• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.258-262
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• 2005

Objective: The 5th lumbar spinal nerve can be entrapped in the intraspinal zone, foraminal zone, and the extraforaminal zone simultaneously. The failure to recognize that the nerve root can be compressed in such manners may be the reason of a number of failures of surgical decompression. Here we describe a microsurgical method for the decompression of the triple entrapment of the L5 spinal nerve in 21 patients. Methods: Clinical manifestations and surgical results of twenty-one patients treated surgically under the diagnosis of the triple entrapment of the L5 spinal nerve were reviewed retrospectively. All patients were treated by the posterior midline approach for the intraspinal entrapment and by the paraspinal approach for the foraminal and the extraforaminal entrapment. Results: Pain relief was obtained in all patients immediately after surgery. The mean follow-up period after the surgery was 13 months, ranged from 6 to 24 months. The mean Numeric Rating Scale (pain score) improved from 8.9 before the surgery to 1.4 (P<0.0001). The mean ODI scores improved from 76.2 before the surgery to 13.1 (P<0.0001). Nineteen patients were satisfied with their result at the last follow-up examination. Neither complications related to the surgery, nor the spinal instability was detected. Conclusion: The triple entrapment of the 5th lumbar spinal nerve is an important pathologic entity to identify for the treatment of L5 radiculopathy. Combined medial and lateral approaches are safe, minimally invasive and it provide the complete decompression of triple entrapment of the L5 spinal nerve without causing secondary instability like after complete facetectomy.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.41 no.2
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• pp.16-23
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• 2018

Postural instability can increase the likelihood of hazardous slip and fall accidents in workplaces. The present study intended to extend understanding of the effect of abnormal neck posture on postural control during quiet standing. The effect of body fatigue on the postural control was also of primary concern. Twelve healthy undergraduate students volunteered to participate in the experiment. Standing on a force platform with the neck neutral, flexed, extended, or rotated, subjects' center of pressures (COP) were measured under the two levels of body fatigue. For the fatigue condition, Subjects exercised in a treadmill to meet the predetermined level of body fatigue. Analyzing the position coordinates of COPs, the length of postural sway path was assessed in both medio-lateral (ML) axis and anterior-posterior (AP) axis. Results showed that, in AP direction, neck extension or rotation significantly increased the sway length as compared with neck neutral. Neck extension led to greater sway length compared to neck rotation. Neck flexion did not differ from neck neutral. The sway length in the AP direction also became significantly larger as the body fatigue accumulated after treadmill exercise. In ML direction, as compared to neutral posture, the neck extension, flexion, or rotation did not significantly affect the length of postural sway path. However, the sway length seemed to increase marginally with the neck extended during the fatigued condition. This study demonstrates that abnormal neck posture may interfere with postural control during standing. The ability to maintain postural stability decreases significantly with the neck extended or rotated. Body fatigue leads to postural instability further.

• Journal of Convergence Korean Medicine
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• v.1 no.1
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• pp.35-44
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• 2021

Objectives: The purpose of this study is to investigate the effect of ultrasound therapy on left knee pain and instability diagnosed with Baker's cyst in a 25-year-old male patient. Methods: Patient was treated with Radio frequency ablation treatment on left knee from Naeseulan (EX-LE4) to Wijoong (BL40). The effect of radio frequency ablation was assessed by Visual Analog Scale (VAS), Western Ontario and McMaster Universities (WOMAC) and Euro Qol-5 Dimension Index (EQ-5D Index). The treatment was executed one time a day everyday form May 28th to June 1st of 2020. Patient was observed from May 26th to June 1st. Results: After five sessions of radio frequency ablation, VAS of left posterior knee pain was improved while no improvement was discovered at left medial knee. In Korean WOMAC scale, only subscale of weight bearing and walking around plain were improved. EQ-5D did not show any improvement. Conclusion: The results suggest that radio frequency ablation treatment can be a valuable option in treating knee pain and daily living function. Further study seems to be needed based on long-term intervention.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.36-40
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• 2008

Purpose: The purpose of this study is to find out the normal results in ankle on varus stress, valgus stress, and anterior draw stress in young men in korea. This would be helpful as the basic data of measuring of ankle instability for operational indication. Materials and Methods: Varus and Valgus stress anteroposterior radiographs and Anterior drawing stress lateral radiographs of 600 normal ankles were reviewed. First, A line parallel was drawn parallel to the articular surface of the distal tibia, and another line was drawn parallel to the articular surface of the talus on anteroposterior radiographs. The interior angle that subtended by these two lines was measured. Second, the reference point is located at the posterior border of the tibia, and the shortest distance from this point to the proximal posterior articular surface of the talus is measured. Results: There were 300 males and 600 ankles. The mean age overall was 21 years (19-22 years) old. The mean length of ankle on anterior draw stress was $5.54{\pm}3.33\;mm$. The mean a interior angle of ankle on varus stress was $0^{\circ}-8.93^{\circ}$, and on valgus stress $0^{\circ}-7.78^{\circ}$. Conclusion: We can consider for operational indication at over the 8.87 mm on anterior draw stress, over the $8.93^{\circ}$ on varus stress, and over the $7.78^{\circ}$ on valgus.

