• Journal of Korean Neurosurgical Society
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• 제51권1호
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• pp.20-23
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• 2012

Objective : To compare radiographic analysis on the sagittal lumbar curve when standing, sitting on a chair, and sitting on the floor. Methods : Thirty asymptomatic volunteers without a history of spinal pathology were recruited. The study population comprised 11 women and 19 men with a mean age of 29.8 years. An independent observer assessed whole lumbar lordosis (WL) and segmental lordosis (SL) between L1 and S1 using the Cobb's angle on lateral radiographs of the lumbar spine obtained from normal individuals when standing, sitting on a chair, and sitting on the floor. WL and SL at each segment were compared for each position. Results : WL when sitting on the floor was reduced by 72.9% than the average of that in the standing position. Of the total decrease in WL, 78% occurred between L4 to S1. There were significant decreases in SL at all lumbar spinal levels, except L1-2, when sitting on the floor as compared to when standing and sitting on a chair. Changes in WL between the positions when sitting on a chair and when sitting on the floor were mostly contributed by the loss of SL at the L4-5 and L5-S1 levels. Conclusion : When sitting on the floor, WL is relatively low; this is mostly because of decreasing lordosis at the L4-5 and L5-S1 levels. In the case of lower lumbar fusion, hyperflexion is expected at the adjacent segment when sitting on the floor. To avoid this, sitting with a lordotic lumbar curve is important. Surgeons should remember to create sufficient lordosis when performing lower lumbar fusion surgery in patients with an oriental life style.

• Journal of Korean Neurosurgical Society
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• 제46권4호
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• pp.285-291
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• 2009

Objective : This study examined the change of range of motion (ROM) at the segments within the dynamic posterior stabilization, segments above and below the system, the clinical course and analyzed the factors influencing them. Methods : This study included a consecutive 27 patients who underwent one-level to three-level dynamic stabilization with Bioflex system at our institute. All of these patients with degenerative disc disease underwent decompressive laminectomy with/without discectomy and dynamic stabilization with Bioflex system at the laminectomy level without fusion. Visual analogue scale (VAS) scores for back and leg pain, whole lumbar lordosis (from L1 to S1), ROMs from preoperative, immediate postoperative, 1.5, 3, 6, 12 months at whole lumbar (from L1 to S1), each instrumented levels, and one segment above and below this instrumentation were evaluated. Results : VAS scores for leg and back pain decreased significantly throughout the whole study period. Whole lumbar lordosis remained within preoperative range, ROM of whole lumbar and instrumented levels showed a significant decrease. ROM of one level upper and lower to the instrumentation increased, but statistically invalid. There were also 5 cases of complications related with the fixation system. Conclusion : Bioflex posterior dynamic stabilization system supports operation-induced unstable, destroyed segments and assists in physiological motion and stabilization at the instrumented level, decrease back and leg pain, maintain preoperative lumbar lordotic angle and reduce ROM of whole lumbar and instrumented segments. Prevention of adjacent segment degeneration and complication rates are something to be reconsidered through longer follow up period.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.107-111
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• 2010

Objective : It has been demonstrated that cervical laminoplasty is an effective and safe method of treating multi-level cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament. However, recent reports have suggested that axial neck pain is frequently encountered after cervical laminoplasty. The aim of the present study was to determine clinical significance of the C7 spinous process on axial neck pain after cervical laminoplasty. Methods : A total of 31 consecutive patients that underwent cervical laminoplasty between March 2002 and December 2008 were reviewed. The authors evaluated and compared axial neck pain and lordotic angle in patients that underwent C7 spinous process preserving surgery (group 1, n=16) and in patients in which the C7 spinous process was sacrificed (group 2, n=15). Results : Severe or moderate early axial pain occurred in 56.2% of patients in group 1 and in 86.6% in group 2. Severe or moderate late axial pain occurred in 12.5% in group 1 and in 73.3% in group 2. Eighty-Six percent of patients in group 2 and 43% in group 1 experienced aggravation of their axial neck pain during the early postoperative period. Aggravation of axial neck pain during early postoperative period was less common in group 1 but not statistically significant (p=0.073). Sixty-six percent of patients in group 2 and 12% in group 1 had aggravated axial neck pain at late postoperative period and aggravation of late axial neck pain was significantly less common in group 1 (p=0.002). Conclusion : The present study demonstrates that C7 spinous process preserving laminoplasty decreases the incidence of aggravated axial neck pain after cervical laminoplasty.

