• 제목/요약/키워드: Spondylosis

검색결과 68건 처리시간 0.034초

The Option of Motion Preservation in Cervical Spondylosis: Cervical Disc Arthroplasty Update

  • Chang, Chih-Chang;Huang, Wen-Cheng;Wu, Jau-Ching;Mummaneni, Praveen V.
    • Neurospine
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    • 제15권4호
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    • pp.296-305
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    • 2018
  • Cervical disc arthroplasty (CDA), or total disc replacement, has emerged as an option in the past two decades for the management of 1- and 2-level cervical disc herniation and spondylosis causing radiculopathy, myelopathy, or both. Multiple prospective randomized controlled trials have demonstrated CDA to be as safe and effective as anterior cervical discectomy and fusion, which has been the standard of care for decades. Moreover, CDA successfully preserved segmental mobility in the majority of surgical levels for 5-10 years. Although CDA has been suggested to have long-term efficacy for the reduction of adjacent segment disease in some studies, more data are needed on this topic. Surgery for CDA is more demanding for decompression, because indirect decompression by placement of a tall bone graft is not possible in CDA. The artificial discs should be properly sized, centered, and installed to allow movement of the vertebrae, and are commonly 6 mm high or less in most patients. The key to successful CDA surgery includes strict patient selection, generous decompression of the neural elements, accurate sizing of the device, and appropriately centered implant placement.

만성 긴장성 두통 환자의 경추 방사선 소견과 일반적 특성과의 상관관계 연구 (Clinical Characteristic and Roentgenographic Finding of the Cervical Spine in Chronic Tension -type Headache)

  • 김민정;이기수;곽병민;이은경;최은희;박양춘;강위창;이진우;이상봉;홍권의
    • Journal of Acupuncture Research
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    • 제26권2호
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    • pp.59-70
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    • 2009
  • Objectives : Although CTTH is one of the most common symptom in primary headache, the mechanism and treatment is not definite. The purpose of this study is to research about clinical characteristic and roentgenographic finding of the cervical spine in CTTH to determine relationship between the cervical spine and headache. Methods : This study was carried out on 93 patients with CTTH. By roentgenographic finding, they were classified into four groups - HNP, Spondylosis, Sprain, Normal. Then the HNP group was divided again into two groups - singer type and multiple type. Results: 1. Among 93 patients with CTTH, 69(74.19%) patients had abnormal cervical spine by roentgenographic finding. 2. There were HNP, spondylosis, sprain in abnormal roentgenographic finding. And a great majority of the patients were diagnosed as cervical sprain. 3. There were no significant difference between four groups on sex, weight, height, blood pressure, pulse, respiratory rate. But on ages, the HNP group showed the highest average while the sprain group showed the lowest. 4. The patients in HNP group had more frequent, severe pain, longer onset and higher onset-age than those of the other three group. 5. The patients in Multiple-type HNP group had severe pain, longer pain-duration, longer onset, more pre-symptoms and younger onset-age than those of the Single-type HNP group. Conclusions : A great majority of the patients with CTTH had abnormal cervical spines. Also, we found out that the worse the grade of HNP, heavier the level of headache.

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A Comparison of Anterior Cervical Discectomy and Fusion versus Fusion Combined with Artificial Disc Replacement for Treating 3-Level Cervical Spondylotic Disease

  • Jang, Seo-Ryang;Lee, Sang-Bok;Cho, Kyoung-Suok
    • Journal of Korean Neurosurgical Society
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    • 제60권6호
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    • pp.676-683
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    • 2017
  • Objective : The purpose of this study is to evaluate the efficacy and safety of 3-level hybrid surgery (HS), which combines fusion and cervical disc replacement (CDR), compared to 3-level fusionin patient with cervical spondylosis involving 3 levels. Methods : Patients in the anterior cervical discectomy and fusion (ACDF) group (n=30) underwent 3-level fusion and the HS group (n=19) underwent combined surgery with fusion and CDR. Clinical outcomes were evaluated using the visual analogue scale for the arm, the neck disability index (NDI), Odom criteria and postoperative complications. The cervical range of motion (ROM), fusion rate and adjacent segments degeneration were assessed with radiographs. Results : Significant improvements in arm pain relief and functional outcome were observed in ACDF and HS group. The NDI in the HS group showed better improvement 6 months after surgery than that of the ACDF group. The ACDF group had a lower fusion rate, higher incidence of device related complications and radiological changes in adjacent segments compared with the HS group. The better recovery of cervical ROM was observed in HS group. However, that of the ACDF group was significantly decreased and did not recover. Conclusion : The HS group was better than the ACDF group in terms of NDI, cervical ROM, fusion rate, incidence of postoperative complications and adjacent segment degeneration.

