• Journal of Korean Neurosurgical Society
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• 제53권6호
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• pp.331-336
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• 2013

Objective : The offset connector can allow medial and lateral variability and facilitate intralaminar screw incorporation into the construct. The aim of this study was to compare the biomechanical characteristics of C7 intralaminar screw constructs with and without offset connector using a three dimensional finite element model of a C6-7 cervical spine segment. Methods : Finite element models representing C7 intralaminar screw constructs with and without the offset connector were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the two techniques were compared under pure moments in flexion, extension, lateral bending and axial rotation. Results : ROM for intralaminar screw construct with offset connector was less than the construct without the offset connector in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in both constructs. Maximum von Mises stress in the construct without offset connector was found to be 12-30% higher than the corresponding stresses in the construct with offset connector in the three principal directions. Conclusion : This study demonstrated that the intralaminar screw fixation with offset connector is better than the construct without offset connector in terms of biomechanical stability. Construct with the offset connector reduces the ROM of C6-7 segment more significantly compared to the construct without the offset connector and causes lower stresses around the C7 pedicle-vertebral body complex.

• PNF and Movement
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• 제21권1호
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• pp.37-45
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• 2023

Purpose: Whiplash-associated disorder is often caused by external impact, such as a car accident, and it involves acceleration and deceleration of the flexion and extension of the neck. The purpose of this study is to determine whether the combination of cyrotherapy and a joint mobilization intervention in patients with acute whiplash-associated disorder is effective for pain, cervical range of motion (ROM), and muscle tone in the neck muscles. Methods: In this study, 20 patients with acute whiplash-associated disorder were randomly assigned to two groups. Group A was treated with cyrotherapy for 5 minutes, while group B was treated with cyrotherapy and a joint mobilization intervention. In both groups, visual analogue scale (VAS), neck disability index (NDI), cervical ROM, and muscle tone values were measured pre- and post-intervention. Results: According to the VAS values, both groups showed significant differences pre- and post-intervention (p<0.05), and in both groups, NDI was significantly decreased pre- and post-intervention (p<0.05). Finally, in terms of muscle tone, both groups showed significant changes before and after the intervention (p<0.05). Conclusion: These results showed that cryotherapy and joint mobilization can be effective interventions in patients with whiplash-associated disorder. In addition, to improve the ROM of the cervical joint and reduce NDI, the combination of cryotherapy and joint mobilization is considered more effective than the single intervention of cryotherapy.

• 한방재활의학과학회지
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• 제26권4호
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• pp.67-75
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• 2016

Objectives The purpose of this study was to investigate the clinical usefulness of M-test (Meridian test) as an adjunctive evaluation and treatment in patients with chronic neck pain. Methods This study was a single arm pre-post comparison study. Thirty-six eligible subjects with chronic neck pain were recruited from August to September, 2015. M-test was used for evaluating the condition of meridian, which can induce the limitation of ROM and body discomfort. Subjects were offered intradermal acupuncture treatment on one-acupoint for 48 hours. Cervical numeric rating scale (NRS), cervical range of motion (ROM), neck disability index (NDI) and surface electromyography (SEMG) were measured before and after the treatment. Total NRS and the number of movement limitation of M-test were also measured before and after the treatment. Results Among the 36 participating subjects, 4 subjects were lost to follow-up or excluded in accordance with the criteria. Significant differences on Cervical NRS and NDI were found after the treatment (p<0.001). There was a significant difference in the range of left cervical rotation (p<0.05). Root mean square (RMS) of SEMG significantly decreased on the right sternocleidomastoid muscle (p<0.05), but significantly increased on the right trapezius muscle (p<0.05). Median frequency (MdF) of SEMG significantly increased on both sternocleidomastoid muscles. There appears to be significant differences after the treatment in total NRS and the number of movement limitation of M-test (p<0.05). Conclusions These results suggest that the evaluation and treatment of M-test based on the meridian and collateral theory were effective on cervical NRS and NDI, and also improved the movability of human body.

• Journal of Korean Neurosurgical Society
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• 제59권5호
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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.

