Objective : The purpose of this study was to analyze the differences of spinopelvic parameters between degenerative spondylolisthesis (DSPL) and isthmic spondylolisthesis (ISPL) patients. Methods : Thirty-four patients with DSPL and 19 patients with ISPL were included in this study. Spinopelvic parameters were evaluated on whole spine X-rays in a standing position. The following spinopelvic parameters were measured : pelvic incidence (PI), sacral slope, pelvic tilt (PT), lumbar lordosis (LL), and sagittal vertical axis from C7 plumb line (SVA). The population of patients was compared with a control population of 30 normal and asymptomatic adults. Results : There were statistically significant differences in LL (p=0.004) and SVA (p=0.005) between the DSPL and ISPL group. The LL of DSPL ($42{\pm}13^{\circ}$) was significantly lower than that of the control group ($48{\pm}11^{\circ}$; p=0.029), but that of ISPL ($55{\pm}6^{\circ}$) was significantly greater than a control group (p=0.004). The SVA of DSPL ($55{\pm}49$ mm) was greater than that of a control group (<40 mm), but that of ISPL ($21{\pm}22$ mm) was within 40 mm as that of a control group. The PT of DSPL ($24{\pm}7^{\circ}$) and ISPL ($21{\pm}7^{\circ}$) was significantly greater than that of a control group ($11{\pm}6^{\circ}$; p=0.000). Conclusion : Both symptomatic DSPL and ISPL patients had a greater PI than that of the asymptomatic control group. In conclusion, DSPL populations are likely to have global sagittal imbalance (high SVA) compared with ISPL populations because of the difference of lumbar lordosis between two groups.
Kim, Jin Kwon;Moon, Byung Gwan;Kim, Deok Ryeng;Kim, Joo Seung
Journal of Korean Neurosurgical Society
/
v.56
no.4
/
pp.315-322
/
2014
Objective : Posterior accessed lumbar interbody fusion (PALIF) has a clear objective to restore disc height and spinal alignment but surgeons may occasionally face the converse situation and lose lumbar lordosis. We analyzed retrospective data for factors contributing to a postoperative flat back. Methods : A total of 105 patients who underwent PALIF for spondylolisthesis and stenosis were enrolled. The patients were divided according to surgical type [posterior lumbar inter body fusion (PLIF) vs. unilateral transforaminal lumbar interbody fusion (TLIF)], number of levels (single vs. multiple), and diagnosis (spondylolisthesis vs. stenosis). We measured perioperative index level lordosis, lumbar lordosis, pelvic tilt, sacral slope, pelvic incidence, and disc height in standing lateral radiographs. The change and variance in each parameter and comparative group were analyzed with the paired and Student t-test (p<0.05), correlation coefficient, and regression analysis. Results : A significant perioperative reduction was observed in index-level lordosis following TLIF at the single level and in patients with spondylolisthesis (p=0.002, p=0.005). Pelvic tilt and sacral slope were significantly restored following PLIF multilevel surgery (p=0.009, p=0.003). Sacral slope variance was highly sensitive to perioperative variance of index level lordosis in high sacral sloped pelvis. Perioperative variance of index level lordosis was positively correlated with disc height variance ($R^2=0.286$, p=0.0005). Conclusion : Unilateral TLIF has the potential to cause postoperative flat back. PLIF is more reliable than unilateral TLIF to restore spinopelvic parameters following multilevel surgery and spondylolisthesis. A high sacral sloped pelvis is more vulnerable to PALIF in terms of a postoperative flat back.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.9
no.1
/
pp.1-14
/
2014
Objective : The purpose of this study is to offer a new approach to diagnostic X-ray in perspective of Chuna manual medicine for clinical application. Methods : Characteristics of each malposition in X-ray were analyzed comprehensively, based on the listing system. By verifying these results, find out the methods of X-ray diagnosis according to the each malposition. Results : 1. Vertebral malposition can be explained by alignment and relative position of vertebral body in the X-ray. To obtain more accurate estimation of subluxation, features of other structures should be considered, such as spinous process, intervertebral foramen and disc space. 2. Pelvic malposition can be determined by relative location of anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS) in the X-ray. Also other pelvic parameters should be utilized to make a diagnosis of sacral malposition. Conclusions : Diagnostic X-ray should be applied to many clinicians for reasonable Chuna manual medicine application. And further studies are needed to use the diagnostic X-ray in the perspective of Chuna manual medicine.
