• Journal of Oral Medicine and Pain
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• v.21 no.2
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• pp.393-405
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• 1996

This study was performed to investigate the effects of changes of head posture and cervical spine shape on the mandibular resting or clenching electromyographic(EMG) activity in anterior temporalis(TA), masseter(MM), sternocleidomastoid muscle(SCM) and trapezius insertion(TI). 30 patients with Temporomandibular Disorders(TMDs) participated in this study. EMG activity($\mu$V) at rest and clenching was observed in four head postures, namely natural head posture(NHP), forward head posture(FHP), upward head posture(UHP), and downward head posture(DHP). For taking in upward or downward head posture head was inclined 10$^{\circ}$ upward or downward and CROM$^\textregistered$(cervical-range-of motion, Performance attainment Inc., USA) was used to maintain same posture during the procedure, and BioEMG$^\textregistered$ (Bioelectromyograph, Bioresearch Inc., USA) was used to record EMG activity in the above four muscles at eight locations on both sides. The recorded EMG activity($\mu\textrm{V}$) were compared and analyzed by cervical spine shape such as the head position from plum line, cervical curvature, and cervical inclination. Head position from plum line was measured in vertical plate calibrated with cm scale, comical curvature by radius was measured with adjustable curved ruler, and cervical inclination by cervical vertebrae tangent(CVT)was measured in lateral cephalograph. The results obtained were as follows : 1. Mean value of head position from plum line, cervical curvature, and cervical inclination were 4.8cm, 26.7cm, and 86.6$^{\circ}$, respectively, And There were no correlationship among these items. 2. For resting EMG activity by head posture, the value in anterior temporalis was higher at FHP than at DHP, the value in masseter was higher at FHP than at NHP, and DHP, the value in sternocleidomastoid muscle was higher at UHP than at NHP, and the value in trapezius insertion was higher at FHP and DHP than, NHP and UHP. The clenching EMG activity, however, did not show any difference by head posture. 3. Comparison of resting and clenching EMG activity between higher and lower groups by head position from plum line, cervical curvature, and cervical inclination did not show any significant difference. From this result, the author concluded that the cervical spine shape had not significantly affected to EMG activity in usual patients with TMDs.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.12 no.1
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• pp.57-70
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• 2017

Objectives : The purpose of this study is to find out the factors affecting the cervical angle with kyphosis. Methods : We investigated 340 cases of patients who had cervical kyphosis. We used cervical angle, flexion malposition angle, odontoid process cline angle, axis-atlas cline angle, odontoid process-atlas cline angle and occiput-atlas cline angle. Correlations between cervical angle and flexion malposition angle, odontoid process cline angle, axis-atlas cline angle, odontoid process-atlas cline angle, occiput-atlas cline angle were analyzed by pearson correlation analysis. Results : The correlation between cervical angle and flexion malposition angle was p-value 0.007, and odontoid process cline angle was p-value 0.002, and axis-atlas cline angle was p-value 0.000, and odontoid process-atlas cline angle was p-value 0.000, and occiput-atlas cline angle was p-value 0.012. Conclusions : Flexion malposition angle, odontoid process cline angle are inversely proportional to cervical angle. And correlation is statistically significant(p<0.01). Axis-atlas cline angle, odontoid process-atlas cline angle are proportional to cervical angle. And correlation is statistically significant(p<0.01). Occiput-atlas cline angle is proportional to cervical angle. And correlation is statistically significant(p<0.05).

