Clinical Research Directory

Correlation Between Forward Head Posture and Executive Functions in Cervical Radiculopathy

PURPOSE: This study aims to: * Investigate the relationship between Forward Head Posture (FHP), Pain Intensity and executive functions in patients with Cervical Radiculopathy (CR). * Investigate whether the severity of Forward Head Posture (FHP) is correlated with the degree of executive dysfunction in this population. BACKGROUND: Forward head posture (FHP) is a condition characterized by anterior translation of the head, resulting in sagittal plane misalignment of the cervical spine. It has become increasingly common in the digital era due to prolonged screen use and sedentary lifestyles. Previous studies have reported that this altered posture and the associated mechanical load on the cervical spine may be correlated with deficits in executive functions, including attention, processing speed, and working memory in older adults. Executive function refers to higher-order cognitive processes responsible for goal-directed behaviour, such as maintaining and manipulating information in short-term memory and selecting task-relevant information. The prefrontal cortex (PFC) plays a central role in regulating these functions through its extensive neuroanatomical connections with multiple cortical and subcortical brain regions, allowing it to participate in several neural networks involved in cognitive control. Recent evidence suggests that cognitive dysfunction may arise not only from localized lesions within these networks but also from degenerative or functional alterations affecting their integrity. HYPOTHESES: * There will be no significant association between Forward Head Posture (FHP), Pain Intensity and executive functions in patients with Cervical Radiculopathy. * There will be no significant correlation between the severity of Forward Head Posture and the degree of executive dysfunction in this population. RESEARCH QUESTION: Is there an association between Forward Head Posture (FHP), Pain intensity and executive dysfunction in patients with Cervical Radiculopathy (CR)?

Ultrasound-Guided Electrical Dry Needling for Chronic Cervical Radiculopathy: A Randomized Controlled Trial

This randomized controlled trial aims to investigate whether ultrasound-guided electrical dry needling with conventional physical therapy is more effective than conventional physical therapy alone in the following outcome measures: disability (Neck Disability Index and Upper Extremity Functional Index-20), average pain over the last 24 hours (Numeric Pain Rating Scale), paraspinal mechanosensitivity (pain-pressure threshold), cervical ipsilateral rotation range-of-motion, and medication intake.

Clinical Outcomes of Magnesium Sulfate in Cervical Interlaminar Epidural Steroid Injection

This single-center observational comparative cohort study evaluates clinical outcomes following two cervical interlaminar epidural steroid injection protocols used in routine care for chronic cervical radicular pain due to cervical disc herniation. Patients underwent the procedure between January 1 and July 1, 2026 and were classified according to the injectate already administered: lidocaine, dexamethasone, and normal saline, or lidocaine, dexamethasone, and magnesium sulfate. Treatment selection was determined by the treating physician during routine clinical care and was not assigned by the investigators. Data available at ethics approval were obtained retrospectively from clinical records. For patients whose scheduled routine follow-up had not yet occurred, follow-up outcomes were recorded prospectively after ethics approval. No research-specific treatment, additional visit, additional test, or modification of routine care was undertaken. Pain, neck-related disability, and health-related quality of life were evaluated using the Numeric Rating Scale, Neck Disability Index, and Short Form-12 over three months.

Myo-Electrical and Nerve Root Function Response to Focused Extracorpeal Shock Wave in Cervical Radiculopathy

BACKGROUND: Upper limb nerve root dysfunction with increased active myofascial trigger point in upper trapezius is common problem in patients with cervical radiculopathy. The purpose of this study was to evaluate the effect of Extracorpeal shock wave on the myo-electric and nerve function responses in patients with cervical radiculopathy.

