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The assessment of cervical myelopathy

Erhard R, Piva S, Cleland J, Whitman J, Fritz J, Palmer J, Cook C, Brown C, Isaacs R, Roman M, Davis S, Richardson W, Wilhelm M, Cook A, Petrosino C, Isaacs R, Moeti P, Marchetti G, Raney N, Petersen E, Smith T, Cowan J, Rendeiro D, Deyle G, Childs J, Salvi F, Jones J, Weigert B...(+28 more)

The Journal of orthopaedic and sports physical therapy, vol. 18, issue 4 (2005) pp. 207-213

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Abstract

STUDY DESIGN: Case series. OBJECTIVE: To describe the clinical outcomes of 15 patients with cervical radiculopathy treated with mechanical intermittent cervical traction. BACKGROUND: Effectiveness of traction for the treatment of cervical spinal syndromes is controversial and the outcome of this treatment has not been established in the literature. METHODS AND MEASURES: Fifteen patients (45.5 +/- 13 years) completed a course of treatment using mechanical intermittent cervical traction. Eleven patients presented at baseline with radicular symptoms of 12 weeks duration or less, and 4 patients had long-standing radicular symptoms lasting more than 12 weeks. Outcome was measured using the Neck Disability Index (NDI) and the Numeric Pain Rating Scale (NPRS). RESULTS: Eight of the 15 cases (53%) in this series demonstrated complete pain resolution; these patients had symptom duration of 12 weeks and less. Seven of these 8 cases displayed a final NDI of 10% or less. Three out of 4 of the patients with symptom duration more [corrected] than 12 weeks showed no reduction in pain or increased pain rating, with minimal change in perceived disability of 12% or less. CONCLUSION: In this case series, patients with radicular symptoms lasting for 12 weeks and less demonstrated a reduction in pain and perceived disability. The NDI, when used in conjunction with the NPRS, provides a more comprehensive assessment of the patient with cervical radiculopathy, thus allowing the clinician to make a better judgment about the clinical effects of cervical traction.

Author-supplied keywords

  • Cervical Spine Myelopathy
  • Cervical traction
  • Classification
  • Diagnostic Accuracy or Sensitivity and Specificity
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Strength
  • Neck pain
  • New Hampshire
  • Outcome Assessment (Health Care)
  • Physical Examination
  • Physical Therapy Specialty
  • Physical Therapy Specialty: methods
  • Radiculopathy
  • Radiculopathy: physiopathology
  • Radiculopathy: therapy
  • Systematic Review
  • Traction
  • and altered
  • at the discovertebral junction
  • biomechanics may lead to
  • cervical spine myelopathy
  • clinical prediction rule
  • diagnostic accuracy
  • enthesopathy and calcifica-
  • increasing age
  • progressive disc dehydration
  • sensitivity
  • specificity
  • spondylosis
  • with osteophytosis

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