Clinical Characteristics of Patients With Psoriatic Spondylitis Versus Those With Ankylosing Spondylitis: Features at Baseline Before Biologic Therapy.

BACKGROUND: Clinical characteristics and manifestations of psoriatic arthritis (PsA) have been extensively studied in western countries, yet data of Korean patients with PsA are very limited. We aimed to investigate the clinical traits of patients with PsA and dissect the characteristics of those with axial involvement. METHODS: In this observational study, we analyzed clinical data of 109 patients with PsA who were enrolled in the Korean College of Rheumatology Biologics and Targeted Therapy registry between December 2012 and March 2022 at the time point of initiating or switching to a biologic agent. Data from 2,221 patients with ankylosing spondylitis (AS) registered during the same period were also analyzed. We divided patients with PsA into patients with or without axial involvement and then added AS patients with psoriasis (total three subgroups) for comparative analyses. RESULTS: Asymmetric oligoarthritis was the most common clinical manifestation in patients with PsA, followed by symmetric polyarthritis and spondylitis. Our analysis indicated that methotrexate and sulfasalazine were the two most prescribed disease-modifying antirheumatic drugs for patients with PsA before starting biologic therapy. The patients with psoriatic spondylitis had more peripheral joint involvement (P = 0.016), less prior uveitis (P < 0.001), and lower human leukocyte antigen B27 (HLA-B27) positivity (P < 0.001) than the AS patients with psoriasis. Furthermore, syndesmophytes and radiographic sacroiliitis were prevalent among patients with PsA and AS patients with psoriasis who had the HLA-B27 gene. CONCLUSION: Our study shows that the degree of peripheral arthritis is less severe in Korean patients with PsA who require biologics and reestablishes that psoriatic spondylitis is a common and important clinical pattern in Korean patients with PsA. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01965132.

Tubercular Spondylitis: A Rare Complication of BCGosis Masquerading as Metastasis on 18F-PSMA-1007 PET/CT.

ABSTRACT: BCGosis is a rare complication of intravesical BCG immunotherapy as adjuvant therapy for urinary bladder cancer manifesting in the form of disseminated tuberculosis or organ-specific tuberculosis, rarely involving the vertebra. PSMA is overexpressed in prostate cancer but also expressed in a variety of benign and malignant conditions. We present a patient with incidental detection of abnormal uptake in a vertebral lesion during assessment of prostate cancer with 18F-PSMA PET/CT, subsequently proven to be vertebral osteitis, likely due to BCG immunotherapy. The case highlights the role of interdisciplinary patient assessment to confirm nature of abnormal foci on 18F-PSMA PET/CT.

Three Cases of Brucellar Spondylitis with Noncontiguous Multifocal Involvement.

BACKGROUND: Brucellosis is an endemic disease. Brucellar spondylitis is mainly manifested as a unifocal lesion, but noncontiguous multifocal brucellar spondylitis is more rare. CASE DESCRIPTION: Herein, we report 3 patients with noncontiguous multifocal involvement of brucellar spondylitis who are over 51 years of age. The diagnosis was established by using magnetic resonance imaging (MRI) and positive brucellar agglutination test. All patients were cured with antibrucellosis chemotherapy and surgery. For patients with a high degree of suspicion of noncontiguous multifocal brucellar spondylitis, especially elderly patients, screening with the use of serologic test for brucellosis and whole spine MRI is crucial to reduce the rate of misdiagnosis and missed diagnosis. CONCLUSIONS: Clinicians should raise awareness of noncontiguous multifocal brucellar spondylitis. The Wright agglutination test and whole spine MRI are the key methods to reduce misdiagnosis and missed diagnosis of noncontiguous multifocal brucellar spondylitis. Drug therapy for brucellar spondylitis is the basis, and surgical treatment is complementary therapy. The use of alternative chemotherapy and surgery for noncontiguous multifocal brucellar spondylitis is also safe and effective.

Successive complications after anterior cervical fixation: pharyngoesophageal diverticulum, fistulization, and cervical spondylitis by Streptococcus milleri - case report and literature review.

