• Journal of Acupuncture Research
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• 제22권3호
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• pp.201-213
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• 2005

봉약침(蜂藥鍼)을 위주로한 한의학적 치료로 경추 신경근 병변의 3증상(일측의 경부 동통과 상완부의 방사통, 수부나 수지의 지각이상)을 호소하는 환자(患者)들을 치료하면서 시각적상사척도(Visual Analogue Scale, VAS), JOA score 및 Odom의 평가기준에 따른 호전 양상을 측정한 결과 다음과 같은 결론을 얻었다. 1. 객관적 치료 성적을 살펴보면 Excellent인 경우가 7예(50%)로 가장 많았으며, Good이 4례 (28.57%), Fair가 3예(21.43%)의 순이며, 불량으로 평가된 경우는 하나도 없었다. 2. 시술 전 pain rate의 평균 8.82(${\pm}1.27$)에서 시술 후 평균 3.25(${\pm}2.21$)로 평균 차이가 5.57로 매우 유의성 있는 차이를 보였으며(p=0.000), 이는 객관적인 호전율과도 일치하였다. 3. 시술 전 JOA score의 평균이 11.00(${\pm}1.57$)에 서 시술 후 평균 12.79(${\pm}0.58$)로 평균 차이가 1.79로 매우 유의성 있는 차이를 보였다 (p=0.000). 4. 시술 전후의 성별, 나이, 수지비증유무, Disc Type에 따른 pain rate에는 유의한 차이가 없다. (P<0.05) 5. 시술 전후의 성별, 연령별, Disc Type 에 따른 JOA score는 유의한 차이가 없으나 (p<0.05), 수지비증유무에 따른 JOA는 유의한 차이가 있었다(p=.025). 수지비증이 있는 경우 가 좀더 유의하게 증가하였다. 이상의 결과로 보아 봉약침(蜂藥鍼) 위주로 한 한의학적 치료가 경추 신경근 병변을 호소하는 환자에게 유의한 효과가 있었으며 다른 한방적 보존적 요법과 더불어 시행시키면 전반적인 경추의 퇴행성 변화에 대한 치료(治療)에 더욱 더 유익하리라 판단된다.

• 척추신경추나의학회지
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• 제3권1호
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• pp.65-72
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• 2008

Objects : This study was to report a clinical effect of Chuna Treatment for Cervical Myelopathy due to disc herniation. Methods : The patient was diagnosed as Cervical Myelopathy due to disc herniation through Cervical spine MRI and treated by cervical traction technique of Chuna Treatment with conservative management. JOA score(Japanese Orthopedic Association score), Recovery rate of Hirabayashi, VAS(Visual Analogue Scale), Dynamometer score, ROM(Range of Motion) and Motor weakness Grade were used. Results and Conclusion : JOA score, VAS, Dynamometer score, ROM and Motor weakness Grade were improved and Recovery rate was 100%.

• 대한물리의학회지
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• 제5권3호
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• pp.331-339
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• 2010

Purpose : Cervical spondylotic myelopathy is a varied clinical syndromes and the most serious condition of cervical spondylosis. Spinal cord dysfunction is often caused by the compression on spinal cord. The purpose of this report was to describe physical examination and the process of disorders on cervical spondylotic myelopathy(CSM). Methods : Three cases with cervical myelopathy were presented with magnetic resonance image(MRI), Nurick's grade and Japanese Orthopaedic Association(JOA) score. Results : This studies showed a variable clinical course with gradual neurological deterioration in two cases. but one case was improved by operation and a regular aerobic exercise. MRI, Nurick's grade, JOA score are a useful adjunct for CSM evaluation. Conclusion : The state of CSM is variable, which may affect conservative treatments and surgery. It is needed to be a carefull approach and studies for a conservative treatment and management on CSM.

• Journal of Korean Neurosurgical Society
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• 제38권2호
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• pp.102-106
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• 2005

