• Journal of Korean Neurosurgical Society
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• v.60 no.4
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• pp.433-440
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• 2017

Objective : Although minimally invasive posterior cervical foraminotomy (MI-PCF) is an established approach for motion preservation, the outcomes are variable among patients. The objective of this study was to identify significant factors that influence motion preservation after MI-PCF. Methods : Forty-eight patients who had undergone MI-PCF between 2004 and 2012 on a total of 70 levels were studied. Cervical parameters measured using plain radiography included C2-7 plumb line, C2-7 Cobb angle, T1 slope, thoracic outlet angle, neck tilt, and disc height before and 24 months after surgery. The ratios of the remaining facet joints after MI-PCF were calculated postoperatively using computed tomography. Changes in the distance between interspinous processes (DISP) and the segmental angle (SA) before and after surgery were also measured. We determined successful motion preservation with changes in DISP of ${\leq}3mm$ and in SA of ${\leq}2^{\circ}$. Results : The differences in preoperative and postoperative DISP and SA after MI-PCF were $0.03{\pm}3.95mm$ and $0.34{\pm}4.46^{\circ}$, respectively, fulfilling the criteria for successful motion preservation. However, the appropriate level of motion preservation is achieved in cases in which changes in preoperative and postoperative DISP and SA motions are 55.7 and 57.1%, respectively. Based on preoperative and postoperative DISP, patients were divided into three groups, and the characteristics of each group were compared. Among these, the only statistically significant factor in motion preservation was preoperative disc height (Pearson's correlation coefficient=0.658, p<0.001). The optimal disc height for motion preservation in regard to DISP ranges from 4.18 to 7.08 mm. Conclusion : MI-PCF is a widely accepted approach for motion preservation, although desirable radiographic outcomes were only achieved in approximately half of the patients who had undergone the procedure. Since disc height appears to be a significant factor in motion preservation, surgeons should consider disc height before performing MI-PCF.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.243-250
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• 2018

Objective : To compare the morphometry of subaxial cervical spine between cerebral palsy (CP) and normal control. Methods : We retrospectively analyzed 72 patients with CP, as well as 72 patients from normal population. The two groups were matched for age, sex, and body mass index. Pedicle, lateral mass (LM), and vertebral foramen were evaluated using computed tomography (CT) imaging. Pedicle diameter, LM height, thickness, width and vertebral foramen asymmetry (VFA) were measured and compared between the two groups. Cervical dynamic motion, disc and facet joint degeneration were investigated. Additionally, we compared the morphology of LM between convex side and concave side with cervical scoliotic CP patients. Results : LM height was smaller in CP group. LM thickness and width were larger in CP group at mid-cervical level. In 40 CP patients with cervical scoliosis, there were no height and width differences between convex and concave side. Pedicle outer diameter was not statistically different between two groups. Pedicle inner diameter was significantly smaller in CP group. Pedicle sclerosis was more frequent in CP patients. VFA was larger in CP group at C3, C4, and C5. Disc/facet degeneration grade was higher in the CP group. Cervical motion of CP group was smaller than those of the control group. Conclusion : LM morphology of CP patients was different from normal population. Sclerotic pedicles and vertebral foramen asymmetry were more commonly identified in CP patients. CP patients were more likely to demonstrate progressive disc/facet degeneration. This data may provide useful information on cervical posterior instrumentation in CP patients.

• International Journal of Advanced Culture Technology
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• v.12 no.3
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• pp.165-169
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• 2024

The neck disc is a disease in which the nucleus of the cervical spine escapes between the cervical vertebrae and the intervertebral disc, pressing on the nerve, The neck disc has a high recurrence. If the neck disc is left untreated, the symptoms will worsen and cause inconvenience to life. Therefore, this study is to carry out a successful approach for non-pharmaceutical treatment of neck disc patients. The paper conducted a survey of 102 people who visited the orthopedics of a general hospital at K area from January 15 to March 28, 2024. Symptoms and changes in practice of neck disc were analyzed by t-test. The results of the research are as follows. Firstly, in the case of incorrect sitting posture, 74.5% of the case group was significantly higher than 33.3% of the control group((X²=3.79, p<.01). Secondly, neckache was significantly higher than the control group's average of 12.73 points, with an average of 39.86 points in the case group(t=3.14, p<.01). Thirdly, leg numbness tended to decrease from 7 days after non-drug application compared to before non-drug application. Therefore, the application of this non-drug management was found to be effective in relieving neck disk. The findings derived will contribute to providing valuable insights into the prevention and treatment of neck disc.

