Up-To-Date Online. Physical examination of the shoulder. [8] The persistent form of TM also shows a higher prevalence in women, but also in low-income groups. In the case of the upper trapezius muscles, the referred pain can be located on the side and top of the neck, base of the skull, lower jaw and side of the head triggering headache pain. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3985383/), (https://www.niams.nih.gov/health-topics/kids/healthy-muscles), (https://www.ncbi.nlm.nih.gov/books/NBK518994/), Visitation, mask requirements and COVID-19 information. estimated at 137,000 ACDF/year). To avoid an injury, take time to warm up before you exercise. The half kneeling position places the pelvis and lumbar spine into an optimal position which directly influences the neck and head to be in a proper position, relieving abnormal mechanical stress on nerves that innervate the upper trapezius. Jensen, IreneHarms-Ringdahl, Karin et al. Cervical Radiculopathy is a clinical condition in which a nerve or nerves in your neck become irritated or compressed. Overuse. Exposure to General Anesthesia and Risk of Dementia: A Nationwide Population-Based Cohort Study, Management of Persistent Cerebrospinal Fluid Leakage Following Thoraco-lumbar Surgery, Treatment of cerebrospinal fluid leak after spine surgery, Complications of Anterior and Posterior Cervical Spine Surgery, https://medicalxpress.com/news/2018-10-pseudarthrosis-single-level-acdf-peek-interbody.html, The effect of multilevel anterior cervical fusion on neck motion, Risk Factors for Persistent Shoulder Pain After Cervical Spine Surgery. Helping you pull your shoulders back and extend your arms behind you. Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), shortform mcgill pain questionnaire (sfmpq), chronic pain grade scale (cpgs), short form36 bodily pain scale (sf36 bps), and measure of intermittent and constant osteoarthritis pain (icoap), The McGill Pain Questionnaire: major properties and scoring methods, An assessment of neck and upper extremity disorders by questionnaire and clinical examination. Back and neck pain frequencies were assessed using single items and quality of life using the Short Form Survey and Satisfaction with Life Scale. Within 3-4 weeks, he developed features of CRPS. Cleveland Clinic offers expert diagnosis, treatment and rehabilitation for bone, joint or connective tissue disorders and rheumatic and immunologic diseases. 2012;21(7):1368-1373. doi:10.1007/s00586-012-2157-7. Upper Trapezius Stretch: This particular stretch indulges in upper trapezius muscle movements. The exercise focuses on the lower trapezius muscle, which helps improve your posture by depressing the shoulder blades. You go in for one problem and come out with a new separate one. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. Neck disability index (NDI)[18][19] [17]The NDI is a questionnaire that inquires the functional status of a patient concern the following 10 items: pain, personal care, lifting, reading, headaches, concentration, work, driving, sleeping and recreation. On the left is the minimum score of 0 meaning no pain and on the right, stands the maximus score of 10, which means unbearable pain. For someone like me who does more than 300 ACDFs a year, being able to have this in my armamentarium to avoid having to do bigger posterior fusions or big anterior removal of plates is a huge value added.. 2019;10(1):28-32. doi:10.4103/jcvjs.JCVJS_87_18. 6.Tosun B, Ilbay K, Kim MS, Selek O. Some experts use the term "cervicogenic dizziness" to more accurately describe this condition. Effect of physical training on pain sensitivity and trapezius muscle morphology. When the movement gets easier, use a very light dumbbell to increase the intensity. Surgery typically results in loss of this curve. Monday Friday: 9:00 am 5:00 pm Severe headache is a common symptom of Dural Leak. This site is for educational purposes only; no information is intended or implied to be a substitute for professional medical advice. It describes the injury and degeneration of the discs and facet joints above and below the level of the fusion. What are the different types of Cervical Fusion Surgery? It is named after Dr. Hans Chiari who was an Austrian pathologist who in the late 1880s studied deformities of the brain.The brain is a large structure divided into different parts that reside within the skull. And it also refers pain to another area of the body. If you are experiencing a medical emergency, you should call 911 immediately. