• Journal of Korean Neurosurgical Society
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• v.38 no.4
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• pp.255-258
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• 2005

Objective : Lumbar lordotic curve on L4 to S1 level is important in maintaining spinal sagittal alignment. Although there has been no definite report in lordotic value, loss of lumbar lordotic curve may lead to pathologic change especially in degenerative lumbar disease. This study examines the changes of lumbar lordotic curve after posterior lumbar interbody fusion with wedge shape cage. Methods : We studied 45patients who had undergone posterior lumbar interbody fusion with wedge shape cage and screw fixation due to degenerative lumbar disease. Preoperative and postoperative lateral radiographs were taken and one independent observer measured the change of lordotic curve and height of intervertebral space where cages were placed. Segmental lordotic curve angle was measured by Cobb method. Height of intervertebral space was measured by averaging the sum of anterior, posterior, and midpoint interbody distance. Clinical outcome was assessed on Prolo scale at 1month of postoperative period. Results : Nineteen paired wedge shape cages were placed on L4-5 level and 6 paired same cages were inserted on L5-S1 level. Among them, 18patients showed increased segmental lordotic curve angle. Mean increased segmental lordotic curve angle after placing the wedge shape cages was $1.96^{\circ}$. Mean increased disc height was 3.21mm. No cases showed retropulsion of cage. The clinical success rate on Prolo's scale was 92.0%. Conclusion : Posterior lumbar interbody fusion with wedge shape cage provides increased lordotic curve, increased height of intervertebral space, and satisfactory clinical outcome in a short-term period.

• Journal of Korean Medicine Rehabilitation
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• v.25 no.4
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• pp.147-159
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• 2015

Objectives The purpose of this study is to investigate the clinical application of chuna for thoracic in the patients with nuchal pain. Methods Seven patients were treated by chuna for thoracic to evaluate the effect of the treatment. The patient's symptoms were assessed by visual analogue scale (VAS), neck disability index (NDI) and cervical lordotic curvature. Results In all cases, the pain was reduced according to VAS, NDI. Cervical lordotic curvature of 6 cases were improved in terms of Jackson's angle. 5 cases were improved in terms of Depth of cervical curve and Method of Jochumsen. 4 cases were improved in terms of Angle of cervical curve (C2~C7) and Ishihara index. 3 cases were improved in terms of Angle of cervical curve (C1~C7). Conclusions These results suggest that chuna on thoracic might be an effective method to treat nuchal pain with extension malposition of thoracic. But, it's necessary to have more observations and experiments.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.22 no.2
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• pp.51-56
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• 2016

Background: The purpose of this study is to compare axis change during cervical flexion and extension according to lordosis angle to patients with scoliosis. Methods: Movement axis change was estimated during cervical flexion and extension in twenty-four scoliosis patients with hypolordosis using radiography. Subjects were divided into mild lordotic curve group (MLCG, n=12, $34{\sim}25^{\circ}$) and severe lordotic curve group (SLCG, n=12, less $25^{\circ}$) according to cervical lordosis angle. Results: During cervical flexion, both group showed movement axis change to upper part of cervical vertebra and SLCG showed greater than MLCG but there is no significant difference. During cervical extension, SLCG showed greater than MLCG and there is significant difference. Conclusion: It is considered that cervical hypolordosis acts as important factor to scoliosis and degenerative joint disease because it leads to change of movement axis and central route of joint.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.2
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• pp.83-90
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• 2012

Objectives : The perpose of this study was to observe the correlation between lumbar lordotic angle and radiological result. Methods : We randomly selected among the 150 patients with lumbar X-ray and MRI films who have visited Jaseng Hospital of Oriental Medicine with low back pain. Radiographic lumbar lordotic angle and lumbar HIVD were collected and stastically analyzed. Results : In this study, if the finding of a X-ray showed straightening of lumbar lordotic curve, based on MRI finding, the number of HIVD increased. Conclusions : There was a significant correlation between lumbar hypolordosis and HIVD, hypolordosis complained mare HIDVs.

• The Journal of the Korea Contents Association
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• v.11 no.12
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• pp.800-806
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• 2011

The objective of this study was to identify the effect of lumbar lordotic curve adjustment on head and neck posture in older adults. Methods Twenty healthy older participants (mean age 71.32) were photographed while watching monitor in sitting with or without lumbar roll support(length 28cm, diameter 10cm). The upper cervical angle and lower cervical angle were measured using the NIH ImageJ 1.32. Comparisons between upper and lower cervical angle with or without lumbar roll support were made using paired-t test analysis. Results Subjects demonstrated a significant difference in the mean upper and lower cervical angle. Mean difference of the upper cervical angle was about $2.83^{\circ}$ with and without lumbar roll support(p<0.005). Mean difference of the lower cervical angle was about $4.44^{\circ}$ with and without lumbar roll support(p<0.0001). Conclusions This study showed that healthy older adults demonstrated more ability to maintain an upright posture of cervical spine during lumbar lordotic curve maintenance with lumbar roll support than without lumbar roll support. When the clinicians consider improvement of the head and neck posture in older adults, they must incorporate adjustment in the lumbar region.

