Anatomical specificities of the degenerated cervical spine: a narrative review of clinical implications, with special focus on targeted spinal injections / Christelle Nguyen in Annals of physical and rehabilitation medicine, Vol. 59, n° 4 (September 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n° 4 (September 2016) . - p. 276-281 Titre : Anatomical specificities of the degenerated cervical spine: a narrative review of clinical implications, with special focus on targeted spinal injections Type de document : texte imprimé Auteurs : Christelle Nguyen, Auteur ; Katherine Sanchez, Auteur ; Alexandra Roren, Auteur Année de publication : 2016 Article en page(s) : p. 276-281 Langues : Anglais (eng) Français (fre) Mots-clés : Cou  Disque intervertébral  Arthrose  Cervical spine,Uncarthrosis,Degenerative disc disease,Spondylosis,Spinal injections Résumé : Background: Cervical radiculopathy is most often related to foraminal stenosis due to osteoarthritic changes of the uncovertebral joints anteriorly or zygapophyseal joints posteriorly, rather than disc herniation. Objectives: To describe anatomical specificities of the degenerated cervical spine. Methods: A critical narrative review was conducted. Articles were non-systematically selected and based on authors’ expertise, self-knowledge, and reflective practice. Results: Vertebral bodies of the lower cervical spine are characterized by 2 lateral prismatic bony protuberances, the uncinate processes, located on C3 to C7 superior vertebral endplates, that are involved in the stabilization of the cervical spine. Degenerative changes at the lower cervical spine can affect different anatomical structures: the intervertebral disc, uncovertebral joints, and facet joints. The incidence and severity of changes increase with age. Furthermore, uncovertebral osteoarthritis is characterized by the presence of transverse fissures in the annulus fibrosus. Discussion: These specific anatomical features of the cervical spine may have clinical implications, including more targeted spinal injections for managing disabling persistent or recurrent symptoms related to cervical spine degenerative changes such as cervical radicular pain. Permalink : ./index.php?lvl=notice_display&id=45205 [article] Anatomical specificities of the degenerated cervical spine: a narrative review of clinical implications, with special focus on targeted spinal injections [texte imprimé] / Christelle Nguyen, Auteur ; Katherine Sanchez, Auteur ; Alexandra Roren, Auteur . - 2016 . - p. 276-281. Langues : Anglais (eng) Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n° 4 (September 2016) . - p. 276-281 Mots-clés : Cou  Disque intervertébral  Arthrose  Cervical spine,Uncarthrosis,Degenerative disc disease,Spondylosis,Spinal injections Résumé : Background: Cervical radiculopathy is most often related to foraminal stenosis due to osteoarthritic changes of the uncovertebral joints anteriorly or zygapophyseal joints posteriorly, rather than disc herniation. Objectives: To describe anatomical specificities of the degenerated cervical spine. Methods: A critical narrative review was conducted. Articles were non-systematically selected and based on authors’ expertise, self-knowledge, and reflective practice. Results: Vertebral bodies of the lower cervical spine are characterized by 2 lateral prismatic bony protuberances, the uncinate processes, located on C3 to C7 superior vertebral endplates, that are involved in the stabilization of the cervical spine. Degenerative changes at the lower cervical spine can affect different anatomical structures: the intervertebral disc, uncovertebral joints, and facet joints. The incidence and severity of changes increase with age. Furthermore, uncovertebral osteoarthritis is characterized by the presence of transverse fissures in the annulus fibrosus. Discussion: These specific anatomical features of the cervical spine may have clinical implications, including more targeted spinal injections for managing disabling persistent or recurrent symptoms related to cervical spine degenerative changes such as cervical radicular pain. Permalink : ./index.php?lvl=notice_display&id=45205

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Patient-preference disability assessment for disabling knee osteoarthritis: Validity and responsiveness of the McMaster-Toronto Arthritis Patient Preference Disability Questionnaire / Katherine Sanchez in Annals of physical and rehabilitation medicine, Vol. 59, n° 4 (September 2016)

