• Title/Summary/Keyword: Cervical disc

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Testing Evaluation for Stand-Alone Cervical Cage (경추용 자립형 케이지의 실험적 평가)

  • Baek, Myong-Hyun;Lee, Mun-Hwan
    • Journal of the Korean Society for Precision Engineering
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    • v.33 no.11
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    • pp.937-941
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    • 2016
  • Stand-alone cervical cage consists of a PEEK body, Ti plate, and screw, which are configured as a single-piece. Through a single operation, this implantable medical device is capable of completely fixing the cervical vertebral body. For example, instead of a plate, which is normally used, the intervertebral disc is removed and replaced with a cervical cage. It should be noted that in Korea, KFDA guidelines for a stand-alone cervical cage have not yet been suggested. Therefore, the aim of this study is to present the systematic study of the static compression test, static torsion test, dynamic compression test, and expulsion test. Further, the test method is designed to refer to the ASTM standard and relative literature.

Magnetic Resonance Imaging Follow-up Study on Five Cases of HIVD-Cervical Spine Patients Treated with Oriental Medical Treatment (한의학적 치료로 호전된 경추추간판탈출증 환자의 영상의학적 변화 5례)

  • Moon, Ja-Young;Song, Joo-Hyun;Lim, Myung-Jang;Kang, In;Lee, Hyo-Eun;Cho, Jae-Hee;Kim, Hak-Jae;Jang, Hyoung-Seok
    • Journal of Acupuncture Research
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    • v.24 no.5
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    • pp.229-240
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    • 2007
  • Objectives : The purpose of this study is to report the image changes of five cases of Cervical intervertebral disc Herniation after Oriental medicine Treatment. Patient & Methods : We examined 5 patients with Cervical intervertebral disc Herniation (HIVD of C-spine) who showed changes on MRI images before/after the treatment among HIVD of C-spine patients who visited Cervical Spine center, Jaseng Hospital of Oriental Medicine from March, 2006 to May, 2007. Results & Conclusions : In this study, the first MRI examination of HIVD of C-spine patients was performed at the first visit and re-examination of MRI was done after the treatment. We assessed clinical symptoms by using Numerical rating scales(NRS). In each case, the size of the disc herniation was considerably reduced in MRI image. NRS was also reduced significantly.

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The Comparative Study on the Effect of Bee Venom Pharmacopuncture Treatment and Hwangryun Pharmacopuncture Treatment of Cervical Disc Herniation (경추 추간판 탈출증 환자의 봉약침치료와 황련약침치료에 대한 비교 연구)

  • Park, So Hyun;Ro, Hae Rin;Kim, Tae Ho;Park, Jae Young
    • Journal of Acupuncture Research
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    • v.30 no.3
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    • pp.117-124
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    • 2013
  • Objectives : This study was designed to compare the effect of bee venom pharmacopuncture treatment and Hwangryun pharmacopuncture treatment in patients with cervical disc herniation Methods : This study was done on 48 cases of patients with cervical disc herniation diagnosed by MRI, symptoms and physical test who admitted in Bu-cheon Jaseng Hospital of Oriental Medicine from January 1st, 2012 to August 31th, 2012. We divided patients into two groups. Bee venom group was treated by bee venom pharmacopuncture treatment and Hwangryun group was treated by Hwangryun pharmacopuncture treatment. We measured the efficacy of treatment with numerical rating scale(NRS) and neck disability index(NDI). The evaluations performed at admission day and 14th day after admission. Results : In both bee venom group and Hwangryun group, NRS and NDI decreased significantly in statistics as treatment was performed. Though bee venom group showed a decreasing NRS and NDI score compared to Hwangryun group, there is no statistical significant difference between the result of both groups. Conclusions : The result of this study suggest that both bee venom pharmacopuncture treatment and Hwangryun pharmacopuncture treatment is effective in reducing pain for patients with cervical disc herniation. Further clinical research is needed to verify these results and findings.

Analysis of Surgical Treatment and Factor Related to Closed Reduction Failure for Patients with Traumatically Locked Facets of the Subaxial Cervical Spine (축추 이하 경추손상 환자에서 외상성 탈구에 의한 도수 정복의 실패 요인의 분석과 수술적 치료에 대한 분석)

