• Journal of Korean Neurosurgical Society
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• 제48권5호
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• pp.465-468
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• 2010

Vertebral artery loop formation causing encroachment on cervical neural foramen and canal is a rare cause of cervical radiculopathy. We report a case of 61-year-old woman with vertebral artery loop formation who presented with right shoulder pain radiating to her arm for 2 years. Plain radiograph and computed tomography scan revealed widening of the right intervertebral foramen at the C5-6 level. Magnetic resonance imaging and angiogram confirmed the vertebral artery loop formation compressing the right C6 nerve root. We had considered microdecompressive surgery, but the patient's symptoms resolved after conservative management. Clinician should keep in mind that vertebral artery loop formation is one of important causes of cervical radiculopathy. Vertebral artery should be visualized using magnetic resonance angiography in suspected case.

• The Korean Journal of Pain
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• 제4권2호
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• pp.152-156
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• 1991

경부 신경근병이 의심되는 31예의 환자에 경막외강 스테로이드 주입으로 치료하여 다음과 같은 결과를 얻었다. 1) 총 31예중 10예에서는 1회만을 주입하였다. 2) 최소한 1주일 간격으로 2회이상 주입한 21예중 15예에서 증상의 호전을 보였고 6예에서는 효과가 없었다. 3) 총 88회 주업중 2회의 지주막 천자외에는 합병증이 없었다. 이상의 결과로 보아 cervical radiculopathy가 의심되는 환자는 수술적 치료를 적용하기 전에 다른 종류의 대중적 치료와 더불어 경막외 스테로이드률 주입하는 것이 안전하고 효과적인 것으로 사료된다.

• Journal of Acupuncture Research
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• 제35권4호
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• pp.248-251
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• 2018

This retrospective study reports the effects of combined traditional Korean treatment of cervical radiculopathy in patients who underwent ineffective epidural steroid injection treatment. This study analyzed cervical radiculopathy in patients who visited traditional Korean medicine hospital following an ineffective epidural steroid injection. There were 29 cases included in this study. Scores for Visual Analog Scale (VAS) and Neck Disability Index (NDI) were measured before and after combined treatment with acupuncture, herbal medicine, and chuna therapy. The results of this study showed that patient VAS scores for neck and shoulder pain were significantly reduced (p < 0.001) when comparing scores before treatment ($6.03{\pm}2.04$) with after treatment ($2.14{\pm}1.27$). In addition, the VAS score for radiating pain before treatment ($6.67{\pm}1.44$) compared with after treatment ($2.89{\pm}1.83$) showed a significant reduction (p < 0.001). Furthermore, the NDI score before treatment ($25.85{\pm}6.33$) compared with after treatment ($11.33{\pm}7.47$), also showed a significant reduction (p < 0.001). The results in this study showed the positive effects of combined traditional Korean medicine treatment in significantly reducing pain for patients with cervical radiculopathy, who had ineffective anesthesia.

• Annals of Clinical Neurophysiology
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• 제10권2호
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• pp.83-97
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• 2008

Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.

• PNF and Movement
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• 제19권3호
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• pp.361-374
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• 2021

Purpose: The study aimed to investigate the effects of neural mobilization with joint mobilization on dysfunction, pain, and range of motion in cervical radiculopathy patients. Methods: Forty-seven cervical radiculopathy patients were recruited for the study. The subjects were randomly allocated to three groups. Group A (n=16) received a neural mobilization with joint mobilization, Group B (n=15) received a neural mobilization (NM), Group C (n=16) received a joint mobilization (JM). All groups had five sets for a day, three days a week, for four weeks. All subjects were evaluated before and after intervention by their neck disability index (NDI), numeric pain rating scale (NPRS), and range of motion (ROM). Results: The results were as follows: First, the NDI was significantly decreased in all groups (p<0.05). Group A had more significantly decreased NDI than Group B and C (p<0.05). Secondly, the NPRS was significantly decreased in all groups (p<0.05). Group A had more significantly decreased cervical NPRS than Group B (p<0.05). Groups A and B were more effective at decreasing upper extremity NPRS than Group C (p<0.05). Thirdly, the ROM was significantly increased in all the groups (p<0.05). Group A had more significantly improved cervical rotation ROM than Group B (p<0.05). Significant short-term effects of the NM with JM on dysfunction, pain, and range of motion in cervical radiculopathy patients were recorded in this study. Conclusion: These findings gave some indications that it may be feasible to include NM with JM in interventions with cervical radiculopathy patients.

• Korean Journal of Acupuncture
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• 제41권2호
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• pp.51-57
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• 2024

This case report aims to illustrate the diagnostic challenge and effective management of acute cervical radiculopathy presenting as shoulder pain, differentially diagnosed through physical examinations, and subsequently treated with acupotomy. A male patient in his late 20s with no significant medical history or comorbidities reported acute left shoulder pain upon awakening, rated at a severity of 7 on the numeric rating scale (NRS). Initial physical evaluations of the shoulder assembly revealed no abnormalities, but a positive Spurling test, relief with cervical distraction, and diminished sensation across the left C5~C8 dermatomes pointed towards a cervical spine origin. Immediate acupotomy at identified tender points significantly reduced pain, with additional therapies enhancing recovery. Pain was eliminated after the second treatment, and this resolution was sustained at the 4-week follow-up, confirming the treatment's effectiveness and verifying the absence of adverse effects. This case presents the critical need for precise diagnosis in cases of neck and shoulder pain. Additionally, the employment of acupotomy provided a swift and effective resolution of symptoms in acute cervical radiculopathy, showing its value in clinical practice.

