See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/341130591

Ayurvedic management of cervical spondylosis radiculopathy

Article · May 2020

DOI: 10.4103/ijhas.IJHAS_139_17

CITATIONS READS
0 3,870

3 authors, including:

Sarvesh Kumar Singh Kshipra Rajoria

National Institute of Ayurveda National Institute of Ayurveda
74 PUBLICATIONS 239 CITATIONS 58 PUBLICATIONS 229 CITATIONS

SEE PROFILE SEE PROFILE

All content following this page was uploaded by Sarvesh Kumar Singh on 04 May 2020.

The user has requested enhancement of the downloaded file.

Spine: 3.5 mm

ISSN
ISSN -2278-4292
0000-0000
S
A

International Journal of
H

Health & Allied Sciences

J
International Journal of Health & Allied Sciences • Volume 1 • Issue 2 • April-June 2018 • Pages 69-***

www.ijhas.in
I

Volume 7 / Issue 2 / April-June 2018

An Official Publication of JSS Academy of
Higher Education & Research - Deemed to be
University, Mysuru
 Case Report

Access this article online

Quick Response Code:
Ayurvedic management of cervical
spondylosis radiculopathy
Archana Kushwaha, Sarvesh Kumar Singh, Kshipra Rajoria

Website:
Abstract:
www.ijhas.in Radiculopathy, commonly referred as pinched nerve, refers to a set of conditions in which one or more
nerves are affected and their functioning is hampered. This phenomenon is termed as neuropathy.
DOI:
10.4103/ijhas.IJHAS_139_17 This can result in pain or more precisely in radicular pain. In a radiculopathy, the problem occurs at
or near the root of the nerve, shortly after its exit from the spinal cord. However, the pain or other
symptoms often radiate to the part of the body served by that nerve. The management available in the
current era of medicine is not satisfactory. Here, we are presenting a case of cervical spondylosis (CS)
radiculopathy which was treated with a combination of Panchkarma procedures and Ayurvedic oral
drugs. Greeva stambh was considered as the Ayurvedic diagnosis for the case. The treatment
protocol designed for the particular case was Panchatikta ksheera Basti (enema with medicated milk)
for 16 days along with Shalishastic pind sweda. The oral medication prescribed was Ashwagandha
churna (Withania somnifera Dunal), Shatavari churna (Asparagus recemosus Wild), Gokshur churna
(Tribulus terrestris L.) each in a dose of 2 g, Sarpgandha churna (Rauvolfia serpentina (L) Benth.
Ex Kurz) 1 grms, Shankha bhasma 500 mg with Luke warm water, Yograj guggulu‑3 tablet with
Dashmool kwath in a dose of 40 ml, Ashwagandha avaleha 10 g with lukewarm water. All these
drugs were prescribed for twice a day. Visual analog scale and range of motion were the parameter
used to assess patient and considerable improvement was noticed in the case after a month of
treatment which sustained in follow‑up duration of 2 months. The case study demonstrate that CS
radiculopathy may be successfully managed with Ayurvedic treatment.
Keywords:
Ayurveda, cervical spondylosis rediculopathy, Greevastambh, Panchkarma

