• Title/Summary/Keyword: Cervical disc

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Morphometric Study of the Nerve Roots Around the Lateral Mass for Posterior Foraminotomy

  • Hwang, Jae-Chan;Bae, Hak-Geun;Cho, Sung-Won;Cho, Sung-Jin;Park, Hyung-Ki;Chang, Jae-Chil
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.358-364
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    • 2010
  • Objective : Morphometric data on dorsal cervical anatomy were examined in an effort to protect the nerve root near the lateral mass during posterior foraminotomy. Methods : Using 25 adult formalin-fixed cadaveric cervical spines, measurements were taken at the lateral mass from C3 to C7 via a total laminectomy and a medial one-half facetectomy. The morphometric relationship between the nerve roots and structures of the lateral mass was investigated. Results from both genders were compared. Results : Following the total laminectomy, from C3 to C7, the mean of the vertical distance from the medial point of the facet (MPF) of the lateral mass to the axilla of the root origin was 3.2-4.7 mm. The whole length of the exposed root had a mean of 4.2-5.8 mm. Following a medial onehalf facetectomy, from C3 to C7, the mean of the vertical distance to the axilla of the root origin was 2.1-3.4 mm, based on the MPF. Mean vertical distances from the MPF to the medial point of the root that crossed the inferior margin of the intervertebral disc were 1.2-2.7 mm. The mean distance of the exposed root was 8.2-9.0 mm, and the mean angle between the dura and the nerve root was significantly different between males and females, at $53.4-68.4^{\circ}$. Conclusion : These data will aid in reducing root injuries during posterior cervical foraminotomy.

Comparative Study of Clinical and Radiological Outcomes of a Zero-Profile Device Concerning Reduced Postoperative Dysphagia after Single Level Anterior Cervical Discectomy and Fusion

  • Son, Doo Kyung;Son, Dong Wuk;Kim, Ho Sang;Sung, Soon Ki;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.103-107
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    • 2014
  • Objective : This study analyzed clinical and radiological outcomes of a zero-profile anchored spacer (Zero-P) and conventional cage-plate (CCP) for single level anterior cervical discectomy and fusion (ACDF) to compare the incidence and difference of postoperative dysphagia with both devices. Methods : We retrospectively reviewed our experiences of single level ACDF with the CCP and Zero-P. From January 2011 to December 2013, 48 patients who had single level herniated intervertebral disc were operated on using ACDF, with CCP in 27 patients and Zero-P in 21 patients. Patients who received more than double-level ACDF or combined circumferential fusion were excluded. Age, operation time, estimated blood loss (EBL), pre-operative modified Japanese Orthopaedic Association (mJOA) scores, post-operative mJOA scores, achieved mJOA scores and recovery rate of mJOA scores were assessed. Prevertebral soft tissue thickness and postoperative dysphagia were analyzed on the day of surgery, and 2 weeks and 6 months postoperatively. Results : The Zero-P group showed same or favorable clinical and radiological outcomes compared with the CCP group. Postoperative dysphagia was significantly low in the Zero-P group. Conclusions : Application of Zero-P may achieve favorable outcomes and reduce postoperative dysphagia in single level ACDF.

Neuralgic Amyotrophy Considered as Cervical Radiculopathy -A case report- (경추부 신경근병증으로 오인된 신경통성 근위축증 -증례보고-)

  • Park, Chan Do;Kim, Joon Woo;Choi, Jong Beom;Lee, Min Jung;Moon, Jee Youn;Lee, Pyung Bok
    • The Korean Journal of Pain
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    • v.22 no.2
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    • pp.171-175
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    • 2009
  • Neuralgic amyotrophy is a syndrome with a broad range of clinical manifestations. It is characterized by acute, severe pain in the shoulder or arm lasting several days or weeks, followed by muscle weakness and atrophy as the pain diminishes. The diagnosis is based on typical clinical features, electromyography (EMG) and a nerve conduction study. The early and correct diagnosis is important to preclude unnecessary testing or surgical procedures. A 59-year-old female patient presented with pain and weakness involving her right palm and 1 3rd fingers. Three weeks before presentation, she noted the sudden onset of severe right shoulder and forearm pain. After the pain was reduced, she noted persistent right palm and 1-3rd finger pain and weakness. On cervical MRI, there was a mild central disc protrusion at C4 5 and C5 6. Electrodiagnostic testing was performed and she was diagnosed with neuralgic amyotrophy. One week after hospital treatment, her pain was relieved from VAS 10 to 3 and she was discharged with mild weakness of the thumb and index finger during pinch grips.