  • Paeng, Sung Hwa
    • Journal of Trauma and Injury
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    • v.25 no.1
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    • pp.7-16
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    • 2012
  • Purpose: Cervical dislocations with locked facets account for more than 50% of all cervical injuries. Thus, investigating a suitable management of cervical locked facets is important. This study examined factors of close reduction failure in traumatically locked facets of the subaxial cervical spine patients to determine suitable surgical management. Methods: We retrospectively analyzed of the case histories of 28 patients with unilateral/bilateral cervical locked facets from Nov. 2004 to Dec. 2010. Based on MRI evaluation of disc status at the injury level, we found unilateral dislocations in 9 cases, and bilateral dislocations in 19 cases, The patients were investigated for neurologic recovery, closed reduction rate, factors of the close reduction barrier, fusion rate and period, spinal alignment, and complications. Results: The closed reduction failed in 23(82%) patients. Disc herniation was an obstacle to closed reduction (p=0.015) and was more frequent in cases involving a unilateral dislocation (p=0.041). The pedicle or facet fracture was another factor, although some patients showed aggravation of neurologic symptoms, most patients had improved by the last follow up. The kyphotic angle were statistically significant (p=0.043). Sixs patient underwent anterior decompression/fusion, and 15 patients underwent circumferential fusion, and 7 patients underwent posterior fusion. All patients were fused at 3 months after surgery. The complications were 1 case of CSF leakage and 1 case of esphageal fistula, 1 case of infection. Conclusion: We recommend closed reduction be performed as soon as possible after injury to maximize the potential for neurological recovery. Patients fot whom closed reduction of the cervical locked facets have a higher incidence of anatomic obstacles to reduction, including facet fractures and disc herniation. Immediate direct open anterior reduction or circumferential fixation/fusion of locked cervical facets is recommended as a treatment of choice for traumatic locked cervical facet patients after closed reduction failure.

New Technical Tip for Anterior Cervical Plating : Make Hole First and Choose the Proper Plate Size Later

  • Park, Jeong-Yoon;Zhang, Ho-Yeol;Oh, Min-Chul
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.212-216
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    • 2011
  • Objective : It is well known that plate-to-disc distance (POD) is closely related to adjacent-level ossification following anterior cervical plate placement. The study was undertaken to compare the outcomes of two different anterior cervical plating methods for degenerative cervical condition. Specifically, the new method involves making holes for plate screws first with an air drill and then choosing a plate size. The other method was standard, that is, decide on the plate size first, locate the plate on the anterior vertebral body, and then drilling the screw holes. Our hypothesis was that the new technical tip may increase POD as compared with the standard anterior cervical plating procedure. Methods : We retrospectively reviewed 49 patients who had a solid fusion after anterior cervical arthrodesis with a plate for the treatment of cervical disc degeneration. Twenty-three patients underwent the new anterior cervical plating technique (Group A) and 26 patients underwent the standard technique (Group B). POD and ratios between POD to anterior body heights (ABH) were measured using postoperative lateral radiographs. In addition, operating times and clinical results were reviewed in all cases. Results : The mean durations of follow-up were $16.42{\pm}5.99$ (Group A) and $19.83{\pm}6.71$ (Group B) months, range 12 to 35 months. Of these parameters mentioned above, cephalad POD (5.43 versus 3.46 mm, p=0.005) and cephalad POD/ABH (0.36 versus 0.23, p=0.004) were significantly greater in the Group A, whereas operation time for two segment arthrodesis (141.9 versus 170.6 minutes, p=0.047) was significantly lower in the Group A. There were no significant difference between the two groups in caudal POD (5.92 versus 5.06 mm), caudal POO/ABH (0.37 versus 0.32) and clinical results. Conclusion : The new anterior cervical plating method represents an improvement over the standard method in terms of cephalad plate-to-disc distance and operating time.

A Comparison of Anterior Cervical Discectomy and Fusion versus Fusion Combined with Artificial Disc Replacement for Treating 3-Level Cervical Spondylotic Disease

  • Jang, Seo-Ryang;Lee, Sang-Bok;Cho, Kyoung-Suok
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.676-683
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    • 2017
  • Objective : The purpose of this study is to evaluate the efficacy and safety of 3-level hybrid surgery (HS), which combines fusion and cervical disc replacement (CDR), compared to 3-level fusionin patient with cervical spondylosis involving 3 levels. Methods : Patients in the anterior cervical discectomy and fusion (ACDF) group (n=30) underwent 3-level fusion and the HS group (n=19) underwent combined surgery with fusion and CDR. Clinical outcomes were evaluated using the visual analogue scale for the arm, the neck disability index (NDI), Odom criteria and postoperative complications. The cervical range of motion (ROM), fusion rate and adjacent segments degeneration were assessed with radiographs. Results : Significant improvements in arm pain relief and functional outcome were observed in ACDF and HS group. The NDI in the HS group showed better improvement 6 months after surgery than that of the ACDF group. The ACDF group had a lower fusion rate, higher incidence of device related complications and radiological changes in adjacent segments compared with the HS group. The better recovery of cervical ROM was observed in HS group. However, that of the ACDF group was significantly decreased and did not recover. Conclusion : The HS group was better than the ACDF group in terms of NDI, cervical ROM, fusion rate, incidence of postoperative complications and adjacent segment degeneration.

