Hijamah (Cupping Therapy) for Pain Management in Patients with Cervical Spondylosis.

Background: Cervical spondylosis is the most common cervical spine disorder which is clinically manifested by axial neck pain, stiffness, and limited movement and sometimes it is accompanied by tingling and radicular symptoms in the upper extremities. Pain is the most frequent complaint for which patients, suffering from cervical spondylosis, consult physicians. In conventional medicine, pain and other symptoms of cervical spondylosis are controlled by systemic and local use of non-steroidal anti-inflammatory drugs (NSAIDs), however long-term use of such medicines produces adverse effects like dyspepsia, gastritis, gastroduodenal ulcer and bleeding. Methods: We searched articles for neck pain, cervical spondylosis, cupping therapy, Hijama, etc. from various databases, including PubMed, Google Scholar, and MEDLINE. We also searched for these topics in the books of Unani medicine available in HMS Central Library, Jamia Hamdard, New Delhi, India. Results: This review elucidated that in Unani medicine several non-pharmacological regimens known as Ilaj bi'l Tadbir (Regimenal therapies) are advised in the management of painful musculoskeletal disorders. Hijama (cupping therapy) stands out among all these regimens and in most of the classical Unani literature, Hijama is suggested as one of the best regimens for the management of pain in Waja' al-Mafasil including Waja' al-'Unuq (cervical spondylosis). Conclusion: On going through the classical texts of Unani medicine and published research papers, it may be concluded that Hijama is a safe and effective non-pharmacological treatment for the management of pain due to cervical spondylosis.

Efficacy of Individualized Homeopathic Medicines in the Treatment of Cervical Spondylosis: A Double-Blind, Randomized, Placebo-Controlled Trial.

INTRODUCTION: Cervical spondylosis (CS) is a degenerative condition of the cervical spine, with approximately 80-90% of people suffering from disc degeneration by the age of 50 years. This trial attempts at evaluating the efficacy of individualized homeopathic medicines (IHMs) against placebos in the treatment of CS. METHODS: A 3-month, double-blind, randomized, placebo-controlled trial was conducted at the Organon of Medicine outpatient department of the National Institute of Homoeopathy, India. Patients were randomized to receive either IHMs (n = 70) or identical-looking placebos (n = 70) in the mutual context of concomitant conservative and standard physiotherapeutic care. Primary outcome measures were 0-10 Numeric Rating Scales (NRSs) for pain, stiffness, numbness, tingling, weakness, and vertigo, and the secondary outcome was the Neck Disability Index (NDI), measured at baseline and every month until 3 months. The intention-to-treat sample was analyzed to detect group differences and effect sizes. RESULTS: Overall, improvements were clinically significant and higher in the IHM group than the placebo group, but group differences were statistically nonsignificant with small effect sizes (all p > 0.05, two-way repeated measure analysis of variance). After 2 months of time points, improvements observed in the IHM group were significantly higher than placebo on a few occasions (e.g., pain NRS: p < 0.001; stiffness NRS: p = 0.024; weakness NRS: p = 0.003). Sulfur (n = 21; 15%) was the most frequently prescribed medication. No harm, unintended effects, or any serious adverse events were reported from either group. CONCLUSIONS: An encouraging but nonsignificant direction of effect was elicited favoring IHMs against placebos in the treatment of CS.

Unusual worm-like radiopacities in the radiographs of patients with cervical spondylosis.

This report describes three patients with cervical spondylosis whose diagnostic radiographs showed worm-like, irregularly curved radiopaque lines and strings in the head and neck region during routine chiropractic examinations. Such artifacts are frequently misinterpreted as parasitic infection, electrostatic discharges, detector image lag, fracture, or ligature wires. All three patients with worm-like radiopacities disclosed their 15-20 years of history of acupuncture treatment to relieve neck pain. The present cases of unexpected and coincidental findings may suggest a possible acupuncture-caused radiographic artifacts in the neck and jaw bones. In particular, the patient had previous gold thread treatments possibly associated with the observed radiographic artifacts. These cases may emphasize the importance of having a thorough understanding of patient history regarding unexpected radiographic artifacts.

