• 시큐리티연구
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• 제21호
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• pp.1-18
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• 2009

인간의 요추는 똑바로 선 자세에서 골반 위에 있는 근육과 인대들에 의해 고정되어 있다. 인간이 움직일 때 마다 중심을 잡아주고, 근 골격계 구조를 적절히 유지시키는 요추부근육들을 효과적으로 스트레칭하고, 강화하여 노화로 인한 '건강의 약화'에서 벗어날 수 있다고 주장하였다. 이와 같은 요부안정화근육 강화는 요추부 재활과 운동 수행능력까지도 증가시킨다. 이 연구는 척추 강화 운동 요추 안정화 운동을 요추부의 근력, 유연성 및 균형, 요추 기능에 (코어프로그램)의 효과를 조사했다. 이 연구의 대상은 민간 경비 회사에 등록된 18명을 선정했다. 각 운동 그룹(n=9)은 무작위로 무선 표집하여 선정됐다. 이 연구의 방법으로 요추부 근력 측정 장비 BTE, 눈금자 줄자, 유연성, 균형과 요추 기능을 사용하였고 이에 따른 결과는 아래에 요약하였다. 굴곡근력 요추 안정화 운동 (핵심 운동) 단체(p<.05)을 개선했다. 신근 근육 강도가 요추 안정화 운동 (코어 프로그램) 그룹(p<.05)을 개선했다. 요추부 유연성 강화 운동 그룹과 요추 안정화 운동 그룹 (p<.05)을 개선했다. 척추의 균형 능력을 강화하는 그룹과 요추 안정화 운동 그룹 (코어 프로그램) 그룹에서 개선되었다(p<.05). 위의 결과에 따른 이 연구에서는 각 개인 경비 및 보안에 척추 강화 운동 요추 안정화 운동의 효과를 보여주어 지속적인 코어프로그램의 활성 방안을 고려해보아야 겠다.

• Journal of Korean Neurosurgical Society
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• 제57권4호
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• pp.229-234
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• 2015

Objective : Pedicle screw fixation for spine arthrodesis is a useful procedure for the treatment of spinal disorders. However, instrument failure often occurs, and pedicle screw loosening is the initial step of a range of complications. The authors recently used a modified transpedicular polymethylmethacrylate (PMMA) screw augmentation technique to overcome pedicle screw loosening. Here, they report on the laboratory testing of pedicle screws inserted using this modified technique. Methods : To evaluate pullout strengths three cadaveric spinal columns were used. Three pedicle screw insertion methods were utilized to compare pullout strength; the three methods used were; control (C), traditional transpedicular PMMA augmentation technique (T), and the modified transpedicular augmentation technique (M). After control screws had been pulled out, loosening with instrument was made. Screw augmentations were executed and screw pullout strength was rechecked. Results : Pedicle screws augmented using the modified technique for pedicle screw loosening had higher pullout strengths than the control ($1106.2{\pm}458.0N$ vs. $741.2{\pm}269.5N$; p=0.001). Traditional transpedicular augmentation achieved a mean pullout strength similar to that of the control group ($657.5{\pm}172.3N$ vs. $724.5{\pm}234.4N$; p=0.537). The modified technique had higher strength than the traditional PMMA augmentation technique ($1070.8{\pm}358.6N$ vs. $652.2{\pm}185.5N$; p=0.023). Conclusion : The modified PMMA transpedicular screw augmentation technique is a straightforward, effective surgical procedure for treating pedicle screw loosening, and exhibits greater pullout strength than traditional PMMA transpedicular augmentation. However, long-term clinical evaluation is required.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.493-500
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• 2001

