• Title/Summary/Keyword: Neck angle

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Surgical Outcome of Cervical Arthroplasty Using $Bryan^{(R)}$

  • Kim, Hong-Ki;Kim, Myung-Hyun;Cho, Do-Sang;Kim, Sung-Hak
    • Journal of Korean Neurosurgical Society
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    • v.46 no.6
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    • pp.532-537
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    • 2009
  • Objective : Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. The study was designed to evaluate early surgical outcome and radiological effects of $Bryan^{(R)}$ cervical disc prosthesis. Methods : The authors retrospectively reviewed radiographic and clinical outcomes in 52 patients who received the $Bryan^{(R)}$ Cervical Disc prosthesis, for whom follow-up data were available. Static and dynamic radiographs were measured by computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of functional spine unit (FSU), and the C2-7 Cobb angle. The range of motion (ROM) was also determined radiographically, whereas clinical outcomes were assessed using Odom's criteria, visual analogue pain scale (VAS) and neck disability index (NDI). Results : A total of 71 $Bryan^{(R)}$ disc were placed in 52 patients. A single-level procedure was performed in 36 patients, a two-level procedure in 13 patients, and a three-level procedure in 3. Radiographic and clinical assessments were made preoperatively. Mean follow-up duration was 29.2 months, ranging from 6 to 36 months. All of the patients were satisfied with the surgical results by Odom's criteria, and showed significant improvement by VAS and NDI score (p < 0.05). The postoperative ROM of the implanted level was preserved without significant difference from preoperative ROM of the operated level (p < 0.05). 97% of patients with a preoperative lordotic sagittal orientation of the FSU were able to maintain lordosis. The overall sagittal alignment of the cervical spine was preserved in 88.5% of cases at the final follow up. Interestingly, preoperatively kyphotic FSU resulted in lordotic FSU in 70% of patients during the late follow up, and preoperatively kyphotic overall cervical alignment resulted in lordosis in 66.6% of the patients postoperatively. Conclusion : Arthroplasty using the $Bryan^{(R)}$ disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although the early results are promising, this is a relatively new approach, therefore long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.

A Prospective Study with Cage-Only or Cage-with-Plate Fixation in Anterior Cervical Discectomy and Interbody Fusion of One and Two Levels

  • Kim, Sam Yeol;Yoon, Seung Hwan;Kim, Dokeun;Oh, Chang Hyun;Oh, Seyang
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.691-700
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    • 2017
  • Objective : The authors prospectively analyzed the effect of one-level or two-level anterior cervical discectomy and fusion (ACDF), comparing stand-alone cages and cage-with-plate fixation constructs with respect to clinical outcomes and radiologic changes. Methods : A total of 84 patients who underwent one-level (n=52) or two-level ACDF (n=32) for cervical disc disease and who completed 2 years of follow-up were included in this study. The patients were divided by cervical level and grouped into ACDF-Cage-only and ACDF-Cage-with-plate groups. The following parameters were assessed using radiographs : subsidence, C2-C7 lordosis angle, fusion segment angle, adjacent disc space narrowing, and fusion status. Clinical outcomes were assessed using the neck disability index (NDI) and visual analog scale scores for arm pain. Results : In the comparison of one-level ACDF-cage-only and ACDF-cage-with-plate groups, the NDI score was better in the cage-only group at the 3-, 12-, and 24-month follow-ups : however, no significant difference in clinical outcomes was observed. In the comparison of two-level ACDF-cage-only and ACDF-cage-with-plate groups, no difference in any clinical outcome was observed between the two groups. At the 24-month follow-up, subsidence was observed in 45.8% of patients in the one-level cage-only group and 32.1% of patients in the one-level cage-with-plate fixation group. There was no statistically significant difference in the incidence rate between the two groups (p=0.312). Subsidence in the two-level cage-only group (66.6%) was significantly more frequent than in the two-level cage-with-plate fixation group (30%; p=0.049). The fusion rate for patients in the one-level cage-only group was not significantly different from that in the one-level cage-with-plate fixation group (cage-only, 87.5%; cage-with-plate fixation, 92.9%; p=0.425) ; fusion rate in the two-level patients were also similar between groups (cage-only, 83.3%; cage-with-plate fixation, 95%; p=0.31). Conclusion : Our clinical results showed that for single-level cases, plate fixation had no additional benefit versus cage-only; for two-level ACDF cases, the fusion rate and clinical outcomes were similar, although the cage-with-plate fixation group had a lower incidence of cage subsidence than did the cage-only group. We conclude that physicians should be aware of this possible disadvantage associated with using cervical plates in one-level ACDF. However, in two-level ACDF, subsidence is more likely to occur without plate fixation, and thus the addition of plate fixation should be considered.

