title: The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification.
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.
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Tz-Yan
authors.initials: TY
authors.lastname: Lin
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Jing-Ting
authors.initials: JT
authors.lastname: Chen
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Yu-Yu
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Tien-Wen
authors.initials: TW
authors.lastname: Chen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Lee
authors.affiliation: Department of Physical Medicine and Rehabilitation, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
authors.forename: Chia-Hsin
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Electronic address: maohuang@ms24.hinet.net.
authors.forename: Mao-Hsiung
authors.initials: MH
authors.lastname: Huang
mesh_terms: D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008022:Ligaments / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008096:Lithotripsy; D019547:Neck Pain / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D055009:Spondylosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Cervical spine; Extracorporeal shock wave therapy; Nuchal ligament; Ossification