• Title/Summary/Keyword: cervical angle

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Extent of Disc Degeneration after Single-Level Cervical Anterior Microforaminotomy Analyzed with Long-Term Radiological Data

  • Han, Chul;Kim, Myung-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.200-205
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    • 2014
  • Objective : To prove the extents and details of cervical degeneration after anterior microforaminotomy (AMF) with 6-years follow-up. Methods : A retrospective study of 24 patients, underwent single-level AMF, was performed. Clinical and radiologic data were analyzed with office charts, questionaires, and picture achieving and communication system images. Results : According to Odom's criteria, 91.6% achieved favorable outcome. The mean visual analog scale score was improved from 8.6 to 3, and the mean neck disability index was improved from 27.9 to 7.3 (p<0.01). Eighteen cases (75%) showed disc height (DH) decrease. The disc invasion was correlated with DH decrease (p<0.05). The disc height decrease correlated with static, dynamic changes of shell angle and spur formation (p<0.05). Any radiological parameters did not affect the clinical outcome. Conclusion : AMF is an effective technique for treating unilateral cervical radiculopathy. It showed excellent surgical outcomes even in long-term follow-ups. However, a decrease in DH occurred in a considerable number of patients. Disc invasion during surgery may be the trigger of sequential degeneration.

Comparison of Spinal Canal Expansion Following Cervical Laminoplasty Based on the Preoperative Lamina Angle : A Simulation Study

  • Jung, Jong-myung;Jahng, Anthony L.;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn
    • Journal of Korean Neurosurgical Society
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    • v.64 no.2
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    • pp.229-237
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    • 2021
  • Objective : Expansion in the spinal canal area (SCA) after laminoplasty is one of the critical factors to relieve the preoperative symptoms. No previous study has compared the increases in SCA achieved by open-door laminoplasty (ODL) and double door laminoplasty (DDL) according to the preoperative lamina angle (LA). This study was designed to clarify the relationship between the laminoplasty opening angle (OA)/laminoplasty opening size (OS) and increases in the SCA following ODL and DDL according to the preoperative LA using a simulation model. Methods : The simulation model was constructed and validated by comparing the clinical data of 64 patients who had undergone C3-C6 laminoplasty (43 patients with ODL and 21 patients with DDL). SCA expansion was predicted with a verified simulation model at various preoperative LAs (from 28° to 32°) with different OAs (40° to 44°) and OSs (10 mm to 14 mm) recruited from patient data. Results : The constructed simulation model was validated by comparing clinical data and revealed a very high degree of correlation (r=0.935, p<0.001). In this validated model, at the same OA, the increase in SCA was higher following ODL than following DDL in the usual LA (p<0.05). At the same OS, the increase in SCA was slightly larger following DDL than following ODL, but the difference was not significant (p>0.05). The difference was significant when the preoperative LA was narrower or much wider. Conclusion : Based on clinical data, a simulation model was constructed and verified that could predict increases in the SCA following ODL and DDL. When applying this model, prediction in SCA increase using the OS parameter was more practical and compatible with clinical data. Both laminoplasties achieved enough SCA, and there was no significant difference between them in the usual range.

Effects of Neck and Pelvic Exercise Using Swiss Ball on Spinal Curve in Adults with Forward Head Posture (전방머리자세 대상자에 대한 목운동과 골반운동이 척추 굽이에 미치는 효과)

