• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.69-80
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• 2015

PURPOSE: The purpose of the present study was to apply joint mobilization in a sitting position and in a prone position to patients with acute mechanical neck pain and compare the immediate treatment effects in these two positions. METHODS: After the baseline was assessed, 46 patients were randomly assigned to two groups: experimental group I ($n_1=23$) for joint mobilization in the sitting position and experimental group II ($n_2=23$) for joint mobilization in the prone position at the symptomatic cervical level. The patients in both groups received treatment by unilateral posterior-anterior gliding for 30 seconds per trial, 10 trials per session, for a total of 5 minutes, and two trials of 10 active extending motions with distraction per trial. RESULTS: In the Wilcoxon signed-rank test, all the pain and physical function variables were significantly improved after intervention in both groups (p<.05). In the Mann-Whitney U test, which compared the differences before and after the intervention between the two groups, experimental group I showed significant improvement over experimental group II in resting pain (p<.01), satisfaction with the treatment (p=.01), left rotation (p<.01) and CCFE (p<.01). In the analysis of covariance results, experimental group I showed significant improvement over experimental group II in the most painful motion pain (p<.01) and the most painful quadrant motion pain (p<.01). CONCLUSION: These outcomes suggest that joint mobilization should be applied in sitting positions for patients with acute mechanical neck pain that feel pain during sustained positions, extension or rotation.

• 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.

• 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.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.570-573
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• 2012

Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.

• Physical Therapy Korea
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• v.22 no.3
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• pp.50-60
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• 2015

The purpose of this study was to apply the joint mobilization technique to the level of segments with pain and to the level of segments with hypomobility respectively and compare the immediate effects of the joint mobilization technique on the pain, the active cervical range of motion (ROM), and treatment satisfaction of patients with acute mechanical neck pain. After the baseline assessment, forty-two patients were randomized into two groups: a painful group ($n_1=21$) that received joint mobilization at the most painful cervical spine level and a hypomobile group ($n_2=21$) that received joint mobilization at the most hypomobile cervical level. The patients received an intervention that applied unilateral posterior-anterior gliding for 5 minutes and two repetitions of 10 times of active extension motion with distraction. In the Wilcoxon signed-rank test, the painful group and the hypomobile group were improved significantly in all pain variables (p<.001), while the painful group was improved significantly in the active cervical flexion (p<.001), extension (p<.001), left side-bending (p<.01), right side-bending (p=.001), left rotation (p<.001), and right rotation (p<.001). The hypomobile group was significantly improved in active cervical flexion (p=.001), extension (p<.001), left side-bending (p<.05), right side-bending (p=.001), left rotation (p=.001), and right rotation (p<.01) after intervention. In the Mann-Whitney U test, there was no significant difference in any of the dependent variables after the intervention between the two groups, but the painful group was slightly superior to the hypomobile group in all variables except for the right lateral flexion ROM and treatment satisfaction. These outcomes suggest that the cervical joint mobilization may be applied to either the level of painful segments or the hypomobile segments for the treatment of patients with acute mechanical neck pain.

• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.343-347
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• 2014

Objective : To evaluate the relationship between postoperative increase in intervertebral disc space height (IVH) and posterior axial neck in cases of degenerative cervical disease treated with anterior cervical discectomy and fusion (ACDF). Methods : A total of 155 patients who underwent ACDF with more than 1 year follow up were included. Radiologically, IVH and interfacet distance (IFD) of the operated segment were measured preoperatively and postoperatively. We clinically evaluated neck and arm pains according to visual analogue scale (VAS) scores and assessed neck disability index (NDI) scores preoperatively, postoperatively, at 3 months, 6 months, and 1 year postoperatively. The relationship between radiological parameters, and clinical scores were analyzed using a regression analysis. Results : The mean increase in IVH was 2.62 mm, and the mean increase in IFD was 0.67 mm. The VAS scores for neck pain preoperatively, postoperatively, and at 3 months, 6 months, 1 year postoperatively were 4.46, 2.11, 2.07, 1.95, and 1.29; those for arm pain were 5.89, 3.24, 3.20, 3.03, and 2.18. The NDI scores were improved from 18.52 to 7.47. No significant relationship was observed between the radiological evaluation results regarding the increase in intervertebral height or interfacet distance and clinical changes in VAS or NDI scores. Conclusion : The increase in intervertebral space or interfacet distance by the insertion of a large graft material while performing ACDF for the treatment of degenerative cervical disease was not related with the change in VAS scores for neck and arm pains and NDI scores postoperatively and during the follow-up period.

