• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.217-221
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• 2008

Objective : Although anterior cervical discectomy and fusion (ACDF) is the standard treatment for degenerative cervical disc disease, concerns regarding adjacent level degeneration and loss of motion have suggested that arthroplasty may be a better alternative. We have compared clinical and radiological results in patients with cervical disc herniations treated with arthroplasty and ACDF. Methods : We evaluated 53 patients treated for cervical disc herniations with radiculopathy, 21 of whom underwent arthroplasty and 32 of whom underwent ACDF. Clinical results included the Visual Analogue Scale (VAS) score for upper extremity radiculopathy, neck disability index (NDI), duration of hospital stay and convalescence time. All patients were assessed radiologically by measuring cervical lordosis, segmental lordosis and segmental range-of-movement (ROM) of operated and adjacent disc levels. Results : Mean hospital stay (5.62 vs. 6.26 days, p<0.05) and interval between surgery and return to work (1.10 vs 2.92 weeks, p<0.05) were significantly shorter in the arthroplasty than in the fusion group. Mean NDI and extremity VAS score improved after 12 months in both groups. Although it was not significant, segmental ROM of adjacent levels was higher in the fusion group than in the arthroplasty group. And, segmental motion of operated levels in arthroplasty group maintained more than preoperative value at last follow up. Conclusion : Although clinical results were similar in the two groups, postoperative recovery was significantly shorter in the arthroplasty group. Although it was not significant, ROM of adjacent segments was less in the arthroplasty group. Motion of operated levels in arthroplasty group was preserved at last follow up.

• 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.

• The Journal of Korean Physical Therapy
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• v.6 no.1
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• pp.17-22
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• 1994

The purpose of this study were to identify the correlation of shoulder pain to Cervical Pathology and effectiveness of Cervical treatment on the neck and shoulder. Sixty patients complaining of shoulder pain only without neck pain were evaluated by physical examination. Cervical X- rays and electrodiagnostic Study. The results were as follows: 1) Forty nine Cases were abnormal in plain Cervical spine X-ray with straightening of Cervical lordotic curve in 41 cases, Cervical spondybsis 16 cases and disc space narrowing in 4 cases. 2) Cervical radiculopathies were diagnosed 52 cases which showed abnormal spontaneous activities in needle. EMG : 26 cases in paraspinal muscles and 26 cases in both paraspinal and upper extremity muscles. 3) The results of treatment were excellent in 6 cases, good in 6 cases and fair in 32 cases. 4) Treatment side were effective with shoulder and conical in 36 cases.

• Journal of Korean Physical Therapy Science
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• v.1 no.2
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• pp.215-222
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• 1994

The aim of this study was to determine the normative strength value for cervical flexors, extensors and right lateral flexors, left lateral flexors to provide a guideline for rehabilitation of cervical radiculopathy patients. The isometric evaluation of cervical flexors, extensors and lateral flexors by using the Hand-held dynamometer was performed on 50 males and 50 females. The result were as follows. The average cervical muscle strength were 5.7 kg in flexor. 10.5 kg in extensors, and 6.6 kg in right lateral flexor, 6.5 kg in left lateral flexor. There was statistically significant difference between the cervical flexors and extensors(p<0.01) but no significant difference between right lateral flexor and left lateral flexor. There was statistically significant difference between male and female(p<0.01). When one of cervical muscle was strong, also the others did in subjects(p<0.01) and the body weight was significantly releated to the cervical muscle strength(p<0.01).

• Journal of Korean Neurosurgical Society
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• v.51 no.5
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• pp.286-291
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• 2012

Objective : To investigate the change of latency of cervical dermatomal somatosensory evoked potential (DSEP) according to stimulation intensity (SI) and severity of carpal tunnel syndrome (CTS). Methods : Stimulation sites were the C6, C7, and C8 dermatomal areas. Two stimulation intensities $1.5{\times}$sensory threshold (ST) and $2.5{\times}ST$ were used on both normal and CTS patients. Results : In moderate CTS, the latencies of C6 and C7 DSEP during $1.5{\times}ST$ SI and those of C7 DSEP during $2.5{\times}ST$ SI were significantly delayed compared with the values of normal subjects. Significant correlation between the latency of C7 DSEP of $2.5{\times}ST$ stimulation and the median sensory nerve conduction velocity was observed. Conclusion : We suggest that these data can aid in the diagnosis of cervical sensory radiculopathy using low stimulation intensity and of those who have cervical sensory radiculopathy combined with CTS patients.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.111-122
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• 1997