Objective : Anterior cervical locking plates are the devices for achieving anterior cervical spinal fusion. This study was conducted to evaluate the locking plate system regarding its long-term advantages and disadvantages in the view of interbody fusion rate, hardware-related failures, vertebral change close to the fusion segment and postoperative complications. Method : Eight-six patients, operated from Jan., 1996 to Jun. 1998, were followed-up for more than two years. All of the cases were fused with iliac bone graft and ORION locking plate(Sofamor Danek USA, Inc., Memphis, TN) fixation. The patients were discharged or transferred to rehabilitation department 2-7 days after operation. A comprehensive evaluation of the interbody fusion state, instrument failure, vertebral change and postoperative complications were made by direct interview and cervical flexion-extension lateral plain films. Results : There were 55 male and 31 female with a mean age of 45 years(18-75 years). The mean follow-up period was 29 months(24-43 months). Various disorders that were operated were 40 cervical discs, 6 cervical stenosis including OPLL, 2 infections, and 38 traumas. Fusion level was single in 59 cases, two levels of each disc space in 15 cases, and two levels after one corpectomy in 12 cases. There was no instrument failure. Pseudoarthrosis was observed in two cases(2%) without radiological instability. The other patients(98%) showed complete cervical fusion with stable instrument. Mild settling of interbody graft with upward migration of screws was found in 12 cases(14%). Anterior bony growth at the upper segment was found in 5 cases(6%). Postoperative foreign body sensation or dysphagia was observed in 12 cases(4%), and disappeared within one month in 7 cases and within six months in 4 cases. One patient complained for more than six months and required reoperation to remove paraesophageal granulation tissue. Conclusion : The results show that Orion cervical locking plate has some disadvantages of upward migration of screws, anterior bony growth at the upper segment, or possibility of esophageal compression even though it has advantages of high interbody fusion rate or low instrument failure. Author believe that anterior cervical locking plate in the future should be thinner, and should have short end from the screw hole, and movable screw with adequate stability.

• 인간행동과 음악연구
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• 제15권2호
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• pp.23-39
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• 2018

본 논문은 척수손상환자의 호흡재활을 위한 하모니카 활용 프로그램이 호흡기능에 어떠한 영향을 미치는지 확인하고자 시행한 연구이다. 평균 연령 37세의 복식호흡이 불가능한 척수손상환자 8명이 본 연구에 참여하였다. 3개월 동안 1회 60분씩 총 10회의 프로그램이 실시되었고, 호흡재활 전후 호흡량을 측정한 결과를 비교 분석하였다. 본 프로그램에서는 신체적 움직임, 특히 목 움직임에 제한이 있는 환자 특성을 고려하여 길이가 짧은 10홀로 구성된 다이아토닉 하모니카를 사용하였고, 척수손상 정도에 따라 손 움직임에 제약이 있는 목걸이 거치대를 사용하였다. 또한 하모니카 연주를 위해 과거 음악경험과 상관없이 쉽게 배울 수 있는 기초적인 악곡을 선정하였고, 음정을 내기 위해 복식호흡을 유도하여 긴 음정과 강한 호흡이 필요한 지점들을 훈련하였다. 연구 결과, 프로그램 참여 후 호흡량이 유의하게 증가하였고, 호흡 기능과 관련된 어지럼증과 가래 증상이 개선된 것으로 나타났다. 또한 삶의 질이 증가하고 우울감이 감소한 것으로 나타나 본 프로그램이 척수손상환자의 호흡재활을 위해 효과적으로 적용될 수 있음을 확인할 수 있었다. 신경학적 손상 환자에 개입하는 프로그램의 필요성이 계속 증가하는 것을 고려할 때, 본 연구는 척수손상환자의 호흡 기능에 효과적으로 개입할 수 있는 프로그램을 제시한 데 그 의의가 있다.

• 대한정형도수물리치료학회지
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• 제16권2호
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• pp.53-60
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• 2010

Purpose : Neck pain is commonly experienced by both adolescents and adults. The purpose of this study was to measure neck disability index(NDI) and the cervical range of motion(CROM) following spinal manipulation and mobilization techniques. Methods : Thirty participants(manipulation=15, mobilization=15) with mild neck disability volunteered for this study. It was used to measure NDI with NDI questionnaire and six motions(neck flexion and extension, left and right lateral flexion, left and right rotation) with the CROM instrument. Independent t-test and paired t-test were used to estimate NDI and CROM, and compared left with right motions. Results : A significant decrease in NDI were found after spinal manipulation and mobilization treatment(p<.05). A trend toward increase in all cervical motions(flexion, extension, left and right lateral flexion, left and right rotation), after interventions, were revealed(p<.05). The significant differences were not found on NDI and CROM between the group(p<.05). It was presented asymmetric motions in cervical lateral flexion(p<.05) before and after treatment. Conclusions : Our results suggest that manipulation and mobilization probably provide at least short-term benefits for patients with mild neck pain. It is needed to be studied the factors and preventive methods influencing the asymmetric cervical motion.

