• Title/Summary/Keyword: Cervical approach

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Myofascial Release improved Regional Kyphosis in a 20-year-old Female patient with Cervical Neuroforaminal Encroachment: A Case Report

  • Han, Song-I;Park, Jae-Man
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.1
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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.

Cervical Esophageal Perforation after Blunt Trauma (둔상에 의한 경부 식도 파열)

  • Cho, Hyun-Min;Kim, Young-Jin
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.45-47
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    • 2011
  • Esophageal perforation due to blunt trauma is rare. A 67-year-old male presented to Konyang University Hospital with painful neck swelling. His neck was injured by blunt trauma at work. Esophageal perforation was detected by neck CT and esophagography. We performed primary repair of cervical esophagus through the Lt. neck approach. The postoperative course was uneventful and the patient was discharged at postoperative day 15.

Cervico-mediastinal Cystic hygroma -Aa Case Report- (경부와 종격동에 걸친 낭성 수활액종 -1례 보고-)

  • 박형주
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.209-212
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    • 1995
  • Cystic hygroma is a cystic tumor developed by lymphatic stasis due to congenital blockage of regional lymphatic drainage. It ususally occurs at neck and axilla. However, in some cases of cervical cystic hygroma, cervical portions of the cysts may extend into the mediastinum. We experienced a case of huge cervico-mediastinal cystic tumor in 11 month old girl presenting a large fluctuating neck mass and severe respiratory distress. Surgical resection was done through combined approach of cervical incision and median sternotomy. Pathological diagnosis was confirmed to cervico-mediastinal cystic hygroma.

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Large Perforation of Hypopharynx Secondary to Anterior Cervical Approach : A Complicated Case

  • Park, Jun Hee;Do, Nam Yong;Kim, Seok Won;Kim, Hyeun Sung
    • Journal of Korean Neurosurgical Society
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    • v.53 no.6
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    • pp.377-379
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    • 2013
  • Perforation of the hypopharynx, which can occur after anterior cervical approach, is a very rare type of complication. If diagnosed late, it can lead to very fatal course, such as mediastinitis and hematosepsis. Therefore, a precise and prompt diagnosis is crucial. When conservative treatment alone is not expected to heal the perforated site or is likely to lead to serious complications, surgical treatment becomes necessary. This report demonstrates that surgical intervention performed immediately after an early diagnosis can lead to the successful treatment of a large perforation in the hypopharynx on a 58-year-old male patient.

Clinical Features of Vocal Cord Paralysis after Anterior Cervical Spine Surgery (전방 접근법을 통한 경추 수술 후 성대 마비의 임상양상)

  • Kim, Il-Woo;Kim, Beom-Gyu;Kim, Young-Bok;Rho, Young-Soo;Ahn, Hwoe-Young;Park, Il-Seok
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.17 no.2
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    • pp.111-114
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    • 2006
  • Objective : The anterior approach to the cervical spine now selves as the surgical across of choice for cervical spine disease. Vocal cord paryalysis(VCP) follow the procedure as a complication, and it is most common complication of this procedure. However, the frequency and etiology of this injury are not clearly defined. This study was performed to establish the clinical features of vocal cord paralysis in anterior cervical spine surgery(ACSS). Material and Method : Retrospectively, medical records of patients who underwent ACSS at Hallym university medical center, Hangang Sacred Heart Hospital between January 2000 and March 2006 were reviewed. Further detailed review of the patients with documented VCP after surgery was then performed. Results : 242 ACSSs were performed and 9 patients with VCP were identified (3.71%) In 9 patients with VCP, 8 patients had right-sided approaches (6.01%) and 1 patient had left-sided approach (0.91%). All 9 patients had VCP on ipsilateral side and 8 patients were recovered completely on follow up period. Duration of ACSS, multilevel exposure and low-level (below the C6 level) exposure have been found to be associated with higher risk. Conclusion : For avoiding the recurrent laryngeal nerve injury, surgeon have to understand the clinical features of VCP in ACSS. As right-sided approach has a greater risk of recurrent laryngeal nerve injury, we suggest that the left-sided approach be given more consideration.

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Hong Kong Chinese Women's Lay Beliefs about Cervical Cancer Causation and Prevention

  • Wang, Linda Dong-Ling;Lam, Wendy Wing Tak;Wu, Joseph;Fielding, Richard
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7679-7686
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    • 2014
  • Background: This study aimed to seek insights into Chinese women's lay beliefs about cervical cancer causal attributions and prevention. Materials and Methods: Twenty-three new immigrant adult women from Mainland China and thirty-five Hong Kong adult women underwent semi-structured in-depth interviews. Interviews were audio taped, transcribed and analyzed using a Grounded Theory approach. Results: This study generated three foci: causal beliefs about cervical cancer, perceived risk of cervical cancer, and beliefs about cervical cancer prevention. Personal risky practices, contaminated food and environment pollution were perceived as the primary causes of cervical cancer. New immigrant women more likely attributed cervical cancer to external factors. Most participants perceived cervical cancer as an important common fatal female cancer with increased risk/prevalence. Many participants, particularly new immigrant women participants, expressed helplessness about cervical cancer prevention due to lack of knowledge of prevention, it being perceived as beyond individual control. Many new immigrant participants had never undergone regular cervical screening while almost all Hong Kong participants had done so. Conclusions: Some Chinese women hold pessimistic beliefs about cervical cancer prevention with inadequate knowledge about risk factors. Future cervical cancer prevention programs should provide more information and include capacity building to increase Chinese women's knowledge and self-efficacy towards cervical cancer prevention.

