• Clinics in Shoulder and Elbow
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• 제9권1호
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• pp.42-49
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• 2006

Purpose: This study evaluated clinical results, and recommended treatment protocol of traumatic anterior shoulder dislocation in the patients older than 60 years of age. Materials and Methods: Thirty-eight patients with first traumatic anterior shoulder dislocation aged over 60 years were included. The average age was 69.4 (range, 60 to 87 years). There were 8 men (average age of 71.6) and 30 women (average age of 69). Most common cause of injuries was a fall on the outstretched hand. The additional injuries were evaluated using MRI or CT arthrogram in the patients with significant pain and weakness while movements after 2 weeks sling immobilization. Results: Fifteen patients (39%) had rotator cuff tears and 5 patients (14%) had greater tuberosity fractures. The sizes of rotator cuff tears were diverse; 2 partial tears, 1 small tear, 4 medium tears, 3 large tears and 5 massive tears. Among 5 massive cuff tears, 3 patients revealed cuff arthropathy after reduction. 4 patients (11%) had recurrent dislocation more than one time during 1 month after the first dislocation. Bankart lesions revealed in 5 patients and three of them had associated rotator cuff tears. 3 out of 5 patients with Bankart lesions, 13 out of 15 patients with rotator cuff tears and 3 patients with displaced greater tuberosity fracture had operations. Conclusion: The injury mechanism of shoulder dislocation in patients older than 60 years of age seems to have either anterior or posterior mechanism. The diagnosis and treatment should be approached 2 weeks after dislocation.

• Clinics in Shoulder and Elbow
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• 제12권1호
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• pp.80-83
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• 2009

목적: 삼중 관절와 순 병변(triple labral lesion)은 전방, 후방, 상방 관절와 순의 파열이 동시에 발생한 경우를 말한다. 문헌 보고가 드물어서, 수상 기전과 증상에 대하여 아직 정립되지는 않았다. 대상 및 방법: 본 저자들은, 교통 사고 후 우측 견관절의 동통과 능동적 외전 장애를 보인 39세 남자에서 삼중 관절와 순 병변을 경험하였다. 내원 시에 관절와 상완 관절의 불안정에 대한 증상을 호소하지는 않았다. 흡수성 봉합 나사못과 봉합 갈고리를 사용하여 관절와 순에 대한 봉합술을 시행하였다. 결과: 수술 후 18개월 추시에서, 능동적 운동범위는 정상으로 호전되었으며 일상 생활 중에는 어려움이 없었다.

• 척추신경추나의학회지
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• 제4권1호
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• pp.85-94
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• 2009

Objects : This study was to report a clinical effect of Korean Treatment for a patient diagnosed by Computed Tomography as Cervical Spinal Stenosis with Ossification of posterior Longitudinal Ligament. Methods : In order to alleviate left shoulder pain and neck stiffness, the patient was treated by acupuncture therapy, herbal medicine, distilled herbal injection, cervical traction technique of Chuna treatment and conservative managements. To evaluate the effect of the treatment, Recovery rate of Hirabayashi, VAS(Visual Anlaogue Scale), NDI and ROM(Range of Motion) were used. Lhermitte's sign, Valsalva test, Distraction test, Compression test and Spurling test were carried out. Results : VAS, NDI and ROM were improved and Recovery rate was 100%. Conclusions : Korean Treatment can be effectively used for a patient with Cervical Spinal Stenosis with OPLL. Further clinical studies are needed to verify the findings.

