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Evaluations and Treatment of the Cervical Spine, 2nd Edition: Summary
RECOMMENDED INTERVENTIONS BASED ON CPG CLASSIFICATIONS CPG Classification Intervention Neck Pain with Radiating Pain Acute: ○ Exercise for mobility and stability ○ Low-level laser therapy ○ Possible short-term collar use Chronic:
○ Therapeutic exercise for strength, endurance, and mobility ○ Mobilization and manipulation ○ Education to encourage participation in occupational and exercise activities ○ Intermittent traction
OTHER MEDICAL PROCEDURES
• Posterior cervical foraminotomy (PCF): Minimally invasive approach to treat radiculopathy due to bone spur and/or disc herniation, for example; patient is prone, and incision is on the posterior neck: ○ Foraminotomy: Removing bone; bone spurs; and, if necessary, the disc to create a larger opening of the foramen—the goal is to relieve pressure on the nerve root • Vertebroplasty and kyphoplasty: Minimally invasive surgical procedures; indicated for compression fractures of the vertebrae, whether traumatic or from chronic changes: ○ Osteoporosis, multiple myeloma (cancer of bone marrow), and tumor ○ Vertebroplasty: Bone cement injected into the compressed bone ○ Kyphoplasty: A balloon is first inserted to reshape the vertebrae prior to bone cement filling • Tumor Resection: ○ Cervical spine deformity is common postoperatively, especially in children and younger patients; radiation therapy can contribute to neuromuscular weakness ○ Facet resection is often required to access the tumor
Epidural Steroid Injections (ESI) • Targeted treatment for radicular pain • Corticosteroid placed directly into the intervertebral foramen near the cervical nerve root Anterior Cervical Discectomy and Fusion (ACDF) • Cervical disc is removed and replaced with an intervertebral cage to allow for proper spacing and vertebral alignment, along with anterior plates and fixed with screws; immobilization collar worn postoperatively • Indicative for patients with cervical degenerative disc disease, radiculopathy, and myelopathy • The segments above and below the fusion undergo a change in mechanical load and physiological demand over time and can be problematic in the future (adjacent segment disease [ASD]) • Cervical disc arthroplasty (CDA): Surgical removal of cervical disc with replacement of artificial disc • Cervical laminectomy: A surgical option to treat myelopathy or cervical stenosis; the patient is prone, and the lamina of the vertebrae, along with bone spurs or other compromised bone, is removed surgically; this relieves neural pressure that was previously present
WORKS CITED https://qr2.mobi/cervical-spine
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