경추 전만 정도 및 연령에 따른 경추 추간판 탈출 양상 분석 연구

임지석,윤강현,이승민,조예은,박지민,이상훈,김용석 대한침구의학회 2015 대한침구의학회지 Vol.32 No.3

Objectives : The aim of this study is to investigate the state of cervical disc herniation according to the degree of cervical lordosis and age. Methods : 67 records of inpatients who were diagnosed with herniated intervertebral disc(HIVD) of the cervical spine were analyzed. Cobb’s method, Jochumsen method and the Ishihara index were used to measure the degree of cervical lordosis. The state of the cervical disc was identified using magnetic resonance imaging(MRI) of the cervical spine. Then correlations among cervical lordosis, age and cervical disc herniation were analyzed. Results : Disc bulging was associated with hypolordosis and disc protrusion was associated with hyperlordosis and age. Disc extrusion was not associated with either cervical lordosis or age. The number of disc herniations in the cervical spine was correlated with age significantly, but not with cervical lordosis. Conclusions : Cervical disc herniation had a tendency to correlate with age and cervical lordosis, although this is not definite. Future studies that analyze more radiographic images of patients with HIVD of the cervical spine might be necessary to identify the influence of cervical lordosis on cervical disc herniation.

경추외상후 수핵탈출편에 의한 척수손상

김근수 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.7

경추 추간판 탈출증 입원 환자 102례에 관한 한의학적 복합치료효과의 관찰 연구

최지훈,이순호,김상민,김현중,구자성,이현호,정성현,윤덕원 대한침구의학회 2016 대한침구의학회지 Vol.33 No.2

Effects of Korean Medical Combination Treatment for 102 Cases of Cervical Disc Herniation : An Observational Study Ji Hoon Choi1,*, Sun Ho Lee1, Sang Min Kim1, Hyun Joong Kim1, Ja Sung Koo2, Hyun Ho Lee3, Seong Hyun Jung3 and Deok Won Youn4 1Department of Acupuncture & Moxibusion Medicine, Daejeon Jaseng Hospital of Korean Medicine 2Department of Oriental Internal Medicine, Daejeon Jaseng Hospital of Korean Medicine 3Department of Oriental Rehabilitation Medicine, Daejeon Jaseng Hospital of Korean Medicine 4Department of Acupuncture & Moxibusion Medicine, Haeundae Jaseng Hospital of Korean Medicine Objectives : The purpose of this study is to investigate the clinical effectiveness of Korean medical combination treatment for cervical disc herniation. Methods : This is an observational study. 102 patients diagnosed with cervical disc herniation by MRI (Magnetic Resonance Imaging) were investigated from January, 2015 through to December, 2015 at Daejeon Jaseng Hospital of Korean Medicine. They were sorted according to the distribution of sex, age, causing factor, the period of disease, admission day and pain area. All patients were treated with acupuncture, Chuna treatment, and herbal therapy and physical therapy during the admission period. After treatment, NRS (Numeric Rating Scale), NDI (Neck Disability Index) and EQ-5D were assessed to evaluate the treatment efficacy. Results : There were more females than Males with a ratio of 1 : 1.37, the age of fifty was the most with 35.29 %, reason unknown was the most with 72.55 % and the subacute stage was the most with 38.24 %. According to disc herniation types, patients with protruded disc types were the most with 66.67 % and a lesion of C5/6 was the most with 41.18 %. For patients diagnosed with cervical disc herniation, neck and shoulder pain NRS decreased from 6.43 ± 1.77 to 3.96 ± 1.96(p<0.001) and radiating pain NRS decreased from 5.64 ± 1.96 to 3.57 ± 1.88 (p<0.001). NDI decreased from 41.72 ± 14.04 to 30.84 ± 15.34(p<0.001), and the EQ-5D index increased from 0.68 ± 0.17 to 0.79 ± 0.14(p<0.001) after treating cervical disc patients. Conclusion : Korean medical combination treatment might be effective in decreasing pain and raising the life quality of patients with cervical disc herniation.