A CONFOCAL MICROSCOPIC STUDY ON DENTINAL INFILTRATION OF ONE-BOTTLE ADHESIVE SYSTEMS AND SELF-ETCHING PRIMING SYSTEM BONDED TO CLASS V CAVITIES (제 5급 와동에서의 단일용기 상아질 접착제와 자가 산부식 접착제의 상아질에 대한 침투도 평가)

  • Kim, Hyung-Su;Park, Sung-Ho
    • Restorative Dentistry and Endodontics
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    • v.27 no.3
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    • pp.257-269
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    • 2002
  • Objective : The purpose of this study was to evaluate the resin infiltration into dentin of one-bottle adhesive systems and self-etching primer bonded to Class V cavities using confocal laser scanning microscope(CLSM). Material and Methods : Forty Class V cavities were prepared from freshly extracted caries-free Human teeth. These teeth were divided into two groups based on the presence of cervical abrasion: Group I, cervical abrasion : Group II, wedge-shaped cavity preparation. Resin-dentin interfaces were produced with two one-bottle dentin bonding systems-ONE COAT BOND(OCB; Coltene$^R$) and Syntac$^R$SPrint$^{TM}$(SS; VIVADENT)-, one self-etching priming system-CLEARFIL$^{TM}$ SE BOND (SB : KURARAY)- and one multi-step dentin bonding system-Scotchbond$^{TM}$Multi-Purpose (SBMP, 3M Dental Products)-as control according to manufacturers' instructions. Cavities were restored with Spectrum$^{R}$(Dentsply). Specimens were immersed in saline for 24 hours and sectioned longitudinally with a low-speed diamond disc. The resin-dentin interfaces were microscopically observed using CLSM. The quality of resin-infiltrated dentin layers were evaluated by five dentists using 0~4 scale. Results : Confocal laser scanning microscopal investigations using primer labeled with rhodamine B showed that the penetration of the primer occurred along the cavity margins. Statistical analysis using one-way ANOVA followed by Duncan's Multiple Range test revealed that the primer penetration of the group 2(wedge-shaped cavity preparation) was more effective than group 1(cervical abrasion) and that of the gingival interfaces was more effective than the occlusal interfaces. In the one-bottle dentin bonding systems, the resin penetration score of OCB was compatible to SBMP, but those of SS and self-etching priming system, SB were lower than SBMP.

A Study of Radiation Incidence Angle in Cervical Vertebra Anteroposterior(AP) Examination by Position (자세에 따른 목뼈 정면 입사각에 대한 연구)

