• Journal of Korean Neurosurgical Society
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• v.67 no.1
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• pp.6-13
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• 2024

The integrity of the high cervical spine, the transition zone from the brainstem to the spinal cord, is crucial for survival and daily life. The region protects the enclosed neurovascular structure and allows a substantial portion of the head motion. Injuries of the high cervical spine are frequent, and the fractures of the C2 vertebra account for approximately 17-25% of acute cervical fractures. We review the two major types of C2 vertebral fractures, odontoid fracture and Hangman's fracture. For both types of fractures, favorable outcomes could be obtained if the delicately selected conservative treatment is performed. In odontoid fractures, as the most common fracture on the C2 vertebrae, anterior screw fixation is considered first for type II fractures, and C1-2 fusion is suggested when nonunion is a concern or occurs. Hangman's fractures are the second most common fracture. Many stable extension type I and II fractures can be treated with external immobilization, whereas the predominant flexion type IIA and III fractures require surgical stabilization. No result proves that either anterior or posterior surgery is superior, and the surgeon should decide on the surgical method after careful consideration according to each clinical situation. This review will briefly describe the basic principles and current treatment concepts of C2 fractures.

• Osong Public Health and Research Perspectives
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• v.9 no.6
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• pp.309-313
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• 2018

Objectives: The purpose of this study was to determine whether the cranial vertebral angle (CVA) and the range of motion (ROM) was different between participants with a forward head posture (FHP), with or without pain. Methods: Forty-four participants who had FHP participated in this study. The FHP was assessed digitally by measuring a lateral view the CVA for each subject. A cervical ROM device measured the cervical ROM. The volunteers were allocated to either, with pain (n = 22), or without pain (n = 22) groups, and pain was evaluated using the Numeric Pain Rating Scale. Results: The FHP in the pain group showed a significant difference in the CVA, and the cervical ROM in both flexion and extension, compared with those in the FHP without pain group (p < 0.05). Logistic regression analysis indicated that the occurrence of cervical area pain was higher amongst subjects who had a decreased CVA and flexion motion. Conclusion: This study suggested that decreased CVA and cervical flexion range, were predictive factors for the occurrence of pain in the cervical region.

• Journal of Haehwa Medicine
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• v.24 no.2
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• pp.1-16
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• 2016

Objectives : This study was designed to evaluate various tools including C-spine X-ray for estimating cervical curvature and identify the effect of wooden pillow on patients diagnosed with straightening of cervical curvature. Methods : This study was carried out on 51 subjects who were encountered traffic accident suffering cervical pain and diagnosed with straightening of cervical curvature by X-ray. 51 subjects were divided into wooden pillow(experimental) group and conservative therapy(control) group. Visual analogue scale, neck disability index and lateral pictures were used and compared after treatment. C-spine AP., Lat. X-ray were used on admission day to calculate cervical curvature and scoliosis by various ways. Results : 4 different measurements of cervical curvature didn't show common results. Both wooden pillow(experimental) group and conservative therapy(control) group showed significant improvement in the visual analogue scale(VAS) and neck disability index(NDI) after hospital treatment. Comparison between center line pictured by lateral view and C-spine Lat. pictured by X-ray showed significant difference in cervical curvature. Lateral deviation of cervical vertebra showed lengthened distance between mastoid process and spinous process of C7. Conclusion : As a result of this research, I found out that various tools for calculating cervical lordosis could derive different results and C-spine AP., Lat X-ray could cause artificial cervical lordosis. According to visual analogue scale(VAS) and neck disability index(NDI) wooden pillow was not effective to reduce pain & disability caused by straightening of cervical curvature. Futhermore, correction effect of straightening of cervical curvature and scoliosis by wooden pillow was weak.

• Journal of Korean Neurosurgical Society
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• v.51 no.3
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• pp.164-166
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• 2012

Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.

• Journal of the Korea Society of Computer and Information
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• v.22 no.12
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• pp.125-130
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• 2017

Screw insertion surgery is frequently required among surgical procedures. Especially, very careful attention should be paid to the insertion of screw in the operation of the cervical vertebra. Therefore, there is a need for a guide that allows the surgeon to reliably and promptly perform treatment by calculating the desired insertion angle and length for screw insertion. In this study, the center and direction of the pedicle were calculated through 3D modeling and 3D vector numerical analysis using the CT or MRI image of the patient for the safe operation of the guide, and based on this, After that, we will implement surgical guide based on this.

• Journal of Oral Medicine and Pain
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• v.21 no.2
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• pp.305-315
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• 1996

