• Korean Journal of Acupuncture
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• v.26 no.4
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• pp.225-235
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• 2009

Objective : The purpose of this study was to report a case of a treatment with Scolopendrae Corpus Herbal-Acupuncture for one patient suffering from the Cervical Myelopathy. Scolopendrae Corpus Herbal-Acupuncture has been used as a analgesics and antispasmodics in the oriental medicine and reported to have antiinflammatory effect, sedative action and immunity enhancing activity, on one patient suffering from the Cervical Myelopathy. Methods : TThe patient was treated with Scolopendrae Corpus Herbal-Acupuncture, acupuncture, herbal medication. Scolopendrae Corpus Pharmacopuncture was administered two or three times per week and we injected 0.2~1.0 ml of Scolopendrae Corpus Pharmacopuncture to the patient's neck and both arms. The improvement of the symptoms was evaluated by JOA score(Japanese Orthopedic Association score), Nurick grading, VAS(Visual Analog Scale), reflex testing, Finger escape sign, Grip and Release test. Result : After 5 weeks of treatment, the patient's JOA score, Nurick grading and VAS were improved from 12 to 16, from grade III to grade II and from 10 to 3 respectively. The movement and power of upper and lower limbs were restored to nearly normal range.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.80-87
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• 2021

Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR. Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63.6±8.2 years; 66 males and 37 females; follow-up period, preoperative to 12 months postoperative). Clinical assessment included the Japanese Orthopaedic Association (JOA) score, University of California, Los Angeles (UCLA) score, Constant score, 36-item short form health survey (SF-36) score, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score from preoperative to 12 months postoperatively. The patients were either assigned to the CRPS group or non-CRPS group depending on CRPS diagnosis until the final follow-up, and clinical outcomes were then compared between the groups. Results: Of 103 patients, 20 (19.4%) had CRPS-related hand lesions that developed entirely within 2 months postoperatively. Both groups showed significant improvement in JOA, UCLA, and Constant scores preoperatively to 12 months postoperatively (p<001). Comparisons between the two groups were not significantly different, except for SF-36 "general health perception" (p<0.05) at 12 months postoperatively. At final follow-up, three patients had residual CRPS-related hand lesions with limited range of motion and finger edema. Conclusions: CRPS-related hand lesions developed in 19.4% of patients following ARCR. Shoulder or upper-limb function improved in most cases at 12 months, with satisfactory SF-36 patient-based evaluation results. Patients with residual CRPS-related hand lesions at the last follow-up require long-term follow-up.

• Journal of Korean Neurosurgical Society
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• v.46 no.1
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• pp.5-10
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• 2009

Objective: The purpose of this study is to evaluate the effectiveness of unilateral decompression and pedicle screw fixation for the unilateral symptomatic foraminal stenosis. Methods: The study group comprises consecutive 16 patients who underwent unilateral decompression and bone cement augmented pedicle screw fixation from May 2003 to January 2006. The patients were evaluated by visual analog scale (VAS) for pain and the scoring system of the Japanese Orthopedic Association (JOA) for low back pain. The result of surgery was also evaluated with McNab's classification. Excellent or good outcome was considered as successful. The patients were followed at postoperative 1 month, 3 month, 6 month, and 1 year with standing AP and lateral films. Results: The average VAS and JOA score of the 16 patients were 7.8(range, 6-9) and 5.8(range, 3 - 10) before surgery and 2.2(range, 0 - 5)and 12.3(range, 9 - 15) at the time of last follow up. Both VAS and JOA score improved significantly after the surgery (p<0.05, t-test). All patients improved after the operation and no revision surgery was required. No metal failure or pseudoarthrosis was observed during the follow-up. The success rate was 87.5%. Conclusion: Our data suggest that unilateral decompression and pedicle screw fixation for the unilateral symptomatic foraminal stenosis is an effect method for obtaining satisfactory clinical outcome. Its possible advantage is shorter operation time and reduced surgical extent. We believe that the reduced stiffness of unilateral fixation was compensated by pedicle screw augmentation and interbody fusion.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.121-129
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• 2014

