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Objective: On the basis of a brief description of the current research status of modern Chinese medicine on the name, etiology, pathogenesis and classification of cervical spondylotic radiculopathy, this paper summarizes the research progress of modern Chinese medicine treatment of cervical spondylotic radiculopathy from the perspective of modern Chinese medicine treatment. This article mainly summarizes the following aspects: modern Chinese medicine for internal and external use; Chinese medicine acupuncture with filiform needle, electro-acupuncture and warm moxibustion; Chinese medicine massage and acupoint therapy; moxibustion, cupping, scraping and other comprehensive treatment; and Chinese medicine comprehensive therapy. The purpose of this article is to provide references for modern Chinese medicine treatment of cervical spondylotic radiculopathy. [ABSTRACT FROM AUTHOR]

Purpose: We assess the application and advantages of modifying the trans-unco-discal (TUD) approach which we underwent for cervical myelo-radiculopathy. We present the surgical techniques of the modified TUD approach. Materials and Methods: The material was 180 cases where anterior cervical decompression (ACD) was performed by the modified TUD approach. We classified the material into four groups based on the location of the nerve root and/or spinal cord compression: I, compression of the root at intervertebral foramen (IVF); II, compression of the posterior margin of the vertebral body; III, compression of the IVF and posterior margin of the vertebral body; IV, compression of the bilateral IVF and posterior margin of the vertebral body. We applied the modified TUD approach to these four types. We present the surgical procedures and techniques for the modified TUD approach. The Japanese orthopedic association (JOA) score and neuroradiological alignment were examined. Results: The improvement rate of the JOA score was 78.4% at 6 months post-surgery and 77.5% in the most recent examinations. By the modified TUD approach, compressive lesions of the spinal cord and/or nerve roots were removed, and good alignment was acquired and sustained. Conclusions: ACD by the modified TUD approach safely achieved appropriate decompression for the spinal cord and/or nerve roots, and the patients had a high improvement rate and good alignment. Complications were less common than with other surgical procedures. If the TUD approach and endoscopic approaches can be combined, their application to new area is anticipated. [ABSTRACT FROM AUTHOR]

Objective: Previous studies have shown that cervical sagittal alignment is strongly associated with cervical deformity, myelopathy, and cervical adjacent‐segmental disease, and these cervical sagittal parameters are correlated with health‐related quality of life. However, less attention has been paid to cervical sagittal balance in various cervical disorders. This study aimed to compare cervical sagittal parameters between patients with nonspecific neck pain (NS‐NP) and patients with cervical spondylotic radiculopathy (CSR) and cervical spondylotic myelopathy (CSM). Methods: We retrospectively examined 236 patients from between January 2020 and October 2022. We divided them into three groups (NS‐NP, CSR, and CSM) and collected general information and cervical sagittal parameters for these patients. The variation of parameters between the size of these parameters and gender differences was analyzed. Pearson's or Spearman's correlation was applied to analyze the association of cervical sagittal parameters of all patients between the three groups. Results: There were significant differences in age and sex among the three groups (p < 0.001), with the NS‐NP group being the youngest and NS‐NP being more common in women. The parameters of cervical sagittal position significantly differed among the three groups (p < 0.05). Pearson's or Spearman's correlation result showed that the C2–C7 Cobb angle was negatively associated with the C2–C7 sagittal vertical angle (SVA), and the C2–C7 Cobb angle and T1 slope (T1s) were negatively associated with the spino‐cranial angle (SCA). There was a positive correlation between the C2–C7 Cobb angle and C7 slope (C7s), C2–C7 SVA and T1s, C2–C7 SVA and SCA, and C7s and T1s. Conclusion: This study showed that between the three groups, patients with nonspecific neck pain had smaller SCA, and among patients with NS‐NP, women had more significant SCA. The smaller anteroposterior diameter of the thorax in women might explain this difference. [ABSTRACT FROM AUTHOR]