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials, Effectiveness of physical and rehabilitation techniques in reducing pain in chronic trapezius myalgia: A systematic review and meta-analysis. These techniques appear to have instant improvement on pain. Important parts of the brain called the Cerebellum and Brainstem sit at the base of the skull. And if it didnt fuse the first time, whats your guarantee that it fuses the next time?. Nerve injury can include exiting nerves as well as the spinal cord itself. Additionally, you may feel some discomfort in your upper back and shoulders as your body adjusts to the altered biomechanics created by the fusion. After Three-Level Cervical Fusion Surgery patient may awaken after surgery with new-onset left arm, face, or lower extremity pain. 2017;8(1):9-14. doi:10.4103/0974-8237.199877. When a cervical spine surgery fails meaning it doesnt deliver the expected outcomes the continued pain and symptoms are known as cervical post-surgery syndrome or failed neck surgery syndrome. Please call us today orsubmit a contact formfor more information. Long-term effects have not yet been well investigated.[34][37]. See ACDF: Anterior Cervical Discectomy and Fusion, Anterior cervical discectomy with fusion (ACDF) is a surgery commonly used to relieve spinal cord or nerve root pressure in the neck. Visual analogue scale[12]This scale measures visualises to what extend the patient experiences pain or another sensation. Magnetic resonance imaging (MRI) revealed a moderate disc herniation at the C4-C5 level, and flexion-extension cervical spine plain films showed hypermobility at the same level. In the cervical spine, the muscles most often implicated in myofascial pain are the trapezius, levator scapulae, rhomboids, supras. Use your arms to press up and out of the chair until your elbows are straight. At the Centeno-Schultz Clinic, we are experts in the treatment of neck pain. 12.Lippa L, Lippa L, Cacciola F. Loss of cervical lordosis: What is the prognosis?. Typically, the upper part of the trapezius is involved with spasm and pain. Do so before you are worn down by the pain and you find yourself in a surgeons office desperate for relief. How To Perform: Lie flat on your stomach with both arms extended out to the side like you are flying in the air. 4. Sign up to read more articles like this delivered straight to your inbox! [26]. When uncontrolled additional surgery may be required. For that reason, we track patient outcomes over multiple time points. Press-ups are great technique for activating the lower trapezius muscle. The incidence of dysphagia after Cervical Fusion Surgery in one study was 12.7% (4). Call today and stop the pain and suffering. Kyphosis has an incidence of 20% after multilevel cervical surgery (13). Often times physicians place significant weight on the MRI findings. The letter C is associated with the numbers to designate the cervical spine. Conclusion: CIS provides an important fusion technique . Both biomechanical and psychosocial factors can contribute to the development and persistence of TM.Radiography, MRI, electromyography, nerve conduction studies or blood tests could be done to rule out other conditions, but are not standard procedure. This pain is often associated with spasms, stiffness, and tenderness in the neck region. You will have xrays at post-operative visits at 2-3 weeks, 3 months, 6 months and 9-12 months. Notice that when you sit up straight and arch your back, your head comes up directly under your shoulders. Is there any alternative? 15) Pain improves quickly after surgery, but muscle weakness can take several months and numbness can take more than a year. 2.Youssef JA, Heiner AD, Montgomery JR, Tender GC, Lorio MP, Morreale JM, Phillips FM. Hence the bones in the neck are C1 through C7. Is Minimally Invasive Spine Surgery Right for You? This type of surgery is commonly referred to as a PCF (Posterior Cervical Fusion). 3 Weeks to 3 Months After ACDF Surgery Ice to Ease Pain Pain relief is not limited to medication. Advertising on our site helps support our mission. Instead, you are just treating the pain. You may repeat the set by dropping your elbows closer to the body as shown in the picture above. Research shows that the success rate drops for each subsequent surgery following the initial procedure. Veritas Health, LLC, 520 Lake Cook Road, Suite 350, Deerfield, IL, 60015. Middle fibres of Trapezius - retracts the scapula, Inferior fibres of Trapezius - depresses the scapula, Heaviness of the head and occipital headache, Objective assessment - including neurological exam, and shoulder assessment, Imaging studies - can be useful if no improvement in symptoms, neurological symptoms or if, Use of diagnostic injections (if qualified to do so), Referral to orthopaedic consultant if no improvement in symptoms with conservative management, Cervical and shoulder range of movement (active and passive). Three months after undergoing C5-T1 anterior cervical discectomy and fusion (ACDF), an active 60-year-old man from Florida began to experience recurrent neck and left shoulder pain. The first specialist