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<div class="noeditbox">Welcome to [[Vrije Universiteit Brussel Evidence-based Practice Project|Vrije Universiteit Brussel's Evidence-based Practice project]]. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div>
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'''Original Editors ''' - [[User:Gertjan Peeters|Gertjan Peeters ]]
'''Original Editors ''' - [[User:Gertjan Peeters|Gertjan Peeters ]]
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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== Search Strategy ==
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== Definition/Description <ref name="MacSween">MacSween R.N.M., Whaley K., Muir’s textbook of pathology – thirteenth edition, Edward Arnold, Great Britain, 1992, p. 853-854.</ref><ref>Benatar M., Neuromuscular Disease - Evidence and Analysis in Clinical Neurology, Humana Press Inc., Totowa, NJ, 2006, p. 61-78. (level: A1)</ref><ref>Macnab I. Cervical spondylosis. Clin Orthop Relat Res. 1975;(109):69-77. (Level: A1)</ref><ref>Emery SE. Cervical spondylotic myelopathy: diagnosis and treatment. J Am Acad Orthop Surg. Nov-Dec 2001;9(6):376-88. (Level: A1)</ref><ref name="update" /> ==
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First I’ve used Pubmed and PEDro, where I combined various terms – such as: cervical spondylosis, cervical disc degeneration, physical therapy, physiotherapy, treatment, … – to search articles on this topic. Through this way I’ve found some studies and reviews. Unfortunately the most of this studies and reviews are quite old. Therefore I decided to search more information about this topic in the medical library of the VUB and in another library. After a while I found some books with primarily medical information about this subject and some books about the physiotherapeutic options.<br>
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== Definition/Description <ref name="MacSween">MacSween R.N.M., Whaley K., Muir’s textbook of pathology – thirteenth edition, Edward Arnold, Great Britain, 1992, p. 853-854.</ref> <ref>Benatar M., Neuromuscular Disease - Evidence and Analysis in Clinical Neurology, Humana Press Inc., Totowa, NJ, 2006, p. 61-78. (level: A1)</ref>
<ref>Macnab I. Cervical spondylosis. Clin Orthop Relat Res. 1975;(109):69-77. (Level: A1)</ref>
<ref>Emery SE. Cervical spondylotic myelopathy: diagnosis and treatment. J Am Acad Orthop Surg. Nov-Dec 2001;9(6):376-88. (Level: A1)</ref>
<ref name="update" /> ==
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Cervical Spondylosis is a degenerative disorder at the level of the cervical spine. It can be described as the result of degeneration of the intervertebral discs or the corpus vertebrae in the cervical region. Possible characteristics are [[Degenerative Disc Disease|Degenerative_Disc_Disease]], the formation of osteophytes, facet and uncovertebral joint arthritis, ossification of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum, [[Spinal Stenosis|spinal stenosis]]. In some cases this degeneration also leads to a posterior protrusion of the annulus fibers of the intervertebral disc. This protrusion can cause compression of nerve roots, which in turn can lead to pain, motor disturbances such as muscle weakness, and sensory disturbances. As the spondylosis progresses there may be even interference with the blood supply to the spinal cord where the vertebral canal is narrowest.<br>
Cervical Spondylosis is a degenerative disorder at the level of the cervical spine. It can be described as the result of degeneration of the intervertebral discs or the corpus vertebrae in the cervical region. Possible characteristics are [[Degenerative Disc Disease|Degenerative_Disc_Disease]], the formation of osteophytes, facet and uncovertebral joint arthritis, ossification of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum, [[Spinal Stenosis|spinal stenosis]]. In some cases this degeneration also leads to a posterior protrusion of the annulus fibers of the intervertebral disc. This protrusion can cause compression of nerve roots, which in turn can lead to pain, motor disturbances such as muscle weakness, and sensory disturbances. As the spondylosis progresses there may be even interference with the blood supply to the spinal cord where the vertebral canal is narrowest.<br>
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*Metabolic diseases - [[Paget's Disease|Paget's disease]], [[Osteoporosis|osteoporosis]], [[Gout|gout]] or [[Gout / Pseudogout|pseudo-gout]]
*Metabolic diseases - [[Paget's Disease|Paget's disease]], [[Osteoporosis|osteoporosis]], [[Gout|gout]] or [[Gout / Pseudogout|pseudo-gout]]
*Infections - [[Osteomyelitis|osteomyelitis]] or [[Tuberculosis|tuberculosis]]
*Infections - [[Osteomyelitis|osteomyelitis]] or [[Tuberculosis|tuberculosis]]
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*Malignancy - primary tumours, secundary deposits or myeloma
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*Malignancy - primary tumours, secundary deposits or myeloma<br>
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== Diagnostic Procedures ==
== Diagnostic Procedures ==
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*vague numbness, tingling or weakness in upper limbs,
*vague numbness, tingling or weakness in upper limbs,
*dizzyness or vertigo,
*dizzyness or vertigo,
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*poor balance.
