Age-Related Incidence of Cervical Spondylosis in Residents of Jeju Island

문명상,윤민근,박봉근,박민석 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.5

Study Design: Cervical spine radiograms of 460 Jeju islanders. Purpose: To investigate the age-matched incidences and severity of the cervical disc degeneration and associated pathologic findings. Overview of Literature: Several related studies on the incidences of disc and Luschka’s and facet joint degeneration have provided some basic data for clinicians. Methods: Cervical radiographs of 460 (220 males and 240 females) patients in their fourth to ninth decade were analyzed. Ninety patients in their third decade were excluded because of absence of spondylotic findings. Results: Overall incidence of cervical spondylosis was 47.8% (220 of 460 patients). The percentile incidences of spondylosis in the fourth, fifth, sixth, seventh, eighth and ninth decade was 13.2% (10 of 76 patients), 34.6% (37 of 107 patients), 58.9% (66 of 112 patients), 58.8% (50 of 85 patients), 70.3% (45 of 64 patients) and 75.0% (12 of 16 patients), respectively. The percentile incidences of one, two, three, four and five level spondylosis among 220 spondylosis patients was 45.5% (n=100), 34.1% (n=75), 15.0% (n=33), 4.5% (n=10), and 0.9% (n=2). Severity of disc degeneration ranged from ± to ++++, and was ± in 6.0% (24 segments), + in 49.6% (198 segments), ++ in 35.3% (141 segments), +++ in 9.0% (36 segments) and ++++ in 0.25% (one segment). Spurs and anterior ligament ossicle formed at the spondylotic segments, mostly at C4~6. The rate of posterior corporal spurs formation was very low. Olisthesis and ossification of the posterior longitudinal ligament were rarely combined with spondylosis. Cervical lordotic curve decreased gradually according to the progress of severity of spondylosis. Conclusions: The incidence of cervical spondylosis and number of spondylotic segments increase, and degeneration gradually becomes more severe with age.

급성 경추부 척수 손상에 미치는 경추증의 영향

서형연,정재윤,김기형 대한척추외과학회 2010 대한척추외과학회지 Vol.17 No.4

Study Design: A retrospective study Objectives: To examine the influence of cervical spondylosis on an acute cervical spinal cord injury. Summary of Literature Review: There are no reports on the relationship between cervical spondylosis and acute cervical spinal cord injuries. Materials and Methods: Twenty six patients who underwent operative treatment for acute cervical injuries with spinal cord injury were evaluated. The mean age and follow-up period was 58 years and 2.2 years, respectively. The evaluation was performed by examining the causes of the injuries, and the classification of fractures according to the presence of cervical spondylosis. This study compared the degrees of postoperative neurological recovery with motor index score in the groups with and without cervical spondylosis. Results: Cervical cord injuries were more prevalent in the group 60 years and older; 17 cases vs. 9 cases in the group under 60 years. Eleven (65%) and 6 (35%) cases in the group 60 years and older had sustained a high and low energy injury, respectively. In contrast,mostly high energy injuries (8 in 9 cases) were encountered in the group under 60 years of age. A low energy injury could cause a acute cervical cord injury in the group 60 years and older, who also had cervical spondylosis. In those cases, previous cervical spondylosis might be one of the etiologic factors. Conclusions: The cases with cervical spondylosis in the group 60 years and older tended to show incomplete cord injury and good postoperative neurological recovery when they had sustained cervical cord injuries. 연구계획: 급성 경추부 척수 손상과 경추증의 관계를 후향적으로 알아보고자 하였다. 목적: 척수 손상이 동반된 급성 경추 손상으로 수술적 치료를 받았던 환자들을 분석하여, 손상의 원인 및 정도, 경추증의 유무, 손상의 종류, 수술의 방법, 치료 결과, 신경학적 회복의 정도 등을 조사하여 경추증이 급성 경추부 척수 손상에 미치는 영향을 알아보고자 하였다. 선행문헌의 요약: 급성 경추부 척수 손상과 경추증의 관계에 대한 선행 연구는 많지 않다. 대상 및 방법: 척수손상이 동반된 급성 경추부 손상으로 수술적 치료를 받았던 환자중 2년 이상 추시가 가능하였던 26례를 대상으로 하였으며, 평균 추시 기간은 2.2년이었다. 남자가 19례, 여자가 6례, 평균 연령은 58세(17세-81세)이었다. 경추증의 유무에 따른 손상의 원인, 골절의 기전, 술전 및 최종추시에서의 근력평가지수 등을 조사하였고 신경학적 회복의 정도를 비교하였다. 결과: 60세 이하가 9명, 60세 이상의 환자가 17명으로 60세 이상군에서 척수 손상이 많이 발생하고 있었다. 60세 이하 9명중 8명(89%)이 고에너지 손상이었던 것에 반해, 60세 이상 17명중에서는 고에너지 손상이 11례(65%), 저에너지 손상이 6례(35%)로 저에너지 손상에서도 척수 손상이 비교적 많이 동반되는 것으로 조사되었으며, 이들에서는 기왕의 경추증이 동반되어있는 것으로 나타났다. 경추증이 있는 예에서는 불완전 척수 손상이 많았으며, 수술후 신경학적 회복율이 다른 예에서보다 양호하였다. 결론: 60세 이상의 연령군에서도 경추부 손상시 급성 척수 손상이 많이 동반되고 있었으며, 이 경우에는 저에너지 손상에 의한 불완전 척수 손상이 많았다. 기왕의 경추증이 한 원인으로 조사되었고, 수술적 치료 후에 상대적으로 양호한 신경학적 회복을 보였다.