Objective : The purposes of this study are to evaluate the efficacy of en bloc open-door laminoplasty and to investigate the validity of various factors as prognotic indicators in patients with multisegmental spondylotic myelopathy and ossification of posterior longitudinal ligament[OPLL]. Methods : The authors reviewed 43 cases in whom laminoplasty were performed for cervical myelopathy between January 2000 and December 2002. Clinical symptoms and results were evaluated using the Japanese Orthopaedic Association[JOA] scale. The recovery rate was calculated and then assessed for prognostic factors such as preoperative JOA scores, ages, history of previous trauma, duration of symptoms and signal change in cord on T2-weighted magnetic resonance Image. Results : In cervical stenosis, canal widening of antero-posterior diameter and dimension after laminoplasty is 4.16mm, $87.43mm^2$ and in OPLL is 6.20mm, $117.61mm^2$. In all cases there wasn't neurologic deterioration, mild postoperative complications developed in seven cases. Four patient had a limitation of range of neck motion and the other one showed kyphotic change and another two showed C5 radiculopathy. The recovery rate of JOA score in cervical stenosis and OPLL was 62% and 68% respectively. Duration of symptoms, the severity[preoperative JOA score], and signal change in cord on T2-weighted magnetic resonance image had close relationship to the clinical outcomes. Conclusion : Unilateral en bloc laminoplasty is simultaneous expansile and decompressive method. And preoperative JOA score, symptom duration and high signal intensity on T2-weighted magnetic resonance image can be used to predict prognosis.

• Journal of Acupuncture Research
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• 제26권1호
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• pp.67-79
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• 2009

Objectives : The study on Acupotomy therapy has recently become a popular academic field as proven to be an great alternative to the limitation of Western medical treatment. However, there has been little study examining acupotomy therapy on treating Cervical Herniated Intervertebral Disc. Thus, this study aims to investigate the sense of improvement and satisfaction from the Cervical Herniated Intervertebral Disc patients treated with acupotomy therapy. Methods : A total of 23 subjects that consists of Cervical Herniated Intervertebral Disc patients were participated in this study. They were treated with acupotomy therapy and acupuncture. All the subjects were asked to answer Odom's degree, VAS(visual analogue scale), NDI(neck disability index) and JOA score before and after the treatment. Results : The results of the Odom's degree, VAS, NDI and JOA score of analysis groups, show that the improvement of neck pain in acupotomy and acupuncture treatment group is significantly effective. Conclusions : It is suggested that acupotomy therapy has development-effectiveness on Cervical Herniated Intervertebral Disc.

• 대한추나의학회지
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• 제6권1호
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• pp.157-167
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• 2005

후종인대 골화증의 수술적 단계 이전의 환자에 대한 보존적 치료는 대증적 치료가 주가 되어 왔다. 본 증례에서는 침구요법, 부항요법, 한약물요법, 한방 이학요법, 추나요법을 시행한 후종인대 골화증 환자에서 시각적 상사척도의 각 치료기간별 감소 및 경추부 가동역의 증가와 더불어 JOA Score의 향상, OPLL의 임상적 등급이 호전되는 치료 효과를 나타내게 되었다. 향후 본 질환에 대하여 보다 심도있는 한의학적 연구가 진행된다면 후종인대 골화증의 보존적 치료에 있어서 한방요법이 뚜렷한 역할을 하리라 기대하며 보다 많은 증례와 더불어 본 질환에 대한 평가의 기준 및 한방적 치료의 지침에 대한 연구가 진행되어야 한다.

• Journal of Korean Neurosurgical Society
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• 제46권3호
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• pp.189-194
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• 2009

Objectives : Ossification of the ligamentum flavum (OLF) is a rare cause of thoracic myelopathy. The aim of this study was to identify factors associated with the surgical outcome on the basis of preoperative clinical and radiological findings. Methods : Data obtained in 26 patients whot underwent posterior decompression for thoracic myelopathy, caused by thoracic OLF, were analyzed retrospectively. Patient age, duration of symptoms, OLF type, preoperative and postoperative neurological status using the Japanese Orthopedic Association (JOA) scoring system, surgical outcome, and other factors were reviewed. We compared the various factors and postoperative prognosis. All patients had undergone decompressive laminectomy and excision of the OLF. Results : Using the JOA score, the functional improvement was excellent in 8 patients, good in 14, fair in 2, and unchanged in 2. A mean preoperative JOA score of 6.65 improved to 8.17 after an average of 27.3 months. According to our analysis, age, gender, duration of symptoms, the involved spinal level, coexisting spinal disorders, associated trauma, intramedullary signal change, and dural adhesions were not related to the surgical outcome. However, the preoperative JOA score and type of OLF were the most important predictors of the surgical outcome. Conclusion : Early diagnosis and sufficient surgical decompression could improve the functional prognosis for thoracic OLF. The postoperative results were found to be significantly associated with the preoperative severity of myelopathy and type of OLF.