Effect of Implant Length on the Immediate Loading at the Anterior Maxilla (즉시하중시 상악 전치부에 식립된 임플란트 길이 변화에 따른 응력 분포의 삼차원 유한요소 연구)

  • Lee, Joon-Seok;Kim, Myung-Joo;Kwon, Ho-Beom;Lim, Young-Jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.3
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    • pp.255-265
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    • 2009
  • Recently many studies have been published on application of immediate loaded implants. However, the immediate loading protocol has not been well documented. The purpose of the present study was to evaluate the stress distribution between bone-implant interfaces and the effect of implant length in the anterior maxilla using 3 dimensional finite element analyses. The diameter 4.0 mm threaded type implants with different length(8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm) were used in this study. The bone quality of anterior maxillary bone block was assumed to D3 bone. Bone-implant interfaces of immediately loaded implant were constructed using a contact element for simulating the non osseointegration status. For simplification of all the processing procedures, all of the material assumed to be homogenous, isotropic, and linearly elastic. The 178 N of static force was applied on the middle of the palatoincisal line angle of the abutment with $120^{\circ}$ angle to the long axis of abutment. Maximum von Mises stress were concentrated on the labial cortical bone of the implant neck area, especially at the cortical-cancellous bone interfaces. Compared the different length, highest peak stress value was observed at the 8.5 mm implants and the results indicated a tendency towards favorable stress distribution on the bone, when the length was increased. Presence of cortical bone was very important to immediate loading, and it appears that implants of a length more than 13 mm are preferable for immediate loading at the anterior maxilla.

Calculation and measurement of optical coupling coefficient for bi-directional tancceiver module (양방향 송수신모듈 제작을 위한 광결합계수의 계산 및 측정)

  • Kim, J. D.;Choi, J. S.;Lee, S. H.;Cho, H. S.;Kim, J. S.;Kang, S. G.;Lee, H. T.;Hwang, N.;Joo, G. C.;Song, M. K.
    • Korean Journal of Optics and Photonics
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    • v.10 no.6
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    • pp.500-506
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    • 1999
  • We designed and fabricated a bidirectional optical transceiver module for low cost access network. An integrated chip forming a pin-PD on an 1.3 urn FP-LD was assembled by flip-chip bonding on a Si optical bench, a single mode fiber with an angled end facet was aligned passively with the integrated chip on V-groove of Si-optical bench. Gaussian beam theory was applied to evaluate the coupling coefficients as a function of some parameters such as alignment distance, angle of fiber end facet, vertical alignment error. The theory is also used to search the bottle-neck between transmittance and receiving coupling efficiency in the bi-directional optical system. Tn this paper, we confirmed that reduction of coupling efficiency by the vertical alignment error between laser beam and fiber core axis can be compensated by controlling the fiber facet angle. In the fabrication of sub-module, a'||'&'||' we made such that the fiber facet have a corn shape with an angled facet only core part, the reflection of transmitted laser beam from the fiber facet could be minimized below -35 dE in alignment distance of 2: 30 /J.m. In the same condition, transmitted output power of -12.1 dEm and responsivity of 0.2. AIW were obtained.

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Effects of Cervical Stabilization and Scapular Stabilization Exercise on the Proprioception and Craniovertebral Angle and Upper Trapezius Muscle Tone of People with F orward Head Posture