INTRODUCTION: Pharyngoesophageal diverticulum is an uncommon complication after anterior cervical discectomy and fusion surgery. CASE PRESENTATION: Our patient was a 48-year-old woman with two previous cervical surgeries with fixation of C4-C5 and C5-C6, the last one in 2003. Two years after surgery, she presented with arthralgia, arthritis, chills, and fluctuating rash. In 2007, she presented with dysphagia, halitosis, and sputum production. She was diagnosed with a pharyngoesophageal diverticulum with a fistula to C6 vertebra and secondary spondylitis. She was taken for open surgery with removal of screws and plates, cricopharyngeal myotomy, and esophageal repair. Streptococcus milleri grew in tissue and osteosynthetic material. She received 4 months of amoxicillin and probenecid and had a complete recovery. Since 1991, 19 similar cases have been reported with one fatality. To our knowledge, this is the first reported case of diverticulum complicated with fistula and secondary spondylitis. CONCLUSIONS: In patients with a history of anterior cervical discectomy and fusion complaining of dysphagia, even years after surgery, it is mandatory to perform an esophagogram. This symptom was referred to in 88% of the cases reported in the literature.

[Effects of serial mud baths on inflammatory rheumatic and degenerative diseases]. / Wirkeffekte serieller Heiltorfbäder bei entzündlich-rheumatischen und degenerativen Erkrankungen.

BACKGROUND: Mud baths have been used for a long time for the treatment of musculoskeletal diseases. In addition to a reduction of pain and improved function, serially applied mud baths lead to a reduction in the inflammatory processes, which often underlie degenerative and inflammatory rheumatic diseases. OBJECTIVE: This study investigated the effects of serial mud baths on parameters of functional health, on pain perception and at the molecular level in patients with inflammatory rheumatic diseases, e.g. rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and degenerative alterations, e.g. gonarthritis and/or coxarthritis. MATERIAL AND METHODS: A total of 41 patients with inflammatory rheumatic (33 RA and 8 AS) and 40 patients with degenerative diseases were subdived into 2 groups by computer-assisted randomization. In each group a subgroup received 9 serial mud baths within 21 days in addition to a multimodal physical rehabilitative complex treatment (intervention groups). In the other subgroups only the physical rehabilitative treatment was carried out and no mud baths were administered (control group). The outcome parameters were assessment of the functional capacity and pain perception (HAQ, FFbH, VAS and WOMAC), diesease activity (DAS28 and BASDAI) as well as laboratory markers of inflammatory activity (CRP, BSG, IL-1 beta and IL-10) and the patient assessment. RESULTS: In the intervention groups after serial mud baths there was a significant improvement in the functional parameters (HAQ and FFbH, both p < 0.01) and a significant reduction in pain strength (VAS, p < 0.01) persisting for 3 months after the end of treatment. A significant reduction in disease activity (RA in DAS28 and AS in BASDAI) could be shown for the intervention groups as well as the control groups, whereby the effect strength was more pronounced in the intervention groups. In patients with gonarthritis and/or coxarthritis a significant improvement in functional limitations (WOMAC, p < 0.01) was only found in the intervention groups. A significant improvement in the proinflammatory cytokine IL-1 beta (p < 0.01) was only found in the intervention groups with a simultaneous increase in the anti-inflammatory cytokine IL-10 (p < 0.01). The CRP and BSG remained within the normal range and showed no significant changes even after serial mud baths. CONCLUSION: Mud baths applied within the framework of a physical rehabilitative complex treatment brought about an improvement of parameters of functional health for both inflammatory rheumatic and degenerative diseases. Effects at the molecular level were induced, which are possibly accompanied by osteoprotective and chondroprotective effects.

Surgical treatment of spondylitis and diaphragm relaxation in patient less than 1 year old.

DESIGN: Case report. INTRODUCTION: The combination of severe post-infectious kyphosis and diaphragm relaxation is extremely rare in patient early than 1 year old. Its no publications concerning their simultaneous surgical treatment. CASE DESCRIPTION: 7-Month-old girl had simultaneous spinal reconstruction with anterior and posterior instrumentation and plastic of diaphragm because of sequelae of non-granulenatous spondylitis complicated by severe kyphosis (54°) and diaphragm relaxation. Between 1.5 and 3 months of live she had several infections incl. pneumonia, enterocolitis, ENT infection. Anterior fusion was done by titanium mesh with auto-rib, posterior - by compressive rods based on low-profile hooks. The deformity was reduced till 20°. 2.5 years after initial surgery and 1 year after removal of posterior instrumentation the adequate level of diaphragm and minimal (4°) loss of kyphosis correction were identified. CONCLUSIONS: The combination of spondylitis and diaphragm relaxation in early aged patient could be explained but it could not be confirmed as a sequelae of late-onset neonatal sepsis with a multi-focal lesions. The simultaneous surgery provided on the combined approaches (trans-thoracic and posterior) looks as optimal options in such combination of pathologies. In remains controversial how will the spine develop after so early reconstructive surgery, including in situ stable anterior fusion carried out by titanium mesh with auto-rib.

