• 대한정형도수물리치료학회지
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• 제16권1호
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• pp.57-63
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• 2010

The palpation of spinous process and transverse process of vertebra are important part of the assesment and treatment from Orthopedic manual therapy. But the palpation area is descriptive differently each of literatures. So we generally got these outcomes. : There are C2, C3, C4 and C6 process as a bony landmarks and these are important part of establish the precise location of pain appears from cervical spine. Even though C7 process regard a prominent part, it is hard to distinguish C6 and process of T1. Thru that differentiation, grab the patient's forehead and try them cervical and hyper-extension check any movement of process or put on the fingers on C7 preocess and check the movement. The palpation of thoracic spine process is the land mark which determines general level orientation in the spine easily, there are T2, T7 spinous process. However, It is depends on how do you test the patient's arm when you palpate it and it can effect on spinous process. The transverse process of C1 is the only spot for palpation in cervical spine, and T1-3, T12 transverse process can palpate it when it stands on the process. The end of T4-6, T11 is placed on middle on vertebra of transverse process and transverse process. T7-9, T10 transverse process is place on same position as spinous process which is upper part of the spine.

• Journal of Korean Neurosurgical Society
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• 제52권6호
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• pp.570-573
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• 2012

Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.107-111
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• 2010

Objective : It has been demonstrated that cervical laminoplasty is an effective and safe method of treating multi-level cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. However, recent reports have suggested that axial neck pain is frequently encountered after cervical laminoplasty. The aim of the present study was to determine clinical significance of the C7 spinous process on axial neck pain after cervical laminoplasty. Methods : A total of 31 consecutive patients that underwent cervical laminoplasty between March 2002 and December 2008 were reviewed. The authors evaluated and compared axial neck pain and lordotic angle in patients that underwent C7 spinous process preserving surgery (group 1, n=16) and in patients in which the C7 spinous process was sacrificed (group 2, n=15). Results : Severe or moderate early axial pain occurred in 56.2% of patients in group 1 and in 86.6% in group 2. Severe or moderate late axial pain occurred in 12.5% in group 1 and in 73.3% in group 2. Eighty-Six percent of patients in group 2 and 43% in group 1 experienced aggravation of their axial neck pain during the early postoperative period. Aggravation of axial neck pain during early postoperative period was less common in group 1 but not statistically significant (p=0.073). Sixty-six percent of patients in group 2 and 12% in group 1 had aggravated axial neck pain at late postoperative period and aggravation of late axial neck pain was significantly less common in group 1 (p=0.002). Conclusion : The present study demonstrates that C7 spinous process preserving laminoplasty decreases the incidence of aggravated axial neck pain after cervical laminoplasty.

• 대한정형외과스포츠의학회지
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• 제11권2호
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• pp.96-98
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• 2012

경추 또는 흉추의 극돌기에 단독으로 발생하는 골절을 Clay shoveler 골절이라 한다. 이 골절이 스포츠 활동 중에 발생하는 경우는 매우 드물다. 본 증례에서는 27세 남성으로 반복적인 골프 스윙으로 인하여 제 7경추 극돌기에 골절이 발생하였다. 환자는 진통제, 근육이완제 복용과 4주간의 토마스 칼라를 착용하였다. 통증은 호전되었고, 수상 후 5개월 째에 다시 골프를 시작하였다.

• 한국전문물리치료학회지
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• 제12권4호
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• pp.41-47
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• 2005

