• Neurospine
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• 제15권4호
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• pp.388-393
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• 2018

Objective: Computed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological patterns of the AMF on CTM and investigated the significance and mechanisms of contrast dye flow into the AMF. Methods: Morphological patterns of the AMF on CTM were examined in 79 patients. Group A (24 patients) underwent surgery because of symptomatic cervical myelopathy. Group B (43 patients) had no clinical symptoms but showed spinal cord compression on CTM. Group C (12 patients), who showed neither clinical symptoms nor cord changes, underwent CTM for lumbar lesion evaluation. AMF patterns were classified into 4 types according to their configurations on CTM (reversed T, Y, V, and O types). Results: In group B, the reversed T type and Y type appeared significantly more often near the compressed portion (p<0.001). A similar tendency was seen in group A. The V and O types were most frequently observed in group C (p<0.001). Conclusion: On CTM, contrast dye tends to flow into the AMF of the cervical cord when the spinal cord is compressed. We speculate that there may be 3 possible mechanisms for this phenomenon: deformation of the epipial layer of the AMF due to cervical cord compression, AMF dilatation due to atrophy of the anterior funiculus or anterior horn, and temporary AMF dilatation when it becomes an alternative route for cerebrospinal fluid circulation.

• 척추신경추나의학회지
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• 제8권1호
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• pp.1-13
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• 2013

Objectives: The present study examines the domestic trend of Chuna manual therapy on cervical spinal disorders in Korea. Methods: We investigated the studies on Chuna manual therapy for cervical spinal disorders via searching 6 Korean web databases. As a result, 51 research papers were found to be analyzed according to their published year, published institution, the titles of journals, the types of study, the techniques of Chuna, the instruments for assessment, the Chuna technique and the number of the treatment trials by the cases of cervical spinal disorders and ethical approvals. Results: The number of the research papers published tended to increase every year. The studies on Chuna manual therapy for cervical spinal disorders were mainly published in The Journal of Korea CHUNA Manual Medicine for Spine & Nerves. The most frequently adopted technique of Chuna in the examined studies was Chuna spine manipulation therapy - cervical spine technique. Visual analogue scale (VAS), neck disability index(NDI) were used as primary means of assessments. The ethical problems of the examined studies needed to be improved. Conclusions: Reviewing the domestic trend of studies on Chuna manual therapy for cervical spinal disorders and examining the strong and weak points of those treatments are essential for the future studies. It is anticipated that this review benefits the future in-depth study on the treatments for Chuna in Korean medicine.

• 대한물리의학회지
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• 제5권3호
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• pp.331-339
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• 2010

Purpose : Cervical spondylotic myelopathy is a varied clinical syndromes and the most serious condition of cervical spondylosis. Spinal cord dysfunction is often caused by the compression on spinal cord. The purpose of this report was to describe physical examination and the process of disorders on cervical spondylotic myelopathy(CSM). Methods : Three cases with cervical myelopathy were presented with magnetic resonance image(MRI), Nurick's grade and Japanese Orthopaedic Association(JOA) score. Results : This studies showed a variable clinical course with gradual neurological deterioration in two cases. but one case was improved by operation and a regular aerobic exercise. MRI, Nurick's grade, JOA score are a useful adjunct for CSM evaluation. Conclusion : The state of CSM is variable, which may affect conservative treatments and surgery. It is needed to be a carefull approach and studies for a conservative treatment and management on CSM.

• 척추신경추나의학회지
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• 제8권2호
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• pp.57-66
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• 2013

Objectives : The present study examines indications and treatment techniques of Chuna manual therapy. Methods : We searched the clinical studies on Chuna manual therapy through 5 korean web databases, 2 journals.(key word 'chuna') After selecting appropriate clinical studies(Bongchuna, massage, side effect, contraindication are excepted), we analyzed them according to diseases, Chuna techniques, type of clinical trials. Results : 101 studies are selected and analyzed. They studied about cervical(26%), thoracic(12%), lumbar (29%)spinal disorders, temporomandibular joint disorders(4%), pelvic region disorders(4%), upper(6%), lower extremity(5%) disorders and other diseases(15%). Spinal disorders are studied frequently. Mild techniques like supine position both hand cervical spine flexion distraction, JS supine position cervical spine distraction, flexion distraction technique are used more frequently than adjustment by thrust. Conclusions : We have to enhance education and training about techniques that are frequently used and studied. Research and improvement of infrequently used techniques are needed. In-depth research about side effects and contraindication is needed. Highquality clinical research and systematic review should be needed to prove the therapeutic effect of Chuna treatment.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.245-250
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• 2007

Tubular retractor system as a minimally invasive surgery (MIS) technique has many advantages over other conventional MIS techniques. It offers direct visualization of the operative field, anatomical familiarity to spine surgeons, and minimizing tissue trauma. With technical advancement, many spinal pathologies are being treated using this system. Namely, herniated discs, lumbar and cervical stenosis, synovial cysts, lumbar instability, trauma, and even some intraspinal tumors have all been treated through tubular retractor system. Flexible arm and easy change of the tube direction are particularly useful in contralateral spinal decompression from an ipsilateral approach. Careful attention to surgical technique through narrow space will ensure that complications are minimized and will provide improved outcomes. However, understanding detailed anatomies and keeping precise surgical orientation are essential for this technique. Authors present the technical feasibility and initial results of use a tubular retractor system as a minimally invasive technique for variaties of spinal disorders with a review of literature.