Objectives : Patients with cervical ossification of posterior longitudinal ligament (OPLL) are susceptible to cord injury, which often develops into myelopathic symptoms. However, little is known regarding the prognostic factors that are involved in minor trauma. We evaluated the relationship between minor trauma and neurological outcome of OPLL and investigated the prognostic factors with a focus on compressive factors and intramedullary signal intensity (SI). Methods : A total of 74 patients with cervical myelopathy caused by OPLL at more than three-levels were treated with posterior decompression surgeries. We surveyed the space available for spinal cord (SAC), the severity of SI change on T2-weighted image, and diabetes mellitus (DM). The neurological outcome using Japanese Orthopedic Association (JOA) scale was assessed at admission and at 12-month follow-up. Results : Among the variables tested, preoperative JOA score, severity of intramedullary SI, SAC, and DM were significantly related to neurological outcome. The mean preoperative JOA were $11.3{\pm}1.9$ for the 41 patients who did not have histories of trauma and $8.0{\pm}3.1$ for the 33 patients who had suffered minor traumas (p<0.05). However, there were no significant differences in the recovery ratios between those two groups. Conclusions : Initial neurological status and high intramedullary SI in the preoperative phase were related to poorer postoperative outcomes. Moreover, the patients with no histories of DM and larger SACs exhibited better improvement than did the patients with DM and smaller SACs. Although the initial JOA scores were worse for the minor trauma patients than did those who had no trauma prior to surgery, minor trauma exerted no direct effects on the surgical outcomes.

• Journal of Korean Neurosurgical Society
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• v.59 no.5
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• pp.471-477
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• 2016

Objectives : The correction of clinical and radiologic abnormalities in patients with symptomatic ossification of the posterior longitudinal ligament (OPLL) is the current mainstay of treatment. This study aimed to identify radiographic predictors of severity of myelopathy in patients with symptomatic OPLL. Methods : Fifty patients with symptomatic cervical OPLL were enrolled. Based on Japanese Orthopedic Association (JOA) scores, patients were divided into either the mild myelopathy (n=31) or severe myelopathy (n=19) group. All subjects underwent preoperative plain cervical roentgenogram, computed tomography (CT), and MR imaging (MRI). Radiological parameters (C2-7 sagittal vertical axis, SVA; C2-7 Cobb angle; C2-7 range of motion, ROM; OPLL occupying ratio; and compression angle) were compared. Compression angle of OPLL was defined as the angle between the cranial and caudal surfaces of OPLL at the maximum level of cord compression Results : The occupying ratio of the spinal canal, C2-7 Cobb angle, C2-7 SVA, types of OPLL, and C2-7 ROM of the cervical spine were not statistically different between the two groups. However, the OPLL compression angle was significantly greater (p=0.003) in the severe myelopathy group than in the mild myelopathy group and was inversely correlated with JOA score (r=-0.533, p<0.01). Furthermore, multivariate regression analysis demonstrated that the compression angle (B=-0.069, p<0.001) was significantly associated with JOA scores (R=0.647, p<0.005). Conclusion : Higher compression angles of OPLL have deleterious effects on the spinal cord and decrease preoperative JOA scores.

• Neurospine
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• v.15 no.4
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• pp.362-367
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• 2018

Objective: To assess the efficacy of cervical open-door laminoplasty by hydroxyapatite implant insertion between the lamina and the lateral mass without suturing. Methods: All patients who underwent cervical open-door laminoplasty with C2/C7 undermining and insertion of hydroxyapatite implants from C3 to C6 were retrospectively evaluated for surgical time and neurological outcomes according to the Japanese Orthopaedic Association (JOA) score. To assess the alignment of the cervical spine and postoperative cervical pain, the C2-7 angle and a visual analogue scale score were used, respectively. Results: The population consisted of 102 women and 222 men ranging in age from 32 to 90 years. The average surgical time was 86 minutes. Fourteen of 1,296 hydroxyapatite implants were kept in place with sutures due to a weak restoration force of the hinge during surgery. No hydroxyapatite implant dislocation was detected on cervical computed tomography at 1 year after surgery. The average JOA score was $10.2{\pm}2.5$ before surgery and $14.6{\pm}2.8$ at 1 year after surgery. The average recovery rate was 61.8%. The average C2-7 angle at the neutral position was $7.1^{\circ}{\pm}6.2^{\circ}$ before surgery and $6.5^{\circ}{\pm}6.3^{\circ}$ at 1 year after surgery. Conclusion: This method enabled us to achieve minimal exposure of the lateral mass, prevention of lateral mass injury and dural injury, and a shorter surgical time while maintaining acceptable surgical outcomes. The idea that firm suture fixation is needed to prevent spacer deviation during cervical open-door laminoplasty may need to be revisited.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.141-148
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• 2019

