Yang, Seung Heon;Kim, Chi Heon;Lee, Chang Hyun;Ko, Young San;Won, Youngil;Chung, Chun Kee
Journal of Korean Neurosurgical Society
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v.64
no.4
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pp.575-584
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2021
Objective : Cervical expansive laminoplasty is an effective surgical method to address multilevel cervical spinal stenosis. During surgery, the spinous processes of C2 and C7 are usually preserved to keep the insertion points of the cervical musculature and nuchal ligament intact. In this regard, dome-like laminectomy (undercutting of C7 lamina) instead of laminoplasty is performed on C7 in selected cases. However, resection of the lamina can weaken the C7 lamina, and stress fractures may occur, but this complication has not been characterized in the literature. The objective of the present study was to investigate the incidence and risk factors for C7 laminar fracture after C7 dome-like laminectomy and its impact on clinical and radiological outcomes. Methods : Patients who underwent cervical open-door laminoplasty combined with C7 dome-like laminectomy (n=123) were classified according to the presence of C7 laminar fracture. Clinical parameters (neck/arm pain score and neck disability index) and radiologic parameters (C2-7 angle, C2-7 sagittal vertical axis, and C7-T1 angle) were compared between the groups preoperatively and at postoperatively at 3, 6, 12, and 24 months. Risk factors for complications were evaluated, and a formula estimating C7 fracture risk was suggested. Results : C7 lamina fracture occurred in 32/123 (26%) patients and occurred at the bilateral isthmus in 29 patients and at the spinolaminar junction in three patients. All fractures appeared on X-ray within 3 months postoperatively, but patients did not present any neurological deterioration. The fracture spontaneously healed in 27/32 (84%) patients at 1 year and in 29/32 (91%) at 2 years. During follow-up, clinical outcomes were not significantly different between the groups. However, patients with C7 fractures showed a more lordotic C2-7 angle and kyphotic C7-T1 angle than patients without C7 fractures. C7 fracture was significantly associated with the extent of bone removal. By incorporating significant factors, the probability of C7 laminar fracture could be assessed with the formula 'Risk score = 1.08 × depth (%) + 1.03 × length (%, of the posterior height of C7 vertebral body)', and a cut-off value of 167.9% demonstrated a sensitivity of 90.3% and a specificity of 65.1% (area under the curve, 0.81). Conclusion : C7 laminar fracture can occur after C7 dome-like laminectomy when a substantial amount of lamina is resected. Although C7 fractures may not cause deleterious clinical outcomes, they can lead to an unharmonized cervical curvature. The chance of C7 fracture should be discussed in the shared decision-making process.
Purpose: Changes in the curvature of the vertebral columns of elderly women with increasing age causes various side effects and disorders. Therefore, this study was conducted to evaluate the effectiveness of the 8-figure scapular brace to improve pulmonary function and balance ability based on lung capacity and foot pressure by increasing the vertebral curvature. Methods: Seventeen elderly women with a forward head posture were selected. Women were asked to wear the 8-figure scapular brace and the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured, as were changes in foot pressure. Measurements were conducted three times each and the mean values were used for subsequent analyses. For static evaluation, we used the paired t-test to identify differences between pre and post values. Results: There was no significant difference in FEV1 and FVC before and after use of the brace (p>0.05); however, there was a significant decrease in forefoot pressure and an increase in rearfoot pressure following application of the brace (p<0.05). Conclusion: Application of the 8-figure scapular brace to correct vertebral curvature in elderly women influenced pressure distribution change from immediate effect body arrange of cervical and thoracic. However, wearing the 8-figure scapular brace may interfere with expansion of the chest and therefore respiratory muscle activity. Accordingly, it is necessary to apply appropriate treatment when wearing a scapular brace and to allow a sufficient intervention period while also providing therapeutic interventions such as posture correction or respiration training.
The purpose of this study was to investigate muscle activity of cervical erector spinae & upper trapezius while using a smartphone according to anterior pelvic tilt & posterior pelvic tilt in sitting position. & we also want to obtain basic data necessary for development of IoT devices. Fifteen healthy men & women aged 20-30 were enolled, After anterior pelvic tilt & posterior pelvic tilt in sitting position were adjusted, they used a smartphone for 5 minutes & EMG signal was measured simultaneously. We used median 3 minutes of measured EMG signal. The results of this study were as follows: In the sitting position, the use of smartphone in anterior pelvic tilt had significantly lower %RVC values in both cervical erector spinae (p <.001), left upper trapezius (p <.001) & right upper trapezius (p <.002) in comparison with posterior pelvic tilt. This means that anterior pelvic tilt make vertebrae maintain normal curvature & prevent forward head posture occurred while using a smartphone. It reduces loads around neck & shoulders, so that %RVC value is significantly lowered. In the future, new posture corrected IoT devices with an aspect of pelvic tilt should be developed.