  • Bae, Won-Sik;Jang, Chel
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.193-201
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    • 2021
  • Purpose : The purpose of this study was to compare the effect of pelvic exercise on the CVA and spinal curve in adults with forward head posture compared to the group using only neck exercise when pelvic exercise was performed in parallel with conventional neck exercise. Methods : GPS 400 and Formetric were used to identify craniovertebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion and were measured by an experienced research manager. Forward head posture (FHP) was selected for people whose angle between the line connecting the ear ball and the seventh cervical spine and the horizontal line is 50 degrees or less. The 30 selected students were randomly divided into 15 experimental groups and 15 control groups. Mackenzie exercise and sling exercise were performed for neck exercise in both the experimental group and the control group, and pelvic exercise using a Swiss ball was additionally performed in the experimental group. All data collected in this study were analyzed using SPSS statistics 21.0. Cervical vetebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion were compared at 0 weeks, 3 weeks, and 6 weeks for each measurement factor using ANOVA with repeated measures. For the statistical significance test, the significance level of α was set to .05. Results : The changes of pelvic torsion, thoracic kyphosis and CVA due to pelvic exercise using Swiss Ball and neck exercise were changed over time, but lumbar lordosis were not changed. And there were no significant differences among the groups. Conclusion : In conclusion, the pelvic correction exercise is considered to be an effective exercise for correcting the FHP and requires regular pelvic correction exercises. We expect the results to be used in clinical trials.

Physicochemical properties, cytotoxicity and penetration into dentinal tubules of sodium hypochlorite with and without surfactants

  • Hernan Coaguila-Llerena;Isadora Barbieri ;Mario Tanomaru-Filho ;Renato de Toledo Leonardo;Ana Paula Ramos ;Gisele Faria
    • Restorative Dentistry and Endodontics
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    • v.45 no.4
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    • pp.47.1-47.11
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    • 2020
  • Objectives: The aim of this study was to assess the physicochemical properties, cytotoxicity and penetration into dentinal tubules of ChlorCidTM Surf (3% sodium hypochlorite [NaOCl] with surfactant) in comparison to ChlorCidTM (3% NaOCl without surfactant). Materials and Methods: The physicochemical properties evaluated were pH, surface tension, free available chlorine (FAC) and contact angle. Cytotoxicity was evaluated in L929 fibroblasts exposed to the solutions by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide and neutral red assays. Assessment of penetration into dentinal tubules was performed by staining single-rooted permanent human teeth with crystal violet (n = 9), which were irrigated with the solutions and analyzed in cervical, middle and apical segments. Data were analyzed by one-way analysis of variance (ANOVA) and Tukey's post-test, 2-way ANOVA and Bonferroni's post-test or t-test (α = 0.05). Results: ChlorCidTM Surf and ChlorCidTM FAC values were close to those indicated by the manufacturer. ChlorCidTM Surf showed lower surface tension and contact angle on dentin, and higher pH than ChlorCidTM (p < 0.05). The penetration of ChlorCidTM Surf was higher in cervical and middle segments, compared with ChlorCidTM (p < 0.05). There was no difference in irrigant cytotoxicity (p > 0.05). Conclusions: ChlorCidTM Surf showed lower surface tension, lower contact angle on root canal dentin, higher penetration into dentinal tubules and more alkaline pH, compared with ChlorCidTM. However, both solutions showed similar cytotoxicity and FAC content.

Effects of Visual Biofeedback on Movement Patterns of Neck Lateral Bending and Muscle Activation of Sternocleidomastoid During Neck Rotation in Adults with Forward Head Posture (전방머리자세를 가진 성인들에게 목 돌림 수행 시 시각적 생체되먹임 적용이 목의 가쪽 굽힘 움직임 패턴과 목빗근 근활성도에 미치는 영향)

  • Yang, No-Yul;Oh, Jae-Seop
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.4
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    • pp.425-432
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    • 2014
  • PURPOSE: The purpose of this study was to investigate that the differences in sternocleidomastoid muscle activity, neck rotation angle, neck lateral bending angle and neck lateral bending onset time between conditions with and without visual biofeedback during neck rotation. METHODS: Ten male and four female adults with condition of forward head posture were recruited in this study. Subjects conducted to left and right maximal neck rotation under the conditions with and without visual biofeedback. During neck rotation, kinematic data of neck rotation, neck lateral bending movement, and electromyography activities of bilateral sternocleidomastold muscles were collected. Differences in dependent variables between conditions with and without visual biofeedback were analyzed using paired t-test. RESULTS: There were significant decreases in lateral bending angle, while lateral bending movement onset time was delayed significantly when applying visual biofeedback (p<.05). However, there were no significant differences in the activation of left and right sternocleidomastoid muscles and neck rotation angle between conditions with and without visual biofeedback (p>.05). CONCLUSION: These findings suggest that visual biofeedback may be effective for axial rotation of cervical spine during neck rotation in adults with forward head posture.