Localizing Value of Pain Distribution Patterns in Cervical Spondylosis

Krishnapundha Bunyaratavej,Peerapong Montriwiwatnchai,Rungsak Siwanuwatn,Surachai Khaoroptham 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.2

Study Design: Prospective observational study. Purpose: To investigate the value of pain distribution in localizing appropriate surgical levels in patients with cervical spondylosis. Overview of Literature: Previous studies have investigated the value of pain drawings in its correlation with various features in degenerative spine diseases including surgical outcome, magnetic resonance imaging findings, discographic study, and psychogenic issues. However, there is no previous study on the value of pain drawings in identifying symptomatic levels for the surgery in cervical spondylosis. Methods: The study collected data from patients with cervical spondylosis who underwent surgical treatment between August 2009 and July 2012. Pain diagrams drawn separately by each patient and physician were collected. Pain distribution patterns among various levels of surgery were analyzed by the chi-square test. Agreement between different pairs of data, including pain diagrams drawn by each patient and physician, intra-examiner agreement on interpretation of pain diagrams, inter-examiner agreement on interpretation of pain diagrams, interpretation of pain diagram by examiners and actual surgery, was analyzed by Kappa statistics. Results: The study group consisted of 19 men and 28 women with an average age of 55.2 years. Average duration of symptoms was 16.8 months. There was no difference in the pain distribution pattern at any level of surgery. The agreement between pain diagram drawn by each patient and physician was moderate. Intra-examiner agreement was moderate. There was slight agreement of interexaminers, examiners versus actual surgery. Conclusions: Pain distribution pattern by itself has limited value in identifying surgical levels in patients with cervical spondylosis.

變形性 脊椎症의 蜂藥鍼 治療 效果

안병준,송호섭 대한침구의학회 2007 대한침구의학회지 Vol.24 No.3

Objectives : This study was to evaluate the effectiveness of Bee Venom acupuncture therapy on patients with cervical spondylosis. Methods : We investigated 29 cases of patients with cervical spondylosis. We divided patients into two groups: Bee venom Acupuncture was performed at one group, and the other group we did acupuncture therapy. To evaluate the effectiveness of treatment applied for two groups, we used visual analog scale(VAS) and neck disability index(NDI). We compared the VAS and NDI score of two groups statistically. Results : As a result of evaluation by using visual analog scale(VAS) and neck disability index(NDI), treatment score at final was significantly different from that at the baseline in each groups. Treatment at final, Bee venom acupuncture therapy group showed significant difference on visual analog scale(VAS) and neck disability index(NDI) compared with acupuncture therapy group. Conclusions : Bee Venom acupuncture therapy can be used with acupuncture therapy for highly effective in the patient with cervical spondylosis.

Rhomboids Strength Training for Improvement of Somatic Symptoms of Cervical Spondylosis

ZHA Yuliang,SUN Jingquan,Cai Ge 한국웰니스학회 2018 한국웰니스학회지 Vol.13 No.1

It could be derived from the relevant traditional Chinese medical theories that rhomboids strength training is expected to improve the somatic symptoms of cervical spondylosis. Twelve cervical spondylosis cases (male, 32.67 ± 7.57 yrs) confirmed were tested for maximum isotonic contraction rhomboids muscle strength, with an improved high-intensity training for a period of a fortnight. Right after the training, maximum muscle strength test of the rhomboids isotonic contraction was done again and was compared with that before the training, for the purpose of determining whether those subjective somatic symptoms were improved. Data collected before and after training were processed by IBM Information Management’s PASW Statistics 18.0 under paired-sample T-test (two-tailed, α= 0.05). This experiment demonstrated that after specific training the rhomboids myodynamia was significantly boosted (P <0.05), and that all subjects’ subjective somatic symptoms were improved. Targeted exercises for Jin (muscles and tendons) in the region around Du Meridian in the upper back is helpful for the treatment of cervical spondylosis, and Qi stagnation and blood stasis in the upper back, neck and shoulder. In modern physical training, compliance with the guidance of traditional Chinese medicine is effective for the control of somatic symptoms of cervical spondylosis, whereupon such compliance is the conjunction of the combination of traditional Chinese and Western medicine in the non-clinical arenas.