  • Kwak, Jonghyeok
    • Journal of the Korean Society of Radiology
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    • v.9 no.2
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    • pp.101-107
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    • 2015
  • In anteroposterior radiation test for cervical vertebra, it is general that the incidence angle of X-ray is $15^{\circ}$ to $20^{\circ}$ degrees to head regardless of position. So this study suggests appropriate incidence angle of cervical vertebra depended on the position. From 1 January 2013 to 31 December 2013, cervical spine radiographys and magnetic resonance imaging was performed in 107 people who visited P Hospital located in Pusan. Among them, 39 people(men 24, women 15) were below 80 above 20 years old(average age 54 years) with normal cervical lordosis(normal $40^{\circ}{\pm}5^{\circ}$). In erect position, the incidence angle of cervical vertebra is measured from lateral radiographic images. And in supine position, it measured from MRI sagittal images. Results based on gender, the incidence angle of cervical vertebra in erect position was $25.9^{\circ}$ for men, women was $23.1^{\circ}$, showed statistically significant (p<0.05). And the angle in supine was $11.6^{\circ}$ for men, women was $12.6^{\circ}$, showed not statistically significant (p>0.05) An analysis of age group shows, the incidence angle of cervical vertebra in erect position was $24.6^{\circ}$ under 50, and $25.0^{\circ}$ over 50. The angle in supine was $12.0^{\circ}$ under 50, and $11.9^{\circ}$ over 50. And all of them showed not statistically significant (p>0.05). At all ages, the average of incidence angles in erect position were $24.8^{\circ}$, and the angle in supine was $12.0^{\circ}$, showed statistically significant (p<0.05). The cervical vertebra incidence angle for X-ray was $15^{\circ}$ to $20^{\circ}$ degrees to head in general. But, through the results, it is recommended that the angle is $24.8^{\circ}$ in erect and $12.0^{\circ}$ in supine position. It could be shown true anteroposterior(AP) view of cervical vertebra and accurate intervertebral fusion fixing devices.

The Human Spine Mechanical Properties Database for Korean (한국인 척추 연구를 위한 물성 정보 구축)

  • Kwak, dai-soon;Lee, seung-bock;Lee, sang-ho;Han, seung-ho
    • Proceedings of the Korea Contents Association Conference
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    • 2011.05a
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    • pp.259-260
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    • 2011
  • 한국과학기술정보연구원과 가톨릭대학교 의과대학 가톨릭응용해부연구소에서는 기초기술연구회 National agenda project 일환으로 척추 연구자들이 쉽게 사용할 수 있는 기초 자료를 구축하고 있다. 척추 관련 컴퓨터 시뮬레이션 연구에 활용할 수 있는 모델 제작을 위한 형상 정보와 물리적 성질 정보를 구축하고 있다. 물리적 성질 정보 구축은 60대, 70대 기증시신 10여 표본을 활용하여 척추뼈의 임상적, 물리적 골밀도를 측정하고, 목척추(cervical vertebra), 등척추(thoracic vertebra), 허리척추(lumbar vertebra) 부분의 굽힘-폄(flexion-extension) 시험, 가쪽 굽힘(lateral bending) 시험, 회전(torsion), 압축(body/disc compression) 시험을 수행하여 작용력과 굽힘량의 관계를 구축하고 있다. 구축된 물성 시험 결과는 형상 모델과 함께 제공되어 자료의 활용도를 높이고 있으며, 이를 이용하여 한국인 특성이 반영된 척추 관련 연구 및 제품 개발에 활용될 수 있다.

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Characteristiis of Dynamic Response in the Human Head and Neck to Implusive Loading (충격력에 대한 인체의 머리와 목의 동력학적 응답특성)

  • 김영은;김정훈
    • Journal of Biomedical Engineering Research
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    • v.16 no.4
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    • pp.491-498
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    • 1995
  • A numerical human head/neck model was constructed for analyzing the implication in decleration injuries. This model consists of nine rigid bodies representing the head, cervical vertebrae C1-C7, and T1. These rigid bodies were connected by intervertebral disks described by massless beam elements. Muscles and ligaments were also incoperated in the model represented by nonlinear spring and viscoblastic element respectively Agreement of the analytical kinematic response with the results of experimental data from a volunteer run was satisfactory. Moreover, possible injury estimation from the calculated moment, force variations in the disc, and force variation in ligaments matched well with clinical observations.

