• 국제물리치료학회지
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• 제10권2호
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• pp.1797-1802
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• 2019

Background: Breathing is the essential step of Pilates exercise and can be used to activate core muscles. Although the effects of breathing exercise on pain, breathing muscles, and cervical posture have been extensively studied, little is known about the impact of Pilates breathing on spinal posture and alignment. Purpose: To determine the effect of 3D-Pilates breathing exercise on spinal curvature and alignment of healthy adults during corrected to normal alignment. Design: One group pre-post test design Methods: Eighteen participants were given a 3D-pilates breathing exercise twice a week (20 minutes per session) for three weeks and warmed up for 10 minutes before each exercise session. To examine spinal curvature and alignment of each subject, this study used radiation free rasterstereography (Formetric III, Germany). Paired t-test and Wilcoxon signed rank test were performed to determine the difference between pre and post exercise. Results: There were statistically significant differences in height (p<.001), kyphosis angle (p<.05), trunk imbalance (p<.05), kyphotic apex (p<.01), cervical fleche (p<.05), pelvic tilt (p<.01), and lateral deviation (p<.05) between before and after 3D Pilates breathing exercise. However, there was no significant difference in lordosis angle. Conclusions: The study results indicated that three week 3D-pilates breathing exercise program could be presented as an effective rehabilitation method for improving spinal curvature and alignment.

• 패션비즈니스
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• 제27권4호
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• pp.125-140
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• 2023

This study aimed to develop a smart wearable device for assessing the risk angle associated with turtle neck syndrome in patients with Video Display Terminal (VDT) syndrome. Turtle neck syndrome, characterized by forward head posture resulting from upper cross syndrome, leads to thoracic kyphosis. In this research, a stretch sensor was used to monitor the progression of turtle neck syndrome, and the sensor data was analyzed using a Universal Testing Machine (UTM) and the Gauge Factor (GF) calculation method. The scapula and cervical spine angles were measured at five stages, with 15-degree increments from 0° to 60°. During the experimental process, the stretch sensor was attached to the thoracic spine in three different lengths: 30mm, 50mm, and 100mm. Among these, the attachment method yielding the most reliable data was determined by measuring with three techniques (General Trim Adhesive, PU film, and Heat Transfer Machine), and clothing using the heat transfer machine was selected. The experimental results confirmed that the most significant change in thoracic kyphosis occurred at approximately 30° of forward head posture. Prolonged deformity can lead to various issues, highlighting the need for textile sensor solutions. The developed wearable device aims to provide users with real-time feedback on their turtle neck posture and incorporate features that can help prevent or improve the condition.

• Journal of Korean Neurosurgical Society
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• 제62권4호
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• pp.450-457
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• 2019

Objective : Anterior cervical discectomy and fusion (ACDF) is commonly used surgical procedure for cervical degenerative disease. Among the various intervertebral spacers, the use of allografts is increasing due to its advantages such as no harvest site complications and low rate of subsidence. Although subsidence is a rare complication, graft collapse is often observed in the follow-up period. Graft collapse is defined as a significant graft height loss without subsidence, which can lead to clinical deterioration due to foraminal re-stenosis or segmental kyphosis. However, studies about the collapse of allografts are very limited. In this study, we evaluated risk factors associated with graft collapse. Methods : We retrospectively reviewed 33 patients who underwent two level ACDF with anterior plating using allogenous bone graft from January 2013 to June 2017. Various factors related to cervical sagittal alignment were measured preoperatively (PRE), postoperatively (POST), and last follow-up. The collapse was defined as the ratio of decrement from POST disc height to follow-up disc height. We also defined significant collapses as disc heights that were decreased by 30% or more after surgery. The intraoperative distraction was defined as the ratio of increment from PRE disc height to POST disc height. Results : The subsidence rate was 4.5% and graft collapse rate was 28.8%. The pseudarthrosis rate was 16.7% and there was no association between pseudarthrosis and graft collapse. Among the collapse-related risk factors, pre-operative segmental angle (p=0.047) and intra-operative distraction (p=0.003) were significantly related to allograft collapse. The cut-off value of intraoperative distraction ${\geq}37.3%$ was significantly associated with collapse (p=0.009; odds ratio, 4.622; 95% confidence interval, 1.470-14.531). The average time of events were as follows: collapse, $5.8{\pm}5.7months$; subsidence, $0.99{\pm}0.50months$; and instrument failure, $9.13{\pm}0.50months$. Conclusion : We experienced a higher frequency rate of collapse than subsidence in ACDF using an allograft. Of the various preoperative factors, intra-operative distraction was the most predictable factor of the allograft collapse. This was especially true when the intraoperative distraction was more than 37%, in which case the occurrence of graft collapse increased 4.6 times. We also found that instrument failure occurs only after the allograft collapse.

