• Title/Summary/Keyword: Cervical Disc Herniation

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Analysis of Surgical Treatment and Factor Related to Closed Reduction Failure for Patients with Traumatically Locked Facets of the Subaxial Cervical Spine (축추 이하 경추손상 환자에서 외상성 탈구에 의한 도수 정복의 실패 요인의 분석과 수술적 치료에 대한 분석)

  • Paeng, Sung Hwa
    • Journal of Trauma and Injury
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    • v.25 no.1
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    • pp.7-16
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    • 2012
  • Purpose: Cervical dislocations with locked facets account for more than 50% of all cervical injuries. Thus, investigating a suitable management of cervical locked facets is important. This study examined factors of close reduction failure in traumatically locked facets of the subaxial cervical spine patients to determine suitable surgical management. Methods: We retrospectively analyzed of the case histories of 28 patients with unilateral/bilateral cervical locked facets from Nov. 2004 to Dec. 2010. Based on MRI evaluation of disc status at the injury level, we found unilateral dislocations in 9 cases, and bilateral dislocations in 19 cases, The patients were investigated for neurologic recovery, closed reduction rate, factors of the close reduction barrier, fusion rate and period, spinal alignment, and complications. Results: The closed reduction failed in 23(82%) patients. Disc herniation was an obstacle to closed reduction (p=0.015) and was more frequent in cases involving a unilateral dislocation (p=0.041). The pedicle or facet fracture was another factor, although some patients showed aggravation of neurologic symptoms, most patients had improved by the last follow up. The kyphotic angle were statistically significant (p=0.043). Sixs patient underwent anterior decompression/fusion, and 15 patients underwent circumferential fusion, and 7 patients underwent posterior fusion. All patients were fused at 3 months after surgery. The complications were 1 case of CSF leakage and 1 case of esphageal fistula, 1 case of infection. Conclusion: We recommend closed reduction be performed as soon as possible after injury to maximize the potential for neurological recovery. Patients fot whom closed reduction of the cervical locked facets have a higher incidence of anatomic obstacles to reduction, including facet fractures and disc herniation. Immediate direct open anterior reduction or circumferential fixation/fusion of locked cervical facets is recommended as a treatment of choice for traumatic locked cervical facet patients after closed reduction failure.

The Comparitive Study on the Effect of Shinbaro Pharmacopuncture and Bee Venom Pharmacopuncture Treatment of Patient Diagnosed as Cervical Disc Hermiation Based on the MRI after Traffic Accident: A Retrospective, Case Series Observational Study (교통사고 이후 MRI상 경추 추간판 탈출증 진단을 받은 환자에 대한 신바로약침과 봉약침의 치료효과 비교 연구: 후향적 환자군 관찰 연구)

  • Kim, Kie Won;Lee, Min Jung;Jun, Jae Yun;Lim, Su Jin;Lee, Chong Hwan;Kim, Hae Sol;Ha, In Hyuk
    • Journal of Acupuncture Research
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    • v.31 no.1
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    • pp.43-50
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    • 2014
  • Objectives : The purpose of this study is to compare the effect of Shinbaro pharmacopuncture treatment and bee venom pharmacopuncture treatment on cervical disc herniation and whiplash injury induced by traffic accident. Methods : This study was carried out on the 59 patients with whiplash injury by traffic accident and diagnosed as cervical disc herniation. The patients were divided into 2 groups ; Shinbaro pharmacopuncture group was treated with Shinbaro pharmacopuncture along with herbal medicine and general acupuncture. Bee venom pharmacopuncture group was treated with bee venom pharmacopuncture along with herbal medicine and general acupuncture. We measured verbal numerical rating scale(VNRS) and neck disability index(NDI) before the treatment and 1, 2, 3 weeks afterwards. Results : Shinbaro pharmacopuncture group and Bee venom pharmacopuncture both showed significant decrease in VNRS and NDI. Shinbaro pharmacopuncture group showed significant decrease over Bee venom pharmacopuncture group in VNRS decrement in the first week, while Bee venom pharmacopuncture group showed significant decrease over Shinbaro pharmacopuncture group in the secone week of treatment. Conclusion : According to the result of this study, it is suggested that Shinbaro pharmacopuncture group is more effective in reducing pain in the earlier period of treatment. Also suggests that further study on the effect of Shinbaro pharmacopuncture on patients diagnosed as cervical disc herniation after traffic accident for longer period of treatment.

Thalamic Pain Misdiagnosed as Cervical Disc Herniation

  • Lim, Tae Ha;Choi, Soo Il;Yoo, Jee In;Choi, Young Soon;Lim, Young Su;Sang, Bo Hyun;Bang, Yun Sic;Kim, Young Uk
    • The Korean Journal of Pain
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    • v.29 no.2
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    • pp.119-122
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    • 2016
  • Thalamic pain is a primary cause of central post-stroke pain (CPSP). Clinical symptoms vary depending on the location of the infarction and frequently accompany several pain symptoms. Therefore, correct diagnosis and proper examination are not easy. We report a case of CPSP due to a left acute thalamic infarction with central disc protrusion at C5-6. A 45-year-old-male patient experiencing a tingling sensation in his right arm was referred to our pain clinic under the diagnosis of cervical disc herniation. This patient also complained of right cramp-like abdominal pain. After further evaluations, he was diagnosed with an acute thalamic infarction. Therefore detailed history taking should be performed and examiners should always be aware of other symptoms that could suggest a more dangerous disease.