Assessment of Upper Extremity Proprioception in Patients With Cervical Radiculopathy

There is no study in the current literature that systematically investigates the extent of upper-extremity proprioceptive impairment in patients with radicular neuropathic symptoms secondary to cervical disc herniation, nor its association with clinical findings. Although existing reviews emphasize proprioceptive deficits in populations with neck pain or cervical spondylosis, no studies specifically address the subgroup of cervical disc-related radiculopathy. This gap in knowledge hinders the integration of proprioceptive assessments with upper-extremity functional outcome measures in diagnostic and rehabilitative processes, suggesting a need for more specific data to guide sensory-motor training approaches. The primary aim of the present study is to assess upper-extremity proprioception in patients with cervical radiculopathy by comparing them with a healthy control group. The secondary aim is to examine the relationship between upper-extremity proprioception and clinical outcomes, including parameters such as pain and functional status.

Endoscopic Posterior Cervical Foraminotomy Versus Anterior Cervical Discectomy and Fusion for Cervical Radiculopathy

Cervical radiculopathy caused by cervical disc herniation or foraminal stenosis is a common condition that may result in upper limb pain, sensory disturbances, and motor deficits. Anterior cervical discectomy and fusion (ACDF) is an established surgical treatment, providing effective nerve root decompression. However, this procedure requires intervertebral fusion and may be associated with complications such as pseudarthrosis, adjacent segment degeneration, dysphagia, and recurrent laryngeal nerve injury. Uniportal endoscopic posterior cervical foraminotomy (UEPCF) is a minimally invasive alternative that enables direct nerve root decompression without intervertebral fusion. This technique may preserve cervical segmental mobility and reduce approach-related morbidity. Nevertheless, prospective randomized evidence comparing uniportal endoscopic posterior cervical foraminotomy with ACDF remains limited. ENDOFOR is a prospective, single-center, randomized, open-label, controlled non-inferiority trial designed to assess whether uniportal endoscopic posterior cervical foraminotomy is non-inferior to ACDF in reducing upper limb radicular pain three months after surgery. A total of 46 patients with cervical radiculopathy related to cervical disc herniation or foraminal stenosis will be randomized in a 1:1 ratio to undergo either uniportal endoscopic posterior cervical foraminotomy or ACDF. The primary outcome is upper limb radicular pain intensity at three months after surgery, assessed using a patient-reported 0-10 pain scale and adjusted for baseline pain intensity. Secondary outcomes include cervical pain, functional disability, postoperative complications, operative duration, length of hospital stay, adjacent segment disc degeneration, and fusion status. Patients will be followed for 12 months after surgery. The study aims to provide prospective randomized evidence regarding the effectiveness and safety of a minimally invasive surgical alternative to cervical fusion.

Cervical Spinal Cord Signal Abnormalities in Patients With Cervical Radicular Pain

This prospective observational study aims to determine the prevalence of cervical spinal cord signal abnormalities, including myelomalacia, among adult patients presenting to a tertiary pain clinic with cervical radicular pain. A total of 400 consecutive patients will be enrolled. Clinical and neurological examination findings, including the Hoffmann sign and other findings suggestive of cervical spinal cord involvement, will be recorded together with cervical magnetic resonance imaging (MRI) findings obtained as part of routine clinical care. The primary outcome is the prevalence of cervical spinal cord signal abnormalities, including myelomalacia, on cervical MRI. Secondary outcomes include the treatment strategy selected during routine clinical care, clinical and radiological factors associated with treatment selection, the relationship between the Hoffmann sign and cervical spinal cord abnormalities, and referral for surgical evaluation. This is an observational study. Participation in the study will not determine or alter diagnostic or treatment decisions, which will be made by the treating physician according to routine clinical practice.

Does the Combination of Cervical and Sacroiliac Mobilization Enhance Clinical Outcomes in Cervical Radiculopathy?

This study evaluated whether adding mobilization and myofascial techniques targeting the lumbar and sacroiliac regions to cervical-focused manual therapy provides additional clinical benefits in individuals with cervical radiculopathy. Changes in pain, disability, cervical range of motion, and sacroiliac joint (SIJ) clinical findings were assessed. The study also examined whether changes in SIJ clinical findings were associated with changes in cervical clinical outcomes, thereby exploring the relationship between cervical and lumbopelvic responses to an extended regional manual therapy approach.

