• Physical Therapy Rehabilitation Science
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• 제9권3호
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• pp.149-154
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• 2020

Objective: This study aimed to evaluate the effects of the Kaltenborn-Evjenth concept of nerve mobilization combined with intermittent cervical segment traction (ICST) on pain, Neck Disability Index (NDI) scores, range of motion (ROM) and endurance in persons with cervical radiculopathy (CR). Design: Two-group pretest-posttest design. Methods: Thirty subjects participated in this study and were randomly assigned to two groups. The ICST group (n=15) was performed simultaneously with nerve mobilization and cervical traction for the segment with cervical pain at the same time. The intermittent cervical total traction (ICTT) group (n=15) performed nerve mobilization and cervical traction for the whole cervical area at the same time. In this study, outcome measures such as the Visual Analog Scale (VAS), NDI, ROM, endurance (cranio-cervical flexion test), and passive intervertebral motion performed before and 4 weeks after the experiment were compared to investigate the effects of each intervention. Results: In both groups, there were significant differences in the VAS, NDI scores, and endurance, and there were significant differences between the two groups except for endurance (p<0.05). In the ICST group, significant differences were found in all ROM, and in the ICTT group, significant differences were found in only extension, and there were significant differences between the two groups (p<0.05). Conclusions: The ICST group showed more improvement than the ICTT group in pain, NDI scores and ROM. Moreover, our findings show that the ICST could be used as a new strategy for manual therapy in persons with CR.

• 한방재활의학과학회지
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• 제19권2호
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• pp.203-212
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• 2009

Objectives : Spurling test is one of the most widely used physical tests to diagnose herniated cervical intervertebral disc. The purpose of this study is to analyse diagnostic validity of Spurling test. Methods : This study was carried out on 382 subjects who visited Bu-Chun Ja-Seng oriental hospital with the neck pain or radiating pain from neck to upper extremities from November, 2007 to October, 2008. All subjects underwent both Spurling test and cervical magnetic resonance imaging(MRI). The associations between Spurling test and herniated cervical intervertebral disc were analysed. Results : 1. The sensitivity of Spurling test for herniated cervical intervertebral disc was 64%. 2. The specificity of Spurling test for herniated cervical intervertebral disc was 86%. 3. The positive predictive value of Spurling test for herniated cervical intervertebral disc was 93%. 4. The negative predictive value of Spurling test for herniated cervical intervertebral disc was 44%. Conclusions : This study suggests that Spurling test is not useful in screening for herniated cervical intervertebral disc due to the test's relatively low sensitivity. Thus it is necessary to consult advanced tests such as diagnostic imaging to diagnose herniated cervical intervertebral disc.

• 대한기관식도과학회지
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• 제5권1호
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• pp.7-13
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• 1999

Background and Objective： The tuberculous lymphadenitis of neck is one of the most common extra-pulmonary tuberculosis in Korea. Although the incidence of pulmonary tuberculo-sis has decreased recently, that of cervical tuberculous lymphadenitis has not decreased. In spite of great efforts and diversity of study, the exact criterias of diagnosis and optimal therapeutic methods of cervical tuberculous lymphadenitis have been the subject of much debate and still remain unclear. So we intend to enucleate clinical manifestations and suggest the optimal therapeutic manners. Material : The 483 cases, diagnosed as cervical tuberculous lymphadenitis by fine needle aspiration biopsy during the past 10 years from Jan. 1987 to Dec. 1996 Method : Retrospective study Results 1) The overall rate of tuberculous cervical lymphadenitis was 23.4% of neck mass. 2) Incidence ratio of male to female was 1：2.7 3) The frequent location of tuberculous lymphadenitis was posterior cervical area, supraclavicular area, jugular chain in order. 4) The response rate of medical treatment in tuberculous cervical lymphadenitis was 84.9%. 5) The duration of medical treatment in remissioned group was 18.6 months in average. 6) Surgical intervention was needed in 15.1%. 7) The duration of post operative medical treatment was 18.4 months in average. Conclusion : Tuberculous cervical lymphadenitis is prevalent in women, age of 20-40 years and mainly involve posterior cervical area. Fine needle aspiration biopsy is a very useful method for early detection of cervical tuberculous lymphadenitis. After diagnosis is made, anti-tuberculosis medication is recommended for more than 18 months. Unless the size of neck mass is decreases inspite of the thorough anti-tuberculosis medication for more than 1 month or if complication like as abscess or fistula occurs, surgery is needed with post operative medical treatment for more than 12 months.

