• 대한물리치료과학회지
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• 제29권3호
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• pp.29-47
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• 2022

Purpose: This study was conducted to find out the mediated effects of smartphone overindulgence in the relationship between attention and spinal health of adolescents and to find out how cognitive strength moderates these relationships. Design: Cross-sectional study. Methods: All subjects measured attention, cognition strength, spinal angle, and smartphone overindulgence by measuring the ratio of SMR and mid-beta power to the power of the brain wave, amplitude variation of Cognitive Gamma-Peak, forward slope angle of the cervical spine, and the scale of diagnosis of smartphone addiction. Results: As a result, it shows a significant correlation between Attention, spinal angle, cognitive strength, and smartphone overindulgence(p<.05). In addition, attention was significantly mediated on the spinal angle through smartphone overindulgence(p<.001), and cognitive strength was significantly mediated in relation to smartphone overindulgence and spinal angle(p<.05). Conclusion: This result indicates that the mediation effect of overindulgence of a Smartphone is mediated according to its cognitive strength in relation to its effect of attention on the spine angle.

• Journal of Oral Medicine and Pain
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• 제23권4호
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• pp.457-473
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• 1998

This study was performed to investigate the morophological and positional correlation between the upper cervical vertebra, the oral structures and the pharyngeal tissues, and the correlation of these anatomical structures with dental features, such as teeth wear area nad tooth contact status, etc. Seventy patients with temporamandibular disorders and sixty three dental students without any signs and symptoms in head and neck region were selected for this study. All they had natural dentition without any fixed and removable protheses. Teeth wear area and arch width wre measured from the upper dental cast, tooth contact status were observed by T-Scan system$^\textregistered$ and four cephaloradiograpohs were taken from four head postures, namely, natural(NHP), forward(FHP), upward(UHP), and downward head postiure(DHP). 22 cephalometric items were measured on the films and the data were processed with SAS statistical program. The result of this study were as follows : 1. In normal group, angle of cervical vertebra tangent and of between hard and soft palate were broader in female subjects than those in male subjacets, but distance from subocciput to axis, size of soft palate, and pharyngeal space width were larger in male subjects. 2. In normal group with natural head posture, the items correlated each others from the three anatomical regions were distance between first nad second vertebra in posterior part, distance from the lingual surface of lower anterior teeth to anterior surface of soft palate, and distance from the hyoid bone to third vertebra. 3. Three set of items showed significant correlation each other in the four head postures in normal group. First set was the angle between hard and soft palate and the idstance from subocciput to posterior arch of first vertebra, second set was the distance between first and second vertebra in posterior part and the teeth wear area, third set was number and force of tooth contact and length of soft palate and distance from anterior tip of hyoid bone to mandibular plane.

• Journal of Korean Neurosurgical Society
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• 제53권4호
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• pp.223-227
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• 2013

Objective : Although there is no consensus on the ideal treatment of the craniocervical instability, biomechanical stabilization and bone fusion can be induced through occipito-cervical fusion (OCF). The authors conducted this study to evaluate efficacy of OCF, as well as to explore methods in reducing complications. Methods : A total of 16 cases with craniocervical instability underwent OCF since the year 2002. The mean age of the patients was 51.5 years with a mean follow-up period of 34.9 months. The subjects were compared using lateral X-ray taken before the operation, after the operation, and during last follow-up. The Nurick score was used to assess neurological function pre and postoperatively. Results : All patients showed improvements in myelopathic symptoms after the operation. The mean preoperative Nurick score was 3.1. At the end of follow-up after surgery, the mean Nurick score was 2.0. After surgery, most patients' posterior occipito-cervical angle entered the normal range as the pre operation angle decresed from 121 to 114 degree. There were three cases with complications, such as, vertebral artery injury, occipital screw failure and wound infection. In two cases with cerebral palsy, occipital screw failures occurred. But, reoperation was performed in one case. Conclusion : OCF is an effective method in treating craniocervical instability. However, the complication rate can be quite high when performing OCF in patients with cerebral palsy, rheumatoid arthritis. Much precaution should be taken when performing this procedure on high risk patients.