Introduction on X‑ray in the age of 60 years.[5] Corporate

social responsibility (CSR) is a disease

C ervical spondylosis (CS) or osteoarthritis

of the cervical spine produces neck
pain radiating to the shoulders or arms
process marked by nerve compression from
herniated disc material or arthritis bone
spurs. This impingement typically produces
with headache in posterior occipital neck and radiating arm pain or numbness,
region. Narrowing of the spine canal by sensory deficits, or motor dysfunction in
osteophytes, ossification of the posterior the neck and upper extremities.[6] There
longitudinal ligament, or a large central are no satisfactory conservative and
disk may compress cervical spinal cord.[1] surgical procedures available in modern
Age, gender, and occupation are the main medicine for CSR and much limitation
risk factors for CS.[2] The CS commonly and complications also encountered in
occurred in below 30 years of age.[3] Recent these procedures. [7] The manifestations
Department of studies depicted that CS increases with had been managed by Ayurveda, related
Panchakarma, National
Institute of Ayurveda, aging before age 50 years and decreases with cases are also reported in PubMed indexed
Jaipur, Rajasthan, India aging after age 50 years,[4] 70% of women journal.[8‑10] Greevastambh (~stiffness in neck)
and 85% of men show consistent CS changes is considered as Ayurvedic diagnosis for the
Address for cases of CSR. The disease come under the
correspondence: This is an open access article distributed under the terms umbrella of Vata‑Nanatmaja Vyadhi (diseases
Dr. Sarvesh Kumar Singh, of the Creative Commons Attribution-NonCommercial-
Department of ShareAlike 3.0 License, which allows others to remix, tweak,
Panchakarma, National and build upon the work non-commercially, as long as the How to cite this article: Kushwaha A,
Institute of Ayurveda, author is credited and the new creations are licensed under Singh SK, Rajoria K. Ayurvedic management of
Jaipur, Rajasthan, India. the identical terms. cervical spondylosis radiculopathy. Int J Health Allied
E‑mail: sarveshksingh21@ Sci 2018;7:104-9.
gmail.com For reprints contact: [email protected]

104 © 2018 International Journal of Health & Allied Sciences | Published by Wolters Kluwer ‑ Medknow
 Kushwaha, et al.: Ayurvedic management of cervical spondylosis radiculopathy

