• Title/Summary/Keyword: Cervical Disc Herniation

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Cervical Disc Herniation Producing Acute Brown-Sequard Syndrome

  • Kim, Jong-Tae;Bong, Ho-Jin;Chung, Dong-Sup;Park, Young-Sup
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.312-314
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    • 2009
  • Brown-Sequard syndrome may be the result of penetrating injury to the spine, but many other etiologies have been described. This syndrome is most commonly seen with spinal trauma and extramedullary spinal neoplasm. A herniated cervical disc has been rarely reported as a cause of this syndrome. We present a case of a 28-year-old male patient diagnosed as large C3-C4 disc herniation with spinal cord compression. He presented with left hemiparesis and diminished sensation to pain and temperature in the right side below the C4 dermatome. Microdiscectomy and anterior cervical fusion with carbon fiber cage containing a core of granulated coralline hydroxyapatite was performed. After the surgery, rapid improvement of the neurologic deficits was noticed. We present a case of cervical disc herniation producing acute Brown-Sequard syndrome with review of pertinent literature.

A Case Report of Prescribing Yanghyeolgeopung-tang(yangxuequfeng-tang) to Two Patients with Cervical Disc Herniation and Headache (양혈거풍탕(養血風湯)을 투여한 두통을 동반한 경추 추간판 탈출증 환자 치험 2례)

  • Cho, Nam-Hoon;Kim, Me-Riong;Jeong, Hoon;Yang, Seung-Hee
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.2
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    • pp.33-44
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    • 2011
  • Objectives : The purpose of this study is to investigate the clinical application of Yanghyeolgeopung-tang(yangxuequfeng-tang) to two patients with cervical disc herniation and headache. Methods : The patients were hopitalized at the Dept. of Oriental Rehabilitation Medicine, Jaseng Oriental Medicine Hospital, and diagnosed as cervical disc herniation and treated mainly with herbal medicine; Yanghyeolgeopung-tang(yangxuequfeng-tang). Additional acupuncture and pharmaco-puncture was provided. NRS(Numeric Rating Scale) and NDI(Neck Disability Index) scores were used as outcome measures. Results : After taking Yanghyeolgeopung-tang(yangxuequfeng-tang), the patients' pain was controlled and the patients slept well after treatment. NRS and NDI scores both decreased. Conclusions : As seen in these two cases of cervical disc herniation with headache, Yanghyeolgeopung-tang(yangxuequfeng-tang) has a positive effect in controlling neck pain and headahce due to cervical disc herniation.

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Computed Tomography Fluoroscopy-Guided Selective Nerve Root Block for Acute Cervical Disc Herniation

  • Eun, Sang-Soo;Chang, Won-Sok;Bae, Sang-Jin;Lee, Sang-Ho;Lee, Dong-Yeob
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.419-422
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    • 2010
  • Objective : To analyze the clinical outcomes of computed tomography (CT) fluoroscopy-guided selective neve root block (SNRB) for severe arm pain caused by acute cervical disc herniation. Methods : The authors analyzed the data obtained from 25 consecutive patients who underwent CT fluoroscopy-guided SNRB for severe arm pain, i.e., a visual analogue scale (VAS) score of 8 points or more, caused by acute soft cervical disc herniation. Patients with chronic arm pain, motor weakness, and/or hard disc herniation were excluded. Results : The series comprised 19 men and 6 women whose mean age was 48.1 years (range 35-72 years). The mean symptom duration was 17.5 days (range 4-56 days) and the treated level was at C5-6 in 13 patients, C6-7 in 9, and both C5-6 and C6-7 in 3. Twenty-three patients underwent SNRB in 1 session and 2 underwent the procedure in 2 sessions. No complications related to the procedures occurred. At a mean follow-up duration of 11.5 months (range 6-22 months), the mean VAS score and NDI significantly improved from 9 and 58.2 to 3.4 and 28.1, respectively. Eighteen out of 25 patients (72%) showed successful clinical results. Seven patients (28%) did not improve after the procedure, and 5 of these 7 underwent subsequent anterior cervical discectomy and fusion. Conclusion : CT fluoroscopy-guided SNRB may play a role as a primary conservative treatment for severe arm pain caused by acute cervical disc herniation.