• Journal of Acupuncture Research
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• v.27 no.2
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• pp.97-104
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• 2010

Objectives : The authors aimed to determine the presence of relationships between cervical pain and cervical curvature, lumbar curvature, sacral slope and sagittal spinal balance. Methods : Medical records of outpatients who made their first visits to the Department of Acupuncture and Moxibustion in the Spine center at Kyung Hee East-West Neo Medical Center between September 1, 2008 and October 31, 2009 were evaluated. A total of 50 patients visiting within the time period had visited with a chief complaint of cervical pain, and had lateral entire spine X-rays taken. After excluding patients with previous spine operations, 46 patients were selected for the final analysis. The cervical lordotic angle(CLA), lumbar lordotic angle(LLA), Ferguson's angle(FA), and sagittal vertical axis(SVA) were measured on the lateral entire spine X-ray cuts, and the relationships between these values and patient gender, age, chief complaint, and duration of symptoms were assessed. Results : No significant difference was found in relationships between gender and measured values. SVA showed statistically significant correlation between age, but CLA, LLA, and FA was not. There was a significant difference in SVA between patients with only cervical pain and those with both cervical pain and low back pain. Patients with a duration of symptoms longer than 6 months showed a statistically significant difference in SVA with those who had shorter symptoms. Correlation analysis between measured values was statistically significant only between LLA and FA. Conclusions : Evaluation and treatment of sagittal imbalance should be considered in patients presenting with cervical pain if symptoms have persisted for over 6 months or have accompanying low back pain.

• Journal of Korean Neurosurgical Society
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• v.43 no.6
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• pp.259-264
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• 2008

Objective : Total laminectomy (TL) is an effective surgical technique for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) along multiple levels. However, kyphosis and probable neurological deterioration have been frequently reported after laminectomy. We analyzed the changes in the cervical curvature after TL and subsequent changes in neurological status. Methods : We retrospectively reviewed the records of 14 patients who underwent TL for the treatment of cervical OPLL between Jan. 1998 and Dec. 2003. TL was selected according to the previously determined criteria. The curvature of the cervical spine was visualized on a lateral cervical spine X-ray and measured using Ishihara's Curvature Index (CI) before the operation and at the last follow-up examination. Perioperative neurological status was estimated using the modified Japanese Orthopedic Association score and the Improvement Rate (IR) at the same time as the images were evaluated. Results : The mean age of the patients was 57 years, the male/female ratio was 10:4, and the mean follow-up period was 41 months. The mean number of OPLL was 4.9, and the mean number of operated levels was also 4.9. The CI decreased after TL (p=0002), which was indicative of a kyphotic change. However, this kyphotic change showed no correlation with the length of the follow-up period, number of operated levels and preoperative CI. Neurological examination at the last follow-up showed an improved neurological status in all patients (p=0.001). There was no neurological deterioration in any case during the follow-up period. Moreover, there was no correlation between IR and the degree of kyphotic change. Postoperative complications, such as C5 radiculopathy and epidural bleeding, resolved spontaneously without neurological sequelae. Conclusion : Kyphotic change was observed in all but one patient who underwent TL for the treatment of cervical OPLL. However, we did not find any contributing factors to kyphosis or evidence of postoperative neurological deterioration.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.9 no.1
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• pp.39-53
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• 2014

Objectives : The purpose of this study is to investigate the clinical application of chuna for temporomandibular joint(TMJ) in nuchal pain patients with temporomandibular joint disorder(TMD). Methods : Four patients were treated by chuna for TMJ to evaluate the effect of the treatment. The patient's symptoms were assessed by visual analogue scale(VAS), neck disability index(NDI), cervical lordotic curvature. Results : In all case, the pain was reduced according to VAS, NDI. cervical lordotic curvature of three cases were improved. Conclusions : These results suggest that chuna for TMJ might be an effective method to treat nuchal pain with TMD. But, it's necessary to have more observations and experiments.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.1
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• pp.37-51
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• 2017