H-reflex is a kind of late respons which can be used for the proximal nerve conduction study. Also it is a useful and widely used nerve conduction technique es to look electrically at the monosynaptic reflex. Although recordable from all muscles theoretically, H-reflexes are most commonly recorded from the calf muscles following stimulation of the tibial nerve in the popliteal fossa. But in this study, We tried to establish the normal data and to evaluate the significance of the H-reflex study in cervical radiculopathy. H-reflexes were recorded from flexor carpi radialis (FCR) muscle, extensor carpi radialis (ECR) muscle, brachioradialis (BR) muscle, and abductor digiti minimi (ADM) muscle in 31 normal adults (62 cases) and 12 patients with cervical radiculopathy. The mean values of H-reflex latency in normal control group were $16.16{\pm}1.65$ msec in FCR; $15.99{\pm}1.25$ msec in ECR; $16.47{\pm}1.59$ msec in BR; $24.46{\pm}1.42$ msec in ADM. And the mean values of side to side difference of H-reflex latency were $0.47{\pm}0.48$ msec in FCR; $0.68{\pm}0.72$ msec in ECR; $0.63{\pm}0.43$ msec in BR; $22.31{\pm}1.24$ msec in ADM. Mean values of side to side differences of interlatency time were $0.49{\pm}0.47$ msec in FCR; $0.73{\pm}0.62$ msec in ECR; $0.79{\pm}0.71$ msec in BR; $0.69{\pm}0.44$ msec in ADM. Also, there were no significant differences in H-reflex latency between right and left side. H-reflex tests in patient group with cervical radiculopathy revealed abnormal findings in 11 out of 12 patients. These results suggest that H-reflex in the upper extremity would be helpful in the diagnosis of the cervical radiculopathy.

• Journal of Acupuncture Research
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• v.22 no.3
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• pp.201-213
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• 2005

Objective : The aim of this study is to investigate the effectiveness of Bee-venom therapy for Cervical radiculopathy patients. Methods : To evaluate the effectiveness of Bee-venom therapy, 14 patients were treated by Bee-venom therapy. To estimate the efficacy of treatment, we used Quardruple Visual Analog Scale (QVAS), JOA score and Odom's degree. Results & Conclusions : 1. As a objectivity treatment record, they test treatment record excellent(7 case) 50%, good(4 case) 28.57%, fair(,3 case) 21.43%. 2. After Bee-venom therapy, pain rate changed from 8.82 to 3.25.(p=0.000) 3. After Bee-venom therapy, JOA score changed from 11.00 to 12.79.(p=0.000) 4. By the results which puts out the statistics in sex, age, existence of finger numbness and disc type, the pain rate is not significantly difference as a therapy. (p<0.05) 5. By the results which puts out the statistics in sex, age and disc type, the JOA score is not significantly difference as a therapy.(p<0.05) But by the results which puts out the statistics in existence of finger numbness the JOA score is significantly difference as a therapy.(p=.025) There was reports about Bee-venom therapy of the Patient with Cervical radiculopathy. It is very effective to reduce the pain and increase the JOA score.

• 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 Korean Neurosurgical Society
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• v.60 no.1
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• pp.30-39
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• 2017

Objective : To compare the clinical outcomes and biomechanical effects of total disc replacement (TDR) and posterior cervical foraminotomy (PCF) and to propose relative inclusion criteria. Methods : Thirty-five patients who underwent surgery between 2006 and 2008 were included. All patients had single-level disease and only radiculopathy. The overall sagittal balance and angle and height of a functional segmental unit (FSU; upper and lower vertebral body of the operative lesion) were assessed by preoperative and follow-up radiographs. C2-7 range of motion (ROM), FSU, and the adjacent segment were also checked. Results : The clinical outcome of TDR (group A) was tended to be superior to that of PCF (group B) without statistical significance. In the group A, preoperative and postoperative upper adjacent segment level motion values were $8.6{\pm}2.3$ and $8.4{\pm}2.0$, and lower level motion values were $8.4{\pm}2.2$ and $8.3{\pm}1.9$. Preoperative and postoperative FSU heights were $37.0{\pm}2.1$ and $37.1{\pm}1.8$. In the group B, upper level adjacent segment motion values were $8.1{\pm}2.6$ and $8.2{\pm}2.8$, and lower level motion values were $6.5{\pm}3.3$ and $6.3{\pm}3.1$. FSU heights were $37.1{\pm}2.0$ and $36.2{\pm}1.8$. The postoperative FSU motion and height changes were significant (p<0.05). The patient's satisfaction rates for surgery were 88.2% in group A and 88.8% in group B. Conclusion : TDR and PCF have favorable outcomes in patients with unilateral soft disc herniation. However, patients have different biomechanical backgrounds, so the patient's biomechanical characteristics and economic status should be understood and treated using the optimal procedure.

• The Korean Journal of Pain
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• v.22 no.2
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• pp.171-175
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• 2009

Neuralgic amyotrophy is a syndrome with a broad range of clinical manifestations. It is characterized by acute, severe pain in the shoulder or arm lasting several days or weeks, followed by muscle weakness and atrophy as the pain diminishes. The diagnosis is based on typical clinical features, electromyography (EMG) and a nerve conduction study. The early and correct diagnosis is important to preclude unnecessary testing or surgical procedures. A 59-year-old female patient presented with pain and weakness involving her right palm and 1 3rd fingers. Three weeks before presentation, she noted the sudden onset of severe right shoulder and forearm pain. After the pain was reduced, she noted persistent right palm and 1-3rd finger pain and weakness. On cervical MRI, there was a mild central disc protrusion at C4 5 and C5 6. Electrodiagnostic testing was performed and she was diagnosed with neuralgic amyotrophy. One week after hospital treatment, her pain was relieved from VAS 10 to 3 and she was discharged with mild weakness of the thumb and index finger during pinch grips.