• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.65-72
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• 2017

Purpose: The purpose of this study was to evaluate the radiologic features of juxtafacet cyst and determine the correlation between these features and clinical outcome. Materials and Methods: We analyzed a total of 23 patients. The degree of facet joint degeneration was classified using the Fujiwara method. The facet joint angles were measured with an magnetic resonance imaging to determine whether there was a difference between the cystic lesion that was occupied and the cystic lesion that was not occupied. Disc degeneration was measured by the Pfirrmann classification method. The clinical result was evaluated using the Oswestry disability index score and visual analogue scale. Results: The L4-5 level of juxtafacet cyst was mostly affected, as found in previous studies. Facet joint arthritis was more severe within the side with the cystic lesion. Significant correlation was found between disc degeneration and juxtafacet joint cyst. All patients underwent wide decompression and fusion. Clinical result was excellent. No patients had signs of recurrence during the follow-up periods. Conclusion: Juxtafacet cyst has a significant correlation with facet joint degeneration. Therefore, aggressive surgical treatment-not just simple cyst excision-should be considered as the treatment option for juxtafacet cyst associated with degenerative lumbar disease.

• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.520-526
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• 2020

Purpose: The need for revision fusion surgery after spinal fusion has increased. A revision rod that connects to the previous rod was newly developed for revision surgery. The purpose of this study was to analyze the clinical and radiological results after spinal fusion revision surgery using revision rods. Materials and Methods: Twenty-one patients who underwent revision fusion surgery after spinal fusion in two university hospitals with minimum 1 year follow-up were reviewed. This study assessed 16 cases of adjacent-segment disease, four cases of thoracolumbar fracture, and one case of ossification of ligament flavum. The Oswestry Disability Index (ODI) and numerical rating scale (NRS) were evaluated as clinical outcomes, and the union rate, lordosis or kyphosis of the revision level, lumbar lordosis, T5-12 kyphosis, and proximal junctional kyphosis angle were evaluated as the radiological outcomes. Results: The average ODI was 54.6±12.5 before surgery and improved to 29.8±16.5 at the final follow-up. The NRS for back pain and leg pain was 5.0±1.7 and 6.4±2.0 before surgery, which changed to 2.9±1.6 and 2.9±2.2 at the final follow-up. Lumbar lordosis was 18.1°±11.9° before surgery and 21.1°±10.3° at the final follow-up. Proximal junctional kyphosis was 10.8°±10.1° before surgery, and 9.2°±10.5° at the final follow-up. These angles were not changed significantly after surgery. Bony union was successful in all cases except for one case who underwent posterolateral fusion. Conclusion: Revision surgery using a newly developed revision rod on the thoracolumbar spine achieved good clinical outcomes with successful bony union. No problems with the newly developed revision rod were encountered.

• Composites Research
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• v.25 no.4
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• pp.98-104
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• 2012

In recent years, degenerative spinal instability has been effectively treated with a cage. However, little attention is focused on the stiffness of the cage. Recent advances in the medical implant industry have resulted in the use of medical carbon fiber reinforced polymer (CFRP) cages. The biomechanical advantages of using different cage material in terms of stability and stresses in bone graft are not fully understood. A previously validated three-dimensional, nonlinear finite element model of an intact L2-L5 segment was modified to simulate posterior interbody fusion cages made of CFRP and titanium at the L4-L5 disc with pedicle screw, to investigate the effect of cage stiffness on the biomechanics of the fused segment in the lumbar region. From the results, it could be found that the use of a CFRP cage would not only reduce stress shielding, but it might also have led to increased bony fusion.

• Journal of Korean Neurosurgical Society
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• v.30 no.11
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• pp.1271-1277
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• 2001

Objectives : Since vertebroplasty has been introduced, we performed short segment pedicle screw fixation with augmented intra-operative vertebroplasty in patients with unstable thoraco-lumbar fracture. Our intentions are to demonstrate the efficacy and indication of this new technique compare to conventional methods. Material and Methods : The surgery comprised of pedicle screw fixations on one level above and below the fracture site, and the fractured level itself, if pedicle is intact, and intra-operative vertebroplasty under the fluoroscopic guide with in-situ postero-lateral bone graft. Also, in cases of bone apposition, we removed those with small impactor through a transfascetal route. During the last 2 years, we performed in seven(7) unstable thoraco-lumbar fracture patients who consisted of two different characteristics, those four(4) with primary or secondary osteoporosis and three(3) of young and very healthy. All patients were followed clinically by A.S.I.A. score and radiography. Results : Mean follow up period was 14 months. We observed well decompressed state via transfascetal route in cases of bone fragments apposition and no hardware pullout in osteoporotic cases, no poly-methyl-methacrylate (PMMA) leakage through the fracture sites into the spinal canal, and no kyphotic deformities in both cases during follow-up periods. All patients demonstrated solid bony fusion except one following osteoporotic compression fracture on other sites. Conclusions : In the management of unstable thoraco-lumbar fracture, we believe that this short segment pedicle screw fixation with augmented intra-operative vertebroplasty reduce the total length or levels of pedicle screw fixation without post-operative kyphotic deformity.