• Korean Journal of Radiology
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• v.23 no.6
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• pp.638-648
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• 2022

Objective: The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. Materials and Methods: C3-C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2-C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 - evening T2)/morning T2 x 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. Results: T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). Conclusion: This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.4
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• pp.131-143
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• 2011

Objectives: The purpose of this study is to make a survey of the effectiveness of the non surgical spinal decompression treatment in patients with cervical disc herniation documented on magnetic resonance imaging(MRI). Methods: We studied about 27 cases of cervical disc herniation which were treated with non surgical spinal decompression and other medical treatment (acupuncture, interferential current therapy and ice poultice). Each patient has been treated with spine decompression and other medical treatment. And degree of improvement has been evaluated by short form-McGill pain questionnaire(SF-MPQ), visual analogue scale(VAS) and neck disability index(NDI) before treatment and 5th, 10th times after treatments. Results: 1. The VAS SF-MPQ and NDI scores showed statistically significant improvement after 5th and 10th treatment. 2. The VAS, SF-MPQ and NDI scores after 5th treatment showed better improvement than those of after 10th treatment. 3. The VAS, SF-MPQ and NDI scores in Subacute stage showed more statistically significant improvement among the other stages. Conclusions: As a result, non surgical spinal decompression treatment has clinical effects of pain reduction on patient with cervical disc herniation.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.271-274
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• 2005

Cervical radicular pain has been recognized as a common cause of neck, shoulder and arm pain. The initial recommended therapy is based on the medical treatment by anti-inflammatory, analgesic agents, rest, traction and physical therapy. In the case of failure with these therapies, the classical alternative is a surgical discectomy, but this is associated with numerous risks inherent to invasive procedures. As a result, a number of percutaneous intradiscal therapies have developed over the last 3 decades, which have specifically focused on the pathology of the disc. However, these treatments have considerable limitations and success rates, and none allow for the extraction of a quantifiable amount of nucleus pulposus via a 17 gauge introducer using fluoroscopic guidance alone. Herein, we describe our experience using a $Dekompressor^{(R)}$ on a 52 year-old female patient with a cervical disc herniation. Percutaneous decompression in the treatment of cervical disc herniation was successfully performed, with a good outcome.

• Journal of Acupuncture Research
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• v.38 no.3
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• pp.227-232
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• 2021

Background: The purpose of this study was to statistically analyze the treatment effect and patient satisfaction of traditional Korean medicine, including acupotomy treatment of cervical herniated intervertebral disc. Methods: This was a retrospective study of 22 patients who received traditional Korean medicine including acupotomy treatment amongst all patients diagnosed with cervical herniated intervertebral discs at the Korean Medicine hospital in Daejeon, Korean, from January 01, 2020 to April 30, 2021. The clinical data from patient medical records were statistically analyzed. Results: The Numeric Rating Scale, the European Quality of Life 5 Dimensions, and the European Quality of Life Visual Analogue Scale questionnaire scores were each compared before and after traditional Korean medicine treatment, including acupotomy, showed significantly improved scores after treatment (p < 0.001). Out of a total of 22 patients, 11 rated the treatment "very satisfactory" (50%), 5 "satisfactory" (22.7%), 5 "indifferent" (22.7%), 1 "unsatisfactory" (4.5%), and 0 "very unsatisfactory" (0%). Of the total 22 patients, 17 patients (77.3%) were willing to have further treatment, and 5 patients (22.7%) were not willing. Conclusion: Traditional Korean medicine treatment including acupotomy was an effective treatment for cervical herniated intervertebral discs. To determine the effect of an individual application (e.g., acupotomy) of traditional Korean medicine treatment for cervical herniated intervertebral disc, a prospective, controlled study is needed.

