• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.17 no.2
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• pp.57-63
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• 2011

Background: To investigate the effect of various intervention application on idiopathic scoliosis patient. Methods: One 20-years-old female subject underwent various intervention 3 times per week for 7 weeks. Modality physical therapy, muscle energy technique, combined pelvic tilt exercise and self exercise was performed for 50minutes. Degree of pain, axial trunk rotation, Cobb's angle, kyphotic angle, lumbar lordotic angle, and sacral angle were measured. Results: The subject decreased in degree of pan, axial trunk rotation, Cobb's angle, thoracic kyphotic angle, lumbar lordotic angle and sacral angle. Conclusions: The various interventions for scoliosis patients are effective in the pain and the improvement of angle on radiograph. However, any method is difficult to determine effective interventions.

• Physical Therapy Korea
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• v.27 no.2
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• pp.102-110
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• 2020

Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included measurements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = -0.601, p< 0.01), and usual pain intensity level based on the SIS (r = -0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = -0.383, p < 0.01), pain-free MMO (r = -0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

• Asian Spine Journal
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• v.12 no.6
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• pp.1053-1059
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• 2018

Study Design: Retrospective review. Purpose: To detect the effect of cannulated (poly-axial head) and solid (mono-axial head) screws on the local kyphotic angle, vertebral body height, and superior and inferior angles between the screw and the rod in the surgical management of thoracolumbar fractures. Overview of Literature: Biomechanics studies showed that the ultimate load, yield strength, and cycles to failure were significantly lower with cannulated (poly-axial head) pedicle comparing to solid core (mono-axial head). Methods: The medical charts of patients with thoracolumbar fractures who underwent pedicle screw fixation with cannulated or solid pedicle screws were retrospectively reviewed; the subjects were followed up from January 2011 to December 2015. Results: Total 178 patients (average age, $36.1{\pm}12.4years$; men, 142 [84.3%]; women, 28 [15.7%]) with thoracolumbar fractures who underwent surgery and were followed up at Hamad Medical Corporation were classified, based on the screw type as those with cannulated screws and those with solid screws. The most commonly affected level was L1, followed by L2 and D12. Surgical correction of the local kyphotic angle was significantly different in the groups; however, there was no significant difference in the loss of correction of the local kyphotic angle of the groups. Surgical correction of the reduction in the vertebral body height showed statistical significance, while the average loss of correction in the reduction of the vertebral body height was not significantly different. The measurement of the angles made by the screws on the rods was not significantly different between the cannulated (poly-axial head) and solid (mono-axial head) screw groups. Conclusions: Solid screws were superior in terms of providing increased correction of the kyphotic angle and height of the fractured vertebra than the cannulated screws; however, no difference was noted between the screws in the maintenance of the superior and inferior angles of the screw with the rod.

• Journal of Acupuncture Research
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• v.19 no.3
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• pp.230-239
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• 2002

Kyphotic cervical curvature, straghtening is commonly caused by trauma, muscle spasm without trauma and wrong posture, etc. Objective : This study is performed to evaluate the clinical effect of neck pain associated with Kyphotic cervical curvatre on cervical x-ray lateral view. Methods : One of the many causes, We examined the patients with neck pain & upper back pain who visited to Department of Acupuncture & Moxibustion, Gumi Oriental Hospital of Kyung-San University from 16th June 1999 to 22th June 2000. Pre and post treatment, We evaluated the cervical angle, Jochumsen's method, VAS(visual analogue scale) and effective score of treatment. Results & Conclusion : 1. Kyphotic cervical curvature is mainly caused by wrong posture during long term, sudden trauma, etc. therfore, postcervical muscles and tendon are injuryed by strong stress. So, muscle imbalance and pain is occured. 2. On these cases, The improvement index for pre/post treatment showed 28/42, 10/15, 9/30, 28/42 degree in cervical angle. Jochumsen's method showed -1/+2, -9/-3, -5/-2, -1/+2mm. Afer treatment VAS is 2, 1, 1, 1 and effective score of treatment is above good. The results suggest that treatments of Oriental Medicine(Acupuncture & Moxibustion, Chu-Na, Cupping and Physical therapy) are effective methods for neck pain with kyphotic cervical curvature on cervical x-ray lateral view.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.1 no.2
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• pp.111-123
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• 2006

Objectives: This study is performed to evaluate the clinical effect of chuna therapy on the neck pain associated with kyphotic cervical curvature. Methods: This study carried out on three patients with neck pain & kyphotic cervical curvature who have received treatment in Depar1ment of Oriental Rehabilitation Medicine, Daejon Oriental Hospital of Daejon University from 28th July 2006 to 3th November 2006. Pre and post treatment, We evaluated the cervical angle, Jackson's angle, Jochumsen method, Ishihara index, VAS and effective score of treatment. Results & Conclusions: Two patients who received Chuna treatment recovered cervical curvature and improved neck pain. But One patient who dosen't received Chuna treatment was no improvement in cervical curvature & neck pain.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.339-345
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• 2014

PURPOSE: This study is to investigate the effect of 4 weeks of gym ball exercise on the pelvis and spine of women in 20s. METHODS: Randomly selected 10 of 20 subjects are allocated to experimental group who will practice gym-ball exercise while the rest 10 subjects are allocated to control group. Values for pelvic obliquity DL-DR, pelvic torsion DL-DR, pelvic rotation, kyphotic angle ICT-ITL (max), and lordotic angle ITL-ILS (max) were measured through recording using 3-dimensional image analyzer as a preliminary inspection. Gym-ball exercise was implemented 3 sessions a week for 4 weeks. Each session consisted of 10 minutes of warm up exercise, 30 minutes of main exercise, and 10 minutes of cool down exercise totaling 50 minutes. Post inspections were measured after exercise. RESULTS: Experimental group showed statistically significant difference in pelvic obliquity DL-DR, pelvic torsion DL-DR, and kyphotic angle ICT-ITL (max) (p<.05) and values of pelvic obliquity DL-DR showed statistically significant difference between two groups (p<.05). However pelvic rotation, lordotic angle ITL-ILS (max) did not show a significant difference. CONCLUSION: These results showed that gym-ball exercise has positive effect in the pelvic obliquity, torsion and spine kyphotic angle and expected to have positive effect on the body balance, body lineup, and coordination.