• 한방재활의학과학회지
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• 제20권4호
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• pp.139-146
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• 2010

Objectives : To compare the differences between the symptoms and the findings of MRI(magnetic resonance imaging) and x-ray, we studied the patients with neck pain or radiating pain, which has been diagnosed as cervical herniated disc recently. Methods : We randomly selected among the 143 patients with x-ray and cervical spine(C-spine) MRI films who have visited Ja-seng hospital with neck pain and neck and radiating pain from April 1 of 2010 to May 1. We used SPSS 13.0 for windows in analyzing statistical data of study results and the level of significance was below 0.05. Results : 1. There were no significant differences between the presence of radiating pain and the amount of cervical herniation(p>0.05). 2. If the finding of a x-ray showed narrowing, based on MRI findings, the amount of herniation was more severe(p>0.05). 3. There were no significant differences between the presence of radiating pain and the findings of x-ray(p>0.05). 4. Among the 143 cases, which showed findings beside HIVD(herniation of intervertebral disc) were 13 cases. 88 cases of straightening(61.5%). 78 cases of uncovertebral joint arthrosis(54.5%). 25 cases of stenosis(17.5%), 13 cases of retrolisthesis(9.1%), 8 cases of osteophyte(6.6%), 4 cases of spondylolisthesis(2.8%), 2 cases of hemangioma(1.4%), 3 cases of OPLL(ossification of posterior longitudinal ligament)(2.1%), 2 cases of block vertebrae(1.4%), 2 cases of spondylitis(1.4%), 1 case of kyphosis(0.1) and 1 case of ligamentum flavum hypertrophy(0.1%). Conclusions : The findings from this study suggest that there was no relation between radiating pain and radiological result. On the other hand, diagnosis of x-ray and MRI showed significant relevance. The narrower disc space there were, the severer the state of herniation there existed.

• 한국전문물리치료학회지
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• 제27권1호
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• pp.1-10
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• 2020

Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (-51.16%); NPQ (-53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (-7.14%); CVA (9.82%); and FSA (-4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic self-mobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

• Journal of Korean Neurosurgical Society
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• 제43권5호
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• pp.232-236
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• 2008

Total laminectomy for the removal of intradural-extramedullary spinal cord tumors has been used widely, but postoperative complications often develop, such as kyphosis, spinal instability, and persistent back pain. In this study, we evaluated seven patients with intradural-extramedullary spinal cord tumors with respect to the value of unilateral limited laminectomy. Our cases included six schwannomas, and one meningioma. The cervical region was involved in four cases, the thoracolumbar region in two cases, and the lumbar region in one case. The rationale for choosing a unilateral approach is to preserve musculoligamentous attachments and posterior bony elements as much as possible. The patients were mobilized on the third postoperative day and preoperative neurological symptoms were recovered within a few weeks. We did not observe any complication relating to unilateral limited laminectomy and at follow-up evaluation (at 3 and 12 months postoperatively), none of the patients showed spinal deformity or spinal instability. We think that the unilateral limited laminectomy is a safe and efficient technique for the treatment of intradural-extramedullary spinal cord tumors. We suggest that this technique is one of the best treatments for these tumors.

• Journal of Genetic Medicine
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• 제13권1호
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• pp.31-35
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• 2016

