• 국제물리치료학회지
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• 제9권1호
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• pp.1381-1386
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• 2018

The purpose of this study is to investigate the effect of pelvic, Lumbar spine and Cervical spine manipulation on the joint position sense in normal adults. Thirty normal adults were divided into an experimental group of 15 subjects and a control group of 15 subjects. The experimental group was treated with pelvic, Lumbar spine and Cervical spine manipulation with massage, whereas the control group received only massage. Both groups were evaluated in terms of joint position errors (JPEs) using a digital dual clinometer before and after the experiment. The comparison of the JPEs of the experimental group and the control group before and after the experiment showed that the experimental group's cervical spine results were significantly different in the flexion, left lateral flexion, and right rotation (p < .05) and lumbar spine results were significantly different in the flexion and extension (p < .05), but the control group's results were not statistically significant in all items (p > .05). The pelvic, lumbar spine and cervical spine manipulation makes an effect on the joint position sense in normal adults. The findings of this study suggest that the pelvis, lumbar spine and cervical spine manipulation improve the motor ability in people with low joint position sense.

• 한국전문물리치료학회지
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• 제22권4호
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• pp.1-7
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• 2015

This case report describes the effectiveness of cervical corrective exercises in a patient with cervical radiculopathy (CR) who experienced radicular pain, upper limb paresis, and limited functional activity. A 39-year-old male with cervical radiculopathy performed the cervical corrective exercises for reducing pain. Pain intensity, cervical posture, and active range of motion of cervical intersegmental spine motion were measured baseline, after 4 weeks, and after 8 weeks with self-reported questionnaire and radiographs. After 8 weeks of intervention, the patient demonstrated alleviated radicular symptoms, improved neck posture and active range of flexion and extension of the cervical intersegmental spine. Especially in the angle between the cervical vertebra 6 and 7, the angle was changed from $-4.69^{\circ}$ to $3.30^{\circ}$ during resting position after intervention. The present case indicates that the cervical corrective exercises might be a possible treatment to effectively reduce radicular symptoms, improve neck posture, and active cervical intersegmental motion for patient with CR.

• Journal of Trauma and Injury
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• 제21권1호
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• pp.15-21
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• 2008

Purpose: National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian Cervical Spine rule (CCR) are commonly used in cervical trauma patients to determine whether a plain cervical X-ray should be performed. However, plain cervical X-rays are so inaccurate that cervical spine computed tomography (CT) is often considered as a screening test. We studied the usefulness of the NEXUS criteria and the CCR for determining the need for a CT evaluation in the emergency department (ED). Methods: This prospective observational study was conducted from January 2007 to March 2008. Plain X-ray and CT scans of the cervical spine were performed on blunt trauma patients with neck pain. The relevancy of CT was examined using the NEXUS criteria and the CCR. Sensitivity, specificity, positive predicted value, and negative predicted value analyses were performed to diagnose the cervical spine injury. Results: During the study period, 284 patients were enrolled in this study. The sensitivity, specificity, positive predicted value, and negative predicted value of the NEXUS criteria were 87.5%, 1.1%, 5.0%, and 60.0% respectively, while those of the CCR were 87.5%, 8.2%, 5.3%, and 91.6%. There were two missed fracture cases when the NEXUS criteria and the CCR were applied independently, however, no cases were missed when both were applied. Conclusion: This study suggests the NEXUS and the CCR in combination can be used as a guide to CT evaluation for cervical spine injury in the ED.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.485-497
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• 2017

Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Advantages of endoscopic spine surgeries are less tissue dissection and muscle trauma, reduced blood loss, less damage to the epidural blood supply and consequent epidural fibrosis and scarring, reduced hospital stay, early functional recovery and improvement in the quality of life & better cosmesis. With precise indication, proper diagnosis and good training, the endoscopic spine surgery can give equally good result as open spine surgery. Initially, endoscopic technique was restricted to the lumbar region but now it also can be used for cervical and thoracic disc herniations. Previously endoscopy was used for disc herniations which were contained without migration but now days it is used for highly up and down migrated disc herniations as well. Use of endoscopic technique in lumbar region was restricted to disc herniations but gradually it is also used for spinal canal stenosis and endoscopic assisted fusion surgeries. Endoscopic spine surgery can play important role in the treatment of adolescent disc herniations especially for the persons who engage in the competitive sports and the athletes where less tissue trauma, cosmesis and early functional recovery is desirable. From simple chemonucleolysis to current day endoscopic procedures the history of minimally invasive spine surgery is interesting. Appropriate indications, clear imaging prior to surgery and preplanning are keys to successful outcome. In this article basic procedures of percutaneous endoscopic lumbar discectomy through transforaminal and interlaminar routes, percutaneous endoscopic cervical discectomy, percutaneous endoscopic posterior cervical foraminotomy and percutaneous endoscopic thoracic discectomy are discussed.

• Journal of Korean Neurosurgical Society
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• 제59권1호
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• pp.65-68
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• 2016

Ochronosis is a musculoskeletal manifestation of alkaptonuria, a rare hereditary metabolic disorder occurs due to the absence of homogentisic acid oxidase and leading to various systemic abnormalities related to deposition of homogentisic acid pigmentation (ochronotic pigmentation). The present case reports the clinical features, radiographic findings, treatments and results of a cervical spondylotic myelopathy woman patient due to the ochronotic arthropathy of the cervical spine. The patient aged 62 years was presented with gait disturbance and hand clumsiness. Physical examination, X-rays, computed tomography and lab results of the urine sample confirmed the presence of ochronosis with the involvement of the cervical spine. The patient underwent a modified cervical laminoplasty due to multi-segment spinal cord compression. The postoperative follow-up showed a good functional outcome with patient satisfaction. The present study concludes the conditions and important diagnostic and surgical aspects of a patient. It is necessary to identify the condition clinically and if cord compression is observed, appropriate surgical interventions needs to be instituted.

• 대한한의학회지
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• 제28권3호통권71호
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• pp.45-56
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• 2007

Objectives : We investigated the possibility of cervical spine misalignment caused by scalenus anticus syndrome to find out how it affects cervical spine misalignments. Methods : 28 patients with scalenus anticus syndrome (sample group), along with 21 participants without neck pain (control group), who attended the Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-guk University from the 20th of June to the 30th of November, 2006 were investigated. After researching misalignments through neutrality, flexion and extension lateral x-ray examination views, we measured the difference of each length of cervical spine misalignment. We analyzed the relationships among the neutrality lateral, flexion lateral and extension lateral positions. Results : We found with statistical significance that there were differences in length of cervical spine misalignments between the sample and control groups. Furthermore, we found that C3 and C4 vertebra bodies were shown in lateral neutrality position, only C3 vertebra body in flexion lateral position, and C2, C3, and C4 vertebra bodies in extension lateral position. Conclusions : It is considered that scalenus anticus syndrome could increase cervical spine misalignment which could be a factor in causing cervical spine disease.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.18-24
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• 2011

Purpose: Missing cervical pathology after injury may lead to disability and influence long-term survival. Controversies continue to evolve concerning the initial screening methods used to predict cervical spine injury. Through a retrospective chart review, we attempted to analyze and propose factors predictive of cervical trauma. Methods: Of all the patients who had visited the Emergency Department of Korea University, from January 2009 to December 2009, a retrospective review of the clinical records of the 217 patients who had undergone cervical spine computed tomography was done. We investigated whether we could predict the need for cervical spine computed tomography shortly after presentation in trauma patients by comparing the group with fractures and group without fractures and by finding risk factors showing significant differences between the two groups that might be used as guides in decision making. Results: Of the 217 subjects who underwent cervical spine computed tomography scans, 33 were identified with fractures of the cervical spine while 184 were not. The most common mechanisms of trauma, in order, for those with fractures were falls, followed by traffic accidents. We found that the injury severity score, multiple injuries, a high-energy injury mechanism, neurologic deficit, and pain and tenderness of the cervical spine showed statistically significant differences between the two groups. Conclusion: Fractures of the cervical spine that are not observed with simple radiography occur with a relatively high frequency in trauma patients. Consideration should be given to the risk factors for cervical spine fracture, and if pertinent, cervical spine computed tomography should be performed with speed for early diagnosis of cervical spine fractures.