Cervical spondylotic myelopathy (CSM) is a severe disease that usually needs surgical treatment. We have treated two CSM patients with Korean traditonal medicine, which includes acupuncture, pharmacopuncture, herbal medicine and manual treatment (Chuna). For objective evaluation, we used Nurick's classification, JOA (Japanses Orthopedic Association) score, grip and release test and hand grasping power measurement. Post-treatment analysis has shown that grip and release test score and grasping power of two patients were both remarkably improved, along with the improvements on both Nurick's classification and JOA score. This study showed that Korean traditional medicine could be effective conservative treatment for CSM.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.15-20
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• 2002

Purpose: The purpose of this study is to evaluate diagnosis and treatment of acetabular labral tears in sports injuries. Materials and Methods: From March 1995 to January 2000, We treated 15 patients with acetabular labral tear by sports injuries. There were 6 men and 9 women. Mean age was 41 years old. Running injuries are 5 cases, fighting 3, aerobic exercise 3, swimming 2, climbing 1, bicycle 1. For conservative treatment, we performed medication and observation at least for 1 year. For the patients with arthroscopic surgery, we performed Harris Hip Score (pain and function) preoperatively and postoperatively at 6, 12 months, and evaluated patient’s pain by JOA pain scoring system and postoperative subjective satisfaction. Results: The mean score of HHS improved 15 points with conservative treatments and 32 points with hip arthroscopy. In 4 cases of conservative treatment, there was 1 scale improvement of JOA pain scoring system. In arthroscopic partial labrectomy, all cases were improved to more than 2 scale. Conclusion: We considered that acetabular labral tears occurred associated with sports injuries. So it is important to be interested in enthusiastic diagnosis and appropriate treatment for hip pain caused by sports injuries, especially about acetabular labral tears.

• Journal of Acupuncture Research
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• v.31 no.3
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• pp.75-82
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• 2014

Objectives : The purpose of this study is to investigate the effects of warm needling therapy in a patient with cervical myelopathy caused by ossification of posterior longitudinal ligament. Methods : A 53-year-old Korean male patient diagnosed with cervical myelopathy due to ossification of posterior longitudinal ligament was treated with warm needling therapy on posterior neck aside from the routine inpatient treatment from June 26th to July 16th. Clinical improvement was evaluated with visual analogue scale(VAS), Japanese orthopedic score(JOA), grip and release test, finger escape sign and patient satisfaction was measured using a five-point Likert scale. Results : After 21 days of treatment, the patient showed improvement in VAS, JOA, grip and release test and finger escape sign. The patient also expressed satisfaction with the treatment. Conclusions : The results suggest that warm needling therapy may be an effective additional treatment for cervical myelopathy and other symptoms related to ossification of posterior longitudinal ligament(OPLL). Further studies should be carried out regarding possible long-lasting effects.

• Journal of Acupuncture Research
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• v.26 no.6
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• pp.251-260
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• 2009

Objectives : The purpose of this study is to report the effect of moxibustion for paitent with Myelopathy hand Methods : A 65-year-old female patient diagnosed with Cervical myelopathy was treated by moxibustion on both hand and neck, from July 17th to July 29th. The improvement of the patient's Myelopathy hand was evaluated based on JOA(Japanese orthopedic score), VAS(visual analog scale), Grips and release test, Finger escape sign, and DITI(digital infrared thermal imaging). Results : After the treatment of moxibustion, the patient's JOA score were not improved, but VAS, Grips and release test, Finger escape sign and DITI were improved. Conclusions : The result suggests that moxibustion of hand and neck is an effective treatment to Myelopathy hand on Cervical myelopathy. But more cases and researches are needed to evaluate the significancy of moxibustion for Myelopathy hand.