• 척추신경추나의학회지
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• 제3권1호
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• pp.65-72
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• 2008

Objects : This study was to report a clinical effect of Chuna Treatment for Cervical Myelopathy due to disc herniation. Methods : The patient was diagnosed as Cervical Myelopathy due to disc herniation through Cervical spine MRI and treated by cervical traction technique of Chuna Treatment with conservative management. JOA score(Japanese Orthopedic Association score), Recovery rate of Hirabayashi, VAS(Visual Analogue Scale), Dynamometer score, ROM(Range of Motion) and Motor weakness Grade were used. Results and Conclusion : JOA score, VAS, Dynamometer score, ROM and Motor weakness Grade were improved and Recovery rate was 100%.

• 대한상한금궤의학회지
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• 제9권1호
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• pp.47-58
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• 2017

Objective : The purpose of this paper is to report the adverse drug reactions of patient with cervical spondylotic myelopathy(CSM) treated by herb medicine, Soshiho-tang. Methods : The patient was prescribed Soshiho-tang herbal medicine for 9days. The patient complained of dizziness, difficulty of concentration and elevation of blood pressure on the 6th day. The doctor made the patient stop to take the herbal medicine and every symptoms and abnormal blood pressure are normalized after 6 days. The abnormal responses were assessed by WHO-UMC Causality Categories and LDS scale. Results : The WHO-UMC Causality is 'probable/likely' and LDS scale is 5, it means 'moderate' severity. Conclusions : The herbal medicine, Soshiho-tang is relevant to abnormal responses of the patient with CSM. This is a first case report of hypertension induced by herbal medicine, Soshiho-tang in Korea.

• Journal of Korean Neurosurgical Society
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• 제66권5호
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• pp.591-597
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• 2023

Cervical disc arthroplasty (CDA) has become more widespread and diverges from the conventional technique used in anterior cervical fusion for cervical degenerative disc disease. As arthroplasty has become a popular treatment option, few complications have been reported in the literature. These include subsidence, expulsion, posterior avulsion fractures, heterotopic ossification, and osteolysis. One of the critical complications is osteolysis, but current studies on this subject are limited in terms of not elucidating the incidence, etiology, and consequences. The authors present two cases, who presented with clinical signs of gradually worsening myelopathy induced by posterior vertebral body osteolysis, 2 years after CDA. Subsequently, the patient underwent posterior decompression and fusion without prosthesis removal. Postoperatively, the clinical symptoms gradually resolved, with no severe deficits. The present rare cases highlight the osteolysis that occurs after CDA, which can cause cervical myelopathy, and suggest spine surgeons to be alert to this fatal complication.

• Journal of Korean Neurosurgical Society
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• 제61권6호
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• pp.767-773
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• 2018

Three male patients diagnosed with surfer's myelopathy (19-30 years) were admitted to our hospital. All three patients were novice surfers showing a typical clinical course of rapid progression of paraplegia following the onset of back pain. Typical history and magnetic resonance imaging features indicated the diagnosis of surfer's myelopathy. Two patients received high-dose steroid therapy and the other was treated with induced hypertension. One patient treated with induced hypertension showed almost full recovery; however, two patients who received high-dose steroid therapy remained completely paraplegic and required catheterization for bladder and bowel dysfunction despite months of rehabilitation. Our case series demonstrates the potentially devastating neurological outcome of surfer's myelopathy; however, early recovery in the initial 24-72 hours of presentation can occur in some patients, which is in accordance with previous reports. Ischemic insult to the spinal cord is thought to play a crucial role in the pathophysiology of surfer's myelopathy. Treatment recommendations include hydration, induced hypertension, early spinal angiography with intra-arterial intervention, intravenous tissue plasminogen activator, and high-dose steroid therapy; however, there is no standardized treatment option available. Early recovery appears to be important for long-term neurological outcome. Induced hypertension for initial treatment can be helpful for improving spinal cord perfusion; therefore, it is important for early and long-term neurological recovery. Education and awareness are essential for preventing surfer's myelopathy and avoiding further deterioration of neurological function.

• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.78-87
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• 2021

Objective : Intraoperative neurophysiological monitoring (IONM) has been widely used during spine surgery to reduce or prevent neurologic deficits, however, its application to the surgical management for cervical myelopathy remains controversial. This study aimed to assess the success rate of IONM in patients with cervical myelopathy and to investigate the factors associated with successful baseline monitoring and the effect of increasing the stimulation intensity by focusing on motor evoked potentials (MEPs). Methods : The data of 88 patients who underwent surgery for cervical myelopathy with IONM between January 2016 and June 2018 were retrospectively reviewed. The success rate of baseline MEP monitoring at the initial stimulation of 400 V was investigated. In unmonitorable cases, the stimulation intensity was increased to 999 V, and the success rate final MEP monitoring was reinvestigated. In addition, factors related to the success rate of baseline MEP monitoring were investigated using independent t-test, Wilcoxon rank-sum test, chi-squared test, and Fisher's exact probability test for statistical analysis. The factors included age, sex, body mass index, diabetes mellitus, smoking history, symptom duration, Torg-Pavlov ratio, space available for the cord (SAC), cord compression ratio (CCR), intramedullary increased signal intensity (SI) on magnetic resonance imaging, SI length, SI ratio, the Medical Research Council (MRC) grade, the preoperative modified Nurick grade and Japanese Orthopedic Association (JOA) score. Results : The overall success rate for reliable MEP response was 52.3% after increasing the stimulation intensity. No complications were observed to be associated with increased intensity. The factors related to the success rate of final MEP monitoring were found to be SAC (p<0.001), CCR (p<0.001), MRC grade (p<0.001), preoperative modified Nurick grade (p<0.001), and JOA score (p<0.001). The cut-off score for successful MEP monitoring was 5.67 mm for SAC, 47.33% for the CCR, 3 points for MRC grade, 2 points for the modified Nurick grade, and 12 points for the JOA score. Conclusion : Increasing the stimulation intensity could significantly improve the success rate of baseline MEP monitoring for unmonitorable cases at the initial stimulation in cervical myelopathy. In particular, the SAC, CCR, MRC grade, preoperative Nurick grade and JOA score may be considered as the more important related factors associated with the success rate of MEP monitoring. Therefore, the degree of preoperative neurological functional deficits and the presence of spinal cord compression on imaging could be used as new detailed criteria for the application of IONM in patients with cervical myelopathy.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1377-1382
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• 2000

