• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2004년도 추계학술대회 논문집
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• pp.1154-1159
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• 2004

Unexpected postoperative changes, such as growth in rib hump, has been occasionally reported after corrective surgery for scoliosis. However there has been experimental data for explanation of these changes, nor the suggestion of optimal correction method. This numerical study was designed to investigate the main correlating elements in operative kinematics with post-operative changes of vertebral rotation and rib cage deformation in the corrective surgery of scoliosis. To develop a scoliotic spine model automatically, a special program for converting normal spine model to scoliotic spine model was developed. A mathematical finite element model of normal spine including rib cage, sternum, both clavicles, and pelvis was developed with anatomical details. The skeletal deformity of scoliosis was reconstructed, by mapping the X-ray images of a scoliosis into this three dimensional normal spine and rib cage model. The geometric mapping was performed by translating and rotating the spinal colume with the amount analyzed from the digitized 12 built-in coordinate axes in each vertebral image. By utilizing this program, problems generated in mapping procedure such as facet joint overlapping, vertebral body deformity could be automatically resolved.

• 척추신경추나의학회지
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• 제1권2호
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• pp.93-100
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• 2006

Objectives: To invesgate correlation between the scoliotic curve and BMI, cervical lordosis, lumbar lordosis and Ferguson angle in spinal scoliotic patient. Methods: The study was composed of 14 scoliosis patients beyond cobb'a angle $10^{\circ}$ (sample I group) and 15 scoliosis patients over cobb'a angle $10^{\circ}$ (sample II group). The patients were evaluated with X-ray findings of full spine AP and lateral views and statistically analyzed. Results: 1. Sample II group showed a significant decrease in BMI as compared with Sample I group(P<0.05). 2. Scoliotic curve had s negative relationship with $BMI({\gamma}=0.406)$ 3. Scolotic patients had a lower cervical angle than normal man. Conclusion: 1. The larger the scoliotic angle, the lower BMI 2. There are no concemed scoliotic curve and cervical lordosis, lumbar lordosis and Ferguson angle.

• 한국방사선학회논문지
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• 제13권3호
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• pp.425-431
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• 2019

본 연구자는 척주 측만증 및 허리뼈 분쇄 골절된 환자의 수술 후 단순 엑스선 척주 측방향 촬영에서 두개의 철심이 겹친 영상을 얻어내기 위해 엑스선관 및 인체팬톰의 각도를 변화시켜 영상을 얻었다. 영상 평가를 위해 대학병원 영상의학과에서 10년 이상 근무한 방사선사 5명에게 주관적 평가를 하였다. 측정 결과 척주 측만증 측방향 촬영은 정중 이마면을 IR면 중심에 일치되게 하고 일곱 번째 등뼈가 중앙이 되도록 자세를 조정한 후 엑스선관과 척주팬톰 자세를 각각 수직으로 촬영하면 척주 측방향 촬영에서 두 개의 겹쳐진 영상을 얻을 수 있었고 주관적 평가에서도 높은 점수를 얻었다. 또한 허리뼈 탈구 골절된 허리뼈 측방향 촬영은 이마면을 IR면 중심에 일치시키고 네번째 허리뼈가 중앙이 되도록 자세를 조정하여 엑스선관 각도를 수직되게 하고 척주 팬톰을 네번째 허리뼈를 수직하여 촬영 하게 되면 척주 측방향 촬영에서 두개의 철심이 겹치는 영상을 얻을 수 있었고 주관적 평가에서도 높은 점수를 얻었다.

• 한국전문물리치료학회지
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• 제5권3호
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• pp.72-87
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• 1998