경추 협척혈 봉약침 치료에 호전을 보인 상지 활동장애를 호소하는 경추 추간판 탈출증 환자 1례

신화영(Hwayoung Shin),김재수(Jaesu Kim),이경민(Kyungmin Lee) 한국한의학연구원 2010 한국한의학연구원논문집 Vol.16 No.2

Cervical disc herniations can press on the spinal cord and cause a problem called cervical myelopathy. The most common symptom of cervical disc herniation is neck pain that spreads down to the upper limb in various locations. There can also be associated with weakness and movement disorders of upper limb. In Oriental medicine, cervical disc herniation is treated with herb-med, physical therapy, acupuncture, Chuna, etc, but the Bee Venom therapy is the most common and effective. In this case, we used the Bee Venom therapy at cervical hyeopcheokhyeol for about 2 months to a patient who was diagnosed with disc herniation at Cervical 5-6, 6-7 and appealed weakness, limited elevation and abduction of the left upper limb. As a result, left upper limb disability was improved. Using the Bee Venom therapy at cervical hyeopcheokhyeol that are effective on movement disorders and neurological diseases of upper limb is an effective treatment to upper limb disability diagnosed with cervical disc herniation, and suggests the direction of the treatment to upper limb weakness and movement disorders diagnosed with cervical disc herniation.

Clinical Features and Surgical Results of Cervical Myelopathy Caused by Soft Disc Herniation

박성주,김승범,김민기,이성호,오인호 대한척추신경외과학회 2013 Neurospine Vol.10 No.3

Objective: There are many causes of cervical myelopathy including trauma, degenerative conditions, tumors and demyelinating disorders. However, myelopathy caused by soft disc herniation might be seen rarely than the spondylosis caused by hard disc. Here, authors retrospectively analyzed the clinical features and results of cervical myelopathy caused by soft disc herniation. Methods: From March 2010 to December 2010, 134 patients with degenerative cervical spinal disease were treated with anterior cervical discectomy and interbody fusion. Among them, 21 patients with cervical myelopathy secondary to cervical soft disc herniation were analyzed. Their clinical features, preoperative and, postoperative clinical results were evaluated by Nurick Grade and Japanese Orthopaedic Association scale (JOA) retrospectively. Preoperative clinical features including duration of myelopathy, pain intensity and postoperative clinical results including improvement rate of myelopathy and radiculopathy were retrospectively analyzed by Nurick Grade and JOA scale. We also evaluated correlation between the duration of symptom, type of the disc herniation, pain intensity and clinical outcome. Results: Mean age was 49.7 and male was predominant. Gait disturbance with mild to moderate pain was most common symptom in clinical features. Severe pain was shown in only 9 cases, and the other 12 cases experienced mild to moderate pain. Mean duration of myelopathy was 1.18 month. The mean JOA scores were 11.22 before surgery and 14.2 after surgery. The mean Nurick grades were 2.78 before treatment and 1.67 after treatment. Neurologic status of mild or moderate pain group on preoperative state is worse than that of severe pain group. The patients with duration of myelopathy symptom (<1 month) showed lower clinical improvement rate than the patients with myelopathy over 1 month. Patients with median type of disc herniation showed poorer neurological status than those with paramedian type of herniation in preoperative state. Conclusion: Authors reviewed the clinical features and surgical outcome of the cervical myelopathy secondary to cervical soft disc herniation. We presumed that patients of more than one month of symptom duration, mild to moderate initial symptom would be related with better postoperative improvement rate.

경추 추간판 탈출증을 진단함에 있어 경추부 자기공명 영상 소견과 비교한 Spurling test의 진단적 타당성에 대한 연구

문태웅 ( Tae Woong Moon ),강명진 ( Myung Jin Kang ),공덕현 ( Duck Hyun Kong ),김준수 ( Jun Su Kim ),양기영 ( Kee Young Yang ),이재훈 ( Jae Hoon Lee ),은영준 ( Young Jun Eun ),김기주 ( Ki Joo Kim ) 한방재활의학과학회 2009 한방재활의학과학회지 Vol.19 No.2

Objectives: Spurling test is one of the most widely used physical tests to diagnose herniated cervical intervertebral disc. The purpose of this study is to analyse diagnostic validity of Spurling test. Methods: This study was carried out on 382 subjects who visited Bu-Chun Ja-Seng oriental hospital with the neck pain or radiating pain from neck to upper extremities from November, 2007 to October, 2008. All subjects underwent both Spurling test and cervical magnetic resonance imaging(MRI). The associations between Spurling test and herniated cervical intervertebral disc were analysed. Results: 1. The sensitivity of Spurling test for herniated cervical intervertebral disc was 64%. 2. The specificity of Spurling test for herniated cervical intervertebral disc was 86%. 3. The positive predictive value of Spurling test for herniated cervical intervertebral disc was 93%. 4. The negative predictive value of Spurling test for herniated cervical intervertebral disc was 44%. Conclusions: This study suggests that Spurling test is not useful in screening for herniated cervical intervertebral disc due to the test`s relatively low sensitivity. Thus it is necessary to consult advanced tests such as diagnostic imaging to diagnose herniated cervical intervertebral disc.

