• 한국전자통신학회논문지
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• 제12권4호
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• pp.679-690
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• 2017

본 연구는 경부 전만이 감소된 성인을 대상으로 경부 자세에 따른 관절가동범위와 목 장애지수의 비교 및 상관관계를 알고자 하였다. 본 연구를 경부 전만이 감소된(Cobb's 각도 35도 이하) 젊은 성인 34명을 선별하였다. 평가자는 경부 관절가동범위 측정기구를 사용하여 모든 대상자의 굴곡, 신전, 좌측굴곡, 우측굴곡, 좌측회전, 우측회전, 전방 변위를 측정하였으며, 설문을 통하여 목 통증지수를 평가하였다. 모든 평가 후, 경부 전만이 감소된 대상자를 하위집단(전만의 심각한 감소)과 상위집단(전만의 경미한 감소)으로 나누어 관절가동범위와 목 통증지수를 비교하였다. 연구 결과, 하위집단은 상위집단과 비교하여 Cobb's 각도, 신전, 좌측굴곡, 우측굴곡, 좌측회전, 우측회전, 전방 변위에서 유의하게 더 높았으며(p<.05), 굴곡과 목 장애지수는 유의한 차이가 없었다(p>.05). 목 장애지수의 하위항목 비교에서 하위집단은 상위집단보다 통증, 들어올리기, 두통에서 유의하게 더 높았다(p<.05). 평가 간에 상관분석에서 Cobb's 각도는 굴곡, 신전, 좌측굴곡, 우측굴곡, 좌측회전, 우측회전과 유의한 양의 상관이 있었으며(p<.05), 전방 변위, 목 통증지수와 유의한 음의 상관이 있었다(p<.05). Cobb's 각도는 목 통증지수의 하위항목인 통증, 들어올리기, 두통과 유의한 음의 상관을 보였다(p<.05). 본 연구의 결과는 경부의 자세가 관절가동범위와 통증에 영향을 줄 수 있음을 시사한다.

• Journal of Korean Neurosurgical Society
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• 제41권2호
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• pp.105-110
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• 2007

Objective : This purpose of this study was to determine the clinical efficiency and applicability, and to analyze the radiologic findings of the anterior cervical approach using two synthetic cages for interbody fusion. Methods : A total of 41 patients with cervical diseases underwent anterior discectomy and interbody fusion with the PEEK $Solis^{TM}$ cage in 21 patients and the carbon composite $Osta-Pek^{TM}$ cage in 20 patients. Outcome assessment was done using Odom's criteria. Radiological assessment was performed with respect to subsidence, bony fusion and lordosis. The mean follow-up period was 13 months. Results : There were 34 [92.9%] successful cases. The average height of the disc space 12 months after surgery compared the height just after surgery was decreased over 3mm in 4 cases, indicating severe subsidence. The use of these synthetic cages have provided the increase in postoperative cervical lordosis. Conclusion : There were no significant differences between the $Solis^{TM}$ and $Osta-Pek^{TM}$ cages on clinical and radiologic outcomes. Both $Solis^{TM}$ and $Osta-Pek^{TM}$ cages showed low subsidences and complications associated with hardware with good clinical outcomes, high fusion rates, restored disc heights, and restored cervical lordosis.

• 국제물리치료학회지
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• 제8권1호
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• pp.1122-1127
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• 2017

The purpose of this case study was to identify the effects of posteroanterior (PA) mobilization on the cervical spine in a patient with chronic whiplash-associated disorder (WAD). The subject of this study was a 58-year-old woman who sustained a chronic WAD as a result of a motor vehicle accident two years prior. The subject has progressively worsening neck pain and stiffness. The subject was determined to have a grade IIb WAD the use of the Modified Quebec Classification. The intervention was central and unilateral PA mobilization on the spinous process of C4 and C5. The PA mobilizations were performed at the end of range to Maitland grade IV. The PA mobilization was conducted once daily for a total of eight days. Two sets of measurements were done one before and one after the intervention. Neck pain, cervical stiffness, range of motion and lordosis of the cervical spine were measured. Experimental intervention decreased the neck pain, and increased the neck stiffness and cervical ROM (range of motion) such as flexion, extension, lateral flexion and rotation. X-ray photographs also represented that cervical curvature increased from $35^{\circ}$ to $40^{\circ}$. This study suggested that PA cervical mobilization applied to hronic WAD is effective in decreasing pain, increasing cervical ROM and cervical curvature.