Antley-Bixler syndrome (ABS) is a rare form of syndromic craniosynostosis with additional systemic synostosis, including radiohumeral or radioulnar synostosis. Another characteristic feature of ABS is mid-facial hypoplasia that leads to airway narrowing after birth. ABS is associated with mutations in the FGFR2 and POR genes. Patients with POR mutations present with either skeletal manifestations or congenital adrenal hyperplasia with ambiguous genitalia. We report here two cases of ABS caused by mutations in FGFR2 and POR. Although the patients had craniosynostosis and radiohumeral synostosis in common and cranioplasty was performed in both cases, the male with POR mutations showed an elevated level of $17{\alpha}$-hydroxyprogesterone during newborn screening and was diagnosed with congenital adrenal hyperplasia by adrenocorticotropic hormone stimulation. This patient has been treated with hydrocortisone and fludrocortisone. He had no ambiguous genitalia but had bilateral cryptorchidism. On the other hand, the female with the FGFR2 mutation showed severe clinical manifestations: upper airway narrowing leading to tracheostomy, kyphosis of the cervical spine, and coccyx deformity. ABS shows locus heterogeneity, and mutations in two different genes can cause similar craniofacial and skeletal phenotypes. Because the long-term outcomes and inheritance patterns of the disease differ markedly, depending on the causative mutation, early molecular genetic testing is helpful.

• 대한통합의학회지
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• 제7권4호
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• pp.265-272
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• 2019

Purpose : Excessive computer use frequently results in musculoskeletal disorders of the neck and shoulder such as forward head posture (FHP). The purpose of this study was to investigate effects of neck and shoulder exercise program on spino-pelvic alignment and the correlation between change in head and neck posture and spino-pelvic alignment in FHP. Methods : The study included 44 participants with FHP. The participants performed the exercise for correction of FHP 2-3 times a week for 4 weeks. We examined whole spine X-ray images in the lateral standing position with both arms crossed. We measured anterior head translation distance (AHT), craniovertebral angle (CVA), cervical lordosis (CL), thoracic kyphosis (TK), lumbosacral lordosis (LSL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) of the subjects. The association between change in AHT and each spino-pelvic parameter was also subjected to Pearson's correlation coefficient analysis. Results : There were statistically significant differences before and after exercise in the parameters of AHT, CVA, and SS (p<.05). Significant negative correlation was observed between the change in AHT and CVA (r=-.768, p<.001), and CL (r=-.388, p<.05). There was significant positive correlation between the change in AHT and SS (r=.328, p<.05), and PI (r=.333, p<.05). However, no significant correlation was observed in change in AHT with that of TK, LSL, and PT. Conclusion : Based on the above results, we conclude that there is a relationship between change in AHT, which is a parameter associated with forward displacement of the head, and that of CVA, CL, SS, and PI after exercise in cases of FHP.

• Journal of Korean Neurosurgical Society
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• 제63권1호
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• pp.89-98
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• 2020

Objective : Ossification of posterior longitudinal ligament (OPLL) in the thoracic spine may cause chronic compressive myelopathy that is usually progressive, and unfavorable by conservative treatment. Although surgical intervention is often needed, the standard surgical method has not been established. Recently, it has been reported that posterior decompression with dekyphosis is effective surgical technique for favorable clinical outcome. The purpose of this study was to evaluate the surgical outcomes in patients with thoracic OPLL according to dekyphosis procedure and to identify predictive factors for the surgical results. Methods : A total of 25 patients with thoracic OPLL who underwent surgery for myelopathy from May 2004 to March 2017, were retrospectively reviewed. Patients with cervical myelopathy were excluded. We assessed the clinical outcomes according to various surgical approaches. The modified Japanese orthopedic association (JOA) scores for the thoracic spine (total, 11 points) and JOA recovery rates were used for investigating surgical outcomes. Results : Of the 25 patients, 10 patients were male and the others were female. The mean JOA score was 6.7±2.3 points preoperatively and 8.8±1.8 points postoperatively, yielding a mean recovery rate of 53.8±31.0%. The mean patients' age at surgery was 52.4 years and mean follow-up period was 40.2 months. According to surgical approaches, seven patients underwent anterior approaches, 13 patients underwent posterior approaches, five patients underwent combined approaches. There was no significant difference of the surgical outcomes related with different surgical approaches. Age (≥55 years) and high signal intensity on preoperative magnetic resonance (MR) image in the thoracic spine were significant predictors of the lower recovery rate after surgery (p<0.05). Posterior decompression with dekyphosis procedure was related to the excellent surgical outcomes (p=0.047). Dekyphosis did not affect the complication rates. Conclusion : In this study, our result elucidated that old age (≥55 years) and presence of intramedullary high signal intensity on preoperative MR images were risk factors related to poor surgical outcomes. In the meanwhile, posterior decompression with dekyphosis affected favorable clinical outcome. Posterior approach with dekyphosis procedure can be a recommendable surgical option for favorable results.