• Title/Summary/Keyword: Neck Disability

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Long-Term Clinical and Radiologic Outcomes of Minimally Invasive Posterior Cervical Foraminotomy

  • Kwon, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.224-229
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    • 2014
  • Objective : To report long-term clinical and radiological outcomes of minimally invasive posterior cervical foraminotomy (MI-PCF) performed in patients with unilateral single-level cervical radiculopathy. Methods : Of forty-six patients who underwent MI-PCF for unilateral single-level radiculopathy between 2005 and 2013, 33 patients were included in the study, with a mean follow-up of 32.7 months. Patients were regularly followed for clinical and radiological assessment. Clinical outcome was measured by visual analogue scale (VAS) for the neck/shoulder and arm, and the neck disability index (NDI). Radiological outcome was measured by focal/global angulation and disc height index (DHI). Outcomes after MI-PCF were evaluated as changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect was used to test for differences in the clinical and radiological parameters repeat measures. Results : There were no complications and all patients had an uneventful recovery during the early postoperative period. VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001). NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001). There were no statistically significant changes in focal and global angulation at follow-up. Percent DHIs of the upper adjacent or operated disc were maintained without significant changes with time. During the follow-up, same site recurrence was not noted and adjacent segment disease requiring additional surgery occurred in two patients (6%) on the contra-lateral side. Conclusion : MI-PCF provides long-term pain relief and functional restoration, accompanied by good long-term radiological outcome.

Comparison between Anterior Cervical Decompression with Fusion and Posterior Cervical Fusion with Wide Facetectomy for Treatment of Severe Bony Foraminal Stenosis

  • Lee, Subum;Cho, Dae-Chul;Chon, Haemin;Roh, Sung Woo;Choi, Il;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.552-561
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    • 2021
  • Objective : To compare the anterior cervical discectomy and fusion (ACDF) and posterior cervical fusion (PCF) with wide facetectomy in the treatment of parallel-shaped bony foraminal stenosis (FS). Methods : Thirty-six patients underwent surgery due to one-or-two levels of parallel-shaped cervical FS. ACDF was performed in 16 patients, and PCF using CPS was performed in 20 patients. All patients were followed up at 1, 3, 6, and 12 months postoperatively. Standardized outcome measures such as Numeric rating scale (NRS) score for arm/neck pain and Neck disability index (NDI) were evaluated. Cervical radiographs were used to compare the C2-7 Cobb's angle, segmental angle, and fusion rates. Results : There was an improvement in NRS scores after both approaches for radicular arm pain (mean change -6.78 vs. -8.14, p=0.012), neck pain (mean change -1.67 vs. -4.36, p=0.038), and NDI score (-19.69 vs. -18.15, p=0.794). The segmental angle improvement was greater in the ACDF group than in the posterior group (9.4°±2.7° vs. 3.3°±5.1°, p=0.004). However, there was no significant difference in C2-7 Cobb angle between groups (16.2°±7.9° vs. 14.8°±8.5°, p=0.142). As a complication, dysphagia was observed in one case of the ACDF group. Conclusion : In the treatment of parallel-shaped bony FS up to two surgical levels, segmental angle improvement was more favorable in patients who underwent ACDF. However, PCF with wide facetectomy using CPS should be considered as an alternative treatment option in cases where the anterior approach is burdensome.

Effects of Cervical Sensorimotor Control Training on Pain, Function and Psychosocial Status in Patients With Chronic Neck Pain (목뼈 부위 감각운동 조절 훈련이 만성 목 통증 환자의 통증과 기능, 심리사회적 수준에 미치는 영향)

  • Min, In-gi;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.28 no.1
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    • pp.36-46
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    • 2021
  • Background: It is reported that the proprioceptive sensation of patients with neck pain is reduced, and neck sensory-motor control training using visual feedback is reported to be effective. Objects: The purpose of this study is to investigate how sensorimotor control training for the cervical spine affects pain, function, and psychosocial status in patients with chronic cervical pain. Methods: The subjects consisted of 36 adults (male: 15, female: 21) who had experienced cervical spine pain for more than 6 weeks. An exercise program composed of cervical stabilization exercise (10 minutes), electrotherapy (10 minutes), manual therapy (10 minutes), and cervical sensorimotor control training (10 minutes) was implemented for both the experimental and the control groups. The cervical range of motion (CROM) and head repositioning accuracy were assessed using a CROM device. In the experimental group, the subjects wore a laser device on the head to provide visual feedback while following pictures in front of their eyes; whereas, in the control group, the subjects had the same training of following pictures without the laser device. Results: There were no statistically significant differences between the two groups in pain, dysfunction, range of motion, or psychosocial status; however, post-test results showed significant decreases after 2 weeks and 4 weeks compared to baseline (p < 0.01), and after 4 weeks compared to after 2 weeks (p < 0.01). The cervical joint position sense differed significantly between the two groups (p < 0.05). Conclusion: In this study, visual feedback enhanced proprioception in the cervical spine, resulting in improved cervical joint position sense. On the other hand, there were no significant effects on pain, dysfunction, range of motion, or psychosocial status.