only due to vitiation of Vata dosha).[11] The symptoms of Table 1: Dashavidha Pariksha
Vata Vyadhi (~various neurological and musculoskeletal Physical examination Result interpretation
disorders) are Sankocha (constrictions of organs), Parva Prakriti Vatakapha
stambha (stiffness in joints), Asthi bheda (pain in bones), Vikriti Vataj Vikriti
Padi prastha shiroghraha (stiffness in lower limbs, back, Pramana (body proportion) Sama Praman (symmetrical)
and head) Spandana, and Gatrasuptta (numbness).[12] Here, Sara (purest form of tissues) Madhyam Sara
we are representing a case of CSR which was successfully Samhanan (medium body built) Madhyam (medium)
managed by Ayurvedic therapy. Satmaya Sarvasatmya (homologation for
all taste)
Satva ( mental strength) Madhyam
Case Report Aahar sakti (food activities and Madhyam (medium)
digestive power)
A 50‑year‑old female patient consulted in outpatient Vyayamsakti (capability of Heen (low)
Department of the National Institute of Ayurveda, Jaipur, physical activities)
with complaints of gradually progressive pain around Vaya (age) Madhyavastha
the neck region which radiated toward bilateral shoulder
joints and both upper limbs along with stiffness in neck examination, sensations of touch and temperature were
and shoulders since 4 years. The patient had restricted lost in the right tip of shoulder joint, position sense,
movement of neck and shoulder joints since 2 years and joint vibration senses were normal bilaterally.
after a traumatic injury which aggravated by prolonged On motor examination nutrition, power, tone, and
sitting and relieved in lying posture. She also suffered coordination of the upper and lower limbs were normal.
from intermittent numbness and tingling sensations Deep tendon reflexes and superficial‑reflexes were
in both upper limbs since a year. The patient had
normal. The patient had Babinski and Hoffman sign
undergone neurological and orthopedic consultation in
negative bilaterally and Spurling sign positive. All
IndoWestern hospital of brain and spine, Jaipur. Surgical
biochemical and laboratory finding were normal except
and conservatives management was recommended.
erythrocyte sedimentation rate (ESR). ESR was elevated
She was taking some painkiller and corticosteroids for
up to ‑ 75 mm/h. Magnetic resonance imaging (MRI)
pain management as prescribed by previous consultant.
of cervical spine that was done on 9 February 2013,
The prime aim of the patient to attend our outpatient
suggested posterior osteophytes at c 4–c 6 vertebral
department was to seek a better nonsurgical approach
bodies and c 5–c 6. Posterior osteophytic ridges and
of her aliment.
protruding disc caused moderate spinal canal stenosis
Case findings with narrowing of the left neural foramina with mildly
The case was admitted to female ward of Panchakarma indenting the theca. MRI scan on October 15, 2014
Department of National Institute of Ayurveda, Jaipur, revealed disc bulge at c3–c4, c4–c5, c5–c6, and c6‑c7, cord
on April 18, 2017, for the treatment. On physical compression at c5‑c6 due to disc bulge – which was
examination, the general condition of the patient was suggestive of CSR.
poor, blood pressure of the patient was 150/100 mmHg.
Pulse was 70/min and often irregular. She was anxious, Diagnostic focus and assessment
appetite was moderate, the tongue was coated, and The patient was known case of CSR, and it was
bladder habits were normal and constipated bowel. The confirmed by previously done MRI. Greevastambha was