This study examined the rates of spinal abnormal curvature and the correlation of the Body Mass Index (BMI), Low Back Pain (LBP) and spinal curvature by measuring scoliosis, kyphosis, and lordosis in university students. The study population included 67 male, 92 female university students, making a total of 159, in Wonju City. Spinal curvature was measured by an electrogoniometer in a computerized skeletal analysis system. Lateral curvature of spine of more than 10 degrees was considered as nonspostural scoliosis. The correlation of BMI, LBP and the spinal curvature was analysed by Pearson's correlation coefficient and t-test. The following results were obtained: 1. The overall incidence and rate of scoliosis in cases with a greater than 10 degree curve in males was an incidence of 8 and a rate of 11%. In females the incidence was 36 and the rate 39.2%. 2. The overall incidence and rate of kyphosis of less than 20 degrees in males was a rate of 9 and an incidence of 11.9%. In females, the rate was 5 and the incidence 5.4%. In kyphosis cases of more than 40 degrees, the male rate was 5 and the incidence 7.7%. For female the rate was 13 and the incidence 14.2%. 3. The overall incidence and rate of lordosis with curves of less than 20 degrees was a rate of 6 for males and an incidence of 9.0%. For females, the rate was 5 and the incidence 5.4%. In cases of more than 50 degrees lordosis, the female rate was 2 and the incidence 2.2%. There were no males in this category. 4. There was a negative correlation between kyphosis and BMI. The greater the kyphotic curve, the less the BMI in males (p<0.05). There was no significant BMI difference by gender in either scoliosis or lordosis. There was, however, a significantly decreased sacral angle in the female group with LBP. The results of this study cannot be generalized to the general population because the subjects were all from one university. The measurements were quite reliable because the angles determined by the Metrocom System were highly correlated with radiologic findings. This study shows the need for a regular screening system for spinal curvatures in university health examination procedures.

• 정형스포츠물리치료학회지
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• 제14권2호
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• pp.99-107
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• 2018

Purpose: This study investigated scoliosis muscle activity after the trunk side shift exercise. Methods: Fifty-eight subjects (control group=30, scoliosis group=28) participated in this study. The patients with idiopathic scoliosis were randomly divided into two groups: the side shift exercise (SSE) group and the trunk stabilization exercise (TSE) group. The SSE group performed SSE with chair training for eight weeks. A one-way ANOVA test was carried out to compare the results within the idiopathic scoliosis patient group prior to and after different exercise methods. Result: The muscle activity differences of the TPS, LPS, and latissimus dorsi muscles significantly decreased in all idiopathic scoliosis exercises groups after training. According to the exercise method, the TPS differed between the control group (CG) and TSE group and between the SSC and TSE groups. The LPS and latissimus dorsi muscles showed differences between the CG and TSE groups. Conclusions: This study found that the side shift exercise effectively improve spine muscles. The side shift exercise was performed using chairs that were designed for this study. Thus, this method is easily accessible for busy students who are exposed to scoliosis or spinal disorders that are caused by a pattern of inactivity.

• Physical Therapy Rehabilitation Science
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• 제12권1호
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• pp.19-25
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• 2023

Objective: Patients with scoliosis complain of various symptoms such as muscle imbalance, dysfunction, back pain, abnormal posture and gait abnormality. The most basic treatment for scoliosis is to observe the progress based on conservative treatment. Therefore, in this case report, the effect of cytoskeletal manual therapy (CMT), a soft tissue mobilization technique, on pain intensity, muscle thickness, and pressure pain threshold (PPT) in a patient with scoliosis was investigated. Design: A case report Methods: A 25-year-old male diagnosed with scoliosis visited the Neuromusculoskeletal Science Laboratory with chronic back pain. In the laboratory, scoliosis was confirmed through the X-ray image used for his diagnosis, and it was confirmed again through Adam's forward bending test. Pain, pressure pain threshold and muscle thickness were measured to compare the immediate effects of CMT applied in the laboratory for 40 minutes. Treatments were visited two weeks after the first visit and outcome measures were assessed after a total of two visits. Results: After receiving CMT up to the second session, the pain intensity decreased by 4 points and the screening angle decreased by 15 degrees. Muscle thickness decreased in all but 10 mm on the dominant side of the thoracic spine. All of the PPTs increased, and the greatest increase was 3.1 lb on the dominant side of the thoracic spine. Conclusions: CMT showed positive improvement in pain during trunk flexion, spinal curvature, muscle imbalance, and pressure pain, which is considered as an ancillary treatment option for scoliosis management.

