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The Frequency of Symptoms in Patients With a Diagnosis of Degenerative Cervical Myelopathy: Results of a Scoping Review
(2023)
Zhilin Jiang
;
Benjamin Davies
;
Carl Zipser
;
Konstantinos Margetis
;
Allan Martin
<jats:sec><jats:title>Study Design</jats:title><jats:p> Delayed diagnosis of degenerative cervical myelopathy (DCM) is associated with reduced quality of life and greater disability. Developing diagnostic criteria for DCM has been identified as a top research priority. </jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p> This scoping review aims to address the following questions: What is the diagnostic accuracy and frequency of clinical symptoms in patients with DCM? </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A scoping review was conducted using a database of all primary DCM studies published between 2005 and 2020. Studies were included if they (i) assessed the diagnostic accuracy of a symptom using an appropriate control group or (ii) reported the frequency of a symptom in a cohort of DCM patients. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> This review identified three studies that discussed the diagnostic accuracy of various symptoms and included a control group. An additional 58 reported on the frequency of symptoms in a cohort of patients with DCM. The most frequent and sensitive symptoms in DCM include unspecified paresthesias (86%), hand numbness (82%) and hand paresthesias (79%). Neck and/or shoulder pain was present in 51% of patients with DCM, whereas a minority had back (19%) or lower extremity pain (10%). Bladder dysfunction was uncommon (38%) although more frequent than bowel (23%) and sexual impairment (4%). Gait impairment is also commonly seen in patients with DCM (72%). </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Patients with DCM present with many different symptoms, most commonly sensorimotor impairment of the upper extremities, pain, bladder dysfunction and gait disturbance. If patients present with a combination of these symptoms, further neuroimaging is indicated to confirm the diagnosis of DCM. </jats:p></jats:sec>
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The value of Clinical signs in the diagnosis of Degenerative Cervical Myelopathy - A Systematic review and Meta-analysis
(2023)
Zhilin Jiang
;
Benjamin Davies
;
Carl Zipser
;
Konstantinos Margetis
;
Allan Martin
<jats:sec><jats:title>Study Design</jats:title><jats:p> Delayed diagnosis of degenerative cervical myelopathy (DCM) is likely due to a combination of its subtle symptoms, incomplete neurological assessments by clinicians and a lack of public and professional awareness. Diagnostic criteria for DCM will likely facilitate earlier referral for definitive management. </jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p> This systematic review aims to determine (i) the diagnostic accuracy of various clinical signs and (ii) the association between clinical signs and disease severity in DCM? </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A search was performed to identify studies on adult patients that evaluated the diagnostic accuracy of a clinical sign used for diagnosing DCM. Studies were also included if they assessed the association between the presence of a clinical sign and disease severity. The QUADAS-2 tool was used to evaluate the risk of bias of individual studies. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> This review identified eleven studies that used a control group to evaluate the diagnostic accuracy of various signs. An additional 61 articles reported on the frequency of clinical signs in a cohort of DCM patients. The most sensitive clinical tests for diagnosing DCM were the Tromner and hyperreflexia, whereas the most specific tests were the Babinski, Tromner, clonus and inverted supinator sign. Five studies evaluated the association between the presence of various clinical signs and disease severity. There was no definite association between Hoffmann sign, Babinski sign or hyperreflexia and disease severity. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> The presence of clinical signs suggesting spinal cord compression should encourage health care professionals to pursue further investigation, such as neuroimaging to either confirm or refute a diagnosis of DCM. </jats:p></jats:sec>
3Scopus© Citations 37
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Multisensory contribution in visuospatial orientation: an interaction between neck and trunk proprioception
(2021)
Jason McCarthy
;
CASTRO ABARCA, PATRICIA BERNARDITA
;
Rachael Cottier
;
Joseph Buttell
;
Qadeer Arshad
<jats:title>Abstract</jats:title><jats:p>A coherent perception of spatial orientation is key in maintaining postural control. To achieve this the brain must access sensory inputs encoding both the body and the head position and integrate them with incoming visual information. Here we isolated the contribution of proprioception to verticality perception and further investigated whether changing the body position without moving the head can modulate visual dependence—the extent to which an individual relies on visual cues for spatial orientation. Spatial orientation was measured in ten healthy individuals [6 female; 25–47 years (SD 7.8 years)] using a virtual reality based subjective visual vertical (SVV) task. Individuals aligned an arrow to their perceived gravitational vertical, initially against a static black background (10 trials), and then in other conditions with clockwise and counterclockwise background rotations (each 10 trials). In all conditions, subjects were seated first in the upright position, then with trunk tilted 20° to the right, followed by 20° to the left while the head was always aligned vertically. The SVV error was modulated by the trunk position, and it was greater when the trunk was tilted to the left compared to right or upright trunk positions (<jats:italic>p</jats:italic> < 0.001). Likewise, background rotation had an effect on SVV errors as these were greater with counterclockwise visual rotation compared to static background and clockwise roll motion (<jats:italic>p</jats:italic> < 0.001). Our results show that the interaction between neck and trunk proprioception can modulate how visual inputs affect spatial orientation.</jats:p>
5Scopus© Citations 9
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Traumatic cervical spine injury due to pole dance accident: A potentially catastrophic unreported injury with a happy ending. Case report and literature review
(2022)
YURAC BARRIENTOS, RATKO JOVAN
;
ZAMORANO PÉREZ, JUAN JOSÉ
;
Andrea Marre
;
Cristian Diaz
<jats:sec id="st1"> <jats:title>Background: </jats:title> <jats:p>Pole dancing is a sport that has become very popular. However, there is scarce literature on injuries associated with this sport. Here, we present a 23-year-old female who sustained a traumatic C4-C5 vertex cervical spine injury caused by a fall of 1 m while practicing pole dancing in an inverted position, requiring a 360 decompression/fusion.</jats:p> </jats:sec> <jats:sec id="st2"> <jats:title>Case Description: </jats:title> <jats:p>A 23-year-old female sustained a 1 m fall in an inverted position while pole dancing resulting in a direct axial impact to the head. She developed the rapid onset of quadriparesis that was attributed to the emergent CT/MR-documented cervical flexodisruptive luxofracture (AOSpine C4-C5 fracture: C, F4 unilateral, N3, M2). Four hours post injury, she underwent a C4-C5 anterior cervical discectomy and fusion. Four days later, a posterior fusion was performed to add to the stabilization. Six years later, the patient remains neurologically intact.</jats:p> </jats:sec> <jats:sec id="st3"> <jats:title>Conclusion: </jats:title> <jats:p>Pole dance is an emerging sport which carries a risk of cervical spine injury.</jats:p> </jats:sec>
1Scopus© Citations 1

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