• 대한인간공학회지
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• 제27권4호
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• pp.59-64
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• 2008

The aims of this study were to compare and analyze two types of deep cervical flexion exercises, craniocervical flexion and cervical flexion, and to ascertain their relative effects on neck and shoulder pain and functional improvement. The participants of the study were individuals who work in sedentary jobs in an office environment. 54 appropriate subjects were chosen and randomly divided into two groups: one group underwent a craniocervical flexion exercise program and the other a cervical flexion exercise program. The six week exercise program consisted of home exercises performed by each subject five times a week and education once a week. Neck-shoulder pain, muscle strengthening, cervical alignment were measured prior to commencement of the exercise programs and again after six weeks. At completion of the six week, both exercise programs decreased neck pain (p<.05). Forward head postures were reduced, and the craniocervical flexion exercise program was more effective in reducing forward head posture (p<.05). The maximum muscle strength and 50% of maximum muscle strength maintaining time of the deep cervical flexor muscles were significantly increased. There were no significant changes of the cervical lordotic curve. The results of this study showed deep cervical flexion exercise was effective in the treatment of neck and shoulder pain, however craniocervical flexion exercise was more effective than cervical flexion exercise.

• 한국전문물리치료학회지
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• 제18권4호
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• pp.1-10
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• 2011

This study compared the stability of the cervical spine according to the presence of neck pain and deep neck flexor performance. Thirty subjects with neck pain, and thirty subjects without neck pain were recruited for this study. The Cranio-cervical flexion (CCF) test was applied using a pressure biofeedback unit to classify the subjects into four subgroups; no cervical pain and good deep neck flexor performance (NG group), no cervical pain and poor deep neck flexor performance (NP group), cervical pain and good deep neck flexor performance (PG group), and cervical pain and poor deep neck flexor performance (PP group). The head sway angle was measured using a three-dimensional motion analysis system. A 3-kg weight was used for external perturbation with the subject sitting in a chair in the resting and erect head positions with voluntary contraction of the deep neck flexors. A one-way analysis of variance (ANOVA) was performed with a Bonferroni post hoc test. The deep neck flexor performance differed significantly among the four groups (p<.05). The NG group had significantly greater deep neck flexor performance than NP and PP groups. The stability of the cervical spine also differed significantly among the four groups in the resting head position (p<.05). The head sway angle was significantly smaller in NG group as compared with the other groups. The PP group had the greatest head sway angle in the resting head position. However, there was no significant difference in the stability of the cervical spine among the groups in the erect head position with voluntary contraction of deep neck flexors (p=.57). The results of this study suggest that the deep neck flexor performance is important for maintaining the stability of cervical spine from external perturbation.

• The Korean Journal of Pain
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• 제20권1호
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• pp.46-49
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• 2007

Background: Cervical epidural injection, performed via the interlaminar approach, represents a useful interventional pain management procedure indicated in patients with a cervical herniated disk. Due to thedecreased epidural space in the cervical region, cervical epidural injections may result in potentially serious complications, especially during a large volume injection. Methods: Thirty-four patients with neck pain due to a cervical herniated disk that were referred to the pain clinic for cervical epidural steroid injection were randomized into two groups. One group received a cervical epidural injection of 4 ml drug and the other group received 2 ml drug. The injected mixture included triamcinolon, ropivacaine and omnipaque. Spread levels of the drug after injection were estimated with the use of C-arm fluoroscopy. Results: Spread levels to the cephalad for patients in the two groups were $4.88{\pm}0.78segments$ and $4.53{\pm}0.49segments$, respectively. Spread levels to the caudad for patients in the two groups were $4.59{\pm}0.93segments$ and $4.47{\pm}0.51segments$, respectively. The results showed no significant difference in the spread level between the two groups. Conclusions: Use of a small volume of drug (2 ml) can provide a sufficient spread level of the injected drug that is desirable for patients with a cervical herniated disk.

• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.433-438
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• 2018

Background: Cervical foraminal stenosis (CFS) is one of the degenerative changes of the cervical spine; however, correlations between the severity of stenosis and that of symptoms are not consistent in the literature. Studies to date on the prevalence of stenosis are based on images obtained from the departments treating cervical lesions, and thus patient selection bias may have occurred. The purpose of this study was to investigate the prevalence of CFS according to the site, extent, and morphology of stenosis using cervical computed tomography (CT) images obtained from patients who were visiting not because of symptoms related to the cervical spine, cervical pain, or upper limb pain. Methods: Among patients who underwent CT from January 2016 to March 2016 for reasons other than cervical spine symptoms, a total of 438 subjects were enrolled, and 2,628 cervical disc images (C4-5, C5-6, and C6-7; left and right sides) were examined. Three orthopedic surgeons performed two measurements each at 4-week intervals. Values were used for analysis if matched by more than two surgeons; if no match was found, the median values were used for analysis. The left and right sides on the same axial image were independently classified. Results: Left C5-6 stenosis was most common (24.66%) among patients. At the left C6-7, there were 20 focal types and 33 diffuse types. At bilateral C4-5 and right C6-7, the focal type was more common, whereas at bilateral C5-6 and left C6-7, the diffuse type was more common. Age and the severity of stenosis showed statistically significant correlation at all cervical levels. Conclusions: The prevalence of CFS was highest at the C5-6 level (19.06%). Compared to other levels, focal stenosis was more frequent at C4-5 and diffuse stenosis was more common at C5-6. At C6-7, the incidence of focal stenosis was higher on the right side and that of diffuse stenosis was higher on the left side.