• Journal of Yeungnam Medical Science
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• 제13권2호
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• pp.234-242
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• 1996

영남대학교 의과대학 부속병원 신경외과에서 1994년 l월부터 1994년 12월까지 1년간 흉요추접합부 파열골절로 입원한 환자중 전측방경유법으로 10례를 수술로 치료경험 하였던 바, 척추골절이 척수원추 상부이면서 전방의 골편에 의해 척수신경이 압박되고 있는 불안정 파열골절시는 전방도달술에 의한 늑골 골융합 및 Kaneda기기내고정술로 좋은 결과를 기대할 수 있겠고, 척수 후주의 심한 손상이나 또는 3 column을 전체가 손상된 불안정 파열골절의 경우에는 후방접근법이나 후측방접근법으로 신경감압 및 내고정술 시행하는 것이 좋은 치료법이라 할 수 있겠다.

• 대한정형도수물리치료학회지
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• 제26권1호
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• pp.19-26
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• 2020

Background: The purpose of this study was compare and analyze the flexibility and dynamic balance in adolescents with idiopathic scoliosis and provide scientific basis for effectively treating idiopathic scoliosis. Methods: The subjects of this study were 20 members of adolescences. To measure the flexibility of the spine, a left buckling instrument was used, and it was measured using a modified sit and reach test. They were randomly divided into core exercise with sling program group (n=10) and general exercise program group (n=10), each consisting 50 minutes each for 4 times per week for 8 weeks. Results: The results of the study are as follows. First, Both groups were increased statistically significantly in spinal flexibility but no significant differences have been found between the two groups after 8 weeks of exercise. Second, Both groups were increased statistically significantly in balance ability of dynamic foot pleasure ratio but no significant differences have been found between the two groups after 8 weeks of exercise. Conclusion: In summarizing the results of this study, sling exercise with core exercise was effective in the decrease of flexibility and stability than general scoliosis exercise in adolescents with idiopathic scoliosis. It is also believed to be applicable to spinal diseases caused by muscular weakness since it is effective in strengthening core muscle strength.

• Journal of Korean Neurosurgical Society
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• 제41권4호
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• pp.241-245
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• 2007

Objective : So called "minimally invasive procedures" have evolved from chemonucleolysis, automated percutaneous discectomy, arthroscopic microdiscectomy that are mainly working within the confines of intradiscal space to transforaminal endoscopic technique to remove herniated epidural disc materials directly. The purpose of this study is to assess the result of endoscopic spinal surgery and favorable indication in the thoracolumbar spine. Methods : The records of 71 patients, 73 endoscopic procedures, were retrospectively analysed. Yeung Endoscopic Spine Surgery system with 7 mm working sleeve and $25^{\circ}$ viewing angle was used. The mean follow up period was 6 months [range, 3-9]. Results : Operated levels were from T12-L1 disc down to L5-L6 of S1 disc. Of 71 cases, 2 patients underwent transforaminal endoscopic surgery twice due to recurrence after initial operation. MacNab's criteria was used to assess the outcome. Favorable outcome, excellent of good, was seen in 78% [57 procedures] of the patients. Among 11 fair outcomes, only 1 procedure was followed by secondary open procedure, laminectomy with discectomy. Two of 5 poor outcomes were operated again by same procedure which resulted in fair outcomes. One patient with aggravated cauda equina syndrome remained poor and a lumbar fusion procedure was performed in other patient with poor outcome. There were 2 postoperative discitis that were treated with conservative care in one and anterior lumbar interbody fusion in the other. Conclusion : Evolving technology of mechanical, visual instrument enables minimal invasive procedure possible and effective. The transforaminal endoscopic spinal surgery can reach as high as T12-L1 disc level. The rate of favorable outcome is mid-range among reported endoscopic lumbar surgery series. Authors believe that the outcome will be better as cases accumulate and will be able to reach the fate of standard open microsurgery.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.224-230
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• 2011