The First Case of Concurrent Infective Endocarditis and Spondylitis Caused by Streptococcus tigurinus

No abstract available.

Spondylitis with an Epidural Abscess due to Mycobacterium fortuitum: A Case Report / 대한내과학회지

Mycobacterium fortuitum is a rapidly growing mycobacteria that causes skin and soft tissue infection, pulmonary infection, and occasionally disseminated disease in severely immunocompromised patients. While three cases of spondylitis caused by M. fortuitum have been reported, no case has been reported in Korea. We describe the first reported case of M. fortuitum spondylitis and an epidural abscess after lumbar acupuncture, and a surgical procedure to treat spinal stenosis.

Use of linezolid to treat MRSP bacteremia and discospondylitis in a dog.

A 1.5 yr old male German shepherd dog was evaluated for recurrent intermittent episodes of fever and lethargy. Clinicopathologic abnormalities were suggestive of a discospondylitis at the seventh and eighth thoracic vertebrae. Blood and urine cultures yielded growth of methicillin-resistant Staphylococcus pseudintermedius (MRSP) that was resistant to all commonly used antibiotics. Extralabel antibiotic susceptibility testing demonstrated susceptibility of both blood and urine isolates to linezolid. The prescribed dose was extrapolated from pharmacokinetic (PK) studies and the isolate's plasma minimum inhibitory concentration (MIC). Linezolid was administered for 23 wk and resulted in successful resolution of bacteremia, bacteriuria, and discospondylitis. When justified, linezolid should be considered to treat methicillin-resistant infections.

Vertebral Osteomyelitis caused by Burkholderia cepacia in an Immunocompetent Elderly Patient After Acupuncture

Burkholderia cepacia is an important nosocomial pathogen in hospitalized patients, particularly those with prior antimicrobial therapy. B. cepacia causes various clinically significant infections such as bacteremia, pneumonia, and urinary tract and surgical site infections. However, osteomyelitis caused by B. cepacia is very rare. We present a case of B. cepacia vertebral osteomyelitis with review of the literature.

Percutaneous Drainage Combined with Hyperbaric Oxygen Therapy for Pyogenic Spondylitis with Iliopsoas Abscess

STUDY DESIGN: A retrospective study. PURPOSE: The purpose of this study was to evaluate outcomes in patients with pyogenic spondylitis accompanied by iliopsoas abscess who were treated by percutaneous drainage combined with hyperbaric oxygen (HBO) therapy. OVERVIEW OF LITERATURE: To the best of our knowledge, there have been no previous reports of the use of percutaneous drainage combined with HBO therapy for the treatment of this condition. METHODS: Twenty-three patients (13 men, 10 women; mean age, 69.0 years; range, 45-85 years) were treated with percutaneous drainage combined with HBO therapy in addition to commonly used conservative therapy. Mean follow-up duration was 27.7 months (range, 12-48 months). Clinical outcomes and imaging examinations were retrospectively investigated. RESULTS: Symptoms such as low back pain, radicular pain, and hip pain resolved in all patients immediately after treatment. Mean time from the start of treatment to the return of C-reactive protein levels to normal or baseline values recorded before the onset of spondylitis was 28.3 days (range, 8-56 days). In the final set of follow-up radiographic studies, all patients were free from progressive destructive changes. Follow-up magnetic resonance images or computed tomography with contrast enhancement confirmed the disappearance or near-total resolution of the iliopsoas abscess cavity with healing of the pyogenic spondylitis in all 23 patients. No recurrences were observed during follow-up. CONCLUSIONS: The present study suggests that patients with pyogenic spondylitis accompanied by iliopsoas abscess can be cured without a prolonged period of therapy or recurrence using this treatment.