patient was assessed on Dashavidha pariksha [Table 1] considered as Ayurvedic diagnosis which is included
patient had normal gait. The active movement of range in Urdhajatrugata roga [13] (disease above the neck
of cervical spine was restricted. Pain aggravated on region) and Nanatamaj Vatavyadhi.[11] Hereditary spastic
the movement of neck. On examination, flexion of paraplegia, frozen shoulder, primary spinal cord tumor,
the neck was 15°, extension was 10°, lateral flexion to muscle spasm, amytrophic lateral sclerosis, cervical
left side was 10°, lateral flexion to the right side was sprain and strain, neoplastic brachial plexopathy, spinal
10°, lateral rotation to the left side was 20°, and lateral cord infraction, and spinal sepsis pan coast tumors were
rotation to the right side was 25°. The visual analog the differential diagnosis of the case. The confirmatory
scale (VAS) scoring was 70. Tenderness was examined diagnosis of CSR was based on MRI finding of the case.
over c4,‑c5 c5‑c6, c6‑c7 vertebras, power of biceps and There was absence of Babinski sign and fasciculation
triceps muscles of both upper limb were normal, lumbar which differentiate it from amyotrophic lateral sclerosis.
spine movement was normal in range. Tenderness was Frozen shoulder was excluded from differential
absent. On neurological examination, higher functions, diagnosis on the base of physical examination. Muscle
consciousness, orientation of time, place, person, spasm, cervical sprain, and strain were rule out with
memory, and speech were normal. The patient was right Spurling test. Other conditions were excluded on the
handed. All cranial nerves were well intact. On sensory basis of MRI finding.
International Journal of Health & Allied Sciences - Volume 7, Issue 2, April‑June 2018 105
 Kushwaha, et al.: Ayurvedic management of cervical spondylosis radiculopathy

Treatment plan with Panchsakar churna in dosage of 6 g with lukewarm

Greevastambha comes under Urdhjatrugat roga[13] and water a night before the commencement of interventions
Nanatmaj Vata Vyadhi (~ various musculoskelton and to the patient. For next 16 days, Shalishastic pind Sweda
neurological disorder) in Ayurveda general line of along with Panchatikta ksheera Basti were administered.
management of Urdhjatrugata roga NanatmakVatavyadi Followed by Nasya karma by K 88 taila (oil) (Vindhynchal
such as Abhyanga (massage), Swedan (sudation), Basti pharmacy) [Table 2] for 7 days. Along with these
procedure (drug administration through anus) and Nasya Panchkarma intervention combinations of oral medicines
(drug administration through the nose) were adopted for were prescribed‑Ashwagandha churna (Withania
the case.[14] Considering the Vata Kapha prakriti (specific somnifera Dunal), Shatavari churna (Asparagus
body constitution) of the patient, Abhyanga, and Swedana recemosus Willd), Gokshur churna (Tribulus terrestris L.)
in the form of Shalishastic pind Sweda and Ksheera each in a dose of 2 g Sarpgandha churna (Rauvolfia
Basti[15] (medicated milk enema) in form of Panchtikta serpentine (L) Benth. Ex Kurz) 1 g, Shankha bhasma
Ksheera Basti were adopted for the patient followed by 500 mg with lukewarm water, Yograj guggulu‑3 tablet
Nasya karma. with Dashmool kwath in a dose of 40 ml, Ashwagandha
avleha 10 g with Lukewarm water. All these drugs
Intervention plan were prescribed for twice a day [Table 3]. These oral
Various Panchkarma interventions were adopted to medications were continued in following 2 months after
treat this patient. Anuloman (mild anuloman) is done the completion of Panchkarma schedule.

