• Title/Summary/Keyword: Lumbar Region

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Development of Brace-type Wearable Robot for Lumbar Stabilization (요부 안정화를 위한 복대형 입는 로봇 개발)

  • Joowan Kim;Jaehoon Sim;Keewon Kim;Sungun Chung;Jaeheung Park
    • The Journal of Korea Robotics Society
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    • v.18 no.2
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    • pp.189-196
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    • 2023
  • An abdominal brace is a recommended treatment for patients with lumbar spinal disorders. However, due to the nature of the static brace, it uniformly compresses the lumbar region, which can weaken the lumbar muscles or create a psychological dependence that worsens the condition of the spine when worn for an extended period of time. Due to these issues, doctors limit the wearing time when prescribing it to patients. In this paper, we propose a device that can dynamically provide abdominal pressure and support according to the lumbar motion. The proposed device is a wearable robot in the form of a brace, with actuators and a driving unit mounted on the brace. To enhance wearability and reduce the weight of the device, worm gears actuator and a multi-pulley mechanism were adopted. Based on the spinal motion of the wearer measured by the Inertia measurement unit sensors, the drives wire by driving pulley, which provide tension to the multi-pulley mechanism on both sides, dynamically tightening or loosening the device. Finally, the device can dynamically provide abdominal pressure and support. We describe the hardware and system configuration of the device and demonstrate its potential through basic control experiments.

Spontaneous Spinal Subdural Hematoma : Treatment with Lumbar Drainage

  • Kim, Chang-Hwan;Kim, Sang-Woo;Chang, Chul-Hun;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.481-483
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    • 2005
  • We report a rare case of spontaneous spinal subdural hematoma[SSDH]. A 63-year-old man presented with radicular pain and paraparesis on both legs for several months. On magnetic resonance images, SSDH was found in lumbar region. Electrodiagnostic report showed bilateral lumbosacral polyradiculopathy, such as cauda equina syndrome. SSDH was drained with lumbar drainage at L4-5 level without direct exploration. The patient improved after drainage of the hematoma and then he was able to walk independently.

The Efficacy of Active Exercise Programs for Work-Related Chronic Low Back Pain (직업성 만성요통에 대한 능동적 운동프로그램의 효과)

  • Hur, Jin-Gang
    • Journal of Korean Physical Therapy Science
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    • v.11 no.3
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    • pp.38-48
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    • 2004
  • The purpose of present study is to examine the relative efficacy of active exercise programs for work-related chronic low back pain and to figure out how much they affect mechanical stability of lumbar. Subjects are 43 employees with work-related chronic low hack pain, and they were randomly divided into two groups with general physiotherapy groups and thoracic exercise groups for increasing thoracic mobility. Active exercise programs were done 3 times a week, for 6 months, and the subjects were tested for Pain intensity(VAS), the Oswestry Disability Index, Maximal stretching with both hands in the overhead direction and the lumbar region angle of inclination. All subjects were reassessed with same measurement with Pre-study and 6 months after study After applying active exercise programs, pain intensity didn't show any significant difference between two groups. The Oswestry Disability Index showed significant difference between two groups and thoracic exercise groups decreased significantly compare to general physiotherapy group(p<0.05). Maximal stretching with both hands in the overhead direction showed significant difference between two groups and thoracic exercise group increased significantly more than general physiotherapy groups(p<0.05). The lumbar region angle of inclination showed significant difference between two groups and thoracic exercise group decreased significantly more than general physiotherapy groups (p<0.05). According to the results above, exercise for increasing thoracic mobility has an effect on lumbar stability. For the work-related chronic lower hack pain workers, it is far more effective for lumbar stabilization than general physiotherapy.

