Research Articles

What's Happening with Cervical Disc Replacements

Much has happened in the last few years related to disc replacements for the neck called cervical disc arthroplasty. The first FDA-approved studies on the subject have been published for three different devices: the Prestige System, the ProDisc-C system, and the Bryan disc. Since the first cervical disc replacement didn't come out until 2007, the results so far are fairly limited. Later implant systems weren't available until 2009, so research data is fairly limited as well.What do we know so fa...

The Benefit of Supervised Exercise for Chronic Neck Pain

Many people with neck pain never bother to seek help or get treatment for this problem. They just muddle along year after year making the best of their situation. After all, it's not a condition that will kill you. It takes time to take off work for the doctor's appointments. And besides that, no one has really found one treatment method that works for everyone. The passive approach (do nothing) ends up being a common way to deal with this condition.Despite all that, health care providers such a...

Fear of Movement, Pain, and Disability After Whiplash Injuries

When neck pain from a whiplash injury occurs and becomes chronic is it the pain that causes disability in a direct chain of events? Or is there some other indirect factor or variable that links pain with disability? In this study, researchers from the George Institute for Global health in Sydney, Australia take a closer look at fear of movement as the possible mediating (indirect link or cause) between neck pain after whiplash injury and disability.Fear of movement (also known as fear-avoidance ...

Neck and Throat Problems from DISH Not as Rare as Once Thought

Dysphagia (difficulty swallowing) and airway obstruction can be caused by a problem known as Diffuse Idiopathic Skeletal Hyperostosis or DISH. Until now, it was believed that DISH was a rare cause of compression of the esophagus and trachea. But thanks to the efforts of researchers in the Netherlands, we have found out that this condition is on the rise around the world.Diffuse Idiopathic Skeletal Hyperostosis (DISH) causes ligaments along the front and back of the vertebrae (spine) to turn into...

Is Early Treatment Making Whiplash Injuries Worse

Is it possible to get too much medical help too soon after a whiplash injury? That's the question posed by the authors of this article. By examining the results of studies reporting results of early treatment for whiplash, they found a surprising amount of evidence that iatrogenic disability is possible.Iatrogenic disability refers to the development of problems caused by the treatment. Chronic pain is one of those problems. Studies consistently showed that too much treatment too soon actually i...

What Is the Best Exercise for Whiplash

Anyone who has had an accident resulting in a whiplash injury knows the neck pain, stiffness, and loss of motion that can develop afterwards. Many people recover in a few days to a few weeks. But just as many develop chronic symptoms referred to as whiplash-associated disorder (WAD). Exercise may be a useful tool in getting past these symptoms and even preventing the transition from an acute problem to a chronic one.In this article, a Physical Therapist from Australia (they call them physiothera...

When Whiplash Causes Chronic Pain

Ever have a moment when you experience a bit of dizziness? Fortunately it passes quickly and you return to normal once again. But for up to 40 per cent of people involved in car accidents, neck trauma in the form of whiplash causes persistent symptoms. Dizziness is one of three most common symptoms after whiplash trauma. Pain and postural unsteadiness are the other two common problems reported.In this article, a Physical Therapist from "down under" (Australia) presents the current information av...

Reason For Chronic Neck Pain After Whiplash Finally Confirmed

The actual source of chronic neck pain after whiplash injuries has been a mystery for a long time. It has been difficult to sort out because there are so many possibilities within the neck structures (hemorrhage, fracture, contusion, tears). But over the last 10 years studies have started to consistently point to one area: the cervical zygapophysial joints.A more common term for these joints is facet joints. Between each pair of vertebrae are two facet joints. These joints connect the vertebrae ...

Best Way to Treat Cervical Radiculopathy

Imagine severe neck pain that is constant. Now add shooting pains down the arms and/or numbness down to the fingers. Now try to imagine working, dressing, answering emails, or sleeping under those conditions. That's what patients with cervical radiculopathy experience every day.Cervical radiculopathy refers to symptoms that come from pressure on the nerve roots as they exit the spinal column. People sometimes refer to this problem as a "pinched nerve". Cervical radiculopathy is caused by any con...

Taking a Closer Look at Neck Motion After Fusion Versus Disc Replacement

For people with severe neck pain from disc degeneration, it is possible to have a disc replacement now instead of a neck fusion procedure. It's a new enough treatment that surgeons are continuing to conduct studies of fusion versus disc replacement.There is particular interest in what happens to the adjacent spinal level. In other words, does the vertebral unit above and/or below the fusion develop problems because of faster degeneration? Does using a disc replacement instead of a fusion procedu...

Effects of Manipulating the Midback on the Neck

You may have heard the statistic that 80 per cent of all adults will experience back pain sometime in their life. Would it surprise you to know neck pain affects up to half of all adults? In both cases (back and neck pain), the condition is referred to as mechanical pain.Mechanical back or neck pain describes pain that usually occurs with movement and is not caused by fracture, inflammation, tumors, nerve problems, or other known systemic causes. Most of the time the underlying cause remains unk...

Difficulty Swallowing After Neck Surgery

It makes sense that patients having anterior cervical spine surgery (from the front of the neck) might experience difficulty swallowing for a few weeks after the procedure. This symptom of painful swallowing is called dysphagia. But how come some patients develop this transient (temporary) symptom and others don't? And how often does it happen?These are the questions posed in this study by surgeons from the University of Pittsburgh. They compared a small number of patients who had an anterior ce...