• Physical Therapy Korea
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• v.28 no.2
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• pp.117-122
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• 2021

Background: Flat-back posture refers to a posture in which the pelvis is tilted backward, the lumbar spine is bent, the upper thoracic spine is increasingly bent, and the lower thoracic spine is straight. Given that most of the day is spent sitting, we need to develop exercise programs and devices that are suitable for people who spend less time exercising than sitting. Objects: This study investigated the effects of resistance footrest exercise on spine posture angles in visual display terminal (VDT) workers with flat back. Methods: We measured the upper lumbar angle (ULA) and lower lumbar angle (LLA) using a flexible ruler for the ULA and LLA. Then, after 1 week of resistance footrest exercise designed to strengthen the lumbar spine musculature, we measured these angles again. We measured each angle three times and then compared measurements from before and after exercise. Results: There were no significant differences in the ULA following the strengthening exercise, but significant differences were observed in LLA. Conclusion: The resistance footrest exercise strengthened the muscles affecting the pelvic and lumbar lordotic angles, and increases in the LLA were changed. This suggests that the role of the lower lumbar spine in the lumbar lordotic curve is greater than that of the upper lumbar spine. In addition, considering the contemporary tendency to lead fairly sedentary lives, these results indicate that exercising while seated can be effective.

• 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.

• The Journal of Korean Physical Therapy
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• v.24 no.3
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• pp.208-215
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• 2012

Purpose: We attempt to assess the differences in the degree of lumbar lordosis in patients with lower back pain caused by the herniation of the nucleus pulposus and in normal people (divided into male and female groups). Methods: This study was conducted with 14 patients (7 males, 7 females) diagnosed with, and being treated for, lumbar herniated nucleus pulposus and 14 normal people (7 males, 7 females). In order to examine the degree of lumbar lordosis in these subjects, hip flexor lengthening tests were conducted and the lumbar curves were measured in three postures (supine, sitting, and prone) and the results were compared. Results: The measured values of the curves for the standing and prone postures showed statistically significant differences between the normal group and the patient group, between the normal male group and the male patient group, and between the normal female group and the female patient group (p<0.05). Conclusion: The measurement method that uses flexible curve rulers in the standing or prone postures can be usefully utilized in assessing the lumbar lordosis of patients with lumbar herniation of the nucleus pulposus.

• Journal of Korean Neurosurgical Society
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• v.59 no.6
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• pp.610-614
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• 2016

Objective : The purpose of this study was to present the outcome of the microsurgical foraminotomy via Wiltse paraspinal approach for foraminal or extraforaminal (FEF) stenosis at L5-S1 level. We investigated risk factors associated with poor outcome of microsurgical foraminotomy at L5-S1 level. Methods : We analyzed 21 patients who underwent the microsurgical foraminotomy for FEF stenosis at L5-S1 level. To investigate risk factors associated with poor outcome, patients were classified into two groups (success and failure in foraminotomy). Clinical outcomes were assessed by the visual analogue scale (VAS) scores of back and leg pain and Oswestry disability index (ODI). Radiographic parameters including existence of spondylolisthesis, existence and degree of coronal wedging, disc height, foramen height, segmental lordotic angle (SLA) on neutral and dynamic view, segmental range of motion, and global lumbar lordotic angle were investigated. Results : Postoperative VAS score and ODI improved after foraminotomy. However, there were 7 patients (33%) who had persistent or recurrent leg pain. SLA on neutral and extension radiographic films were significantly associated with the failure in foraminotomy (p<0.05). Receiver-operating characteristics curve analysis revealed the optimal cut-off values of SLA on neutral and extension radiographic films for predicting failure in foraminotomy were $17.3^{\circ}$ and $24^{\circ}s$, respectively. Conclusion : Microsurgical foraminotomy for FEF stenosis at L5-S1 level can provide good clinical outcomes in selected patients. Poor outcomes were associated with large SLA on preoperative neutral (>$17.3^{\circ}$) and extension radiographic films (>$24^{\circ}$).

• Korean Journal of Applied Biomechanics
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• v.22 no.2
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• pp.151-158
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• 2012

The purpose of this study was to investigate variables of significantly difference as the structure of the spine, pelvic deviation and foot pressure between undergraduates and golf player subjects. The subjects of study were composed of 20 male golf players and 20 male undergraduates. Both groups were right handed persons. The measurement tools of this study were Formetric 4D(Diers, Germany) which is a three dimensional measure. The result are the follows: there were a significant difference between golf players and general students of trunk imbalance, pelvic tilt, pelvic torsion, pelvic rotation, surface rotation, lumbar lordotic curve, foot pressure(fore & behind foot), weight distribution(right & left foot). In conclusion, golf players might cause transform of spine and foot pressure due to golf exercise for several years. Such as imbalance affect to induce functional impairment and pain of musculoskeletal system, and appropriate evaluation and treatment were necessary for golf players.