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Endoscopic Spine Surgery

  • Choi, Gun;Pophale, Chetan S;Patel, Bhupesh;Uniyal, Priyank
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.485-497
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    • 2017
  • Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Advantages of endoscopic spine surgeries are less tissue dissection and muscle trauma, reduced blood loss, less damage to the epidural blood supply and consequent epidural fibrosis and scarring, reduced hospital stay, early functional recovery and improvement in the quality of life & better cosmesis. With precise indication, proper diagnosis and good training, the endoscopic spine surgery can give equally good result as open spine surgery. Initially, endoscopic technique was restricted to the lumbar region but now it also can be used for cervical and thoracic disc herniations. Previously endoscopy was used for disc herniations which were contained without migration but now days it is used for highly up and down migrated disc herniations as well. Use of endoscopic technique in lumbar region was restricted to disc herniations but gradually it is also used for spinal canal stenosis and endoscopic assisted fusion surgeries. Endoscopic spine surgery can play important role in the treatment of adolescent disc herniations especially for the persons who engage in the competitive sports and the athletes where less tissue trauma, cosmesis and early functional recovery is desirable. From simple chemonucleolysis to current day endoscopic procedures the history of minimally invasive spine surgery is interesting. Appropriate indications, clear imaging prior to surgery and preplanning are keys to successful outcome. In this article basic procedures of percutaneous endoscopic lumbar discectomy through transforaminal and interlaminar routes, percutaneous endoscopic cervical discectomy, percutaneous endoscopic posterior cervical foraminotomy and percutaneous endoscopic thoracic discectomy are discussed.

The Effects of Chiropractic Therapy and Low Back Exercise of University Students in Commuter (카이로프랙틱 요법과 요통 운동 요법이 요추 자세 및 통증 변화에 미치는 영향 비교 - 통학버스 이용 대학생을 대상으로 -)

  • Jung, Han-Suk;Ham, Joo-Hyun;Choi, Seo-Yeon;Jung, Moon-Young
    • The Journal of Korean Society for School & Community Health Education
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    • v.15 no.1
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    • pp.77-87
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    • 2014
  • Objectives: The Purpose of this study was to investigate the effects of chiropractic treatment and low back exercise on lumbar lordosis angle, gravity line, range of motion, and pain degree of university students who are taking a commuter bus at least 4 hours of round trip. Methods: A group of 15 participants received chiropractic treatment around the lumbar spine region twice per week for 8 weeks. Another group of 15 participants were treated with low back exercise three times per week for 8 weeks. Results: In the present results, both chiropractic treatment and low back exercise did not affect the change of lumbar lordosis. However, chiropractic treatment also significantly improved the range of the lumbar motion, including Flexion, Extension, Right Lateral Flexion and Left Lateral Flexion(p<0.05), and consequently decreased the pain degree. Low back exercise significantly moved the lumbar gravity line to almost normal scale, and improved the range of the lumbar motion, including Flexion, and Right Lateral Flexion (p<0.05), resulting in the reduction of pain degree, although both chiropractic treatment and exercise treatment did not change the lumbar lordosis angle at the statistically significant. Conclusions: From these results, it can be inferred that chiropractic treatment might be beneficial to alleviating the low back pain of the university students using a commuter bus by improving the range of lumbar motion or stabilizing the lumbar gravity line.

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The Effect of Proprioceptive Position Sense by Lumbar Flexors and Extensors

  • Park, Ji-Won;Ko, Yu-Min;Park, Seol
    • The Journal of Korean Physical Therapy
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    • v.24 no.6
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    • pp.414-418
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    • 2012
  • Purpose: Muscle fatigue affects proprioception, and it causes problems in spinal stability. The purpose of this study was to examine the effect on the accuracy of reproducing the lumbar angles before lumbar exercise and after fatiguing isokinetic lumbar exercise. Methods: Thirty healthy adults participated in this study. Before induction of fatigue by exercise, the proprioception was measured by Biodex. Lumbar positions were passively maintained on stimulation position ($25^{\circ}$ flexion and $25^{\circ}$ extension), and back to the starting position. Subjects actively repositioned the remembered stimulation position, and error degrees between the stimulation position and reposition were measured. Using an isokinetic device at $120^{\circ}$/sec of velocity of angle lumbar flexion/extension exercise resulted in muscle fatigue. The post-fatigue proprioceptive position sense was used in the same way as in pre-fatigue measurement. Results: Means of position sense of pre-fatigue were $2.19{\pm}1.97$ on flexion angle, and $5.04{\pm}2.84$ on extension angle. After exercise induced fatigue, means of position sense were $2.37{\pm}1.83$ on flexion angle, and $4.93{\pm}2.57$ on extension angle. Results of this study showed significant differences of lumbar proprioceptive position sense between pre- and post-fatigue. Conclusion: Lumbar proprioception sense in active repositioning in flexion and extension was affected in the presence of muscle fatigue. Therefore, it should be noted that therapeutic exercise for patients with abnormal proprioceptive sense or elderly people must be performed with care because muscle fatigue can cause secondary damage.

