• Journal of Haehwa Medicine
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• v.20 no.1
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• pp.85-89
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• 2011

Hyperhidrosis is common complication of spinal cord injury, but localized unilateral hyperhidrosis is relatively rare disorder without autonomic disreflexia. A 52-year-old man with a 10-month history of cervical injury induced tetraplegia complained of excessive intermittent left-sided sweating. The sweating occurred by urinary retention or without any autonomic dysreflexia. The patient sweated excessively on the left face and upper body. In the point of Differentiation of Syndrom (辨證), the patient was diagnosed as Gi-Heo-Hyeol-Eo (Pi-Wei-Qi-Xu 氣虛血瘀) and was administered revised Boyanghwano-tang (reserved Bu-Yang-Huan-Wu-tang), and he was almost complaint free during 4 month about none dysreflexial hyperhidrosis.

• Journal of Korean Neurosurgical Society
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• v.58 no.5
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• pp.483-486
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• 2015

Cervical epidural steroid injection is frequently used in the conservative management of neck pain and cervical radiculopathy. Epidural cervical transforaminal injections are usually well-tolerated with mild side effects such as transient decreased sensory and motor function, or headache due to dural puncture. Although there are a few case reports about adverse effects of cervical epidural injection in the literature, it can cause severe complications such as large hematoma, infarction by spinal vascular injury. Subdural hematoma has been occurred much less common rather than epidural hematoma in the spinal cord. We report a rare catastrophic case of cervical spinal subdural hematoma with quadriparesis after cervical transforaminal epidural block.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.108-113
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• 2014

Objective : Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. Methods : Between January 2003 and December 2013, 12 patients with 13 fractures with neurological complications were treated. Neuroimaging evaluation was obtained in all patients by using plain radiography, CT scan, and MR imaging. The ASIA Impairment Scale was used in order to evaluate the neurologic status of the patients. Management was based on the presence or absence of spinal instability. Results : A total of 9 cervical and 4 thoracolumbar fractures were identified in a review of patients in whom ankylosing spondylitis had been diagnosed. Of these, 7 fractures were associated with a hyperextension mechanism. 10 cases resulted in a fracture by minor trauma. Posttraumatic neurological deficits were demonstrated in 11 cases and neurological improvement after surgery was observed in 5 of these cases. Conclusions : Patients with ankylosing spondylitis are highly susceptible to spinal fracture and spinal cord injury even after only mild trauma. Initial CT or MR imaging of the whole spine is recommended even if the patient's symptoms are mild. The patient should also have early surgical stabilization to correct spinal deformity and avoid worsening of the patient's neurological status.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.570-573
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• 2012

Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.

• The Journal of Korean Physical Therapy
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• v.4 no.1
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• pp.27-42
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• 1992

The purpose of this study is to investigate the occurence properties of the complications in spinal cord injured patients. Clinical observation were for 116 cases in and out wards, were carried out during one year from july, 1990 to June, 1991 at 4 general hospitals in Taegu, Korea. The results of this study is summarized as follows : 1. Among the 116 cases, $67.7\%$ was male and $35.3\%$ was female. The largest groups were noted in $60.7\%$, of the forties by age, in $34.5\%$ of the middle school by educational career, in $27.6\%$ of the administer by professional division. 2. The number of complications in a patient in the largest group was two-type. The next groups were three-type, $23.3\%$ and five-type, $20.7\%$. Of each factors, the largest numbers of two-type recorded tuberculosis of spine$(71.4\%)$, thoracic cord injury$(63.4\%)$, incomplete paraplegia$(48.4\%)$, and inwards during 1-2 months $(47.4\%)$. 3. Total number of the complications were counted to 367 cases. The largest group of complications was pain, $24.8\%$. The next groups were pressure sores, $19.9\%$. spasticity, $12.5\%$, and urinary tract infection, $9.3\%$. 4. The number of the 4 major complications(pain, pressure sores, joint contracture, spasticity) was counted to 280 cases. The largest group of the major complications was pain, $32.5\%$. The next groups were pressure sores, $26.1\%$, joint contracture, $25.9\%$ and spasticity, $16.4\%$. Of each factors, the largest numbers of the pain recorded female$(40.5\%)$, thirties$(49.2\%)$, non-educate $(53.8\%)$, labor$(38.2\%)$, traffic accidents$(32.8\%)$, thoracic cord injury$(34.4\%)$, complete paraplegia$(58.1\%)$, and inwards during above 13 months$(37.5\%)$. 5. The largest group of the pain portion was shoulder. $49.4\%$. The non groups were lower extremity, $25.2\%$, hip, $11.0\%$, and all bodies, $4.3\%$. The largest numbers of the shoulder pain recorded thirties$(59.4\%)$, traffic accidents $(52.7\%)$, cervical cord injury$(67.2\%)$. complete quadriplegia$(81.8\%)$, and inwards during above 13 months$(100.0\%)$. 6. The largest group of the pressure sores sites was sacral portion, $83.6\%$. The next groups were hip, $6.8\%$, maleollus, $4.1\%$. The largest numbers of pressure sores formation in the sacral portion recorded below 19 and above $60(100.0\%)$, falling objects$(100.0\%)$, lumbar cord injury$(100.0\%)$, incomplete paraplegia$(100.0\%)$, and in wards during 3-4 months$(95.9\%)$. 7. The largest group of the joint contracture portion was lower extremity, $61.4\%$, follows was upper extremity, $38.6\%$. The largest numbers of the joint contrcture portions recorded thirties$(100.0\%)$, traffic accidents$(86.1\%)$, cervical cord injury$(80.4\%)$, complete quadriplegia$(86.7\%)$, and inwards during 3-4 months $(82.2\%)$ 8. The largest group of spasticity portion was lower extremity, $53.0\%$. The next groups were hip. 23.9, 23.9, ankle, $8.7\%$, and elbow, $4.3\%$. The largest numbers of the spasticity portions recorded above $60(100.0\%)$, falling $(100.0\%)$, cervical cord injury$(71.4\%)$, incomplete quadriplegia$(71.4\%)$, and inwards during 1-2 months $(100.0\%)$.