Table 2: Panchkarma procedures

Panchkarma Drugs Method of preparation Method of application Day of treatment
procedure
Shalishastica Shashtika rice (O. sativa), 300 g of Shashtika rice (O. Massage with Dashmool oil was 16 days
pind sweda Balamoola (S. cordifolia) sativa) is cooked with 1.5 l of done over whole body for 15 min
milk and decoction of Balamoola followed by massage over
(root of S. cordifolia). Four body for 45 min with the help of
boluses made by this mixture cotton pottali filled with bolus of
with the help of four piece of processed rice
cloth. Another portion of milk
and decoction of same quantity
was mixed and warming in low
temperature to dip the above
boluses for heated the pottali
Panchtikta Nimb (A. indica), 25 g honey and 5 g Saindhav After Abhyang and Swedana Continue Kwath basti
ksheera Patola (T. dioica), salt mix properly then 30 ml luke over local aria Basti was given was given for 16 day
Basti Guduchi (T. cordifolia), warm Panchtikta ghrita and 50 before the meal Anuvasan basti was not
Kantkari (S. sursttense), ml luke warm Ashwagandha tail required in milk Basti
Vasa (J. adhatoda) mix and entire mixture stirred. 30
g Shatpushpa kalka (A. sowa)
added in this mixture followed
by 400 ml processed with milk
decoction of Panchtikta kwath
added
Nasya K-88 oil Ingredients- Massage with Dashmoola oil 7 days
Bhringraj(Eclipta alba), over face followed by Mridu
Brahmi(Centella asiatica), swedana. 6 drops of k‑88 oil
B. monnieri (C. asiatica), administered in each nostrils
Nimb patra (A. indica), followed by Dhoompan
Heena (L. inermis), Gunja
(A. precatorius), Aamalki
(P. emblica), Karanj beez
(M. pinnata), Mustak (C.
rotundus), Piperment
(M. piperita), Karpur (C.
camphora), Shweta chandan
(S. album), N. jatamansi
(N. jatamansi), Sariva
(H. indicus), Tila taila (S.
indicum)
O. sativa = Oryza sativa, S. cordifolia = Sida cordifolia, A. indica = Azadirachta indica, T. dioica = Trichosanthes dioica, T. cordifolia = Tinospora cordifolia,
S. sursttense = Solanum sursttense, J. adhatoda = Justicia adhatoda, A. sowa = Anethum sowa, E. prostrate = Eclipta prostrate, C. asiatica = Centella asiatica
A. precatorius = Abrus precatorius, L. inermis = Lawsonia inermis, P. emblica = Phyllanthus emblica, M. pinnata = Millettia pinnata, C. rotundus = Cyperus
rotundus, M. piperita = Mentha piperita, C. camphora = Cinnamomum camphora, S. album = Santalum album, N. jatamansi = Nardostachys jatamansi, H. indicus
= Hemidesmus indicus, S. indicum = Sesamum indicum, B. monnieri = Bacopa monnieri

106 International Journal of Health & Allied Sciences - Volume 7, Issue 2, April‑June 2018
 Kushwaha, et al.: Ayurvedic management of cervical spondylosis radiculopathy