Lumbar Spinal Extradural Angiolipoma : Case Report and Review of the Literature

  • Park, Jin-Hoon;Jeon, Sang-Ryong;Rhim, Seung-Chul;Roh, Sung-Woo
    • Journal of Korean Neurosurgical Society
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    • v.44 no.4
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    • pp.265-267
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    • 2008
  • Angiolipomas in the lumbar spinal region are extremely rare. The present report describes the identification of such a tumor and its removal, and discusses the tumor characteristics and prognosis. A 74-year-old woman was presented with a 5-month history of lower back pain. Severe radiculopathy was experienced in the left leg for 5 days prior to the presentation, and there were no neurological deficits. Magnetic resonance (MR) images showed an approximately 3.5 cm heterogeneously enhanced and elongated mass at the left L5-S1 level. A portion of the mass appeared with high signal intensity on T2-weighted MR images, with low signal intensity on T1-weighted images, and with high signal intensity on T1 fat suppression enhancement images. Resection of the tumor was approached via an L5 and S1 laminectomy. A fibrous sticky yellowish hypervascular tumor was identified. Histological study revealed the tumor as an angiolipoma. Symptoms were relieved after tumor excision, and there were no neurological sequelae. Although extremely rare, lumbar epidural angiolipoma should be considered in the differential diagnosis of lumbar spinal epidural lesions. The prognosis after surgical management of this lesion is favorable.

A Comprehensive Anatomical Approach to Low Back Pain (요통의 해부학적 고찰)

  • Kim Yoing-Su
    • The Journal of Korean Physical Therapy
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    • v.10 no.2
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    • pp.149-159
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    • 1998
  • Normal lumbar vertebrae function only when soft tissues are in position, constituting vertebral body, discs and facet feints. Considering the mechanism of supporting bodily weight, the widest movement of vertebral column reaches a lumbar sacral joint to cause structural changes. The feet is proved that lumbago is the damage of lumbar vertebrae accompanied with the change of soft tissues surrounding lumbar vertebrae, rather than simple pain in a certain lesion. It is based on the mechanism of vertebral body and intervertebral discs in the anatomical structure of the lumbar region. In my opinion, it is necessary to prove more accurately the cause of lumbago, escaping from the conventional cause of the abnormality of disc.

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Biomechanical Analysis of Lumbar Interspinous Process Fixators and Design of Miniaturization and Advanced Flexibility (요추부 극돌기간 고정기구의 생체역학적 해석과 소형화 및 유연성 향상 설계)

  • Park, Jung-Hong;Heo, Soon;Lee, Sung-Jae;Son, Kwon
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.30 no.12 s.255
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    • pp.1509-1517
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    • 2006
  • The intervertebral fusion was reported to increase the degeneration of the neighboring region. Recently, a new technique of inserting an interspinous process fixator has been introduced to minimize the degenerative change in the lumbar spine. This study analyzed biomechanical effects of the fixator in the lumbar spine, and designed a new prototype to improve flexibility of the fixator with a reduced size. The evaluation was based on the displacement, stiffness and von-Mises stress obtained from the mechanical test and finite element analysis. A finite element lumbar model of L1 to L5 was constructed. The finite element model was used to analyze intervertebral fusion, insertion of a commercial fixator and a new prototype. The range of motion of intervertebral segments and pressures at vertebral discs were calculated from FEA. The results showed that the stiffness of the prototype was reduced by 32.9% than that of the commercial one.