• 국제물리치료학회지
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• 제7권2호
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• pp.1051-1055
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• 2016

The purpose of this study was to investigate the effect of the screen size of smart devices on the bending angle of the cervical spine. The subjects of this study were 30 healthy adults(15 men and 15 women) who used smartphones and tablet PC(personal computer). The changes in the bending angle of the upper and lower cervical spine were measured in the subjects after they had used a smartphone and a tablet PC for 300 seconds each. To make sure that all subjects began in the same starting position, an angle-measuring instrument was used to set the angles of the ankle, knee, hip, and arm joints to 90 degree. The subjects were asked to keep the trunk straight. They were asked to hold a smartphone in their hand and to bend their neck so that they could look down at the screen. Once they began using the smartphone in this manner, they were free to change their posture. We used a paired t-test to compare the bending angle of the cervical spine on subjects who used smartphones and tablet PC in the long-term and short-term there production error of cervical and the significance level was cervical. The results showed that, when using a smartphone and a tablet PC for 300 seconds, there was no significant difference in the bending angle of the upper cervical spine(p>.05), although there was a significant difference in the bending angle of the lower cervical spine(p<.05).

• 척추신경추나의학회지
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• 제1권2호
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• pp.11-20
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• 2006

Objectives: The aim of this study is to investigate clinical effects of Chuna treatment on the neck pain patient with hypolordotic cervical spine. Methods: From June 2006 to August 2006, 20 cases of neck pain patient with hypolordotic cervical spine were divided into 2 groups. Control group(n=10) was treated only acupuncture therapy, and sample group(n=10) was treated Chuna after acupuncture therapy same as control group. Degrees of pain were measured with Visual Analogue Scale(VAS), and the change of cervical curvature was assessed Depth of cervical curve, Method of Jochumsen, and Angle of cervical curve. Results: 1. After 3th and 5th treatment, there was statistical significance between control and sample group in VAS. 2. After 5th treatment, there was not statistical significance between control and sample group in Depth of cervical curve, Method of Jochumsen, and Angle of cervical curve. Conclusions: On treating the neck pain patient with hypolordotic cervical spine, Chuna treatment is more effective than only acupuncture therapy in reducing neck pain, but Chuna treatment for short-term is not more effective than only acupuncture therapy in restoring cervical curvature.

• Journal of Trauma and Injury
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• 제22권2호
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• pp.154-160
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• 2009

Purpose: This study aimed to determine new criteria for detecting independent factors with high sensitivity in cases of cervical spine injury. We compared the sensitivity, the specificity, and the false negative predictive value (NPV) of plain radiographs with those of computed tomography for cervical spine injury in patients with minor head injury. Methods: We retrospectively reviewed the cases of 357 patients who underwent both cervical plain radiographs and computer tomography from January 2006, to September 2008. Patients were divided into two groups: the cervical spine injury group and the no cervical spine injury group. New criteria were organized based on variables that had significant differences in the logistic regression test. Results: Among the 357 patients, 78 patients had cervical spine injuries. The average age was $43.9{\pm}15.2$ yrs old, and the male-to-female ratio was 1.90. The most common mechanism of injury was motor vehicle accidents. There was a significant difference in loss of consciousness, Glasgow Coma Scale (GCS)=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs between the two groups on the logistic regression test. New criteria included the above five variables. If a patient has at least variable, the area under the ROC curve of the new criteria was 0.850, and the sensitivity and the false NPV were 87.2% and 5.2%, respectively. Conclusion: New criteria included loss of consciousness, GCS=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs. If the patient had at least 1 variable, he or she could have a of cervical spine injury with a sensitivity of 87.2% and a false NPV of 5.2%.