다분절 경추증에서 경추 후궁 성형술과 경추 후궁 절제술 및 유합술의 결과 비교

이철원,강진헌,이규열,성현우 대한척추외과학회 2010 대한척추외과학회지 Vol.17 No.3

Study Design: This is a retrospective study. Objectives: We wanted to compare the clinical and radiographic outcomes of laminoplasty and laminectomy & fusion to treat multilevel cervical spondylosis. Summary of the Literature Review: Laminoplasty and laminectomy & fusion are being increasingly used to treat multilevel cervical spondylosis, but definitive guidelines have not yet been established. Materials and Methods: Fifty eight patients who were followed up for more than a year and who were treated for multilevel cervical spondylosis with either laminoplasty or laminectomy & fusion between March 2000 and March 2009 were reviewed. Twenty eight patients who underwent laminectomy & fusion were matched with 30 patients who underwent laminoplasty. Results: The laminoplasty group showed statistically significant improvements in the Japanese Orthopaedic Association (JOA) score and Visual analogue scale (VAS) score. The cervical lordosis for the preoperative and latest sagittal alignment in the laminoplasty group decreased from 14 degrees to 5 degrees and the cervical kyphosis in the laminectomy & fusion group increased from 10 degrees to 15degrees with no statistically significant difference. However, 3 cases with less than 5 degrees of cervical lordosis in the laminoplasty group showed progression of kyphosis at the last follow-up. Conclusion: The clinical outcomes of laminoplasty for multilevel cervical spondylosis were better than those of laminectomy & fusion. However, it is considered that additional study for laminectomy & fusion is needed to prevent the long-term progress of cervical kyphosis in cases with preoperatively decreased cervical lordosis of less than 5 degrees, though it is impossible to make such comparisons with the small number of cases in our study. 연구계획: 다분절 경추증의 치료에서 경추 후궁 성형술과 경추 후궁 절제술 및 유합술의 임상적 및 방사선학적 결과를 비교하는 후향적 연구. 목적: 다분절 경추증의 치료에서 우수한 방법으로 점진적으로 사용이 증가되고 있는 경추 후궁 성형술과 경추 후궁 절제술 및 유합술에 대한 임상적 및방사선학적 결과를 비교하여 평가하고자 한다. 선행문헌의 요약: 다분절 경추증의 치료에서 경추 후궁 성형술과 경추 후궁 절제술 및 유합술의 사용이 증가되고 있지만 이에 대한 명확한 치료 지침이확립되어 있지 않다. 대상 및 방법: 2000년 3월부터 2009년 3월까지 다분절 경추증의 치료에서 경추 후궁 성형술과 경추 후궁 절제술 및 유합술을 시행한 환자 중 1년 이상추시 가능한 58명을 대상으로 하였다. 이 중 30명은 경추 후궁 성형술을 시행하였고, 28명은 경추 후궁 절제술 및 유합술을 시행하였다. 결과: Japanese Orthopaedic Association (JOA) score와 Visual analogue scale (VAS) score는 경추 후궁 성형술 군에서 통계적으로 우수한 것으로 나타났다. 그리고 수술 전과 최종 추시시의 시상 정렬은 경추 후궁 성형술 군의 경우 경추 전만곡이 14도에서 5도로 감소하였고, 경추 후궁 절제술 및 유합술 군의 경우 경추 후만곡이 10도에서 15도로 증가하였으며 이는 통계적 유의성이 없었다. 그러나 본 연구에서 경추 후궁 성형술을 시행한 군 중 경추전만곡이 5도 이하인 3예에서 최종 추시시에 경추 후만곡이 진행되었다. 결론: 다분절 경추증의 치료에서 경추 후궁 성형술이 경추 후궁 절제술 및 유합술보다 임상적 평가에서 우수한 결과를 보였다. 그러나 5도 이하로 전만각이 감소한 경우에는 장기적인 경과관찰이 필요하며 경추 후만곡의 진행을 방지하기 위해 경추 후궁 절제술 및 유합술에 대한 추가 연구가 필요할 것으로 사료된다.

