• Journal of Korean Medicine Rehabilitation
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• v.31 no.2
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• pp.57-67
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• 2021

Objectives To observe the pain reduction effect of Korean medical treatment combined with supine JS cervical therapy on neck pain and headache caused by whiplash injury. Methods The medical records of 30 patients suffering from neck pain and headache caused by traffic accidents from August 1, 2020 to October 30, 2020 were studied. 15 patients receiving supine JS cervical therapy combined with Korean medical treatment were assigned to group A and another 15 patients receiving Korean medical treatment but without Chuna therapy were assigned to group B. The following patient data were analyzed retrospectively - age, sex, and number of admission days, neck pain and headache visual analogue scale (VAS), and neck disability index (NDI). Statistical analysis was conducted using IBM SPSS 25.0. for Windows. A p-value≤0.05 was considered to be statistically significant. Results Both neck pain and headache VAS score in group A and B showed a statistically significant decrease. The changes in neck pain and headache VAS score in group A was statistically significant higher compared to those of group B. NDI in group A showed a statistically significant decrease, but NDI in group B did not decreased statistically significant. Conclusions Korean medicine treatment effectively reduces neck pain and headache. Especially, the pain reduction effect is better in patients receiving Korean medicine treatment combined with supine JS cervical therapy than in those receiving Korean medicine treatment without supine JS cervical therapy.

• Journal of Korean Neurosurgical Society
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• v.60 no.4
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• pp.456-464
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• 2017

Objective : Although little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors. Methods : Between March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity. Results : A total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain. Conclusion : We managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.125-128
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• 2013

A 65-year-old man who had lateral cervical disc herniation underwent cervical posterior laminoforaminotomy at C5-6 and C6-7 level right side. During the operation, there was no serious surgical bleeding event. After operation, he complained persistent right shoulder pain and neck pain. Repeated magnetic resonance image (MRI) showed diffuse cervical epidural hematoma (EDH) extending from C5 to T1 level right side and spinal cord compression at C5-6-7 level. He underwent exploration. There was active bleeding at muscular layer. Muscular active bleeding was controlled and intramuscular hematoma was removed. The patient's symptom was reduced after second operation. Symptomatic postoperative spinal EDH requiring reoperation is rare. Meticulous bleeding control is important before wound closure. In addition, if patient presents persistent or aggravated pain after operation, rapid evaluation using MRI and second look operation is needed as soon as possible.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.343-345
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• 1998

Stellate ganglion block and cervical epidural nerve block are frequently practiced in pain clinics because of simple procedure and good effect. Nerve block at head and neck may produce serious complication such as loss of consciousness and cardiac arrest. Blood supply is rich in neck and inadvertent arterial injection of local anesthetics may enter directly into brain. We experienced convulsion and respiratory arrest during SGB and cervical epidural block. The patients were resuscitated successfully and recovered without any adverse effects.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.279-282
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• 1996

A 45-year-old male received cervical continuous epidural block for posterior neck pain radiating to right upper extremity secondary to cervical herniated nucleus pulposus. Three days after epidural catheterization, fever, radicular pain and weakness of both upper extremities were developed. On admission, his temperature was $38.3^{\circ}C$ and showed progressive weakness and numbness in both upper and lower extremities. Cervical epidural abscess was suspected; MRI showed an epidural abscess from C4 to C7 level. Within 24 hours of admission, surgical decompression and drainage was effected. Culture of pus obtained at the lesion yielded Staphylococcus aureus. He was treated with intravenous antibiotics for 7 weeks resulting marked improvement of neurologic signs and symptoms.

• The Korean Journal of Pain
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• v.27 no.3
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• pp.266-270
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• 2014

Background: Knowledge of the anatomical variation of the vertebral artery has clinical importance not only for the performance of interventional or surgical procedures itself but also to ensure their safety. We conducted a study of the anatomical variation by reviewing multi-detector computed tomography (MDCT) images of the cervical spine from 460 Korean patients. Methods: 16-row MDCT data from 460 patients were used in this study. We observed 920 vertebral arteries. Examination points included level of entrance of the artery into the transverse foramen of the cervical vertebra, origin site of the vertebral artery, course of a vertebral artery with aberrant entrance. Result: The vertebral artery in 2 (0.2%) cases in this study entered into the transverse foramen of the 7th cervical vertebra from the left. In 45 (4.9%) cases, the vertebral artery entered into the transverse foramen of the 5th cervical vertebra. Of these, the entrance was on the right in 15 (1.6%) and on the left in 30 (3.3%). We found 17 (1.8%) cases in which the artery entered into the transverse foramen of the 4th cervical vertebra, 10 (1.1%) on the right and 7 (0.7%) on the left side. As is commonly acknowledged, the 6th cervical vertebra was the most common site of entry; the vertebral artery entered the transverse foramen of the 6th cervical vertebra in the remaining 855 (93.0%) cases, on the right in 434 (47.2%) and on the left in 421 (45.8%). Conclusions: In conclusion, the possibility of an atypical course of the vertebral artery in segments V1 and V2 should be evaluated with magnetic resonance imaging (MRI) or CT images before carrying out procedures involving the anterior cervical vertebrae.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.2
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• pp.35-45
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• 2015