Pubmed분석을 통한 경추통과 경추 척추증의 임상연구 최신동향 및 평가도구에 관한 고찰 (Review of Research Trends and Evaluation Tools for Clinical Studies of Neck Pain and Cervical Spondylosis : Using the Pubmed Database)

  • 김명관;김영일;김은석;정인철;박양춘;전주현
    • 동의생리병리학회지
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    • 제32권4호
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    • pp.232-246
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    • 2018
  • The purpose of this research is to contribute to clinical researches on neck pain and cervical spondylosis by reviewing the latest research trends and evaluation tools through the analyses of clinical studies on neck pain and cervical spondylosis over the last 5 years. 70 papers satisfying the selection conditions among the RCT papers that had been searched as "neck pain" or "cervical spondylosis" at Pubmed(https://www.ncbi.nlm.nih.gov/pubmed) from March 2011 to February 2016 were targeted. Papers were numbered in order of their publication dates and analyzed by classifying their contents into 1) pain classification, 2) treatment type, 3) treatment duration, 4) treatment time, 5) number of participants, 6) evaluation tools and methods of research, and 7) evaluation duration. 55 papers targeted chronic neck pain, 6 papers acute and subacute neck pain, and 2 papers subacute and chronic neck pain. In comparison by intervention, 43 papers corresponded to physical therapy, 3 papers to acupuncture, 1 to herbal fomentation, 5 to medication, and 18 papers corresponded to multilateral comparisons comparing the efficacy by various interventions. In research period, there were 50 papers based on treatment period, 16 papers based on the number of treatments, and 4 papers based on different periods depending on each group. In treatment duration, the cases from 1 month or more to less than 3 months were most, followed by the cases of less than 1 month, and the cases from 3 months or more to less than 6 months. In treatment frequency, the number of treatments of the treatment group was the same as that of the control group in 51 papers, and many treatments were conducted by the methods of acupuncture, manual therapy, and injection therapy in cases of once or twice of treatments, and physical therapy and electroacupuncture corresponded mainly to the cases from 3 times or more to less than 10 times of treatments, and retrospective observation and exercise programs corresponded mainly to the cases of more than 30 times of treatments. In the number of subjects of the researches, the cases from 50 or more to less than 100 were most, followed by the cases from 20 or more to less than 50. There were 7 evaluation tools cited 10 times or more: VAS, NRS, PPT, NDI, NPQ, CROM, and SF-36. In evaluation period, 37 papers evaluated only during the treatment period, and 33 papers conducted follow-up. In follow-up period, the cases of less than 3 months were most, followed by the cases from 6 months or more to less than 1 year, and the cases from 3 months or more to less than 6 months. When planning clinical researches on cervical pain in the future, appropriate intervention methods, frequency and duration of treatment, period of follow-up, appropriate number of subjects and selection of evaluation tools for objective validity will have to be considered. In addition, randomization, double-blind, etc. will have to be considered for researches with high basis level.

급성 경추 경막외 농양 및 경추척추염과 동반된 결핵성 수막염 1예 (A Case of Tuberculous Meningitis Combined with Acute Cervical Epidural Abscess and Cervical Spondylitis)

  • 이동국
    • Annals of Clinical Neurophysiology
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    • 제4권2호
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    • pp.140-145
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    • 2002
  • Neurologic sequelae of tuberculous meningitis include hemiparesis, paraparesis, quadriparesis, aphasia, developmental delay, dementia, blindness, visual field defect, deafness, cranial nerve palsies, epilepsy, and hypothalamic and pituitary dysfunction. But cervical epidural abscess and cervical spondylitis are rare. A 64-year-old woman who was diagnosed as tuberculous meningitis presented a severe neck pain and stiffness after 3 weeks of anti-tuberculous medication. Electromyography and cervical X-ray showed a cervical spondylosis with polyradiculopathy. But cervical MRI showed an acute cervical epidural abscess and mild cervical spondylitis. After continuous anti-tuberculous medication with supportive care, she showed a slow clinical improvement. But about 1 month of anti-tuberculous therapy, she presented a more aggravation of neck pain, neck stiffness, radicular pain, and neck motion limitation. Follow-up cervical MRI showed an more advanced cervical spondylitis. Afterthen she has recovered slowly by cervical laminectomy with posterior stabilization and continuous anti-tuberculous medication.