골밀도(骨密度)와 퇴행성 척추증 환자의 치료예후와의 상관관계

권영민 ( Young Min Kwon ),반사평 ( Shih Ping Pan ),김순중 ( Sun Jung Kim ) 한방재활의학과학회 2002 한방재활의학과학회지 Vol.12 No.4

Objective : The purpose of this study is Quantitative analysis of oriental medical treatment by QCT(quantitative computed tomography), in order to explain of improvement for Degenerative spondylosis. Methods : We use method of projection with Quantitative computed tomography(QCT) to estimate Bone mineral density(BMD) of lumbar spine more precisely. From January 2002 to July 2002, We compared VAS(Visual Analogue Scale) with lumbar BMD, T-score, Z-score of patient who visited Hospital by QCT.Result : The scores of BMD don`t have correlation with VAS. The scores of Z-score has somewhat correlation with VAS, but there was no Significant. The score of T-scores has strongly correlation with VAS and there had valid Significant. Conclusion : These results suggest that We can use more T-score than BMD or Z-score to estimate improvement of oriental medical treatment for Degenerative spondylosis.

흉요추이행부의 다발성수핵탈출증 및 골극형성에 의한 척추강 협착증 : 증례보고

조기홍,안영환,안영민,윤수한,조경기 아주대학교 의과학연구소 1996 아주의학 Vol.1 No.1

Thoracic spondylosis is relatively uncommon compared to cervical or lumbar spondylosis. It may cause spinal canal stenosis and result in radiculopathy, neurogenic claudication, and most commonly, myelopathy. Difficulty in detecting abnormality at the thoracolumbar junction on plain X-ray, and similarity of the symptoms to peripheral nerve disease often lead to a delay in diagnosis. We present a case with symptomatic thoracic spondylosis due to multiple disc herniation and osleophytes at the thoracolumbar junction. The significance of examinations including thoracolumbar junction in cases of lower lumbar peripheral symptoms and the method of operation in such cases is discussed here. The result of discectomy, osteophytectomy and interbody fusion by thoracoabdominal approach for our case was acceptable.

Radiculomyelopathy를 동반한 Cervical Spondylosis의 Posterior Approach

김대현,강병직,황성규,함인석,박연묵,김승래 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.6

Radiculomyelopathy의 소견을 나타낸 68명의 Cervical spondylosis환자중에서 posterior approach에 의한 cervical laminectomy로써 Neural decompressive surgery를 받은 28명의 환자에 대해서 수술치료의 결과를 분석하였으며 아울러 경부 단순엑스선상에서 경추관 전후경의 크기를 분석 검토하였다. 경추 C_(3-7) 부위에서 계측된 경추관 전후경의 평균치(mean±SD)는 정상 성인에서는 16.5±1.83㎜ 이었으며 radiculomyelopathy의 소견을 나타낸 환자에서는 정상 성인에 비해 현저히 협소한 7.3±1.08㎜이었다(p<0.01). 그리고 cervical spondylosis 환자에서 병변이 없는 병소 직상 및 하부위에서의 경추관 전후경은 각각 11.8±1.20 및 12.1±1.61㎜로서 정상 대조군에 비해 역시 현저히 협소한 평균치를 나타내었다(p<0.01). Posterior approach에 의한 cervical laminectomy를 받은 29명 환자의 수술결과는 술후 현저한 호전의 결과를 나타낸 것이 51.7% 그리고 호전이 44.8%로 분석되었다. Of the 68 cervical spondyltic patients showing symptoms of radiculomyelopathy, assessments were made on 29 patients who underwent neural decompressive surgery with cervical laminectomy through posterior approach for the results of surgery. Analyses were also made on the anterior-posterior diameters of cervical canal on the plain film of cervical spine. The mean values of anterior-posterior diameters measured on the levels of cervical C3-7 were 16.5±1.83㎜ in the normal adult and 7.3±1.08㎜ in the cervical spondylotic patients with radiculomyelopathy, which is far narrower than that of the normal. In cervical spondylotic patients, the anterior-posterior diameters of directly upper and lower parts of the lesions were 11.9±1.20㎜ and 12.1±1.61㎜ respectively, also much narrower mean values than those of the normal control group. The results of the 29 patients who received cervical laminectomy by posterior approach were much improved for 51.7% and improved for 44.8%.

단순방사선 검사상 주관절 외상과염과 경추 척추증의 관계

윤우석,한순현,이종수,심우진,Youn, You-Suk,Han, Soon-Hyun,Lee, Jong-Soo,Sim, Woo-Jin 척추신경추나의학회 2002 대한추나의학회지 Vol.3 No.1

Objectives : To study that lateral epicondylitis(tennis elbow) is related with cervical spondylosis. Subjects : The study was composed of 25 patients of lateral epicondylitis(LEP group) and 25 normal control group(CON group). Method : Simple radiologic scale was compared such as cervical lordotic angle, grading for disc degeneration. Pavlov ratio and Intervertebral body Index Results : Cervical lordotic angle and disc degeneration is not significantly different. And Pavlov ratio and intervertebral body index is significantly decrease in the LEP group. Conclusion : The cervical spondylosis is related with ocuuring lateral epicondylitis.