Retrospective Statistical Analysis of Patients with Disc Herniation Treated with Cervical or Lumbar Decompression Treatment (경·요추 감압치료를 시행한 추간판탈출증 환자에 대한 후향적 통계 분석)

  • Lee, Ye Ji;Kim, Jeong il;Jeon, Ju Hyun;Kim, Eunseok;Kim, Young Il
    • The Journal of Korean Medicine
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    • v.42 no.2
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    • pp.1-20
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    • 2021
  • Objectives: The purpose of this study was to confirm the relavance between the dependent variables and the treatment effects of nonsurgical spinal decompression(NSD). Methods: 105 patients suffering from disc herniation and treated with NSD were investigated and analyzed. Results: The intention of retreatment showed a tendency to be higher in having occupation, western treatment only before NSD(WTB) and non-western treatment(WTN) group. As the number of NSD increased, satisfaction score and the Numeric Rating Scale(NRS) difference increased and the NRS after NSD decreased. On the other hand, as western treatment after NSD increased, satisfaction score and the NRS difference decreased and the NRS after NSD increased. The odds ratio of having intention of retreatment was lower in western treatment only after NSD(WTA) group than WTN group. The NRS difference showed a high tendency in the age group of 20s, 60s, and 70s and older. The NRS difference of group with NSD more than 10 times was higher than that of the group with less than 10 times. Satisfaction score of WTN and WTB group was higher than that of WTA group. Adjusted NRS after NSD was the lowest in non-western treatment group and the highest in WTA group. Adjusted NRS after NSD was the lowest in the group with NSD over 21 times, and the NRS after NSD increased as the number of NSD decreased. Conclusion: This study included patients with cervical or lumbar disc herniation and showed that occupation, the number of NSD, western treatment and age statistically affected the treatment effect.

Air Bubbles Mimic Disc Herniation in MRI after Cervical Epidural Block

  • Kim, Tae-Sam;Shin, Sung-Sik;Kim, Jung-Ryul;Kim, Dal-Yong
    • The Korean Journal of Pain
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    • v.23 no.3
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    • pp.202-206
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    • 2010
  • Magnetic resonance image (MRI) is the most sensitive imaging test of the spine in routine clinical practice. Unlike conventional x-ray examinations and computed tomography scans, high-quality magnetic resonance images can be assured only if patients are able to remain perfectly still. However, some patients find it uncomfortable to remain still because of pain. In that condition, interlaminar cervical epidural injections can reduce pain and allow the procedure. When using air with the "loss of resistance" technique in epidural injections to identify the epidural space, there is the possibility of injected excessive air epidurally to mimic a herniated disc. We describe a case report of epidural air artifact in a cervical MRI after cervical epidural injections.

Acupuncture and Spontaneous Regression of a Radiculopathic Cervical Herniated Disc

  • Kim, Sung-Ha;Park, Man-Young;Lee, Sang-Mi;Jung, Ho-Hyun;Kim, Jae-Kyoun;Lee, Jong-Deok;Kim, Dong-Woung;Yeom, Seung-Ryong;Lim, Jin-Young;Park, Min-Jung;Park, Se-Woon;Kim, Sung-Chul
    • Journal of Pharmacopuncture
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    • v.15 no.2
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    • pp.36-39
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    • 2012
  • The spontaneous regression of herniated cervical discs is not a well-established phenomenon. However, we encountered a case of a spontaneous regression of a severe radiculopathic herniated cervical disc that was treated with acupuncture, pharmacopuncture, and herb medicine. The symptoms were improved within 12 months of treatment. Magnetic resonance imaging (MRI) conducted at that time revealed marked regression of the herniated disc. This case provides an additional example of spontaneous regression of a herniated cervical disc documented by MRI following non-surgical treatment.

Correlation Analysis between Cervical Hypolordosis and Radiological Result in Neck Pain (경항통 환자에 있어서 경추의 전만 감소와 영상의학검사 소견상의 연관성 분석)

  • Lee, Joon-Seok;Lee, Seul-Ji;Kim, Eun-Seok;Han, Kyung-Wan;Woo, Jae-Hyuk;Kim, Sang-Joo;Lee, Han;Kim, Chang-Youn
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.1-8
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    • 2010
  • Objectives : The propose of this study was to observe the correlation between Cervical hypolordosis and radiological result. Methods : We randomly selected among the 110 patients with X-ray and C-spine MRI films who have visited Jaseng Hospital of Oriental Medicine with neck pain. Radiographic measures of cervical lordosis and herniated disc were collected, and statistically analyzed. Results : In this study, if the finding of a X-ray showed straightening of cervical lordotic curve, based on MRI finging, the amount of herniation was more severe. Conclusions : There was a significant correlation between Cervical hypolordosis and herniated disc. Hypolordosis group complained a severe herniated disc.