Objective : This study aimed to show the possibility of neural canal enlargement and restoration of bony fragments through laminectomy and minimal facetectomy without pediculectomy or an anterior approach, and also to prove the adequacy of posterior stabilization of vertebral deformities after thoracolumbar bursting fracture. Methods : From January 2003 to June 2009, we experienced 45 patients with thoracolumbar burst fractures. All patients enrolled were presented with either a neural canal compromise of more than 40% with a Benzel-Larson Grade of VI, or more than 30% compromise with less than a Benzel-Larson Grade of V. Most important characteristic of our surgical procedure was repositioning retropulsed bone fragments using custom-designed instruments via laminectomy and minimal facetectomy without removing the fractured bone fragments. Beneath the dural sac, these custom-designed instruments could push the retropulsed bone fragments within the neural canal after the decompression and bone fragment repositioning. Results : The mean kyphotic deformities measured preoperatively and at follow-up within 12 months were 17.7 degrees (${\pm}6.4$ degrees) and 9.6 degrees (${\pm}5.2$ degrees), respectively. The mean midsagittal diameter improved from 8.8 mm (${\pm}2.8$ mm) before surgery to 14.2 mm (${\pm}1.6$ mm) at follow-up. The mean traumatic vertebral body height before surgery was 41.3% (${\pm}12.6%$). At follow-up assessment within 12 months, this score showed a statistically significant increase to 68.3% (${\pm}12.8%$). Neurological improvement occurred in all patients. Conclusion : Though controversy exists in the treatment of severe thoracolumbar burst fracture, we achieved effective radiological and clinical results in the cases of burst fractures causing severe canal compromise and spinal deformity by using this novel custom-designed instruments, via posterior approach alone.

• 한국보건간호학회지
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• 제17권1호
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• pp.83-95
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• 2003

The purpose of this study was to provide basic data for nursing interventions to promote rehabilitation motivation by identifying the influencing factors of motivating rehabilitation intention in patients with spinal cord injury. The data were collected using self-reported questionnaires and questionnaires by postal mail services, from September 1 through the October 6, 2002. A total of 148 questionnaires were completed and returned. The instrument developed by Han, Hye Sook(2001) was used to measure the rehabilitation motivation, and depression, family support, participation of self-help group, self-esteem, and self-efficacy were measured to test the variables influencing the rehabilitation motivation. Using SPSS WIN 10.0, descriptive statistics, t-test, one-way ANOVA. Turkey inspection, Pearson's correlation coefficient, and stepwise multiple regression analysis was conducted. The results of the study are as follows: The rehabilitation motivation score ranged from 30 to 100, and the average was $76.78(\pm12.40)$. In terms of the types of motivation, mean task-oriented motivation score was $23.28(\pm3.39)$, change-oriented motivation $22.25(pm3.16)$, obligatory motivation $9.90(\pm2.02)$, external motivation $9.85(\pm1.89)$, and mean amotivation score was $11.50(\pm1.94)$. The scores for the rehabilitation motivation was significantly associated with the time elapsed since injury, economic status, and the degrees of disability. Significant correlations were found between the rehabilitation motivation and the time elapsed since injury(r=-0.222, p=0.007), self-efficacy(r=0.204, p=0.013), depression(r=-0.210, p=0.010). and the economic status(r=-0.189, p=0.022). The variables that can predict the rehabilitation motivation included the time elapsed since injury, and self-efficacy. These variables accounted for $12.8\%$ of the variance of the rehabilitation motivation. In conclusion, the factors influencing the rehabilitation motivation in patients with spinal cord injury were found to be the time elapsed since injury, self-efficacy, depression, and the economic status of the patient, Accordingly, nursing interventions which could alleviate patients' depression and enhance self-efficacy should be designed to motivate rehabilitation. Before planning nursing interventions for patients with spinal cord injury, needs assessment should be conducted including the assessment of patients' economic status and time elapsed since injury.