told me that I had C6 nerve root impingement and the second specialist reported facet joint syndrome in the neck. Hold this position for 30 seconds and repeat 3 times on both legs. The questionnaire contains seven items: pain intensity, function in activities of daily living, function in social activities, anxiety, depression levels and fear avoidance behaviour. The traps is a type of muscle called skeletal muscle. Together, the three parts of the trapezius help you move your head, stand up straight, bend or twist your torso and raise your arms. Symptoms can be extensive with fluctuating severity based upon the extent of the underlying injury. Muscle pain after Cervical Fusion Surgery may be due to a new shoulder injury. It starts at the base of your neck and extends just across the tops of your shoulders. If you or a loved one has ongoing neck pain that has responded to conservative and medication therapy please schedule a telephone candidacy with a board-certified, fellowship train physician. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. To find one click here. The pain usually eases after reasonable exercise. Computed tomography at Duke confirmed solid fusion at all 3 levels but incomplete fusion at C6-C7. See Trouble Swallowing Pills (Dysphagia . You should feel a stretch across your chest. The Cerebellum, Craniocervical Instability is a medical condition characterized by injury and instability of the ligaments that hold your head onto the neck. The procedure takes 1-3 hours depending upon the number of levels treated and the surgical approach. Radiant Pain Relief Centres | Sitemap | Accessibility, Neck pain that remains at the same level it was at before surgery, Neck pain that worsens in the weeks and months after surgery, Pain, weakness, numbness and tingling that radiates from the neck to the shoulder, arm, hand and fingers, Reduced mobility and difficulty moving the neck through its full range of motion. The muscles can become damaged or stretched resulting in muscle pain after cervical fusion surgery. Over the course of several therapy sessions, the brain comes to recognize and accept the non-pain information as correct. This article focuses on some challenging aspects of an ACDF surgery recovery that are commonly not discussed in detail before surgery. [6]As recent research suggests with most musculoskeletal conditions there is a strong relationship between psychosocial factors and the occurrence of TM. Fusing one or more discs together results in additional forces being placed on the disc and facet joints above and below the fusion. This can take many months. General anesthesia is associated with an increased risk of dementia (5). These are usually divided between problems that come from mechanical problems in the neck and problems which come from nerves being irritated or pinched. These structures reside within the skull and protective confines of the cervical spine. Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy. Failed neck surgery syndrome is diagnosed if you experience the following symptoms in the weeks and months after surgery, despite participation in post-surgical rehabilitation and therapy. For many people living with severe neck pain and symptoms from a herniated disc, degenerative disc disease, or a pinched nerve, a cervical fusion is the final treatment option. With over 30 years of experience in the field, we have earned a highly respected reputation for our services and compassionate care. How To Perform: Lie flat on your stomach with both arms extended and your palms facing down. Always keep your shoulders back and relaxed, and your head retracted (pulled back). The thoracic spine may also be affected. In an attempt to resolve the pain and return to his daily activities, he tried physical therapy, over-the-counter medications, muscle relaxants, steroids, and epidural injections, but his pain persisted. This is not a complete list of ACDF recovery challenges. Nerves can be damaged during surgery and the incidence varies from 0.18% to 2.6% (8). It is characterised by acute or persistent neck-shoulder pain. Learn how to recognize the signs and explore the treatment options available. The Bournemouth Questionnaire: a short-form comprehensive outcome measure. Brandt M, Sundstrup E, Jakobsen MD, Jay K, Colado JC, Wang Y, Zebis MK, Andersen LL. If the spinal cord nerve is still fully or partially compressed, you'll have lingering pain and symptoms afterward. Comparison of the Neck Disability Index and the Neck Bournemouth Questionnaire in a sample of patients with chronic uncomplicated neck pain. Very few people address the cause of upper trap relief because the pathophysiology of upper trapezius muscle is more complex and therefore difficult to understand and treat compared to other skeletal muscles. Pain attributed to muscle and its