Cervical Spondylosis Managed With Homoeopathy: A Case Report.

Context: Cervical spondylosis (CS) is a chronic degenerative condition that presents with chronic neck pain and stiffness with radiation of pain to the occiput or upper limbs and a sensation of numbness or tingling. Conservative treatment only provides short term relief. Objective: This case was undertaken to evaluate the efficacy of individualised homoeopathy in the management of CS. Methods: A 39-year-old female patient was treated in the outpatient dept at Dr. D. Y. Patil homoeopathic medical college and research centre with the complaint of neck pain with stiffness. Radiological findings revealed the diagnosis of cervical spondylosis. Individualised homoeopathic medicine was selected after detailed case taking. 'Modified naranjo criteria' were used to assess the effect of homoeopathic medicine. Result: Homoeopathic medicine silicea terra was prescribed and found to be effective in this case. Conclusion: Further studies can be undertaken to assess the effectiveness of individualised homoeopathic medicine in the management of cervical spondylosis.

Cervical arterial dissection and traumatic myelopathy following yoga: surgical case report.

INTRODUCTION: Cervical spondylosis can predispose patients to central canal stenosis. In this setting, myelopathy through further flattening of the cord from extrinsic compression can be precipitated by relatively minor traumas. Arterial dissection is similarly considered a result of high velocity or momentum during trauma, commonly associated with fractures, cervical hyperflexion, or direct blunt force to the neck. Overall, precautions for both arterial dissection and myelopathy are rarely considered in low-velocity, static activities such as yoga. CASE PRESENTATION: The authors report the case of a 63-year-old man who suffered concurrent cervical myelopathy from multilevel spondylopathy, right vertebral artery dissection, and left cervical carotid artery dissection following a yoga session. Symptomatology consisted of acute onset neck pain, upper extremity sensory paresthesia, worsening gait and balance, and impaired dexterity for several weeks. Cervical MRI was obtained given myelopathic symptoms and revealed spondylosis with compression and T2 signal change at C3-C4. CT angiography of the neck revealed aforementioned dissections without flow limiting stenosis or occlusion. A therapeutic heparin infusion was started preoperatively until the patient underwent C3-C4 anterior cervical discectomy and fusion. Aspirin and Plavix were then started without incidence and the patient had significant but gradual improvement in myelopathic symptoms at 6-week follow-up. DISCUSSION: The static yet intensive poses associated with yoga present a rare etiology for arterial dissection and myelopathy, but patients with persistent and progressive symptoms should be screened with the appropriate imaging modality. Cervical decompression should be expedited before initiating an antiplatelet medication.

Clinical observation of Long chiropractic treatment on patients with neurogenic cervical spondylosis: Study protocol for a randomized controlled trial.

ABSTRACT: Neurogenic cervical spondylosis is the most common type of cervical spondylosis, accounting for approximately 60% percent of the incidence of cervical spondylosis. Cervical spine Long manipulation and sling exercise training (SET) have obtained good therapeutic results in clinical rehabilitation. The aim of this study was to evaluate the effect of Long manipulation combined with SET on neurogenic cervical spondylosis. In this assessor-blind, randomized controlled trial, 90 eligible patients will be randomized into a combination treatment group (Long manipulation combined with SET), a Long manipulation group and a conventional massage group. The visual analogue score, the Neck Disability Index score, and muscle fatigue in the bilateral upper oblique and Musculus sternocleidomastoideus, using mean power frequency and median frequency from the surface electromyography frequency domain index, will be assessed before and after the intervention at 0 and 4 weeks, respectively.Trial registration: Registered in the Chinese Clinical Trial Registration Center with the number ChiCTR2100054978. Registered December 30, 2021.

