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首页> 外文期刊>Journal of radiology case reports >Improvements in Cervical Spinal Canal Diameter and Neck Disability Following Correction of Cervical Lordosis and Cervical Spondylolistheses Using Chiropractic BioPhysics Technique: A Case Series
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Improvements in Cervical Spinal Canal Diameter and Neck Disability Following Correction of Cervical Lordosis and Cervical Spondylolistheses Using Chiropractic BioPhysics Technique: A Case Series

机译：使用脊椎疗法生物物理技术校正颈椎病和颈椎病和颈椎病的颈部脊柱管直径和颈部残疾的改善：案例系列

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Cervical spondylolisthesis indicates instability of the spine and can lead to pain, radiculopathy, myelopathy and vertebral artery stenosis. Currently degenerative cervical spondylolisthesis is a wait-and-watch condition with no treatment guidelines. A literature review and discussion will be provided. 8 females presented with neck pain, disability, and history of motor vehicle collision. Radiographs revealed abnormal cervical alignment, spinal canal narrowing, and spondylolistheses. After 30 sessions of Chiropractic BioPhysics? care over 12 weeks, patients reported improved symptoms and disabilities. Radiographs revealed improvements in cervical alignment, spondylolistheses, and spinal canal diameter. Motor vehicle collision may cause instability and abnormal alignment of the cervical spine leading to cervical spondylolisthesis. Improving spinal alignment may be an effective treatment to reduce vertebral subluxation and cervical spondylolistheses and improve neck disability as a result of improved spinal alignment. Keywords: chiropractic, Chiropractic BioPhysics, adjustment, CBP, spinal instability, cervical spondylolisthesis, cervical spine, postureCASE SERIESINTRODUCTIONSpondylolisthesis refers to the slippage of one vertebral body on the vertebra below. It is considered uncommon in the cervical spine when compared to the lumbar spine and is now being recognized as an under-studied condition [1].The two main types are congenital and acquired spondylolisthesis. Congenital spondylolisthesis is caused by a failure of formation of facet joint in the vertebrae and acquired spondylolisthesis refers to a defect in the pars interarticularis caused by degeneration, trauma, pathology, or surgery [2]. Degenerative cervical spondylolisthesis (DCS) is categorized into 3 different categories dependent on radiographic features, symptoms, and morphology. Each type has a suggested surgical procedure. Stage 1 presents with pain and noticeable facet joint degeneration; surgical recommendations include single level discectomy, repositioning, and fusion. Stage 2 patients will present with radiculopathy or myelopathy with facet degeneration and vertebral body degeneration; surgical recommendations include a multi-level discectomy, repositioning, and fusion. Stage 3 patients are identified with severe myelopathy and spinal deformity; surgical recommendations include corpectomy along with fusion of adjacent segments [1,3,4]. As of 2020, there are no current medical guidelines to follow. Surgery is indicated when the patient’s symptoms continually worsen and there is a proven instability or spinal cord compression [5].DCS prevalence is estimated to be 5.2% to 11% of the population and is understudied in comparison to the more common lumbar spondylolisthesis. The male-to-female ratio is 1.5 to 1 in grade 1 and 2.2 to 1 in grade 2 spondylolisthesis and there is an increased prevalence after 60 years