Effect of Virtual Reality- Based Training on Cervical Mobility, Proprioceptive Accuracy and Hand Grip Strength in Patients With Cervical Radiculopathy

The aim of this study is to investigate the effect of virtual reality training on cervical mobility, proprioceptive accuracy and hand strength in patients with cervical radiculopathy. Forty patients of both sexes diagnosed with cervical radiculopathy will participate in this study. The participants' ages will be varied from 35 to 50 years, with a body mass index less than 30 kg/m². Patients will be randomly allocated to virtual reality and control groups. Both groups will receive a conventional physical therapy program in the form of electrotherapy, manual therapy, and strengthening exercises. The virtual reality group will receive virtual reality training in addition to the same physical therapy program. All participants will be assessed before and after treatment using the Joint Position Error by laser pointer for proprioceptive accuracy assessment; cervical ROM (CROM) for cervical mobility assessment; and hand dynamometer for hand grip strength. The treatment will be conducted three sessions per week for six weeks.

Rehabilitation After Anterior Cervical Discectomy and Fusion

Anterior cervical discectomy and fusion (ACDF) is a commonly performed surgical procedure for cervical disc herniation, cervical radiculopathy, and degenerative cervical spine disorders. Although surgery may reduce pain and neurological symptoms, some patients experience swallowing difficulties, neck pain, restricted neck movement, reduced respiratory muscle strength, and impaired quality of life after surgery. The purpose of this randomized controlled study is to determine whether a structured postoperative rehabilitation program improves swallowing function, respiratory muscle strength, pulmonary function, neck-related disability, pain, cervical range of motion, and health-related quality of life in adults who have undergone single- or two-level ACDF. A total of 60 eligible participants will be randomly assigned in a 1:1 ratio to either a structured rehabilitation group or a standard postoperative follow-up group. The structured program will include breathing exercises, inspiratory muscle training, swallowing and safe feeding education, cervical and scapular exercises, postural training, upper-extremity exercises, walking, and gradual physical activity. Participants in the control group will receive the standard postoperative recommendations provided by the surgical team. Assessments will be conducted before the rehabilitation program and during postoperative follow-up. The primary outcome will be swallowing difficulty measured using the Eating Assessment Tool-10. Additional outcomes will include dysphagia severity, oral intake level, respiratory muscle strength, spirometric pulmonary function, neck pain, neck-related disability, cervical range of motion, health-related quality of life, treatment adherence, and adverse events.

Efficacy Of Gross Myofascial Release With Neural Mobilization Versus Neural Mobilization Alone On Pain, Functional Limitations, And Cervical Range Of Motion In Cervical Radiculopathy

This is a randomized control trial aims to evaluate the efficacy of gross myofascial release with neural mobilization versus neural mobilization alone on pain, functional limitations, and cervical range of motion in cervical radiculopathy. Cervical radiculopathy, is characterized by neck pain, pain radiating down the arm, numbness, tingling, weakness of muscles and functionality limitations with compression or irritation of the cervical nerve root due to cervical spondylosis, cervical disc herniations or degeneration of the cervical spine leading to cervical radiculopathy and the diminished quality of life from decreased day-to-day functional capacity and productivity at work. The study will evaluate pain, functional limitations, and cervical range of motion.

Cervical Epidural Block in Chronic Neck Pain

Chronic neck pain can negatively affect daily activities, work ability, and quality of life. Cervical epidural block is commonly used to reduce pain and inflammation, while exercise and physical therapy aim to improve muscle strength, endurance, movement control, and physical function. However, there is limited evidence comparing cervical epidural block alone with its combined use with exercise or physical therapy. This study aims to compare the effects of three treatment approaches in patients with chronic neck pain associated with cervical disc pathology or degenerative changes. Participants will receive cervical epidural block alone, cervical epidural block combined with cervical stabilization exercises, or cervical epidural block combined with physical therapy. Pain intensity, neck-related disability, and quality of life will be evaluated before treatment and at 1, 3, and 6 months after treatment using the Numeric Rating Scale, Neck Disability Index, and 12-Item Short Form Health Survey. The study will determine whether adding exercise or physical therapy to cervical epidural block provides additional clinical and functional benefits.