[Manual therapy combined with posterior percutaneous endoscopic cervical decompression for the treatment of cervical spondylotic radiculopathy].

OBJECTIVE: To explore the clinical efficacy and safety of manual therapy combined with posterior percutaneous endoscopic cervical decompression(PECD) in the treatment of intractable cervical spondylotic radiculopathy. METHODS: From May 2016 to May 2018, 23 CSR patients who responded poorly to conservative treatment for at least 6 weeks underwent the combination management. Firstly, the patients received the posterior percutaneous endoscopic cervical decompression routine care for the following 4 weeks and manual therapy for another 4 weeks. A total of 23 patients were followed up, including 14 males and 9 females, the age ranged from 29 to 78 years old with an average of (50.30±12.28) years, the course of disease was 3 to 24 months with an average of (9.74±5.76) months. The lesion segment involved C4,5 in 4 cases, C5,6 in 13 cases, C6,7 in 6 cases. The visual analogue scale (VAS), neck disability index (NDI), changes of cervical physiological curvature and interbody stability, adverse events were observed before and after operation. The follow-up time points were before operation, 1 day after operation and 1, 3 and 6 months after operation. RESULTS: All patients successfully completed the operation and manual treatment for 4 to 8 times. Among the 29 cases, 23 patients were followed up for more than 6 months. There was no spinal cord and nerve root injury during the treatment and follow-up. Operation time was from 80 to 120 min with a median of 90 min;intraoperative blood loss was from 35 to 80 ml with a median of 50 ml. NDI, VAS of neck, shoulder and arm each period after operation were significantly lower than those before PECD(P<0.05), while there were no significant improvement in cervical physiological curvature and target segment intervertebral space height(P>0.05);there was no significant change in interbody stability (P>0.05). After received the manual therapy, NDI significantly decreased (P<0.05), however, there was no significant difference in VAS of neck, shoulder and arm, physiological curvature of cervical spine and intervertebral space height of target segment compared with that before manual treatment (P>0.05);there was no significant change in interbody stability (P>0.05). CONCLUSION: Manual therapy combined with PECD in the treatment of intractable cervical spondylotic radiculopathy can not only quickly improve the symptoms, but also alleviate the residual symptoms after PECD safely and effectively, and can not cause obvious signs of accelerated instability of cervical adjacent segments in the short term.

The efficacy and safety of fire needle for cervical spondylotic radiculopathy: A protocol for systematic review and meta-analysis.

BACKGROUND: Cervical spondylotic radiculopathy (CSR) is one of the most common types of cervical spondylosis, and its treatments are mainly for relieving radicular pain and improving dysfunction. The existing randomized controlled trials (RCTs) suggest that fire needle may be a potential therapy in the treatment of CSR, but there is no evidence-based medical evidence to date. Therefore, this study will systematically evaluate the efficacy and safety of fire needle in the treatment of CSR. METHODS: We will search for 7 electronic databases (PubMed, EMBASE, Cochrane library, China National Knowledge Infrastructure, Chinese Scientific Journals Database, Sinomed, and Wanfang Database) and 2 trial registration platforms (ClinicalTrials.gov and Chinese Clinic Trials.gov) to collect eligible studies. The RCTs related to fire needle for CSR and published up to June 30, 2021 will be included, regardless of language. We will consider the visual analogue scale as the primary outcome and the secondary outcome will include cervical range of motion, assessment of muscle strength, neck disability index, the MOS item short from health survey, activities of daily living, total efficiency, and adverse reactions. We will use the standard proposed in Cochrane Handbook 5.1.0 to assess the quality and bias risk of every RCT, and all analyses will be conducted through RevMan software V5.3 (Copenhagen: Nordic Cochrane Center, Cochrane, Collaborative Organization, 2014). RESULTS: This systematic review and meta-analysis will provide a convincing synthesis of existing evidences on the efficacy and safety of fire needle for CSR, and the results will be submitted to a peer-reviewed journal for publication. CONCLUSION: The results of this study will provide high-quality evidence of fire needle in the treatment of CSR for clinical decision-making. INPLASY REGISTRATION NUMBER: INPLASY202170041.

