Integrative Korean medicine as a possible conservative treatment for mild cervical spondylotic myelopathy

Abstract

Rationale:Cervical spondylotic myelopathy (CSM) is the most common spinal cord disorder in older patients. The purpose of this case report is to introduce conservative treatment with integrative Korean medicine (KM) as a possible alternative to surgery in patients with mild CSM.Patient concerns:An 81-year-old male with both hand weakness and dysesthesia was diagnosed with CSM and was recommended laminectomy. However, considering the patient's age and the underlying disease, he refused immediate surgery and preferred KM treatmentDiagnoses:The diagnosis of mild CSM was based on a modified Japanese Orthopedic Association (mJOA) score as well as the presence of compression on the spinal cord in magnetic resonance imaging findingsInterventions:Integrative KM treatment consisting of acupuncture, acupotomy, Bee venom herbal acupuncture, cupping therapy, moxibustion, and herbal medicine was provided during the 12-week admission.Outcomes:Clinical improvement was detected with a mJOA score (11 to 17), a numerical rating scale for dysesthesia intensity (5 to 2), finger escape sign (+/+ to +/−), grip and release test (11/14 to 32/31) and grasp power measured by dynamometer (3.1/9.7 to 10.8/18.3 kg) at 12 weeks. This improvement was maintained without surgery until 1 year.Lessons:This case suggests that integrative KM was a possible conservative management option for mild CSM.

A Review of the Korean Traditional Medicine for Cervical Spondylotic Myelopathy

“…국내 데이터베이스에서는 ("경추" and "척수증") or ("경추증" or "척수증")으로 연구 대상을 검색한 뒤, ("침" or "뜸" or "구" or "한의학적 치 료" or "한방요법")를 검색하여 한의학적 치료와 조합하였 으며, 중국 데이터베이스에서는 ("脊髓型頸椎病" or "頸椎 脊髓損傷") and ("中醫" or "針" or "灸")의 검색식을 이용 (Table II). (Table II) [8][9][10][11][12][13][14][16][17][18][19][20][21][22][23][24][25][26][27] .…”

Treatment of Cervical Myelopathy with Acupotomy Combined with Korean Medicine Treatments: Two Clinical Cases

“…4. Operation method [5,6] After sterilizing the treatment site with povidone-iodine and alcohol, the acupotomy needle was inserted towards the facet joint. The blade tip of the needle was held parallel to the articular surface of the facet joint and handled up/down to incise the adhesions surrounding the facet joint capsule.…”

“…If symptoms are severe, surgical treatments such as central-separated laminectomy, interbody fusion, and osteotomy, are considered [3,4]. Conservative treatments include drug therapy, injection therapy, and physical therapy, amongst others [5]. Conservative treatment is more effective than surgical treatment in patients with mild symptoms [3,4].…”

“…Recently, Korean medicine treatments including acupuncture, moxibustion, and acupotomy have been studied for the treatment of various spinal diseases [2,[5][6][7]. Acupotomy has been used to restore soft tissue damage, and the original dynamic state of abnormal lesions of the body by removing adhesions, nodules, and scars [5]. However, reviews report that there are only a few studies using combined Korean medicine treatment including acupotomy for the cervical region [6,7].…”

Clinical Study on 2 Cases of Cervical Spondylotic Myelopathy Treated by Korean Traditional Medicine

“…경추증성 척수증이 지속되면 인접 신경근들이 압박 되어 신경근병증이 초래되기도 하는데 6) 경추 주변의 인 접한 신경근이 압박되어 목과 상지의 저림, 통증, 감각둔 화, 마비 등의 증상을 유발한다 7) . 이에 해당 신경근 부위 이완을 위해 경혈과 근육에 한의학적 침치료, 약침치료, 추나요법을 시행하고 더불어 한약 복용까지 함께한 복 합적 한방치료가 증상개선에 효과가 있다는 임상증례가 다수 보고되고 있다 [8][9][10][11] .…”