PURPOSE: The aim of this study is to investigate how upper thoracic manipulation and cervical stability training affects cervical range of motion and neck disability index of patients with chronic mechanical neck pain. METHODS: 30 patients with chronic mechanical neck pain, and randomly divided into the upper thoracic manipulation and the cervical stability training group. Upper thoracic manipulation group was conducted to the upper thoracic manipulation, and cervical stability training was conducted to the cervical stability training. Intervention period was 6 weeks, and 3 sessions, each of which was run for 5~10 minutes. The subjects were measured neck range of motion before and after intervention by electro-goniometer. Neck disability index was used to measure neck disability index Korean version. RESULTS: Comparison within groups, there were significant difference in neck range of motion before and after intervention, and Neck disability index significantly reduced in the cervical stability training group. The comparison between groups, there were no significant difference in neck range of motion and neck disability index. CONCLUSION: Upper thoracic manipulation and cervical stability training to the patients with chronic neck pain was helpful to improve neck range of motion and cervical stability training was helpful to improve neck disability index.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.570-573
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• 2012

Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.3
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• pp.141-148
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• 2013

Objectives The purpose of this study was to investigate the clinical effects of repeatedly performed of balneotherapy on cervical pain. Methods We investigate 19 cervical pain subjects in this study. Subjects took 5 session of balneotherapy once a week during 5 weeks. Each session consisted of 15 minutes of high pressure underwater shower ($32{\sim}36^{\circ}C$) and another 15 minutes of whole body bathing ($32{\sim}40^{\circ}C$). To evaluate the efficiency of balneotherapy visual analogue scale (VAS) and pain threshold were applied before treatment and after 1st, 2nd, 3rd, 4th, 5th treatment. Then the results were analysed. Results 1) The average of VAS significantly decressed from $59.11{\pm}14.67$ to $33.95{\pm}20.988$ after 5 weeks of balneothreapy treatment (p<0.001). 2) The average of pain threshold significantly increased from $5.76{\pm}1.294$ lbf to $8.74{\pm}1.126$ lbf after 5 weeks of balneothreapy treatment (p<0.001). Conclusions Balneotherapy has clinical effscts of pain reduction on cervical pain subjects. Balneotherapy can be used in addition to the Oriental physiotherapy for high effective treatment on cervical pain. Further clinical studies are required to verify these findings.

• Journal of Acupuncture Research
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• v.25 no.5
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• pp.69-76
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• 2008

Objectives : The objective of this study was to observe the correlation between Cervical hypolordosis and Neck pain. Methods : Cervical lordosis(Cobb method[C1-C7], Cobb method[C2-C7], Ishihara index) was measured using the sagittal radiograph of the cervical spine and Neck pain(VAS scale, Neck Disability Index) was evaluated. Based on Cobb method[C1-C7], 48 subjects(Cobb method[C1-C7]${\leq}45^{\circ}$) were divided into Hypolordosis group and Normal group. Window version SPSS 12K was used for statistical analysis about correlation between Cervical lordosis and Neck pain, also about difference of the Neck pain between Normal and Hypolordosis group. Results : It was as follows, 1. Cobb method[C1-C7] and Neck pain(VAS scale, NDI) showed a significant correlation coefficient (p<0.05). Ishihara Index and NDI also showed a significant correlation coefficient of -0.297(p=0.040). 2. The VAS scale in the hypolordosis group was $5.62{\pm}2.34$ and that of the normal group was $3.41{\pm}2.01$(p=0.001). The NDI in the hypolordosis group was $2.30{\pm}0.66$ and that of the normal group was $1.81{\pm}0.51$(p=0.007). There was no significant difference in Age, Sex between both group. Conclusions : There was a significant correlation between Cervical hypolordosis and Neck pain. Hypolordosis group complained a severe neck pain.