Yunmen (LU 2) combined with neck-seven-acupoint acupuncture for arm numbness caused by cervical spondylotic radiculopathy: A case report.

RATIONALE: Cervical spondylotic radiculopathy (CSR) is a common sensory, motor, and reflex disorder. Numbness, a common subjective symptom of CSR, lacks objective quantitative indicators and recognized effective treatments, but is also difficult to recover from. We present a case report describing a traditional acupuncture treatment for CSR, utilizing a special acupuncture method and point, namely the Yunmen point. PATIENT CONCERNS: A 40-year-old woman presented with unilateral arm numbness caused by CSR. DIAGNOSES: A diagnosis of CSR was made in the orthopedic department of a local hospital. INTERVENTIONS: We attempted acupuncture at the Yunmen (LU 2) acupoint combined with neck-seven-acupoint under computed tomographic guidance. OUTCOMES: After 10 times treatment sessions, the patient no longer experienced weakness, coldness, or numbness in the affected upper limb. In addition, the stiffness in the neck and shoulders was reduced. On physical examination, the patient's left brachial plexus traction test was negative; reassessment of the CSR-20-point score scale showed a perfect score, and the visual analog scale score was 0. LESSONS: Our report indicates that acupuncture at the LU 2 acupoint combined with neck-seven-acupoint is effective in treating numbness and coldness of the arm, and other neurological symptoms caused by cervical spondylosis. Moreover, with the appropriate acupuncture technique, the risk of acupuncture at the LU 2 acupoint can be minimized.

Efficacy and safety of electroacupuncture in treatment of cervical spondylosis: A protocol of randomized controlled trial.

BACKGROUND: Cervical Spondylotic radiculopathy (CSR) is the most common spinal degenerative disease. Its clinical manifestations are pain and numbness in the neck and arm and limitation of neck movement, which greatly affects the life and work of patients. Acupuncture and electroacupuncture are commonly used in China, the efficacy of acupuncture has been confirmed. Existing evidence shows that electroacupuncture seems to be better than acupuncture, but there is a lack of clinical research to directly compare the two. METHODS: This is a prospective randomized controlled trial to compare the efficacy of electroacupuncture and acupuncture in the treatment of CSR and to explore the safety and potential mechanism of electroacupuncture in the treatment of CSR. Approved by the Clinical Research Ethics Committee of our hospital, the patients are randomly divided into an experimental group (electroacupuncture group) or control group (acupuncture group). The patients are followed up for 30 days after 4 weeks of treatment. Observation indexes included VAS score, Neck Disability Index, Yasuhisa Tanaka 20 Score Scale, adverse reactions and so on. Finally, the data will be analyzed by SPSS 18.0 software. DISCUSSION: This study will directly compare the advantages and disadvantages of electroacupuncture and acupuncture in the treatment of CSR. The results of this study will help to guide patients with CSR to choose appropriate treatment. TRIAL REGISTRATION: OSF Registration number: DOI 10.17605/OSF.IO/9MKPN.

Cervical balance and clinical outcomes in cervical spondylotic myelopathy treated by three-level anterior cervical discectomy and fusion and hybrid cervical surgery: A CONSORT-compliant study with minimum follow-up period of 5 years.

