• Title/Summary/Keyword: Neck disability index (NDI)

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Ultrasonic Osteotome Assisted Posterior Endoscopic Cervical Foraminotomy in the Treatment of Cervical Spondylotic Radiculopathy Due to Osseous Foraminal Stenosis

  • Ye Jiang;Chen Li;Lutao Yuan;Cong Luo;Yuhang Mao;Yong Yu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.4
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    • pp.426-437
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    • 2023
  • Objective : To investigate the efficacy and safety of the posterior endoscopic cervical foraminotomy (PECF) using ultrasonic osteotome for the treatment of cervical osseous foraminal stenosis, focusing on introduction of the advantages of ultrasonic osteotome in partial pediculectomy and ventral osteophyte resection in PECF. Methods : Nineteen patients with cervical osseous foraminal stenosis who underwent PECF using ultrasonic osteotome in our institution between April 2018 and April 2021 were enrolled in this study. All the patients were followed up more than 12 months. The patients' medical data, as well as pre- and postoperative radiologic findings were thoroughly investigated. The visual analogue score (VAS), Japanese Orthopaedic Association (JOA) score, cervical dysfunction index (Neck disability index, NDI), and modified MacNab criteria were used to assess the surgical efficacy. Results : All the patients were successfully treated with PECF using ultrasonic osteotome. The pre- and postoperative VAS, NDI, and JOA scores were significantly improved (p<0.05). According to the modified MacNab criteria, 17 patients were assessed as "excellent", two patients were assessed as "good" at the last follow-up. There was no dura tear, nerve root damage, incision infection, neck deformity, or other complications. Conclusion : Adequate nerve root decompression can be accomplished successfully with the help of ultrasonic osteotome in PECF, which has the advantage of reducing the probability of damage to the nerve root and dura mater, in addition to the original merits of endoscopic surgery.

Neck Pain Patient with Cervical Block Vertebra-A Case Report (경추부 융합척추(block vertebra)를 동반한 경추통 환자 증례보고)

  • Byun, Jang-Hoon;Kim, Min-Kyu;Shin, Ye-Sle;Park, Sang-Won;Sung, Ik-Hyun;Lee, Kap-Soo;Kim, Won-Woo;Jung, Jae-Hoon;Lee, Jae-Hwan;An, Yong-Jun;Lee, Jong-Hwan
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.9 no.2
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    • pp.35-43
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    • 2014
  • Objective : To report a case of cervical block vertebra with neck pain successfully treated with conservative Korean Traditional Medicine treatment with Thoracic Chuna Manipulation. Methods : A patient diagnosed with block vertebra was treated with Thoracic Chuna manipulation, acupuncture, pharmacoacupuncture, and herbal medicine. Numeric Rating Scale(NRS) and Neck Disability Index(NDI) scores were collected before and after treatment for comparison. Results : There was a significant decrease in NRS and NDI scores. The mean NRS score decreased from 8 to 1, and NDI from 50 to 8. Conclusion : Conservative Korean Traditional Medicine treatment appears to be effective for treatment of cervical block vertebra.

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The Effects of Chuna for Thoracic in Patients with Nuchal Pain, Seven Cases Report (흉추의 추나요법을 시행한 경항통 환자 치험 7례 보고)

  • Cho, Dong-In;Yoon, Jeong-won;Kim, Soon-Joong;Park, Dong-Su
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.4
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    • pp.147-159
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    • 2015
  • Objectives The purpose of this study is to investigate the clinical application of chuna for thoracic in the patients with nuchal pain. Methods Seven patients were treated by chuna for thoracic to evaluate the effect of the treatment. The patient's symptoms were assessed by visual analogue scale (VAS), neck disability index (NDI) and cervical lordotic curvature. Results In all cases, the pain was reduced according to VAS, NDI. Cervical lordotic curvature of 6 cases were improved in terms of Jackson's angle. 5 cases were improved in terms of Depth of cervical curve and Method of Jochumsen. 4 cases were improved in terms of Angle of cervical curve (C2~C7) and Ishihara index. 3 cases were improved in terms of Angle of cervical curve (C1~C7). Conclusions These results suggest that chuna on thoracic might be an effective method to treat nuchal pain with extension malposition of thoracic. But, it's necessary to have more observations and experiments.

Comparison between Anterior Cervical Decompression with Fusion and Posterior Cervical Fusion with Wide Facetectomy for Treatment of Severe Bony Foraminal Stenosis