• The Korean Journal of Pain
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• 제19권1호
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• pp.51-55
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• 2006

Background: A cervical transforaminal steroid injection is an effective therapeutic modality for radiculopathy of a herniated cervical disc or a cervical foraminal stenosis. However, there is some debate regarding the safety of the transforaminal approach under C-arm guidance compared with the posterior interlaminar approach. We report a new technique for cervical transforaminal steroid injection guided by MDCT. Methods: Patients presenting with radiating pain on their shoulder or arm were diagnosed using CT or MRI of a cervical herniated disc or a foraminal stenosis. Each patient whose symptoms were compatible with the image scan was enrolled in this study. They received a cervical transforaminal steroid injection under CT guidance, and the effectiveness and complications of this technique were evaluated over a 2-month period. Results: According to the CT scan, none of the participants had an internal jugular vein or a carotid artery invasion during the procedure. No vertebral artery injection was noted, and no patient developed a hematoma after the injection. The VAS score had improved significantly by 2, 4 and 8 weeks after the injection. Conclusions: While a conventional C-arm guided cervical transforaminal steroid injection does not appear to differentiate between the major vessels and structures in images, a CT guided approach is a more useful and safer technique for the precise placement of a needle.

• Physical Therapy Rehabilitation Science
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• 제6권4호
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• pp.208-213
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• 2017

Objective: Despite reliable evidence of abnormal scapular motions increases, there is not yet sufficient evidence of abnormal humeral translations. This study aims to analyze the motion of the humeral head toward the scapula when the shoulder is actively abducted using the C-arm. Design: A case report. Methods: The participant was a healthy man without any limitation and pain during shoulder movement. The participant's shoulder was abducted; this movement in the frontal plane was measured using a C-arm (anterior-posterior view) and was analyzed with computer-aided design. The starting posture was $15^{\circ}$, and as the participant abducted his shoulder measurements were taken and analyzed at $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$, $150^{\circ}$, and ending at $165^{\circ}$. A line was drawn perpendicularly to the line connecting the humeral head axis to the glenoid, and another line was drawn perpendiculary to the line connecting the scapular axis to the glenoid. The distance between the two lines measured is defined as the e value. Results: At the starting posture ($15^{\circ}$), the central axis of the humeral head was located 1.92 mm inferior to the central axis of the scapula. The humeral head was superiorly translated from the starting posture to $120^{\circ}$, and then, showed an inferior translation to the ending posture ($165^{\circ}$). Conclusions: The results of this study showed that the humeral head moved upward from the starting posture ($15^{\circ}$) up to $120^{\circ}$ indicating, superior translation, and it moved downward when the posture was past $120^{\circ}$, indicating inferior translation.

• Clinical Pain
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• 제20권2호
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• pp.145-149
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• 2021

Ankylosing spondylitis (AS) is a chronic inflammatory disease presenting progressive spinal stiffness and sacroiliitis. Cervical spine fracture combined with AS should be treated with operation, but it is closely related with increased rates of surgical site infection, which are associated with an elevated erythrocyte sedimentation rate and elevated C-reactive protein. We report a case of delayed postoperative infection appeared in cervical paravertebral space, which was masked by laboratory findings and clinical characteristics represented in this rheumatic disease. A 53-year-old man who had medical history of AS got operation after cervical spine fracture. During hospitalization, he experienced aching pain originating from left posterior neck to shoulder, which was revealed out to be delayed postoperative infection, diagnostically obscured by elevated values of inflammatory markers. This case emphasizes detailed evaluation considering symptoms and comorbidity of the patient should be performed to apply proper management.

• 한국콘텐츠학회논문지
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• 제10권6호
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• pp.323-328
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• 2010