ABSTRACT: As the technology of combining with fusion and nonfusion procedure, cervical hybrid surgery (HS) is an efficacious alternative for treatment with cervical spondylotic myelopathy. While studies on cervical alignment between 3-level HS and anterior cervical discectomy and fusion (ACDF) were seldom reported. The effects of cervical imbalance on its related clinical outcomes are yet undetermined as well.Patients with cervical spondylotic myelopathy, who underwent 3-level ACDF or HS, were included to compare cervical alignment parameters after surgery and then explore the relationship between cervical balance and clinical outcomes.Forty-one patients with HS (HS group) and 32 patients who with ACDF (ACDF group) were reviewed from February 2007 to September 2013 with the mean follow-up of 90.3 ±â€Š25.5 (m) and 86.3 ±â€Š28.9 (m), respectively. Cervical alignments parameters including the C2 to C7 cervical lordosis (CL), C2 to C7 sagittal vertical axis, T1 slope. and T1SCL (T1 slope minus CL), and the clinical outcomes like neck disability index (NDI) and Japanese Orthopedic Association (JOA) score were measured and recorded preoperatively (PreOP), intraoperatively, and on the first preoperative day and the last follow-up (FFU). The balance and imbalance groupings were sorted based on the T1SCL: T1SCL≤20°,balance; T1SCL > 20°, imbalance.We found significant improvements (P < .001) in NDI and JOA at intraoperatively and FFU after ACDF and HS, and no difference on cervical alignment and clinical outcomes between the 2 procedures on the basis of intergroup comparisons. By between-subgroups comparisons, however, we found significant differences in CL and T1SCL at PreOP (P < .05). Nonetheless, there was no significant difference on the clinical outcomes between balance and imbalance subgroups at FFU at PreOP (P > .05), indicating that the change of T1SCL was not correlated to NDI and JOA at FFU.Both HS and ACDF groups showed significant clinical improvements after surgery. There was no correlation between cervical balance and clinical symptoms.

Clinical Efficacy and Safety of "Three-Dimensional Balanced Manipulation" in the Treatment of Cervical Spondylotic Radiculopathy by Finite Element Analysis.

Cervical spondylotic radiculopathy (CSR) is the most commonly encountered cervical spine disorder. Cervical manipulation has been demonstrated as an effective therapy for patients. However, the mechanisms of manipulations have not been elucidated. A total of 120 cervical spondylotic radiculopathy patients were divided into the "three-dimensional balanced manipulation" treatment group (TBM group) and control group randomly. The control group was treated with traditional massage; the TBM treatment group was treated with "three-dimensional balanced manipulation" based on traditional massage. The symptoms and clinical efficacy of the patients were compared before and after treatment for one month. A three-dimensional finite element model was established. The mechanical parameters were imported to simulate TBM, and finite element analysis was performed. The results showed that the total effective rate was significantly higher in the TBM group compared with the control group. The biomechanical analysis showed the vertebral body stress was mainly distributed in the C3/4 spinous processes; the deformation mainly concentrated in the anterior processes of the C3 vertebral body. The intervertebral disc stress in the C3~C7 segment was mainly distributed in the anterior part of the C3/4 intervertebral disc, and the deformation extends to the posterior part of the C3/4 nucleus pulposus. In summary, these data are suggesting that TBM was effective in CSR treatment. The results of the finite element model and biomechanical analysis provide an important foundation for effectively avoiding iatrogenic injuries and improving the effect of TBM in the treatment of CSR patients.

Optimized acupuncture treatment (acupuncture and intradermal needling) for cervical spondylosis-related neck pain: a multicenter randomized controlled trial.