Ectopic Thymus Presenting as a Submandibular Neck Mass (경부 종물로 발현된 이소성 흉선 1예)

  • Hwang Won-Hyo;Park Jung-Je;Jeon Sea-Yuong;Kim Jin-Pyeong
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.1
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    • pp.52-54
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    • 2004
  • Ectopic cervical thymic tissue is rarely reported in medical literature, but it should be included in the differential diagnosis of neck masses, especially in children. It occurs in the line of descent of the thymus from the angle of the mandible to the superior mediastinum. A preoperative diagnosis is seldom considered and is often misdiagnosed as a possible tumor or a lymph node. We present a case of a 2-month-old infant with an asymptomatic enlarging right neck mass. Patient underwent complete excision of the mass.

The Effect of Position on Measured Lung Capacity of Patients with Spinal Cord Injury (척수손상환자의 폐활량에 자세가 미치는 영향)

  • Kim, Myoung-Kwon;Hwangbo, Gak
    • Proceedings of the Korea Contents Association Conference
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    • 2012.05a
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    • pp.173-174
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    • 2012
  • To determine whether position affects measured lung capacity of spinal cord injury patients. The study subjects were 45 patients with spinal cord injury (cervical level 15, thoracic level 15, lumbar level 15). Subjects were provided with a full explanation of the experimental procedures and all provided written consent signifying their voluntary participation. We used a spirometer (Spirometer, Micromedical Ltd, UK) to measure pulmonary function in the supine and sitting positions (straightened upper body at an angle of $90^{\circ}$). Forced vital capacity (FVC), forced expiratory volume during the first second (FEV1), tidal volume (TV), and maximum insufflation capacity (MIC) were also measured. FVC, FEV1, TV, MIC (%) were greater in the supine than in the sitting position for those with injury at the cervical or thoracic injury level. On the other hand, FVC, FEV1, TV, MIC (%) were lower in the supine position for those with an injury at the lumbar level. More attention should be paid to the effect of injury level on measured lung capacity.

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Preliminary Experience with Cervical Implantable Titanium Cage(RABEA) in Patients with Monosegmental Degenerative Disease : Clinical and Radiological Outcomes without Cancellous Bone Filling into Cage (단일 분절 퇴행성 경추질환에서 Titanium Cage를 이용한 전방 융합술의 조기 치험 : 골편 이식을 동반하지 않은 경우의 임상적 방사선학적 초기 결과)

  • Lee, Young-Kyun;Han, Young-Min;Kim, Jong-Tae;Chung, Dong-Sup;Park, Young-Sup;Park, Chun-Kun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.300-308
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    • 2001
  • Objectives : Anterior cervical discectomy and interbody fusion has become a well-accepted surgical treatment of degenerative cervical diseases. Implatable cages have a stabilizing effect without plates and no need for autogenous bone graft. The authors evaluates the effect of implatable titanium cage(RABEA) on the clinical and radiological outcomes. Methods : 34 patients with symptomatic cervical degenerative diseases due to one level disc pathology were underwent anterior cervical discectomy and interbody fusion with titanium cages(RABEA) which were not filled with cancallous bone grafts from January 1999 to May 2001. Patients with osteoporosis and older than 65 years were not included. Among them, 15 patients could be followed-up for at least 1 year. The authors retrospectively reviewed the charts and radiographic data. Mean follow-up period was $1.3{\pm}0.2years$. Results : Clinical results according to the Odom's criteria was exellent and good in 14(93%) patients. One patient with fair result showed complete loss of the disc space height due to settlement of the cage. Preoperatively, the mean height of the disc space(${\pm}$standard deviation) was $3.42{\pm}1.10mm$(range 2.0-5.5mm), and at 1 day postoperatively it was $7.88{\pm}0.90mm$(range 6.50-9.0). The mean height of the disc space after 1 year was $6.50{\pm}1.38mm$(range 3.0-8.0). The restoration of the height was statistically significant(p<0.05). The mean height after 1 year was $82.7{\pm}15.9%$ of the height at 1 day postoperatively. Preoperatively the mean value of the cervical lodortic angle was $21.8{\pm}11.8^{\circ}$ and 1 year postopertively, it was $24.5{\pm}8.3^{\circ}$, which was statistically not significant. All patients showed no abnormal movements on flexion and extension lateral film after 6 months. Conclusion : Implantable titanium cages appear safe and effective in selected patients, and their use helps to avoid complications associated with bone graft harvest. Subsidence of the cage seems to be a potential risk factor for recurrence of the symptoms. For long-term results, a longer follow-up is required.