Clinical Outcomes of Epidural Neuroplasty for Cervical Disc Herniation

박은정,박선영,이세진,김난설,Do Yle Koh 대한의학회 2013 Journal of Korean medical science Vol.28 No.3

Cervical disc herniation is a common disorder characterized by neck pain radiating to the arm and fingers as determined by the affected dermatome. This condition has a favorable prognosis, but pain can have a serious detrimental impact on daily activities. Epidural neuroplasty has been applied as a treatment option for cervical disc herniation; however,no study has addressed the clinical outcomes. This retrospective study evaluated the clinical outcomes of epidural neuroplasty on 128 patients for the treatment of cervical disc herniation. To measure pain-related disabilities over time, the changes of pain scores in neck and arm were evaluated using a numerical rating scale (NRS) and the neck disability index (NDI). Compared with preprocedural values, the pain NRS of neck and arm demonstrated significant improvement at day 1, and 1, 3, 6, and 12 months after the procedure (P < 0.001). Likewise, the NDI was significantly reduced at 3, 6, and 12 months after the procedure (P < 0.001). There were no serious complications. Cervical epidural neuroplasty shows good clinical outcomes in the treatment of cervical disc herniation and can be considered a treatment modality for cervical disc herniation refractory to conservative treatment.

Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI

이지숙,차장규,한종규,김현주 대한영상의학회 2015 Korean Journal of Radiology Vol.16 No.4

To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2–3 though C6–7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI. The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39–0.53 for MDCT images; k = 0.45–0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI. Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI.

경추추간판탈출증과 경부통증에 대한 추나치료에 관한 해외연구동향분석 -Pubmed 검색중심으로-

박상원,변장훈,이종환,하인혁,이진호,Park, Sang-Won,Byun, Jang-Hun,Lee, Chong-Hwan,Ha, In-Hyuk,Lee, Jin-Ho 척추신경추나의학회 2013 척추신경추나의학회지 Vol.8 No.2

Objectives : The purpose of this study is to explore the trends of Chuna(manipulation) treatment on neck pain and cervical disc displacement. Methods : We set up the two searching strategies and investigated the latest clinical trials on Chuna(manipulation) therapy for Neck disorders and cervical disc herniation through PubMed search. The searched papers were analyzed and the year, journals, article types of literatures were examined. Of the articles, Randomized controlled trials(RCTs) are assessed by Jadad scale. Results : Studies on Chuna(manipulation) treatment to cervical disc herniation were very few. Articles on Chuna(manipulation) treatment to neck pain were relatively more than those of cervical disc herniation. The most frequently published journal was J Manipulative Physiol Ther. The main design of study was RCT. The limited quality assessment of RCT was conducted by Jadad scale and the average Jadad score was 1.73, which indicates low quality in terms of Jadad evaluation criteria. Conclusions : International trends of studies on Chuna therapy of cervical disease is increasingly reviewed. Although this review has several limitations, analyzing the latest trends of studies on Chuna(manipulation) treatment on neck pain and cervical disc displacement is necessary for further studies.

한방 병원에 경추 통증으로 내원한 환자들의 흉추부 만곡 및 경추부 추간판탈출증의 상관 관계에 관한 보고

최영준,유수빈,문병헌,정재현,윤영웅,김길환,남항우,이차로,Choi, Young-Jun,Yoo, Su-Bin,Moon, Byung-Heon,Chung, Jai-Hyeon,Yun, Yeong-Ung,Kim, Kil-Hwan,Nam, Hang-Woo,Lee, Cha-Ro 척추신경추나의학회 2015 척추신경추나의학회지 Vol.10 No.1

Objectives : This study is planned to classify correlation between thoracic kyphosis angle and prevalence of cervical intervertebral disc. Methods : We Measured the thoracic kyphosis angel of the 110 men and 179 women patients with neck pain in 00 Korean Medicine Hospital. We use Cobb's angle method and Thoracic cage dimension method for measuring the thoracic kyphosis. And We use Magentic Resonance Imaging(MRI) for classifying the patient who has cervical intervertebral disc or not. Results : 1. There was statistical difference on the thoracic cage dimension with gender(P<0.001), while there was no statistical difference on Cobb's angle with gender(P=0.882). 2. Age and thoracic cage dimension(r=0.383) is statistically more correlative than age and cobb's angle(r=-0.59). Conclusions : 1. Thoracic cage dimension and gender, Thoracic cage dimension and age were statistically concerned on patient who has neck pain, while Cobb's angle had no statistical correlation with age and gender. 2. There was no statistical difference on the Cobb's angle and Thoracic cage Dimension between patient who has one or more cervical disc herniation(Protrusion disc, Extrusion disc) segment and patient who didn't have cervical disc herniation(Protrusion disc, Extrusion disc) segment.