• Title/Summary/Keyword: Spinal Curvature

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Evaluation of the Degenerative Changes of the Distal Intervertebral Discs after Internal Fixation Surgery in Adolescent Idiopathic Scoliosis

  • Dehnokhalaji, Morteza;Golbakhsh, Mohammad Reza;Siavashi, Babak;Talebian, Parham;Javidmehr, Sina;Bozorgmanesh, Mohammadreza
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1060-1068
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    • 2018
  • Study Design: Retrospective study. Purpose: Lumbar intervertebral disc degeneration is an important cause of low back pain. Overview of Literature: Spinal fusion is often reported to have a good course for adolescent idiopathic scoliosis (AIS). However, many studies have reported that adjacent segment degeneration is accelerated after lumbar spinal fusion. Radiography is a simple method used to evaluate the orientation of the vertebral column. magnetic resonance imaging (MRI) is the method most often used to specifically evaluate intervertebral disc degeneration. The Pfirrmann classification is a well-known method used to evaluate degenerative lumbar disease. After spinal fusion, an increase in stress, excess mobility, increased intra-disc pressure, and posterior displacement of the axis of motion have been observed in the adjacent segments. Methods: we retrospectively secured and analyzed the data of 15 patients (four boys and 11 girls) with AIS who underwent a spinal fusion surgery. We studied the full-length view of the spine (anterior-posterior and lateral) from the X-ray and MRI obtained from all patients before surgery. Postoperatively, another full-length spine X-ray and lumbosacral MRI were obtained from all participants. Then, pelvic tilt, sacral slope, curve correction, and fused and free segments before and after surgery were calculated based on X-ray studies. MRI images were used to estimate the degree to which intervertebral discs were degenerated using Pfirrmann grading system. Pfirrmann grade before and after surgery were compared with Wilcoxon signed rank test. While analyzing the contribution of potential risk factors for the post-spinal fusion Pfirrmann grade of disc degeneration, we used generalized linear models with robust standard error estimates to account for intraclass correlation that may have been present between discs of the same patient. Results: The mean age of the participant was 14 years, and the mean curvature before and after surgery were 67.8 and 23.8, respectively (p<0.05). During the median follow-up of 5 years, the mean degree of the disc degeneration significantly increased in all patients after surgery (p<0.05) with a Pfirrmann grade of 1 and 2.8 in the L2-L3 before and after surgery, respectively. The corresponding figures at L3-L4, L4-L5, and L5-S1 levels were 1.28 and 2.43, 1.07 and 2.35, and 1 and 2.33, respectively. The lower was the number of free discs below the fusion level, the higher was the Pfirrmann grade of degeneration (p<0.001). Conversely, the higher was the number of the discs fused together, the higher was the Pfirrmann grade. Conclusions: we observed that the disc degeneration aggravated after spinal fusion for scoliosis. While the degree of degeneration as measured by Pfirrmann grade was directly correlated by the number of fused segments, it was negatively correlated with the number of discs that remained free below the lowermost level of the fusion.

The Effect of Heel Height on Lumbar Sagittal Curvature at Standing Posture (기립자세에서 신발 굽의 높이가 요추부 시상만곡각에 미치는 영향)

  • Yoon, Bum-Chul;Lee, Myung-Hwa
    • Journal of Korean Physical Therapy Science
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    • v.5 no.4
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    • pp.763-775
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    • 1998
  • Some segment or segments of the body must compensate for the heel, and the higher the heel the greater the compensation. Such compensation was once generally thought to take place in the lumbar region and therefore to increase the lumbar lordosis. The purpose of this study is to analyze changes of lumbar sagittal curvature in barefoot and 6cm 12cm high-heel stance. We selected 19 subjects(11 males, 8 females} without history of lower back pain, significant spinal abnormality. And lateral view X-ray of lumbar region from T12 to S1 was taken of each individual. On each X-ray film, lumbar lordotic angle lumbosacral angle and lumbar segmental angles were measured by Cobb method. We drew the following interpretations from the analysis of measured variables of the lumbar region. 1. In comparison of barefoot 6cm heel 12cm heel stance, lumbar lordotic angle had a tendency to decrease according as the heel height was higher. The change in lumbar lordosis measured in high-heel stance was inconsistent with clinical forkelord of hyperlordosis in wearers of high-heeled. 2. Lumbar lordotic angle from T12 to L5 showed sex difference, and was more lordotic in female(p<0.05). 3. There was no sex difference in lumbosacral angle and lumbar segmental angles(p>0.05). 4. There was a significant correlation between lumbar lordotic angle and lumbosacral angle(r>0.60).

