• Title/Summary/Keyword: Cervical disc

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The Clinical Analysis of Traffic Accident Patients Treated by Oriental Medicine (교통사고 후유증 환자의 임상적 분석과 한방치료효과)

  • Song, Young-Il;Jin, Kwang-Seon;Shin, Hye-Lan;Yoon, Il-Ji;Choi, Seung-Hoon;Oh, Min-Suck
    • Journal of Korean Medicine Rehabilitation
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    • v.15 no.2
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    • pp.77-89
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    • 2005
  • Objectives : This study was designed to find out the characteristic of patients who had admitted due to traffic accident and to promote the superiority of oriental medical treatment on the sequelae of traffic accident. Methods : We analyzed 332 traffic accident patients statistically according to medical charts, who had been hospitalized from January 1,20000 to October 30, 2004. Results and Conclusions : The analysis showed that there was no significant difference in sex(p<0.05), but the older group and the shorter group of interval time from onset to addmission had the better remedial result(p<0.05). The most common diagnosis that had the better remedial result was lumbar sprain, followed by multiple contusion, cervical sprain, herniated lumbar disc, herniated cervical disc(p<0.05), and the most effective oriental medical treatment was moxibusition, followed by blood cupping therapy, taping therapy, chuna therapy except acupuncture, herbal medication, oriental physical therapy(p<0.05). In using of TENS, ICT, U/S, complex therapy had better remedial result than single therapy(p<0.05). The longer period of treatment group had better remedial result generally(p<0.05).

Effects of Head Posture on the Rotational Torque Movement of Mandible in Patients with Temporomandibular Disorders (두경부 위치에 따른 측두하악장애환자의 하악 torque 회전운동 분석)

  • Park, Hye-Sook;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.25 no.2
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    • pp.173-189
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    • 2000
  • The purpose of this study was to evaluate the effect of specific head positions on the mandibular rotational torque movements in maximum mouth opening, protrusion and lateral excursion. Thirty dental students without any sign or symptom of temporomandibular disorders(TMDs) were included as a control group and 90 patients with TMDs were selected and examined by routine diagnostic procedure for TMDs including radiographs and were classified into 3 subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Mandibular rotational torque movements were observed in four head postures: upright head posture(NHP), upward head posture(UHP), downward head posture(DHP), and forward head posture(FHP). For UHP, the head was inclined 30 degrees upward: for DHP, the head was inclined 30 degrees downward: for FHP, the head was positioned 4cm forward. These positions were adjusted with the use of cervical range-of-motion instrumentation(CROM, Performance Attainment Inc., St. Paul, U.S.A.). Mandibular rotational torque movements were monitored with the Rotate program of BioPAK system (Bioresearch Inc., WI, U.S.A.). The rotational torque movements in frontal and horizontal plane during mandibular border movement were recorded with two parameters: frontal rotational torque angle and horizontal rotational torque angle. The data obtained was analyzed by the SAS/Stat program. The obtained results were as follows : 1. The control group showed significantly larger mandibular rotational angles in UHP than those in DHP and FHP during maximum mouth opening in both frontal and horizontal planes. Disc displacement with reduction group showed significantly larger mandibular rotational angles in DHP and FHP than those in NHP during lateral excursion to the affected and non-affected sides in both frontal and horizontal planes(p<0.05). 2. Disc displacement without reduction group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening as well as lateral excursion to the affected and non-affected sides in both frontal and horizontal planes. Degenerative joint disease group showed significantly larger mandibular rotational angles in FHP than those in any other head postures during maximum mouth opening, protrusion and lateral excursion in both frontal and horizontal planes(p<0.05). 3. In NHP, mandibular rotational angle of the control group was significantly larger than that of any other patient subgroups. Mandibular rotational angle of disc displacement with reduction group was significantly larger than that of disc displacement without reduction group during maximum mouth opening in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group or degenerative joint disease group during maximum mouth opening in the horizontal plane(p<0.05). 4. In NHP, mandibular rotational angles of disc displacement without reduction group were significantly larger than those of the control group or disc displacement with reduction group during lateral excursion to the affected side in both frontal and horizontal planes. Mandibular rotational angle of disc displacement without reduction group was significantly smaller than that of the control group during lateral excursion to the non-affected side in frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of disc displacement with reduction group during lateral excursion to the non-affected side in the horizontal plane(p<0.05). 5. In NHP, mandibular rotational angle of the control group was significantly smaller than that of disc displacement with reduction group or disc displacement without reduction group during protrusion in the frontal plane. Mandibular rotational angle of disc displacement without reduction group was significantly larger than that of the disc displacement with reduction group or degenerative joint disease group during protrusion in the horizontal plane. Mandibular rotational angle of the control group was significantly smaller than that of disc displacement without reduction group or degenerative joint disease group during protrusion in the horizontal plane(p<0.05). 6. In NHP, disc displacement without reduction group and degenerative joint disease group showed significantly larger mandibular rotational angles during lateral excursion to the affected side than during lateral excursion to the non-affected side in both frontal and horizontal planes(p<0.05). The findings indicate that changes in head posture can influence mandibular rotational torque movements. The more advanced state is a progressive stage of TMDs, the more influenced by FHP are mandibular rotational torque movements of the patients with TMDs.