Prevalencia de brucelosis en columna: Evolución clínica y manejo quirúrgico / Prevalência de brucelose na coluna vertebral: Evolução clínica e conduta cirúrgica / Prevalence of brucellosis in the spine: Clinical course and surgical management

OBJETIVO: Conocer la prevalencia, características clínicas y de tratamiento de la espondilodiscitis por Brucella. MÉTODOS: Un total de 104 pacientes con diagnóstico de espondilitis espinal de los cuales 20 correspondieron a espondilitis por Brucella, tratados de forma conservadora con antibióticos o quirúrgicamente, mediante descompresión y estabilización de la columna en cualquier segmento, en el periodo comprendido entre Enero 2006 a Junio 2011. Se elaboró una hoja de captura para recolección de la información, la cual contenía la identificación del paciente, síntomas referidos, signos físicos, parámetros laboratoriales y tratamiento médico y quirúrgico. RESULTADOS: Trece pacientes del sexo masculino y 7 del sexo femenino, con edad promedio de 59,2 años y desviación estándar de 13,6 años. Tres pacientes tenían afectación del segmento torácico, 13 del segmento lumbar y 4 del segmento lumbo-sacro. Trece pacientes presentaron fiebre, el dolor lumbar se presentó en los 20 pacientes, parestesias en 12, debilidad en 9, artralgias, mialgias y anorexia en 5, radiculopatía en 13, cefalea en 1 y pérdida de peso en 5 pacientes. Veinte casos recibieron tratamiento médico con doxiciclina combinada con rifampicina. En 8 casos se realizó instrumentación posterior combinada con laminectomía y fusión póstero-lateral, en 2 se realizó instrumentación posterior combinada con discectomía del nivel afectado y fusión póstero-lateral y en 1 caso se realizó laminectomía combinada con discectomía y fusión. CONCLUSIÓN: La prevalencia de espondilodiscitis fue del 19,2%, siendo el dolor lumbar y la fiebre síntomas con alto índice de sospecha de espondilitis espinal. La descompresión combinada con estabilización y fusión es el tratamiento quirúrgico de elección.

OBJETIVO: Conhecer a prevalência, as características clínicas e de tratamento da espondilodiscite por Brucella. MÉTODOS: Um total de 104 pacientes com diagnóstico de espondilite espinal, dos quais 20 corresponderam a espondilite por Brucella, tratados de forma conservadora com antibióticos ou cirurgicamente, por descompressão e estabilização da coluna em qualquer segmento, no período de janeiro de 2006 a junho de 2011. Foi elaborado um formulário de dados para coleta das informações, contendo identificação do paciente, sintomas relatados, sinais físicos, parâmetros laboratoriais e tratamento médico e cirúrgico. RESULTADOS: Treze pacientes do sexo masculino e 7 do sexo feminino, com média de idade de 59,2 anos e desvio padrão de 13,6 anos. Três pacientes foram acometidos no segmento torácico, 13 no segmento lombar e 4 no segmento lombossacral. Treze pacientes tiveram febre, a dor lombar estava presente nos 20 pacientes, parestesias em 12, debilidade em 9, artralgias, mialgias e anorexia em 5, radiculopatia em 13, cefaleia em um e perda de peso em 5 pacientes. Vinte casos receberam tratamento clínico com doxiciclina combinada com rifampicina. Em 8 casos, realizou-se instrumentação posterior combinada com laminectomia e fusão póstero-lateral, em 2 realizou-se instrumentação posterior combinada com discectomia do nível afetado e fusão póstero-lateral e em um caso, procedeu-se à laminectomia combinada com discectomia e fusão. CONCLUSÃO: A prevalência de espondilodiscite foi de 19,2%, sendo a dor lombar e a febre sintomas com alto índice de suspeita de espondilite espinal. A descompressão combinada com estabilização e fusão é o tratamento cirúrgico de escolha.

OBJECTIVE: To determine the prevalence, clinical characteristics, and treatment of spondylodiscitis due to Brucella. METHODS: A total of 104 patients diagnosed with spinal spondylitis, of which 20 corresponded to Brucella spondylitis, treated conservatively with antibiotics or surgically by decompression and stabilization of the spine in any segment, from January 2006 to June 2011. We created a data sheet for collecting information containing patient identification, reported symptoms, physical signs, laboratory parameters and medical and surgical treatment. RESULTS: Thirteen patients were males and 7 females, with a mean age of 59.2 years and standard deviation of 13.6 years. Three patients were affected in the thoracic segment, 13 in the lumbar and lumbosacral segment, 4. Thirteen patients had fever, low back pain was present in the 20 patients, in 12 there were paresthesias, weakness in 9, arthralgias, myalgias and anorexia in 5, radiculopathy in 13, headache, and weight loss in 5 patients. Twenty cases received medical treatment with doxycycline combined with rifampicin. In 8 cases, posterior instrumentation combined with laminectomy and posterolateral fusion was performed, on 2, posterior instrumentation combined with discectomy and fusion of the affected level posterolateral was held and in one case, laminectomy and discectomy combined with fusion was performed. CONCLUSION: The prevalence of spondylodiscitis was 19.2%, with lower back pain and fever symptoms with high suspicion of spinal spondylitis. The decompression combined with stabilization and fusion is the treatment of choice.

