• Journal of Korean Neurosurgical Society
• /
• 제64권4호
• /
• pp.575-584
• /
• 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.

• The Journal of Korean Physical Therapy
• /
• 제30권4호
• /
• pp.141-145
• /
• 2018

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.

• 융합정보논문지
• /
• 제7권4호
• /
• pp.97-103
• /
• 2017

본 연구의 목적은 앉은 자세에서 골반의 앞방향경사와 뒷방향경사에 따른 스마트폰의 사용이 목세움근과 위등세모근의 근활성도를 알아보고 IoT 디바이스 개발에 필요한 기초자료를 얻고자 하였다. 건강한 20-30대 성인남녀 15명을 대상으로 앉은 자세에서 골반앞방향경사와 골반뒷방향경사를 중재한 뒤 5분간 스마트폰을 사용하여 근전도 신호를 측정하고 중앙 3분의 근전도 신호를 사용하였다. 연구결과 앉은 자세에서 골반앞방향경사의 스마트폰 사용이 골반뒤방향경사와 비교하여 양측 목세움근(p<.001), 왼쪽 위등세모근(p<.001), 오른쪽 위등세모근(p<.002)의 %RVC 값이 유의하게 낮았다. 이는 골반의 앞방향경사를 통한 앉은 자세가 척추의 정상적인 만곡을 유지하여 스마트폰 사용 시 발생하게 되는 전방머리자세를 방지하여 목과 어깨 주변의 부하를 감소시켜 %RVC 값이 유의하게 낮았다고 사료되며 향후 골반경사에 중점을 둔 새로운 자세교정 IoT 디바이스들이 개발되어야할 것이다.

• 대한인간공학회지
• /
• 제34권2호
• /
• pp.151-165
• /
• 2015

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.

• 척추신경추나의학회지
• /
• 제2권2호
• /
• pp.1-16
• /
• 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.

• 대한치과교정학회지
• /
• 제28권4호
• /
• pp.499-515
• /
• 1998

두경부 자세 및 혀, 설골의 위치와 두개안면골격간의 연관성을 알아보기 위해, 원광대학교 치과대학 재학생 중 선천적 두경부 이상이나 결손치가 없고 과거 교정 치료나 보철치료의 경험이 없는 남자 50명과 여자 40명을 대상으로 natural head position(NHP)상태에서 두부방사선 사진을 채득하여 전통적인 두개내 참고선과 두개의 진성 참고선을 이용하여 계속한 결과 다음과 같은 결론을 얻었다. 1. 두경부 자세변수들에서는 남녀간 차이가 없었으나, 설골의 위치는 남자가 여자에 비해 더 전하방에 위치하였으며, 더 큰 전하방 경사도를 보였다. 2. 경추의 경사도가 클수록 NHP에서 안면돌출도는 작게 나타났으며, 경추의 전방만곡이 증가할수록 수직적인 안모형태를 보였다. 3. 두경부각이 작을수록 두개저에 대하여 설골이 전방에 위치하였으며, 두경부각과 설골의 수직적인 위치는 연관성을 보이지 않았다. 4. 하악골이 전돌될수록 설골은 전방에 위치하였으며, 두개안면형태와 설골의 수직적인 위치는 미약한 연관성을 나타냈다.

• 대한물리치료과학회지
• /
• 제3권4호
• /
• pp.207-214
• /
• 1996

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.

• 대한한방체열의학회지
• /
• 제9권1호
• /
• pp.51-56
• /
• 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.

• 척추신경추나의학회지
• /
• 제4권1호
• /
• pp.65-73
• /
• 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.

• 한방재활의학과학회지
• /
• 제19권1호
• /
• pp.113-124
• /
• 2009

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.