value of intensive rehabilitation in fixed dropped head syndrome]

OBJECTIVES: To point out the diagnostic and etiologic context of neck extensor weakness and to consider orthopedic and rehabilitation treatment of dropped head syndrome. METHODS: We report a case of a 68-year-old hospitalized woman with atypical and serious idiopathic neck extensor weakness who was treated by orthopedic measurements and intensive rehabilitation. RESULTS: Our patient had progressive neck extensor weakness and total inflection of the cervico-cephalic axis over two years. Fixed and permanent contact of the chin and the sternum severely affected her ability to eat, and mandibular and sternal pressure ulcers developed. Cervical spine radiography revealed degenerative lesions. Other clinical and biological parameters were normal. Atypical idiopathic head drop was diagnosed because of painful and fixed head position. Rehabilitation consisted of cervical traction with a halo apparatus during eight weeks and an exercise programme based on cervical proprioception and muscular work. Orthopedic management consisted of cervical collar immobilization after cutaneous cicatrization. After ten weeks of treatment, the patient was able to raise her head and maintain it horizontally. Two years later, clinical results were stable. DISCUSSION: Neck extensor weakness may be the presenting feature of several neuromuscular disorders. Generally, idiopathic dropped head syndrome appears to be the most likely diagnosis in patients with isolated neck extensor involvement. For our patient, clinical findings and cervical computed tomography showed important muscular weakness. However, painful passive extension and progressive stiffness of the neck do not represent the typical clinical course of idiopathic head drop. Neither degenerative lesions of the cervical spine nor other joint diseases can cause head drop. This case may result from the combined effects of idiopathic dropped head syndrome and cervical arthrosis. Orthopedic treatment and intensive rehabilitation had spectacular effects. Clinical management of head drop syndrome should always consist of orthopedic and rehabilitation treatment.     

Phrenic Nerve Injury After Radiofrequency Denervation of the Cervical Medial Branches

Radiofrequency denervation of the cervical medial branches is a possible treatment for chronic cervical facet pain syndrome when conservative management has failed. According to the literature, complications after radiofrequency denervation of the cervical medial branches are rare. We report a case of possible phrenic nerve injury after ipsilateral radiofrequency denervation of the cervical medial branches following a posterolateral approach.     

Anterior cervical corpectomy decompression and fusion for cervical kyphosis in a girl with Ehlers-Danlos syndrome:A case report

BACKGROUND Spinal deformities in Ehlers-Danlos syndrome(EDS; type VI) are generally progressive and severe. Surgical treatment has been described for kyphoscoliosis in the thoracolumbar spine. However, there are few studies describing the consequences of an anterior approach in cervical kyphosis. An anterior approach may not be able to fully decompress the spinal canal and restore the normal curvature of the cervical spine. Therefore, the anterior approach for cervical kyphosis in young children is hard. We describe the first case in an EDS girl with cervical kyphosis who received satisfactory anterior cervical corpectomy decompression and fusion.CASE SUMMARY The chief complaints of a 16-year-old girl with EDS were double upper limb weakness for 7 years and double lower limb walking instability for 2 years.Moreover, the imaging results revealed that the degree of kyphosis from cervical vertebra 2 to 4 accompanying with spinal cord compression was 30°. An anterior cervical corpectomy involving cervical vertebra 3 and a titanium mesh implant were performed with internal fixation. The results at 3 mo after surgery demonstrated that the anterior fusion was solid, and the kyphosis of the cervical spine was corrected. Additionally, the power of all four extremities was significantly improved.CONCLUSION The incidence rate of cervical kyphosis in EDS is rare. The surgical treatment for these patients, especially an anterior approach, is challenging. Therefore, to develop safer and more effective strategies to treat cervical kyphosis in EDS,there is still much work to do.     