• Journal of Korean Neurosurgical Society
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• v.53 no.3
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• pp.145-149
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• 2013

Objective : We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. Methods : We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. Results : PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were $3.6{\pm}2.9$ and $5.4{\pm}6.4$ in the unresected PARS group, $5.8{\pm}2.1$ and $11.3{\pm}7.1$ in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. Conclusion : The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.168-172
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• 1998

Discoid lateral menisci were common morphological anomaly and several classifications were proposed. Watanabe et al classified all discoid menisci, as seen arthroscopically, into three types 1) complete 2) incomplete and 3) Wrisberg ligament type. The purpose of this study is to report a rare case of both painful snapping knee joints in 6 year-old female. On arthroscopic examination, complete lateral discoid meniscus which consisted of taut Wrisberg ligament and intact tibial insertion of posterior horn was found, and abnormal anterior cruciate ligament(ACL) which has expanded femoral origin over the posterior articular surface of lateral femoral condyle was also found. At the time of arthroscopic surgery, hypertrophied high-riding Wrisberg ligament was resected, and expanded femoral origin of the anterior cruciate ligament was partially resected nearly to normal margin, and discoid lateral meniscus was saucerized. After these procedures, abnormal snapping sound was disappeared in full range of motion. On the follow-up examination after 1 year, pain and snapping sound were disappeared and any instability and limping were not found.

• Journal of Korean Neurosurgical Society
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• v.37 no.1
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• pp.39-43
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• 2005

Objective: For Posterior lumbar interbody fusion(PLIF) various cages or iliac bone dowels are used with or without pedicle screw fixation(PSF). To evaluate and compare the clinical and radiological results of different fusion methods, we intend to verify the effect of added PSF on PLIF, the effect of bone cages and several factors which are thought to be related with the postoperative prognosis. Methods: One hundred and ninety seven patients with lumbar spinal stenosis and instability or spondylolisthesis underwent various fusion operations from May 1993 to May 2003. The patients were divided into five groups, group A (PLIF with autologous bone dowels, N=24), group B (PLIF with bone cages, N=13), group C (PLIF with bone dowels and PSF, N=37), group D (PLIF with bone cages and PSF, N=30) and group E (PSF with intertransverse bone graft, N=93) for comparison and analyzed for the outcome and fusion rate. Results: Outcome was not significantly different among the five groups. In intervertebral height (IVH) changes between pre- and post-operation, Group B ($2.42{\pm}2.20mm$) was better than Group A ($-1.33{\pm}2.05mm$). But in the Group C, D and E, the IVH changes were not different statistically. Fusion rate of group C, D was higher than that of Group A and B. But the intervertebral height(IVH) increased significantly in group B($2.42{\pm}2.20mm$). Fusion rate of group C and D were higher than that of group A and D. Conclusion: Intervertebral cages are superior to autologous iliac bone dowels for maintaining intervertebral height in PLIF. The additional pedicle screw fixation seems to stabilize the graft and improve fusion rates.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.105-109
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• 2005

Purpose: To Analyze the exit site of pin inserted at the anterior glenoid rim in the reconstruction of the Bankart lesion and SLAP lesion using transglenoid suture technique. Materials and Methods: In the twenty adult right cadeveric scapula, insertions of pin were performed using guide at the position of 1, 2, 3 O'clock of glenoid rim. We measured the exit site of dorsal surface of the scapula by medial distance from sagittal plane of lateral border of scapular spine and the vertical distance from posterior border of the scapular spine. Results: When the pin was inserted caudally within 10 degree, at the position of 1, 2, 3 O'clock, the medial distance from lateral border of the scapula is averaged 29.4, 19.2, 34.0 mm respectively and the vertical distance from posterior border of the scapular spine is averaged 15.0, 18.6, 17.2 mm respectively. When the pin was inserted caudally within 20-30 degree, the medial distance is averaged 14.6, 14.2, 15.8 mm respectively and the vertical distance is averaged 31.6, 31.9, 32.1 mm respectively. Conclusion: When the pin was inserted caudally within ten degrees using the guide, the pin exit appeared at the more medial side of the base of scapular spine and the more inferior of scapular spine. This can make the firm suture tied over scapular spine during repair SLAP and the Bankart lesion, and also prevent the injury of suprascapular nerve.

• Korean Journal of Applied Biomechanics
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• v.17 no.1
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• pp.135-144
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• 2007

The purpose of this study was to identify the effect of the subtalar sling ankle taping, by measuring changes in peak plantar pressure and subtalar angle during jump landing and walking in healthy subjects with subtalar sling ankle taping applied of the ankle joint. Fifty healthy subjects(8 males and 7 female, aged 22 to 25) were randomly divided into a participated in this study. They were free of musculoskeletal injury and neurologic deficit in lower extremity. The subjects were asked to perform 5M walking and single leg jump landing by under the guidance of physical therapists. Subtalar motions were typically measured as the angle made between the posterior aspect of the calcaneous and the posterior aspect of the lower leg during walking with taping or not. This measurement were made using a video system (30Hz sampling rate, rectified 60 Hz sampling rate). At the same time, peak lateral and vertical pressure were investigated using pressure distribution platforms(MatScan system) under foot during walking and single leg jump landing with taping or not. Statistical analysis was done by paired t-test and intraclass correlation coefficient [ICC(3.1)], using software SPSS. We have recently demonstrated significantly altered patterns of subtalr joint and peak plantar pressure when applied subtalar sling ankle taping(p<.05). Inversion angle of subtalar joint significantly decreased with taping(p<.05). The result suggest that pressure patterns observed in subjects are likely to result due to significant decrease in stress on ankle joint structures during jump landing and walking. Also, the result that the subtalar sling ankle taping procedure provides greater restiction of motion associated with ankle inversion. However, this study involved asymptomatic subjects without history of ankle inversion injury, further research is needed to assess the motion restraining effect of the subtalar sling ankle taping in subjects with lateral ankle instability.