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Anterior Cervical interbody Fusion with Cervical Spine Locking Plate (경추 물림 금속판을 이용한 경추 전방추체간 유합술)

  • Park, Joo-Tae;Ahn, Gil-Young;Lee, Young-Tae;Ahn, Myun-Whan
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.209-219
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    • 1997
  • Objectives: Anterior approach to achieve arthrodesis of the cervical spine has become a widely accepted and often-used approach since its earliest reports by Bailey and Badgley, Smith and Robinson and Cloward. However, anterior interbody fusion in the presence of the posterior instability may be complicated by the bone graft dislodgement, kyphotic defomity or nonunion. As an attemp to prevent this undesirable complication, additional methods such as skeletal traction, halo appratus or even posterior fusion has been utilized. Therefore, The cervical spine locking plate(CSLP) with the anterior intervertebral body bone grafting provide immediate cervical stabilization and widely successful in achieving fusion. Material and methods: This study analysed 14 patients who underwent a single anterior procedure and application of CSLP for the treatment of the cervical spinal disorder. Eleven patients were disc herniations and three patients were traumatic lesion. The average age of the patient was 47 years and the mean follow up periods was 20 months ranging from 13 to 27 months. Results: Ambulation was started 2nd day after the operation with the aid of the Philadelpia orthoses. Bone union was observed 13 cases on average 12 weeks after operation. The one case was nonunion with plate breakage without clinical symptom. Conclusion: Anterior fusion with CSLP are thought to be a safe and valuable method for treating cervical spine disorder.

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The Effect of Acupuncture-like TENS on Finger Control Gate -Patients with cervical sprain and postoperative pain of laminectomy- (전기수지자극의 통증관리효과 -척추후궁절제술 환자의 수술 후 통증과 경추부 염좌환자에 대한 통증관리효과-)

  • Lee, Sang-Hun;Kim, Seong-Kon;Woo, Nam-Sik;Lee, Ye-Chul;Chang, Sang-Keun;Kim, Sun-Bok
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.140-144
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    • 1996
  • Electrical stimulation is a common method for successful pain management for both acute and a some cases of chronic pain. The incidence of cervical sprain is very high with automobile accidents. Treatment of cervical sprain is consists of analgesic drugs and physical therapy. Lower back pain is a common problem in pain clinics. back pain management are complex, so we have difficulty to choose best treatment modality. The prevalence of herniated lumbar disc(HLD) is 1~3% of lower back pain. The cases of laminectomy varies between 10~20% and postoperative pain is prolonged for several day. We applied Acupuncture like TENS (ALTENS) on the digit for cervical sprain patients and post laminectomy pain patient for three days. The result was very satisfactory. And we found that total hospital days in ALTEND groups are shorter than control group in both disease entities. In conclusion, acupuncture like TENS on finger control gate is an effective method of the pain management.