• 대한통합의학회지
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• 제7권2호
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• pp.189-195
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• 2019

Purpose : The purpose of this study was to investigate the effects of chin tuck exercise (CTE) on the craniovertebral angle (CVA), strength and endurance of deep cervical flexor (DCF) muscles in subjects with forward head posture(FHP). This study was performed on 30 subjects with FHP. Method : Thirty subjects were divided into two groups; modified CTE (n=15), conventional CTE (n=15). Both of the group performed the exercise 4 times a week for 6 weeks. The subjects performed CTE in two different methods; modified CTE, with device designed that help keep cervical lordois curve, and coventional CTE, without using device. The CVA was measured using Image software version. A pressure biofeedback unit was used to measure the strength and endurance of the DCF muscles. The data was analyzed by the paired t-test for comparing before and after changes of variables in each group and the independent t-test for comparing the between groups. Result : There was statistically significant difference of before and after strength and endurance of DCF muscles in modified CTE (p<0.05). There was statistically significant difference of before and after only endurance of DCF muscles in conventional CTE (p<0.05). There was statistically significant difference of between the two group in strength of DCF muscles (p<0.05). Conclusion : Muscle strength to stabilize the spine plays an important role in maintaining a good posture. Therefore, we suggest that the application of CTE with a device designed to maintain the lordotic curvature in the neck is likely to yield better outcomes in FHP subjects in future studies.

• 한국산학기술학회논문지
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• 제19권5호
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• pp.346-356
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• 2018

좌식 생활 및 신체활동의 부족에서 발생하는 과체중 및 복부비만은 요추 신전근의 약화 및 위축으로 인하여 요부통증(Low back Pain, LBP)의 위험요인으로 추정된다. 그러므로 이 연구는 LBP를 소유하고 있는 복부비만 중년남성(n=80)에게 체중감량에 효과가 있는 고강도서키트트레이닝(High Intensity Circuit Training, HICT)을 적용했을 때 신체조성의 변화가 척추만곡도(Spine Curvature, SC) 및 시각적통증척도(Visual Analog Scale, VAS)에 미치는 영향을 관찰하고자 한다. 운동 프로그램으로는 체간 중심의 운동을 포함한 전신의 근육을 동원할 수 있는 다관절 형태의 12가지 종목으로 구성된 HICT(1회 운동 30분, 격일제 주당 3회)를 12주간 적용하였다. 그 결과, 비만관련 신체조성에서 긍정적인 변화가 관찰되었으며, 흉추후만도(Kypotic Angle, KA) 및 요추전만도(Lordotic Angle, LA)가 정상치에 가깝게 이동하였다. 이것은 궁극적으로 요부통증의 척도인 VAS의 지표가 낮아지는 결과를 보여 주었다. 결국, 복부비만에 의한 비정상적인 흉추후만도, 요추전만도 및 요부통증의 개선은 본 연구에서 적용된 고강도의 운동트레이닝에 의한 신체조성의 변화가 척추만곡도와 요부통증의 개선을 유도하는 것으로 생각된다.

• 한국산학기술학회논문지
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• 제18권9호
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• pp.347-355
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• 2017

본 연구의 목적은 골반 교정이 중년 여성의 만성 요통과 척추 골반 지표들에 미치는 영향을 규명하는데 있다. 이를 위하여 만성 요통이 있는 중년 여성 38명을 실험군(20명)과 무처치 대조군(18명)에 무선 할당하여 실험군에게는 골반 교정을 주 4회, 8주 간 시술하였다. 시술 전과 8주 후에 요통은 시각적 상사 척도와 Oswestry 요통 장애 지수로 측정하였고, 그 외 요부 유연성, 염증인자인 혈중 C-reactive protein (CRP) 및 척추 골반 지표들을 평가하였다. 처치 8주 후 대조군에 비하여 골반 교정군에서 요통 강도, 요통 장애 지수 및 요부 유연성 모두가 유의하게 향상되었으며, 혈중 CRP의 유의한 변화는 없었다. 척추 골반 지표들을 분석한 결과 골반 교정군에서 대조군에 비해 요추전만각, 천골경사 및 골반균형지표는 유의하게 변화된 반면, 골반입사각의 변화가 뚜렷하지 않았다. 따라서 골반 교정은 요통 환자의 통증 경감과 기능 향상에 효과적일 것이며, 척추 골반 정렬의 변화의 결과일 것이다.