• 국제물리치료학회지
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• 제10권4호
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• pp.1914-1920
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• 2019

Background: Mobilization and cranio-cervical flexion exercise has been reported in reducing pain from cervical part and improving its motor function; also, has been represented that alleviate of neck pain and recover of neck muscles improve the normal gait performance. However, few studies have identified the effects of mobilization and exercise on pain and gait parameters with preceding issues. Objective: To examine the effects or changes of pressure pain threshold (PPT) and gait parameters in patients with chronic neck pain. Design: Cross-Sectional Clinical Trials Methods: Twenty patients with the history of neck pain (>3 months) performed the cervical mobilization and cranio-cervical flexion exercise. Gait parameters were assessed with wireless device and collected data were transmitted to the personal computer via Bluetooth. The PPT was measured posteroanterior direction at the prone position and the mean of subsequent three PPT measurements was used for the final analysis. Results: Both cervical central posteroanterior mobilization (CCPAM) (p<.000) and sling-based cranio-cervical flexion exercise (SBCCFE) (p<.000) group showed a significant increase in the PPT and the gait parameters, cadence (p<.023), was significantly increased in the CCPAM group, however slightly increased in the SBCCFE group. The comparison between the CCPAM and the SBCCFE groups after treatment did not show significant differences for the score on the PPT and gait parameters. Conclusions: This study suggests that CCPAM and SBCCFE increase PPT, cadence, and gait speed.

• 대한정형도수물리치료학회지
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• 제29권3호
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• pp.43-53
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• 2023

Background: Patients with neck pain develop instability due to muscle imbalance, decreased proprioception, and balance disorders. Studies have examined various exercise methods as treatment methods, but few studies have compared the effects of cervical stabilization exercise and dynamic balance exercise. The purpose of this study was to investigate the effects of dynamic balance exercise on pain, functional level, and psychosocial level in patients with non-specific chronic neck pain. Methods: Thirty-four non-specific chronic neck pain patients were randomly assigned to the experimental group (EG, n=17) and control group (CG, n=17); the cervical stabilization exercise and dynamic balance exercise program were applied to the EG; and only the cervical stabilization exercise program was applied to the CG. The intervention was conducted twice a week, for six weeks. Assessment items evaluated pain, dysfunction (Korean version neck disability index), range of motion, craniocervical flexion test, cervical deep flexor endurance test, and psychosocial level. Data analysis was performed using intention-to-treat analysis as assigned. To analyze differences in the items assessed in the two groups, we used a repeated measures analysis of variance with an interaction between group (EG, CG) and time point (baseline, 6 weeks, 12 weeks). Results: The endurance of the cervical flexor muscles between the group and the measurement point after intervention (p<.05). Both groups showed significantly improved endurance between time points after the intervention (p<.05), with the EG showing a greater change than the CG. None of the other measurement items differed in the pattern of change between measurement points. Conclusion: In conclusion, the EG applying a cervical stabilization exercise and a dynamic balance exercise experienced a significant difference in muscle endurance improvement compared to the CG. We propose an exercise intervention program that includes stabilization exercises and dynamic balance exercises for patients with chronic cervical pain who lack muscle endurance.

• 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.

• Journal of Korean Neurosurgical Society
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• 제57권5호
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• pp.376-378
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• 2015

Cervical epidural steroid injection is indicated for radicular symptoms with or without axial neck pain. Complications are rare but can be serious. Here, we report the case of a 54-year-old man with cervical radicular pain who was treated with cervical epidural steroid injection. Injection was administered twice under fluoroscopic guidance with the loss-of-resistance technique using air to confirm the epidural space. After the second procedure, the patient complained of severe persistent headache and was diagnosed with pneumocephalus on brain computed tomography. The patient returned home without any neurological complication, after a few days of conservative treatment. Though, a fluoroscopic guidance cervical epidural injection is also known to diminish the risk of complications. Physicians should always keep in mind that it does not guarantee safety, particularly in the cervical region, related to its anatomical considerations.

• 척추신경추나의학회지
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• 제18권2호
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• pp.65-73
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• 2023

Objectives This case study aimed to investigate efficacy of Chuna manual therapy (CMT) on acute neck pain patients with abnormal cervical curvature. Methods CMT was administered to five patients with abnoraml cervical curvature in the Department of Korean Medicine Rehabilitation, College of Korean Medicine, Semyung University Korean Hospital from June 2018 to May 2023. Cervical angle, Jackson's angle, Jochumsen method, Ishihara index and visual analog scale (VAS) scores were evaluated before and after treatment. Results In cases 1, 2, 3, 4, and 5, the cervical angle, Jackson's angle, Jochumsen method, Ishihara index all increased, while VAS scores decreased after CMT. Conclusions The observed improvements suggest that CMT is effective in restoring the cervical curvature and alleviating neck pain in patients with acute neck pain.