To explore the efficacy and safety of ultrasound-guided injection acupotomy as a minimally invasive intervention treatment of cervical spondylotic radiculopathy (CSR). 160 CSR subjects were recruited who met the inclusion criteria in our hospital from October 2019 to December 2021. The subjects were randomly divided into the experimental and control group, with 80 cases in each. The experimental group received ultrasound-guided injection acupotomy as a minimally invasive intervention therapy. The control group received ultrasound-guided selective nerve root block (SNRB). The Odom's criteria clinical curative effect, visual analogue scale (VAS), neck disability index (NDI), and 36-Item Short Form Health Survey questionnaire (SF-36) were used to evaluate the outcome of subjects at several different points in time. At 30 min and 1 month after the end of treatment, there was no significant difference in any scores. However, after six months, the excellent and good rate was better in the experimental group compared to the control (RD = 0.175; 95% CI, 0.044–0.300, p = 0.009). The total effective rate was also better in the experimental group (RD = 0.126; 95% CI, 0.021–0.232, p = 0.018). In contrast, the VAS score (MD = −0.500; 95% CI, −1.000–0.000, p = 0.030) and NDI score (MD = −6.460; 95% CI, −11.067 to −1.852, p = 0.006) were lower in the experimental group compared to the control. The total SF-36 score was higher in the experimental group (MD = 7.568; 95% CI, 2.459–12.677, p = 0.004). Ultrasound-guided injection acupotomy minimally invasive interventional treatment of CSR has no significant difference in short-term curative effect compared with ultrasound-guided SNRB, but the data indicators are significantly better than the latter at 6 months after the end of the course of treatment, showing better long-term efficacy. [ABSTRACT FROM AUTHOR]

This paper summarized the nursing management of a case of cervical spondylotic radiculopathy treated with Traditional Chinese Medicine ointment. Based on nursing evaluation and syndrome differentiation, Traditional Chinese Medicine ointment and rubbing technique was used to relieve the symptoms of cervical spondylotic radiculopathy, and comprehensive nursing interventions such as daily living guidance and health education were carried to improve the quality of life during the treatment. (本文总结1例中药膏摩治疗项痹病(神经根型颈椎病)的护理体会。护理人员科学评估, 明确患者证型, 开展辨证施护, 采用中药膏摩技术治疗项痹病, 同时配合生活指导、健康教育等常规护理措施, 明显改善患者颈部疼痛的症状, 值得临床参考应用。)

Objective: The purpose of this study was to compare the clinical and radiological outcomes of unilateral biportal endoscopic (UBE) and percutaneous posterior endoscopic cervical discectomy (PE) keyhole surgeries. Methods: Patients diagnosed with cervical spondylotic radiculopathy (CSR) treated by UBE or PE keyhole surgery from May 2017 to April 2020 were retrospectively analyzed. The length of incision, fluoroscopic time, postoperative hospital stay, and total cost were compared. The clinical efficacy was assessed using a visual analog scale (VAS), neck disability index (NDI), and modified MacNab criteria. Moreover, the C2-7 Cobb's angle, range of motion (ROM), intervertebral height, vertebral horizontal displacement, and angular displacement of the surgical segment were measured. Results: A total of 154 patients were enrolled, including 89 patients in the UBE group and 65 patients in the PE group, with a follow-up period of 24–32 months. Compared with PE surgery, UBE surgery required shorter fluoroscopic times (6.76 ± 1.09 vs. 8.31 ± 1.10 s) and operation times (77.48 ± 17.37 vs. 84.92 ± 21.97 min) but led to higher total hospitalization costs and longer incisions. No significant differences were observed in the postoperative hospital stay, bleeding volume, VAS score, NDI score, effective rate, or complication rate between the UBE and PE groups. Both the C2-7 Cobb's angle and ROM increased significantly after surgery, with no significant differences between groups. There were no significant differences between intervertebral height, vertebral horizontal displacement, and angular displacement of the surgical segment at different times. Conclusions: Both UBE and PE surgeries in the treatment of CSR were effective and similar after 24 months. The fluoroscopic and operation times of UBE were shorter than those of PE. [ABSTRACT FROM AUTHOR]

