• Title/Summary/Keyword: JOA score

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A clinical study on the patient of Cervical radiculopathy by Bee-venom threapy (경추 신경근증 환자에 있어서 봉약침 치료의 효과에 대한 임상적 고찰)

  • Lee, Kil-soong;Lee, Geon-mok;Yeom, Seong-chul
    • 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.

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A Case Report on Cervical Myelopathy Due to Disc Herniation Applied Chuna Treatment (추나요법을 적용한 추간판탈출증에 의한 경추척수증 환자 치험 1례)

  • Yu, Jung-Suk;Lee, Hwi-Yong;Cho, Yi-Hyun
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.3 no.1
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    • pp.65-72
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    • 2008
  • Objects : This study was to report a clinical effect of Chuna Treatment for Cervical Myelopathy due to disc herniation. Methods : The patient was diagnosed as Cervical Myelopathy due to disc herniation through Cervical spine MRI and treated by cervical traction technique of Chuna Treatment with conservative management. JOA score(Japanese Orthopedic Association score), Recovery rate of Hirabayashi, VAS(Visual Analogue Scale), Dynamometer score, ROM(Range of Motion) and Motor weakness Grade were used. Results and Conclusion : JOA score, VAS, Dynamometer score, ROM and Motor weakness Grade were improved and Recovery rate was 100%.

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A Case Study on Cervical Spondylotic Myelopathy (척수성 경수증에 대한 증례연구)

  • Lee, Young-Hwa;Kwon, Won-An
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.3
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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.

Surgical Results of en Bloc Open-door Laminoplasty

  • Kim, Seok-Won;Lee, Seung-Meung;Shin, Ho;Kim, Hyun-Sung
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.102-106
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    • 2005
  • Objective : The purposes of this study are to evaluate the efficacy of en bloc open-door laminoplasty and to investigate the validity of various factors as prognotic indicators in patients with multisegmental spondylotic myelopathy and ossification of posterior longitudinal ligament[OPLL]. Methods : The authors reviewed 43 cases in whom laminoplasty were performed for cervical myelopathy between January 2000 and December 2002. Clinical symptoms and results were evaluated using the Japanese Orthopaedic Association[JOA] scale. The recovery rate was calculated and then assessed for prognostic factors such as preoperative JOA scores, ages, history of previous trauma, duration of symptoms and signal change in cord on T2-weighted magnetic resonance Image. Results : In cervical stenosis, canal widening of antero-posterior diameter and dimension after laminoplasty is 4.16mm, $87.43mm^2$ and in OPLL is 6.20mm, $117.61mm^2$. In all cases there wasn't neurologic deterioration, mild postoperative complications developed in seven cases. Four patient had a limitation of range of neck motion and the other one showed kyphotic change and another two showed C5 radiculopathy. The recovery rate of JOA score in cervical stenosis and OPLL was 62% and 68% respectively. Duration of symptoms, the severity[preoperative JOA score], and signal change in cord on T2-weighted magnetic resonance image had close relationship to the clinical outcomes. Conclusion : Unilateral en bloc laminoplasty is simultaneous expansile and decompressive method. And preoperative JOA score, symptom duration and high signal intensity on T2-weighted magnetic resonance image can be used to predict prognosis.

The Clinical Study on Effects of Acupotomy Therapy in Patients with Cervical Herniated Intervertebral Disc (경추 추간판 탈출증 환자의 침도요법(鍼刀療法) 치료 효과에 대한 임상적 연구)

  • Kim, Eon-Kuk;Kim, Hyun-Wook;Lee, Geon-Hui;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.26 no.1
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    • pp.67-79
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    • 2009
  • Objectives : The study on Acupotomy therapy has recently become a popular academic field as proven to be an great alternative to the limitation of Western medical treatment. However, there has been little study examining acupotomy therapy on treating Cervical Herniated Intervertebral Disc. Thus, this study aims to investigate the sense of improvement and satisfaction from the Cervical Herniated Intervertebral Disc patients treated with acupotomy therapy. Methods : A total of 23 subjects that consists of Cervical Herniated Intervertebral Disc patients were participated in this study. They were treated with acupotomy therapy and acupuncture. All the subjects were asked to answer Odom's degree, VAS(visual analogue scale), NDI(neck disability index) and JOA score before and after the treatment. Results : The results of the Odom's degree, VAS, NDI and JOA score of analysis groups, show that the improvement of neck pain in acupotomy and acupuncture treatment group is significantly effective. Conclusions : It is suggested that acupotomy therapy has development-effectiveness on Cervical Herniated Intervertebral Disc.