  • Lee, Subum;Cho, Dae-Chul;Chon, Haemin;Roh, Sung Woo;Choi, Il;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.552-561
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    • 2021
  • Objective : To compare the anterior cervical discectomy and fusion (ACDF) and posterior cervical fusion (PCF) with wide facetectomy in the treatment of parallel-shaped bony foraminal stenosis (FS). Methods : Thirty-six patients underwent surgery due to one-or-two levels of parallel-shaped cervical FS. ACDF was performed in 16 patients, and PCF using CPS was performed in 20 patients. All patients were followed up at 1, 3, 6, and 12 months postoperatively. Standardized outcome measures such as Numeric rating scale (NRS) score for arm/neck pain and Neck disability index (NDI) were evaluated. Cervical radiographs were used to compare the C2-7 Cobb's angle, segmental angle, and fusion rates. Results : There was an improvement in NRS scores after both approaches for radicular arm pain (mean change -6.78 vs. -8.14, p=0.012), neck pain (mean change -1.67 vs. -4.36, p=0.038), and NDI score (-19.69 vs. -18.15, p=0.794). The segmental angle improvement was greater in the ACDF group than in the posterior group (9.4°±2.7° vs. 3.3°±5.1°, p=0.004). However, there was no significant difference in C2-7 Cobb angle between groups (16.2°±7.9° vs. 14.8°±8.5°, p=0.142). As a complication, dysphagia was observed in one case of the ACDF group. Conclusion : In the treatment of parallel-shaped bony FS up to two surgical levels, segmental angle improvement was more favorable in patients who underwent ACDF. However, PCF with wide facetectomy using CPS should be considered as an alternative treatment option in cases where the anterior approach is burdensome.

Posterior Cervical Fixation with a Nitinol Shape Memory Loop for Primary Surgical Stabilization of Atlantoaxial Instability : A Preliminary Report

  • Kim, Duk-Gyu;Eun, Jong-Pil;Park, Jung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.21-26
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    • 2012
  • Objective : To evaluate a new posterior atlantoaxial fixation technique using a nitinol shape memory loop as a simple method that avoids the risk of vertebral artery or nerve injury. Methods : We retrospectively evaluated 14 patients with atlantoaxial instability who had undergone posterior C1-2 fusion using a nitinol shape memory loop. The success of fusion was determined clinically and radiologically. We reviewed patients' neurologic outcomes, neck disability index (NDI), solid bone fusion on cervical spine films, changes in posterior atlantodental interval (PADI), and surgical complications. Results : Solid bone fusion was documented radiologically in all cases, and PADI increased after surgery (p<0.05). All patients remained neurologically intact and showed improvement in NDI score (p<0.05). There were no surgical complications such as neural tissue or vertebral artery injury or instrument failure in the follow-up period. Conclusion : Posterior C1-2 fixation with a nitinol shape memory loop is a simple, less technically demanding method compared to the conventional technique and may avoid the instrument-related complications of posterior C1-2 screw and rod fixation. We introduce this technique as one of the treatment options for atlantoaxial instability.

A Clinical Study on Effect of Electro-acupuncture Treatment for Whiplash Injury Patients Caused by Traffic Accident (교통사고로 인한 편타성 손상 환자의 전침치료 효과에 대한 임상적 연구)

  • Han, Sang-Yeob;Lee, Jae-Young;Park, So-Hyun;Yang, Kee-Young;Lee, Jae-Hoon;Kim, Jun-Su;Park, Jai-Young;Kim, Chang-Youn;Lee, Hyun-Jong
    • Journal of Acupuncture Research
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    • v.28 no.6
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    • pp.107-115
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    • 2011
  • Objectives : The purpose of this study is to investigate the effect of electro-acupuncture treatment for whiplash injury patients caused by traffic accident. Methods : 58 patients were divided into two groups, experimental group and control group, of 29 patients each. Experimental group was treated with electro-acupuncture treatment and general acupuncture treatment twice per week for four weeks. Control group was treated with general acupuncture treatment twice per week for four weeks. We evaluated the treatment effect of each group with the visual analog scale(VAS) and neck disability index(NDI). Results : 1. In both two groups, VAS and NDI were decreased significantly in statistics as treatment went on. 2. From 1st medical examination day to 4th treated day and From 1st medical examination day to 8th treated day, there were significant reduction of the VAS in experimental group than control group. 3. From 1st medical examination day to 8th treated day, there were not significant reduction of the NDI in experimental group than control group. Conclusions : We suggest that cotreatment of electro-acupuncture treatment could be recommended as a useful therapy in the early stages whiplash injury patients.

The Comparative Study on the Effect of Bee Venom Pharmacopuncture Treatment and Hwangryun Pharmacopuncture Treatment of Cervical Disc Herniation (경추 추간판 탈출증 환자의 봉약침치료와 황련약침치료에 대한 비교 연구)

  • Park, So Hyun;Ro, Hae Rin;Kim, Tae Ho;Park, Jae Young
    • Journal of Acupuncture Research
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    • v.30 no.3
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    • pp.117-124
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    • 2013
  • Objectives : This study was designed to compare the effect of bee venom pharmacopuncture treatment and Hwangryun pharmacopuncture treatment in patients with cervical disc herniation Methods : This study was done on 48 cases of patients with cervical disc herniation diagnosed by MRI, symptoms and physical test who admitted in Bu-cheon Jaseng Hospital of Oriental Medicine from January 1st, 2012 to August 31th, 2012. We divided patients into two groups. Bee venom group was treated by bee venom pharmacopuncture treatment and Hwangryun group was treated by Hwangryun pharmacopuncture treatment. We measured the efficacy of treatment with numerical rating scale(NRS) and neck disability index(NDI). The evaluations performed at admission day and 14th day after admission. Results : In both bee venom group and Hwangryun group, NRS and NDI decreased significantly in statistics as treatment was performed. Though bee venom group showed a decreasing NRS and NDI score compared to Hwangryun group, there is no statistical significant difference between the result of both groups. Conclusions : The result of this study suggest that both bee venom pharmacopuncture treatment and Hwangryun pharmacopuncture treatment is effective in reducing pain for patients with cervical disc herniation. Further clinical research is needed to verify these results and findings.