• The Korean Journal of Pain
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• 제4권2호
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• pp.147-151
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• 1991

Cervical epidural steroid injection, although not as familiar to many anesthesiologists, can be useful in the management of patients with acute and chronic neck, shoulder and arm pain. My clinic personally contacted and interviewed thirty patients with cervical radiculopathy who received cervical epidural steroid injection. Twenty seven percent of the patients had a excellent response(greater than 75% improvement) and fifty percent of the patients had a good response (greater than 50% improvement) to an injection of steroid into the cervical epidural space. We have concluded that cervical epidural steroid injection was very effective in the management of cervical radiculopathy and represented a possible alternative to surgery. Many anesthesiologists should add to their armamentarium the use of such techniques in the management of cervical radiculopathy.

• Physical Therapy Rehabilitation Science
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• 제8권4호
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• pp.202-209
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• 2019

Objective: The purpose of this study was to evaluate the effects of temporomandibular joint and cervical vertebra treatment in persons with tension-type headaches on pain, tenderness, and functional improvement. Design: Three-group pretest-posttest design. Methods: Subjects with tension-type headaches were divided into the temporomandibular joint and cervical vertebra treatment group (n=11), temporomandibular joint treatment group (n=11), and cervical vertebra treatment group (n=11), and pre- and post-evaluation was performed. The temporomandibular joint treatment group underwent compression massage and joint ply of the muscles around the temporomandibular joint. The cervical vertebra group received deep tendon massage and Myofascial Release of the cervical muscles. The temporomandibular joint and cervical vertebra treatment group performed both types of treatment. Treatment was performed for 50 minutes, three times a week for 4 weeks. Measurement tools included the Korean version of the short form-McGill Pain Questionnaire (SF-MPQ, K), Headache Impact test-6 (HIT-6), Neck Disability Index (NDI), and the Digital Algometer FPX25. Results: The groups showed significant differences in SF-MPQ, HIT-6 test, NDI, and Alogometer FPX25 test scores before and after intervention (p<0.05). The differences between the groups were most significant in the group that received treatment of the temporomandibular joint and cervical vertebra (p<0.05). Conclusions: In this study, the treatment of the temporomandibular joint and cervical vertebra was shown to be effective for improving pain, quality of life, and cervical vertebra in persons with tension-type headaches. This data may be helpful in identifying treatment techniques for tension-type headaches in the future.

• 셀메드
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• 제13권15호
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• pp.54.1-54.4
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• 2023

Objective: A single-patient case study on the use of OCNT for cervical spinal stenosis. Methods: A50-year-old Korean male with frequent leg muscle cramps and severe muscle weakness was treated with OCNT. Results: After OCNT, pain and cramps disappeared, and muscle strength improved to the point of no longer hindering daily activities. Conclusion: OCNT can be beneficial in alleviating symptoms of pain and muscle weakness in patients with cervical spinal stenosis.

• The Korean Journal of Pain
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• 제9권1호
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• pp.98-101
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• 1996

Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

• The Korean Journal of Pain
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• 제22권1호
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• pp.52-57
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• 2009

Background: Transforaminal epidural injection (TEI) may be useful to treat unilateral pain that has a dermatomal distribution. In this approach, the needle tip can be placed closer to the dorsal root ganglion and ventral aspect of the nerve root. However many studies have reported that serious complications following TEI occurred more frequently when it was conducted at the cervical level. One of the presumptive mechanisms of the complication is intravascular injection. Therefore this study was conducted to identify the incidence of complications in response to intravascular injections at cervical segments. Methods: This study included all patients, who visited our pain clinic and had radicular symptoms or herpes zoster associated pain. All procedures were conducted under fluoroscopic guidance with contrast enhancement by one of the authors. After the ideal needle position was confirmed by biplanar fluoroscopy, the blood aspiration through the needle hub was evaluated, and a 3 ml mixture of nonionic contrast (2 ml) with normal saline (1 ml) was injected at a rate of 0.3-0.5 ml/sec continuously under real time fluoroscopic visualization. We then classified the contrast spreading pattern as neural, simultaneous neural and vascular, or vascular. Results: A total 71 cervical TEIs were performed. In 26 cases (36.6%), the contrast only spread to the nerve sheath. However, 45 cases (63.4%) showed an intravascular spreading pattern, 37 (52.1%) of which showed a neural and vascular pattern and 8 (11.3%) of which showed only a vascular pattern. Conclusions: Approximately two thirds of the cases of cervical TEI were found to lead to intravascular spreading, which is much higher than the incidence reported in previous studies.