• Hip & pelvis
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• 제30권4호
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• pp.226-232
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• 2018

Purpose: Pain caused by osteoarthritis is primarily nociceptive pain; however, it is considered that a component of this pain is due to neuropathic pain (NP). We investigated the effects of total hip arthroplasty (THA) in patients with NP diagnosed by the PainDETECT questionnaire. Materials and Methods: One hundred sixty-three hips (161 patients) were evaluated. All patients were asked to complete the PainDETECT questionnaire based on their experience with NP, and clinical scores were evaluated using the Japanese Orthopaedic Association (JOA) Hip Score before and after THA. Results: The patients of 24.5% reported NP before THA; 5.5% reported NP 2 months after THA. Prior to THA, there was no significant correlation between the PainDETECT score and the radiographic severity; however, there was a significant correlation between the PainDETECT score and JOA score. NP at 2 months after THA was not significantly correlated with pain scores at 1 week after THA; however, a significant correlation was observed between the preoperative pain score and NP at 2 months after THA. Conclusion: THA was useful for relieving nociceptive pain and for relieving NP in patients with hip osteoarthritis. Preoperative pain was a risk factor for NP after THA. Controlling preoperative pain may be effective for reducing postoperative NP.

• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.78-87
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• 2021

Objective : Intraoperative neurophysiological monitoring (IONM) has been widely used during spine surgery to reduce or prevent neurologic deficits, however, its application to the surgical management for cervical myelopathy remains controversial. This study aimed to assess the success rate of IONM in patients with cervical myelopathy and to investigate the factors associated with successful baseline monitoring and the effect of increasing the stimulation intensity by focusing on motor evoked potentials (MEPs). Methods : The data of 88 patients who underwent surgery for cervical myelopathy with IONM between January 2016 and June 2018 were retrospectively reviewed. The success rate of baseline MEP monitoring at the initial stimulation of 400 V was investigated. In unmonitorable cases, the stimulation intensity was increased to 999 V, and the success rate final MEP monitoring was reinvestigated. In addition, factors related to the success rate of baseline MEP monitoring were investigated using independent t-test, Wilcoxon rank-sum test, chi-squared test, and Fisher's exact probability test for statistical analysis. The factors included age, sex, body mass index, diabetes mellitus, smoking history, symptom duration, Torg-Pavlov ratio, space available for the cord (SAC), cord compression ratio (CCR), intramedullary increased signal intensity (SI) on magnetic resonance imaging, SI length, SI ratio, the Medical Research Council (MRC) grade, the preoperative modified Nurick grade and Japanese Orthopedic Association (JOA) score. Results : The overall success rate for reliable MEP response was 52.3% after increasing the stimulation intensity. No complications were observed to be associated with increased intensity. The factors related to the success rate of final MEP monitoring were found to be SAC (p<0.001), CCR (p<0.001), MRC grade (p<0.001), preoperative modified Nurick grade (p<0.001), and JOA score (p<0.001). The cut-off score for successful MEP monitoring was 5.67 mm for SAC, 47.33% for the CCR, 3 points for MRC grade, 2 points for the modified Nurick grade, and 12 points for the JOA score. Conclusion : Increasing the stimulation intensity could significantly improve the success rate of baseline MEP monitoring for unmonitorable cases at the initial stimulation in cervical myelopathy. In particular, the SAC, CCR, MRC grade, preoperative Nurick grade and JOA score may be considered as the more important related factors associated with the success rate of MEP monitoring. Therefore, the degree of preoperative neurological functional deficits and the presence of spinal cord compression on imaging could be used as new detailed criteria for the application of IONM in patients with cervical myelopathy.

• Journal of Acupuncture Research
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• 제20권4호
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• pp.220-229
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• 2003

Objective : Cervical myelopathy is one of the most severe disease, as well as a common diesaes. However, its clinical study and report about efficiency of oriental treatment are absolutely insufficient. Therefore, we report the treatment about 1 case of Cervical myelopathy like followings. Methods : From November 27th, 2002 to January 11th, 2003, we observed patient hospitalized because of cervical myelopathy, and for its valuation, JOA score(Japanese Orthopedic Association score), Nutric grading, VAS(visual analog scale), and D.I.T.I(Digital Infrared Thermal Imaging)were used. Results : After being hospotalized for 50 days, the patients' JOA score, Nuric grading system, and VAS were improved each from 7 to 13, from grade IV to grade II, and from 8 to 2. Conclusions : We considered that oriental treatment has an useful effect on cervical myelopathy patients' treatment and recovery. But continuous studies, such as comparative studies accompanied by more treatment case.