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  1. 0 資料タイプ別
  2. 02 学位論文
  1. 250 大学院医歯学総合研究科(医)
  2. 60 博士学位論文
  3. 10 博士学位論文

The clinical features, risk factors, and surgical treatment of cervicogenic headache in patients with cervical spine disorders requiring surgery

http://hdl.handle.net/10191/48144
http://hdl.handle.net/10191/48144
e85a640e-62ff-41e3-a7a7-9412d17d3ba3
名前 / ファイル ライセンス アクション
h29nmk765.pdf 本文 (544.7 kB)
h29nmk765_a.pdf 要旨 (193.5 kB)
Item type 学位論文 / Thesis or Dissertation(1)
公開日 2018-11-16
タイトル
タイトル The clinical features, risk factors, and surgical treatment of cervicogenic headache in patients with cervical spine disorders requiring surgery
タイトル
言語 en
タイトル The clinical features, risk factors, and surgical treatment of cervicogenic headache in patients with cervical spine disorders requiring surgery
言語
言語 eng
資源タイプ
資源 http://purl.org/coar/resource_type/c_46ec
タイプ thesis
その他のタイトル
その他のタイトル 頸椎疾患手術患者おける頸原性頭痛の臨床的特徴、危険因子、手術による治療効果についての検討
著者 Shimohata, Keiko

× Shimohata, Keiko

WEKO 175306

Shimohata, Keiko

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著者別名
識別子 175307
識別子Scheme WEKO
姓名 下畑, 敬子
抄録
内容記述タイプ Abstract
内容記述 Objective: To clarify the clinical features and risk factors of cervicogenic headache (CEH; as diagnosed according to the International Classification of Headache Disorders-Third Edition beta) in patients with cervical spine disorders requiring surgery. Background: CEH is caused by cervical spine disorders. The pathogenic mechanism of CEH is hypothesized to involve a convergence of the upper cervical afferents from the C1, C2, and C3 spinal nerves and the trigeminal afferents in the trigeminocervical nucleus of the upper cervical cord. According to this hypothesis, functional convergence of the upper cervical and trigeminal sensory pathways allows the bidirectional (afferent and efferent) referral of pain to the occipital, frontal, temporal, and/or orbital regions. Previous prospective studies have reported an 86–88% prevalence of headache in patients with cervical myelopathy or radiculopathy requiring anterior cervical surgery; however, these studies did not diagnose headache according to the International Classification of Headache Disorders criteria. Therefore, a better understanding of the prevalence rate, clinical features, risk factors, and treatment responsiveness of CEH in patients with cervical spine disorders requiring surgery is necessary.
抄録
内容記述タイプ Abstract
内容記述 Methods: We performed a single hospital-based prospective cross-sectional study and enrolled 70 consecutive patients with cervical spine disorders such as cervical spondylotic myelopathy, ossification of the posterior longitudinal ligament, cervical spondylotic radiculopathy, and cervical spondylotic myeloradiculopathy who had been scheduled to undergo anterior cervical fusion or dorsal cervical laminoplasty between June 2014 and December 2015. Headache was diagnosed pre-operatively according to the International Classification of Headache Disorders-Third Edition beta. The Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire, Neck Disability Index, and a 0–100 mm visual analog scale (VAS) were used to evaluate clinical features, and scores were compared between baseline (i.e. preoperatively) and 3, 6, and 12 months post-surgery. Results: The prevalence of CEH in our population was 15/70 (21.4%, 95%CI: 11.8% to 31.0%). The main clinical features were dull and tightening/pressing headache sensations in the occipital region. Headache severity was mild (VAS, 32 ± 11 mm) and only 1 patient reported use of an oral analgesic. Compared to patients without CEH, patients with CEH had higher frequencies of neck pain (86.7% vs. 50.9%; p = 0.017), cervical range of motion limitation (ROM) (66.7% vs. 38.2%; p = 0.049), and higher Neck Disability Index scores (14 vs. 3; p < 0.001). Among the different cervical spine disorders, the prevalence of CEH was highest in cervical spondylotic myeloradiculopathy patients (60%), being ≤ 20% for all other disorders. Surgical treatments including cervical laminoplasty to relieve abnormal pressure on the spinal cord via a posterior approach, were associated with initial improvements in headache VAS that slightly diminished by 12 months post-surgery (P < 0.001). Conclusions: We report a lower prevalence of CEH in patients with cervical spinal disorders requiring surgery than that reported previously. The main clinical features of CEH were mild, dull, and tightening/pressing headache sensations in the occipital region. Potential risk factors for CEH included neck pain, limited cervical ROM, high Neck Disability Index score, and a diagnosis of cervical spondylotic myeloradiculopathy. The further accumulation of patients in a multi-institutional study may be required in order to discuss the diagnostic criteria and pathophysiology of this condition.
内容記述
内容記述タイプ Other
内容記述 学位の種類: 博士(医学). 報告番号: 甲第4352号. 学位記番号: 新大院博(医)甲第765号. 学位授与年月日: 平成29年9月20日
内容記述
内容記述タイプ Other
内容記述 Headache. 2017, 57(7), 1109-1117.
内容記述
内容記述タイプ Other
内容記述 This is the peer reviewed version of the following article: Headache. 2017. 57(7), 1109-1117, which has been published in final form at DOI: 10.1111/head.13123. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
書誌情報 発行日 2017-09-20
出版者
出版者 新潟大学
DOI
識別子タイプ DOI
関連識別子 info:doi/10.1111/head.13123
著者版フラグ
値 ETD
学位名
学位名 博士(医学)
学位授与機関
学位授与機関名 新潟大学
学位授与年月日
学位授与年月日 2017-09-20
学位授与番号
学位授与番号 13101甲第4352号
学位記番号
内容記述タイプ Other
内容記述 新大院博(医)甲第765号
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