Objectives This study was designed to identify the effect of acupuncture combined with wooden neck pillow self-exercise program (WSP). Methods 25 eligible subjects with chronic neck pain were recruited from September 2015 to August 2016. Subjects were treated by acupuncture twice a week for 4 weeks, also were educated WSP and exercised every day for 4 weeks. They were assessed using PI-NRS, NDI and the maximum muscle strength of deep cervical flexor muscles (DCF) before and after treatment. Also the Cobb's angle (C1-C7), Ishihara index, Park method were assessed for evaluating the radiographical changes. Variables were compared using paired t-test. And correlates analysis was used for analyzing relationship between differentials in the maximum muscle strength of DCF and differentials in cervical spine curvature measurement methods. Results Among the 25 subjects, 4 subjects were lost to follow-up or excluded in accordance with the criteria. Significant differences on NRS, NDI and the maximum muscle strength of DCF were seen after treatment (p<0.001). In radiological finding, cervical spine curvature measurement methods were significantly increased (p<0.001, p<0.05, p<0.05). Differentials in the maximum muscle strength of DCF significantly correlates to differentials in Ishihara index (R=0.479, p<0.05). Conclusions Acupuncture combined with WSP may decrease neck pain intensity and associated disability, and also increase the muscle strength of DCF and cervical lordosis, in patients with chronic neck pain. Especially, Improving the muscle strength of DCF has a relationship with improving Ishihara index. However, due to the design of this study, this treatment can not be compared with other treatments. Future randomized project should be needed.

• The Journal of Korea CHUNA Manual Medicine
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• v.2 no.1
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• pp.85-92
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• 2001

Objectives : To study the cervical lordosis and disc degeneration in neck pain patients with or without low back pain. Subjects. The study was composed of 57 neck pain patients with low back pain(LBP group) and 40 neck pain patients without low back pain(Non-LBP group). Methods : Radiographic measures of spinal lordosis(cervical and lumbar) and disc degeneration were collected, and statistically analyzed. Results: LBP group showed a significant increase in cervical lordotic angle as compared with Non-LBP group, whereas no significant change in cervical disc degeneration. A relationship was found between cervical and lumbar disc degeneration in LBP $group({\gamma}-0.3064)$. Conclusions : The findings from this study suggest that the curvature of the cervical spine is related to the subject's low back pain.

• Journal of Korean Neurosurgical Society
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• v.60 no.4
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• pp.456-464
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• 2017

Objective : Although little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors. Methods : Between March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity. Results : A total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain. Conclusion : We managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.2
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• pp.199-208
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• 2010

Objectives : To study the cervical lordosis and roentgenographic analysis of cervical disc space in neck pain with or without temporomandibular disorder(TMD). Methods : Radiographic measures of cervical lordosis, cervical disc space narrowing were collected, statiscally analyzed. Results : TMD group showed a significant increase in cervical lordotic angle as compared with non-TMD group, whereas no significant change in cervical disc degeneration. Conclusions : The findings from this study suggest that the curvature of the cervical spine is related to the subject's TMD.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.2
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• pp.213-225
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• 2009

Objectives : The purpose of this study was to investigate the factors related on pain in female office workers. Methods : Neck pain group of 31 female subjects complained of neck and arm discomfort. Normal group of 20 female subjects had no complaints or minimal discomfort. Cervical curvature and muscle tone were assessed by whole spine x-ray, meridian-electromyography(MEMG), craniovertebral angle, and Moire. Neck pain was evaluated by Neck Disability Index(NDI) and Visual Analog Scale(VAS). The emotional and other physical factors that could effect neck pain were checked by questionnaires including Beck Depression Index(BDI), Stress Reaction Index(SRI), Holmes & Rahe Social Readjustment Rating Scale(SRRS), International Physical Activity Questionnaire(IPAQ), and Gastrointestinal Symptom Rating Scale(GSRS). Results : The contraction and fatigue of upper trapezius by MEMG was significantly higher in the neck pain group. And BDI, SRI, SRRS, and GSRS were significantly higher in the neck pain group (p<0.05). However, there was no significant difference in the Jackson's angle, Cobb's method, craniovertebral angle, and moire between two groups. Conclusions : The results suggest that neck pain is related to mental stress rather than physical stress and physical stress does not change cervical curvature significantly.