Objective: (1) To evaluate the effects of surgery and conservative treatments for cervical spondylotic radiculopathy and (2) provide reference for choosing the time and method of treatment. Methods: A literature search was performed using PubMed, EMbase, The Cochrane Library, Web of Science, and ClinicalTrials from inception to September 2021. Randomized controlled trials (RCTs) on the use of surgery or conservative Treatments in Cervical Spondylotic Radiculopathy (CSR) were selected. The primary outcomes were the neck and arm visual analog scale (VAS) and Neck Disability Index (NDI). Secondary outcomes included active range of cervical motion (ROM) and Mental Health. Two reviewers proceeded study selection and quality assessment. Results: A total of 6 studies, which comprised a total of 464 participants were included in the final meta-analysis. Compared with conservative treatment, surgical treatment was more effective in lowering Neck-VAS (<3 m: MD = −29.44, 95% CI = (–41.62,–17.27), P <.00001; 3–6 M: MD = −20.97, 95% CI = (–26.36,–15.57), P <.00001; 6 M: MD = −13.40, 95% CI = (–19.39, −7.41), P<.0001; 12 M: MD=−15.53, 95% CI=(-28.38, −2.68), P=.02), Arm-VAS(<3 m: MD = −33.52, 95% CI = (–39.89, −27.16), P <.00001; 3-6 M: MD = −20.97, 95% CI = (–26.36, −15.57), P <.00001; 6 M: MD = −17.52, 95% CI=(–23.94, −11.11), P <.0001; 12 M: MD = −21.91, 95% CI=(–27.09, −16.72), P <.00001) and NDI (<3 m: MD = −8.89, 95% CI = (–11.17, −6.61), P <.00001; 6 M: MD = −5.14, 95% CI = (–7.60, −2.69), P <.0001). No significant difference was observed in NDI at 12-month time point (MD = −5.17, 95% CI = (–12.33, 2.00), P =.16), ROM(MD = 2.91, 95% CI = (–4.51, 10.33), P =.77) and Mental Health (MD =.05, 95% CI=(–.24,.33), P =.74). Conclusion: The 6 included studies that had low risk of bias, providing high-quality evidence for the surgical efficacy of CSR. The evidence indicates that surgical treatment is better than conservative treatment in terms of VAS score and NDI score, and superior to conservative treatment in less than one year. There was no evidence of a difference between surgical and conservative care in ROM and mental health. A small sample study with a follow-up of 5 to 8 years showed that surgical treatment was still better than conservative treatment, but the sample size was small and the results should be carefully interpreted. Compared with conservative treatment, surgical treatment had a faster onset of response, especially in pain relief, but did not have a significant advantage in range of motion or NDI. This seems to mean that for patients with severe or even unbearable pain, the benefits of surgery as soon as possible will be significant. Although it is not clear whether the short-term risks of surgery are outweighed by the long-term benefits, rapid pain relief is necessary. Conservative treatment (including medical exercise therapy, mechanical cervical tractions, transcutaneous electrical nerve stimulation, pain management education, and cervical collar) once or twice a week for 3 months is beneficial in the long term and avoids the risks of surgery. In consideration of the good natural history of CSR and the relatively good outcome of conservative treatment (although symptom relief is slow), we think that surgery is not necessary for patients who do not need rapid pain relief. [ABSTRACT FROM AUTHOR]

This paper summarized the nursing strategies for a patient with cervical spondylotic radiculopathy with superficies excess syndrome of cold pathogen of Taiyang treated by five-element cupping therapy. In addition to psychological nursing and dietary care, the five-element cupping therapy based on Traditional Chinese Medicine syndrome differentiation was carried out to relieve the symptoms of cervical spondylotic radiculopathy. (总结1例项痹太阳伤寒表实证患者受寒后采用五行能量罐的治疗护理经验。护理人员在心理、饮食等常规护理干预的基础上, 通过中医辨证理论指导, 取督脉、足太阳膀胱经、足少阳胆经之经络, 运用五行能量罐循经治疗, 以减轻患者背部发凉怕冷症状。)