• Journal of Acupuncture Research
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• v.19 no.6
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• pp.264-279
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• 2002

Objective : Ossification of the posterior longitudinal ligament(OPLL) is considered kind of degenerative disease usually found in the cervical vertebrae. Most of cases of OPLL have radiculopathy, myelopathy or both of them such as neck pain, numbness, myatonia. These symptoms seems to be similar with those of HIVD(Herniated intervertebral disc), sprain, spondylosis of C-spine. Lost of patients who have those symptoms are visiting oriental medicine hospital, clinic so we thought that making differential diagnosis, treating and prognosing might be needed with acupuncture, Herb medication. Methods : We examined the 3 patients of OPLL who visited Dong-in-dang Oriental Medicine Hospital from 1st November 1999 to 1st February 2002. We treated patients of OPLL with Oriental Medicine care (Acupuncture, Herb medication, Negative treatment) based on oriental diagnosis of neck pain(項强痛), numbness(痺證), myatonia. Results : clinical grade of 3 cases was all Gr III. After treated with oriental medical care, 2 cases were evaluated poor, I cases were evaluated fair and resulted in Clinical grade II. Conclusions : Treating OPLL with oriental medical carte was very difficult to palliate symptoms, to stop progress of OPLL. We might need to reconsider oriental medical care as conservative treatment for OPLL.

• Journal of Korean Neurosurgical Society
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• v.45 no.4
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• pp.246-248
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• 2009

Atlantoaxial rotatory fixation (AARF) in adult is a rare disorder that occurs followed by a trauma. The patients were presented with painful torticollis and a typical 'cock robin' position of the head. The clinical diagnosis is generally difficult and often made in the late stage. In some cases, an irreducible or chronic fixation develops. We reported a case of AARF in adult patient which was treated by immobilization with conservative treatment. A 25-year-old female was presented with a posterior neck pain and limitation of motion of cervical spine after a traffic accident. She had no neurological deficit but suffered from severe defect on the scalp and multiple thoracic compression fractures. Plain radiographs demonstrated torticollis, lateral shift of odontoid process to one side and widening of one side of C1-C2 joint space. Immobilization with a Holter traction were performed and analgesics and muscle relaxants were given. Posterior neck pain and limitation of the cervical spine' motion were resolved. Plain cervical radiographs taken at one month after the injury showed that torticollis disappeared and the dens were in the midline position. The authors reported a case of type I post-traumatic AARF that was successfully treated by immobilization alone.

• 대한상한금궤의학회지
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• v.10 no.1
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• pp.125-132
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• 2018

Objective : The purpose of this study is to review a case of hypertension. The patient was 41 years, a male. We stabilized blood pressure after administration of Daehuanghuanglianxiexin-tang. In this paper, we review the interpretation of Shanghanlun by analyzing the patient's progress, diagnosis, treatment. Methods : Blood pressure changes have been monitored during the period. Additionally, We have observed the patients' compliance and accompanied symptom by the timeline analysis. Results : According to Shanghanlun disease pattern identification diagnostic system, Wediagnosed a Greater yang disease. The patient was treated with Daehuanghuanglianxiexin-tang for 2 months. Daehuanghuanglianxiexin-tang was able to control blood pressure to under 120mmhg / 80mmhg. During the treatment period, the accompanied symptom Stiffness and pain in posterior neck has improved, patient's compliance was good, and symptoms improved without significant complication Conclusions : Taking of the Daehuanghuanglianxiexin-tang makes patient's blood pressure controlled to safe and stable range and eases the discomfort of posterior neck pain.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.186-190
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• 2013

A C2-3 zygapophygeal joint is a major source of cervicogenic headache. Radiofrequency (RF) neurotomy is preformed widely for zygapophygeal joint pain. Conventional RF denervation technique is generally performed under fluoroscopic control. Recently, ultrasound-guided radiofrequency on zygapophygeal joint has emerged as an alternative method. We report our experiences of two successful ultrasound-guided pulsed radiofrequencies on 39-year-old and 42-year-old males, who complained occipital headache and posterior neck pain.