• Journal of Korean Neurosurgical Society
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• 제64권6호
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• pp.843-852
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• 2021

The purpose of this review was to synthesize the research on global spinal alignment and reciprocal changes following cervical or thoracolumbar reconstruction surgery. We carried out a search of PubMed, EMBASE, and Cochrane Library for studies through May 2020, and ultimately included 11 articles. The optimal goal of a truly balanced spine is to maintain the head over the femoral heads. When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. Historically, deformity correction has focused on correcting scoliosis and preventing scoliotic curve progression. Following substantial correction of a spinal deformity, reciprocal changes take place in the flexible segments proximal and distal to the area of correction. Restoration of lumbar lordosis following surgery to correct a thoracolumbar deformity induces reciprocal changes in T1 slope, cervical lordosis, pelvic shift, and lower extremity parameters. Patients with cervical kyphosis exhibit different patterns of reciprocal changes depending on whether they have head-balanced or trunk-balanced kyphosis. These reciprocal changes should be considered to in order to prevent secondary spine disorders. We emphasize the importance of evaluating the global spinal alignment to assess postoperative changes.

• 한국한의학연구원논문집
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• 제16권2호
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• pp.119-124
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• 2010

Cervical disc herniations can press on the spinal cord and cause a problem called cervical myelopathy. The most common symptom of cervical disc herniation is neck pain that spreads down to the upper limb in various locations. There can also be associated with weakness and movement disorders of upper limb. In Oriental medicine, cervical disc herniation is treated with herb-med, physical therapy, acupuncture, Chuna, etc, but the Bee Venom therapy is the most common and effective. In this case, we used the Bee Venom therapy at cervical hyeopcheokhyeol for about 2 months to a patient who was diagnosed with disc herniation at Cervical 5-6, 6-7 and appealed weakness, limited elevation and abduction of the left upper limb. As a result, left upper limb disability was improved. Using the Bee Venom therapy at cervical hyeopcheokhyeol that are effective on movement disorders and neurological diseases of upper limb is an effective treatment to upper limb disability diagnosed with cervical disc herniation, and suggests the direction of the treatment to upper limb weakness and movement disorders diagnosed with cervical disc herniation.

• The Korean Journal of Pain
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• 제37권1호
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• pp.3-12
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• 2024

One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

• Journal of Korean Neurosurgical Society
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• 제64권6호
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• pp.901-912
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• 2021

Objective : In the cervical spine, many surgical procedures have been developed to achieve optimal results for various disorders, including degenerative diseases, traumatic injury, and tumor. In this study, we report our experience and follow-up results with a new surgical technique for cervical spine entitled posterior floating laminotomy (PFL) in comparison with conventional laminectomy and fusion (LF). Methods : Data for 85 patients who underwent conventional LF (n=66) or PFL (n=19) for cervical spine disorders between 2012 and 2019 were analyzed. Radiological parameters, including cervical lordosis (CL), T1 slope (T1S), segmental lordosis (SL), and C2-7 sagittal vertical axis (SVA), were measured with lateral spine X-rays. Functional outcomes, comprising the modified Japanese Orthopaedic Association (mJOA), neck disability index (NDI), and visual analog scale (VAS) scores, were also measured. For the patients who underwent PFL, postoperative magnetic resonance image (MRI) was performed in a month after the surgery, and the degree of decompression was evaluated at the T2-weighted axial image, and postoperative computed tomography (CT) was conducted immediately and 1 year after the operation to evaluate the gutter fusion. Results : There was no difference in CL, T1S, SL, and C2-7 SVA between the groups but there was a difference in the preoperative and postoperative SL angles. The mean difference in the preoperative SL angle compared with that at the last follow-up was -0.3° after conventional LF and 4.7° after PFL (p=0.04), respectively. mJOA, NDI, and VAS scores showed significant improvements (p<0.05) during follow-up in both groups. In the PFL group, postoperative MRI showed sufficient decompression and postoperative CT revealed gutter fusion at 1 year after the operation. Conclusion : PFL is a safe surgical method which can preserve postoperative CL and achieve good clinical outcomes.

• 대한방사선기술학회지:방사선기술과학
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• 제29권3호
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• pp.157-165
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• 2006

자기공명영상에 의해 진단된 척추질환에 대하여 성별 및 나이별 발생빈도, 발생부위 등 임상적 특성을 분석하여 임상에서 참고 자료로 활용할 수 있도록 하였다. 수도권 소재의 B대학병원에서 2004년 1월부터 12월까지 척추 자기공명영상 검사를 하여 척추질환 유소견자로 진단된 총 1,291명을 대상으로 하였고, 수집된 자료는 SPSS WIN 11.5 프로그램을 이용하여 분석하였으며, 그 결과는 다음과 같다. 1. 연구의 조사대상자에 대한 일반적 특성은 총 1,291명 중 남자가 53.5%, 여자 46.5%이었다. 2. 척추질환의 부위별 발생빈도는 요추 65.6%, 경추 27.3%, 흉추 7.0% 순으로 나타났다. 3. 척추질환의 빈도가 높은 상위 10개 질환은 다음과 같다. 1) posterior bulging disc 65.8%. 2) narrowing of neural foramen 23.8% 3) herniated intervertebral disc (HIVD) 22.4% 4) spinal stenosis 16.7% 5) osteochondrosis 6.4% 6) compression fracture 6.4% 7) facet joint arthropathy 6.2% 8) spondylolisthesis 6.0% 9) spinal cord tumor 3.5% 10) inter body fusion 2.6%