• Title/Summary/Keyword: JOA

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A Case Report on the Ossification of the Posterior Longitudinal Ligament of the Cervical Spine (경추부 후종인대 골화증 1례에 대한 증례보고)

  • Lee, Jeong-Han;Park, Tae-Yong;Jo, Joon-Ki;Kim, Dae-Joong;Kim, Nam-Su;Shin, Byung-Cheul;Song, Yung-Sun;Ko, Youn-Seok
    • The Journal of Korea CHUNA Manual Medicine
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    • v.6 no.1
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    • pp.157-167
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    • 2005
  • Objective : There is hardly case report in oriental Medicine about the ossification of the posterior longitudinal ligament(OPLL). We experienced a patient(64-year-old male) with OPLL improved by oriental Medicine treatment, and we report it clinically. Methods : While the patient with OPLL was treated acupuncture, physical therapy, and CHUNA manual therapy, we evaluated the patient's symptoms and function by visual analogue scale(VAS), clinical criteria for evaluation of the cervical myelopathy by the japanese orthopaedic association(JOA Score) and cervical spine's range of motion(ROM) in three limes for the 17 days that were a hospitalization period. Results : VAS, JOA score and ROM in OPLL patient were improved. VAS in symptoms became lower from 10 to 5. JOA score increased from 12 points to 13 points. As for the ROM, it was improved in 30.1%. Conclusion : Oriental medicine treatment may be effective in conservative treatment of OPLL. We propose that more clinical studies and reaches are accomplished in oriental medicine.

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A Case of Erythema Multiforme(EM) (다형홍반 치험 1례)

  • Hong Chul-hee;Shim Eun-ki;Park Joon-young;Song Seong-pil;Hong Seok-hoon;Hwang Chung-yeon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.17 no.2
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    • pp.153-158
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    • 2004
  • Background and Objective: Erythema multiforme(EM) is related disorders of skin and mucous membranes which is typically associated with antecedent medications or infections. etc. EM is an erythematous maculopapular cutaneous eruption of variable form. However, the pathophysiology of the EM remains obscure. Treatment at present is symptomatic and supportive. There is no report on EM treated with oriental medical treatment. Methods: We conducted one patient with EM seen at Won-Kwang University Kwang-Ju Oriental Medical Hospital in 2004. We treated EM in a twenty-two years old man by a herbal medicine(Joa-Chang-Bang), a herbal medicine for external use, acupunture, moxa, COTDE-made cosmetics, and P-Tx(carbon). Conclusions. We had a significant results. So we report this case to estimate the efficiency of oriental medical treatment and management on EM.

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Unilateral Augmented Pedicle Screw Fixation for Foraminal Stenosis

  • Kim, Jeong-Gyun;Jin, Yong-Jun;Chung, Sang-Ki;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.46 no.1
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    • pp.5-10
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    • 2009
  • Objective: The purpose of this study is to evaluate the effectiveness of unilateral decompression and pedicle screw fixation for the unilateral symptomatic foraminal stenosis. Methods: The study group comprises consecutive 16 patients who underwent unilateral decompression and bone cement augmented pedicle screw fixation from May 2003 to January 2006. The patients were evaluated by visual analog scale (VAS) for pain and the scoring system of the Japanese Orthopedic Association (JOA) for low back pain. The result of surgery was also evaluated with McNab's classification. Excellent or good outcome was considered as successful. The patients were followed at postoperative 1 month, 3 month, 6 month, and 1 year with standing AP and lateral films. Results: The average VAS and JOA score of the 16 patients were 7.8(range, 6-9) and 5.8(range, 3 - 10) before surgery and 2.2(range, 0 - 5)and 12.3(range, 9 - 15) at the time of last follow up. Both VAS and JOA score improved significantly after the surgery (p<0.05, t-test). All patients improved after the operation and no revision surgery was required. No metal failure or pseudoarthrosis was observed during the follow-up. The success rate was 87.5%. Conclusion: Our data suggest that unilateral decompression and pedicle screw fixation for the unilateral symptomatic foraminal stenosis is an effect method for obtaining satisfactory clinical outcome. Its possible advantage is shorter operation time and reduced surgical extent. We believe that the reduced stiffness of unilateral fixation was compensated by pedicle screw augmentation and interbody fusion.