The Effects of the Action Observation and Visual Feedback Convergence Exercise on the Alignment, Pain and Function of Forward Head Posture and Round Shoulder Posture (동작관찰과 시각적 되먹임 융합 운동이 머리전방자세와 둥근어깨의 정렬, 통증과 기능에 미치는 영향)

  • Kang, Hyo Jeong;Yang, Hoe Song
    • Journal of the Korea Convergence Society
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    • v.9 no.12
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    • pp.123-128
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    • 2018
  • The aim of this study was to determine the effects of the action observation and visual feedback on the alignment, pain and function of forward head posture(FHP) and round shoulder(RS). A total of 24 participants with FHP and RSP were randomly assigned to general exercise(GE, n=8), action observation(AO, n=8), and visual feedback(VF, n=8). All subjects were exercised three times a week for four weeks. The groups were assessed for craniovertebral angle(CVA), round shoulder posture(RSP), visual analog scale(VAS), and neck disability index(NDI) before and after exercise, There was a significant difference in CVA in the GE, AO and RSP, VAS and NDI were significantly different in all groups. AO was more effective than GE, VF for VAS. The results of this study suggest that action observation may be effective to improve the FHP and RS.

Comparison of effectiveness for fluoroscopic cervical interlaminar epidural injections with or without steroid in cervical post-surgery syndrome

  • Manchikanti, Laxmaiah;Malla, Yogesh;Cash, Kimberly A;Pampati, Vidyasagar;Hirsch, Joshua A
    • The Korean Journal of Pain
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    • v.31 no.4
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    • pp.277-288
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    • 2018
  • Background: Neck and back pain are leading sources of disability placing substantial burden on health care systems. Surgical interventions in managing chronic neck pain secondary to various disorders continue to increase. Even though surgical interventions are effective, a significant proportion of patients continue to have symptomatology and develop cervical post-surgery syndrome. This study was performed to know the effectiveness of cervical interlaminar epidural injections with or without steroids. Methods: The effectiveness of fluoroscopic cervical interlaminar epidural injections in post-surgery syndrome was evaluated in a randomized, active controlled trial. The study population included 116 patients assigned to 2 groups. Group 1 received cervical interlaminar epidural injections with local anesthetic alone and Group 2 received injection with local anesthetic and steroids. The main outcomes were defined as significant improvement (greater than 50%) of pain relief using the numeric rating scale and/or functional status improvement using the Neck Disability Index (NDI). Results: Both groups had similar results with significant improvement (${\geq}50%$ pain relief and functional status improvement) in 69% of the patients in Group I, whereas, in Group II, 71% of the patients showed significant improvement at the end of 2 years. During a 2-year period, the average number of procedures was 5 to 6, with an average of approximately 12 weeks of significant improvement per procedure. Conclusions: Fluoroscopic cervical interlaminar epidural injections administered in cervical post-surgery syndrome using local anesthetic, regardless of the use of steroids, may be effective in approximately 70% of the patients at 2-year follow-up.

Effects of Cervical Joint Mobilization on the Forward Head Posture and Neck Disability Indexes (경부관절가동술이 두부전방자세와 경부장애지수에 미치는 영향)

  • Oh, Hyunju;Hwang, Byeongjun;Choi, Yoorim
    • Journal of the Korean Society of Radiology
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    • v.8 no.2
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    • pp.89-96
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    • 2014
  • This paper tries to examine whether the application of joint mobilization to subjects who have the forward head posture due to malalignment in the cervical joint has influence on posture changes and functions in the cervical joint. The subjects were 39 students from G University in Gyeongsangbuk-do. The cervical joint mobilization was applied to 20 subjects and not to 19. The students with a cervical lordosis angle of $21^{\circ}C$ or less, an anterior weight bearing (AWB) of 15mm or greater, and a cervical extension ROM of $70^{\circ}C$ or less in terms of radiography were selected as subjects under their voluntary agreement. The patients actively performed the joint mobilization slowly 8 times per session while therapists continuously applied sustained accessory glide to their painful joints 3 times per week for 4 weeks along with the cervical expansion and flexion in SNAGS among other Mulligan's (1995) techniques. The measurement was carried out in terms of radiographic inspection and neck disability indexes. As a result of the experiment, it turned out that the subjects with the forward head posture had changes in the cervical AWB and ARA, the ranges of expansion and flexion, and the NDI(Neck Disability Index) after the intervention for the experimental group by applying cervical joint mobilization. There were no changes observed in the control group. In conclusion, the application of joint mobilization turned out to have influence on the improvement of cervical joint postures, and craniocervical region functions.