Efecto diferencial de una intervención breve basada en la conciencia plena (mindfulness) y valores en las dimensiones del dolor crónico en espondilitis y artritis / Differential effect of brief values and mindfulness-based intervention in chronic pain dimensions for spondylitis and arthritis

En el modelo multidimensional del dolor se destaca la influencia de los componentes emocionales y cognitivos en la experiencia subjetiva del mismo. Desde esta perspectiva, se hace imprescindible el tratamiento psicológico para facilitar su afrontamiento. El presente estudio examinó los efectos diferenciales de una intervención breve basada en conciencia plena y valores en las diversas dimensiones del dolor crónico asociado a las enfermedades reumáticas. Se evaluaron a 10 participantes mediante el "Cuestionario de dolor, de McGuill" y una escala de "Preocupación y autoeficacia". Los resultados mostraron la eficacia de la intervención para mejorar la dolencia de la enfermedad, disminuyendo en la evaluación pos-intervención específicamente el componente valorativo del dolor, la percepción de la intensidad actual del mismo y la preocupación respecto al dolor. Asimismo, en la evaluación del seguimiento a los 8 meses se encontró una educción en el número de puntos considerados dolorosos. Nuestro estudio, pese a sus limitaciones metodológicas, ofrece unos resultados prometedores que sugieren la utilidad de la intervención en conciencia plena y valores para el manejo del dolor crónico en las enfermedades reumáticas (AU)

The multidimensional model of pain emphasizes the influence of emotional and cognitive components in the subjective experience of pain. From this perspective, the successful management of pain seems to require psychological treatment. The present study examined the differential effects of a brief psychological intervention program based on mindfulness and values in the diverse dimensions of chronic pain associated with rheumatic disease. Ten participants were assessed with the McGuill's Pain Questionnaire and a Scale of Worry and Self-efficacy. The results indicate that the intervention program improved the management of pain at post-intervention assessment, showing specific reductions in the following dimensions: evaluative component of pain, perception of actual pain intensity and worry about illness and pain. In addition, a reduction in amount of painful points was found at 8-months follow-up. Despite its methodological limitations, our results suggest that a brief mindfulness and values-based intervention can be useful in the management of pain in patients with chronic rheumatic conditions

Capacitive coupling reduces instrumentation-related infection in rabbit spines: a pilot study.

BACKGROUND: Postoperative spine infections cause considerable morbidity. Patients are subjected to long-term antibiotic regimens and may require further surgery. Delivery of electric current through instrumentation can detach biofilm, allowing better antibiotic penetration and assisting in eradicating infection. QUESTION/PURPOSES: We asked (1) whether capacitive coupling treatment in combination with a single dose of antibiotics would reduce infection rates when compared with antibiotics alone in a rabbit spine infection model, (2) whether it would decrease the overall bacterial burden, and (3) whether there was a time-dependent response based on days treated with capacitive coupling. METHODS: Thirty rabbits were subjected to a well-established spine infection model with a single dose of intravenously administered systemic ceftriaxone (20 mg/kg of body weight) prophylaxis. Two noncontiguous rods were implanted inside dead space defects at L3 and L6 challenged with 10(6) colony-forming units of Staphylococcus aureus. Rabbits were randomly treated with a capacitive coupling or control device. Instrumentation and soft tissue bacterial growth were assessed after 7 days. RESULTS: Sites treated with capacitive coupling showed a decrease in the incidence of positive culture: 36% versus 81% in the control group. We observed no difference in the soft tissue's infectious burden. Overall bacterial load was not decreased with capacitive coupling. CONCLUSIONS: Capacitive coupling in conjunction with antibiotics reduced the instrumentation-related infection rate compared with antibiotics alone. CLINICAL RELEVANCE: Capacitive coupling noninvasively delivers an alternating current that may detach biofilm from instrumentation. Treatment of infection may be successful without removal of instrumentation, allowing for improved stability and overall decreased morbidity.