• Journal of the Korean Institute of Oriental Medical Informatics
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• v.11 no.2
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• pp.23-31
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• 2005

Central cord syndrome (CCS) is the most common incomplete spinal cord injury (SCI) syndrome, occured by cervical hyperextension injury. It is characterized by disproportionately greater motor impairment in the upper extremities compared to the lower extremities, bladder dysfunction, and variable degrees of sensory loss below the level of injury. Recently 36 year-old male was admitted with upper motor neuron weakness, sensory loss in the upper extremities and stiff neck. We report the improvement of his symptoms through both western medical treatment and oriental medical treatment.

• Journal of Auto-vehicle Safety Association
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• v.10 no.3
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• pp.20-26
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• 2018

It was a pilot study for developing an algorithm to determine the presence or absence of cervical spine injury by analyzing the severity factor of the patients in motor vehicle occupant accidents. From August 2012 to October 2016, we used the KIDAS database, called as Korean In-Depth Accident Study database, collected from three regional emergency centers. We analyzed the general characteristics with several factors. Moreover, cervical spine injury patients were divided into two groups: Group 1 for from Quebec Task Force (hereinafter 'QTF') grade 0 to 1, and group 2 for from QTF grade 2 to 4. The score was assigned according to the distribution ratio of cervical spine injured patients compared to the total injured patients, and the cut-off value was derived from the total score by summation of the assigned score of each factors. 987 patients (53.0%) had no cervical spine injuries and 874 patients (47.0%) had cervical spine injuries. QTF grade 2 was found in 171 patients (9.2%) with musculoskeletal pain, QTF grade 3 was found in 38 patients (2.0%) with spinal cord injuries, and QTF grade 4 was found in 119 patients (6.4%) with dislocation or fracture, respectively. We selected the statistically significant factors, which could be affected the cervical spine injury, like the collision direction, the seating position, the deformation extent, the vehicle type and the frontal airbag deployment. Total score, summation of the assigned each factors, 10 was presented as a cut-off value to determine the cervical spine injury. In this study, it was meaningful as a pilot study to develop algorithms by selecting limited influence factors and proposing cut-off value to determine cervical spine injury. However, since the number of data samples was too small, additional data collection and influencing factor analysis should be performed to develop a more delicate algorithm.

• The Journal of the Korea institute of electronic communication sciences
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• v.8 no.11
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• pp.1785-1792
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• 2013

For patients suffering from spinal cord injuries, both of the possibility of having complications with the respiratory system and the related fatal rate are still high, while pneumonia is the most important cause of these fatalities. This research was carried out to find out what effects does a breathing exercise have on the respiratory functions and the improvement in the quality of life. The study was carried out for male patients suffering cervical spinal cord injuries for the purpose of inspiratory muscle strengthening. The objects of the study were 17 non-smoking-at-present male patients with C4 to C6 cervical spinal cord injuries. They had practiced inspiratory muscle strengthening training for three times a week for six weeks. The quality of life and the dyspnea (breathing difficulty) were self-measured before and after the training. As a result, the change in respiratory function was only significantly reduced (p<0.01) within the chronic group. In terms of the changes in the quality of life, the sub-acute group has only seen a significant improvement (p<0.05) for the VT(vitality), while the chronic group has seen significant improvements(p<0.05, p<0.01) in: GH(general health); BP(back pain); and VT(vitality). In this research, the inspiratory muscle strengthening has reduced the dyspnea (breathing difficulties) and improved the quality of life.

• Clinical and Experimental Reproductive Medicine
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• v.19 no.1
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• pp.87-94
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• 1992

From December 1991 to March 1992, 34 anejacuratory patients with spinal cord injury underwent 90 of electric stimulations with Seager NRH model 12. The average patient age was 43.5 years with a range of 23 to 48 years. The level of cord injury was cervical in 7, thoracic in 6, lumbar in 11, lumbosacral in 7 and conus medullaris in 3. The average number of electric stimulation per a patient was 2.65 with a range of 1 to 4. The average voltage and amplitude per a stimulation were 17.72 volts and 309. 89 mAmp with ranges of 5 to 25 volts and 50 to 500 mAmp. The total and motile sperm number were evaluated microscopically and analyzed statistically by paired t-test according to the frequency of electroejaculation, level of cord injury and voiding pattern. The results were obtained as follows. 1. An overall success rate of electroejaculation was 85.3% among 34 patients and 82.2% among 90 electric stimulations. 2. The total and motile sperm number per a stimulation were not correlated the frequency of electric stimulation, level of cord injury and voiding pattern. 3. Complications occured in 10 cases; severe low abdominal pain in 5, hypertension in 2, sweating in 1, headache in 1 and neck stiffness in 1. All the copmlications subsided spontaneously within 5 to 10 minutes after transient interruption of the electric stimulation. In summary, rectal probe electroejaculation is an accepted safe means of procuring sperm from spinal cord injury patients with ejaculatory incompetence. However very poor sperm motility was found and it was not related with the frequency of electroejaculation, level of cord injury and voiding pattern. Further investigation would be needed to conclude and to identify the reasons for impaired sperm motility.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.73-91
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• 2002

Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.