• Physical Therapy Korea
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• v.10 no.1
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• pp.63-76
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• 2003

This research was performed to compare spinal segment motion angle between low back pain (LBP) group and painless group during trunk flexion-extension and to investigate the effect of transversus abdominis strengthening exercise on spinal segment motion angle in LBP group. Nine subjects with LBP and ten subjects without LBP participated. Transversus abdominis strengthening exercise was performed in LBP group for three weeks, and spinal segment motion angles were compared before and after the exercise performance. Spinal segment motion angles were measured both in sitting and standing position. Results were as followed: 1) Subjects' average age was 24.79 years, height was 167.84 cm, and weight was 59.95 kg. 2) Spinal segment motion angle of T10/l1 was significantly higher in LBP group compared with painless group (p<.05) in sitting position during trunk flexion-extension. 3) In sitting position, whereas entire lumbar segment motion angles were lower in LBP group compared with painless group (p<.05), angle of L4/5 was higher in LBP group compared with painless group (p<.05). 4) There was no significant difference in thoracic segment motion angle in standing position. 5) After three weeks of transversus abdominis strengthening exercise, thoracic segment motion angle increased both in sitting and standing position (p<.05). 6) In painless group, there was no significant difference in entire spinal segment motion angles in sitting and standing position (p>.05). When spinal segment motion angles were compared between sitting and standing position, there were slight differences. In sitting position, there was no difference in spinal segment motion angle between LBP group and painless group while hip joint motion angle and sacral inclination angle of LBP group was lower than those of painless group (p<.05). In standing position, lumbar segment motion angle was significantly lower in LBP group than that of painless group. Transversus abdominis strengthening exercise influenced thoracic segment motion angle more significantly than lumbar segment motion angle.

• Korean Journal of Applied Biomechanics
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• v.24 no.4
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• pp.375-383
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• 2014

The purpose of this study was to assess the inter-segmental trunk motion during which multi-segmental movements of the spinal column was designed to interpret the effect of segmentation on the total measured spine motion. Also it analyzed the relative motion at three types of the spine models in drop landing. A secondary goal was to determine the intrinsic algorithmic errors of spine motion and the usefulness of such an approach as a tool to assess spinal motions. College students in the soccer team were selected the ten males with no history of spine symptoms or injuries. Each subject was given a fifteen minute adaptation period of drop landing on the 30cm height box. Inter-segmental spine motion were collected Vicon Motion Capture System (250 Hz) and synchronized with GRF data (1000 Hz). The result shows that Model III has a more increased range of motion (ROM) than Model I and Model II. And the Lagrange energy has significant difference of at E3 and E4 (p<.05). This study can be concluded that there are differences in the three models of algorithm during the phase of load absorption. Especially, Model III shows proper spine motion for the inter-segmental joint motion with the interaction effects using the seven segments. Model III shows more proper observed values about dynamic equilibrium than Model I & Model II. The findings have shown that the dynamic stability strategy of Model III toward multi-directional spinal motion supports for better function of the inter-segmental motor-control than the Model I and Model II.

• PNF and Movement
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• v.1 no.1
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• pp.43-57
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• 2003