• 한국전문물리치료학회지
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• 제28권2호
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• pp.138-145
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• 2021

Background: Forward head posture (FHP) causes various posture imbalances associated with the head and neck. Myofascial release is an effective treatment method used for relaxing muscles and reducing muscle hyperactivity, but no studies have been conducted on suboccipital and neck muscles related to FHP. Objects: The purpose of this study was to investigate the immediate effect of roller massages on the cranio-cervical flexion (CCF) range of motion (ROM) and CCF strength applied to suboccipital and neck muscles in subject with forward head posture. Methods: Twenty-four FHP subjects (male: 13, female: 11) were recruited for this study. All subjects were recruited with a craniovertebral angle (CVA) of 53 degrees or less and a head tilt angle (HTA) of 20.66 degrees or higher. CCF strength was measured using Pressure biofeedback unit (PBU) in the supine posture and CCF ROM was measured using smartphone-based inclinometer. Roller massage (RM) was applied to suboccipital and neck muscles for 2 minutes and CCF ROM and strength were remeasured. Results: These results of this study showed that CCF ROM was a significant difference in CCF ROM before and after RM (p < 0.05). CCF strength also showed a significant difference before and after RM (p < 0.05). Conclusion: RM method might be recommended to increase the immediate ROM and strength of CCF in subjects with forward head posture.

• 대한방사선기술학회지:방사선기술과학
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• 제28권2호
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• pp.91-95
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• 2005

I. 목 적 : 경추의 퇴행성 질환이나 분리증을 진단하는데 필수적인 전 후 사방향 촬영은 $45^{\circ}$사방향 (하 상방향 tube angle $15^{\circ}$)으로 촬영하여 경추 추간공과 주변 구조물을 살피는 것으로 알려져 있으나 아직까지 우리나라 성인에 대한 연구결과는 거의 없는 실정이다. 본 연구는 우리나라 성인에 적합한 전 후 사방향 촬영 각도를 알아보는데 목적이 있다. II. 대상 및 실험방법 : 1. 연구대상인 성인의 경추 신경공과 정중 시상면이 이루는 평균 각을 알아보기 위해 C-spine MRI를 촬영한 환자 200명(남 100명, 평균 40.3세, 여자 100명 47.6세)을 대상으로 축방향 T2 강조영상에서 C2-C3부터 C7-T1까지의 평균 각을 구하였다. 2. 경추에 이상이 없는 남자 10명(평균 36.2세)을 대상으로 전 후 사방향 촬영시 경추 신경공과 정중 시상면이 이루는 각도에서 실제로 추간공이 가장 크게 관찰되는지를 알아보기 위하여 나선식CT(QXi, GE medical) 촬영을시행하여, 축방향 영상에서 추간공이 이루는 각과 3D Raysum기법에서의 추간공의 최대횡경을 이루는 각도를 비교하였다. 또한 경추 전후 사방향 $45^{\circ}$, $50^{\circ}$, $55^{\circ}$(하 상방향 tube angle $15^{\circ}$)로 촬영한 일반촬영 영상을 PACS로 전송하여 최대횡경을 측정하고, 그 차이를 비교하였다. III. 결 과 : 연구대상인 성인추간공의 평균 각도를 MR영상에서 측정한 결과 C2-C3, C3-C4, C4-C5, C5-C6, C6-C7, C7-T1에서의 각은 $47.4^{\circ}{\pm}3.3$, $50.5^{\circ}{\pm}2.3$, $52.7^{\circ}{\pm}4.2$, $53.2^{\circ}{\pm}1.9$, $53.2^{\circ}{\pm}2.3$, $55.2^{\circ}{\pm}2.3$로 나타나 하부 경추로 갈수록 신경공과 정중 시상면이 이루는 각이 커짐을 알 수 있었다. 10명을 대상으로 CT촬영하여 Raysum 영상에서 추간공의 최대 횡경을 보이는 각도와 2D 축방향 영상에서 측정한 추간 공의 각도의 비교에서는 유의한 차이가 없었다(P>0.01). 전 후 사방향 $45^{\circ}$, $50^{\circ}$, 그리고 $55^{\circ}$로 촬영한 일반촬영에서의추간공의최대횡경을측정한결과 C2-C3, C3-C4, C4-C5까지는 각도가 $5^{\circ}$씩 커질수록 횡경이 감소($0.11\;mm{\sim}0.21\;mm$)한 반면 C5-C6, C6-C7, C7-T1에서는 횡경이 증가($0.32\;mm{\sim}0.91\;mm$)함을 알 수 있었으며, 그 차이를 분산분석(ANOVA)을 통해 비교한 결과 하부경추로 갈수록 유의한 차이가 있는 것으로 나타났다(P<0.001). IV. 결 론 : 우리나라 성인에 있어서 추간공을 관찰하기 위한 전 후 사방향촬영각도는 상부 경추의 경우 전 후사방향 $50^{\circ}$에서, 하부 경추의 경우 $55^{\circ}$에서 추간공을 가장 크게 관찰할 수 있었다. 따라서 향후 경추의 퇴행성 질환을 진단하는데 본 연구의 촬영법이 유용할 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• 제25권1호
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• pp.99-108
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• 2000