  • Seung-Hwan, Lee;Byoung-Ha, Yoo;Hyun-Seo, Pyo;Dongyeop, Lee;Ji-Heon, Hong;Jae-Ho, Yu;Jin-Seop, Kim;Seong-Gil, Kim
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.4
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    • pp.1-13
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    • 2022
  • PURPOSE: This study examined the effects of the craniovertebral angle, proprioception (joint error test), and the upper trapezius on the muscle tone when comparing cervical stabilization and scapula stabilization exercises and when two exercises were performed together. METHODS: The participants in this study agreed in advance, and this study was carried out by recruiting 27 university students in their twenties with mild frontal posture. The subjects were assigned randomly to three groups that performed cervical stabilization exercises, scapular stabilization exercises, and both cervical and scapular stabilization exercises. One-way repeated ANOVA was used to analyze the evaluation values of the 1st, 3rd, and 6th weeks of exercise intervention within the group, and one-way ANOVA was used to compare the difference in the effects of exercise intervention among the three groups. RESULTS: Proprioception was significantly different in the cervical stabilization exercises (CSE) group and the cervical stabilization exercises + Scapular stabilization exercises (CSE+SSE) groups at three weeks, and there was a significant difference between the scapular stabilization exercises (SSE) group and the CSE+SSE group (p < .05). At six weeks, there was a significant difference between the CSE group and the CSE+SSE group, and there was a significant difference between the SSE group and the CSE+SSE group (p < .05). There was a significant difference between three and six weeks in the CSE group (p < .05). In the SSE group, there was a significant difference between pre and six weeks, and between three and six weeks (p < .05). In the CSE+SSE group, there was a significant difference between pre and three weeks, and between pre and six weeks (p < .05). On the other hand, there were no significant differences between CVA and muscular tone in all three groups (P > .05). CONCLUSION: In all groups, the proprioception (joint error test) showed significant improvement, and the CSE+SSE group showed greater improvement than the other groups. As a result, the appropriate combination of neck stabilization exercise and scapular stabilization exercise effectively improved proprioception in the presence of forward head posture (FHP).

A Review of the Anatomy of Face for the Clinical Application of Facial Acupuncture (안면침(顔面鍼) 시술(施術)을 위한 안면(顔面) 근육(筋肉)의 해부학적(解剖學的) 이해(理解) 및 임상적(臨床的) 적용(適用)에 대한 고찰(考察))

  • Kim, Joo-Hee;Kwon, Hyo-Jung;Song, Jeong-Hwa;Choi, Do-Young;Lee, Sang-Hoon;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.25 no.3
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    • pp.221-228
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    • 2008
  • Objectives : The purpose of this study is to understand the anatomical basis of the facial muscles and to apply this knowledge on the clinical practice of facial acupuncture. Methods : We searched both contemporary and the latest literatures on the practical application of facial muscle anatomy on Facial Acupuncture. Conclusions : Facial Acupuncture improves skin tone, texture and wrinkling by assisting the circulation of Ki. It stimulates the facial muscles directly to undo the stagnation of the meridians. To practice Facial Acupuncture, thorough understanding of facial anatomy is required. In this study the muscles of the head and neck, appropriate depth and angle of acupuncture needle, etc. were reviewed. The upper facial muscles including frontalis, procerus, corrugator supercilii and orbicularis oculi, the mid facial muscles including auricularis, nasalis, levator labii superioris, zygomaticus and so on, and the lower facial muscles including orbicularis oris, depressor labii inferioris, depressor anguli oris, mentalis and platysma etc. were reviewed in this study. For safer and more effective use of Facial Acupuncture, further study on the objective outcome of the technique should be done.

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THE USE OF TISSUE EXPANSION IN SOFT TISSUE RECONSTRUCTION OF THE HEAD AND NECK (조직확장술을 이용한 두경부 연조직 재건)

  • Jeong, Jong-Cheol;Park, Jun-Aa;Kim, Young-Woon;Jung, Soong-Rhyong;Lee, Jong-Ho;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.3
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    • pp.231-238
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    • 1994
  • Tissue expansion has now been widely used in various soft tissue defects and deformities. It is to reconstruct the lesion site by providing donor tissue of the same color, texture, and similar thickness and sensation with minimal scar formation and minor donor site morbidity. It is achieved through using a temporary expander capable of accumulating normal saline. Internal pressure from expander exerts its force on the flap, which gradually expands to provide additional tissue for reconstruction. We have applied tissue expander in three patients. The first case was soft tissue loss on the left forehead. The second case was multiple scar formation on the left mandibular angle and upper cervical area. The third case was scar contraction on the right cheek. All cases have been successfully reconstructed without complications.