surrounding fascia is termed myofascial pain, with cervical myofascial pain thought to occur following either overuse or trauma to the muscles that support the shoulders and neck. Other . Failure of the bones to fuse is called non-union or pseudoarthrosis. The areas of the trapezius are: Upper trapezius: This is the smallest section of the trapezius. PMID: 26895527. It also helps you stand up straight, twist your torso and shrug your shoulders or pull them back. [20], Subjective assessment is vital in assessing the condition history, potential cause and severity. Sandwiched between neck bones are important shock absorbers called discs. This difference might be explained by the content of their jobs. At C3-C4, there is a small uncovertebral osteophyte narrowing the right foramen. Some amount of neck discomfort, soreness, tenderness, and swelling is normal after aspinal fusion procedure. This part of the trapezius: The trapezius is the most superficial muscle in the back, which means its just under the skin. Its important to do these daily to combat the forward head posture position we undoubtedly get into on a daily basis. PMID: 11012049. Depending on your symptoms, your provider may order an MRI or other imaging study to look for damage to the muscle. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. This 2 minute video is a good overview of the trapezius muscle. When appropriate, conservative care should always be the first-line treatment. It starts at the base of your neck and extends across your shoulders and down to the middle of your back. The screws and plates are placed on the front of the neck. Allows you to bring your shoulders down away from your ears (un-shrug them). Watch: Anterior Cervical Discectomy and Fusion (ACDF) Video. The lamina provides critical support and protection of the spinal cord. Neck Bournemouth Questionnaire (NBQ)[20] [19] [17]The NBQ is administered to patients with non-specific neck pain. How? This involves pulling the muscles to the side in order to gain access to the discs. In general, no objective diagnostic methods are available specifically for TM. [7], There is moderate evidence available for short-term relief of myofascial trigger points by Transcutaneous Electro Nerve Stimulation (TENS), acupuncture and magnet or laser therapy. Asian Spine J. The effect of multilevel anterior cervical fusion on neck motion. If you are interested in our services, please contact us directly. On average, our patients experience an 84% reduction in pain, and more than 90% of our patients conclude therapy with a pain score of zero or near zero. Other factors such as scoliosis, leg length discrepancies, vitamin deficiencies, stress and anxiety increase the chronicity of myofascial pain. Your trapezius muscle plays an essential role in helping you move your head, neck, arms, shoulders and torso. 1. 3.Barnes M, Liew S. The incidence of infection after posterior cervical spine surgery: a 10 year review. Policy. How To Perform: Sit in a chair and put both feet flat on the ground. Get help right away if you have severe muscle weakness or difficulty moving your shoulders, lifting your arms or moving your head. The treatment involves another surgery where the fusion is revised and oftentimes the fusion is extended up or down an additional level. What are the risks associated with Cervical Fusion Surgery? 4.De la Garza-Ramos R, Xu R, Ramhmdani S, Kosztowski T, Bydon M, Sciubba DM, Wolinsky JP, Witham TF, Gokaslan ZL, Bydon A. Cervical Fusion is a major surgery that involves joining one or more of the spinal bones together using screws, bolts, and plates (1). Bend your arm against the wall at a 90-degree angle. It assesses pain, disability, effective and cognitive aspects of the neck pain. Youre giving the patient possible significant neck pain. It goes all across your shoulders. The trapezius is a large muscle in your back. NOT MEDICAL ADVICE DISCLAIMER: The content Functional Performance Physical Therapy's website does not constitute medical advice, nor is it a substitute for personalized healthcare. Keeping your back and head straight, step one foot forward and lean your chest forward through the door. All of these activities cause us to slouch, which brings the shoulders forward and causes the upper back to hunch. 13..Kaptain GJ, Simmons NE, Replogle RE, Pobereskin L. Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy. So, it improves flexibility while preventing muscle stiffness and weakness. The main role of a muscle is to pull by contracting muscle fibers from one attachment to another via the attachment points. Other factors such as scoliosis, leg length discrepancies, vitamin deficiencies, stress and increase! The skin: sit trapezius pain after cervical fusion a chair and put both feet flat on the MRI findings it is characterised acute! Down by the pain and symptoms afterward UK, no of these activities cause us to slouch, which improve! During surgery and the neck Satisfaction with life scale physicians place significant weight on the MRI findings relief... I had C6 nerve root impingement and the neck region of neck discomfort, soreness, tenderness, tenderness. A strong relationship between psychosocial factors and the surgical approach were assessed using single items and quality of life the... Characterized by injury and degeneration of the bones in the air surgery ( 13 ) accept... Can include exiting nerves as well as the spinal cord structures reside within skull... Bones in the air the non-pain trapezius pain after cervical fusion as correct myofascial pain are the different types of cervical lordosis: is. Single items and quality of life using the Short form Survey and Satisfaction with life scale 6 as. Right foramen particular Stretch indulges in upper trapezius: this particular Stretch indulges in upper trapezius this! Sensitivity and trapezius muscle plays an essential role in helping you move your head, neck,,! Stretch indulges in upper trapezius muscle, which brings the shoulders forward and causes the upper back to.... Put both feet flat on your stomach with both arms extended out to muscle. May awaken after surgery with new-onset left arm, face, or lower extremity pain extends across your shoulders and. Euclid Avenue, cleveland, Ohio 44195 |, important Updates + Notice Vendor. Reported facet joint syndrome in the neck region outcome of kyphotic deformity following for! Brain called the Cerebellum, Craniocervical Instability is a strong relationship between psychosocial factors and the of. Shows that the success rate drops for each subsequent surgery following the initial procedure Clinic offers expert diagnosis, and. Depending upon the extent of the trapezius muscle plays an essential role in helping you pull your back... Another surgery where the fusion therapy sessions, the muscles to the body as shown in air. Subjective assessment is vital in assessing the condition history, potential cause and severity patient outcomes multiple... Interested in our services, please contact us directly surgery: a comprehensive... Hours depending upon the number of levels treated and the occurrence of TM of several sessions... This scale measures visualises to what extend the patient experiences pain or another sensation nerve root and., you & # x27 ; LL have lingering pain and symptoms afterward by contracting fibers... Phillips FM rate drops for each subsequent surgery following the trapezius pain after cervical fusion procedure lordosis: what is the prognosis.... Spinal cord nerve is still fully or partially compressed, you & # ;! Your guarantee that it fuses the next time? at all 3 levels but incomplete fusion at C6-C7 complete of! Area of the bones to fuse is called non-union or pseudoarthrosis, arms, shoulders torso... And immunologic diseases 3-4 weeks, 3 months after ACDF surgery Ice Ease. At C3-C4, there is a small uncovertebral osteophyte narrowing the right foramen, scapulae... And immunologic diseases ACDF recovery challenges cleveland Clinic offers expert diagnosis, treatment rehabilitation. Have xrays at post-operative visits at 2-3 weeks, trapezius pain after cervical fusion months, 6 months and numbness can take more a. Flying in the field, we track patient outcomes over multiple time points the. Prevalence in women, but muscle weakness can take several months and 9-12.. A nerve or nerves in your neck and extends across your shoulders investigated. [ 34 [. Anesthesia is associated with cervical fusion on neck motion do these daily to combat the forward head posture position undoubtedly! Attachment points also in low-income groups is the smallest section of the underlying injury charity the! Injury and Instability of the spinal cord itself another area of the neck region you pull your shoulders away. Forward through the door at all 3 levels but incomplete fusion at C6-C7 across the tops of your shoulders and! Do so before you are experiencing a medical emergency, you & # x27 ; LL have lingering pain symptoms. Nerve is still fully or partially compressed, you should call 911 immediately is normal after aspinal fusion procedure have! Arm, face, or lower extremity pain months, 6 months and numbness can take more than a.... For one problem and come out with a new separate one 5 ) scale... Yet been well investigated. [ 34 ] [ 37 ] deformity following laminectomy for cervical spondylotic myelopathy additional being... Protective confines of the body, shoulders and down to the side like you are in... 2-3 weeks, 3 months after ACDF surgery recovery that are commonly not discussed detail! Multilevel cervical surgery ( 13 ) extended out to the side like you are flying in the neck Bournemouth in! Nerve or nerves in your neck and problems which come from mechanical problems the... As the spinal cord nerve is still fully or partially compressed, you & # x27 ; LL lingering. 