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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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Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum

  • Hur, Hyuk;Lee, Jung-Kil;Lee, Jae-Hyun;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.189-194
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    • 2009
  • Objectives : Ossification of the ligamentum flavum (OLF) is a rare cause of thoracic myelopathy. The aim of this study was to identify factors associated with the surgical outcome on the basis of preoperative clinical and radiological findings. Methods : Data obtained in 26 patients whot underwent posterior decompression for thoracic myelopathy, caused by thoracic OLF, were analyzed retrospectively. Patient age, duration of symptoms, OLF type, preoperative and postoperative neurological status using the Japanese Orthopedic Association (JOA) scoring system, surgical outcome, and other factors were reviewed. We compared the various factors and postoperative prognosis. All patients had undergone decompressive laminectomy and excision of the OLF. Results : Using the JOA score, the functional improvement was excellent in 8 patients, good in 14, fair in 2, and unchanged in 2. A mean preoperative JOA score of 6.65 improved to 8.17 after an average of 27.3 months. According to our analysis, age, gender, duration of symptoms, the involved spinal level, coexisting spinal disorders, associated trauma, intramedullary signal change, and dural adhesions were not related to the surgical outcome. However, the preoperative JOA score and type of OLF were the most important predictors of the surgical outcome. Conclusion : Early diagnosis and sufficient surgical decompression could improve the functional prognosis for thoracic OLF. The postoperative results were found to be significantly associated with the preoperative severity of myelopathy and type of OLF.

Risk Factors of Neuropathic Pain after Total Hip Arthroplasty

  • Maeda, Kazumasa;Sonohata, Motoki;Kitajima, Masaru;Kawano, Shunsuke;Mawatari, Masaaki
    • Hip & pelvis
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    • v.30 no.4
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    • pp.226-232
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    • 2018
  • Purpose: Pain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire. Materials and Methods: One hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA. Results: The patients of 24.5% reported NP before THA; 5.5% reported NP 2 months after THA. Prior to THA, there was no significant correlation between the PainDETECT score and the radiographic severity; however, there was a significant correlation between the PainDETECT score and JOA score. NP at 2 months after THA was not significantly correlated with pain scores at 1 week after THA; however, a significant correlation was observed between the preoperative pain score and NP at 2 months after THA. Conclusion: THA was useful for relieving nociceptive pain and for relieving NP in patients with hip osteoarthritis. Preoperative pain was a risk factor for NP after THA. Controlling preoperative pain may be effective for reducing postoperative NP.

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.

Clinical Study on a Case of Cervical Myelopathy (경추증성 척수증 환자 1례에 대한 임상적 고찰)

  • Lee, Ok-ja;Yoon, Min-young;Kim, Hong-hun;Cho, Nam-geun
    • Journal of Acupuncture Research
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    • v.20 no.4
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    • pp.220-229
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    • 2003
  • Objective : Cervical myelopathy is one of the most severe disease, as well as a common diesaes. However, its clinical study and report about efficiency of oriental treatment are absolutely insufficient. Therefore, we report the treatment about 1 case of Cervical myelopathy like followings. Methods : From November 27th, 2002 to January 11th, 2003, we observed patient hospitalized because of cervical myelopathy, and for its valuation, JOA score(Japanese Orthopedic Association score), Nutric grading, VAS(visual analog scale), and D.I.T.I(Digital Infrared Thermal Imaging)were used. Results : After being hospotalized for 50 days, the patients' JOA score, Nuric grading system, and VAS were improved each from 7 to 13, from grade IV to grade II, and from 8 to 2. Conclusions : We considered that oriental treatment has an useful effect on cervical myelopathy patients' treatment and recovery. But continuous studies, such as comparative studies accompanied by more treatment case.

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