견관절 탈구나 골절로 인해 arm sliding를 착용한 환자에서 외전(abduction)이 불가능한 경우 superior-inferior axial projection view를 대신하여 시행하는 velpeau view는 탈구나 골절 환자가 상체를 뒤로 젖히는 자세를 취하기가 어려워 고통이 가중되었다. 하지만 환자의 상체를 숙여 검사하는 새로운 검사법인 'modified velpeau view'를 제안하며 검사 시 자세고정의 용이함과 임상적 유용성에 대해 알아 보고자 2009년 10월부터 2010년 1월까지 견관절 탈구나 골절로 의심되어 본원에 내원한 환자들 중 velpeau view 처방을 받은 환자 20명과 정상인 30명을 대상으로 velpeau view와 modified velpeau view에서 wall-bucky와 환자의 상체 숙임각(30도, 45도, 60도, 75도)의 변화에 따른 골 구조의 차이를 비교하였다. 영상의학과 전문의와 정형외과 전문의에게 영상평가 기준을 제시하고 0점부터 5점을 만점으로 영상이 평가되었다. 정상인군에서 wall-bucky와 상체의 숙임각 변화에 따른 골구조의 비교결과 45도와 60도가 velpeau view 와 비슷한 진단수준을 보였으며, 진단 가치를 증명하기 위한 영상평가 결과 velpeau view에서는 shoulder head의 anterior와 posterior, glenoid fossa의 anterior와 posterior를 관찰할 수 있었지만, modified velpeau view에서는 velpeau view에서 관찰되는 부위 뿐만 아니라 acromioclavicular joint와 coracoid process도 관찰할 수 있었다. modified velpeau view가 velpeau view와 비교시 velpeau view를 대체할 만한 수준의 진단적 가치를 지닌 유용한 검사임이 확인 되었다. 또한 modified velpeau view는 velpeau view position이 어려운 환자를 대상으로 적용 가능한 대체법으로서 뿐만 아니라 어깨 골절과 탈구 이외의 어깨 질환의 진단을 위한 새로운 검사로서의 임상적 적용을 위해 다양한 시각에서의 연구와 개선의 노력이 필요함을 시사한다.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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• pp.224-229
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• 2014

Objective : To report long-term clinical and radiological outcomes of minimally invasive posterior cervical foraminotomy (MI-PCF) performed in patients with unilateral single-level cervical radiculopathy. Methods : Of forty-six patients who underwent MI-PCF for unilateral single-level radiculopathy between 2005 and 2013, 33 patients were included in the study, with a mean follow-up of 32.7 months. Patients were regularly followed for clinical and radiological assessment. Clinical outcome was measured by visual analogue scale (VAS) for the neck/shoulder and arm, and the neck disability index (NDI). Radiological outcome was measured by focal/global angulation and disc height index (DHI). Outcomes after MI-PCF were evaluated as changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect was used to test for differences in the clinical and radiological parameters repeat measures. Results : There were no complications and all patients had an uneventful recovery during the early postoperative period. VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001). NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001). There were no statistically significant changes in focal and global angulation at follow-up. Percent DHIs of the upper adjacent or operated disc were maintained without significant changes with time. During the follow-up, same site recurrence was not noted and adjacent segment disease requiring additional surgery occurred in two patients (6%) on the contra-lateral side. Conclusion : MI-PCF provides long-term pain relief and functional restoration, accompanied by good long-term radiological outcome.

• 척추신경추나의학회지
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• 제5권2호
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• pp.135-149
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• 2010

Objectives : This study was designed to observe the effect of Chuna manual therapy on the asymmetrical alignment. Methods : To analyze static structural alignment, posterior inferior ilium deviation(PI), inflare change of pelvis were checked from full spine AP X-ray. And Cobb's angle of spine and height of shoulder girdle were analyzed. To evaluate the pain visual analogue score(VAS) was scored. Chuna therapy treated 8-10 times for 1 month. Results and Conclusions : In 3 cases, VAS was improved significantly. Full spine AP X-ray shows improvement of structural imbalace. Shoulder height difference, cobb's angle, pelvic insufficiency improved considerably. These results suggest that Chuna therapy might be effective for malalignment patients.

• Journal of Korean Neurosurgical Society
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• 제50권2호
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• pp.139-142
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• 2011

Vertebral involvement of fibrous dysplasia (FD) is rare, especially in the cervical spine. Moreover, cervical FD presenting as a pathologic fracture in older patients is extremely rare. We report a case of symptomatic cervical FD associated with pathologic fracture in a 63-year-old man. The patient presented with progressive weakness of the left arm and pain in the shoulder and arm. Radiologic studies revealed a collapsed and typical 'ground glass' radiolucency of C4. Multiple lytic lesions involved the odontoid process of C2 and the body, left pedicle, and posterior elements of C4. Combined anterior and posterior decompression and reconstruction were performed. Post-operatively, the histopathologic examination confirmed FD. On the post-operative follow-up examination, the neurologic deficits had completely resolved.