Percutaneous Cervical Discectomy using Dekompressor® to the Patient with Posterolateral Extrusion Disc -A case report- (후측면으로 거대 탈출된 경추부 추간판 탈출증 환자에게 Dekompressor®를 이용한 경피적 수핵 감압술 -증례보고-)

  • Jo, Daehyun;Kim, Sangjin;Kim, Myounghee
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.253-256
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    • 2006
  • Cervical disc herniation is one of the most common causes of neck, shoulder and arm pain. There are many treatments for a cervical disc herniation, such as rest, physical therapy, medication, epidural steroid injection and surgery. However, conservative treatments sometimes have limited effectiveness, and a surgical discectomy is often associated with numerous complications. Nowadays, a percutaneous discectomy, using a $Dekompressor^{(R)}$, has been used in herniated disc patients, but a posterolateral extruded disc is not an indication. Herein, our experience using a 19 G $Dekompressor^{(R)}$, on a 52 year-old male patient with a left C6-⁣7 posterolateral extruded disc, is reported. Decompression was successfully performed, and the pain and range of motion was immediately improved.

Effects of Korean Medical Combination Treatment for 102 Cases of Cervical Disc Herniation : An Observational Study (경추 추간판 탈출증 입원 환자 102례에 관한 한의학적 복합치료 효과의 관찰 연구)

  • Choi, Ji Hoon;Lee, Sun Ho;Kim, Sang Min;Kim, Hyun Joong;Koo, Ja Sung;Lee, Hyun Ho;Jung, Seong Hyun;Youn, Deok Won
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.11-20
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    • 2016
  • Objectives : The purpose of this study is to investigate the clinical effectiveness of Korean medical combination treatment for cervical disc herniation. Methods : This is an observational study. 102 patients diagnosed with cervical disc herniation by MRI (Magnetic Resonance Imaging) were investigated from January, 2015 through to December, 2015 at Daejeon Jaseng Hospital of Korean Medicine. They were sorted according to the distribution of sex, age, causing factor, the period of disease, admission day and pain area. All patients were treated with acupuncture, Chuna treatment, and herbal therapy and physical therapy during the admission period. After treatment, NRS (Numeric Rating Scale), NDI (Neck Disability Index) and EQ-5D were assessed to evaluate the treatment efficacy. Results : There were more females than Males with a ratio of 1 : 1.37, the age of fifty was the most with 35.29 %, reason unknown was the most with 72.55 % and the subacute stage was the most with 38.24 %. According to disc herniation types, patients with protruded disc types were the most with 66.67 % and a lesion of C5/6 was the most with 41.18 %. For patients diagnosed with cervical disc herniation, neck and shoulder pain NRS decreased from $6.43{\pm}1.77$ to $3.96{\pm}1.96$(p<0.001) and radiating pain NRS decreased from $5.64{\pm}1.96$ to $3.57{\pm}1.88$ (p<0.001). NDI decreased from $41.72{\pm}14.04$ to $30.84{\pm}15.34$(p<0.001), and the EQ-5D index increased from $0.68{\pm}0.17$ to $0.79{\pm}0.14$(p<0.001) after treating cervical disc patients. Conclusion : Korean medical combination treatment might be effective in decreasing pain and raising the life quality of patients with cervical disc herniation.

Results of Microsurgical Anterolateral Tunnel Approach for Cervical Disc Herniation (경추간판탈출증에 대한 미세 전측방 Tunnel Approach의 결과)

  • Jang, Woo-Young;Kim, Keun-Soo;Lee, Jung-Chung;Kim, Chul-Jin;Choi, Ha-Young;Xuan, Xiu-Nan;Han, Dong-Han
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.600-604
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    • 2001
  • Objective : The authors report the microsurgical anterolateral tunnel approach for the treatment of the cervical disc diseases and its postoperative surgical results. Methods : All surgical procedures followed the method of classical microsurgical anterior discectomy. Small tunnel(7-8mm) was made on the disc space reaching to the posterior longitudinal ligament. The disc materials and bony spurs were removed through this tunnel. Thirty-one patients of cervical disc herniation(24 cases with pure disc herniation, 7 cases with combined cervical spondylosis) were evaluated on the symptoms, conformation in plain X-ray, C-T, and MRI. The follow up time was over 2 years. Results : Postoperatively the result(following the out come scale) was excellent and good in Twenty-nine patients. One with fair result showed remnant disc particle and spur and another one is combined with cord contusion. One patient with lesion in C 3-4 space and two cervicothoracic junction showed excellent result. Two patients with osteoporosis also showed good results. Cervical spine curvature and disc space height were not changed on the plain X-ray and MRI in all patients. Twenty-nine patients were discharged within 3 days after surgery without any postoperative complications. Conclusions : The microsurgical anterolateral tunnel approach could be indicated for the treatment of patients with cervical disc diseases and with difficulty in achieving interbody fusion(the higher cervical level and cervicothoracic junction, osteoporosis etc.).