Effects of Cervical Stabilization Exercise in patients with Cervical Artificial Disc Replacement

  • Kim, Dae Hun;Jeong, Myeong-Kyun
    • The Journal of Korean Physical Therapy
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    • v.25 no.6
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    • pp.417-421
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    • 2013
  • Purpose: This study was to identify the effect of cervical stabilization exercise on pain and structure in patients with cervical artificial disc replacement. Methods: Forty-four individuals with cervical artificial disc replacement volunteered to participate from FEB 2012 to MAR 2013 in this study. They were allocated to either Experimental Group (EG) or Control Group (CG), with 22 subjects in each group. Subjects from the EG performed cervical stabilization exercise program and subjects from the CG performed isometric exercise program. Assessment tools were made with the Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Cervical Lordosis Angle (CLA). Results: In this study, in within-group and between-group comparison, the EG and CG showed significant differences in all parameters(p<0.05). But EG showed more improvement than CG at all parameters. Conclusion: These findings suggest that cervical stabilization exercise may be favorably used to improve VAS, NDI and CLA in patients with cervical artificial disc replacement. Further studies with larger sample and long-term follow-up period need to generalize the results of this study.

The Effects of Modality, Taping and Joint Mobilization for Patients with Acute Whiplash-Associated Disorder : Case Study (전기치료, 테이핑과 관절가동기법이 급성기 편타증 손상환자에게 미치는 영향-사례연구)

  • Ahn, Seung-Won
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.18 no.1
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    • pp.73-82
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    • 2012
  • Background: The purpose of this study was to investigate the effects of modality, taping and joint mobilization for patients with acute whiplash-associated disorders. Methods: Joint mobilization technique and kinesio taping was done to the patients who diagnosed with acute whiplash-associated disorders due to traffic accidents. Results: We got the results that it is quite effective to increase cervical range of motion and decrease the pain, according to the results, present study was performed to assess the impact on the neck disability index and fatigability. Conclusion: Joint mobilization technique applied to a person and taping applied to the other person then both people increasing cervical range of motion and reducing pain for the treatment of patients with acute whiplash-associated disorders was effective.

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A Randomized Controlled Double Blinding Study of Bee Venom Acupuncture Therapy on Sprain of C-spine (무작위 대조 이중맹검 시험을 통한 봉약침(蜂藥鍼)의 경항통(頸項痛)에 미치는 영향(影響))

  • Kim, Kyung-Tae;Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.22 no.4
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    • pp.189-195
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    • 2005
  • Objectives : This study was to evaluate the effectiveness of Bee Venom acupuncture therapy on sprain of C-spine by randomized controlled double blinding method. Methods : A randomized double blinding study of bee venom acupuncture therapy was conducted on sprain of C-spine. We divided sprain of C-spine patient into 2 groups: one group with both acupuncture and saline acupuncture therapy, and another group with both acupuncture and bee venom acupuncture therapy. To estimate the efficacy of treatment that applied for two groups, we used visual analog scale(VAS) and neck disability index(NDI). We compared the VAS and NDI score of two groups statistically. Results : STZ induced increase of serum creatinine, BUN and albumin secretion were lowered by AD-1 treatment.

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Clinical Effect of Bong Chuna Manual Therapy and Acupunture Treatment for Improving Cervical Curvature of Turtle Neck Syndrome and Measurement Method of Radiography (거북목증후군의 경추만곡 호전에 대한 봉추나요법과 침술의 효과와 방사선학적 평가방법 연구)

  • Oh, Won-Kyo;Lee, Eugune;Shin, Byung-Cheul
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.1
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    • pp.113-124
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    • 2009
  • Objectives : The aim of this study was to observe the effect of Bong Chuna manual therapy(BCMT) and acupuncture on the Turtle Neck Syndrome(TNS) by the changes of radiological findings and symptoms. Methods : Total twenty-eight patients diagnosed as TNS were evaluated. Twenty patients in experimental group were treated by the combination of BCMT and acupuncture, eight patients in control group were treated by acupuncture only. We measured VAS(Visual analogue scale) as pain intensity and Neck Pain and Disability Scale(NDI) at pre- and post-treatment. Also the four line Cobb's method and Jochumsen method were assessed for evaluating the radiographical changes, additionally we used 'two line method'. Results : VAS score showed statistically significant reduction in pain intensity in both experimental group and control group after 8 weeks treatment, $-44.05{\pm}14.91$ vs $-23.75{\pm}14.08$ respectively. Also NDI score presented $-11.40{\pm}8.63$ reduction in experimental group, and it was significant statistically, however not in control group, $-8.63{\pm}9.84$ reduction after 8weeks treatment. In radiological findings, the four line Cobb's method, Jochumsen method and two line method were reduced after 8weeks treatment, $-9.30{\pm}10.33$, $-0.65{\pm}1.72$ and $-14.35{\pm}5.68$ in experimental group respectively, $-0.75{\pm}1.91$, $-0.25{\pm}0.71$ and $0.38{\pm}2.20$ in control group respectively. However they were statistical significance only in the four line Cobb's method and two line method in both group. Conclusions : Combination treatment of CMT and acupuncture showed better effect on pain reduction, VAS score and the correction of neck anteversion than acupuncture only in TNS. Two line method seems valuable for evaluating the improvement of radiographical changes in TNS.