Seo, Jun-Yeong;Ha, Kee-Yong;Kim, Young-Hoon;Kim, Seong-Chan;Yoon, Eun-Ji;Park, Hyung-Youl
Journal of Korean Medical Science
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v.33
no.48
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pp.316.1-316.10
/
2018
Background: Water pressure and muscle contraction may influence bone mineral density (BMD) in a positive way. However, divers experience weightlessness, which has a negative effect on BMD. The present study investigated BMD difference in normal controls and woman free-divers with vertebral fracture and with no fracture. Methods: Between January 2010 and December 2014, traditional woman divers (known as Haenyeo in Korean), and non-diving women were investigated. The study population was divided into osteoporotic vertebral fracture and non-fracture groups. The BMD of the lumbar spine and femoral neck was measured. The radiological parameters for global spinal sagittal balance were measured. Results: Thirty free-diving women and thirty-three non-diving women were enrolled in this study. The mean age of the divers was $72.1{\pm}4.7$ years and that of the controls was $72.7{\pm}4.0$ years (P = 0.61). There was no statistical difference in BMD between the divers and controls. In divers, cervical lordosis and pelvic tilt were significantly increased in the fracture subgroup compared to the non-fracture subgroup (P = 0.028 and P = 0.008, respectively). Sagittal vertical axis was statistically significantly correlated with cervical lordosis (Spearman's rho R = 0.41, P = 0.03), and pelvic tilt (Spearman's rho R = 0.46, P = 0.01) in divers. Conclusion: BMD did not differ significantly between divers and controls during their postmenopausal period. When osteoporotic spinal fractures develop, compensation mechanisms, such as increased cervical lordosis and pelvic tilt, was more evident in traditional woman divers. This may be due to the superior back muscle strength and spinal mobility of this group of women.
Jae Hwang Song;Woo Jin Shin;Sung Jun Moon;Jin Woong Yi;Tae Gyun Kim
Journal of Korean Foot and Ankle Society
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v.28
no.2
/
pp.48-54
/
2024
Purpose: Foot alignment affects the overall balance and alignment of the body. This study examined the relationship between the foot parameters and scoliosis in children and adolescents through simple radiographs. Materials and Methods: Two hundred and forty-one outpatients under 15 years old from 2013 to 2022 were evaluated. Patients with an abnormal leg length discrepancy or pelvic tilt were screened. The patients included were divided into four groups. Each group was tested to determine if they had scoliosis. The foot anterior-posterior/lateral X-rays were selected for the foot parameters, and the EOS system was used for the spline and pelvis parameters. Results: A t-test of all groups showed no statistically significant difference as the p-value exceeded 0.05. An analysis of variance (ANOVA) comparing the Cobb's angle and foot parameters did not show a significant correlation. On the other hand, female and older patients had a higher Cobb's angle. Conclusion: No direct relationship was noted between scoliosis and the foot parameters that could be measured radiographically among children and adolescents. In addition, no correction between the Cobb's angle and foot parameters was found.
Hoe-Song Yang;Chan-Joo Jeong;Young-Dae Yoo;Hyo-Jeong Kang;Min-Kyu Kim
Journal of The Korean Society of Integrative Medicine
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v.11
no.4
/
pp.269-279
/
2023
Purpose : The most effective intervention for flat foot is strengthening exercises for the intrinsic and extrinsic of the foot. Additionally, visual feedback is necessary for movement accuracy. However, the effectiveness of the intervention when combined with visual feedback was not revealed. To confirm this, the research was to investigate the effect of visual feedback and a complex exercise program on navicular bone height, plantar pressure, and lower extremity alignment. Methods : The twenty eight adult men and women with flat foot were randomly assigned to group 1 (n=14) and group2 (n=14), group1 performed complex exercises with visual feedback, and group 2 performed only complex exercises. Both groups performed a 40 minute compound exercise program three times a week. Navicular drop test, plantar pressure test, and lower extremity alignment test were performed equally in both group. Results : As a result of comparing the change in navicular height within the group according to the intervention, both groups showed a significant difference before and after the exercise (p>.05). There was not significant difference comparing the difference between the groups in the navicular height (p>.05). Comparing the change in plantar pressure within groups, there was not significant difference in the change in plantar pressure in both groups (p>.05). Coparing the difference before and after exercise between groups, there was not significant plantar pressure (p>.05). Comparing the change in leg alignment within the group, there was a significant difference in the change in ankle before and after exercise in group 1 (p<.05), but there was not significant difference in group 2. There was not significant difference in pelvic tilt and knee tilt before and after exercise in both groups (p>.05). Comparing the before and after exercise difference between groups, there were not significant in all variables of leg alignment (p>.05). Conclusion : The results of this study showed that complex exercise applied to patients with flat foot were effective in increasing the height of the navicular bone and ankle angle, but there was no effect due to visual feedback.