A Case Report of Cervical Myelopathy Caused by Ossification of Posterior Longitudinal Ligament: Focusing on Warm Needling Therapy (후종인대 골화증으로 유발된 경추 척수병증 1례에 대한 증례보고: 온침요법을 중심으로)

  • Lee, Seung Min;Yoon, Kang Hyun;Lim, Ji Seok;Cho, Ye Eun;Park, Ji Min;Nam, Dong Woo;Choi, Do Young
    • Journal of Acupuncture Research
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    • v.31 no.3
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    • pp.75-82
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    • 2014
  • Objectives : The purpose of this study is to investigate the effects of warm needling therapy in a patient with cervical myelopathy caused by ossification of posterior longitudinal ligament. Methods : A 53-year-old Korean male patient diagnosed with cervical myelopathy due to ossification of posterior longitudinal ligament was treated with warm needling therapy on posterior neck aside from the routine inpatient treatment from June 26th to July 16th. Clinical improvement was evaluated with visual analogue scale(VAS), Japanese orthopedic score(JOA), grip and release test, finger escape sign and patient satisfaction was measured using a five-point Likert scale. Results : After 21 days of treatment, the patient showed improvement in VAS, JOA, grip and release test and finger escape sign. The patient also expressed satisfaction with the treatment. Conclusions : The results suggest that warm needling therapy may be an effective additional treatment for cervical myelopathy and other symptoms related to ossification of posterior longitudinal ligament(OPLL). Further studies should be carried out regarding possible long-lasting effects.

Successful Motor Evoked Potential Monitoring in Cervical Myelopathy : Related Factors and the Effect of Increased Stimulation Intensity

  • Shim, Hyok Ki;Lee, Jae Meen;Kim, Dong Hwan;Nam, Kyoung Hyup;Choi, Byung Kwan;Han, In Ho
    • Journal of Korean Neurosurgical Society
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    • v.64 no.1
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    • pp.78-87
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    • 2021
  • Objective : Intraoperative neurophysiological monitoring (IONM) has been widely used during spine surgery to reduce or prevent neurologic deficits, however, its application to the surgical management for cervical myelopathy remains controversial. This study aimed to assess the success rate of IONM in patients with cervical myelopathy and to investigate the factors associated with successful baseline monitoring and the effect of increasing the stimulation intensity by focusing on motor evoked potentials (MEPs). Methods : The data of 88 patients who underwent surgery for cervical myelopathy with IONM between January 2016 and June 2018 were retrospectively reviewed. The success rate of baseline MEP monitoring at the initial stimulation of 400 V was investigated. In unmonitorable cases, the stimulation intensity was increased to 999 V, and the success rate final MEP monitoring was reinvestigated. In addition, factors related to the success rate of baseline MEP monitoring were investigated using independent t-test, Wilcoxon rank-sum test, chi-squared test, and Fisher's exact probability test for statistical analysis. The factors included age, sex, body mass index, diabetes mellitus, smoking history, symptom duration, Torg-Pavlov ratio, space available for the cord (SAC), cord compression ratio (CCR), intramedullary increased signal intensity (SI) on magnetic resonance imaging, SI length, SI ratio, the Medical Research Council (MRC) grade, the preoperative modified Nurick grade and Japanese Orthopedic Association (JOA) score. Results : The overall success rate for reliable MEP response was 52.3% after increasing the stimulation intensity. No complications were observed to be associated with increased intensity. The factors related to the success rate of final MEP monitoring were found to be SAC (p<0.001), CCR (p<0.001), MRC grade (p<0.001), preoperative modified Nurick grade (p<0.001), and JOA score (p<0.001). The cut-off score for successful MEP monitoring was 5.67 mm for SAC, 47.33% for the CCR, 3 points for MRC grade, 2 points for the modified Nurick grade, and 12 points for the JOA score. Conclusion : Increasing the stimulation intensity could significantly improve the success rate of baseline MEP monitoring for unmonitorable cases at the initial stimulation in cervical myelopathy. In particular, the SAC, CCR, MRC grade, preoperative Nurick grade and JOA score may be considered as the more important related factors associated with the success rate of MEP monitoring. Therefore, the degree of preoperative neurological functional deficits and the presence of spinal cord compression on imaging could be used as new detailed criteria for the application of IONM in patients with cervical myelopathy.