Table 3: Oral medications

Name of drug Dose Anupana Day
Ashwagandha avleh (procured from Dabur India 10 ml twice in a day Lukewarm water Three months from first day
company) of admission
Yograj gugulu 3 tab twice in a day in Dashmool kwath (decoction Three months from first day
the crushed form of ten herbs) of admission
Ashwagandha churna (W. somnifera) (2 g), 4.5 g bid (twice in a With Luke warm water Three months from first day
Shatavari churna (A. racemosus) (2 g), Shankha day) of admission
bhasma (500 mg)
Sarpgandha churna (R. serpentina) (1 g), 3 g bid (twice in a day) With Luke warm water Three months from first day
Gokshur churna (T. terrestris) (2 g) of admission
W. somnifera = Withania somnifera, A. racemosus = Asparagus racemosus, R. serpentine = Rauvolfia serpentine, T. terrestris = Tribulus terrestris

Table 4: Timeline age. These changes lead to cracks and fissures and
Years Incidence collapsing of intervertebral discs causing annulus
2012 Patient got trauma followed by neck pain to bulge outward. Annulus fissure and herniation
February 09, 2013 Posterior osteophytes are seen in c4-c6 may complicate chronic spondylotic changes. The
vertebral bodies and at c5-c6 posterior
cross‑sectional area of the canal is narrowed due to
osteophytic ridges and protruding disc
causes moderate spinal canal stenosis with annulus bulges. The uncinate process over rides and
narrowing of left neural foramina with mildly hypertrophy compromising the ventrolateral portion of
indenting the theca the foramen to disc degeneration marginal osteophytes
2014 Neck pain which radiated toward shoulders start developing changes lead to radiculopathy. Other
and right forearm started
conditions aggravated the changes by trauma and
October 15, 2014 Disc bulge at c3‑c4, c4‑c5, c5‑c6 and c6‑c7,
cord compression at c5‑c6 due to disc heavy work.[16,17] The disease has resemblance with the
bulge Greevastambh disease described in Ayurveda which is
2015 Stiffness in the neck region and restricted Urdhajatrugata roga and Nanatmak Vata Vyadhi. There
movement of neck are two type of pathology in Vata Vyadhi. First due to
2016 Numbness and tingling sensation started in the Kshaya of Dhatu (diminished of body tissue) and
the right upper arm and both shoulders
second due to Margaavrodha (obstructive pathology).[18]
2017 Admitted in National Institute of Ayurveda
Degeneration of vertebras and discs occurs mainly due
April 20, 2017 Shalishastic pind sweda, Panchatikta
ksheera basti, and combination of oral to Kshaya type of pathology in which Vata Pitta dosha
medication started are vitiated. Here, Asthi poshan chikitsa (nutrition to
April 15, 2017 Nasya and combination of oral drugs same bone tissue) is the main treatment to treat the condition.
as previous Chikitsa of Asthigata roga (treatment of musculoskelton
May, 2017 Patient had got relief from symptoms as disease) are Panchkarma, Tikta (bitter taste herbs) sadhit
pain, restricted movement, numbness, and
tingling sensation
ksheer basti along with oil and ghrita.[19] According to
May 24, 2017 Patient had discharged Charak, Basti[20] is best chikitsa for Vata and half chikitsa.[21]
August, 2017 Patient came with improved symptoms Arundatta, a commentator of classics of Ayurvedic text
mention that Tikta ksheera basti, is the combination of
Outcome measures and follow‑up Snigdha (unctuous) and Shoshana property. It pacifies
After completion of Panchkarma procedures, the patient the vitiated Vata dosha and produces the Khara guna
condition was reassessed. The patient had no giddiness (roughness property) in Asthi dhatu (bone tissue) so Tikta
and neck pain improved, VAS score decreased to 20 and ksheera basti promotes Asthi poshana (proper osteogenesis
stiffness improved. Flexion of the neck had improved and nourishment of bone).[22] Tikta rasa (bitter taste) itself
to 45° and extension to 40°. Lateral flexion to left side work as Twak mansa shthirikaro (increase the durability of
was improved to 30°. Lateral flexion to the right side muscle and skin) by which it gives strength to muscles
was improved to 30°. Lateral rotation to the left side was and ligaments of neck region.[23] Ashwagandha taila is
improved to 45°. Lateral rotation to the right side was used in basti. Ashwagandha is Balya (anabolic, provide
improved to 45°. Spurling sign was negative. The patient strength), Bramhana (nourishes the bone and muscles)
was discharged on 24 may 2017. The patient condition and Rasayana (immunomodulator).[24] Panchtikta ghrita
was stable in the follow‑up period of 2 months. Details had been used for its Tikta rasa (taste) and useful in Asthi
of patient case history and follow up is given in Table 4. dhatu chikitsa. This Yapana manner is suitable for healthy
persons, patients, and old age persons.[25] Shalishastic
Discussion pind swedan is mentioned in Vata vikara.[26] Bala moola
kwath which was used in Shalishastic pinda Sweda is
Intervertebral discs and their surrounding ligament having Balya property (provide strength).[27] Nasya used in
lose their normal elasticity and hydration with Urdhajatrugata roga. Nasya enter in head region and pacify
International Journal of Health & Allied Sciences - Volume 7, Issue 2, April‑June 2018 107
 Kushwaha, et al.: Ayurvedic management of cervical spondylosis radiculopathy