Functioning in Individuals With Cervical Radiculopathy After Posterior Cervical Decompression

Compression on structures, as spinal nerves, in the cervical spine can cause cervical radiculopathy which leads to pain, disability, and reduced quality of life for the affected individual. Cervical foraminotomy with our without laminectomy are common posterior decompression surgical techniques for treating cervical radiculopathy. There is a lack of knowledge regarding function in patients with cervical radiculopathy after posterior cervical decompression. The aim with this study is to study pain, function, psychosocial factors, and health related quality of life after posterior cervical decompression in patients with cervical radiculopathy. This is a prospective multicenter longitudinal observational cohort study with follow-up at three, 12- and 24 months postoperative. A total of 154 individuals scheduled to undergo foraminotomy with our without laminectomy due to cervical radiculopathy will be included. Primary outcome is neck-specific function measured with the Neck Disability Index. Data will be collected preoperatively and at three, 12 and 24 months with electronic questionnaire.

Effect of Core Stabilization Exercises on Patients With Cervical Radiculopathy

The goal of this clinical trial is to evaluate the effect of core stabilization exercise on functional outcome and craniovertebral angle which is the angle of forward head , in adults with cervical radiculopathy. The main questions it aims to answer are: * Is there a significant effect of core stabilization exercises (CSEs) on craniovertebral angle (CVA) in patients with cervical radiculopathy? * Is there a significant effect of core stabilization exercises (CSEs) on functional outcome in patients with cervical radiculopathy? Researchers will compare effect of adding core stabilization exercises to conventional physical therapy program (TENS, hot pack, US, manual therapy and strengthening exercises) Vs conventional physical therapy program alone to see if there is a beneficial effect of adding core stabilization exercises to physical therapy program Participants in study group will perform core stabilization exercises in addition to conventional PT program while participants in control group will receive conventional PT program

Nerve Gliding Exercises in Cervical Radiculopathy

The aim of this study is to investigate the effect of nerve gliding exercises on pain, cervical range of motion, joint position sense, grip strength, functional status and quality of life in individuals with cervical radiculopathy.

Neurodynamic Mobilization for Cervical Radiculopathy

Cervical radiculopathy is a condition caused by compression or irritation of cervical nerve roots, leading to neck pain, arm pain, sensory disturbances, and functional limitations. This randomized controlled trial evaluated whether adding neurodynamic mobilization to conventional physiotherapy improves pain intensity and functional disability in individuals with cervical radiculopathy. Participants received either conventional physiotherapy alone or conventional physiotherapy combined with neurodynamic mobilization over a 5-week treatment period.

CRIS Based Evaluation of Cervical Interlaminar Epidural Steroid Injection Outcomes

This prospective single-center study aims to evaluate the clinical efficacy of fluoroscopy-guided cervical interlaminar epidural steroid injection (CIESI) in patients with unilateral, single-level cervical radiculopathy due to cervical disc herniation. Unlike previous studies that assessed neck and arm symptoms separately, this study uses the Cervical Radiculopathy Impact Scale (CRIS) as the primary outcome measure to simultaneously evaluate cervical and upper extremity symptoms and their functional impact. A total of 98 patients resistant to conservative treatment will be assessed at baseline, 3 weeks, and 3 months after CIESI using CRIS, Numeric Rating Scale (NRS), Neck Disability Index (NDI), and QuickDASH scores. The primary outcome is improvement in CRIS scores following the intervention, while secondary outcomes include changes in pain intensity and functional disability. The study seeks to determine whether CRIS provides a more comprehensive and clinically meaningful assessment of treatment response in cervical radiculopathy.

Effects of DRT on Neck Pain, ROM, and Chest Expansion in Patients With CR

This randomized controlled trial aims to determine the effects of the diaphragmatic release technique on neck pain, cervical range of motion, and chest expansion in patients with cervical radiculopathy. Participants will be randomized to either the baseline treatment or the experimental group for five weeks.