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Diagnostic and Therapeutic Utility of Ultrasonography-guided Facet Joint Block in Chronic Cervical Spinal Pain (만성 경추 동통 환자에서 초음파를 이용한 후관절 차단술의 진단 및 치료적 유용성)

  • Kim, Tae Kyun;Shim, Dae Moo;Oh, Sung Kyun;Choi, Byong San;Han, Sang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.54-58
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    • 2010
  • Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

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Treatment of Canine Cervical and Lumbar Disc Disease by Injection-Acupuncture (개 경부 및 요부 디스크의 수침치료)

  • Kim Duck-Hwan;Liu Jian-Zhu;Lee Young-Won;Song Kun-Ho;Kang Sang-Kyu;Choi Ho-Jung;Seo Kang-Moon;Choi Seok-Hwa;Nam Tchi-Chou;Rogers Phil A.M.
    • Journal of Veterinary Clinics
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    • v.23 no.1
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    • pp.65-68
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    • 2006
  • Two cases of canine intervertebral disc disease (IVDD) were treated twice a week with injection-acupuncture (injection-AP) using 0.1 ml/acupoint. In case 1, a paralysed dog with cervical intervertebral disc disease (C3-C4), was submitted to injection-AP with dexamethasone (1 mg/ml) at session 1-2 and thiamine (25 mg/ml) at session 3-5. Injected acupoints included GV-16, GB-20, BL-10, LU-7, LI-4 and SI-6. The acupoints GV-6, GV-20 and SP-6 were added at session 2-5. Trigger point (TP) therapy with 0.2 ml of 2% lidocaine was used in session 3-5 at TP in the infraspinatus and triceps muscles. Treatment was stopped when paralysis disappeared after 5 injection-AP treatments; there were no recurrent symptoms in the follow-up period of 5 months. In case 2, an ataxic dog with lumbar IVDD (L1-L2), was submitted to injection-AP with dexamethasone at session 1 and 2 and thiamine at session 3-4. Injected acupoints included GV-6 as the main point, ST-36, GB-30, ST-40, GB-34, ST-41 and BL-40. TP therapy with 0.2 ml of 2% lidocaine was used at TP in the ileocostorum lumborum and quadriceps muscles. Treatment was stopped when ataxia disappeared after 4 treatments; there were no recurrent symptoms In the fallow-up period of 5 months. Injection-AP using dexamethasone and thiamine, combined with TP therapy using lidocaine, effectively alleviate the symptoms of canine cervical and lumbar IVDD.

A Statistical Study of the Patients Admitted to the Department of Acupuncture and Moxibustion Medicine (침구의학과에 입원한 환자들에 대한 통계적 고찰)

  • Lee, Chang-Woo;Lee, Seung-Min;Jeon, Ju-Hyun;Kim, Young-Il;Nam, Seung-Kyu;Kim, Jung-Ho
    • Journal of Acupuncture Research
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    • v.29 no.5
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    • pp.139-149
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    • 2012
  • Objectives : The aim of this study was to investigate clinical features of the patients admitted to the department of acupuncture and moxibustion in an oriental medicine hospital in order to provide clinical preliminary data for advancement of acupuncture and moxibustion Methods : Total 526 patients were admitted to the department of Acupuncture and Moxibustion in Dunsan Oriental Hospital of Daejeon University from September 1st, 2011 to August 31st, 2012. Of these patients 11 were discharged on the day that they were admitted and the remaining 526 patients who were hospitalized for over 2 days were investigated this study. We analyzed inpatients by discharge progress notes and medical records, using PASW statistics 18.0 for statistical analysis. Results : 1. There were 361 females(62.9%) and 213 males(37.1%). The age distribution was skewed to 40s and 50s and the average age of the patients was 42.91 years. 2. The prevalence of the diseases groups was in the order of musculoskeletal disease, neuromuscular disease, neuro-psychological disease, and EENT disease. The musculoskeletal disease and neuromuscular disease together made up 92% of all diseases. 3. The prevalence of individual diagnosis was in the order of Bell's palsy, cervical sprain, lumbar sprain, herniated lumbar disc, herniated cervical disc, and lumbar spinal stenosis. 4. There were 261 patients with single diagnosis and 193 with two and 120 with three or more diagnoses. The days of hospitalization significantly increased with the number of diseases the patients were diagnosed with. Conclusions : With high concentration of patients seen in certain disease groups, continuous efforts needed to expand the usage of acupuncture and moxibustion treatments to other disease groups and to explore and develop other diverse treatment methods for better outcome of the disease treated.