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Comparison of Subjective and Objective Sleep Quality in Subjects with and without Hyper-kyphosis

  • Kim, Jun-hee;Hwang, Ui-jae;Choi, Sil-ah;Jung, Sung-hoon
    • The Journal of Korean Physical Therapy
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    • v.34 no.5
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    • pp.272-277
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    • 2022
  • Purpose: This study compared the subjective and objective sleep quality between subjects with and without thoracic hyper-kyphosis. Methods: Forty participants were divided into a hyper-kyphosis (n=17) and normal group (n=17) by thoracic spinal angle measurement. The subjective sleep quality was measured using PSQI, a self-report, and objective sleep quality was measured using an actigraphy that measures time according to sleep patterns. Results: The PSQI scores of subjects with thoracic hyper-kyphosis were significantly higher than those with normal thoracic curvature (p=0.013). The total sleep time and real sleep time were less in subjects with hyper-kyphosis than in normal subjects (p=0.006; p=0.029). The light sleep time was less in subjects with excessive spondylolisthesis than in normal subjects (p=0.010). Light sleep time was less in those with hyper-kyphosis, but deep sleep time was similar to the subjects with a normal thoracic curvature (p=0.003; p=0.140). Conclusion: Subjects with thoracic hyper-kyphosis had a decrease in subjective sleep quality, such as sleep discomfort, and objective sleep quality, such as a decrease in sleep time compared to normal subjects.

A case of neurofibromatosis(NF-I) (신경섬유종증(Neurofibromatosis) 환아(患兒) 1예(例)에 대한 증례보고(症例報告))

  • Min Sang-Yeon;Jang Gyu-Tae;Kim Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.2
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    • pp.69-73
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    • 2001
  • The neurofibromatosis (NF) are a set of genetic disorders which cause tumors to grow along various types of nerves and, in addition, can affect the development of non-nervous tissues such as bones and skin. NF causes tumors to grow anywhere on or in the body. It also leads to developmental abnormalities. For example, individuals with NF have a higher incidence of learning disabilities. Neurofibromatosis(NF) has been classified into two distinct types: NF-I and NF-II. neurofibromatosis 1(NF-I), also known as von Recklinghausen NF or Peripheral NF, occurring in 1:4,000 births, is characterized by multiple cafe-au-lait spots and neurofibromas on or under the skin. Enlargement and deformation of bones and curvature of the spine (scoliosis) may also occur. Occasionally, tumors may develop in the brain, on cranial nerves, or on the spinal cord. About 50% of people with NF also have learning disabilities. Neurofibromatosis 2(NF-II), also known as Bilateral Acoustic NF(BAN), is much rarer occurring in 1:50,000 births. NF-II is characterized by multiple tumors on the cranial and spinal nerves, and by other lesions of the brain and spinal cord. Tumors affecting both of the auditory nerves are the hallmark. Hearing loss beginning in the teens or early twenties is generally the first symptom. We reported a 10-year-old female patient with NF-I, she has pain and edema in left leg, no symptoms of NF.

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Correlation between Lumbar Malposition and Disc Herniation in Lumbar Disc Herniation Patients: Focused on L4-L5, L5-S1 (요추 추간판 탈출 환자에서 나타나는 요추부 변위와 추간판 탈출의 상관관계: L4-L5, L5-S1 요추 간 추간판 탈출을 중심으로)