• 대한물리의학회지
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• 제9권2호
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• pp.141-149
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• 2014

PURPOSE: This study uses X-rays investigate how university students' smart phone use affects the cervical vertebral angle. METHODS: Ninety-two randomly selected students agreed to participate in this study. The participants' number of hours of smart phone use was gathered using a questionnaire. An X-ray of the participants' cervical vertebrae was taken, and the cervical vertebral angle was measured using the Cobb and the absolute rotation angle (ARA) method. Also, the relation between pain and hours of smart phone use was identified using a visual analog scale (VAS). Using SPSS ver18, the relationships among the cervical vertebral angle and the items in the questionnaire were identified and a frequency analysis, an independent t-test, and the analysis of variance (ANOVA) were calculated. RESULTS: The study showed that an increase in the number hours of smart phone per day led to cervical lordosis(p<0.05). The relationships between points of smart phone addiction and cervical vertebral angle have a negative correlation (p<0.05). Therefore, there are the higher smart phone addiction points, the decrease the cervical vertebral angle. CONCLUSION: The results of the study showed that increase in smart phone use lead to cervical lordosis, and smart phone addiction scores resulted in decreased in the cervical vertebral angle.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.231-235
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• 2015

Objective : Degenerative changes in the cervical spine are commonly accompanied by cervical kyphosis which can cause neck pain. This study examined the relationship between neck pain and cervical alignment. Methods : A total of 323 female nursing staff from our hospital were enrolled. Sagittal radiographs of the cervical spine, Body Mass Index (BMI), Visual Analogue Scale (VAS) measures of neck and arm pain, Neck Disability Index (NDI) and the Short Form (36) Health Survey (SF-36 scores) were obtained and reviewed retrospectively. Global lordosis (GL) of the cervical spine was measured on radiograph images. Correlations between GL and questionnaire scores were investigated using the following three methods : 1) correlation between GL and questionnaire scores among the entire sample; 2) subgroup analysis of patients with "kyphosis (KYP) : GL scores<0" vs. those with "lordosis (LOR) : GL scores>0" on questionnaire measures; and 3) subgroup analysis of patients with pain vs. those without pain, on GL and questionnaire measures. Results : There was no significant correlation between GL and any questionnaire measure. There was a significant difference between the mean GLs of the KYP and LOR groups, but there were no group differences in BMI, age or any questionnaire measures. There was no difference between the pain (n=92) and pain-free (n=231) groups in age, BMI or GL, but there were differences in neck, and arm pain, and physical function and NDI scores. Conclusions : Our data suggest that kyphotic deformity was not associated with neck pain.

• 대한물리의학회지
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• 제16권3호
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• pp.81-87
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• 2021

PURPOSE: This study compared the cross-sectional areas (CSA) of the cervical muscles of straight neck patients and normal participants during a craniocervical flexion exercise (CCFE) using computerized tomography (CT) to investigate the effects of CCFE on the cervical curve. METHODS: Eighteen subjects were recruited for this study. Nine subjects were allocated to the straight neck group (subjects with pain and a cervical lordosis angle of less than 20°); the remainder formed the control group (subjects with a cervical lordosis angle greater than 20°). The CSA of the subjects' neck flexors (longus colli, longus capitis, and sternocleidomastoid) were measured by CT during rest and CCFE in the supine position, and the range of motion (ROM) of neck flexion was measured using a C-ROM instrument in a sitting. RESULTS: The straight neck group had a significantly smaller CSA of the longus colli, longus capitis, and sternocleidomastoid than the control group (p < .05). Both the straight neck and control groups showed statistically significant increases in the CSA of the neck flexors during CCFE compared to that at rest (p < .05). In addition, the straight neck group showed a significantly smaller ROM of neck flexion than the control group (p < .05). CONCLUSION: The results of this study provide more concrete evidence for therapists by demonstrating that CCFE improves the neck function by strengthening the neck flexors and increasing the neck stability for straight neck patients. Therefore, it is necessary to perform CCFE and neck extension exercises to rehabilitate straight neck patients.

