• Title/Summary/Keyword: Posterior cervical

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The Incidence and Clinical Implications of Congenital Defects of Atlantal Arch

  • Kwon, Jong-Kyu;Kim, Myoung-Soo;Lee, Ghi-Jai
    • Journal of Korean Neurosurgical Society
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    • v.46 no.6
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    • pp.522-527
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    • 2009
  • Objective : Atlantal arch defects are rare. Few cadaveric and imaging studies have been reported on the variations of such anomalies. Our goal in this study was to examine the incidence and review the clinical implications of this anomaly. Methods : A retrospective review of 1,153 neck or cervical spine computed tomography (CT) scans was performed to identify patients with atlantal arch defects. Neck CT scans were performed in 650 patients and cervical spine CT scans were performed in 503 patients. Posterior arch defects of the atlas were grouped in accordance with the classification of Currarino et al. In patients exhibiting this anomaly, special attention was given to defining associated anomalies and neurological findings. Results : Atlantal arch defects were found in 11 (11/1153, 0.95%) of the 1,153 patients. The type A posterior arch defect was found in nine patients and the type B posterior arch defect was found in two patients. No type C, D, or E defects were observed. One patient with a type A posterior arch defect had an anterior atlantal-arch midline cleft (1/1153, 0.087%). Associated cervical spine anomalies observed included one $C_{6-7}$ fusion and two atlantal assimilations. None of the reviewed patients had neurological deficits because of atlantal arch anomalies. Conclusion : Most congenital anomalies of the atlantal arch are found incidentally during investigation of neck mass, neck pain, radiculopathy, and after trauma.

Congenital Cleft of Anterior Arch and Partial Aplasia of the Posterior Arch of the C1

  • Choi, Ji-Won;Jeong, Je-Hoon;Moon, Seung-Myung;Hwang, Hyung-Sik
    • Journal of Korean Neurosurgical Society
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    • v.49 no.3
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    • pp.178-181
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    • 2011
  • Congenital anomalies in arches of the atlas are rare, and are usually discovered incidentally. However, a very rare subgroup of patients with unique radiographic features is predisposed to transient quadriparesis after minor cervical or head trauma, A 46-year-old male presented with a 2-month history of tremor and hyperesthesia of the lower extremities after experiencing a minor head trauma. He said that he had been quadriplegic for about 2 weeks after that trauma. Radiographs of his cervical spine revealed bilateral bony defects of the lateral aspects of the posterior arch of C1 and a midline cleft within the anterior arch of the atlas. A magnetic resonance imaging revealed an increased cord signal at the C2 level on the T2-weighted sagittal image. A posterior, suboccipital midline approach for excision of the remnant posterior tubercle was performed. The patient showed significant improvement of his motor and sensory functions. Since major neurologic deficits can be produced by a minor trauma, it is crucial to recognize this anomaly.

The Surgical Management of Traumatic C6-C7 Spondyloptosis

  • Keskin, Fatih;Kalkan, Erdal;Erdi, Fatih
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.49-51
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    • 2013
  • A case of traumatic spondyloptosis of the cervical spine at the C6-C7 level is reported. The patient was treated succesfully with a anterior-posterior combined approach and decompression. The patient had good neurological outcome after surgery. A-51-year-old female patient was transported to our hospital's emergency department after a vehicle accident. The patient was quadriparetic (Asia D, MRC power 4/5) with severe neck pain. Plain radiographs, computerize tomography and spinal magnetic resonance imaging (MRI) showed C6-7 spondyloptosis and C5, C6 posterior element fractures. Gardner-Wells skeleton traction was applied. Spinal alignment was reachived by traction and dislocation was decreased to a grade 1 spondylolisthesis. Then the patient was firstly operated by anterior approach. Anterior stabilization and fusion was firstly achieved. Seven days after first operation the patient was operated by a posterior approach. The posterior stabilization and fusion was achieved. Postoperative lateral X-rays and three-dimensional computed tomography showed the physiological realignment and the correct screw placements. The patient's quadriparesis was improved significantly. Subaxial cervical spondyloptosis is a relatively rare clinical entity. In this report we present a summary of the clinical presentation, the surgical technique and outcome of this rarely seen spinal disorder.

Solitary Xanthogranuloma of the Upper Cervical Spine in a Male Adult

  • Lee, Sun-Joo;Jo, Dae-Jean;Lee, Seung-Hwan;Kim, Sung-Min
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.54-58
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    • 2012
  • We present the rare case of solitary xanthogranuloma in the upper cervical column mimicking a Brown-Sequard syndrome. A 29-year-old man complained with right hemiparesis and left hypoesthesia after a car accident. Computed tomography and magnetic resonance images revealed a lobulated homogenously well-enhancing mass in between posterior arch of the atlas (C1) and spinous process of the axis (C2) resulting in a marked spinal canal narrowing with cortical erosions. The patient was managed by complete resection of the tumor with partial laminectomy with lower half of C1 posterior arch and upper half of C2 spinous process. The authors advise complete removal of the xanthogranuloma and consideration as a differential diagnosis of lesions among upper cervical lesions.