  • Yeon-Hoo Yi;Da-woon Song;Jae-Min Jeong;Tae-ha Kwon;Sae-young Bong;Yoo-jin Lee;Jin-Bong Choi
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.185-193
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    • 2023
  • Objectives This study was conducted to find out the correlation between lumbar malposition and lumbar disc herniation. Methods Among the patients who visited Gwangju Jaseng Hospital of Korean Medicine from January 2019 to January 2021, taking 92 patients under age 60 who had the records of X-rays and magnetic resonance imaging (MRI) images as the research subjects, Cobb's angle was measured in anterior-posterior (AP) view and lateral (LAT) view, the number of displacements was scored by listing categories defined by The Korean Society of Chuna Manual Medicine for Spine and Nerves. The degree of lumbar intervertebral disc herniation was expressed as a percentage according to the method of Kato, etc., and the correlation between each factor was analyzed. Results AP curvature and MRI herniation index showed significant positive correlation in L4-L5 level but there was no significant difference in L5-S1 level. LAT curvature and MRI herniation index had no correlation in L4-L5 level, but there was a significant negative correlation in L5-S1 level. Malposition score and MRI herniation index had a significant positive correlation in L5-S1 level, whereas there was no correlation in L4-L5. Conclusions As a result of the study, AP curvature and MRI herniation index showed a significant positive tendency in L4-L5 lumbar spine, and LAT curvature and MRI herniation index showed a significant negative tendency in L5-S1 lumbar spine. Malposition score and MRI herniation index were found to have a significant positive tendency in L5-S1 lumbar spine.

Measurement of Spinal Curvature by Using Enhanced Hough Transform on X-ray Imaging (X-ray 영상에서 개선된 허프 변환을 이용한 척추만곡도 측정)

  • Jeong, Hyang su;Kim, Kwang Beak
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2018.05a
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    • pp.360-362
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    • 2018
  • 본 논문에서는 X-ray 영상에서 척추 영역을 추출 및 분석하여 척추만곡도를 자동으로 측정하는 방법을 제안한다. 제안된 방법은 X-ray 영상에서 어깨뼈와 골반뼈 등과 같이 필요 없는 영역을 제거한 ROI(Region of Interest) 영역을 추출하고, 추출된 ROI 영역에서 척추 에지를 검출하기 위해 가우시안-라플라시안(Laplacian of Gaussian) 필터를 적용하여 척추 에지를 검출한다. 추출된 척추 영역을 척추의 Apex를 기준으로 Above Apex와 Below Apex 영역으로 구분하고 허프 변환(Hough Transform) 기법을 적용하여 두 영역에 대한 ($r,{\theta}$) 허프 공간을 구한다. ($r,{\theta}$) 허프 공간에서 척추만곡도 측정에 필요한 수평 직선만을 검출하기 위하여 수직 직선을 나타내는 교점들의 영역을 제거하여 척추만곡도 측정에 필요한 영역을 추출한다. 제안된 척추 추출 방법을 다양한 X-ray 영상을 대상으로 실험한 결과, 전문의가 척추만곡도를 효과적으로 측정하고 분석할 수 있는 척추 영역이 추출된 것을 확인할 수 있었다.

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Effects of Yoga Exercise on Physical Flexibility and Perception of Posture Management in Adolescents (요가운동이 청소년의 신체 유연성과 자세관리 인지에 미치는 효과)

  • Jung, Hyang-Mi;Kim, Yi-Soon
    • Child Health Nursing Research
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    • v.12 no.1
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    • pp.96-103
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    • 2006
  • Purpose: This study was done to evaluate the effects of Yoga exercise on improvements in physical flexibility, posture management behavior, and self-efficacy in adolescents. Method: In this study, the design was a quasi-experimental research design with a one group pretest-posttest design. Participants were 32 students from one high school in Busan Metropolitan City, Korea, who did not engage in regular aerobic exercise and were willing to participate in this study. Yoga exercise was conducted for 70 minutes twice a week for 15 weeks. The data were collected from March 16 to June 22, 2004. The data were analyzed using descriptive statistics, and paired t-test with SPSS Win 12.0. Results: Trunk flexibility, posture management behavior, and self-efficacy significantly increased after the yoga exercise. Conclusion: Yoga exercise is recommended as a useful nursing intervention that could help prevent spinal-curvature-related disorders among adolescents.