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Clinical Characteristics of Cervical and Thoracic Radiculopathies: Non-Invasive Interventional Therapy (목 및 가슴신경뿌리병증의 임상적 고찰: 비침습적 중재시술치료)

  • Roh, Hakjae;Lee, Sang-Heon;Kim, Byung-Jo
    • Annals of Clinical Neurophysiology
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    • v.10 no.2
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    • pp.83-97
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    • 2008
  • Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.

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The Clinical Study on 88 Patients of Cervical Disc Herniation (경추 추간판 탈출증 환자 88례에 대한 임상적 고찰)

  • Lee, Hyo-Eun;Cho, Jae-Hee;Moon, Ja-Young;Lim, Myung-Jang;Kang, In;Lee, Han;Jung, Ho-Suk;Jang, Hyoung-Seok
    • Journal of Acupuncture Research
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    • v.25 no.6
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    • pp.145-152
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    • 2008
  • Objectives : This study is to survey the effectiveness of the oriental medicine treatment on cervical disc herniation. Methods : The clinical study was done on 88 cases of patients with cervical disc herniation diagnosed by M.R.I, symptoms and physical test who admitted in Ja-seng Oriental Medicine Hospital from January 2006 to March 2008. After treatment, the efficacy was evaluated according to the criteria of Robinson et al. Results : The clinical results were satisfactory as excellent in cases, good in cases, fair in cases, 92.05% of all were improved above good state Conclusions : Oriental medicine treatment is effective on the recovery of cervical disc heniation.

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Changes on MRI(Magnetic Resonance Imaging) in Cervical Disc Herniations Treated with Oriental Medical Therapy (한의학적 치료법으로 호전된 경추 추간판 탈출증 환자에서의 영상의학적 변화)

  • Kim, Ki-Yuk;Kim, Wu-Young;Han, Sang-Yup;Lee, Hyun-Jong;Kim, Ki-Ju;Jeong, Da-Un;Moon, Tae-Woong;Kim, Chang-Youn
    • Journal of Acupuncture Research
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    • v.26 no.4
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    • pp.71-77
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    • 2009
  • Objectives : The aim of this study is to investigate radiological changes in cervical disc herniation after oriental medical treatment. Methods : 9 patient diagnosed as cervical disc herniation by MRI were treated with oriental medical treatment and underwent a follow up MRI study. Results & Conclusions : Comparison of initial MRI with follow-up MRI showed that 2 of the herniations dimensions decreased between 1% and 25%, 1 decreased between 26% and 50%, 5 decreased between 50% and 75%. The mean disc herniation dimensions decrease was 40% in 9 patients. Comparison of initial MRI with follow-up MRI showed that 4 of the herniations diameter decreased between 1% and 25%, 2 decreased between 26% and 50%, 3 decreased between 50% and 75%. The mean disc herniation diameter decrease was 36% in 9 patients.

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Effect of Cervical Spinal Decompression on the Cervical Muscle Tone and Disc Height in Patients with Cervical Intervertebral Disc Herniation

  • Kang, Jeong il;Jeong, Dae Keun;Choi, Hyun
    • Journal of International Academy of Physical Therapy Research
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    • v.9 no.1
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    • pp.1420-1425
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    • 2018
  • The purpose of this study was to investigate the effect of traction and decompression therapies on the cervical muscle tone and disc height. The decompression group (n=16) received decompression therapy and Mckenzie exercises once a day and four times a week respectively, for three weeks. The traction group (n=15) also received traction therapy and Mckenzie exercises for the same period. Muscle tone was measured with a myotonometer, and the disk height was measured using magnetic resonance imaging (MRI), before the interventions. Three weeks later, we investigated the therapeutic effect by repeating these measurements. The difference in disk height between the two groups was not significant. There was a significant difference in the disk herniation index (p<.05). A significant difference was found only in the upper trapezius muscle after comparison of muscle tone and stiffness between the groups (p<.05). Findings from this study suggest that the decompression therapy is a more effective intervention for patients with cervical intervertebral disc herniation.