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Effect of posture correction training in dental scaling using rapid upper limb assessment and 3D motion analysis (Rapid upper limb assessment와 3차원 동작 분석을 활용한 치석제거 자세교정 교육의 효과)

  • Yoon, Tae-Lim;Min, Ji-Hyun;Kim, Han-Na
    • Journal of Korean society of Dental Hygiene
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    • v.18 no.3
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    • pp.269-280
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    • 2018
  • Objectives: The purpose of this study was to investigate the change in the posture of dental hygiene students and clinical dental hygienists when implementing dental scaling before and after posture correction training using the rapid upper limb assessment (RULA) method and 3D motion analysis. Methods: Thirty-two healthy volunteers performed dental scaling to remove artificial calculus on dental manikin. The movement and angle of the joints were verified by RULA and 3D motion analysis during the procedure. The subjects were also photographed for 1 minute during the procedure for 10 minutes while the calculus was removed. After the removal of the calculus, the subject and the instructor checked the video together. Posture correction training was conducted by the instructor so that the subject could perform the calculus removal operation in the correct posture. Artificial calculus of the adjacent teeth was then removed for the same period of time, and the change in posture was reviewed. Results: The total score of the posture change using RULA was $5.72{\pm}0.58$ before training and $4.31{\pm}0.10$ after training, showing a significant decrease after training (p<0.001), and upper arm, lower arm, wrist position, neck and waist position showed significant decrease after training. The three-dimensional motion analysis showed significant differences according to the criteria measured at all measurement sites except the left shoulder (p<0.05) Conclusions: It was confirmed through RULA and 3D motion analysis that postural correction training using calculus removal images was effective, and that correct postural education is essential to preventing musculoskeletal diseases caused by removal of calculus.

A Therapeutic Approach Based on Motor Development in Congenital Muscular Torticollis: A Case Report (선천성 근육 사경 환아에 대한 운동 발달적 치료 접근: 증례보고)

  • Ryu, Je-Yong;Kim, Yu-Jin;Sung, Ju-Yeon;Shim, Jae-Hun;Lee, Gyu-Wan;Oh, Duck-Won
    • Physical Therapy Korea
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    • v.13 no.2
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    • pp.77-84
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    • 2006
  • Although conservative management of congenital muscular torticollis (CMT) has been well documented, relatively little is known about the response to the treatment. The purposes of this case report were to describe the use of a therapeutic approach based on motor development in physical therapy intervention for an infant with CMT and to report the result of the treatment. The patient was a 20-day-old baby boy with left CMT presenting muscular mass in the left sternocleidomastoid muscle. The angle of the lateral head tilt was 20 degrees. The size of muscular mass was 5.3 mm in ultrasonography. Intervention included ultrasonic therapy, soft tissue massage, passive and active range of motion exercises, motor developmental therapy, and parent instruction. The procedures of motor developmental therapy and changes in the amount of lateral head tilt were documented using photography. The size of the mass was decreased to .3 mm before the 5-month follow-up. The patient also maintained a midline head position in the supine position and a midline head alignment during all functional activities. A therapeutic approach based on motor development is a beneficial method for reducing an asymmetrical head and neck position, and facilitating normal development as a component of physical therapy intervention.

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Impact of Firefighters' Protective Clothing and Equipment on Upper Body Range of Motion (소방용 방화복 및 방화 장비에 따른 상반신 관절 각도의 동작 범위 연구)

  • Kim, Seonyoung;Park, Huiju
    • Fashion & Textile Research Journal
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    • v.17 no.4
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    • pp.635-645
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    • 2015
  • This study analyzed the range of motion of upper body in different configurations of firefighters' protective clothing and equipment. The purpose of this study was to understand the influence of firefighters' protective clothing and equipment over upper body motion in order to improve design of firefighters' protective clothing and equipment. 12 firefighters' upper body range of motion was analyzed while performing standing and walking trials in five different garment configurations including turnout ensemble, fire boots and the self-contained breathing apparatus. Analysis of upper body range of motion included spinal joints of L5S1, L4L3, T1C7, and C1Head. During standing trials, garment configurations caused a significant difference in range of motions at joints of L5S1, L4L3, T1C7, and C1Head. Analysis on the mean of range of motions at L5S1 and L4L3, showed that firefighters' waist bent forward significantly to a greater extent while they wore a self-contained breathing apparatus. A significantly increased range of motion was found for T1C7 and C1Head while carrying a self-contained breathing apparatus, which indicated an increase in the extension of the trunk and neck backward to stand upright and look squarely. A significant difference in range of motion was also found for L5S1 and L4L3 during walking trials.