ABSTRACT: Cervical spondylosis (CS)-related neck pain is difficult to treat because of its degenerative nature. The aim of this 9-center, single-blinded, randomized controlled trial was to evaluate the efficacy of optimized acupuncture for CS-related neck pain. Participants who met the inclusion criteria were randomized to optimized, shallow, and sham acupuncture groups (1:1:1). The primary outcome was the change from baseline in the Northwick Park Neck Pain Questionnaire score at week 4. Participants were followed up until week 16. Of the 896 randomized participants, 857 received ≥1 intervention session; 280, 286, and 291 received optimized, shallow, and sham acupuncture, respectively. A total of 835 (93.2%) participants completed the study. At week 4, significant differences (P < 0.001) were observed in the changes in Northwick Park Neck Pain Questionnaire scores between the optimized acupuncture group and both the shallow {7.72 (95% confidence interval [CI], 5.57-9.86)} and sham acupuncture (10.38 [95% CI, 8.25-12.52]) groups. The difference in the scores at week 16 between the optimized acupuncture group and the shallow (8.84 [95% CI, 6.34-11.34]) and sham acupuncture (10.81 [95% CI, 8.32-13.30]) groups were significant. The center effect indicated wide variability in the treatment effects (Cohen's d = 0.01-2.19). Most SF-36 scores were higher in the optimized acupuncture group than those in the other groups. These results suggest that 4-week optimized acupuncture treatment alleviates CS-related neck pain and improves the quality of life, with the effects persisting for minimum 3 months. Therefore, acupuncture can have positive effects on CS-related neck pain, although the effect size may vary widely.

Effects of Percutaneous Neuromuscular Electrical Stimulation for Neck Pain in Patients With Cervical Spondylosis.

CONTEXT: Cervical spondylosis (CS) is a very common, age-related, chronic, disc-degeneration condition. Alternative medicine has been widely used to treat neck pain in CS. However, no randomized controlled trials have focused on the effects and safety of percutaneous neuromuscular electrical stimulation (PNMES) for neck-pain relief in patients with CS. OBJECTIVE: The study aimed to evaluate the effects and safety of PNMES for treating neck pain in patients with cervical spondylosis (CS). DESIGN: The research team designed a two-arm, double-blinded, randomized, sham-controlled trial. SETTING: The study was conducted at the People's Hospital of Yan'an in Yan'an, China. PARTICIPANTS: Participants were 124 patients with neck pain from CS at the hospital. INTERVENTION: Participants were randomly divided into an intervention group and a control group in a ratio of 1:1. The intervention group received PNMES (PNMES group), and the control group received sham PNMES for 30 minutes daily 3 times weekly, for 12 weeks. OUTCOME MEASURES: The outcome measures included: (1) a visual analog scale (VAS), (2) a test of cervical range of motion (ROM), and (3) the neck disability index (NDI) score. All outcome measurements were measured immediately postintervention and in a follow-up at 4 weeks postintervention. In addition, AEs were also recorded duration the period of treatment. RESULTS: Immediately postintervention and at the follow-up, the PNMES group exhibited decreases in the mean VAS (P < .01) and NDI score (P < .01) that were significantly greater than those of the control group. Additionally, the increase in the mean ROM was significantly higher in the PNMES group than that in the control group, both immediately postintervention and at the follow-up (P < .01). No AEs were found in either group. CONCLUSIONS: The results of this study have demonstrated that PNMES is more effective than sham PNMES for neck-pain relief in patients with CS.

Acupuncture for neck pain caused by cervical spondylosis: a systematic review and meta-analysis protocol.

INTRODUCTION: Neck pain causes serious social and economic burden. Research on the use of acupuncture for managing cervical spondylosis has increased over time, with the quality of studies showing an improved trend. The present study seeks to use a systematic review approach to understand efficacy and safety of acupuncture for treatment of neck pain caused by cervical spondylosis. METHODS AND ANALYSIS: We will search PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Chinese BioMedical Literature, Wanfang database and VIP databases, from their inception to July 2020, to identify and retrieve all randomised controlled trials, describing the use of acupuncture for treatment of cervical spondylosis. Thereafter, two reviewers will independently select the studies, extract data and assess the risk of bias. Any disagreements, between them, will be resolved through a discussion with a third reviewer. Data synthesis and statistical analyses will be performed using the Revman V.5.3 software. Specifically, data will be synthesised by either fixed-effects (heterogeneity less than 50%) or random-effects models, following a heterogeneity test, with outcome measures focusing on pain intensity, functional disability, psychological improvements and adverse events. In cases where no considerable heterogeneity is detected, a meta-analysis will be conducted. ETHICS AND DISSEMINATION: No ethical approval will be required for this study, since it does not infringe on anyone's interests. The findings will be published in a peer-reviewed journal or disseminated through conferences. PROSPERO REGISTRATION NUMBER: CRD42020152379.