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Case Report of Syringomyelia with Herniated Intervertebral Disc of Cervical Spine Treated by Korean Medicine Therapy (척수공동증과 경추 추간판 탈출증을 진단받은 환자에 대한 한방치료의 치험 1례 보고)

  • Jung, Bum-Hwan;Jo, Joo-Hyun;Choi, Seung-Peom;Na, Hyun-Wook;Kim, Kyung-Woon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.2
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    • pp.97-104
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    • 2013
  • Objectives : The purpose of this clinical case is to evaluate the efficacy of Korean Medicine treatment on Syringomyelia with Herniated Intervertebral Disc(HIVD) of C-SPINE. Methods : We used Acupunture, herbal acupuncture, herbal medicine for this patient. This patient received hospital treatment for 15 days. Results : Patient's chief complain were neck pain and trapezius pain. NRS of chief complaint decreased from 6 to 2 and Patient's NDI decreased from 46 to 14. Conclusions : We experienced improvement of symptoms in this case by acupuncture stimulation, herbal medicine. and we hope this study is helpful for the treatment of Syringomyelia with HIVD of C-SPINE.

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Unrecognized C1 Lateral Mass Fracture Without Instability: The Origin of Posterior Neck Pain

  • Seo, So-Jin;Kim, Hye-Rim;Choi, Eun-Joo;Nahm, Francis Sahn-Gun
    • The Korean Journal of Pain
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    • v.25 no.4
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    • pp.258-261
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    • 2012
  • Posterior neck pain is a common complaint of patients in the pain clinic. The atlas (C1) burst fracture is known to be a cause of posterior neck pain and instability. Although the atlas burst fracture and instability can be discovered by plain X-rays which show lateral mass displacement or widening of the atlantodental interval, assessment of an atlas burst fracture can be difficult if there is no instability in the imaging study. Here we report a case of a 46-year-old female patient who had complained of sustained posterior neck pain for 6 months. Plain X-rays showed only disc space narrowing at C4/5 and C5/6, without any cervical instability. However, an unrecognized C1 lateral mass fracture was detected by CT and MRI. The patient's pain was then successfully treated after atlantoaxial joint injection with a C2 DRG block.

The Treatment of a Droopy Shoulder Syndrome Patient -A case report- (Droopy Shoulder Syndrome 환자의 치료경험 -증례보고-)

  • Park, Eun Young;Shim, Jae Kwang;Rhee, Ho Dong;Kim, Won Oak;Yoon, Kyung Bong;Yoon, Duck Mi
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.296-298
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    • 2006
  • Droopy shoulder syndrome (DSS) is a rare disease, characterized by drooping shoulders, which stretches the brachial plexus, and causes pain, but without any signs of neurological impairment. These patients suffer from pain in the neck, shoulders, arms and hands, which result in long, graceful, swan necks, low-set shoulders, and horizontal or down sloping clavicles. No abnormalities in the vascular, neurological or electrical findings have also been known. The T1 and/or T2 bodies can be seen in the lateral view in a radiological study of the cervical spine. In the majority of cases, conservative treatments, such as postural correction and shoulder girdle strengthening exercise, are commonly recommended. However, DSS may be misdiagnosed as severe thoracic outlet syndrome or herniated cervical disc disease, leading to unnecessary and hazardous invasive treatments. The presented case was consistent with DSS, and was treated with stellate ganglion block, trigger point injection, and shoulder girdle strengthening exercise.

Effect of Cervical Interlaminar Epidural Steroid Injection: Analysis According to the Neck Pain Patterns and MRI Findings

  • Choi, Ji Won;Lim, Hyung Woo;Lee, Jin Young;Lee, Won Il;Lee, Eun Kyung;Chang, Choo Hoon;Yang, Jae Young;Sim, Woo Seog
    • The Korean Journal of Pain
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    • v.29 no.2
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    • pp.96-102
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    • 2016
  • Background: It is widely accepted that cervical interlaminar steroid injection (CIESI) is more effective in treating radicular pain than axial neck pain, but without direct comparison. And the differences of effect after CIESI according to MRI findings are inconsistent. In this retrospective study, we evaluated the therapeutic response of CIESI according to pain sites, durations, MRI findings, and other predictive factors altogether, unlike previous studies, which evaluated them separately. Methods: The medical records of 128 patients who received fluoroscopy guided CIESI were analyzed. We evaluated the therapeutic response (more than a 50% reduction on the visual analog scale [VAS] by their second visit) after CIESI by (1) pain site; neck pain without radicular pain/radicular pain with or without neck pain, (2) pain duration; acute/chronic (more than 6 month), and (3) findings of MRI; herniated intervertebral disc (HIVD)/spinal stenosis, respectively and altogether. Results: Eighty-eight patients (68%) responded to CIESI, and there were no significant differences in demographic data, initial VAS score, or laboratory findings. And there were no significant differences in the response rate relating to pain site, pain duration, or MRI findings, respectively. In additional analysis, acute radicular pain with HIVD patients showed significantly better response than chronic neck pain with spinal stenosis (P = 0.04). Conclusions: We cannot find any sole predictive factor of therapeutic response to the CIESI. But the patients having acute radicular pain with HIVD showed the best response, and those having other chronic neck pain showed the worst response to CIESI.