Rare Intractable Cervicalgia Related to Exaggerated Disc Height Distraction : Report of Two Cases and Literature Review

  • Choi, Man Kyu;Kim, Sung Bum;Lee, Jun Ho
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.530-536
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    • 2018
  • We present two cases of unexpected postoperative intractable cervicalgia due to over-sized implant insertion during simple anterior cervical decompression and fusion (ACDF) or artificial disc replacement (ADR). These patients experienced severe cervicalgia mostly related to their neck motion even after standard cervical operations. In both cases, the restored disc heights after the operations were prominently greater than the preoperative disc heights. The patients had not responded to any of the conservative treatments, and unloading of these excessively distracted segments through ultimate revision surgery led to dramatic pain relief. This report emphasizes the increase in distractional forces that takes place after a standard ACDF or ADR, as well as the importance of a proper sized implant. It also includes the reviews of other biomechanical or clinical reports dealing with this issue, thereby cautioning the surgeons not to disregard these factors, which might have an adverse effect in patients with cervicalgia even after radiographically successful cervical procedures.

Magnetic Resonance Imaging for Each Type of Herniated Cervical Intervertebral Disc (경추 추간판 탈출증의 유형별 자기공명영상 소견)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.23 no.2
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    • pp.21-26
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    • 2000
  • The classification of herniated intervertebral cervical disc types are clinically important, as treatment methods would be slightly different according to the specific type of the herniated disc. 423 patients who suffered from herniated intervertebral cervical discs were tested with Magnetic Resonance Imaging (MRI), to distinguish the type of the herniated discs. The followings are the results ; 1) The age of the patients tested ranged from 16 to 75 years old and the mean age of the patients was 41.4 years of age. 2) There were twice as many male patients, with a ratio of 288 : 135 men to women. 3) 101 patients suffered from single herniated discs, while 322 patients suffered from multi-herniated discs. 4) Of single herniated disc injuries, 52 patients had protruded discs (52%), while 25 patients had extruded discs (25%). 21 Patients (21%) had herniated intervertebral discs between $C_4{\sim}C_5$, and 51 patients (50%), and had the same injury between $C_5$ and $C_6$. 5) Of multi-herniated disc injuries, 140 patients had protruded discs(44%). while 45 patients had extruded discs (14%). 54 patients had both protruded and extruded discs(17%). 36 patients(11%), herniated discs $C_3{\sim}C_6$ ; 69 patients (21%), herniated discs $C_3{\sim}C_7$ ; 47 patients(15%) herniated discs $C_4{\sim}C_6$ and 67 patients(20%) herniated discs $C_5{\sim}C_7$.

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Spontaneous Regression of a Radiculopathic Cervical Herniated Disc following Non-surgical Treatment -3 case reports- (비수술적 치료 후 자연소실된 경추추간판탈출증 -증례보고-)

  • Kim, Hyeun Sung;Jo, Dae Hyun;Park, In Ho;Rhu, Jae Kwang;Sun, Kwang Jin;Lim, Kyung Joon
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.84-88
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    • 2008
  • The spontaneous regression of herniated cervical discs is not a well established phenomenon. However, we encountered the 3 cases of spontaneous regression of severe radiculopathic herniated cervical discs that were treated using a non-surgical method. Each of the patients were treated with a combination of manipulation, dry needling and analgesics. In each case, the symptoms improved within 12 months of treatment and magnetic resonance imaging (MRI) conducted at that time revealed marked regression of the herniated disc in all cases. These cases provide additional examples of spontaneous regression of herniated cervical discs documented by MRI following non-surgical treatment.

The Effects of Proprioceptive Neuromuscular Facilitation for Pain, Grip Strength on Cervical Herniated Intervertebral Disc (HIVD) (고유수용성신경근촉진법이 경추추간판탈출증 환자의 통증 및 손의 악력에 미치는 효과)

  • Kim, Jae-Young;Kim, Min-Soo;Kim, Jwa-Jun
    • PNF and Movement
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    • v.13 no.3
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    • pp.145-153
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    • 2015
  • Purpose: The current study aims to identify the effects of proprioceptive neuromuscular facilitation (PNF) on pain and grip strength in patients with cervical herniated intervertebral disc (HIVD) and provide effective interventions for such patients. Methods: Included in this study were 20 subjects (10 men, 10 women) in their 30s-50s who had been diagnosed with cervical HIVD. Intervention methods included PNF neck patterns, dynamic reversal of antagonists, and a combination of isotonics. The visual analogue scale (VAS) was used to measure pain and dynamometers were used to measure grip strength. Results: After four weeks of muscle strengthening exercises, neck pain was significantly reduced, and hand grip strength significantly increased. Conclusion: PNF can be utilized as an effective intervention to reduce the pain of patients with cervical HIVD and to increase grip strength.