Cervical Kyphotic Deformity Worsening After Extensor Cervical Muscle Paralysis from Botulinum Toxin Injection

Agyei, Justice O.; Smolar, David E.; Hartke, Joelle N.; Fanous, Andrew A.; Gibbons, Kevin J.

doi:10.1016/j.wneu.2019.02.057

Cited by 5 publications

(7 citation statements)

References 14 publications

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“…Regarding the role of cervical spine muscles in the preservation of cervical spine lordosis, there are many facts published in the literature supporting their strong connection. For example, botulinum toxin injection can deteriorate cervical spine kyphotic deformity [ 61 ]. Drop head syndrome can be the result of cervical spondylotic amyotrophy [ 62 ].…”

Section: Discussionmentioning

confidence: 99%

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

et al. 2021

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Cervical spine musculature still remains a less studied component of the cervical spine anatomical compartments, although it plays a significant role in the mobility of the head and the preservation of cervical spine alignment. The goal of this study was to extract any significant information from the literature regarding the role of cervical spine muscles morphology in the outcome of surgically treated patients for degenerative disc disease (DDD) based on preoperative magnetic resonance imaging (MRI) studies. Eleven clinical case series were found, from which four were prospective and seven were retrospective. Six studies were concentrated on anterior approaches and five studies on posterior approaches in the cervical spine. In posterior approaches aiming at the preservation of muscles attachments and overall less surgical manipulations, results on cervical lordosis, axial pain and patient's functionality were found superior to traditional laminectomies. The study of cross-sectional areas (CSAs) of deep paraspinal muscles in the cervical spine could add significant information for the spine surgeon such as the prediction of adjacent level disease (ALD), fusion failure, axial pain persistence, postoperative cervical alignment and patient's postoperative functionality. It seems that MRI studies focusing on muscle layers of the cervical spine could add significant information for the spinal surgeon regarding the final surgical outcome in terms of pain and function expres-sion. Larger multicenter clinical studies are a necessity in defining the role of the muscle component of the cervical spine in the surgical treatment of DDD.

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Section: Discussionmentioning

confidence: 99%

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

et al. 2021

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“…SPL is a deep layer rotator, and UTr and SCM are superficial rotators. The superficial and deep rotators synergistically contribute to the posture control and rotating motion ( Panjabi et al, 1998 ; Cheng et al, 2011 ; Agyei et al, 2019 ). HR is a general phenomenon in populations.…”

Section: Discussionmentioning

confidence: 99%

“…HR is a general phenomenon in populations. It first came to light publicly in 1995 in Japan when a television program reported that a man who wore a wire hanger around his head subsequently rotated his head ( Agyei et al, 2019 ), and this phenomenon was formally termed as the “HR” by Kajimoto et al at the University of Electro-Communications in 2008 ( Matsue et al, 2008 ). An epidemiological investigation by Asahi T et al found that HR is a general phenomenon in populations (120 healthy Japanese adults, 60 men and 60 women, aged 19–65 years), and it can be observed in 92.1% of the healthy subjects ( Asahi et al, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

“…The hanger reflex (HR) is an involuntary head rotation that occurs in response to a clothes hanger encircling the head, which compresses the unilateral frontal-temporal area ( Asahi et al, 2018 ). In this situation, the head will rotate towards the compressed side spontaneously, which is termed as the HR ( Asahi et al, 2018 ; Agyei et al, 2019 ; Asahi et al, 2020 ). HR is a general phenomenon in populations, and it can be observed in 92.1% of the healthy subjects ( Asahi et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

“…Although previous studies have proved the HR phenomenon and estimated the efficacy on several kinds of muscular diseases, the muscular electrophysiology mechanism of HR is still unclear. The superficial and deep cervical rotators synergistically contribute to the posture control and rotation movement ( Panjabi et al, 1998 ; Cheng et al, 2011 ; Agyei et al, 2019 ). This study aims to identify the impacts of HR on myoelectrical activity of cervical rotators and neuromuscular function, as well as the affecting factors.…”

Section: Introductionmentioning

confidence: 99%

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Effects of hanger reflex on the cervical muscular activation and function: A surface electromyography assessment

Wang

Liu

2022

Front. Physiol.