Public ISBD [article]  inAnnals of physical and rehabilitation medicine > Vol. 59, n° 4 (September 2016) . - p. 255-262 Titre : Patient-preference disability assessment for disabling knee osteoarthritis: Validity and responsiveness of the McMaster-Toronto Arthritis Patient Preference Disability Questionnaire Type de document : texte imprimé Auteurs : Katherine Sanchez, Auteur ; Clémence Palazzo, Auteur ; Cécile Escalas, Auteur Année de publication : 2016 Article en page(s) : p. 255-262 Langues : Anglais (eng) Français (fre) Mots-clés : Genou  Ostéoporose  Handicap  Questionnaire  Knee,Osteoarthritis,Handicap,Disability assessment,Validity,Responsiveness,McMaster Toronto Arthritis Patient Preference Disability Questionnaire Résumé : Background: The McMaster-Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) measurement of function may be more comprehensive and add useful information about disability than traditional fixed-item questionnaires, especially about issues that really matter to the patient, for developing personalized medicine. Objectives: We aimed to assess priorities in disability and restriction in participation in patients with disabling knee osteoarthritis (OA) by the MACTAR and evaluate its validity and responsiveness. Methods: We evaluated 127 in- and outpatients with knee OA in two tertiary care teaching hospitals between August 2010 and July 2012 by using the MACTAR, the Western Ontario and McMaster Universities Osteoarthritis Index, Lequesne scale, Fear Avoidance Beliefs Questionnaire, a life satisfaction score and pain, global assessment of disease activity and functional impairment scores on a numerical rating scale. Validity was assessed by Pearson correlation and responsiveness by the standardized response mean (SRM) and effect size (ES). Results: Patients ranked 35 different activities by the MACTAR; the 3 domains of the International Classification of Functioning, Disability and Health most often identified were mobility (cited 233 times, 52.3%); community, social and civic life (cited 122 times, 27.4%); and domestic life (cited 64 times, 14.4%). The MACTAR score was best correlated with functional impairment (r =0.5). Convergent and divergent validity was as expected. In all, 108 patients completed a 6-month follow-up evaluation: 27 patients shifted their priorities at 6 months, for a decrease in SRM and ES. The SRM (0.64) and ES (0.92) for the MACTAR without shifts in priorities were the highest among the outcome measures tested; for patients considering their condition improved, the values were 0.85 and 1.17, respectively. Conclusions: For assessing priorities in disability and restriction in participation among patients with knee OA, the MACTAR has acceptable validity and responsiveness. Permalink : ./index.php?lvl=notice_display&id=45218 [article] Patient-preference disability assessment for disabling knee osteoarthritis: Validity and responsiveness of the McMaster-Toronto Arthritis Patient Preference Disability Questionnaire [texte imprimé] / Katherine Sanchez, Auteur ; Clémence Palazzo, Auteur ; Cécile Escalas, Auteur . - 2016 . - p. 255-262. Langues : Anglais (eng) Français (fre) in Annals of physical and rehabilitation medicine > Vol. 59, n° 4 (September 2016) . - p. 255-262 Mots-clés : Genou  Ostéoporose  Handicap  Questionnaire  Knee,Osteoarthritis,Handicap,Disability assessment,Validity,Responsiveness,McMaster Toronto Arthritis Patient Preference Disability Questionnaire Résumé : Background: The McMaster-Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) measurement of function may be more comprehensive and add useful information about disability than traditional fixed-item questionnaires, especially about issues that really matter to the patient, for developing personalized medicine. Objectives: We aimed to assess priorities in disability and restriction in participation in patients with disabling knee osteoarthritis (OA) by the MACTAR and evaluate its validity and responsiveness. Methods: We evaluated 127 in- and outpatients with knee OA in two tertiary care teaching hospitals between August 2010 and July 2012 by using the MACTAR, the Western Ontario and McMaster Universities Osteoarthritis Index, Lequesne scale, Fear Avoidance Beliefs Questionnaire, a life satisfaction score and pain, global assessment of disease activity and functional impairment scores on a numerical rating scale. Validity was assessed by Pearson correlation and responsiveness by the standardized response mean (SRM) and effect size (ES). Results: Patients ranked 35 different activities by the MACTAR; the 3 domains of the International Classification of Functioning, Disability and Health most often identified were mobility (cited 233 times, 52.3%); community, social and civic life (cited 122 times, 27.4%); and domestic life (cited 64 times, 14.4%). The MACTAR score was best correlated with functional impairment (r =0.5). Convergent and divergent validity was as expected. In all, 108 patients completed a 6-month follow-up evaluation: 27 patients shifted their priorities at 6 months, for a decrease in SRM and ES. The SRM (0.64) and ES (0.92) for the MACTAR without shifts in priorities were the highest among the outcome measures tested; for patients considering their condition improved, the values were 0.85 and 1.17, respectively. Conclusions: For assessing priorities in disability and restriction in participation among patients with knee OA, the MACTAR has acceptable validity and responsiveness. Permalink : ./index.php?lvl=notice_display&id=45218

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