Effects of Mulligan Belt Traction Versus Fisted Traction in Patients With Lower Cervical Spine Radiculopathy

Individuals with a lower cervical spine radiculopathy diagnosis will undergo screening to determine their eligibility based on inclusion and exclusion criteria. Eligible participants will be asked for their informed consent

Effects of Mckenzie Exercises and Neural Flossing Technique in Patients With Cervical Rediculopathy

The primary objective of this research was to conduct a comparative analysis of the outcomes following McKenzie therapy and neural mobilization in individuals diagnosed with cervical radiculopathy

Ultrasound Guided Transcutaneous Pulsed Radiofrequency for Cervical Radiculopathy

Cervical radiculopathy (CR) is a painful condition caused by irritation of the cervical nerve roots, often leading to neck, shoulder, and arm pain, sometimes with numbness or weakness. These symptoms can reduce quality of life and place a burden on healthcare systems. Current treatments, such as physical therapy, cervical traction, and medication, are often not fully effective. Pulsed radiofrequency (PRF) has shown benefits for nerve-related pain, but because it requires an invasive procedure, its use is limited. Transcutaneous pulsed radiofrequency (TCPRF) is a non-invasive version of PRF. It has shown promising results in animal studies and in clinical research for knee and shoulder conditions, but has not been tested for CR. Recent improvements in ultrasound allow more precise targeting of cervical nerve roots, making ultrasound-guided TCPRF a potentially safe and accessible treatment option. This pilot study will evaluate the efficacy and safety of ultrasound-guided TCPRF in patients with CR compared to a sham treatment. A total of 32 participants with CR lasting more than six weeks will be randomly assigned to either TCPRF or sham treatment. Both groups will receive 12 treatment sessions over four weeks, combined with a standard rehabilitation program. The main outcome is pain intensity measured by the Numeric Rating Scale (NRS). Secondary outcomes include neck-related disability, medication use, and any side effects.

Prospective Comparative Analysis of ACDF vs Fusion Interbody Cages With nanoLOCK Osseointegrative Technology

Study team will plan a prospective, randomized control trial using our institution's spine clinical outcomes registry. Eligible patients undergoing ACDF (see inclusion criteria listed below) will be randomized to an Intervention or Control Group, which will differ according to the interbody cage used during the procedure. In the Intervention Group (100 patients), Medtronic Titan Endoskeleton TCS zero-profile, stand-alone interbody cages with nanoLOCK osseointegrative technology will be implanted at each treated level. In the Control Group (100 patients), patients will receive an alternative interbody cage system that does not employ nanoLOCK ossteointegrative technology. Interbody cages used in the Control Group (along with the decision to apply anterior plate fixation) will be determined according to surgeon preference. There will be no blinding to the type of implant used. Standard demographic and procedural variables will be collected for all patients (including history of diabetes, tobacco, use, prior use of oral corticosteroids, number of levels fused, and presence of bicortical screw placement). Clinical and radiographic outcomes in the Intervention and Control Groups will be directly compared.

Transcutaneous Auricular Vagus Nerve Stimulation Combined With Cervical Epidural Injection for Cervical Radiculopathy

This is a prospective, randomized, double-blinded, sham-controlled trial conducted to investigate the efficacy and safety of transcutaneous auricular vagus nerve stimulation (taVNS) combined with cervical epidural injection in the treatment of cervical radiculopathy. A total of 80 subjects will be enrolled and randomly assigned (1:1) to either the experimental group or the control group. The primary outcome measure is the proportion of subjects with a ≥50% reduction in the Numerical Rating Scale (NRS) pain score at discharge. Secondary outcomes include pain intensity, pain interference, psychological status, sleep quality, physical disability, and autonomic function measurements. Adverse events will be monitored throughout the study.

Transcutaneous Electrical Nerve Stimulation Versus Repetitive Transcranial Magnetic Stimulation on Pain and Functional Outcome in Cervical Radiculopathy

this study will be conducted to compare between transcutaneous electrical nerve stimulation versus repetitive transcranial magnetic stimulation on pain and functional outcome in cervical radiculopathy