• Journal of Korean Neurosurgical Society
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• 제29권7호
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• pp.891-898
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• 2000

Objective : It is difficult to differentiate intramedullary spinal cord tumors preoperatively from non-neoplastic pathologies in patients presenting as non-compressive myelopathies in magnetic resonance imaging(MRI). In this report, the authors reviewed nonneoplastic intramedullary spinal cord lesions preoperatively diagnosed as tumors and discussed their clinical and radiological characteristics and usefulness of surgical intervention. Methods : From January, 1985 to January, 1999, authors experienced eight non-neoplastic pathologies mimicking intramedullary spinal cord tumors and analysed their medical records, radiological findings and histopathological specimens retrospectively. Results : There were five males and three females and the duration of symptoms were from two to 20 months(mean, 9.8 months). The location of lesions were four cervical, one cervicothoracic and three thoracic. All patients manifested sensory abnormality, seven motor weakness, and six bladder symptom. All cases had swollen spinal cords and increased signal intensities in spin-echo sequences. Six cases showed contrast enhancement : four cases were focal and two diffuse. Under the impression of intramedullary tumors, the patients were operated upon. Final diagnoses on the base of clinical and pathologic finding were : three subacute necrotizing myelopathies, two multiple scleroses, two myelopathy of unknown etiology. One case showed no gross abnormality in surgical field in spite of adequate exposure of the lesion, so biopsy was not performed. In that case, postoperative MRI revealed spontaneous resolution of the lesion. Conclusion : MRI is invaluable diagnostic tool in screening myelopathies. However, its high sensitivity and lack of specificity make difficulty in preoperative differential diagnosis of non-compressive myelopathies. Although no surgical morbidity occurred in our series, we sometimes failed to confirm definite diagnosis even with biopsy. In such a circumstance, long-term follow up is needed.

• Journal of Acupuncture Research
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• 제29권1호
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• pp.159-167
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• 2012

Objectives : The purpose of this study is to investigate the effecacy of Korean medical treatments on cervical myelopathy patient diagnosed by magnetic resonance imaging(MRI). Methods : The patient was treated by Korean medical treatments including acupunture, pharmacopuncture, herbal medicine, cervical traction technique of Chuna treatment. To evaluate the change of MRI view, slipped disc ratio and A-P compression ratio were used. The improvement of the clinical symptoms was observed by Score of pain part and Nurick grade. Results : After treatment, patient's score of pain part, Nurick grade were decreased and slipped disc ratio, A-P compression ratio were also improved. Conclusions : The Korean medical treatments might be an effective method to improve the clinical symptoms and radiological view of cervical myelopathy.

• PNF and Movement
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• 제16권3호
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• pp.333-343
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• 2018

Purpose: The purpose of this study was to investigate the effects of a neck exercise using a proprioceptive neuromuscular facilitation (PNF) neck flexion and extension pattern on body balance in a progressive range of positions (supine, prone on elbow, and sitting), on numbness in the upper extremities, and on neck flexion motions in cervical myelopathy patients. Methods: One participant who was diagnosed with cervical myelopathy participated in this study. A reversal design (A-B-A') was used. The A and A' were the baseline period (no intervention), and B was the intervention period. The intervention used a neck extension pattern with a hold-relax technique and a neck flexion pattern with a combination of isotonic techniques in the supine position. Then, neck flexion and extension patterns were applied together with a reversal technique for stabilization, followed by a neck extension pattern with a combination of isotonic techniques in the prone position on the elbows. Finally, a neck flexion and extension pattern was used with a stabilizing reversal technique, and a neck extension pattern was applied with a combination of isotonic techniques in the sitting position for 60 minutes per day, 3 times per week for 8 weeks. To measure balance, numbness, and neck motion during neck flexion, the one-leg stand test and the visual analogue scale were used. Results: The right and left one-leg stand tests showed increased balance ability in the intervention phase. Upper extremity numbness was decreased in the intervention phase, and neck flexion motion was increased in the intervention phase. These increases were maintained after the intervention (Baseline II). Conclusion: These results suggest that a neck exercise using a PNF neck pattern with additional techniques in a progressive range of positions has a positive effect on cervical myelopathy patients for balance, numbness, and neck motion.

• 혜화의학회지
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• 제16권1호
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• pp.147-156
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• 2007

This study was performed to investigate the cause, symptom, treatment of OPLL through Western medicine and Dong-Eui-Bo-Kham(東醫寶鑑) Results & conclusins 1. Ossification of the posterior hgament(OPLL) have radiculopathy, myelopathy or both of them such as neck pain, numbness, myatonia 2. Neck pain of OPLL seems to be simular with pain in the neck(頸項痛), neck stiffness(項强), stiffness and pain of head and neck(頭項彈痛). The causes were usually Dampness and Cold, Wind. The treatments were classified according to pathoigenic factor(病因) and muscle along the regular meridian(經筋) 3. Radiculopathy of OPLL seems to be similar with numbness(痺證). The causes were usually, pathogenic Wind, Cold, Dampness. The treatments were classified according to diagnosis of three kinds of BI syndrome(三痺), five kind of Bi synrome(五痺), five jang Bi(五臟痺), six Bu Bi(六腑痺) 4. Myelopathy of OPLL seems to be simular with myatonia(痿證) The cause of myatoma was Lung scorched by Heat(肺熱葉無). And the treatment was purping the south and reinforcing the north(寫南方 補北方). We considered that more study to find various and effective methods oriental medicine for OPLL should be made.