This study was performed to investigate the changes of head posture according to natural standing or sitting posture. Twenty seven healthy dental students without any signs and symptoms of temporomandibular disorders participated in this study. Cervical resting posture (CRP) of the head in sagittal plane was measured by Cervical-Range-of-Motion $^\textregistered$(CROM, U.S.A.) and lateral cephalograph was taken in natural posture. The items related to angle in cephalograph were the angles of cranial and cervical inclination to true vertical line(VER/NSL, VER/AML), the angles of cervical inclination to nasion-sella line(CVT/NSL, OPT/NSL), the angles of comical inclination to horizontal line(CVT/HOR, OPT/HOR), the angle of cervical lordosis(CVT/OPT). The items related to line measurement were the distance from subocciput to Cl(Dl), Cl to C2(D2), C2 to C3(D3), C3 to C4(D4), the upper(PNS to posterior pharyngeal wall) and the lower(tongue base to posterior pharyngeal wall) pharyngeal space, the distance from nation to mention(Na-Me), and the radius of comical curvature from the first comical vertebra(Cl ) to the fifth cervical vertebra(C5). The data were analyzed with SAS/STAT program. The obtained results were as follows : 1. Most items related to angular measurement showed significant difference between in standing and sitting posture. The angles of CRP, CVT/NSL, OPT/NSL, CVT/HOR, OPT/HOR, and CVT/OPT were high in sitting posture, but the angles of VER/NSL, VER/NSL were low in sitting posture. 2. In vertebral distance, only the distance between C3 and C4 was differed by the posture, which decreased in sitting posture. In sitting posture, the distance from nasion to menton(Na-Me) was longer, but the radius was shorter than in standing posture. 3. Correlationship in angular measurements was almost same in both postures. Ceervical resting posture(CRP) was correlated with VER/NSL, VER\ulcornerNSL was correlated with CRP, CVT/NSL, and OPT/NSL, VER/AML was correlated with CVT/HOR, OPT/HOR, CVT/OPT, and the angle of cervical lordosis(CVT/OPT) was correlated with the radius. 4. Correlationship in linear measurement was observed only in among D3, D4, and radius. And the Na-Me was not correlated with any other items. From this results, The author concluded that the head posture in sitting was mote backward extended than in standing.

• Journal of Korean Neurosurgical Society
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• v.53 no.6
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• pp.331-336
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• 2013

Objective : The offset connector can allow medial and lateral variability and facilitate intralaminar screw incorporation into the construct. The aim of this study was to compare the biomechanical characteristics of C7 intralaminar screw constructs with and without offset connector using a three dimensional finite element model of a C6-7 cervical spine segment. Methods : Finite element models representing C7 intralaminar screw constructs with and without the offset connector were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the two techniques were compared under pure moments in flexion, extension, lateral bending and axial rotation. Results : ROM for intralaminar screw construct with offset connector was less than the construct without the offset connector in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in both constructs. Maximum von Mises stress in the construct without offset connector was found to be 12-30% higher than the corresponding stresses in the construct with offset connector in the three principal directions. Conclusion : This study demonstrated that the intralaminar screw fixation with offset connector is better than the construct without offset connector in terms of biomechanical stability. Construct with the offset connector reduces the ROM of C6-7 segment more significantly compared to the construct without the offset connector and causes lower stresses around the C7 pedicle-vertebral body complex.

• Korean Journal of Veterinary Service
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• v.46 no.1
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• pp.87-92
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• 2023

A 7-year-old dog weighing 3.9 kg visited the hospital with symptoms of inability to stand and quadriparesis. There were seizure symptoms 2 months before admission to the hospital, and the symptoms of stiffness and rigidity appeared. Radiographs showed normal vertebrae in cervical vertebral column. Magnetic resonance imaging (MRI) and computed tomography (CT) were performed immediately to diagnose vertebral lameness. As a result of the CT, it was possible to observe the fracture of the odontoid process of the axis, and the exact location of the damage was identified. The odontoid process was fractured and separated from the body of the 2^nd cervical vertebra (axis), and fragment of the process was observed inside the vertebral arch of the first cervical vertebra (atlas), and the body of the axis was lifted to the dorsal side. The MRI examination reflected the CT findings and confirmed severe spinal cord compression due to the fracture of the odontoid process. The patient was applied by neck brace and medical management including Mycophenolate mofetil administration was performed. The patient was able to move legs and tail after 2 weeks, and was able to voluntarily defecate, urinate and stand up after 4 weeks of administration.

• The Korean Journal of Pain
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• v.7 no.2
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• pp.170-174
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• 1994

Stellate Ganglion (SG) of l0 cadavers were removed during autopsy at Saga Medical College. Length, width, thickness, shape and location of SG were measured before formalin fixation. The results are as follows; 1) Length, width, thickness of SG were 22.33+5.23mm, 9.34+2.23mm and 5.03+1.19mm in right respectively, and 29.67+10.56 mm, 11.29+3.20mm and 5.51+1.09mm respectively in left. 2) Weight of right SG is 0.69+0.25 gm and weight of left SG is 1.04+0.63 gm. 3) Shape of SG is oval and snowman type. 4) Location of SG is variably located from the base of 7th cervical vertebra to first thoracic vertebra.

• Korean Journal of Bronchoesophagology
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• v.14 no.2
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• pp.64-69
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• 2008

Craniovertebral junction (CVJ) tuberculosis is a rare disease, and potentially fatal due to the risk of atlantoaxial dislocation. The disease usually accompanies a retropharyngeal cold abscess, which can cause subsequential otolaryngologic symptoms such asdysphagia, odynophagia, or airway obstruction. Such a patient must be handled with great care to avoid a disaster. The disease is diagnosed with microbiological or other laboratory tests on the pus collected through puncture and aspiration, which will need otolaryngologic skills. For treatment, otolaryngologists play an important role by doing incision and drainage of the retropharyngeal abscess, or by attending the transoral vertebra surgery as partners with spine surgeons who will manage the CVJ lesions and ensure the craniocervical stability.