• Journal of Veterinary Science
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• 제25권1호
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• pp.2.1-2.14
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• 2024

Background: Sufficient surgical resection is necessary for effective tumor control, but is usually limited for vertebral tumors, especially in the cervical spine in small animal neurosurgery. Objective: To evaluate the primary stability and safety of customized three-dimensional (3D)-printed implants for cervical spine reconstruction after total vertebrectomy. Methods: Customized guides and implants were designed based on computed tomography (CT) imaging of five beagle cadavers and were 3D-printed. They were used to reconstruct C5 after total vertebrectomy. Postoperative CT images were obtained to evaluate the safety and accuracy of screw positioning. After harvesting 10 vertebral specimens (C3-C7) from intact (group A) and implanted spines (group B), implant stability was analyzed using a 4-point bending test comparing with groups A and C (reconstituted with plate and pins/polymethylmethacrylate after testing in Group A). Results: All customized implants were applied without gross neurovascular damage. In addition, 90% of the screws were in a safe area, with 7.5% in grade 1 (< 1.3 mm) and 2.5% in grade 2 (> 1.3 mm). The mean entry point and angular deviations were 0.81 ± 0.43 mm and 6.50 ± 5.11°, respectively. Groups B and C significantly decreased the range of motion (ROM) in C3-C7 compared with intact spines (p = 0.033, and 0.018). Both groups reduced overall ROM and neutral zone in C4-C6, but only group B showed significance (p = 0.005, and 0.027). Conclusion: Customized 3D-printed implants could safely and accurately replace a cervical vertebra in dog cadavers while providing primary stability.

• 산업융합연구
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• 제18권2호
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• pp.27-35
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• 2020

본 연구는 목뼈와 등뼈에 적용한 관절가동술이 전방머리자세를 가진 성인의 목통증, 목관절가동범위 및 균형에 미치는 영향을 알아보고자 실시되었다. 전방머리자세로 판명된 대학생 26명을 목뼈 관절가동술 그룹과 등뼈 관절가동술 그룹으로 13명 씩 무작위 배정하여 모든 대상자에게 각각 하루 10회, 1회당 30초 적용, 30초 휴식으로, 주 3회, 4주간 관절가동술을 적용한 후 변화를 비교하였다. 연구 결과, 통증과 관절가동범위에서 두 그룹 모두 유의한 효과가 있었고(p<.01), 그룹 간 비교에서는 유의한 차이가 없었다. 정적 균형의 그룹 내 변화에서 목뼈 관절가동술 그룹이 오른발 및 눈을 감았을 때 유의한 개선을 보였고(p<.05), 등뼈 관절가동술 그룹에서는 유의한 변화가 없었다(p<.05). 왼발 정적 균형은 두 그룹 모두 유의한 개선이 없었고(p<.05). 그룹 간 정적 균형의 비교에서도 유의한 차이가 없었다(p<.05). 동적 균형의 그룹 내 변화에서 목뼈 관절가동술 그룹이 앞쪽, 왼쪽, 오른쪽에서 유의한 개선을 보였고(p<.05), 등뼈 관절가동술 그룹이 앞쪽과 오른쪽에서 유의한 개선을 보였다(p<.05). 그룹 간 동적 균형에서는 왼쪽에서 유의한 차이가 나타났다(p<.05). 본 연구를 통하여 목뼈 및 등뼈 관절가동술은 전방머리자세 성인의 통증, 관절가동범위, 균형 능력에 대하여 유의한 효과가 있었다.

• 척추신경추나의학회지
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• 제3권2호
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• pp.43-52
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• 2008

Objective : The purpose of this study is to evaluate the conservative treatment for supraspinatus tendinitis with kyphotic cervical curvature patient. Methods : We used chuna, Herbal medication, Acupuncture, Bee Venom Acupuncture, Physical Therapy for this patient. And we measured of VAS score, ROM and Extent of the subjective symptoms of shoulder pain to evaluate treatment effects. Result : Patient's shoulder pain and cervical curvature has improved. VAS score and Extent of the subjective symptoms of shoulder pain score were also decreased.