The purpose of this study was to determine the intra-rater and inter-rater reliability of various forward head posture measurements. Ten healthy adults (age, $20.4{\pm}2.2$ yrs; height, $164.0{\pm}5.5$ cm; weight, $58.7{\pm}7.3$ kg) participated in the study. They were free of injury and neurologic deficits in the upper extremities and neck at the time of testing. The subjects were asked to perform head forward posture by under the guidance of physical therapists. Markers were placed on the C7 spinous process, mastoid process, tragus of the ear, outer canthus, and forehead. Measurement 1 for forward head posture assessment was measured as the angle between the horizontal line through C7 and the line connecting the C7 spinous process with the tragus of the ear. Measurement 2 was measured as the angle between the C7 spinous process, the mastoid process and the outer canthus. Measurement 3 was measured as two kinds of angles the HT (head tilt) angle is between the line from the midpoint of forehead to the tragus line and Y-axis at the tragus point. The NF (neck flexion) angle is between the line from the tragus to the C7 line and the Y-axis at the C7. Intra-rater, inter-rater reliability and coefficient of variation was assessed by comparing the measured values from three kinds of measurements of forward head posture. The intra-rater reliability was indicated by intraclass correlation coefficients [ICC(1,1)] and inter-rater reliability was shown by intraclass correlation coefficients [ICC(3,k)]. The results of study were as follows: ICC(1,1) values for intra-rater reliability of three measurements were in the 'excellent' category. ICC(3,k) values for inter-rater reliability of three measurements were also in the 'excellent' category. The coefficient of variation of method 2 had a lower value than method 1 and method 3. This data means that the measured value of method 2 was less scattered. Further research is needed to determine whether the validity of all measurements is revealed in the 'excellent' category.

• The Journal of Korean Physical Therapy
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• 제35권6호
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• pp.163-166
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• 2023

A 30-year-old male novice golfer was diagnosed with a clay-shoveler's fracture. During golf practice, he experienced persistent posterior neck and upper back pain for a month. Cervical radiographs and computed tomography revealed a series of sequential spinous process fractures from C7 to T3. The patient was prescribed analgesic medication and fitted with a cervical brace alongside extracorporeal shockwave therapy (ESWT) directed explicitly toward the upper back region, subsequently leading to a notable reduction in pain. Therefore, ESWT could be considered an additional method for pain management in patients with clay-shoveler's fractures.

• The Journal of Korean Physical Therapy
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• 제23권2호
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• pp.7-15
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• 2011

Purpose: We investigated the relationship between the muscle activity and kinematic variables of the upper extremity during a push-up task on stable and unstable surfaces. Methods: We recruited 15 healthy subjects. Subjects completed the push-up task on stable and unstable surfaces. Surface electromyograms were recorded from the serratus anterior, upper trapezius, latissimus dorsi, infraspinatus to monitor changes in muscle activity. Markers for kinematic changes of elbow flexion, shoulder extension, shoulder retraction and scapular adduction were attached at C7, the T7 spinous process, both acromions, the scapula superior and inferior angle, the humerus lateral epicondyle, and the ulnar styloid process. Correlation coefficients between muscle activity and kinematic variables were analyzed by SPSS for Windows, version 15.0. Results: On the unstable surface, elbow flexion and shoulder extension increased with increasing muscle activity of serratus anterior, upper trapezius and infraspinatus. On the stable surface, shoulder retraction decreased with increasing muscle activity of serratus anterior and infraspinatus. Scapular adduction decreased with all types of increasing muscle activity, regardless of the support surface. Conclusion: Correlations between muscle activity and kinematic variables were observed on stable and unstable surfaces during a push-up task, while correlations between right and left variables were not clear. These finding suggest that it may be used to develop a rehabilitation program which could be effective in improving shoulder function in patients with shoulder problems.

• Journal of Korean Neurosurgical Society
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• 제64권4호
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• pp.575-584
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• 2021