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흉선암 절제술 후 발생한 양측성 횡격막 마비의 치유 -1예 보고- (Treatment of Bilateral Diaphragmatic Paralysis after Resection of Thymic Carcinoma -One case report-)

  • 김재욱;김승우;류지윤;김욱성;장우익;진재용;김민경;김태식;김연수
    • Journal of Chest Surgery
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    • 제36권12호
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    • pp.985-990
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    • 2003
  • 양측성 횡격막 마비는 드문 질환으로 외상, 심흉부 수술, 신경근육질병, 경부척추굳음증, 감염이 원인이 될 수 있다. 우폐상엽, 심낭, 상대정맥과 무명정맥을 침범한 흉선암의 적출술을 시행한 후 60세 남자 환자에서 양측성 횡격막 마비가 발생하였다. 심한 호흡곤란이 발생하였고, 인공호흡기 이탈이 불가능하였다. 양측 횡격막 주름성형술을 시행하였고, 인공호흡기 이탈 및 누운 자세에서 수면이 가능하게 되어 만족할 만한 결과를 얻었기에 문헌 보고하는 바이다.

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

  • 이영화;권원안
    • 대한물리의학회지
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    • 제5권3호
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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 Treatment of the Atlantoaxial Osteoarthritis

  • Jin, Kwang-Ouk;Kim, Young-Woo;Rim, Dae-Cheol;Ahn, Sung-Ki
    • Journal of Korean Neurosurgical Society
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    • 제41권4호
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    • pp.264-266
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    • 2007
  • Atlantoaxial facet joint osteoarthritis is rare, often undiagnosed because it may be misdiagnosed as occipital neuralgia, or degenerative cervical spondylosis. Unilateral occipitocervical pain aggravated by head rotation is a specific symptom. Conservative treatment is usually effective. But when the patient complains of intractable neck pain localized to occipitocervical junction and unresponsive to medical therapy, surgical treatment should be considered. Though a few reports of surgically treated atlantoaxial osteoarthritis has been published, surgical outcome is favorable. A case of a surgically treated atlantoaxial osteoarthritis is presented with a review of the literatures.

개의 흉·요추 디스크 질환에 대한 전침요법 시술 예 (Electroacupuncture therapy for the treatment of thoracolumbar disc disease in dogs)

  • 서강문
    • 대한수의학회지
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    • 제35권4호
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    • pp.863-868
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    • 1995
  • Electroacupuncture therapy was performed in 2 dogs with thoracolumbar disc disease. Case was a 3-year-old female chihuahua with a calcified disc between the 13th thoracic and 1st lumbar vertebrae. Treatment was done by electroacupuncture at San sho yu, Shen yu, Huan tiao and Fu yang-San yin jiao with the current of 0.5~8 volts, 30 Hz for 30 min. She could pass feces and urine 2 days, and walk 9 days after the beginning of the therapy. Case 2 Was a 6-year-old male cocker spaniel with 4 calcified discs(T12-T13, T13-L1, L2-L3 and L6-L7) and spondylosis(lumbosacral junction). Treatment was done by electroacupuncture at Tian ping, Bai hui and Pung kung yu with the current of 2~4 volts, 30 Hz for 20 min. He could pass feces 6 days, urine 8 days, and stand 21 days, after the beginning of the therapy.

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IMS란 무엇인가 (What is IMS?)

  • 한재복
    • Journal of Acupuncture Research
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    • 제24권5호
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    • pp.127-136
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    • 2007
  • Objectives : To review the history, the theoretical basis and the technique of Intramuscular Stimulation (IMS), papers and books on IMS were searched. Methods : 15 papers were searched with the keyword 'Gunn CC' at Pubmed(http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed). Several full texts of them and other papers were found at the internet homepage of The Institute for the Study and Treatment of Pain (http://www.istop.org/). 16 Korean papers on IMS were searched at KoreaMed(http://www.koreamed.org/SearchBasic.php) and Koreanstudies Infomation Service System(http://kiss.kstudy.com/KsiKiss.asp). Results : Dr. Gunn has made unique model which can explain the pathology of chronic pain and the mechanism of acupuncture treatment. In this model, he postulated that most of chronic pain is radiculopathy due to spondylosis and acupuncture treatment to the hyperalgesic muscle can restore the normal function of involved muscles and nerves. Conclusions : IMS is an acupuncture technique in which the muscles under the Ah-shi or tender points in periphery and intrasegmental paravertebral muscles are stimulated with needles.

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