This study was performed to investigate the effect of suboccipital stretch on the head and neck posture and the electromyographic(EMG) activity of some cervical muscles. For this study, 39 patients with temporomandibular disorders(TMD) and 34 dental students without any signs and symptoms in the masticatory system were selected as the patients group and as the normal group, respectively. Head position by goniometer CROM$^{(R)}$(Performance attainment, St. Paul, USA), EMG activity by BioEMG$^{(R)}$(Bioresearch Inc., Milwaukee, USA), and craniocervical posture by cephaloradiography were observed in both natural head posture(NHP) and head posture with suboccipital stretch(tuck posture) abtained from slight posteroinferior finger pressure on the chin. Variables measured on the cephaloradiograph were SN angle, atlas angle, CVT angle, occiput-atlas and atlas-axis distance, and pharyngeal width. The data obtained were analysed by SPSS windows program and the results of this study were as follows : 1. In the sagittal plane, degree of anterior rotation of the head by suboccipital stretch was 6.3 in the patients group, and 6.2 in the normal group, respectively. So there was no significant difference between the two groups for degree of anterior rotation, but the position of the head in the patients group were more posteriorly extended than in the normal group in both NHP and tuck posture. 2. EMG activity of the stemocleidomastoideus in the patients group, and that of the upper trapezius and the sternocleidomastoideus in the normal group were increased by suboccipital stretch. The range of EMG activity, however, in these cervical muscles were 1.6 -2.3)u.V. 3. Cephalometric variables such as SN angle, atlas angle, CVT angle, occiput-atlas and atlas-axis distance except pharyngeal width were generally increased by suboccipital stretch. There was some difference, however, in results between the two groups. Atlas angle was not changed in the patients group whereas CVT angle was not changed in the normal group. 4. The distance from subocciput to spinous process of axis was significantly increased as much as 3.0mm in the patients group, and 3.7mm in the normal group by suboccipital stretch.

• The Korean Journal of Pain
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• 제20권2호
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• pp.143-147
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• 2007

Background: The safety of cervical transforaminal epidural block has been the subject of debate, therefore, this study was conducted to measure the angle of the cervical transforaminal axis and to investigate its relationship to the internal jugular vein, internal carotid artery and vertebral artery. Methods: One hundred cases of cervical MRI were reviewed. The angle between a line passing through the center of the vertebral body and spinous process and a line passing through the center of the lamina in C3-4, C4-5 and C5-6 was measured and designated as A-degree. Additionally, we drew a line at the back of the vertebral artery that ran parallel to a line passing through the center of the lamina, which was presented as A-line. We then examined the distribution of the area in which the internal jugular vein and the internal carotid artery were located. Results: The mean values of the A-degree in C3-4, C4-5 and C5-6 were $53.5{\pm}4.3$, $54.2{\pm}4.6$ and $54.3{\pm}4.8$, respectively. There were no statistically significant differences among age groups or vertebral levels (ANOVA test, P > 0.05). The A-line was distributed primarily throughout zone 3, 4, and 5 in C3-4 and zone 5 in C4-5 and C5-6. Conclusions: The results of this study indicate that the mean values of A-degree were not statistically different among each age group and each vertebral level. However, the A-line may be located in the zone in which the internal jugular vein and the internal carotid artery lie and individual differences in the A-degree remain.

• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.36-41
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• 2015

Objective : To investigate the causes for failed anterior cervical surgery and the outcomes of secondary laminoplasty. Methods : Seventeen patients failed anterior multilevel cervical surgery and the following conservative treatments between Feb 2003 and May 2011 underwent secondary laminoplasty. Outcomes were evaluated by the Japanese Orthopaedic Association (JOA) Scale and visual analogue scale (VAS) before the secondary surgery, at 1 week, 2 months, 6 months, and the final visit. Cervical alignment, causes for revision and complications were also assessed. Results : With a mean follow-up of $29.7{\pm}12.1$ months, JOA score, recovery rate and excellent to good rate improved significantly at 2 months (p< 0.05) and maintained thereafter (p>0.05). Mean VAS score decreased postoperatively (p<0.05). Lordotic angle maintained during the entire follow up (p>0.05). The causes for secondary surgery were inappropriate approach in 3 patients, insufficient decompression in 4 patients, adjacent degeneration in 2 patients, and disease progression in 8 patients. Complications included one case of C5 palsy, axial pain and cerebrospinal fluid leakage, respectively. Conclusion : Laminoplasty has satisfactory results in failed multilevel anterior surgery, with a low incidence of complications.

• Journal of Korean Neurosurgical Society
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• 제48권5호
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• pp.406-411
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• 2010

Objective : Esophageal/hypopharyngeal injury can be a disastrous complication of anterior cervical surgery. The amount of hypopharyngeal wall exposure within the surgical field has not been studied. The objective of this study is to evaluate the chance of hypopharyngeal wall exposure by measuring the amount of axial rotation of the thyroid cartilage (ARTC) and posterior projection of the hypopharynx (PPH). Methods : The study was prospectively designed using intraoperative ultrasonography. We measured the amount of ARTC in 27 cases. The amount of posterior projection of the hypopharynx (PPH) also was measured on pre-operative CT and compared at three different levels; the superior border of the thyroid cartilage (SBTC), cricoarytenoid joint and tip of inferior horn of the thyroid cartilage (TIHTC). The presence of air density was also checked on the same levels. Results : The angle of ARTC ranged from $-6.9^{\circ}$ to $29.7^{\circ}$, with no statistical difference between the upper and lower cervical group. The amount of PPH was increased caudally. Air densities were observed in 26 cases at the SBTC, but none at the TIHTC. Conclusion : Within the confines of the thyroid cartilage, surgeons are required to pay more attention to the status of hypopharynx/esophagus near the inferior horn of the thyroid cartilage. The hypopharynx/esophagus at the TIHTC is more likely to be exposed than at the upper and middle part of the thyroid cartilage, which may increase the risk of injury by pressure. Surgeons should be aware of the fact that the visceral component at C6-T1 surgeries also rotates as much as when the thyroid cartilage is engaged with a retractor. The esophagus at lower cervical levels warrants more careful retraction because it is not protected by the thyroid cartilage.

• 한방재활의학과학회지
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• 제20권3호
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• pp.37-60
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• 2010

Objectives : The purpose of this study was to investigate the relationship between masseter and cervical muscle activity and temporomandibular disorder in female office workers. Methods : Experimental group of 24 healthy subjects complained of temporomandibular joint related to computer use which lasted more than 3 months in the past year and was present in the past 7 days as well as on the day of test. Control group of 20 healthy subjects had no complaints of minimal discomfort on the day of test, and had no discomfort in the past 7 days. If they had reported discomfort in the past 12 months, it was of a short duration(<3 months) and resolved at least 3 months prior to participation. Outcomes were assessed by meridian-electromyography(MEMG), whole spin x-ray, mandibular function impairment questionnaire(MFIQ), neck disability index(NDI), visual analog scale(VAS), Beck depression inventory(BDI), stress reaction inventory(SRI) and Holmes & Rahe social readjustment rating scale(SRRS). Results : The contraction power of masseter muscle, upper trapezius, sternocleido-mastoid muscle and erector spinae by MEMG was significantly higher in the experimental group. The muscle fatigue of masseter muscle and sternodeido-mastoid muscle by MEMG was significantly higher in the experimental group. SRI was significantly higher in experimental group. There was no significant difference between two groups in the Jackson's angle, Cobb's method and cranio-cervical posture. Conclusions : The results suggest that temporomandibular disorder related mental stress but physical stress does not change cervical structure significantly.