Objective: This study aims to develop and scientifically investigate the efficacy of the Spine S-curve Reactive Backrest that responds to the spine curvature of the user when seated, and maintains and enhances the natural S-curve of the lower back, thereby helping to relieve fatigue, correct posture and prevent spine deformities. Background: The focus of current development, design guidelines and/or standards for office chairs is mainly placed on the chair's dimensions, incline angle, adjusting features and lumbar support. Research and development was called for developing a chair backrest that maintains and improves the S-curve of the full spine. Method: The Spine S-curve Reactive Backrest was ergonomically designed to maintain correct posture and enhance user comfort. When leaned on, the backrest responds to the user's spine line and the whole lower back sits closely against the backrest, thereby aligning the user's lower back and backrest as one to maintain and improve the natural S-curve formation of the spine. In order to evaluate the efficacy of the newly designed chair (new design) and the comparison target (chair), five male college students of standard body type with normal spine curvature were selected as test subjects, and a motion analyzer and electromyography were utilized to measure S-curve and erector spinae muscle activity when seated. Results: The spine S-curve was better maintained and improved when sitting in the new design than in the comparison chair. Particularly notable was the greater displacement gap of the thoracic spine than the cervical spine, and also that of the lumbar more than the thoracic spine, with the increase of the backrest tilting angle. Furthermore, the electromyogram results showed the new design caused a lower fatigue level of the erector spinae muscles compared to the comparison chair, and also earned a higher preference in the subjective opinion results. Conclusion: The newly designed chair in this study responds to the user's spine curvature and maintains and enhances the lower back's natural S-curve, and thereby relieves fatigue, promotes better posture, and helps to prevent spine deformities better than existing office chairs. There is a need to widely introduce and supply this new design. Application: The new design is applicable to office and student chairs, and is expected to improve concentration and work efficiency.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.2
no.2
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pp.1-16
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2007
Objectives : The purpose of this study was to identify spinal curvatures, plantar pressure and foot angles in a walking. Methods : 19 outpatients under 19 years old were included. Plantar pressure and foot angle in a walking were measured by using Gaitview AFA-50. Spinal curvatures were measured by using radiograph. Results : The cervical lordotic angle is significantly difference with left and right plantar pressure(p=0.027). The thoracic kyphotic angle is significantly difference with left and right plantar pressure(p=0.026). Cobb's angle is significantly difference with left and right plantar pressure(p=0.027). The other plantar pressure were no difference from spinal curvatures and foot angle in a walking. Conclusion : There were no correlation between plantar pressure, spinal curvatures and foot angle. We consider that needed more additional study.
The purpose of this study was to examine the associations of head posture the position of the tongue or the hyoid bone to craniofacial structure. Cephalograms taken in Natural head position(NHP) of 90 dental students (50 in male, 40 in female, 20 to 30 years in age) were traced and measured using the extracranial true horizontal and vertical lines. The obtained results were as follows; 1. There was no sex difference in head posture, but the hyoid bone was placed anteroinferiorly in male more than in female and anteroinferior inclination of the hyoid bone showed greatly in male. 2. The more inclined was the cervical column, the less prognathic was the face in natural head posture, and the larger cervical curvature, the more vertical pattern of the face. 3. The less small showed craniocervical angulation, the more anteriorly placed was the hyoid bone to the cranial base, and there was no significantly association between craniocervical angulation and the vertical position of the hyoid bone. 4. The more prognathic was the mandible, the more anteriorly placed was the hyoid bone, and there was slightly association between the craniofacial morphology and the vertical position of the hyoid bone.
Main cause of low back pain is a poor posture. Most low back pains are due to a poor posture. The poor posture induces muscle tension and finaliy low back pain. The poor posture arehabitually trained from the childhood by the environmetal factors. In general, maintaining good posture during working and sleeping hours are the first line of defence against back pam. (1) Supine posture is the easiest posture that relaxes and fixes muscles. Supine posture is thus a starting position for on exercise. Lying down releases the weight pressures of head and shoulder and thus body can be relaxed and extended which are helpful for treating back pain. However, supine posture can increase the pressure in ribcage posture aspect and disphragram due to visceral oragans. (2) Sitting in one position for a long time results in fatigue and relaxation of spinal muscies. Finally, body strength is weakened and sitting posture will become poor. If this poor posture continues for a longer time, pain will be accompanied due to overelongation of muscle ligaments. The habitual poor posture could induce intervertebral disc distortion. If the intervertebral disc is damaged, sitting in one position or movement causes pain. (3) Abnormal lumbar curve induces the tention of abdominal muscle and paravertebral muscle groups as well as tention of lower limb muscle group connected to pelvis. For a person with weak body strength, muscle relaxation increases curvature in lumbar, chest and cervical regions. This will induce a pelvic anterior tilting of the imaginary line between A. S. I. S. and P. S. I. S. Hip joint extensor muscle acts on releasing the pelvic anterior tilting. Contrections of hamstring muscle and femoral muscle recover the imaginary line between A.S.LS. and P.S.I.S. from pelvic anterior tilting. thus, contraction of rectus abdominis muscle are required to maintain the normal lumbar curve.