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Introduction: Cervical muscular dysfunction is closely associated with disorders and neuromuscular diseases of the cervical spine, and the hanger reflex (HR) has the potential to become a rehabilitation method. The muscular electrophysiology mechanism of HR is unclear. This study aims to identify the impacts of HR on cervical rotators’ myoelectrical activity and function.Methods: We designed a self-control clinical trial, and asymptomatic volunteers were continuously included from 1 September 2021 to 30 April 2022 in our department. Rotation tasks were performed on both sides under each of the situations: no HR, unilateral HR, and bilateral HR. Surface electromyography (SEMG) was used to detect the myoelectrical activity of agonistic splenius capitis (SPL), upper trapezius (UTr), and sternocleidomastoid (SCM). The co-contraction ratio (CCR) during rotation tasks was calculated. Correlation analyses and multiple linear regression were performed.Results: Finally, 90 subjects were enrolled (power >90%). The adjusted EMG value (aEMG) of SPL UTr, SCM, and rotating CCR under the unilateral HR and bilateral HR were higher than no HR; the aEMG of SPL and rotating CCR under the bilateral HR were higher than the unilateral HR. Multiple linear regression showed that HR pattern and age were the independent affecting factors for the aEMG of SPL (p < 0.001, p < 0.001), UTr (p < 0.001, p < 0.001), and SCM (p < 0.001, p < 0.001); BMI was an independent affecting factor for the aEMG of SPL (p < 0.001) and SCM (p < 0.001); HR pattern was the only affecting factor for CCR (p < 0.001).Conclusion: HR can increase the cervical rotators’ myoelectrical activities and rotating CCR, and the effects of bilateral HR are greater than unilateral HR, suggesting that bilateral HR has a greater clinical potential to become a rehabilitation method for treating cervical neuromuscular disorders.

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Intramuscular injections of botulinum toxin for the treatment of upper back myofascial pain syndrome: A systematic review of randomized controlled trials

Leonardi,

Alito,

Portaro

et al. 2023

European Journal of Pain

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Background and ObjectiveMyofascial pain syndrome (MPS) is a chronic musculoskeletal disorder characterized by the presence of trigger points. Among the treatment options, botulinum toxin injections have been investigated. The aim of this paper was to provide a synthesis of the evidence on intramuscular botulinum toxin injections for upper back MPS.Databases and Data TreatmentA systematic review of the literature was performed on the PubMed, Scopus and Cochrane Library, using the following formula: (“botulinum”) AND (“musculoskeletal”) AND (“upper back pain”) OR (“myofascial pain”).ResultsTen studies involving 651 patients were included. Patients in the control groups received placebo (saline solution) injections, anaesthetic injections + dry needling or anaesthetic injections. The analysis of the trials revealed modest methodological quality: one “Good quality” study, one “Fair” and the other “Poor”. No major complications or serious adverse events were reported. Results provided conflicting evidence and did not demonstrate the superiority of botulinum toxin over comparators. Most of the included trials were characterized by a small sample size, weak power analysis, different clinical scores used and non‐comparable follow‐up periods. Even if there is no conclusive evidence, the favourable safety profile and the positive results of some secondary endpoints suggest a potentially beneficial action in pain control and quality of life.ConclusionThe currently available studies show conflicting results. Their overall low methodological quality does not allow for solid evidence of superiority over other comparison treatments. Further insights are needed to properly profile patients who could benefit more from this peculiar injective approach.SignificanceThe randomized controlled trials included in this review compared using botulinum toxin to treat upper back MPS with placebo or active treatments (e.g., dry needling or anaesthetics) showing mixed results overall. Despite the lack of clear evidence of superiority, our study suggests that the use of botulinum toxin should not be discouraged. Its safety profile and encouraging results in pain control, motor recovery and disability reduction make it an interesting treatment, particularly in the subset of patients with moderate to severe chronic pain and active trigger points. To support the safety and efficacy of botulinum toxin, further high‐quality studies are needed.

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Cervical Kyphotic Deformity Worsening After Extensor Cervical Muscle Paralysis from Botulinum Toxin Injection

Cited by 5 publications

References 14 publications

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

The Role of Cervical Muscles Morphology in the Surgical Treatment of Degenerative Disc Disease: Clinical Correlations Based on Magnetic Resonance Imaging Studies

Effects of hanger reflex on the cervical muscular activation and function: A surface electromyography assessment

Intramuscular injections of botulinum toxin for the treatment of upper back myofascial pain syndrome: A systematic review of randomized controlled trials

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