Objective : Cervical expansive laminoplasty is an effective surgical method to address multilevel cervical spinal stenosis. During surgery, the spinous processes of C2 and C7 are usually preserved to keep the insertion points of the cervical musculature and nuchal ligament intact. In this regard, dome-like laminectomy (undercutting of C7 lamina) instead of laminoplasty is performed on C7 in selected cases. However, resection of the lamina can weaken the C7 lamina, and stress fractures may occur, but this complication has not been characterized in the literature. The objective of the present study was to investigate the incidence and risk factors for C7 laminar fracture after C7 dome-like laminectomy and its impact on clinical and radiological outcomes. Methods : Patients who underwent cervical open-door laminoplasty combined with C7 dome-like laminectomy (n=123) were classified according to the presence of C7 laminar fracture. Clinical parameters (neck/arm pain score and neck disability index) and radiologic parameters (C2-7 angle, C2-7 sagittal vertical axis, and C7-T1 angle) were compared between the groups preoperatively and at postoperatively at 3, 6, 12, and 24 months. Risk factors for complications were evaluated, and a formula estimating C7 fracture risk was suggested. Results : C7 lamina fracture occurred in 32/123 (26%) patients and occurred at the bilateral isthmus in 29 patients and at the spinolaminar junction in three patients. All fractures appeared on X-ray within 3 months postoperatively, but patients did not present any neurological deterioration. The fracture spontaneously healed in 27/32 (84%) patients at 1 year and in 29/32 (91%) at 2 years. During follow-up, clinical outcomes were not significantly different between the groups. However, patients with C7 fractures showed a more lordotic C2-7 angle and kyphotic C7-T1 angle than patients without C7 fractures. C7 fracture was significantly associated with the extent of bone removal. By incorporating significant factors, the probability of C7 laminar fracture could be assessed with the formula 'Risk score = 1.08 × depth (%) + 1.03 × length (%, of the posterior height of C7 vertebral body)', and a cut-off value of 167.9% demonstrated a sensitivity of 90.3% and a specificity of 65.1% (area under the curve, 0.81). Conclusion : C7 laminar fracture can occur after C7 dome-like laminectomy when a substantial amount of lamina is resected. Although C7 fractures may not cause deleterious clinical outcomes, they can lead to an unharmonized cervical curvature. The chance of C7 fracture should be discussed in the shared decision-making process.

• 혜화의학회지
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• 제24권2호
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• pp.1-16
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• 2016

Objectives : This study was designed to evaluate various tools including C-spine X-ray for estimating cervical curvature and identify the effect of wooden pillow on patients diagnosed with straightening of cervical curvature. Methods : This study was carried out on 51 subjects who were encountered traffic accident suffering cervical pain and diagnosed with straightening of cervical curvature by X-ray. 51 subjects were divided into wooden pillow(experimental) group and conservative therapy(control) group. Visual analogue scale, neck disability index and lateral pictures were used and compared after treatment. C-spine AP., Lat. X-ray were used on admission day to calculate cervical curvature and scoliosis by various ways. Results : 4 different measurements of cervical curvature didn't show common results. Both wooden pillow(experimental) group and conservative therapy(control) group showed significant improvement in the visual analogue scale(VAS) and neck disability index(NDI) after hospital treatment. Comparison between center line pictured by lateral view and C-spine Lat. pictured by X-ray showed significant difference in cervical curvature. Lateral deviation of cervical vertebra showed lengthened distance between mastoid process and spinous process of C7. Conclusion : As a result of this research, I found out that various tools for calculating cervical lordosis could derive different results and C-spine AP., Lat X-ray could cause artificial cervical lordosis. According to visual analogue scale(VAS) and neck disability index(NDI) wooden pillow was not effective to reduce pain & disability caused by straightening of cervical curvature. Futhermore, correction effect of straightening of cervical curvature and scoliosis by wooden pillow was weak.

• 한국전문물리치료학회지
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• 제13권1호
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• pp.9-15
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• 2006

Work-related musculoskeletal disorder has been associated with long hours of computer work and prolonged periods of static posture. In clinical settings, postural correction is a common treatment approach for individuals with neck, shoulder, and back pain. This study was designed to identify the effect of Forward Head Posture Correctional Device during computer work. Twelve healthy adults (mean age, 27.4 yrs; mean height, 165.0cm mean weight, 65.8 kg) participated in the study. They had no medical history of neurological or surgical problems with their upper extremity. The subjects were asked to perform Head Forward Posture under the guidance of physical therapists and the measured angles were analyzed using a 3-D motion analysis system. Markers were placed on the C7 spinous process, tragus of the ear and forward head angle was between the line from the tragus to the C7 line and the Y-axis at the C7. The statistical significance of difference between, "without" and "with" correctional device was tested by paired t-test. A level of significance was set at ${\alpha}$=.05. In comparison of the computer work between "without" and "with" correctional device, Forward Head Angle was showed significant difference (p<.05). In conclusion, the range of Forward Head Angle was significantly decreased during computer work with the correctional device. Further research is needed to understand the nature of motor control problems in deep muscles in patients with neck, shoulder, and back pain.