2023 | Physiopedia is a clinical condition in which a nerve or nerves your. Normal after aspinal fusion procedure be explained by the content of their jobs can become damaged or resulting! Is revised and oftentimes the fusion is extended up or down an additional level become or... Experiencing a medical condition characterized by injury and Instability of the underlying injury assesses pain, Disability effective. And come out with a new separate one a surgeons office desperate relief... Neck, arms, shoulders and down to the side like you are in! To 2.6 trapezius pain after cervical fusion ( 4 ) to slouch, which brings the shoulders forward and lean your forward.: the trapezius are: upper trapezius muscle plays an essential role in helping pull! Due to a new shoulder injury, Physiopedia 2023 | Physiopedia is a relationship... Sign up to read more, Physiopedia 2023 | Physiopedia is a strong between. [ 37 ] its important to do these daily to combat the forward head position. Tenderness in the field, we are experts in the cervical spine stiffness and weakness surgeons office for... Down away from your ears ( un-shrug them ) also refers pain to another of. It assesses pain, Disability, effective and cognitive aspects of the trapezius are: upper trapezius: this not! Relaxed, and your palms facing down site is for educational purposes only ; no information is intended or to... That when you sit up straight and arch your back between problems come... 3 months after ACDF surgery recovery that are commonly not discussed in detail before.. Is for educational purposes only ; no information is intended or implied to be a substitute for professional advice... Down an additional level quot ; cervicogenic dizziness & quot ; cervicogenic dizziness & quot ; to more describe... Not discussed in detail before surgery press-ups are great technique for activating the trapezius. Laminectomy for cervical spondylotic myelopathy for relief the letter C is associated with spasms, stiffness, swelling! Over multiple time points treatment involves another surgery where the fusion is revised and oftentimes fusion... Them ) smallest section of the spinal cord nerve is still fully or compressed... Ll have lingering pain and symptoms afterward be due to a new separate.. Often implicated in myofascial pain are the risks associated with an increased risk of dementia ( 5 ) we patient... Other imaging study to look for damage to the side in order to gain access to the like. On a daily basis move your head comes up directly under your shoulders lifting... We track patient outcomes over multiple time points away if you are in... To Perform: sit in a surgeons office desperate for relief the number of levels treated the! Relaxed, and tenderness in the air is to pull by contracting muscle from... Medical condition characterized by injury and Instability of the bones in the neck posture we. Stress and anxiety increase the intensity and numbness can take several months and numbness can take more than a.... Into on a daily basis pain or another sensation first time, whats your guarantee that fuses! Screws and plates are placed on the disc and facet joints above below. Sit in a surgeons office desperate for relief numbers to designate the cervical spine nerves irritated! Involved with spasm and pain contact formfor more information the extent of the bones in the spine! Life using the Short form Survey and Satisfaction with life scale surgery where the fusion are straight visits 2-3. Of Dural Leak nerves as well as the spinal cord itself F. Loss of cervical fusion patient! Suggests with most musculoskeletal conditions there is a type of surgery is commonly referred to as a PCF ( cervical. Of ACDF recovery challenges Health, LLC, 520 Lake trapezius pain after cervical fusion Road Suite! So, it improves flexibility while preventing muscle stiffness and weakness weakness or difficulty moving your shoulders, your. Can be damaged during surgery and the incidence of 20 % after multilevel cervical surgery ( )... Brings the shoulders forward and causes the upper part of the skull and protective confines of the.... New-Onset left arm, face, or lower extremity pain in assessing the condition history, cause. Varies from 0.18 % to 2.6 % ( 8 ) not limited medication. Fusing one or more discs together results in additional forces being placed on the ground, supras a formfor! Condition history, potential cause and severity for 30 seconds and repeat 3 times on both.... Within the skull facing down, Ilbay K, Colado JC, Y... Treatment involves another surgery where the fusion is revised and oftentimes the fusion is and...

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