A randomized, double-blind, placebo-controlled trial for Yi-Qi Hua-Yu tong-sui granule in the treatment of mild or moderate cervical spondylotic myelopathy.

BACKGROUND: Neck pain, sensory disturbance and motor dysfunction in most patients suffered cervical spondylotic myelopathy (CSM). However, some conservative treatments are limited by their modest effectiveness. In the other hand, surgical treatment is necessary when symptoms are refractory to conservative treatments and neurological function of the patients has deteriorated. Many patients use complementary and alternative medicine, including traditional Chinese medicine, to address their symptoms. The purpose of the present study is to examine effectiveness and safety of Yiqi-Huayu-Tongsui (YQHYTS) granule, a compound traditional Chinese herbal medicine, on symptoms in patients with mild or moderate CSM. METHODS/DESIGN: A randomized, double blinded, placebo-controlled clinical trial to evaluate the efficacy and safety of YQHYTS granule is proposed. 72 patients in Longhua Hospital with the diagnosis of mild or moderate CSM will be randomly allocated into 2 groups, and treated with YQHYTS granule or placebo. The prescription of the trial drugs (YQHYTS granule/placebo) is 20 grams twice a day for 3 months. The primary outcome measurements include visual analog scale, Japanese Orthopedic Association, and Neck Disability Index score. The secondary outcome measurements are electromyogram and Pfirrmann classification. DISCUSSION: YQHYTS granule has been established and applied in Longhua Hospital for many years. As it has a potential benefit in treating mild or moderate CSM, we designed a double-blind, prospective, randomized controlled trial and would like to publish the results and conclusions later. If YQHYTS granule can alleviate neck pain, sensory disturbance, and even motor dysfunction without adverse effects, it may be a unique strategy for the treatment of mild or moderate CSM. TRIAL REGISTRATION: Chinese Clinical Trial Registry ID: ChiCTR1900028192. Registered 15 December 2019, Available at: http://www.chictr.org.cn/edit.aspx?pid=46913&htm=4.

Clinical study on improving postoperative symptoms of cervical spondylotic myelopathy by Qishe pill.

BACKGROUND: Cervical spondylotic myelopathy (CSM) is the most serious type of cervical spondylosis, which is often treated surgically in patients with progressive neurological symptoms following ineffective conservative treatment. However, some patients have residual symptoms such as neck pain, stiffness, and C5 nerve palsy after surgery. The Qishe pill can effectively relieve the symptoms of neck pain and numbness, but there is no evidence showing the efficacy and safety of the Qishe pill in treating symptoms after spinal cord surgery. METHODS/DESIGN: A multicenter, randomized controlled clinical trial will be conducted to evaluate the efficacy and safety of the Qishe Pill. A total of 330 patients with CSM who receive surgical treatment will be randomly divided into 2 groups, treated for 12 weeks and with a 1-year follow-up. The primary outcome will be Japanese Orthopaedic Association score from the baseline to 4 weeks, 12 weeks, 24 weeks, and 48 weeks after surgery. Secondary outcomes will include Visual Analogue Scale score, Neck Disability Index, and imaging indicators (including magnetic resonance imaging and X-ray). Additionally, adverse reactions will be observed and recorded as safety indicators. DISCUSSION: Although the Qishe pill can effectively improve the discomfort of the neck and upper limbs in clinical applications, there is a lack of clinical research on postoperative patients. This study will investigate the efficacy and safety of the Qishe pill in treating postoperative symptoms of CSM. TRIAL REGISTRATION: Clinical Trials.gov ID: ChiCTR1900028173. Registered on 17 December 2019.

Acupotomy combined with massage for cervical spondylotic radiculopathy: A protocol for systematic review and meta-analysis.