the Dosha.[28] Dashmoola kwath is Tridoshara (alleviating References

all deranged doshas), Vedanasthapana (pain killer),
and Shothahar (subside inflammation). [29] Gokshuru 1. Kasper Dennis L, Fauci Anthony S, Hauser Stephen L,
is having Mutrvirechniya (diuretics) and Shothahara Longo Dan L, Jameson J. Lorry, Loscelzo Joseph, et al. Harrison’s
Principle of Internal Medicine. 19th ed. New Delhi: McGraw Hill;
property by which Gokshura lower down the blood 2015. p. 122.
pressure.[30,31] Sarpgandha is sleep inducer and lower 2. Singh S, Kumar D, Kumar S. Risk factors in cervical spondylosis.
the blood pressure.[32] Shatavari is a promoter of the J Clin Orthop Trauma 2014;5:221‑6.
muscle strengths and health.[33] Ashwagandha is gives 3. Alshami AM. Prevalence of spinal disorders and their
relationships with age and gender. Saudi Med J 2015;36:725‑30.
strength to the muscles and ligaments and promotes
4. Wang C, Tian F, Zhou Y, He W, Cai Z. The incidence of cervical
the health. Yograja gugulu is very effective in Vata vyadhi spondylosis decreases with aging in the elderly, and increases
and Asthi–majjagat vata roga. Yograj gugulu increases with aging in the young and adult population: A hospital‑based
the Agni (digestive power) and Bala (strength).[34] All clinical analysis. Clin Interv Aging 2016;11:47‑53.
these treatment break the pathology of disease either 5. Binder AI. Cervical spondylosis and neck pain. BMJ
2007;334:527‑31.
of kshaya by Bramhana (provide strength to bone and
6. Eubanks JD. Cervical radiculopathy: Nonoperative management
muscle) property and Margavrodha by Shrotoshodhak of neck pain and radicular symptoms. Am Fam Physician
property (clearance of micro channels) and give 2010;81:33‑40.
improvement in the symptoms of disease. In cases 7. Cheung JP, Luk KD. Complications of anterior and posterior
of CSR, the modern medicine considers various cervical spine surgery. Asian Spine J 2016;10:385‑400.
nonsurgical treatments such as cervical traction, cervical 8. Singh SK, Rajoria K. Ayurvedic approach for management of
ankylosing spondylitis: A case report. J Ayurveda Integr Med
immobilization (collar or neck brace), skull traction 2016;7:53‑6.
and physical therapy (isometric exercise) but with 9. Singh SK, Rajoria K. Ayurvedic management in cervical
limitations and at times surgical intervention are also spondylotic myelopathy. J Ayurveda Integr Med 2017;8:49‑53.
considered necessary. The cervical laminectomy is not 10. Singh SK, Rajoria K. Ayurvedic approach in the management of
appropriate for all patients. It may lead to neurologic spinal cord injury: A case study. Anc Sci Life 2015;34:230‑4.
11. Chaturvedi G. Sutra Sthan, Charaka Samhita of Agnivesha
deterioration and attributed to a development of latent Elaborated by Charaka & Drudhabala. Reprinted. Part‑1, Ch. 20.
instability of the spine with development of kyphotic Shloka 11. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti
spinal deformities.[35] Hence, this case study is important Academy Prakashan; 2008. p. 399.
one as this shows the clinical improvement in CSR with 12. Chaturvedi G. Chikitsa Sthan, Charaka Samhita of Agnivesha
Elaborated by Charaka & Drudhabala. Reprinted. part‑2, Ch. 28.
Panchakarma and combinations of Ayurvedic medicines.
Shloka 23. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti
There was no need to use any surgical intervention for Academy Prakashan; 2011. p. 780.
this case. 13. Harisadashiva Shastri Paradakara Sutra Sthan, editor. Astang
Hridya of Vagbhata with Sarvang Sundar Commentary by
Arundatta and Ayurveda Rasayan Commentary by Hemadri.
Conclusion Reprinted. Verse no‑019. Ch. 20. Varanasi: Choukhambha
Surbharati Prakashan; 2011. p. 287.
The case report shows clinical improvement in a CSR 14. Chaturvedi G. Sutra Sthan, Charaka Samhita of Agnivesha
with Panchakarma and Ayurvedic medicinal interventions. Elaborated by Charaka & Drudhabala. Reprinted. Part‑1, Ch. 20.
Shloka 13. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti
Academy Prakashan; 2008. p. 402.
Consent
15. Chaturvedi G. Viman Sthan, Charaka Samhita of Agnivesha
Written informed consent was taken from the patient for Elaborated by Charaka & Drudhabala. Reprinted. Part‑1, Ch. 6.
procedures and article publications. Shloka 16. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti
Academy Prakashan; 2008. p. 721.
Declaration of patient consent 16. Epstein N. Posterior approaches in the management of cervical
spondylosis and ossification of the posterior longitudinal
The authors certify that they have obtained all appropriate
ligament. Surg Neurol 2002;58:194‑207.
patient consent forms. In the form, the patient has given 17. Epstein N. Ossification of the posterior longitudinal ligament:
her consent for her images and other clinical information A review. Neurosurg Focus 2002;13:ECP1.
to be reported in the journal. The patient understand 18. Trikamji Acharya VJ, editor. Charaka Samhita of Agnivesha
that her name and initials will not be published and due Elaborated by Charaka & Drudhabala with Ayurveda Dipika
Commentary by Chakrapanidatta. Chikitsa Sthana. Reprinted.
efforts will be made to conceal identity, but anonymity Verse No. 59. Ch. 28. Varanasi: Choukhambha Surbharati
cannot be guaranteed. Prakashan; 2008. p. 619.
19. Caturvedi G. Sutra Sthan, Charaka Samhita of Agnivesha
Financial support and sponsorship Elaborated by Charaka & Drudhabala. Reprinted. Part‑1, Ch. 28.
Nil. Shloka 27. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti
Academy Prakashan; 2008. p. 573.
20. Chaturvedi G. Sutra Sthan, Charaka Samhita of Agnivesha
Conflicts of interest Elaborated by Charaka & Drudhabala. Reprinted. Part‑1, Ch. 25.
There are no conflicts of interest. Shloka 40. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti

108 International Journal of Health & Allied Sciences - Volume 7, Issue 2, April‑June 2018
 Kushwaha, et al.: Ayurvedic management of cervical spondylosis radiculopathy

