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  • Cervical Radiofrequency Neurotomy Reduces Central Hyperexcitability and Improves Neck Movement in Individuals with Chronic Whiplash

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    Author(s)
    Smith, Ashley Dean
    Jull, Gwendolen
    Schneider, Geoff
    Frizzell, Bevan
    Hooper, Robert Allen
    Sterling, Michele
    Griffith University Author(s)
    Sterling, Michele
    Smith, Ashley D.
    Year published
    2014
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    Abstract
    Objective. This study aims to determine if cervical medial branch radiofrequency neurotomy reduces psychophysical indicators of augmented central pain processing and improves motor function in individuals with chronic whiplash symptoms. Design. Prospective observational study of consecutive patients with healthy control comparison. Setting. Tertiary spinal intervention centre in Calgary, Alberta, Canada. Subjects. Fifty-three individuals with chronic whiplash associated disorder symptoms (Grade 2); 30 healthy controls. Methods. Measures were made at four time points: two prior to radiofrequency neurotomy, and 1- and 3-months ...
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    Objective. This study aims to determine if cervical medial branch radiofrequency neurotomy reduces psychophysical indicators of augmented central pain processing and improves motor function in individuals with chronic whiplash symptoms. Design. Prospective observational study of consecutive patients with healthy control comparison. Setting. Tertiary spinal intervention centre in Calgary, Alberta, Canada. Subjects. Fifty-three individuals with chronic whiplash associated disorder symptoms (Grade 2); 30 healthy controls. Methods. Measures were made at four time points: two prior to radiofrequency neurotomy, and 1- and 3-months post-radiofrequency neurotomy. Measures included: comprehensive quantitative sensory testing (including brachial plexus provocation test), nociceptive flexion reflex, and motor function (cervical range of movement, superficial neck flexor activity during the craniocervical flexion test). Self-report pain and disability measures were also collected. One-way repeated measures analysis of variance and Friedman's tests were performed to investigate the effect of time on the earlier measures. Differences between the whiplash and healthy control groups were investigated with two-tailed independent samples t-test or Mann-Whitney tests. Results. Following cervical radiofrequency neurotomy, there were significant early (within 1 month) and sustained (3 months) improvements in pain, disability, local and widespread hyperalgesia to pressure and thermal stimuli, nociceptive flexor reflex threshold, and brachial plexus provocation test responses as well as increased neck range of motion (all P < 0.0001). A nonsignificant trend for reduced muscle activity with the craniocervical flexion test (P > 0.13) was measured. Conclusions. Attenuation of psychophysical measures of augmented central pain processing and improved cervical movement imply that these processes are maintained by peripheral nociceptive input.
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    Journal Title
    Pain Medicine
    Volume
    15
    Issue
    1
    DOI
    https://doi.org/10.1111/pme.12262
    Copyright Statement
    © 2014 The American Academy of Pain Medicine. Published by Blackwell Publishing. This is the pre-peer reviewed version of the following article: Cervical Radiofrequency Neurotomy Reduces Central Hyperexcitability and Improves Neck Movement in Individuals with Chronic Whiplash, Pain Medicine, Vol. 15 (1), 2014, pp. 128-141, which has been published in final form at https://doi.org/10.1111/pme.12262
    Subject
    Clinical sciences
    Physiotherapy
    Pharmacology and pharmaceutical sciences
    Publication URI
    http://hdl.handle.net/10072/62398
    Collection
    • Journal articles

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