Improvement of triceps muscle weakness in patients with cervical spondylotic myelopathy using Korean medicine therapy including shinbaro-2 pharmacopuncture: A CARE-compliant case series.

Rationale: Cervical spondylotic myelopathy (CSM) is the most prevalent spinal cord impairment among adults, primarily due to age-related degenerative changes. Although surgical interventions are commonly recommended for severe cases, the optimal timing and procedural complexities remain controversial. Evidence supporting the efficacy of Korean medicine (KM) as a treatment alternative for CSM is currently limited.

Patient Concerns: This report details 2 cases involving middle-aged Korean patients presenting with significant neck pain, upper extremity numbness, and muscle weakness. Case 1 involved a 50-year-old male (172 cm, 80 kg) experiencing left arm numbness, muscle weakness, and neck pain persisting for 3 months. Case 2 involved a 51-year-old male (182 cm, 85 kg) with persistent right arm and neck symptoms for 12 months.

Diagnoses: Both patients were diagnosed with cervical compressive myelopathy associated with herniated intervertebral disc - Case 1 at cervical levels C4-C6 and Case 2 at cervical levels C6-C7.

Interventions: Patients received integrated KM treatments, including acupuncture, pharmacopuncture (particularly Shinbaro pharmacopuncture), herbal medicine, and Chuna manual therapy.

Outcomes: Both patients exhibited significant improvements in neck and arm pain, assessed via numeric rating scales. Additionally, manual muscle testing indicated notable enhancements in triceps brachii muscle strength.

Lessons: The reported cases highlight KM treatment as a promising nonsurgical alternative for managing mild to moderate CSM, particularly in patients reluctant or unsuitable for surgery. KM treatments showed efficacy in improving pain, numbness, and muscular strength. Further rigorous studies are necessary to evaluate and confirm the broader applicability and effectiveness of KM approaches for CSM management.