목적: 병원치료가 필요하지 않을 만큼의 경부통증/증상과 관절가동범위, 경흉추의 다각적 면에서 관계를 조사하기 위해서이다. 방법: 연령은 19세에서 42세(평균연령 28세로 실험에 참여하기를 원하는 건강한 성인 40명을 대상으로 하였다. 경흉추의 척추 자세, 경추 능동 관절 가동범위, 경부 분절 길이 등의 다각적인 면을 측정하였다. 모든 측정들은 동일시에 각 대상자에게 서로 다른 측정자에 의해 두 번 실시되었다. 경부 근 지구력은 수정된 Biering-Sorensen 검사법에 의해 측정되었다. 마지막으로 대상자들에게 경부 통증/증상의 재발에 대한 질문을 하였다. 결과: 14명의 대상자들은 경미한 재발성 경부 통증/증상을 보고하였다. 경부 근 지구력 시간(F(1,38)=6.75, p=0.01)과 좌측 회전 가동 범위(F(1,38)=4.56, p=0.04)가 경부 통증을 가진 대상자들에서 유의하게 감소하였다. 신전 가동범위가 재 측정에서 특정군 변화 즉, 정상군 증가, 경부 통증/증상군 감소(F(1,38)=4.67, p=0.04)가 보였다. 경부 통증/증상군은 정상군과 비교 시 후인 가동 범위의 증가하였다(F(1,38) =4.56, p=0.04). 통증 유무에 관계없이 모든 대상자들에서 우측 회전보다 좌측 회전에서 가동범위가 더 크게 나타났고(F(1,38) =4.34, p=0.04), 반복 측정에서 좌측 측방굴곡 (F(1,38) =5.10, p=0.03)과 우측 측방 굴곡(F(1,38) = 5.27, p=0.03)의 감소가 나타났다. 결론: 경미한 증상의 경부통증 대상자군과 정상적인 대상자군을 비교할 때 그룹 간 차이는 경부 근 지구력 시간의 감소, 좌측 회전 가동 범위 감소와 특히, 두 번 째 측정에서 신전범위 감소가 나타났으나 후인의 가동범위는 증가로 관찰되었다. 이러한 결과들은 경부 통증의 발생과 관련된 초기 가동범위 변화를 제안한다.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.3
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• pp.73-84
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• 2023

Background: This study aimed to compare pressure pain thresholds (PPTs) in the vertebral segments between patients with chronic lower back pain (CLBP) and healthy participants without back pain and to determine the correlation between vertebral bone-segment PPT and pain level, lower back pain dysfunction, and psychological status in patients with CLBP. Methods: The subjects of this study were 23 healthy adults and 23 adults with CLBP. PPT was measured in 23 spinal bone segments using a PPT device, and the CLBP group was subjected to a pain level test (NRS) and a psychological test using the Korean version of the pain catastrophizing scale (KPCS). The functional level was assessed using the Korean version of the Oswestry disability index (KODI). Results: PPTs of the spinal sclerotomes were significantly lower in patients with CLBP than in healthy participants. In the CLBP group, the composite score of lumbar PPTs showed a high correlation with the composite scores for all segments, but not with the pain level (NRS), KPCS score, and spinal sclerotome PPT. Moreover, PPT in the sacral sclerotomes showed a significant negative correlation coefficient with function, with a KODI score of -.462 (p<.01). Conclusion: In this study, PPTs in all spinal segments in patients with CLBP was significantly lower than that in healthy subjects. The PPTs of the lumbar region was significantly correlated with the PPTs of other spinal regions. Through this study, it was found that there were changes in PPTs in CLBP patients not only in the lumbar region but also in other spinal regions. This information should be considered during clinical treatment of patients with low back pain.

• Korean Journal of Ecology and Environment
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• v.56 no.4
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• pp.414-419
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• 2023

Aquatic ecosystem is composed of various organic and inorganic matters. Its health is essential for sustaining its members such as vegetations, mammals, birds, fishes and invertebrates. Samcheonpo stream is one of candidate streams in Sacheon area of ecological restoration. For this reason, this study conducted to build up a data base for future comparison. The results shows that biodiversity of Epilithic Diatoms and Invertebrates is below average which means that human impacts such as artificial structures and activities have been negatively related to stream health. Consequently, we suggest several key factors when ecological restoration is performed in the stream.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.713-718
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• 1997

Fracture of the sternum has been considered as a serious injury and also associated with major complications such as myocardial, major thoracic vascular, and spinal injury. Retrospective datas from blunt trauma victims admitted to our hospital were analyzed to determine significance of sternal fractures and possible associated injures. 101 sternal fractures by blunt trauma were admitted from january, 1986 to december, 1995. Frequency was about 3.51 olo of the nonpenetrating chest trauma. The ratio of male to female was 1.82 versus 1. Most common cause in the stemal fracture was high decelerating injury(73 cases). Most common fracture site was sternal body(75 cases). Average days of adm ssion were 26 days. Abnormal ECG findings were sinus bradycardia(Teases), complete or incomplete RBBB(6 cases), sinus tachycardia(4 cases), specific S-T change(3 cases), 1st degree A-V block(2 cases), LVH(1 case), PVC(1 case), and Low voltage(1 case). CPK-MB was increased about 32.Lolo of sternal fractures. Except of expired 2 patients, patients were treated with conservative treatment(94 cases) and open reductions & steel wire fixations(5 cases). Complication after operation was wound infection(1 case). Causes of death were 1 hypovolemia and 1 acute respiratory distress syndrome. In conclusion, although sternal fracture is less frequent, and mostly treats with conservative treatment, it shoed be carefully observed because of critical associated injuries.