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T1 Slope and Cervical Sagittal Alignment on Cervical CT Radiographs of Asymptomatic Persons

  • Park, Ji Hoon;Cho, Chul Bum;Song, Jun Ho;Kim, Seok Woo;Ha, Yoon;Oh, Jae Keun
    • Journal of Korean Neurosurgical Society
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    • v.53 no.6
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    • pp.356-369
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    • 2013
  • Objective : We performed a retrospective analysis of medical records and radiographic images of patients who never underwent spinal treatment including diagnosis. The objective of this study is to explain the biomechanical and physiologic characteristics of cervical alignment related to thoracic inlet angle including T1 slope changes in each individual. Methods : We reviewed the cervical CT radiographs of 80 patients who visited ENT outpatient clinic without any symptom, diagnosis and treatment of cervical spine from January 2011 to September 2012. All targeted people were randomized without any prejudice. We assessed the data-T1 slope, Cobb's angle C2-7, neck tilt, sagittal vertical axis (SVA) C2-7 and thoracic inlet angle by the CT radiographs. Results : The relationships between each value were analyzed and we concluded that Cobb's angle C2-7 gets higher as the T1 slope gets higher, while the SVA C2-7 value decreases. Conclusion : We propose that the T1 slope is background information in deciding how much angle can be made in the cervical spinal angle of surgical lordotic curvature, especially severe cervical deformity.

Change of Lumbar Lordotic angle by Taping Therapy on Low Back Pain Patient with Lumbar Hyperlordosis ; A Case Report (테이핑 요법으로 호전된 요통환자의 요추전만도 변화 1례)

  • Youn, Yu-Suck;Lee, Jong-Soo;Moon, Sang-Hyun
    • The Journal of Korea CHUNA Manual Medicine
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    • v.4 no.1
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    • pp.157-165
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    • 2003
  • Low back pain (LBP) is a significant in today's society, with lifetime include factors associated with LBP ar reporter. Among the causes, aberration of posture may play a role in the development of LBP. Many investigators have assessed the curvature of spine in standing posture. But LBP is associated with Lumber Hyperlordosis of Hyperlordosis is controversial Subjects: In conservative treatment(acupuncture, herb med, manipulation & TENS. exercise, potural correction) for a 40 years old woman who had low back pain(V AS) be caused by decrease lumbar lordotic angie. Objectives: The object is change of lumbar lordotic angle of a 40 years old woman who had low back pain with Lumbar hyperlordosis, In conservative treatment. Method: In conservative treatment, We added taping therapy(mechanical correction taping of Kinesio Taping) about Lumbar Lordosis. Conclusion: We experienced a 40 years old woman who had love pack pain with Lumbar hyperlordosis. In conservative treatment, Her pain was Improved by additional taping therapy In company with decrease of Lumbar Lordosis. 1. abnormal spinal curvature, specially lumbar hyperlordosis act on induction & perpetuation agent for low back pain 2. In a patient had low back pain with lumbar hyperlordosis, change of lumbar lordotic angle is of utility value for the effect of treatment and assessment of prognosis. 3. pain control is more relative with change of lumbosacral angle than lumbar lordotic angle, in patient had low back pain with lumbar hyperlordosis. 4. mechanical taping therapy with elastic adhesive tape is effective for patient had low back pain with lumbar hyperlordosis

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Roentgenographic Analysis of Cervical Lordosis and Disc Degeneration in Neck Pain Patients with or without Low Back Pain (요통 유무에 따른 경항통 환자의 경추 전만각 퇴행성 변화 비교분석)

  • Lee, Sang-Ho;Chung, Seok-Hee;Lee, Jong-Soo;Kim, Sung-Soo;Shin, Hyun-Dae
    • The Journal of Korea CHUNA Manual Medicine
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    • v.2 no.1
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    • pp.85-92
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    • 2001
  • Objectives : To study the cervical lordosis and disc degeneration in neck pain patients with or without low back pain. Subjects. The study was composed of 57 neck pain patients with low back pain(LBP group) and 40 neck pain patients without low back pain(Non-LBP group). Methods : Radiographic measures of spinal lordosis(cervical and lumbar) and disc degeneration were collected, and statistically analyzed. Results: LBP group showed a significant increase in cervical lordotic angle as compared with Non-LBP group, whereas no significant change in cervical disc degeneration. A relationship was found between cervical and lumbar disc degeneration in LBP $group({\gamma}-0.3064)$. Conclusions : The findings from this study suggest that the curvature of the cervical spine is related to the subject's low back pain.

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