Purpose: It has been reported that C7 and C8 nerve root impairment can cause drop finger; however, the clinical characteristics of each injured nerve root and post-operative outcomes remain unclear. This study aimed to investigate the detailed features and surgery-related prognostic factors of drop finger caused by cervical radiculopathy. Methods: We retrospectively investigated the clinical characteristics, paralysis patterns and surgery-related prognostic factors of 23 patients with drop finger caused by cervical radiculopathy who underwent posterior cervical foraminotomy. We classified paralysis into three patterns based on the fingers predominantly exhibiting extensor digitorum communis (EDC) muscle weakness: index finger side-dominant, middle and ring fingers-dominant and little finger side-dominant. Results: The aetiologies were cervical disc hernia (CDH) in ten patients, cervical spondylotic radiculopathy (CSR) in eight and both CDH and CSR in five. The levels of the decompressed root were C7 in one patient, C8 in 11 and both C7 and C8 in 11. Scapular pain was frequently observed as the initial symptom (78%), especially in patients with only C8 nerve root disorder (91%). Drop finger recovered to a score of ≥ 3 on manual muscle testing in 17 patients; patients with the little finger side-dominant pattern tended to have poor recoveries. Patients with CDH improved significantly than those with CSR or both CDH and CSR (p < 0.05). Conclusions: Good surgical recovery of drop finger can be expected in patients with CDH and in those with index fingers-dominant and middle and ring fingers-dominant patterns. [ABSTRACT FROM AUTHOR]

Purpose: To identify the changes of intrinsic brain activity and regional cerebral blood flow in patients with chronic neck and shoulder pain (CNSP) by using amplitude of low-frequency fluctuation (ALFF) analysis and arterial spin labelling study. Material and methods: In total, 28 CNSP patients and 25 age-matched and sex-matched healthy controls (HCs) participated in the study. Resting-state functional magnetic resonance imaging (rs-fMRI) and arterial spin labelling (ASL) MRI were acquired. Correlations between ALFF and cerebral blood flow (CBF) were analysed. Subsequently, the differences in ALFF and CBF were compared in the two groups. Finally, the visual analogue scale (VAS) was also assessed in the CNSP group. Results: Compared with HCs, CNSP patients showed significantly abnormal ALFF and CBF in several brain regions, including the cerebellum posterior lobe, middle orbitofrontal gyrus, medial superior frontal gyrus, middle temporal gyrus, precuneus, cingulate gyrus, middle occipital gyrus, middle frontal gyrus, postcentral gyrus, precentral gyrus, and superior parietal gyrus. Correlation analysis showed that the ALFF value of the medial superior frontal gyrus positively correlated with the VAS score. However, no correlation was found between the CBF values and the VAS score. Conclusions: The altered ALFF and CBF values in CNSP patients were observed in different pain-related brain regions that were involved in pain modulation and perception. The combination of rs-fMRI and ASL MRI might provide complementary information for increasing our understanding of the neuropathology in CNSP. [ABSTRACT FROM AUTHOR]

A retrospective study of operative results after a minimum follow-up period of five years was carried out in a series of 34 patients operated upon for cervical spondylotic myelopathy (CSM). In all the cases, myelography showed involvement of two or more intervertebral spaces. Constitutional spinal canal narrowing was not present, and only one operation was performed in each patient. Of the 34 patients, 16 also had symptoms of cervical spondylotic radiculopathy (CSR). Seventy-four percent of the patients thought that operation resulted in overall improvement of the preoperative clinical picture. This subjective improvement was similar whether the operative procedure consisted of anterior intersomatic fusion or of laminectomy. Amelioration of CSM symptoms occurred in only 8 of the 20 patients subjected to anterior fusion (40%), in contrast to 10 of the 14 patients subjected to laminectomy (71%). In the 16 patients with CSR symptoms associated with CSM, amelioration of CSR symptoms occurred in 6 of the 11 patients subjected to anterior fusion (55%), and in 4 of the 5 patients subjected to laminectomy (80%). It is suggested that laminectomy offers the best results for CSM, associated or not with CSR, when two or more intervertebral spaces are affected. [ABSTRACT FROM AUTHOR]