Academy Prakashan; 2008. p. 468. 28. Chaturvedi G. Siddhi Sthan. Charaka Samhita of Agnivesha
21. Chaturvedi G. Siddhi Sthan, Charaka Samhita of Agnivesha Elaborated by Charaka & Drudhabala Reprinted. Part‑2. Ch. 2.
Elaborated by Charaka & Drudhabala. Reprinted. Part‑2, Ch. 1. Shloka 22. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti
Shloka 39. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti Academy Prakashan; 2011. p. 986.
Academy Prakashan; 2011. p. 971. 29. Lochan K. Bhaisajya Ratnavali of Govinda Dasji Bhisagratna
22. Astanga Hridaya by Vagbhatta, with the Commentaries‘ Commented upon by Vaidya Shri Ambika Datta Shastri. 2006
Sarvangasundara’ of Arunadatta and Ayurvedarasayana of Edition. Verse No. 37. Vol. 2. Ch. 29. Varanasi: Chaukhambha
Hemadri, Arunadatta on Sutrasthana. Ch. 11. Shloka 31. Varanasi: Sanskrit Sansthana; 2006. p. 335.
Krishnadas Academy; 2000. p. 187.
30. Al‑Ali M, Wahbi S, Twaij H, Al‑Badr A. Tribulus terrestris:
23. Chaturvedi G. Sutra Sthan, Charaka Samhita of Agnivesha
Preliminary study of its diuretic and contractile effects and
Elaborated by Charaka & Drudhabala. Reprinted. Part‑1, Ch. 26.
Shloka 42. Varanarsi: Vidhyotini Vyakhya Choukhambha Bharti comparison with Zea mays. J Ethnopharmacol 2003;85:257‑60.
Academy Prakashan; 2008. p. 506. 31. Mohd J, Akhtar AJ, Abuzer A, Javed A, Ali M, Ennus T.
24. Chaturvedi G. Sutra Sthan, Charaka Samhita of Agnivesha Pharmacological scientific evidence for the promise of
Elaborated by Charaka and Drudhabala. Reprinted. Part‑1 Ch. 4. Tribulusterrestris. Int Res J Pharm 2012;3:403‑6.
Shloka 17. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti 32. Douglas L. Rauwolfia in the treatment of hypertension. Integr
Academy Prakashan; 2008. p. 77. Med 2015;14:40-6.
25. Chaturvedi G. Siddhi Sthan, Charaka Samhita of Agnivesha 33. Bhavprakash Nighantu,The Indian meteria medica
Elaborated by Charaka & Drudhabala. Reprinted. Part‑2, Ch. 12, of Shri Bhavmishra, commentary by Prof.K.C. Chunekar
Shloka 21. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti Guguchayadivarga chapter verse 187,Chaukhamba Bharti
Academy Prakashan; 2011. p. 1107.
Academy Prakashan Varanasi; 2013. p 379.
26. Chaturvedi G. Sutra Sthan, Charaka Samhita of Agnivesha
34. Mishra S. Bhaishjya Ratnavali of Kaviraj Shri Govind Das Sen
Elaborated by Charaka & Drudhabala. Reprinted. Part‑1, Ch. 14.
Shloka 25. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti Elaborated edited with Siddhiprada Hindi Commentary. Shloka
Acedemy Prakashan; 2008. p. 286. 152‑157. 1st ed., Vol. 1, Ch. 29. Varanasi: Chaukhambha Surbharati
27. Chaturvedi G. Sutra Sthan, Charaka Samhita of Agnivesha Prakashan; 2005. p. 608.
Elaborated by Charaka & Drudhabala. Reprinted. Part‑1, Ch. 25. 35. Mikawa Y, Shikata J, Yamamuro T. Spinal deformity and
Shloka 40. Varanasi: Vidhyotini Vyakhya Choukhambha Bharti instability after multilevel cervical laminectomy. Spine (Phila Pa
Academy Prakashan; 2008. p. 466. 1976) 1987;12:6‑11.

International Journal of Health & Allied Sciences - Volume 7, Issue 2, April‑June 2018 109

View publication stats