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Correlation Analysis between Radiological Result and Radiating Pain in Neck Pain (경항통 환자에 있어서 방사통과 영상의학검사 소견상의 연관성 분석)

  • Han, Kyung-Wan;Kim, Eun-Seok;Woo, Jae-Hyuk;Kim, Ho-Jun;Lee, Myeong-Jong
    • Journal of Korean Medicine Rehabilitation
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    • v.20 no.4
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    • pp.139-146
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    • 2010
  • Objectives : To compare the differences between the symptoms and the findings of MRI(magnetic resonance imaging) and x-ray, we studied the patients with neck pain or radiating pain, which has been diagnosed as cervical herniated disc recently. Methods : We randomly selected among the 143 patients with x-ray and cervical spine(C-spine) MRI films who have visited Ja-seng hospital with neck pain and neck and radiating pain from April 1 of 2010 to May 1. We used SPSS 13.0 for windows in analyzing statistical data of study results and the level of significance was below 0.05. Results : 1. There were no significant differences between the presence of radiating pain and the amount of cervical herniation(p>0.05). 2. If the finding of a x-ray showed narrowing, based on MRI findings, the amount of herniation was more severe(p>0.05). 3. There were no significant differences between the presence of radiating pain and the findings of x-ray(p>0.05). 4. Among the 143 cases, which showed findings beside HIVD(herniation of intervertebral disc) were 13 cases. 88 cases of straightening(61.5%). 78 cases of uncovertebral joint arthrosis(54.5%). 25 cases of stenosis(17.5%), 13 cases of retrolisthesis(9.1%), 8 cases of osteophyte(6.6%), 4 cases of spondylolisthesis(2.8%), 2 cases of hemangioma(1.4%), 3 cases of OPLL(ossification of posterior longitudinal ligament)(2.1%), 2 cases of block vertebrae(1.4%), 2 cases of spondylitis(1.4%), 1 case of kyphosis(0.1) and 1 case of ligamentum flavum hypertrophy(0.1%). Conclusions : The findings from this study suggest that there was no relation between radiating pain and radiological result. On the other hand, diagnosis of x-ray and MRI showed significant relevance. The narrower disc space there were, the severer the state of herniation there existed.

Prevalence of Disc Degeneration in Asymptomatic Korean Subjects. Part 2 : Cervical Spine

  • Lee, Tae Hoon;Kim, Sang Jin;Lim, Soo Mee
    • Journal of Korean Neurosurgical Society
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    • v.53 no.2
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    • pp.89-95
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    • 2013
  • Objective : Similar to back pain, neck pain has recently shown to have increasing prevalence. Magnetic resonance imaging (MRI) is useful in identifying the causes of neck pain. However, MRI shows not only pathological lesions but also physiological changes at the same time, and there are few Korean data. The authors have attempted to analyze the prevalence of disc degeneration in highly selective asymptomatic Korean subjects using MRI. Methods : We performed 3 T MRI sagittal scans from C2 to T1 on 102 asymptomatic subjects (50 men and 52 women) who visited our hospital between the ages of 14 and 82 years (mean age 46.3 years). All images were read independently by three observers (two neurosurgeons and one neuroradiologist) who were not given any information about the subjects. We classified grading for cervical disc herniation (HN), annular fissure (AF), and nucleus degeneration (ND), using disc degeneration classification. Results : The prevalence of HN, AF, and ND were 81.0%, 85.9%, and 95.4%, respectively. High prevalence of HN, AF, and ND was shown compared to previous literature. Conclusion : In asymptomatic Korean subjects, the abnormal findings of 3 T MRI showed a high prevalence in HN, AF, and ND. Several factors might play important roles in these results, such as population-specific characters, MRI field strength, and disc degeneration grading system.

Spontaneous Regression of a Radiculopathic Cervical Herniated Disc following Non-surgical Treatment -3 case reports- (비수술적 치료 후 자연소실된 경추추간판탈출증 -증례보고-)

  • Kim, Hyeun Sung;Jo, Dae Hyun;Park, In Ho;Rhu, Jae Kwang;Sun, Kwang Jin;Lim, Kyung Joon
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.84-88
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    • 2008
  • The spontaneous regression of herniated cervical discs is not a well established phenomenon. However, we encountered the 3 cases of spontaneous regression of severe radiculopathic herniated cervical discs that were treated using a non-surgical method. Each of the patients were treated with a combination of manipulation, dry needling and analgesics. In each case, the symptoms improved within 12 months of treatment and magnetic resonance imaging (MRI) conducted at that time revealed marked regression of the herniated disc in all cases. These cases provide additional examples of spontaneous regression of herniated cervical discs documented by MRI following non-surgical treatment.