激痛点缺血性压迫治疗颈肩肌筋膜疼痛综合征疗效观察

目的:观察激痛点缺血性压迫法治疗颈肩肌筋膜疼痛综合征的疗效。方法:选择颈肩肌筋疼痛膜综合征患者20例,按照随机数字表法分为对照组和治疗组,每组10例。对照组仅接受健康宣教;治疗组在对照组基础上实施激痛点缺血性压迫疗法。首先通过Booster Pro3筋膜枪渐次提高振动频率的方法松解斜方肌上束,提高痛阈,达到放松并激活上斜方肌的目的,随后使用缺血性压迫激痛点的方法进行干预,治疗1次/d,连续治疗2周。分别在治疗前、后,采用肌力与脊柱活动度测量仪测量颈部关节活动度与肌力,采用疼痛视觉模拟评分法(VAS)评价颈肩部的疼痛程度,采用颈椎功能障碍指数(NDI)评价颈部功能障碍水平。结果:与治疗前比较,治疗第1次结束即刻治疗组左右侧肌力明显增加,治疗后2周治疗组颈部关节活动度(前屈方向)、左右侧肌力明显增加,左屈、右屈、右旋方向上的VAS评分与NDI评分明显降低,差异有统计学意义(P<0.05);与对照组比较,治疗后2周治疗组颈部关节活动度(前屈方向)、左右侧肌力更高,左屈、右屈、右旋方向上的VAS评分与NDI评分更低,差异有统计学意义(P<0.05)。结论:激痛点缺血性压迫疗法治疗颈肩肌筋膜疼痛综合征,可以有效提高MPS患者颈部关节活动度、左右侧肌力,缓解颈部肌肉僵硬不适和疼痛,改善颈椎功能障碍状态,值得临床推广应用。     

近15年中医外治法治疗颈心综合征研究概况

对近15年中医外治法治疗颈心综合征的有关文章查阅分析,发现包含针刺、带刃针具、灸法、推拿按摩等方法的中医外治法对该病有较好的临床疗效,可以显著改善患者的临床症状。通过分析研究近年文献发现,中医外治法治疗本病有确切的疗效,但是更多的中医外治研究是关于推拿手法治疗本病的研究,目前对于颈心综合征的诊断治疗标准不统一、其结果的可靠性不高,且颈心综合征尚无统一的中医外治法疗效评定标准,不能客观全面的评价中医外治法治疗颈心综合征的作用,而经济安全、方法简单、操作方便、疗效确切的中医外治法应是未来治疗颈心综合征的重要发展方向。因此在总结评述的同时,提出近年来中医外治法治疗颈心综合征研究的不足以及今后研究的重点及方向,今后关于颈心综合征的中医外治法研究尚需要严谨的科研设计、大样本、多中心、随机双盲对照实验来验证可靠性。     

Behandlung des oberen Zervikalsyndroms mit funktioneller computerassistierter Reflextherapie (Spineliner)

If the textbook definition of upper cervical syndrome is a dysfunction of the upper cervical spine, functional computer-assisted reflex therapy (with the medical device Spineliner) can attain observable clinical improvement. An observational study was performed to determine the possibility of objective detection and treatment. A total of 21 patients suffering from cervical syndrome (headache, nausea and hypomobility of cervical joints) were investigated by palpation for signs of hypomobility and by goniometry for range of movement of the head before, immediately and 24 h after treatment by a special reflex therapy with mechanical impulses (Spineliner). Significant symptomatic improvement could be found in all subjective and objective parameters examined using the overall mean of the clinical study group. So for the first time there is strong evidence that this condition can be diagnosed and treated in a controlled computer-assisted manner independent of the investigator.     

Medium-term outcomes of artificial disc replacement for severe cervical disc narrowing

ObjectiveTo determine if the Bryan cervical disc prosthesis could relieve objective neurological symptoms, signs, and restore mobility in patients with severe cervical disc narrowing.MethodsClinical data of thirty-two patients underwent Bryan cervical disc replacement has been collected from April 2006 to February 2010. Severe cervical disc narrowing with grade V disc degeneration were included in this study. Bryan cervical disc prostheses have been implanted through anterior approach. Japanese Orthopedics Association (JOA) score, visual analog scale, Odom's scale, and flexion-extension radiological follow-ups were applied for evaluations.ResultsA total of 41 Bryan disc prostheses from 32 patients with an average follow-up duration of 33.5 months (range 23 to 44 months) were evaluated. Clinical functions of patients were significantly improved. Preoperative averaged visual analog scale score of 6.3±2.2 was decreased to 1.3±1.2 (at 36 months, P<0.001), while preoperative averaged JOA score of 14.4±1.2 was increased to 16.3±0.9 (at 36 months, P<0.001). Thirty of 32 patients received excellent to good outcomes in Odom's scale. Averaged mobility was restored to (9.9±3.2)° at the last follow-up evaluation of 36 months. No subsidence or migration of implant was identified.ConclusionsAcceptable clinical outcome for treatment of severe cervical disc narrowing with cervical disc replacement technique has been performed in current study. Most patients maintained good postoperative mobility and no significant adjacent level degeneration were found. Cervical disc replacement may be applicable in treatment of severe cervical disc narrowing; however, longer follow-ups are required for ensuring the long-term efficacy of cervical disc replacement.