Clinical outcomes following conservative management of chronic traumatic cervical myelopathy: A case report
Justin Bridges1, Roberto Sandoval1
1a School of Physical Therapy , University of the Incarnate Word , San Antonio , Texas , USA.
Background And Purpose:
There is limited evidence supporting the conservative management of patients with cervical myelopathy. The purpose of this report is to describe the intervention and outcomes of conservative physical therapy interventions for one patient with chronic cervical myelopathy.
Case Description:
This case was a 50-year-old male who sustained a neck injury following a rear-end collision 4 years prior to this therapeutic episode. The patient presented with decreased range of motion in the cervical spine and right upper extremity, strength deficits, altered sensation, poor posture, and reported chronic cervical region pain and difficulty sleeping.
Intervention:
The patient completed 10 weeks of conservative physical therapy. The patient completed the Neck Disability Index (NDI), Medical Outcome Survey Sleep Scale (MSS), short-form McGill Pain Questionnaire (SFMPQ), Patient-Specific Functional Scale (PSFS), and baseline clinical measurements of flexibility and strength were obtained.
Outcomes:
After the 10-week episode of care, the following changes were noted from baseline: 18% improvement on the NDI, 26% improvement on the MSS, 25% decrease in pain on the SFMPQ, and a 39% improvement on the total score of the PSFS. Cervical range of motion measurements increased between 25% and 100%. Grip strength demonstrated a 465% increase on the right upper extremity and a 25% increase on the left upper extremity.
Discussion:
This case report suggests that conservative management of chronic traumatic cervical myelopathy was effective in helping to improve pain, sleep, and function in this patient with a traumatic mechanism of injury.
