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Randomized Controlled Trial
. 2015 Jul;31(7):337-43.
doi: 10.1016/j.kjms.2015.05.003. Epub 2015 Jun 20.

The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification

Tz-Yan Lin  1 , Jing-Ting Chen  1 , Yu-Yu Chen  1 , Tien-Wen Chen  1 , Chia-Ling Lee  2 , Chia-Hsin Chen  3 , Mao-Hsiung Huang  4
Affiliations
Randomized Controlled Trial

The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification

Tz-Yan Lin et al. Kaohsiung J Med Sci. 2015 Jul.

Abstract

We investigated the effects of extracorporeal shockwave therapy (ESWT) on the rehabilitation of cervical spondylosis with nuchal ligament (NL) calcification under X-ray and ultrasound guidance. Sixty patients with cervical spondylosis and calcification of NL were selected and randomly assigned to three groups: A, B, and C. Patients in Group A received rehabilitation with 20 minutes of hot packs and underwent 15 minutes of intermittent cervical traction three times/week for 6 weeks. Patients in Group B received the same rehabilitation as those in Group A and ESWT (2000 impulses, 0.27 mJ/mm(2)) over the calcified NL guided by X-ray image. Patients in Group C received the same treatment as those in Group B, but the ESWT was guided by musculoskeletal sonography. The therapeutic effects were evaluated by: changes in range of motion (ROM) of the cervical spine including flexion, extension, lateral bending, and rotation; visual analog pain scale; and Neck Disability Index before and after treatment and at follow up 3 months later. We found a significant reduction in pain in each treated group after treatment and at follow up. However, patients in Groups B and C showed more improvements in ROM and neck pain relief after treatment and a decrease in Neck Disability Index. Furthermore, patients in Group C showed better cervical ROM at follow up than Group B. ESWT is an adjuvant treatment in the management of cervical spondylosis with calcification of NL and ultrasound-guided ESWT results in more functional improvements.

Keywords: Cervical spine; Extracorporeal shock wave therapy; Nuchal ligament; Ossification.

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Figures

Figure 1
Figure 1
(A) X‐ray and (B) ultrasound image of calcification of nuchal ligament (arrows).
Figure 2
Figure 2
A flowchart of the study. * Evaluation included: range of motion of neck, pain severity, Neck Disability Index, and cross‐sectional areas of ossification of the nuchal ligament. ESWT = extracorporeal shockwave therapy.
See this image and copyright information in PMC

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