Randomized Controlled study on Multi-method Evaluation of the Clinical Value of Supine Cervical Vertebra Traction with Neck Flexion in the Treatment of Cervical Spondylotic Radiculopathy_West China Medical Journal

Authors：

 WangYi , WeiHao , ZhouRui

Neck-shoulder and Lumbocrural Pain Division 2, Sichuan Orthopeadic Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

Keywords：

Cervical spondylotic radiculopathy; Supine vertebra traction with neck flexion; A variety of evaluations; Randomized controlled study

DOI：

10.7507/1002-0179.20160010

Video：

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Objective To probe into the clinical value of supine cervical vertebra traction with neck flexion in treating cervical spondylotic radiculopathy. Methods From August 2011 to December 2013, 71 patients were divided randomly into a treatment group of 36 cases and a control group of 35 cases. They were treated respectively with supine cervical vertebra traction with neck flexion, and cervical vertebra traction on a sitting position. Both groups had acupuncture, moxibustion, massage and medium frequency electrotherapy. The period of observation was 15 days. We evaluated the results by surveying physiological curvature of the cervical spine on lateral radiograph, and visual analogue scale (VAS), neck disability index (NDI), criteria of diagnosis and therapeutic effect of syndromes in traditional Chinese medicine syndrome and clinical assessment scale for cervical spondylosis (CASCS) were also used. Results Physiological curvature of cervical spine was much improved in both groups after treatment (P<0.05). The distance of cervical vertebra arc between vertebral anterior edge sequences in treatment group before treating was (4.07±3.63) mm and it was (9.03±4.31) mm after treatment. For the control group, those two numbers were respectively (4.13±3.02) and (8.87±3.97) mm. There was no significant difference in the distance of cervical vertebra arc and its increase between vertebral anterior edge between the two groups after treatment. There was significant difference in the efficiency rate between the two groups (P<0.05) (treatment group 100.00%, control group 97.14%). When cured rate and cured-markedly effective rate were added, the treatment group (80.56%) was much better than the control group (51.43%) (P<0.01). As to VAS score, NDI and CASCS scores, both groups got much better after treatment (P<0.01). For VAS, the treatment group decreased from 8.43±0.75 before treatment to 1.40±0.61 after treatment, while the control group from 8.35±0.78 before treatment to 2.55±0.59 after treatment. For NDI, the treatment group decreased from 54.13±7.44 before treatment to 10.78±4.55 after treatment, while the control group from 55.85±8.72 to 12.66±5.48. For CASCS, the treatment group rose from 34.88±5.39 before treatment to 74.65±6.73 after treatment, while the control group from 34.77±4.89 to 69.03±6.21. After treatment, VAS score of the treatment group was much lower than the control group (P<0.01). There was no difference between the two groups on NDI (P>0.05). CASCS score of the treatment group was significantly higher than the control group after the treatment (P<0.01). There was no significant difference in the increase of CASCS score between the two groups after treatment (P>0.05). Conclusion Vertebra traction combined with acupuncture, moxibustion, massage and medium frequency electrotherapy is therapeutic for cervical spondylotic radiculopathy and traction at a supine and flexing position is better.

Citation： WangYi, WeiHao, ZhouRui. Randomized Controlled study on Multi-method Evaluation of the Clinical Value of Supine Cervical Vertebra Traction with Neck Flexion in the Treatment of Cervical Spondylotic Radiculopathy. West China Medical Journal, 2016, 31(1): 37-42. doi: 10.7507/1002-0179.20160010 Copy

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15.	朱发宝, 张勋, 丁小飞. 两种不同牵引角度对神经根型颈椎病牵引疗效的影响[J]. 中医临床研究, 2014, 6(26):128-129.
16.	郭玉海, 林定坤, 孔畅, 等. 前屈位牵引治疗神经根型颈椎病的临床疗效[J]. 广东医学, 2006, 27(1):66-67.
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1. Macdermid JC, Stratford P. Applying evidence on outcome measures to hand therapy practice[J]. J Hand Ther, 2004, 17(2): 165-173.
2. Mokkink LB, Terwee CB, Patrick DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes[J]. J Clin Epidemiol, 2010, 63(7):737-745.
3. 国家中医药管理局. 中医病证诊断疗效标准[M]. 南京:南京大学出版社, 1994:186.
4. 赵定麟. 颈椎病专题座谈会纪要[J]. 中华外科杂志, 1985, 23(1):57.
5. Vernon H. The neck disability index:State-of-the-Art, 1991-2008[J]. J Manipulative Physiol Ther, 2008, 31(7):491-502.
6. Vos CJ, Verhagen AP, Koes BW. Reliability and responsiveness of the Dutch version of the Neck Disability Index in patients with acute neck pain in general practice[J]. Eur Spine J, 2006, 15(11):1729-1736.
7. Cook C, Richardson JK, Braga L, et al. Cross-cultural adaptation and validation of the Brazilian Portuguese version of the neck disability index and neck pain and disability scale[J]. Spine (Phila Pa 1976), 2006, 31(14):1621-1627.
8. Lee H, Nicholson LL, Adams RD, et al. Development and psychometric testing of Korean language versions of 4 neck pain and disability questionnaires[J]. Spine (Phila Pa 1976), 2006, 31(16):1841-1845.
9. 王晓红, 丁明甫, 何成奇, 等. 颈椎病颈椎功能评定表[J]. 华西医学, 2003, 18(1):35-36.
10. 王为民, 唐臻一, 张君涛, 等. 神经根型颈椎病的牵引治疗近况[J]. 中医正骨, 2012, 4(4):68-70.
11. 景海龙, 王喜祥. 颈椎牵引配合手法整复治疗神经根型颈椎病320例临床观察[J]. 中医临床研究, 2015(23):110-111.
12. 潘国昌. 颈椎牵引加运动疗法治疗神经根型颈椎病的疗效观察[J]. 现代诊断与治疗, 2013(11):2438, 2467.
13. 潘峰, 蔡婷婷, 胡乐星. 推拿结合牵引治疗神经根型颈椎病疗效观察[J]. 中医临床研究, 2015(4):49, 51.
14. 杨利学, 刘智斌, 祝海滨. 颈椎病角度牵引研究近况[J]. 中国中医骨伤科杂志, 2006, 14(6):82-84.
15. 朱发宝, 张勋, 丁小飞. 两种不同牵引角度对神经根型颈椎病牵引疗效的影响[J]. 中医临床研究, 2014, 6(26):128-129.
16. 郭玉海, 林定坤, 孔畅, 等. 前屈位牵引治疗神经根型颈椎病的临床疗效[J]. 广东医学, 2006, 27(1):66-67.
17. 汪芳俊, 魏威, 廖胜辉, 等. 前屈位不同角度牵引治疗颈椎病的有限元分析[J]. 中国骨伤, 2014, 27(7):592-596.
18. 麻国尧, 汪芳俊, 魏威, 等. 不同角度牵引治疗颈椎病的生物力学研究[J]. 中华全科医学, 2015, 13(8):1223-1225, 1261, 1385.

West China Medical Journal

Randomized Controlled study on Multi-method Evaluation of the Clinical Value of Supine Cervical Vertebra Traction with Neck Flexion in the Treatment of Cervical Spondylotic Radiculopathy

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