• Journal of Korean Neurosurgical Society
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• 제56권5호
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• pp.436-440
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• 2014

Sarcoidosis is a systemic disease of unknown etiology that may affect any organ in the body. The nervous system is involved in 5-16% of cases of sarcoidosis. Here, we report a case of intramedullary sarcoidosis presenting with delayed spinal cord swelling after laminoplasty for the treatment of compressive cervical myelopathy. A 56-year-old woman was admitted to our hospital complaining of upper extremity pain and gait disturbance. The patient had undergone laminoplasty for compressive cervical myelopathy 3 months previously. Follow-up magnetic resonance imaging revealed a large solitary intramedullary lesion with associated extensive cord swelling, signal changes, and heterogeneous enhancement of spinal cord from C2 to C7. Spinal cord biopsy revealed non-necrotizing granulomas with signs of chronic inflammation. The final diagnosis of sarcoidosis was based upon laboratory data, imaging findings, histological findings, and the exclusion of other diagnoses. Awareness of such presentations and a high degree of suspicion of sarcoidosis may help arrive at the correct diagnosis.

• 척추신경추나의학회지
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• 제5권1호
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• pp.145-156
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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, pharmacopucture, cervical traction technique of Chuna treatment and conservative managements. To evaluate the effect of the treatment, Recovery rate of Hirabayashi, VAS(Visual Analogue 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.

• 한방재활의학과학회지
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• 제31권3호
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• pp.105-114
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• 2021

A 38-year-old Korean man without any other history was diagnosed with myelopathy due to a spinal dural arteriovenous fistula. Following embolization and high-dose steroid therapy, the patient was treated with complex Korean medical therapies including acupuncture, pharmacopuncture, electro-acupuncture, Chuna manual therapy, herbal medicine, and cupping therapy in addition to conventional treatment. To assess the patient's improvement, international standard for neurological classification of spinal cord injury, Korean version of modified Barthel index, functional independence measure, spinal cord independence measure III, walking index for spinal cord injury II, modified Ashworth scale were used. After treatment, the muscle strength and sensory function of the lower extremities were improved, and the spasticity was reduced, resulting in a rapid improvement in performance of daily activities. These results suggest that complex Korean medical therapies may be effective for myelopathy, and further clinical studies are needed to clarify their effects.

• 한국임상수의학회지
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• 제23권2호
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• pp.218-221
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• 2006

This report described clinical findings and Magnetic resonance image (MRI) results in two small breed dogs with fibrocartilaginous embolism (FCE). They were admitted with asymmetric acute-onset tetra/paraparesis with superficial pain sensation. In addition, there were no back pain and no progression of clinical signs. Cerebrospinal fluid and laboratory findings were evaluated. MRI revealed a similar focal intramedullary lesion of hyperintensive signals on T2-weighted images. Based on these findings, it was diagnosed as fibrocartilaginous embolic myelopathy in those two dogs.

• Journal of Korean Neurosurgical Society
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• 제42권3호
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• pp.168-172
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• 2007

Objective : Hirabayashi's open-door laminoplasty is a good procedure to use to treat patients with myelopathy of the cervical spine; however, the authors have experienced problems in maintaining an open-window in cervical spines after the surgery. The authors developed a modified method of the expanded open-door laminoplasty and compared the radiological and clinical results with those of the classical method. Methods : In the modified method, wiring fixation with lateral mass screws on the contra lateral-side instead of fixing the paraspinal muscle or facet joint, as in the classical methods, was used in the open window of the cervical spine. Fifteen patients with cervical myelopathy were treated using the classical method and 12 patients were treated using the modified method. Preoperative and postoperative clinical conditions were assessed according to the Japanese Orthopedic Association (JOA) score. The radiological results were compared with the preoperative and postoperative computed tomography (CT) findings. Results : In both methods, the clinical results revealed a significant improvement in neurological function (p<0.001). Image analysis revealed that the cervical canals were continuously expanded in patients treated using the modified methods. However, authors have observed restenosis during the follow-up periods in 4 patients treated using the original method. Progression to deformity and spinal instability were not observed in any of the patients in the radiological results. Conclusion : Although analysis with a larger population and a longer follow-up period needs to be undertaken, our modified open-door laminoplasty has shown an advantage in better maintaining an open window in comparison with the Hirabayashi's open-door laminoplasty.

• 대한수의학회지
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• 제51권1호
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• pp.73-77
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• 2011

A 6-year old, female, Schnauzer dog with chief complaint of tetraparesis was referred to the Veterinary Medicine Teaching Hospital of Chungnam National University. On physical examination, neulologic examinations and magnetic resonance imaging, this patient was diagnosed into fibrocartilaginous embolic myelopathy. Although conventional treatment such as prednisolone, cefotaxime and enrofloxacin revealed no improvement, this patient showed favorable therapeutic response by combined therapy with aquapuncture with prednisolone, modified moxibustion, herbal medicine and massage.