Ossification of ligamentum flavum(OLF) is a type of ectopic bone formation developed within the spinal ligament. Thoracic myelopathy is common symptom of OLF but radiculopathy is uncommon. We present 3 operated cases of OLF. Two showed myelopathy and one radiculomyelopathy. Main symptoms were motor weakness, sensory disturbance, incoordination of both legs, and back pain. One patient complained of left girdle pain in T4 dermatome. Deep tendon reflex(DTR) was increased in all cases. The diagnosis was made from myelogram, CT and MRI. Sufficient posterior decompressive laminectomy and medial facetectomy were performed. Postoperative diagnosis was comfirmed by histopathological examination. One patient could return to work 3 months after operation and two patients showed satisfactory improvement 2-3 months after operation. Early diagnosis and appropriate surgical treatment were prerequisite of good outcome.

• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.347-349
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• 2013

We report a very rare case of cervical compressive myelopathy by an anomalous bilateral vertebral artery (VA) entering the spinal canal at the C1 level and compressing the spinal cord. A 70-year-old woman had been suffering from progressive gait disturbance. Magnetic resonance imaging revealed that a bilateral VA at the V4 segment had abnormal courses and caused compression to the high cervical cord. VA repositioning was performed by anchoring a suture between the artery and around the arachnoid membrane and dentate ligament, and then, microvascular decompression using a Teflon sponge was done between the VA and the spinal cord. The weakness in the patient improved in the lower extremity after the operation. Anomalous VA could be one of the rare causes of cervical compressive myelopathy. Additionally, an anchoring suture and microvascular decompression around the VA could be a sufficient and safe method to indirectly decompress the spinal canal.

• 척추신경추나의학회지
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• 제5권1호
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• pp.81-89
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• 2010

Objects : This study was to report a clinical effect of Chuna Treatment for a patient diagnosed by Magnetic Resonance Imaging(MRI) as Cervical Myelopathy. Methods: In order to alleviate shoulder pain and neck stiffness, the patient was treated by acupuncture therapy, herbal medicine, phamacopucture, 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 Myelopathy. Further clinical studies are needed to verify the findings.

• Korean Journal of Acupuncture
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• 제26권4호
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• pp.225-235
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• 2009

Objective : The purpose of this study was to report a case of a treatment with Scolopendrae Corpus Herbal-Acupuncture for one patient suffering from the Cervical Myelopathy. Scolopendrae Corpus Herbal-Acupuncture has been used as a analgesics and antispasmodics in the oriental medicine and reported to have antiinflammatory effect, sedative action and immunity enhancing activity, on one patient suffering from the Cervical Myelopathy. Methods : TThe patient was treated with Scolopendrae Corpus Herbal-Acupuncture, acupuncture, herbal medication. Scolopendrae Corpus Pharmacopuncture was administered two or three times per week and we injected 0.2~1.0 ml of Scolopendrae Corpus Pharmacopuncture to the patient's neck and both arms. The improvement of the symptoms was evaluated by JOA score(Japanese Orthopedic Association score), Nurick grading, VAS(Visual Analog Scale), reflex testing, Finger escape sign, Grip and Release test. Result : After 5 weeks of treatment, the patient's JOA score, Nurick grading and VAS were improved from 12 to 16, from grade III to grade II and from 10 to 3 respectively. The movement and power of upper and lower limbs were restored to nearly normal range.

• 대한약침학회지
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• 제25권2호
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• pp.138-144
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• 2022

Cervical spondylotic myelopathy (CSM) is common in elderly people and severe CSM patients are recommended to receive surgery. However, in some cases, surgery may fail to improve the patients' symptoms. An 80-year-old man diagnosed with CSM complained of right hemiplegia and right arm and leg pain with the presence of a Foley catheter, despite treatment with laminectomy and laminoplasty. Acupuncture, bee venom pharmacopuncture, and herbal medicine were administered for 129 days. As a result, manual muscle testing (MMT) and the Modified Barthel Index (MBI) improved, the pain in his right arm and leg decreased, and he was able to urinate by himself. This case report implies that integrative Korean medicine (IKM) can be an option for patients suffering from muscular weakness resulting from myelopathy.