• Clinical Pain
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• 제18권1호
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• pp.8-15
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• 2019

Objective: To determine the relationship between cervical sagittal parameters and the degree of the cervical disc degeneration at each cervical level by using cervical plain radiographs and disc degeneration grading. Method: This study analyzed 110 patients with posterior neck pain. Cervical radiographic measurements included the occipito-cervical (O~C2) angle; sagittal Cobb angles of C1~C2, C2~C7; and sagittal vertical axis (SVA) of C1~C7 and C2~C7. The degenerations of cervical discs at each level were evaluated through Pfirrmann grading system by magnetic resonance images of the cervical spine. The correlations between the cervical sagittal measurements and the disc degeneration at each level were analyzed by Spearman's correlation. Results: A significant correlation was found for the C2~C7 angle with disc degenerations at C2~C6 levels. O~C2 angle was correlated significantly with disc degenerations at C2~C4 and C5~C7 levels. There was significant correlation between C1~C2 angle and disc degeneration at C6~C7 level. No significant relationship was found between the cervical SVA and the cervical disc degeneration at all cervical levels. Conclusion: Cervical sagittal parameters representing cervical angles (C2~C7, O~C2, and C1~C2 angles) were significantly correlated with the degree of the cervical disc degeneration. These findings suggest that the loss of the natural cervical lordosis rather than loss of natural SVA could be correlated with progression of the cervical disc degeneration.

• Journal of Korean Neurosurgical Society
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• 제30권12호
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• pp.1369-1374
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• 2001

Objectives : The rates of pseudarthrosis for two- and three level fusion have been reported to be 17-63 and 50% without anterior cervical plating. The purpose of this study is to assess the effects of anterior cervical plating in the treatment of multilevel degenerative cervical disease such mostly the additional risks associated with hardware implants and its benefits, fusion rate and radiographic results, and clinical outcomes. Methods : Forty-seven patients who underwent operations between 1993 and 1997 were retrospectively reviewed. The technique for operation was same for both groups(Smith Robinson with autologous iliac bone graft). Group I consisted of 35 consecutive patients treated with anterior cervical decompression and fusion with anterior cervical plate fixation. Group II consisted of 12 consecutive patients treated without plate fixation. We compared clinical outcomes by Prolo score, radiographic results in the rate of fusion, cervical lordosis by Gore angle, disc height by Farfan method, and surgical complications between two groups. Results : The favorable clinical outcomes(excellent and good) by Prolo score were observed with the use of anterior cervical plate fixation(89% vs 75%). The successful fusion rate of multilevel cervical fusion was as seen with anterior cervical plate fixation(97% vs 75%). The overall graft complication rate in multilevel fusions was decreased, with anterior cervical plate fixation, and the hardware related complications were relatively minimal without serious consequences. Conclusion : Anterior cervical plate fixation in the treatment of multilevel cervical disorders is an effective stabilizing method which provides increased bony fusion rate, decreased graft complications, maintained cervical lordosis, early mobilization of the these patients without serious hardware related complications.

• 대한물리의학회지
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• 제15권1호
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• pp.19-24
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• 2020

PURPOSE: This paper describes the effects of the myofascial release (MFR) approach in a 20-year-old female patient with neuroforaminal encroachment and regional kyphosis in the cervical area, who also had neck pain. METHODS: A 20-year-old female presented with the chief complaint of neck pain while studying with a level of seven on the rating analogue scale (RAS) and was not taking any drugs or undergoing treatment for the control of neck pain prior to visiting. The cervical radiograph demonstrated neuroforaminal encroachment from C4-5. The patient showed 3.5° kyphosis at C4-5 and 22.9° lordosis at C2-7 according to the Harrison posterior tangent method. The anterior head translation (AHT) was 13.9mm. She reported pain of RAS 5 at the scapular medial border while rotating her neck in the left direction and flexing forward. The patient was treated a total 16 times, three times/week for six weeks using the MFR approach. RESULTS: After the treatment sessions, studying without pain was possible for approximately two hours, but after approximately two hours of studying, she experienced pain of RAS 6 and a stiff feeling in front of the neck. Neuroforaminal encroachment was not detected in the radiographs taken after applying MFR. Improvement of C4-5 kyphosis was noted (from 3.5° kyphosis to 3.8° lordosis). AHT was decreased by 13.6 mm (from 13.9 mm to 0.3 mm). The pain with motion had disappeared. CONCLUSION: The MFR approach in this patient with neuroforaminal encroachment could reduce the pain related to motion and restore the regional cervical lordosis.

• 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.