One Advantage of Cervical Disc Replacement Over Spinal Fusion

Surgeons are actively studying the advantages and disadvantages of neck fusion compared with disc replacement. In this study, they take a closer look at the amount of ossification of the surrounding ligaments in two groups of patients after surgery. Ossification refers to the formation of bone within soft tissue structures such as muscles and ligaments.The exact cause of ossification isn't quite clear. It could be part of the healing response of the soft tissues after being cut and moved away fr...

New Disc Replacement for Cervical Spine

Early Results with New Disc Replacement for the Cervical Spine Twenty-five patients treated with the new Discover disc replacement for the cervical spine (neck) provide some early results from this study. The implant (manufactured by DePuy) is made of titanium with a polyethylene (plastic) insert to mimic the natural disc. It is designed to restore full motion and even incorporates the lordotic angle (curvature) of the natural spine.The patients could have had the more traditional procedure cal...

Long Term Results of Cervical Spine Disc Replacement

The first report of long-term results with disc replacement for the cervical spine (neck) is now available. Patients in France treated with the Bryan Cervical Disc Arthroplasty were followed for at least eight years after surgery. This report gives us an idea of how well those 21 patients did past the first two to four years (which is the time period most other studies have reported on).Artificial disc replacements were developed to avoid neck fusions and thus preserve neck motion. The idea came...

Performance of Plate-Only Laminoplasty

Surgery to take pressure off the spinal cord in the neck area continues to progress and change. New and better surgical techniques have the potential to improve results for patients suffering from pressure on the spinal cord.In this study, surgeons from Emory Spine Center in Atlanta, Georgia use a special plate as the only fixation device after performing a laminoplasty for cervical myelopathy. Cervical refers to the neck and myelopathy means damage to the spinal cord. This condition can cause d...

Can Disc Replacements in the Cervical Spine Prevent Further Disc Disease?

Surgeons from the Spine Institute of Louisiana who wrote this article received the 2010 Outstanding Paper award for Surgical Science. The award was based on their study of adjacent segment degeneration (ASD) following artificial disc replacements (ADRs) in the cervical spine (neck).There have been many reports that after a spinal fusion for disc degenerative disease, the disc at the next level (usually the one above the fused segment) is the next to degenerate. The loss of motion and adjacent se...

A New Look at Neck Pain

Physical Therapy in Mesa, Tempe and Chandler for Neck Pain A group of Physical Therapists from the University of Iceland posed the question, Does neck pain from shoulder problems differ from neck pain associated with whiplash injuries? This is an important question when working with patients who may have altered muscle function depending on the etiology (cause) of their neck pain.They compared two groups of patients with neck pain. One group had been involved in a motor vehicle accident (MVA). ...

Surgical Treatment of Brachial Plexus Injuries

Advances in the Surgical Treatment of Brachial Plexus Injuries Traumatic injuries of the brachial plexus refer to stretching, avulsion, or rupture of a group of nerves that come from the spinal cord in the neck. Avulsion tells us the nerve root is torn from the spinal cord where it attaches. Rupture refers to a complete tear across the nerve dividing it into two or more parts. The upper part is still attached to the spinal cord. Plexus refers to the entire group of nerves as they first start ou...

Disc Replacement for the Neck: Does It Really DO Anything?

Disc Replacement for the Neck: Does It Really DO Anything? Disc degeneration in the cervical spine (neck) can create pain, loss of motion, loss of function, and disability. Surgeons are now able to replace the damaged disc with an artificial unit. Artificial disc replacement is rapidly replacing spinal fusion. But the question has been raised: does it really do anything more than fusion?The intended advantage of artificial discs is that they allow the spine to move normally. This concept is ref...

Effect of Changes Over Time on Trends in Neck Fusion

Benjamin Franklin was credited with saying, In this world nothing can be said to be certain, except death and taxes. But there is one more thing that could be added: change. Whether it occurs quickly or slowly, change is a constant in our lives. This is especially true in the world of medicine.Medications change, procedures change, treatment methods change, and so on. In the field of orthopedic surgery, length of hospital stays are shorter, surgical tools and techniques are improved, and the kin...

Effects of Spinal Fusion on Adjacent Segments Over Time

Have you had a spinal fusion surgery or have been recommended to have one? This article discusses the wear and tear that occurs around the fusion site.

A Possible Solution to the Problem of Metal Plates in Neck Fusion

Bioabsorbable plates are fairly new to the spinal fusion scene. For a long time now, surgeons have used an approach called the anterior cervical discectomy and fusion (ACDF). Anterior refers to the location of the incision and the way surgeon enters the spine (front of the neck). Anterior fusion is performed through the front of the spine to avoid the spinal cord and spinal nerves. Cervical refers to the neck and discectomy is the removal of the disc from between two vertebrae. Most surgeons use...

Scientific Evidence for Physical Therapy to Treat Neck Pain

Physical Therapists, like everyone else in the health care field, are working hard to find ways to treat patients safely and effectively. Instead of treatment as usual, therapists are striving to find scientific evidence to support (or refute) current treatment approaches.

Conservative Care for Neck Fractures in Older Adults

Researchers from Australia present the positive results of 42 patients with a Type II odontoid (neck) fracture who were treated conservatively (without surgery). Everyone in the study was at least 65 years old. Ages ranged from 67 to 91 years old. This type of fracture is most common in older adults who fall and break off the odontoid in the cervical spine (neck).

Treatment of Severe Brachial Plexus Injuries

Trauma to the upper arm during accidents can result in avulsion (complete tear) of the brachial plexus. In this study, the use of nerve transfers is explored for these injuries in six patients.