BACKGROUND: Cervical spondylotic radiculopathy (CSR) is a clinical syndrome of radial neck and shoulder pain. Both Massage and Acupotomy have been widely used in the treatment of CSR, in China and achieved satisfied efficacy. Therefore, the aim of this study is to systematically evaluate the clinical efficacy of acupotomy combined with massage in the treatment of CSR. METHODS: The following electronic databases will be searched: PubMed, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Library, Embase, SinoMed, Clinical Trials. gov, the China National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database. Two review authors independently search databases from their respective inception dates to September 2019 to identify potentially eligible studies. Cochrane Handbook 5.1 risk of bias assessment tool will be used to evaluate the methodological quality of the included studies. The Review Manager 5.3 will be used for all statistical analysis of the final included study. RESULTS: The results of this systematic review and meta-analysis will provide a synthesis of existing evidences for the treatment of acupotomy combined with massage on CSR, especially in improving visual analog scale and symptom score. CONCLUSION: This study will summarize the current evidence of acupotomy combined with massage for the treatment of CSR. This study can further guide the promotion and clinical decisions. ETHICS AND DISSEMINATION: Ethical approval and patient consent are not required because this study is a literature-based study. This systematic review and meta-analysis will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020171825.

Thunder-fire moxibustion for cervical spondylotic radiculopathy: Study protocol for a randomized controlled trial.

BACKGROUND: Thunder-fire moxibustion originated in China and contains traditional Chinese medicine. It can produce strong firepower, infrared thermal radiation, and medicinal effects when burning on the acupoints. Thunder-fire moxibustion is commonly used in patients with neck pain, but its efficacy has rarely been systematically demonstrated. We designed a randomized trial of thunder-fire moxibustion on cervical spondylotic radiculopathy (CSR) to investigate whether it is more effective than ibuprofen sustained-release capsules. METHODS: One hundred patients will be recruited and randomly divided into thunder-fire moxibustion and ibuprofen groups. The intervention consists of ten treatments and will last for 2 weeks. The Yasuhisa Tanaka 20 Score Scale is used as the primary outcome measure. It contains a combination of the self-conscious symptom in patients, objective clinical evaluation from doctors, and social evaluation (the ability to work and live). The objective and comprehensive evaluation of CSR patients before and after treatment is particularly needed. The Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2), Neck Disability Index score scale (NDI), and the Quality of Life Assessment (SF-36) are applied as secondary outcome measures. The assessment will take place at the baseline and the first and second weekends of treatment. If an adverse event (AEs) occurs, it will be reported. DISCUSSION: The aim of this trial is to determine whether thunder-fire moxibustion is more effective than ibuprofen in the treatment of patients with CSR. TRIAL REGISTRATION: Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR1800018820. Registered on 11 October 2018.

Meta-analysis of the therapeutic effect of acupuncture and chiropractic on cervical spondylosis radiculopathy: A systematic review and meta-analysis protocol.

BACKGROUND: The pathogenesis of cervical spondylotic is degenerative changes of the cervical intervertebral disc, or bone hyperplasia of the posterior and hook joints, and instability of the joints of the cervical vertebrae. It causes the nerve roots to be stimulated and oppressed. The clinical manifestations are the sensation, movement, and reflex disorder of the cervical spinal nerve roots that are stimulated and oppressed, especially the numbness and pain of the neck, shoulders, upper limbs, and fingers. In this systematic review, we aimed to evaluate the efficacy and safety of acupuncture and chiropractic in the treatment of cervical spondylotic. METHODS AND ANALYSIS: We will search for PubMed, Cochrane Library, AMED, Embase, WorldSciNet; Nature, Science online and China Journal Full-text Database (CNKI), China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to September 2019. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the RevMan 5.3 and Stata 13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of cervical spondylotic. ETHICS AND DISSEMINATION: This systematic review will evaluate the efficacy and safety of acupuncture and chiropractic for cervical spondylotic. Because all of the data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process trial.