• CELLMED
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• v.13 no.15
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• pp.54.1-54.4
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• 2023

Objective: A single-patient case study on the use of OCNT for cervical spinal stenosis. Methods: A50-year-old Korean male with frequent leg muscle cramps and severe muscle weakness was treated with OCNT. Results: After OCNT, pain and cramps disappeared, and muscle strength improved to the point of no longer hindering daily activities. Conclusion: OCNT can be beneficial in alleviating symptoms of pain and muscle weakness in patients with cervical spinal stenosis.

• Korean Journal of Radiology
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• v.1 no.1
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• pp.11-18
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• 2000

Objective: To evaluate the hydrodynamic changes occurring in cerebrospinal fluid (CSF) flow in cervical spinal stenosis using the spatial modulation of magnetization (SPAMM) technique. Materials and Methods: Using the SPAMM technique, 44 patients with cervical spinal stenosis and ten healthy volunteers were investigated. The degree of cervical spinal stenosis was rated as low-, intermediate-, or high-grade. Low-grade stenosis was defined as involving no effacement of the subarachnoid space, intermediate-grade as involving effacement of this space, and high-grade as involving effacement of this space, together with compressive myelopathy. The patterns of SPAMM stripes and CSF velocity were evaluated and compared between each type of spinal stenosis and normal spine. Results: Low-grade stenosis (n = 23) revealed displacement or discontinuity of stripes, while intermediate- (n = 10) and high-grade (n = 11) showed a continuous straight band at the stenotic segment. Among low-grade cases, 12 showed wave separation during the systolic phase. Peak systolic CSF velocity at C4-5 level in these cases was lower than in volunteers (p < .05), but jet-like CSF propulsion was maintained. Among intermediate-grade cases, peak systolic velocity at C1-2 level was lower than in the volunteer group, but the difference was not significant (p > .05). In high-grade stenosis, both diastolic and systolic velocities were significantly lower (p < .05). Conclusion: Various hydrodynamic changes occurring in CSF flow in cervical spinal stenosis were demonstrated by the SPAMM technique, and this may be a useful method for evaluating CSF hydrodynamic change in cervical spinal stenosis.

• Korean Journal of Radiology
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• v.24 no.3
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• pp.224-234
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• 2023

Magnetic resonance imaging (MRI) is a standard imaging modality for diagnosing spinal stenosis, which is a common degenerative disorder in the elderly population. Standardized interpretation of spinal MRI for diagnosing and grading the severity of spinal stenosis is necessary to ensure correct communication with clinicians and to conduct clinical research. In this review, we revisit the Lee grading system for central canal and neural foraminal stenosis of the cervical and lumbar spine, which are based on the pathophysiology and radiologic findings of spinal stenosis.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.4 no.1
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• pp.85-94
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• 2009

Objects : This study was to report a clinical effect of Korean Treatment for a patient diagnosed by Computed Tomography as Cervical Spinal Stenosis with Ossification of posterior Longitudinal Ligament. Methods : In order to alleviate left shoulder pain and neck stiffness, the patient was treated by acupuncture therapy, herbal medicine, distilled herbal injection, cervical traction technique of Chuna treatment and conservative managements. To evaluate the effect of the treatment, Recovery rate of Hirabayashi, VAS(Visual Anlaogue Scale), NDI and ROM(Range of Motion) were used. Lhermitte's sign, Valsalva test, Distraction test, Compression test and Spurling test were carried out. Results : VAS, NDI and ROM were improved and Recovery rate was 100%. Conclusions : Korean Treatment can be effectively used for a patient with Cervical Spinal Stenosis with OPLL. Further clinical studies are needed to verify the findings.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.3
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• pp.115-123
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• 2021

This study reports the effects of Korean medicine treatments including Chuna manual therapy (CMT) and exercise treatment for a patient suffering with cervical spinal stenosis. We treated patient diagnosed with cervical spinal stenosis. The patient was treated with CMT once a day for 26 days. Manual muscle testing (MMT), ratio and degree of numbness, numerical rating scale (NRS) were used as tools for evaluating the patient's progress. MMT was increased from 3+ to 5, ratio and degree of numbness were decreased from grade (Gr.) 9 to Gr. 4, NRS was decreased from 5 to 3. This study suggests that CMT and self-exercise can be considered as effective treatment for cervical spinal stenosis.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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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.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.3-15
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• 2014