• Asian Spine Journal
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• v.12 no.6
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• pp.1092-1099
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• 2018

Study Design: In-vitro biomechanical investigation. Purpose: To evaluate the biomechanical effects of the degeneration of the biodegradable cervical plates developed for anterior cervical discectomy and fusion (ACDF) on fusion and adjacent levels. Overview of Literature: Biodegradable implants have been recently introduced for cervical spine surgery. However, their effectiveness and safety remains unclear. Methods: A linear three-dimensional finite element (FE) model of the lower cervical spine, comprising the C4-C6 vertebrae was developed using computed tomography images of a 46-year-old woman. The model was validated by comparison with previous reports. Four models of ACDF were analyzed and compared: (1) a titanium plate and bone block (Tita), (2) strong biodegradable plate and bone block (PLA-4G) that represents the early state of the biodegradable plate with full strength, (3) weak biodegradable plate and bone block (PLA-1G) that represents the late state of the biodegradable plate with decreased strength, and (4) stand-alone bone block (Bloc). FE analysis was performed to investigate the relative motion and intervertebral disc stress at the surgical (C5-C6 segment) and adjacent (C4-C5 segment) levels. Results: The Tita and PLA-4G models were superior to the other models in terms of higher segment stiffness, smaller relative motion, and lower bone stress at the surgical level. However, the maximal von Mises stress at the intervertebral disc at the adjacent level was significantly higher in the Tita and PLA-4G models than in the other models. The relative motion at the adjacent level was significantly lower in the PLA-1G and Bloc models than in the other models. Conclusions: The use of biodegradable plates will enhance spinal fusion in the initial stronger period and prevent adjacent segment degeneration in the later, weaker period.

• Journal of Korean Neurosurgical Society
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• v.30 no.8
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• pp.1042-1046
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• 2001

The incidence of paraplegia following drain of cerebrospinal fluid(CSF) by lumbar puncure below a spinal block is rare, and most of them occurred in spinal tumor. We report a case of acute paraplegia following lumbar puncture for computed tomography myelography(CTM) in a 42-year-old man who sustained a cervical disc herniation. Four hours after lumbar puncture for CTM, sudden paraplegia was developed. After emergent anterior cervical discectomy and fusion with cervical plating, the patient recovered completely. To the authors' knowledge, this is the first case of spinal shock complicating lumbar puncture for routine myelography in a patient with cervical disc herniation. The prompt recognition of this unusual complication of lumbar puncture may lead to good clinical outcome. Instead of CTM requiring lumbar puncture, MRI should be considered as the initial diagnostic procedure in a patient of cervical disc herniation associated with myelopathy. We discuss the possible mechanisms of acute paraplegia following lumbar puncture with literature review.

• Journal of Pharmacopuncture
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• v.17 no.4
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• pp.7-14
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• 2014

Objectives: The purpose of this study is to analyze trends in domestic studies on pharmacopuncture therapy for treating cervical disease. Methods: This study was carried out on original copies and abstracts of theses listed in databases or published until July 2014. The search was made on the Oriental medicine Advanced Searching Integrated System (OASIS) the National Digital Science Library (NDSL), and the Korean traditional knowledge portal. Search words were 'pain on cervical spine', 'cervical pain', 'ruptured cervical disk', 'cervical disc disorder', 'stiffness of the neck', 'cervical disk', 'whiplash injury', 'cervicalgia', 'posterior cervical pain', 'neck disability', 'Herniated Nucleus Pulposus (HNP)', and 'Herniated Intervertebral Disc (HIVD)'. Results: Twenty-five clinical theses related to pharmacopuncture were selected and were analyzed by year according to the type of pharmacopuncture used, the academic journal in which the publication appeared, and the effect of pharmacopuncture therapy. Conclusion: The significant conclusions are as follows: (1) Pharmacopunctures used for cervical pain were Bee venom pharmacopuncture, Carthami-flos pharmacopuncture, Scolopendra pharmacopuncture, Ouhyul pharmacopuncturen, Hwangryun pharmacopuncture, Corpus pharmacopuncture, Soyeom pharmacopuncture, Hwangryunhaedoktang pharmacopuncture, Shinbaro phamacopuncture. (2) Randomized controlled trials showed that pharmacopuncture therapy combined with other methods was more effective. (3) In the past, studies oriented toward Bee venom pharmacopuncture were actively pursued, but the number of studies on various other types of pharmacopuncture gradually began to increase. (4) For treating a patient with cervical pain, the type of pharmacopuncture to be used should be selected based on the cause of the disease and the patient's condition.