• Journal of Korean Neurosurgical Society
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• v.60 no.5
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• pp.577-583
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• 2017

Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.763-771
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• 2000

Objectives : Thoracolumbar burst fractures(TBLF) result in not only compressive deformity of vertebral body but also spinal cord compression by bony fragments. Many thoracolumbar burst fractures demand both anterior decompression and intervertebral fusion. Most of spinal surgeons use anterior instrumentation for anteior intervertebral bony fusion. The use of Z-plate has been increased recently, however there has been only a few reports regarding its clinical long-term strength. We studied nineteen patients with TBLF to find out the long-term stability of Z-plate. Methods : We have operated 19 patients from March 1996 to August 1998. They were treated with anterior decompression through either a transthoracic, retroperitoneal extrapleural or retroperitoneal approach. Retropulsed bony fragments were removed completely by corpectomy. Iliac bone graft was used for interbody fusion in all of the cases. They were evaluated by plain X-ray films including flexion and extention lateral films. Cobbs angle was used to evaluate kyphotic and lateral wedging deformity. Results : Burst fractured sites were T11 in two, three T12, nine L1, and five L2. Mean follow-up duration was fifteen months. Preoperative average kyphotic angle was 23.7 degree. Immediate postoperative kyphotic angle was 10.2 degree. Follow-up resluts of average kyphotic angles revealed 14 degrees. Four patients(21%), including two spinal 3-column injury, showed increasement of kyphotic angle more than 5 degree or breakage of intrumentation. Two patients showed the difference of kyphotic angle more than 3 degree. Five patients(26%) revealed lateral wedging deformity more than 3 degrees. Postoperative complications were two meralgia parestheticas, one pulmonary atelectasis and two donor site infections. Four of the eight patients, who initially showed incomplete spinal cord deficits, were nerologically improved by Frankel's grade. Conclusion : Z-plate fixation and iliac bone graft after anterior decompression in thoracolumbar burst fractures is a safe and easy method. Immediate postoperative results revealed excellent correction of posttraumatic kyphosis, but long-term follow-up evalution showed insufficient strength. Therefore we believe that use of Z-plate should be carefully decided, especially in the case of large lumbar fracture or 3-column injury.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1055-1062
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• 2000

Objectives : Burst fracture of the lower lumbar spine(L3-L5) is rare and has some different features compare to that of thoracolumbar junction. Lower lumbar spine is flexible segments located deeply, and has physiologic lordosis. All of these contribute to making surgical approach difficult. Generally, lower lumbar burst fracture is managed either anteriorly or posteriorly with various fixation and fusion methods. But there is no general guideline or consensus regarding the proper approach for such lesion. We have tried to find out the influencing factors for selecting the surgical approach through the analysis of lower lumbar burst fractures treated for last 4 years(1994.3-1998.3). Method : This study includes 15 patients(male : 10, female : 5, age range 20-59 years with mean age of 36.7 years, L3 : 8 cases, L4 : 5 cases, L5 : 2 cases). Patients were classified into anterior(AO) and posterior operated(PO) groups. We investigated clinical findings, injured column, operation methods, and changes in follow-up radiologic study (kyphotic angle) to determine the considerable factors in selecting the surgical approaches. Results : There were 5 AO and 10 PO patients. Anterior operation were performed with AIF with Kaneda or Z-plate and posterior operation were done with pedicle screw fixation with PLIF with cages or posterolateral fusion. Canal compression was 46.6% in AO and 38.8% in PO. The degree of kyphotic angle correction were 10.7 degree(AO) and 8.5 degree(PO), respectively. There was no statistical difference between anterior and posterior operation group. All patients showed good surgical outcome without complications. Conclusion : Anterior operation provided good in kyphotic angle correction and firm anterior strut graft, but it difficulty arose in accessing the lesions below L4 vertebra. While posterior approach showed less correction of kyphotic angle, it required less time and provided better results for accompanied adjacent lesion and pathology such as epidural hematoma. The level of injury, canal compression, biomechanics, multiplicity, and pathology are considered to be important factors in selection of the surgical approach.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.1
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• pp.95-101
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• 2012

Objectives : This study is performed to evaluate the clinical effect of Chuna therapy on the neck pain associated with kypotic cervical curvature. Methods : This study carried out on two patients with neck pain & kyphotic cervical curvature who have received treatment in Department of Oriental Rehabilitation Medicine, Dong-seo Oriental Medical hospital from 4th April 2011 to 26th May 2012. Pre and post treatment, We evaluated the cervical angle, Jackson's angle, Jochumsen method, VAS and effective score of treatment. Results & Conclusions : Two patients who received Chuna treatment recovered cervical curvature and improved neck pain.