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*poor balance.<br>
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== Outcome Measures ==
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== Examination ==
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== Medical Management<ref name="Benatar">Benatar M., Neuromuscular Disease - Evidence and Analysis in Clinical Neurology, Humana Press Inc., Totowa, NJ, 2006, p. 61-78.</ref> <ref>Macnab I. Cervical spondylosis. Clin Orthop Relat Res. 1975;(109):69-77. (Level: A1)</ref><br> ==
== Medical Management<ref name="Benatar">Benatar M., Neuromuscular Disease - Evidence and Analysis in Clinical Neurology, Humana Press Inc., Totowa, NJ, 2006, p. 61-78.</ref> <ref>Macnab I. Cervical spondylosis. Clin Orthop Relat Res. 1975;(109):69-77. (Level: A1)</ref><br> ==
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3 Recent reviews<ref>Gross AR, Hoving JL, Haines TA, Goldsmith CH, Kay T, Aker P, Bronfort G. A Cochrane review of manipulation and mobilization for mechanical neck disorders. Spine (Phila Pa 1976). 2004 Jul 15;29(14):1541-8. (Level: A1)</ref><ref>Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J. 2004 May-Jun;4(3):335-56. (Level: A1)</ref><ref>Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S. Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl): S1 23-52. (Level: A1)</ref> reach similar conclusions. First they conclude that there is little evidence for using exercises alone or mobilization and/or manipulations alone as physical treatment. Then they also conclude that mobilization and/or manipulations in combination with exercises are effective for pain reduction and improvement in daily functioning in sub acute or chronic mechanical neck pain with or without headache. When they compare mobilization with manipulations, they concluded that there is no difference between both. The end conclusion of these reviews is that there is only for multimodal treatment (manual therapy in combination with exercises and education) enough evidence. Another study<ref>Swezey RL, Swezey AM, Warner K. Efficacy of home cervical traction therapy. Am J Phys Med Rehabil. Jan-Feb 1999;78(1):30-2. (Level: B)</ref> reported that cervical traction leads to symptomatic relief in 81% of the patients with cervical spondylosis.<br>
3 Recent reviews<ref>Gross AR, Hoving JL, Haines TA, Goldsmith CH, Kay T, Aker P, Bronfort G. A Cochrane review of manipulation and mobilization for mechanical neck disorders. Spine (Phila Pa 1976). 2004 Jul 15;29(14):1541-8. (Level: A1)</ref><ref>Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J. 2004 May-Jun;4(3):335-56. (Level: A1)</ref><ref>Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S. Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl): S1 23-52. (Level: A1)</ref> reach similar conclusions. First they conclude that there is little evidence for using exercises alone or mobilization and/or manipulations alone as physical treatment. Then they also conclude that mobilization and/or manipulations in combination with exercises are effective for pain reduction and improvement in daily functioning in sub acute or chronic mechanical neck pain with or without headache. When they compare mobilization with manipulations, they concluded that there is no difference between both. The end conclusion of these reviews is that there is only for multimodal treatment (manual therapy in combination with exercises and education) enough evidence. Another study<ref>Swezey RL, Swezey AM, Warner K. Efficacy of home cervical traction therapy. Am J Phys Med Rehabil. Jan-Feb 1999;78(1):30-2. (Level: B)</ref> reported that cervical traction leads to symptomatic relief in 81% of the patients with cervical spondylosis.<br>
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A 2011 study<ref>Aslan Telci E, Karaduman A. Effects of three different conservative treatments on pain, disability, quality of life, and mood in patients with cervical spondylosis. Rheumatol Int. 2011 Jan 19. (level B)</ref> on the effects of three different conservative treatments (active + passive physiotherapy methods, active treatment methods and medication-therapy) on pain, disability, quality of life, and mood in patients with cervical spondylosis reports that there was more improvement in the two groups receiving exercise treatment than the group receiving medical treatment, especially during long-term follow up.
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A 2011 study<ref>Aslan Telci E, Karaduman A. Effects of three different conservative treatments on pain, disability, quality of life, and mood in patients with cervical spondylosis. Rheumatol Int. 2011 Jan 19. (level B)</ref> on the effects of three different conservative treatments (active + passive physiotherapy methods, active treatment methods and medication-therapy) on pain, disability, quality of life, and mood in patients with cervical spondylosis reports that there was more improvement in the two groups receiving exercise treatment than the group receiving medical treatment, especially during long-term follow up.
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== Key Research ==
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])
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== Resources <br> ==
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== Clinical Bottom Line ==
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== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) ==
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see tutorial on [[Adding PubMed Feed|Adding PubMed Feed]]
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== References ==
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see [[Adding
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==
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[[Category:Vrije_Universiteit_Brussel_Project]][[Category:Cervical_Conditions]]
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[[Category:Vrije_Universiteit_Brussel_Project]] [[Category:Cervical_Conditions]]