• Journal of Acupuncture Research
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• 제27권2호
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• pp.43-49
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• 2010

Objectives : Among young generation, the prevalence of spinal disorders is known to be increasing. This study aimed to analyze the clinical data of spinal disorder in young ages in Korea. Methods : Number of patient, kinds of disorder, and medical cost were analyzed for patients(7~18 years) underwent spinal disorders using computerized database of Health Insurance Review and Assessment Service(HIRAS) from 2004 to 2008. We included dorsopathies as spinal disorder according to Korean Classification of Diseases(KCD) and excluded spinal disorder caused by trauma. We compared the data of traditional Korean medicine treatment with that of western medical care. Results : 4.8% of the children and adolescents had medical treatment with spinal disorder in 2008. The claim number and medical cost for both traditional Korean medicine and western medicine treatment are increasing 1.8 and 1.3 times respectively over 5 years. Total medical spent of western clinic was 2.1 times than those of traditional Korean clinic. The most common spinal disorder was dorsalgia(31.8%) and scoliosis(13.5%) in western clinics while back pain(29.0%) and neck pain(10.8%) in oriental clinic. Conclusions : We first reported the clinical tendency of spinal disorder in Korean children adolescents from 2004 to 2008. This study will support the development of a strategy for traditional Korean medicine-based prevention or treatment of spinal disorders in young generation.

• Asian Spine Journal
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• 제12권6호
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• pp.1028-1036
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• 2018

Study Design: Single-center, observational, case-control study. Purpose: Comparison and analysis of the metabolic and coagulative profiles in patients with idiopathic scoliosis, patients with congenital scoliosis, and healthy controls. Overview of Literature: Serum melatonin deficiency has been a controversial topic in the etiopathogenesis of scoliosis. Low bone mineral density, low vitamin D3 levels, and high parathyroid hormone levels are common metabolic abnormalities associated with scoliosis that may be responsible for its pathogenesis. In addition to metabolic defects, several studies have shown coagulation defects that either persist from the preoperative period or occur during surgery and usually lead to more than the expected amount of blood loss in patients undergoing deformity correction for scoliosis. Methods: The study population (n=73) was classified into those having congenital scoliosis (n=31), those with idiopathic scoliosis (n=30), and healthy controls (n=12). After detailed clinicoradiological evaluation of all the subjects, 10-mL blood samples were collected, measured, and analyzed for various metabolic and coagulation parameters. Results: The mean serum melatonin levels in patients with idiopathic scoliosis were significantly lower than those in the healthy controls. Although the mean serum melatonin level in the congenital group was also low, the difference was not statistically significant. Serum alkaline phosphatase and parathyroid hormone levels were higher in the scoliosis groups, whereas the vitamin D level was lower. No differences were observed in the coagulation profiles of the different groups. Conclusions: Low serum melatonin levels associated with scoliosis can be a cause or an effect of scoliosis. Moreover, low bone mineral density, high bone turn over, and negative calcium balance appear to play an important role in the progression, if not the onset, of the deformity.

• Asian Spine Journal
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• 제12권6호
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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.

• 대한추나의학회지
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• 제4권1호
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• pp.1-16
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• 2003

Objectives : The purpose of this study is researching for possibility that Moire topography be applied in group school screening for scoliosis known school health problem, and find acceptable method of early detection and early treatment for scoliosis Methods : The authors practiced Moire topography for primary & middle school 1,895 students[male 976, female 919] in Jeonju, korea in 2001. After we distinguished students who had abnormal finding in Moire topography and then re-examined spinal X-ray analysis. The data was analysed and evaluated statistically Results : According to this research, the abnormal finding in Moire topography was 53.7% (1,018 students), and students needed X-ray re-examination were 11.2% (213 students). Students diagnosed scoliosis by X-ray re-examination were 1.8%. According to statistical analysis, interval between vertical base line of pelvis and vertical base line of neck, gap between left distance and right distance to the vertical base line of pelvis and difference of contour lines have strong correlations with deformity degree of the body surface examined by Moire. Conclusions : Following this research, throughout early detection for scoliosis by Moire topography could reduce exposure from scoliosis radiographs, and could detect trunk asymmetry that couldn't be found existing X-ray examination, so it made selecting students under observation who have bad posture possible.