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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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. 國家中醫藥管理局. 中醫病證診斷療效標準[M]. 南京:南京大學出版社, 1994:186.
4. 趙定麟. 頸椎病專題座談會紀要[J]. 中華外科雜志, 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. 王曉紅, 丁明甫, 何成奇, 等. 頸椎病頸椎功能評定表[J]. 華西醫學, 2003, 18(1):35-36.
10. 王為民, 唐臻一, 張君濤, 等. 神經根型頸椎病的牽引治療近況[J]. 中醫正骨, 2012, 4(4):68-70.
11. 景海龍, 王喜祥. 頸椎牽引配合手法整復治療神經根型頸椎病320例臨床觀察[J]. 中醫臨床研究, 2015(23):110-111.
12. 潘國昌. 頸椎牽引加運動療法治療神經根型頸椎病的療效觀察[J]. 現代診斷與治療, 2013(11):2438, 2467.
13. 潘峰, 蔡婷婷, 胡樂星. 推拿結合牽引治療神經根型頸椎病療效觀察[J]. 中醫臨床研究, 2015(4):49, 51.
14. 楊利學, 劉智斌, 祝海濱. 頸椎病角度牽引研究近況[J]. 中國中醫骨傷科雜志, 2006, 14(6):82-84.
15. 朱發寶, 張勛, 丁小飛. 兩種不同牽引角度對神經根型頸椎病牽引療效的影響[J]. 中醫臨床研究, 2014, 6(26):128-129.
16. 郭玉海, 林定坤, 孔暢, 等. 前屈位牽引治療神經根型頸椎病的臨床療效[J]. 廣東醫學, 2006, 27(1):66-67.
17. 汪芳俊, 魏威, 廖勝輝, 等. 前屈位不同角度牽引治療頸椎病的有限元分析[J]. 中國骨傷, 2014, 27(7):592-596.
18. 麻國堯, 汪芳俊, 魏威, 等. 不同角度牽引治療頸椎病的生物力學研究[J]. 中華全科醫學, 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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