• 대한물리치료과학회지
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• 제6권4호
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• pp.145-151
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• 1999

Pain is the most common symptom that brings a patient to the hospital. Repetitious stress and sprain injury result in various pains, and so we tried to improve cervical movement and release from pain by using taping technique of actual agonists and postural muscles in addition to psychological relaxation. The 4 patient with neck problems were applied Arikawa taping approaches. The flexor or extensor patterns were determined by Arikawa method at first. if the symptoms and patterns were similar, the taping was attached same point. After taping on major muscles of causing neck pain levator scapula, scalenus medius, sternocleidomastoid, splenius capitis, semispinalis capitis. - we found neck pain released and cervical ROM increased. In conclusion, we determined cervical movement related to rotation of splenius capitis, extention of semispinalis capitis, levator scapula, flexion and rotation of scalenus medius.

• 한국전문물리치료학회지
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• 제23권2호
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• pp.57-66
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• 2016

Background: For the treatment of forward head posture (FHP) and forward shoulder posture, methods for strengthening scapular retractors and deep cervical flexors and stretching pectoralis and upper cervical extensors are generally used. No study has yet assessed whether suboccipital release (SR) followed by cranio-cervical flexion exercise (CCFE) (SR-CCFE) will result in a positive change in the shoulders and neck, showing a "downstream" effect. Objects: The purpose of this study was to investigate the immediate effects of SR-CCFE on craniovertebral angle (CVA), shoulder abduction range of motion (ROM), shoulder pain, and muscle activities of upper trapezius (UT), lower trapezius (LT), and serratus anterior (SA) and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction in subjects with FHP. Methods: In total, 19 subjects (7 males, 12 females) with FHP were recruited. The subject performed the fifth phase of CCFE immediately after receiving SR. CVA, shoulder abduction ROM, shoulder pain, muscle activities of UT, LT, and SA, and LT/UT and SA/UT muscle activity ratios during maximal shoulder abduction were measured immediately after SR-CCFE. A paired t-test and Wilcoxon signed-rank test were used to determine the significance of differences in scores between pre- and post-intervention in the same group. Results: The CVA (p<.001) and shoulder abduction ROM (p<.001) were increased significantly post-versus pre-intervention. Shoulder pain was decreased significantly (p<.001), and LT (p<.05) and SA (p<.05) muscle activities were increased significantly post- versus pre-intervention. The LT/UT muscle activity ratio was increased significantly post- versus pre-intervention (p<.05). However, there was no significant change in UT muscle activity and SA/UT muscle activity ratio between pre- and post-intervention (p>.05). Conclusion: SR-CCFE was an effective intervention to improve FHP and induce downstream effect from the neck to the trunk and shoulders in subjects with FHP.

• The Journal of Korean Physical Therapy
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• 제17권4호
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• pp.519-535
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• 2005

The main purpose of this study is to evaluate the effects of manual therapies which are Posterior Anterior Central Vertebral Pressure (PACVP) and Posterior Anterior Unilateral Vertebral Pressure(PAUVP} in patients having a chronic pain in the neck. This study focused on sixty patients having a chronic pain in the neck from 19 years old and 65years old. There are 33 females and 27 males each. This study randomize two groups from all subjects that have been mentioned above. Group 1 received a cervical spine manual therapy, Group 2 received a conservative physical therapy. Each therapy was held for 3 times a week, totally, 6 times for two weeks. The tape was used to measure cervical range of motion(ROM) in six areas-flexion, extension, left lateral flexion, right lateral flexion, left rotation, right rotation. 100mm Visual Analogue Scale(100mm VAS) was used to measure the subjective pain level. All measurements of each patient were measured at pre-treatment and 2 weeks post-treatment. The results of this study would be summarized as follow: 1. The manual treatment group has much more recovery than that of conservative physical therapy group in terms of the degree of the ROM improvement showing a significant difference between two groups(p<0.05) 2. The manual treatment group has more recovery than that of the conservative physical therapy group in the improvement of pain(p<0.05).