A Case Report of Glancing Up Motor Tic Disorder Managed by Temporomandibular Joint Balancing Therapy with Korean Medicine Treatment (위로 치켜뜨는 운동 틱 장애 환자에 대해 턱관절균형요법을 병행한 한방치료 치험 1례)

  • Chang Min Shin;Tae Kyung Kim;Eun Ju Lee;Hyun Seob Park;Young Jun Lee;Cheol Hong Kim
    • Journal of TMJ Balancing Medicine
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    • v.13 no.1
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    • pp.21-26
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    • 2023
  • Objectives: The purpose of this study is to report the effect of Korean medical treatment with Temporomandibular Joint Balancing Therapy (TBT) on Tic disorder patient who often glancing up when feels nerves, frightened or tired. Methods: In this study, Tic disorder patient was treated to △△ Korean medicine Hospital from June 12nd, 2022 to July 26th, 2023 by outpatient way. During the clinic period, the patient was treated by Korean medical treatment (acupuncture, cupping, herb medicine), especially using TBT. YGTSS (Yale Global Tic Severity Scale), NDI (Neck Disability Index) and VAS were used for measuring the Tic disorder and neck pain. Results: After treatment for 46 days, the YGTSS showed a decrease from 17 to 3, the VAS associated with Tic disorder also decreased from 6 to 1 and NDI associated with neck pain decreased from 7 to 4. Conclusions: These results showed that Korean medical treatment especially using TBT may have an effect on reducing symptoms of Tic disorder and neck pain. But the further researches are needed.

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The Effect of Korean Medical Treatments with Functional Cerebrospinal Therapy on Patients from Traffic Accidents with Temporomandibular Joint Disorder (기능적 뇌척주요법을 병행한 한방치료가 턱관절 장애가 있는 교통사고 환자에 미치는 영향)

  • Seo, Yeon Ju;Seo, Jong Cheol;Kim, Shin Young;Yoon, Hyun Min;Jang, Sun Hee;Song, Chun Ho;Lee, Young Jun;Cho, Sung Woo;Kang, Seok Hwan;Kim, Cheol Hong
    • Journal of Acupuncture Research
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    • v.33 no.4
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    • pp.149-163
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    • 2016
  • Objectives : The purpose of this study is to determine the effect of Functional Cerebrospinal Therapy(FCST) on patients from traffic accidents with Temporomandibular Joint Disorder. Methods : We reviewed the medical records of 33 patients who were treated for injuries stemming from traffic accidents at the Dong-Eui University Korean Medicine Hospital from December 29th, 2015 to August 29th, 2016. The patients were divided into 2 groups: Group A(n = 15) and Group B(n = 18). In Group A, patients received Korean medical treatments with FCST using an Accurate Balancing Appliance(ABA) - a standard intra-oral appliance. In Group B, patients received Korean medical treatments without FCST. To estimate the efficacy of the treatments in decreasing pain, we analyzed the Visual Analogue Scale(VAS), Neck Disability Index(NDI) and Oswestry Disability Index(ODI). Results : In Group A, VAS of headache(VAS H), VAS of neck & nuchal pain(VAS N), VAS of shoulder pain(VAS S), and VAS of low back pain(VAS L) were significantly improved during each period. In Group B, VAS H was significantly improved during each period, except the period from the first visit to two weeks later. VAS N, S, L were significantly improved during each period, except the period from the first visit to one week later. The total VAS improvement during each period in Group A was significantly higher than Group B. In both groups, NDI and ODI were improved significantly during each period. The improvement of NDI and ODI during each period in Group A was significantly higher than Group B. Conclusion : According to the results, FCST using ABA may be an effective treatment for patients from traffic accidents.

MULTIDISCIPLINARY APPROACH FOR THE DENTAL TREATMENT OF A PATIENT HAVING TRACHEOSTOMY TUBE (기관내삽관을 가진 장애환자의 치과치료를 위한 협의 진료)

  • Cha, Yoon-Sun;Kim, Ji-Hun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.38-42
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    • 2014
  • A tracheostomy tube serves as airway management for patients whose respiration is impeded due to inflammation, tumor, or traumatic events. If the patients who have tracheostomy tube, visit dental clinic for dental treatments, we should consider the underlying general condition of patients and then make treatment plans according to their state. A 22-Year old male patient, who had tracheostomy tube on his neck, came to our department for comprehensive dental treatment. Mild mental retardation was observed and he was taking anti-convulsant drugs for the prevention of epileptic seizure. Multiple advanced dental caries, hopeless teeth, and impacted third molars were also observed by clinical and radiographic examination. Due to the risk of epileptic seizure and low cooperativity to tolerate the treatment, general anesthesia was recommended by physician, and the anti-convulsant drug was administrated during procedure. In this case, we aimed to report the multidisciplinary approach for the dental treatment of patient having a tracheostomy tube.