An Anatomical Variant : Low-Lying Bifurcation of the Common Carotid Artery, and Its Surgical Implications in Anterior Cervical Discectomy

  • Gulsen, Salih;Caner, Hakan;Altinors, Nur
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.32-34
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    • 2009
  • The common carotid artery generally bifurcates into the internal and external carotid arteries at the level of C3-4. Injury to the common carotid artery during anterior cervical discectomy is a complication that is very much feared but encountered rarely. Knowing the anatomic variations of the common carotid artery and using an operating microscope during the anterior cervical approach for cases with low-lying bifurcation of the common carotid artery would prevent injuries to this artery. We present a 42-year-old female who has successfully undergone anterior cervical discectomy at the level of C5-6 and C6-7. She had a low-lying bifurcation of the common carotid artery.

Descending Necrotizing Mediastinitis Combined with Cervical Spine Injury (경추 손상과 동반된 하행성 괴사성 종격동염)

  • 금동윤;양보성
    • Korean Journal of Bronchoesophagology
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    • v.7 no.1
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    • pp.76-79
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    • 2001
  • A 60-year-old male was admitted due to cervical spine injury (C7-T1 fracture dislocation) and quadriparesis after slip down. During conservative management in department of neurologic surgery, he complainted of fever, dyspnea, neck swelling. Follow up cervicothoracic CT revealed abscess pocket in paraglottic, retropharyngeal, anterior cervical spaces and mediastinum. Also noted bilateral pleural effusions. Under impression of descending necrotizing mediastinitis (DNM). cervical drainage and bilateral chest tube insertion was performed immediately. On next day. mediastinal drainage through mediastinotomy was performed with careful handling of cervical spine. Escherichia coli was identified in bacteriologic culture. Wire fixation of dislocated C7-T1 spine through Posterior approach was performed on 30th days after mediastinotomy. Right chest tube was removed on 40th days. At now, the patient is on rehabilitation and physical training program. DNM is relatively rare, but lethal disease with high mortality. Immedate and sufficient mediastinal drainage is essential in treatment.

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The Inaccuracy of Surface Landmarks for the Anterior Approach to the Cervical Spine in Southern Chinese Patients

  • Ko, Tin Sui;Tse, Michael Siu Hei;Wong, Kam Kwong;Wong, Wing Cheung
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1123-1126
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    • 2018
  • Study Design: Observational study. Purpose: To assess the correlational accuracy between the traditional anatomic landmarks of the neck and their corresponding vertebral levels in Southern Chinese patients. Overview of Literature: Recent studies have demonstrated discrepancies between traditional anatomic landmarks of the neck and their corresponding cervical vertebra. Methods: The center of the body of the hyoid bone, the upper limit of the lamina of the thyroid cartilage, and the lower limit of the cricoid cartilage were selected as representative surface landmarks for this investigation. The corresponding vertebral levels in 78 patients were assessed using computed tomography. Results: In both male and female patients, almost none of the anatomical landmarks demonstrated greater than 50% correlation with any vertebral level. The most commonly corresponding vertebra of the hyoid bone, the lamina of the thyroid cartilage, and the cricoid cartilage were the C4 (47.5%), C5 (35.9%), and C7 (42.3%), respectively, which were all different from the classic descriptions in textbooks. The vertebral levels corresponding with the thyroid and cricoid cartilage were significantly different between genders. Conclusions: The surface landmarks of the neck were not accurate enough to be used as the sole determinant of vertebral levels or incision sites. Intra-operative fluoroscopy is necessary to accurately locate each of the cervical vertebral levels.

The Surgical Management of Traumatic C6-C7 Spondyloptosis

  • Keskin, Fatih;Kalkan, Erdal;Erdi, Fatih
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.49-51
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    • 2013
  • A case of traumatic spondyloptosis of the cervical spine at the C6-C7 level is reported. The patient was treated succesfully with a anterior-posterior combined approach and decompression. The patient had good neurological outcome after surgery. A-51-year-old female patient was transported to our hospital's emergency department after a vehicle accident. The patient was quadriparetic (Asia D, MRC power 4/5) with severe neck pain. Plain radiographs, computerize tomography and spinal magnetic resonance imaging (MRI) showed C6-7 spondyloptosis and C5, C6 posterior element fractures. Gardner-Wells skeleton traction was applied. Spinal alignment was reachived by traction and dislocation was decreased to a grade 1 spondylolisthesis. Then the patient was firstly operated by anterior approach. Anterior stabilization and fusion was firstly achieved. Seven days after first operation the patient was operated by a posterior approach. The posterior stabilization and fusion was achieved. Postoperative lateral X-rays and three-dimensional computed tomography showed the physiological realignment and the correct screw placements. The patient's quadriparesis was improved significantly. Subaxial cervical spondyloptosis is a relatively rare clinical entity. In this report we present a summary of the clinical presentation, the surgical technique and outcome of this rarely seen spinal disorder.