• 한국전문물리치료학회지
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• 제28권1호
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• pp.36-46
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• 2021

Background: It is reported that the proprioceptive sensation of patients with neck pain is reduced, and neck sensory-motor control training using visual feedback is reported to be effective. Objects: The purpose of this study is to investigate how sensorimotor control training for the cervical spine affects pain, function, and psychosocial status in patients with chronic cervical pain. Methods: The subjects consisted of 36 adults (male: 15, female: 21) who had experienced cervical spine pain for more than 6 weeks. An exercise program composed of cervical stabilization exercise (10 minutes), electrotherapy (10 minutes), manual therapy (10 minutes), and cervical sensorimotor control training (10 minutes) was implemented for both the experimental and the control groups. The cervical range of motion (CROM) and head repositioning accuracy were assessed using a CROM device. In the experimental group, the subjects wore a laser device on the head to provide visual feedback while following pictures in front of their eyes; whereas, in the control group, the subjects had the same training of following pictures without the laser device. Results: There were no statistically significant differences between the two groups in pain, dysfunction, range of motion, or psychosocial status; however, post-test results showed significant decreases after 2 weeks and 4 weeks compared to baseline (p < 0.01), and after 4 weeks compared to after 2 weeks (p < 0.01). The cervical joint position sense differed significantly between the two groups (p < 0.05). Conclusion: In this study, visual feedback enhanced proprioception in the cervical spine, resulting in improved cervical joint position sense. On the other hand, there were no significant effects on pain, dysfunction, range of motion, or psychosocial status.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.784-790
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• 2021

Objective : The purpose of this study was to investigate the correlations among various radiological parameters used to determine cervical alignment from cervical spine radiographs (X-CS) and cervical spine computed tomography (CT-CS), both within and between modalities. Methods : This study included 168 patients (≤60 years old) without a definite whole spine deformity who underwent CT-CS and X-CS. We measured occipital slope (O-s), C1 slope, C2 slope, C7 slope, sella turcica - C7 sagittal vertical axis (StC7-SVA), spino-cranial angle, T1 slope, and C27-SVA. We calculated the O-C2 angle, O-C7 angle, and C2-7 angle from the measured parameters and conducted correlation analyses among multiple parameters. Results : The intrinsic correlation features among multiple cervical parameters were very similar for both X-CS and CT-CS. The two SVA parameters (C27-SVA and StC7-SVA) were mainly influenced by the upper cervical slope parameters (r=|0.13-0.74|) rather than the lower slope cervical parameters (r=|0.08-0.13|). The correlation between X-CS and CT-CS for each radiological parameter was statistically significant (r=0.26-0.44) except for O-s (r=0.10) and StC7-SVA (r=0.11). Conclusion : The correlation patterns within X-CS and CT-CS were very similar in this study. The correlation between X-ray and CT was statistically significant for most radiological parameters, and the correlation score increased when the horizontal gaze was consistently maintained. The lower cervical parameters were not statistically associated with translation-related parameters (C2-7 SVA and StC7-SVA). Therefore, the upper cervical segment may be a better predictor for determining head and neck translation.

• 대한물리치료과학회지
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• 제30권3호
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• pp.23-30
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• 2023

Background: Flexion of cervical and lumbar joints is required when viewing a smartphone screen. Thus, these joints are overused, together with the surrounding joints and muscles. Long-term use of smartphones will cause changes in cervical and lumbar posture. The effect on forward head posture will vary, depending on the angle of cervical flexion start position in relation to the smartphone. This study investigated how forward head posture changes over time when using a smartphone at 20° and 40° cervical flexion start positions. Design: Cross-sectional study. Methods: Twenty-five subjects with a forward head posture angle of 35° or less participated in the study. A Forward Head Posture app on the participants' smartphones measured forward head posture 5 and 10 minutes after watching videos on their smartphones. Cervical range of motion was used to set a smartphone watching start posture of 20° and 40° of cervical flexion. Results: There was no significant difference in forward head posture, irrespective of cervical flexion start position, but the angle of forward head posture increased more at cervical flexion of 40° than at cervical flexion of 20°. There was no significant difference in what according to smartphone video viewing times, but the angle of forward head posture increased over time. Conclusion: An increase in forward head posture over time with smartphone usage poses a potential risk of neck and shoulder pain. Therefore, smartphone users should avoid prolonged screen time.