Acute Hydrocephalus Following Cervical Spinal Cord Injury

  • Son, Seong;Lee, Sang Gu;Park, Chan Woo;Kim, Woo Kyung
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.145-147
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    • 2013
  • We present a case of acute hydrocephalus secondary to cervical spinal cord injury in a patient with diffuse ossification of the posterior longitudinal ligament (OPLL). A 75-year-old male patient visited the emergency department with tetraparesis and spinal shock. Imaging studies showed cervical spinal cord injury with hemorrhage and diffuse OPLL from C1 to C4. We performed decompressive laminectomy and occipitocervical fusion. Two days after surgery, his mental status had deteriorated to drowsiness with dilatation of the right pupil. Findings on brain computed tomography revealed acute hydrocephalus and subarachnoid hemorrhage in the cerebellomedullary cistern, therefore, extraventricular drainage was performed immediately. Acute hydrocephalus as a complication of cervical spine trauma is rare, however, it should be considered if the patient shows deterioration of neurologic symptoms.

Cervical Traction (경추견인법)

  • Park Ji-Whan;Park Youn-ki
    • The Journal of Korean Physical Therapy
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    • v.3 no.1
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    • pp.203-209
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    • 1991
  • Cervical traction effects its benefits by immobilizing the neck when it is used in a continuous manner from a reclining position. when used intermittently traction functions by elongating the neck and straightening the cervical Lordosis. This position of slight flexion opens the posterior articulations, widens the intervetebral foramina, disengages the facet surfaces, and elongates the posterior muscular tissues and Ligaments. The duration of traction is arbitary but the amount of traction is that which is tolerated by the patient and benefits the patient's problem. Application of traction in slingh flexion accomplishes the same separation with Less force and thus with Less discomfort experienced by the patient. But the effect of traction on the disks is debated.

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Trend of Pharmacopuncture Therapy for Treating Cervical Disease in Korea

  • Kim, Seok-Hee;Jung, Da-Jung;Choi, Yoo-Min;Kim, Jong-Uk;Yook, Tae-Han
    • 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.

Posterior Mediastinal Goiter - A Case Report - (후종격동 갑상선종;1례 보고)

  • 조용준
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1116-1120
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    • 1992
  • Posterior mediastinal goiter extending to carotid sheath posteriorly is rare repoted case. Recently we experienced huge posterior mediastinal goiter with compressin of trachea in 57-year old male, The patient that complained of dyspnea referred to our hospital for further evaluation of mediasitnal tumor. We confirmed huge secondary posterior mediastinal intrathoracic goiter with diagnostic methods following by chest X-ray, thyroid scan, chest CT, and CT guided fine needle aspiration biopsy in this patient, and performed operation for excision Exision of posterior mediasitnal goiter performed through initial transeverse cervical incision and additional median sternotomy, and the mass removed completely without any complications. The postoperative course were uneventful.

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The Effects of Tongue Positions on the Cervical Range of Motion (혀의 자세가 경추의 관절가동범위에 미치는 영향)

  • Han, Dong-Wook;Park, Min-Hee;Jeong, Yeon-Hee
    • Journal of Korean Clinical Health Science
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    • v.1 no.1
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    • pp.29-34
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    • 2013
  • Purpose : This study was to investigate that tongue positions have effect on the cervical range of motion (ROM). Methods : 18 subjects, 20 to 25 years of age, were participated in this study. The tongue positions were neutral position, anterior protrusion, posterior protrusion, superior protrusion, inferior protrusion, left side protrusion and right side protrusion. The neck movements were right side flexion, left side flexion, right rotation and left rotation. The cervical range of motion measured by cervical range of motion instrument (CROM, C9266-49, USA). The changes were analyzed using the paired t-test. SPSSWIN (ver. 20.0) was used for data analysis and the significance level was chosen as ${\alpha}$=0.05. Results : In the lateral flexion, the angle of left lateral flexion increased in anterior protrusion(p<0.05) and right side protrusion(p<0.05) significantly. In the rotation, the angle of right rotation increased in anterior protrusion(p<0.05), posterior protrusion (p<0.05), superior protrusion(p<0.05), inferior protrusion(p<0.05), and left side protrusion (p<0.05) significantly. Conclusions : In conclusion, we found that the tongue positions affected some cervical movements.

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Regrowth of Cervical Intradural Lipoma without Spinal Dysraphism

  • Son, Doo Kyung;Son, Dong Wuk;Choi, Chang Hwa;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.56 no.2
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    • pp.157-161
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    • 2014
  • A 49 years old male patient who suffered from deterioration of posterior neck pain, left hand numbness, left lower limb pain and gait disturbance for 3 years visited our outpatient department. He had been diagnosed as non-dysraphic cervical intradural lipoma and operated in August 1990. On the radiologic images, we found the regrowth of non-dysraphic cervical intradural lipoma from C2 to C7 level, which surrounds and compresses the cervical spinal cord. Previous subtotal laminectomy from C2 to C7 and severe cervical lordosis were also found. Appropriate debulking of lipoma mass without duroplasty was successfully done with intraoperative neurophysiological monitoring (IONM). We are following up the patient for 24 months via outpatient department, his neurologic symptoms such as hand numbness, gait disturbance, left lower limb pain and posterior neck pain have improved. We describe a rare case of regrowth of non-dysraphic cervical intradural lipoma.