Purpose: The objectives of the present study were to investigate the disadvantages of tire pressure asymmetry of a wheelchair tire and recommend the criterion for appropriate tire pressure without generating negative changes in the musculoskeletal system in asymptomatic participants. Methods: Fourteen asymptomatic participants were asked to sit in pressure-controlled wheelchairs and perform desk work for 20 minutes in each tire condition. The asymmetry of the tire conditions was set as 0% difference, 25% difference, and 50% difference from the recommended pressure. The pelvic alignment and muscular recruitment represented as a flexion-relaxation ratio (FRR) were measured at pre-test, and after each condition of desk work. The displacement of the center of pressure (COP) was measured during the desk work. Results: The tire air pressure condition significantly affected the FRR and COP (P < 0.05). Both sides of the FRR values were significantly higher under the symmetrical tire conditions (0% difference) and pre-test, compared with the asymmetrical tire condition of 50% difference (P < 0.05). The mediolateral COP displacement of the asymmetrical tire conditions (25% and 50% difference) was significantly higher than that of the symmetrical tire conditions (0%) (P < 0.05). Conclusion: Asymmetrical tire conditions could cause changes in the muscle recruitment pattern of the erector spine and mediolateral COP displacement. Tire pressure asymmetry higher than 50% could be a risk factor for prevalence of back pain, so this level of asymmetry in tire pressures should be cautioned against for wheelchair users.
Cytokines are protein mediators that possess the ability to assist cell-to-cell communication in immune system-related activities. In general, pathogen endotoxins activate the release of inflammatory mediators, and with time, there is an increase in the cytokine levels in the body. Interleukin (IL)-6 mediates the acute-phase inflammatory response, and elevated IL-6 levels have been reported in peritoneal fluids of women with pelvic inflammation and endometriosis, thereby associating it with oocyte quality and infertility. To overcome subfertility or infertility in humans and animals, the present study was done to examine the effect of recombinant IL-6 on porcine oocytes matured in vitro and subsequently to determine the fertilization rate and embryo development. Porcine oocytes were incubated with varying concentrations of IL-6 (0 - 2 ㎍·mL-1) for 44 h followed by in vitro fertilization and culturing of the oocytes. The oocytes or embryos were fixed with 3.7% paraformaldehyde (PFA) and stained with fluorescence dyes, and the meiotic spindle, chromosome organization, fertilization status and embryo development were subsequently assessed under a fluorescence microscope. We observed induction of an abnormal meiotic spindle alignment in the oocytes incubated with IL-6 compared to the control oocytes incubated without IL-6. Moreover, significantly decreased fertilization rates and embryo development were observed for oocytes incubated with IL-6 (p < 0.05). Thus, an increased IL-6 level during oocyte maturation could be associated with fertilization failure due to an aberrant chromosomal alignment and a disruption of the cortical granules. Taken together, our results indicate that successful assisted reproduction can be achieved by controlling the levels of inflammatory cytokines.
Lee, Won-Hwee;Kang, Tae-Hee;Kim, Jeong-Ha;suryanti, Tri
The Journal of Korean Physical Therapy
/
v.27
no.5
/
pp.315-319
/
2015
Purpose: The purpose of this study was to investigate the effect of leg-crossing positions on muscle activities of rectus femoris, tensor fascia latae, and hamstring in healthy 20's adults. Methods: Twenty healthy subjects were asked to perform three leg-crossing positions, leg crossing (LC), tailor crossing (TC), and ankle crossing (AC). Surface electromyography (EMG) was used to evaluate the activities of rectus femoris, tensor fascia latae, and hamstring during upright sit posture (UP) and three leg-crossing positions and UP was compared to three leg-crossing positions. Repeated one way ANOVA was used for data analysis. The alpha level was set at 0.05. Results: The results showed significant difference in the muscle activities of rectus femoris, tensor fascia latae, and hamstring among leg-crossing positions. The muscle activity of the rectus femoris was significantly lower in LC and TC positions than UP. The muscle activity of tensor fascia latae was significantly higher in LC position than UP and other leg-crossing positions. The muscle activity of hamstring was significantly higher in LC and TC positions and significantly lower in AC position than in UP. Conclusion: Our study suggests that the activity of hip muscles was affected by pelvic and knee alignment in various leg-crossing positions.
Alignment of the hip joint and pelvis affects it's weight-bearing capabilities as well as the motion available at the joints. The normal hip joint is well designed to withstand the forces that act through and around it, assisted by the trabecular systems, cartilagious, muscles, and ligaments. Alterations in the direction or magnitude of forces action around the injury and degenerative changes. The integration of motion of the pelvis with motion of the vertebral column not only increases the ROM available to the total column but also reduces the amount of flexibility required of the lumbar lesion. In any instance in which there is normal or abnormal pelvic motion during weight hearing and the head must remain upright, compensatory motions of the lumber spine will occur if available. The motions that occur at the hip, pelvis, and lumbar spine during forward trunk bending with the motions that occur during anterior and posterior tilting of the pelvis in the erect standing postion.
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