• The Korean Journal of Pain
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• 제27권2호
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• pp.125-132
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• 2014

Background: To improve residual pain management in acute cervical radiculopathy treated with NSAIDs, the feasibility of early and repeated low-dose interscalene brachial plexus block (IS-BPB) needs to be assessed. Methods: This was a prospective study on patients receiving NSAIDs (loxoprofen) for cervical radiculopathy of ${\leq}2$-week onset. Pain was assessed using the visual analogue scale (VAS). A low-dose ultrasonography (USG)-guided IS-BPB (dexamethasone [1.65 mg; 0.5 ml] and mepivacaine [1%; 3.0 ml]) was performed at baseline and weekly thereafter for 4 weeks in an outpatient setting for the intervention group. All patients were evaluated using a visual satisfaction score (VSS) at week 4. Patients with baseline VAS scores < 70 (mild to moderate pain; MM group) and ${\geq}70$ (severe pain; SE group) were compared to the controls receiving NSAIDs. Results: A total of 316 IS-BPBs were performed in the intervention group. There was a significant difference in the decline in the VAS from week 0 to week 3 in the MM and SE groups (P < 0.05); however, from week 3 to week 4, the therapeutic effect exhibited no significant difference. Thirteen patients at week 2 (15.5%; MM: 27.7%; SE: 0%), 43 at week 3 (51.2%; MM: 83.0%; SE: 10.8%), and 47 at week 4 (56.0%; MM: 85.1%; SE: 18.9%) achieved a VAS score of ${\leq}20$. Patient satisfaction was high, and the decrease in VAS scores in both groups was significant (P < 0.05) compared to the controls. Conclusions: Weekly, low-dose, USG-guided IS-BPB can be implemented for early pain relief in acute cervical radiculopathy, with high patient satisfaction.

• Journal of Korean Neurosurgical Society
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• 제48권6호
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• pp.528-531
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• 2010

Ehlers-Danlos syndrome (EDS) type IV is characterized by its clinical manifestations, which are easy bruising, thin skin with visible veins, and rupture of arteries, uterus, or intestines. Arterial complications are the leading cause of death in vascular EDS because they are unpredictable and surgical repair is difficult due to tissue fragility. The authors report a case presented with cervical radiculopathy due to a segmental fusiform aneurysm of the cervical vertebral artery. Transfemoral cerebral angiography (TFCA) was done to verify the aneurysmal dilatation. However, during TFCA, bleeding at the puncture site was not controlled, skin and underlying muscle was disrupted and profound bleeding occurred during manual compression after femoral catheter removal. Accordingly, surgical repair of the injured femoral artery was performed. At this time it was possible to diagnose it as an EDS with fusiform aneurysm on cervical vertebral artery. Particularly, cervical fusiform aneurysm is rare condition, and therefore, connective tissue disorder must be considered in such cases. If connective tissue disorder is suspected, the authors suggest that a noninvasive imaging modality, such as, high quality computed tomography angiography, be used to evaluate the vascular lesion to avoid potential arterial complications.

• Journal of Korean Neurosurgical Society
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• 제30권7호
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• pp.870-875
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• 2001

Objectives : Anterior tunnelling technique consist of anterior cervical fractional interspace decompression without fusion. This method provides sufficient space for adequate neuroforaminal decompression but avoids the need for fusion or fixation. We report early clinical results of 32 cases that underwent anterior tunnelling operation for treatment of cervical radiculopathy. Methods : This method is identical to conventional approach until the exposure of anterior cervical body and bilateral retraction of longus colli is made. A vertical window is then made at the vertebral bodies and disc space lateral to the insertion site of the longus colli. The window is deepened with drilling that follows a tunnelling fashion down to the compressive lesion. We analyzed clinical results from 32 patients who treated between December 1998 and August 2000. Results : Satisfactory results were obtained in 87% of the patients. Two patients required revision surgery. None revealed surgical spinal instability on last follow-up. Conclusion : Anterior tunnelling operation is an acceptable surgical option for the treatment of cervical radiculopathy. Its advantages are short hospitalization, minimal postoperative discomfort, and technical feasibility.

• Physical Therapy Rehabilitation Science
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• 제9권3호
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• pp.149-154
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• 2020

Objective: This study aimed to evaluate the effects of the Kaltenborn-Evjenth concept of nerve mobilization combined with intermittent cervical segment traction (ICST) on pain, Neck Disability Index (NDI) scores, range of motion (ROM) and endurance in persons with cervical radiculopathy (CR). Design: Two-group pretest-posttest design. Methods: Thirty subjects participated in this study and were randomly assigned to two groups. The ICST group (n=15) was performed simultaneously with nerve mobilization and cervical traction for the segment with cervical pain at the same time. The intermittent cervical total traction (ICTT) group (n=15) performed nerve mobilization and cervical traction for the whole cervical area at the same time. In this study, outcome measures such as the Visual Analog Scale (VAS), NDI, ROM, endurance (cranio-cervical flexion test), and passive intervertebral motion performed before and 4 weeks after the experiment were compared to investigate the effects of each intervention. Results: In both groups, there were significant differences in the VAS, NDI scores, and endurance, and there were significant differences between the two groups except for endurance (p<0.05). In the ICST group, significant differences were found in all ROM, and in the ICTT group, significant differences were found in only extension, and there were significant differences between the two groups (p<0.05). Conclusions: The ICST group showed more improvement than the ICTT group in pain, NDI scores and ROM. Moreover, our findings show that the ICST could be used as a new strategy for manual therapy in persons with CR.