Jo, Jun-Young;Kim, Jin-Woo;Park, Kyoung-Sun;Lee, Jin-Moo
Journal of Oriental Medical Thermology
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v.9
no.1
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pp.51-56
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2011
Purpose : The purpose of this study is to report the comparison of X-ray and Digital Infrared Thermographic Imaging (DITI) of a patient with idiopathic scoliosis. Method: The patient in this case was a 25-year-old female. Her chief complaint was a pain in lumbar, scapular and shoulder regions. We examined her with DITI and X-ray. And then We compared DITI and X-ray. Results: Cobb's angle of thoracic spine was $24.78^{\circ}$ as a primary curve. Cobb's angle of thoracolumbar spine was $17.63^{\circ}$. Temperature on convex side of the thoracic spine was $0.3^{\circ}C$ higher than the other side. Temperature on convex side of cervical spine was $1.4^{\circ}C$ higher than the other side. There was no correlation curvature degree with temperature difference. Conclusion : There was a tendency that the temperature on convex side of the spine is higher than the other side of the spine. DITI is a useful assessment tool when it is used with X-ray as a diagnostic tool of idiopathic scoliosis. Further studies are needed.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.4
no.1
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pp.65-73
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2009
Objectives : The propose of this study is to analyze characteristics with sex, age, motivation, symptom, Impression, treatment effect about temporomandibular disorder patients. Method : We performed a retrospective study of 52 patients who visited the Jaseng Hospital of Oriental Medicine, from August 2008 to October 2008. Result : Women occupied the most part. And 27 persons in the 20th are the most distribution of age. The majority of patients occured the symptom for no reason. In the distribution of symptoms, TMD pain(88.46%), Click sound(82.69%), neck pain(52.92%), headache(38.46%), lumbago(21.15%) happened. In the impression through radiological diagnoses, The majority of patients diagnosed Straightening of cervical lordotic curvature. Oriental medical treatment showed a very valuable effect on improvement of TMD symptom. Conclusion : The results showed a valuable treatment effect of temporotandibular disorders on Oriental medical treatment. Therefore this work have the necessity of continuous study and observation and will help us to understand the features of patients who visiting the TMD clinic of Jaseng Hospital of Oriental medicine.
Objectives : The aim of this study was to observe the effect of Bong Chuna manual therapy(BCMT) and acupuncture on the Turtle Neck Syndrome(TNS) by the changes of radiological findings and symptoms. Methods : Total twenty-eight patients diagnosed as TNS were evaluated. Twenty patients in experimental group were treated by the combination of BCMT and acupuncture, eight patients in control group were treated by acupuncture only. We measured VAS(Visual analogue scale) as pain intensity and Neck Pain and Disability Scale(NDI) at pre- and post-treatment. Also the four line Cobb's method and Jochumsen method were assessed for evaluating the radiographical changes, additionally we used 'two line method'. Results : VAS score showed statistically significant reduction in pain intensity in both experimental group and control group after 8 weeks treatment, $-44.05{\pm}14.91$ vs $-23.75{\pm}14.08$ respectively. Also NDI score presented $-11.40{\pm}8.63$ reduction in experimental group, and it was significant statistically, however not in control group, $-8.63{\pm}9.84$ reduction after 8weeks treatment. In radiological findings, the four line Cobb's method, Jochumsen method and two line method were reduced after 8weeks treatment, $-9.30{\pm}10.33$, $-0.65{\pm}1.72$ and $-14.35{\pm}5.68$ in experimental group respectively, $-0.75{\pm}1.91$, $-0.25{\pm}0.71$ and $0.38{\pm}2.20$ in control group respectively. However they were statistical significance only in the four line Cobb's method and two line method in both group. Conclusions : Combination treatment of CMT and acupuncture showed better effect on pain reduction, VAS score and the correction of neck anteversion than acupuncture only in TNS. Two line method seems valuable for evaluating the improvement of radiographical changes in TNS.
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