The application of Mechanical Diagnosis and Therapy and changes on MRI findings in a patient with cervical radiculopathy

Spanos, George; Zounis, M.; Natsika, Margarita; May, Stephen

doi:10.1016/j.math.2012.09.011

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…The directional preference assessment process is welldescribed in the literature 9,28 (and a synopsis is provided in this paper's introduction). Following the ascertainment of a directional preference in the patient with NP/R, exercise and manual therapies matched to the preferred direction were performed.…”

Section: Methodsmentioning

confidence: 99%

Factors in Patient Responsiveness to Directional Preference-Matched Treatment of Neck Pain With or Without Upper Extremity Radiation

Holmes

Brazauskas

Cassidy

et al. 2017

Journal of Patient-Centered Research and Reviews

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Journal of Patient-Centered Research and Reviews ( JPCRR) is a peerreviewed scientific journal whose mission is to communicate clinical and bench research findings, with the goal of improving the quality of human health, the care of the individual patient, and the care of populations. Recommended CitationHolmes B, Brazauskas R, Cassidy LD, Wiegand RA. Factors in patient responsiveness to directional preference-matched treatment of neck pain with or without upper extremity radiation. J Patient Cent Res Rev. 2017;4:60-8.

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Section: Methodsmentioning

confidence: 99%

Factors in Patient Responsiveness to Directional Preference-Matched Treatment of Neck Pain With or Without Upper Extremity Radiation

Holmes

Brazauskas

Cassidy

et al. 2017

Journal of Patient-Centered Research and Reviews

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Section: Introductionmentioning

confidence: 99%

“…MDT assessment and treatment has demonstrated the ability to abolish symptoms associated with cervical radiculopathy, even in the presence of positive MRI findings [15]. Spanos et al [15] showed repeated movements used by the clinician not only resolved the patient's symptoms, but altered the size of disc herniation on MRI by more than 50%. Recent case reports [16][17][18] have confirmed that end-range loading strategies based Orthopedics and Rheumatology Open Access Journal on MDT principles, including extension which is known to physiologically narrow the spinal canal, are safe for patients with an MRI confirmed radiculopathy.…”

Section: Introductionmentioning

confidence: 99%

“…There has been no publication reporting the MDT management for continuing, or worsening, cervical radiculopathy following ACDF. Current literature disputing the reliability of special tests [19][20][21][22] and utility of diagnostic tests [15] warrants consideration for other diagnostic and prognostic treatments, such as MDT. The aim of this case report was to demonstrate a MDT evaluation, classification, and management of a patient with worsening cervical radiculopathy following ACDF.…”

Section: Introductionmentioning

confidence: 99%

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2017

OROAJ

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The prevalence of neck pain is estimated to be 30-50 % in the general population, the second leading source of reported pain in the United States. There is limited research on the use of mechanical diagnosis and therapy (MDT) on patients with cervical pain. The effects and safety of MDT assessment and treatment for failed anterior cervical discectomy and fusion (ACDF) has yet to be established. This case report presents a 42-year-old female with a complaint of worsening neck pain with intermittent radiculopathy after an ACDF to address cervical radiculopathy. The patient received a MDT evaluation and was classified as a thoracic spine derangement. The patient was treated based on mechanical and symptomatic responses to repeated movements and mobilizations using principles of MDT. Short-and long-term outcomes were excellent, demonstrating rapid abolishment of symptoms and improvement of function in 6 visits over 4 weeks. The patient reported no pain or functional disability and had returned to all work and recreational activities. The patient demonstrated the ability to prevent and manage recurrence of symptoms independently at one-year follow-up. This case report confirms the efficacy and safety of MDT evaluation after a failed ACDF. The patient was successfully managed using MDT with full resolution of symptoms. This case report provides preliminary evidence that MDT may provide effective short-and long-term outcomes after failed ACDF. Less invasive, conservative methods, such as MDT, may be more effective at resolving cervical radiculopathy. Level of evidence 4.

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