with a 33.3% prevalence in 20 to 59 years and 66.7% in 60 to 99 years of age [6]. DCS in symptomatic patients was found to be 16.4% prevalence of grade 1 and 3.4% of grade 2 (Table 2). DCS was graded and defined by the following criteria. Grade 1 is defined as 2–3mm of displacement and grade 2 is defined as displacement greater than 3mm [1,7]. Table 2 Summary table of cervical spondylolisthesis in the sagittal plane Spondylolisthesis Summary Etiology Translation of vertebra with respect to vertebra belowAbnormal weight distribution, soft tissue laxity, and instabilityExcessive joint play and degeneration of the IVDAbnormal spinal alignment and positional loading of the cervical spineMay present with neck pain, radiculopathy, or no symptomsIncidence 5.2 to 11%Gender Ratio Male:Female is 1.5:1 in grade 1 and 2.2:1 in grade 2 spondylolisthesis.Age Predilection Increase in prevalence after 60 years33.3% of 20–59-years-olds; 66.7% of 60–99-years-oldsRisk Factors Increased age, sex, facet hypertrophy, cervical hypolordosis/kyphosis, anterior head translation, cervical spondylosis/degeneration, history of cervical spine surgeryAbnormal spinal alignmentCorrelation with cervicothoracic sagittal alignment factorsTreatment Spinal fusion surgery to stabilizeNon-surgical methods include active physical therapy, education or counseling for exercising, nonsteroidal anti-inflammatory drugs, homeopathic remedies, soft tissue massage, trigger point therapy, spinal mobilization techniques to restricted areas, cryotherapy, and chiropracticPrognosis Degenerative condition unless the spine is stabilizedFindings on Imaging Most common levels are C3–C4, C4–5, and C5–C6 followed by C6–C7Radiograph imaging shows extent of segmental translationMRI shows extent of soft tissue damageOpen in a separate windowWhen left untreated, DCS can lead to pain, radiculopathy, myelopathy and vertebral artery stenosis [1,5]. DCS is also an indicator of cervical vertebrae instability. This is associated with disc degeneration and facet joint arthropathy [8]. C3–C5 disc levels a
机译：颈椎椎间盘细节表明脊柱的不稳定性，可以导致疼痛，放射性，肌钙病和椎动脉狭窄。目前退行性颈椎椎间露是一种等待和观察条件，没有治疗指南。将提供文献审查和讨论。 8例颈部疼痛，残疾和机动车碰撞史上的女性。射线照相显示出异常的宫颈取向，脊柱狭窄和脊柱孔。 30次脊椎按摩术生物物理学后？患者报告了12周超过12周，报告症状和残疾改善。射线照片揭示了宫颈取向，脊柱孔和椎管直径的改善。机动车碰撞可能导致颈椎导致颈椎脊柱杆菌的不稳定性和异常对准。改善脊柱对准可能是有效的治疗，以减少椎体子晶和宫颈脊柱型，并且由于改善的脊柱取向而改善颈部残疾。关键词：脊椎按摩术，脊椎按摩术生物物理学，调整，CBP，脊柱不稳定性，颈椎椎间盘，宫颈脊柱，POSTURECASE SERIENTINTRODUCTIONSPONDYLTINSISIC指是下面椎骨上一个椎体的滑点。与腰椎相比，宫颈脊柱中被认为是罕见的，现在被认为是研究的病情[1]。这两种主要类型是先天性和获得的脊柱肌细胞。先天性脊柱型脊椎细节是由椎骨中的面关节形成的失败引起的，并且获得的脊间肌细胞是指由退化，创伤，病理学或手术引起的术中的缺陷[2]。退行性颈椎椎间露（DCS）分为3种不同类别，依赖于放射线照相特征，症状和形态。每种类型都有一个建议的外科手术。第1阶段具有疼痛和明显的面关节变性;外科建议包括单级椎间盘切除术，重新定位和融合。第2阶段患者将呈现出与小关节变性和椎体变性的无菌病或髓病变;外科建议包括多级别的椎间切除术，重新定位和融合。第3阶段患者被严重的肌钙病和脊柱畸形鉴定出来;手术建议包括核心术以及相邻段的融合[1,3,4]。截至2020年，没有目前的医疗指导。在患者的症状不断恶化时表明手术，并且有一种经过验证的不稳定性或脊髓压缩[5] .dcs患病率估计为5.2％至11％的人口，并且与更常见的腰椎脊椎细胞相比，被描述为5.2％。血对2级和2.2至1级中的血对女性比例为2.2至1级，在20至59岁的患病率为33.3％和66.7％后，60岁以下的患病率增加了60至99岁年龄[6]。症状患者的DCS被发现为1级和3级级别的16.4％（表2）。 DCS被以下标准进行分级和定义。 1级定义为2-3mm的位移，等级2被定义为位移大于3mm [1,7]。表2宫颈脊柱型术中矢状平面脊髓型脊椎细胞度概述椎骨相对于椎体术后重量分布，软组织松弛和不可能的颈部脊柱脊柱定位和定位载荷与颈部的颈椎脊柱脊柱定位和定位负荷疼痛，放射疗法，或没有症状5.2至11％的性别比例男性：女性为1.5：1，在2级和2.2：1的2级脊椎细胞凋亡。在20-59年的60年度33.3％后患病率增加普及 - 老人; 66.7％占60-99岁 - 年龄阶级的因素增加，性别，面部肥大，颈椎低位症，颈椎平衡，颈椎病翻译，颈椎脊柱脊柱术病史与宫颈癌术脊柱术脊柱腐败术治疗脊柱融合手术 - 狼人的方法包括活跃的物理治疗，教育或咨询，用于锻炼，非甾体抗炎药，顺势疗法，软组织按摩，脊柱动员技巧，脊髓调动技术，抑制区域，冷冻治疗和脊椎按术，除非脊柱是稳定的挑解成像最常见的含量是C3-C4，C4-5和C5-C6，然后是C6-C7，C5-C6，显示在分段换算的程度上显示出软组织的程度在单独的窗口中损伤的程度迫使留下未经处理的窗口，DC可以导致疼痛，放射性疗法，肌钙病变和椎动脉狭窄[1,5]。 DCS也是颈椎不稳定性的指标。这与盘变性和面关节病有关[8]。 C3-C5光盘水平A.

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