As our population ages and the rate of spine surgery continues to rise, the use epidural lysis of adhesions (LOA) has emerged as a popular treatment to treat spinal stenosis and failed back surgery syndrome. There is moderate evidence that percutaneous LOA is more effective than conventional ESI for both failed back surgery syndrome, spinal stenosis, and lumbar radiculopathy. For cervical HNP, cervical stenosis and mechanical pain not associated with nerve root involvement, the evidence is anecdotal. The benefits of LOA stem from a combination of factors to include the high volumes administered and the use of hypertonic saline. Hyaluronidase has been shown in most, but not all studies to improve treatment outcomes. Although infrequent, complications are more likely to occur after epidural LOA than after conventional epidural steroid injections.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.51-55
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• 2006

Background: A cervical transforaminal steroid injection is an effective therapeutic modality for radiculopathy of a herniated cervical disc or a cervical foraminal stenosis. However, there is some debate regarding the safety of the transforaminal approach under C-arm guidance compared with the posterior interlaminar approach. We report a new technique for cervical transforaminal steroid injection guided by MDCT. Methods: Patients presenting with radiating pain on their shoulder or arm were diagnosed using CT or MRI of a cervical herniated disc or a foraminal stenosis. Each patient whose symptoms were compatible with the image scan was enrolled in this study. They received a cervical transforaminal steroid injection under CT guidance, and the effectiveness and complications of this technique were evaluated over a 2-month period. Results: According to the CT scan, none of the participants had an internal jugular vein or a carotid artery invasion during the procedure. No vertebral artery injection was noted, and no patient developed a hematoma after the injection. The VAS score had improved significantly by 2, 4 and 8 weeks after the injection. Conclusions: While a conventional C-arm guided cervical transforaminal steroid injection does not appear to differentiate between the major vessels and structures in images, a CT guided approach is a more useful and safer technique for the precise placement of a needle.

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.919-925
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• 2022

This study is an image reconstruction method after cervical CT scan. According to the oblique coronal reconstruction angle, i would like to suggest the reconstruction angle that can best express neural foraminal bony stricture. The angle created by drawing a line passing through the center of the spinal cord in the midsagittal plane of the cervical spine and the uncovertebral joint was measured. A line passing through the center of the spinal cord was drawn from the neural foramen, and the angle formed with the midsagittal plane was measured and compared. At the C4-5 level, the average was 9.2°, at the C5-6 level, the average was 9.9°, and at the C6-7 level, the average was 8.4°, the neural foraminal angle was measured to be larger than the uncovertebral joint angle. There was a statistically significant difference in mean (p<0.01). Also, it was found that the angle increased toward the lower cervical vertebrae. The angle between the neural foramen of the lower cervical vertebrae (C5-6, C6-7) and the center of the spinal cord is between 55 and 60°. Here, if the oblique coronal image is reconstructed to be 90°, the degree of neural foramen stenosis can be observed well. Because it is an image reconstruction using a conventional CT scan image, it does not receive additional radiation exposure. It is of great significance in diagnosing cervical neural foramen bony stenosis.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.83-88
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• 2013

Objective : The authors reviewed their experiences of combined surgery (open door laminoplasty with unilateral screw fixation) for unstable multi-level cervical stenosis, to clarify the situation regarding the surgical approach most appropriate for the treatment of diffuse unstable multi-level cervical stenosis. Methods : From January 2011 to January 2012, combined surgery was performed for unstable multi-level cervical stenosis by one surgeon at our institution. The subjects of this study were 6 men of mean age 53.7 years (range, 48-71) with a mean follow-up of 9.3 (range, 3-14) months. All imaging studies showed severe multi-level cervical stenosis with spinal cord signal change, and instability or kyphotic deformity. A retrospective review of clinical, radiological, and surgical data was conducted. Results : Average laminoplasty level was 4.8 and the average screw fixation level was 5.0. Japanese Orthopedic Association score improved from an average of 5.2 to 11.2 points. According to Nurick's grades and Odom's criteria, symptom improvement was statistically significant. On the other hand, Cobb's angle changes were not significant. Average operation time was 5.86 hours with an average blood loss of 460 mL. No significant surgical complication was encountered. Conclusion : Despite the small cohort and the short follow-up duration, the present study demonstrates that laminoplasty with unilateral screw fixation is a safe and effective treatment for unstable multi-level cervical stenosis.