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The Correlation Between Forward Head Position and Neck Flexor Thickness During Cranio-Cervical Flexion Exercise (머리-목굽힘 운동 시 앞쪽머리자세와 목굽힘근 근두께 간의 상관성 연구)

  • Lee, Ji-Min;Yu, Jun-Su;Lim, Ji-Eun;Lee, Hyun-Ah;Moon, Sung-Gi;Jang, Hyun-Jeong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.20 no.1
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    • pp.1-7
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    • 2014
  • Background: As the increase of forward head position, we studied the change of thickness of deep cervical flexor (DCF) compared of with sternocleidomastoid (SCM). we measured and analysed the change of thickness of the neck flexor for forward head position and cranio-cervical flexion exercise (CCFE). Methods: Using a cross-sectional design, we conducted the study selecting 35 healthy adults (12 males, 23 females). We measured the craniovertebral angle (CVA), instructed them to perform the CCFE, and measured the DCF and SCM using ultrasonography during the contraction and relaxation period. Results: Intra-reliability of SCM is .96, longus capitis is .92 and longus coli is .97. we compared according to the change of forward head position, Correlation of DCF is .841, and DCF/SCM is .754 by significant positive correlation. At the comparison of CCFE and Resting muscle thickness, SCM and DCF is .00, DCF/SCM is .68. Conclusion: There is a strong positive correlation between the change amount of DCF and DCF/SCM as the increase of CVA.

Expandable Cage for Cervical Spine Reconstruction

  • Zhang, Ho-Yeol;Thongtrangan, Issada;Le, Hoang;Park, Jon;Kim, Daniel H.
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.435-441
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    • 2005
  • Objective : Expandable cage used for spinal reconstruction after corpectomy has several advantages over nonexpendable cages. Here we present our clinical experience with the use of this cage after anterior column corpectomy with an average of one year follow up. Methods : Ten patients underwent expandable cage reconstruction of the anterior column after single-level or multilevel corpectomy for various cervical spinal disorders. Anterior plating with or without additional posterior instrumentation were performed in all patients. Functional outcomes, complications, and radiographic outcomes were determined. Results : There was no cage-related complication. Functionally, neurological examination revealed improvement in 7 of 10 patients and no patient had neurological deterioration after the surgery. Immediate stability was achieved and maintained throughout the period of follow-up. There was minimal subsidence [<2mm] noticeable in three of the cases that underwent a two-level corpectomy. Subsidence was noted in osteoporotic patients and patients undergoing multi-level corpectomies. Average pre-operative kyphotic angle was 9 degrees. This was corrected to an average of 5.4 degrees in lordosis postoperatively. Conclusion : In conclusion, expandable cages are safe and effective devices for vertebral body replacement after cervical corpectomy when used in combination with anterior plating with or without additional posterior stabilization. The advantages of using expandable cages include its ability to easily accommodate itself into the corpectomy defect, its ability to tightly purchase into the end plates after expansion and thus minimizing the potential for migration, and finally, its ability to correct kyphosis deformity via its in vivo expansion properties.