A Case of Mycobacterium Abscessus Spondylitis / 대한내과학회지

The designation nontuberculous mycobacteria (NTM) applies to mycobacterial species other than organisms of the Mycobacterium tuberculosis complex and Mycobacterium leprae. In recent decades, the prevalence of human disease caused by NTM has increased; thus, the clinical significance of NTM is increasing. Mycobacterium abscessus is a rapidly growing nontuberculous mycobacterial species that is usually associated with chronic pulmonary disease, posttraumatic soft-tissue infections, nosocomial bloodstream infections, wound infections, and abscesses at the site of prior intramuscular injections; however, vertebral osteomyelitis due to this species is rare. Here, we present a case of vertebral osteomyelitis due to M. abscessus that occurred in a patient with iatrogenic Cushing's syndrome and a history of acupuncture who was treated with wide surgical excision and prolonged combined antibiotic treatment.

Use of electrical stimulation and exercise to increase muscle strength in a patient after surgery for cervical spondylotic myelopathy.

Current literature offers little research on the restoration of function in patients following anterior decompression surgery for cervical spondylotic myelopathy. This case report describes the functional outcomes for a physical therapy program using a protocol of alternate day electrical stimulation to hip and knee extensor muscles along with exercise. The protocol, designed to increase lower extremity strength necessary for ambulation in a patient who was status post anterior cervical decompression and fusion surgery, consisted of treatment sessions five times per week for 6 weeks and included electrical stimulation [medium frequency alternating current (MFAC)] in conjunction with active range of motion exercises, followed by functional mobility training and gait training. Outcome measures included Manual Muscle testing, the Functional Independence Measure (FIM), and the Walking Index for Spinal Cord Injuries (WISCI). Improvement was demonstrated in all three measures following the use of the treatment regimen, suggesting there may be a benefit to the use of electrical stimulation and exercise to increase lower extremity strength and improve gait outcomes in this population. Definitive conclusions regarding the correlation between this treatment protocol and the outcomes achieved are limited by the case report design. Carefully designed research studies are needed to demonstrate the effectiveness of the protocol.

A Case of Brucellar Spondylitis Complicated by Acupuncture / 대한류마티스학회지

Brucellosis is an endemic zoonotic disease, particularly in the Middle East and Mediterranean regions, and can involve many organs and tissues. Recently, the incidence of human brucellosis has increased rapidly in Korea. Brucellosis may often appear as other infections and asymptomatic conditions because of its range of clinical manifestations. Therefore, its diagnosis is frequently missed or delayed. Early diagnosis of brucellar spondylitis is important for reducing the number and intensity of complications. Therefore, it should be included in a differential diagnosis of back pain with an unknown origin. Brucellosis is normally transmitted to humans by direct contact with infected animals or by the ingestion of unpasteurized dairy products. We report an unusual case of brucellar spondylitis complicated by acupuncture.

[Clinical observation on Xiaoyusan plaster and Daoyin in the treatment of disease of cervical vertebrae].

OBJECTIVE: To investigate the effects of Xiaoyusan plaster and Daoyin in the treatment of cervical vertebrae disease, to search new methods in the treatment of cervical vertebrae disease. METHODS: From May 2007 to April 2008, 63 patients with disease of cervical vertebrae were treated. By odd or even numbers in random digits table, the patients were randomly divided into two groups included treatment group and control group. Thirty-three patients in the treatment group were treated with Xiaoyusan plaster and Daoyin included 21 males and 12 females with an average age of (30.60+/-7.89) years ranging from 20 to 49. Thirty patients in the control group were treated with Votalin Sustained Release Tablets included 16 males and 14 females with an average age of (32.43+/-8.00) years ranging from 20 to 49. The pain, pressing pain, activity of cervical vertebrae were observed before and after treatment in two groups. RESULTS: Compared the scores before and after treatment in treatment group: pain (t=8.953, P<0.001); pressing pain (t=7.867, P<0.001); activity (t=6.918, P<0.001). Compared the scores before and after treatment in control group: pain (t=8.733, P<0.001); pressing pain (t=7.663, P<0.001); activity (=5.066, P<0.001). The symptoms such as pains, pressing pain, movement restriction improved significantly in two groups. CONCLUSION: Xiaoyusan plaster and Daoyin are one of the effective methods in the treatment of disease of cervical vertebrae, especially can improve symptoms and correct dynamic balance of cervical vertebrae.