A Clinical Study on Patients with Traumatic Rupture of Intervertebral Disc Treated by Oriental Medicine Treatment in Combination with Soyeom Pharmacopuncture Therapy (추간판 외상성 파열 환자에 대한 소염약침 병행 치험 2례)

  • Lee, Hyung-Eun;Heo, Dong-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.241-256
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    • 2011
  • Objectives: This study is to observe the effect of oriental medicine treatment combined with Soyeom pharmacopuncture therapy on traumatic rupture of intervertebral disc patients caused by traffic accidents. Methods: The patients who have traumatic rupture in lumbar(L)-spine(case 1) and cervical(C)-spine(case 2) were treated by oriental medicine treatment in combination with Soyeom pharmacopunture therapy. VAS(visual analog scale), ROM(range of motion), and physical exam were checked on a daily basis while NDI(neck disability index) and ODI(Oswestry disability index) were examined for 3 times at 7 day interval. Results: 1. Fer 8-9 days from the admission day, the sole use of oriental medicine treatment did not make many improvements in the case of two patients' symptoms. After combining with Soyeom pharmacopuncture therapy, chief complaints were improved significantly. 2. In case 1, lumbago decreased from VAS 10 to VAS 5 and lumbar ROM got better than before. ODl score cropped from 42 to 27. 3. In case 2, left shoulder pain and nuchal pain lowered from VAS 10 to VAS 4, left upper limb numbness and weakness were improved, The patient showed nearly fun ROM. NDI score decreased from 26 to 19. Conclusions: Oriental medicine treatment in combination with Soyeom pharmacopuncture therapy is proved to be helpful to improve the symptoms of the traumatic rupture of intervertebral else patients caused by traffic accident.

A Clinical Survey of the Patients in Neuro-Pain Clinic at Ajou University (신경통증클리닉 환자의 1년간 통계고찰)

  • Park, Eun Jung;Han, Kyung Ream;Kim, Do Wan;Kim, Chan
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.181-185
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    • 2007
  • Background: The first pain clinic opened in korea in 1973 at Yonsei University Hospital, however, since then the number of pain clinics has gradually increased, as has the number of patients visiting them. This increase in patient has caused concerns about the way in which pain is managed, therefore, we conducted a retrospective review of data according to the sex, age and disease in an attept to aid us in planning for the future of our pain clinic. Methods: We analyzed 1,282 new patients who had visited our pain clinic and 828 inpatients who were admitted to our pain clinic between March 2006 and February 2007. Results: The most frequent age group was in the sixties in outpatient and in the seventies in inpatient. In addition, the incidence of disease in new patients and inpatients was as follows: in new patients, lumbar herniated intervertebral disc 16.5%, hyperhidrosis 12.3%, cervical disc disorder 10.5%, acute herpes zoster 8.2%, postherpetic neuralgia 7.9%, and trigeminal neuralgia 7.0%; in admitted patients, acute herpes zoster 17.6%, trigeminal neuralgia 15.6%, lumbar herniated intervertebral disc 13.0%, postherpetic neuralgia 11.2%, hyperhidrosis 9.8%, and complex regional pain syndrome 7.0%. Conclusions: The patients visiting our pain clinic have presented with a wide variety of diseases. This improved care reflects an effort to expand our fields not only to the management of outpatients but also inpatients, as well as to the treatment of new fields of disease. In the future, We need to manage various pain patients not only in outpatients but also in inpatients to expand our field even through pain clinic is rapidly growing in Korea.