• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.661-668
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• 2018

Among the spinal disorders, the treatment approach for spinal deformities has been discussed least among department of neurosurgery. But nowadays, more and more neurosurgeons are interested in spinal deformities as well as complex spinal disorders and are doing not a few surgeries for these kinds of disease. Nevertheless, it is mandatory to understand the course of spinal deformity, principles of treatment, and surgical outcomes and complications. Understanding of the biology, biomechanics and metallurgy of the spine and instrumentation are also required for successful spinal deformity surgery. We need senior mentors and good surgical and neurophysiologic monitoring team. Knowledge of spinal deformity may be augmented with spine fellowships and surgical experience. Step by step training such as basic knowledge, orthopedic as well as neurosurgical disciplines and surgical skills would be mandatory. Neurosurgeons can have several advantages for spinal deformity surgeries. By high-level technical ability of the spinal cord handling to preserve neurological function and familiarity with microscopic surgery, better synergistic effect could be expected. A fundamental understanding of pediatric spinal deformity and growing spine should be needed for spinal deformity surgery.

• Physical Therapy Rehabilitation Science
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• v.5 no.1
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• pp.22-28
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• 2016

Objective: The Back Mapper is one type of Rasterstereography and it can be used in the clinic without radiation exposure. The purpose of our study was to prove the reliability and validity of the Back Mapper and to compare it with the Spinal Mouse, which is an assessment tool for spinal curvatures using a wheeled mouse, and the Cobb angle by X-ray. Design: Cross-sectional study. Methods: Twenty healthy adults participated in the test to investigate for the inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with assessment devices for scoliosis such as the Back Mapper, Spinal Mouse and Cobb's angle. Data was analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement for reliability and correlation analysis for validity. Results: Intra-rater reliability of the Back Mapper was good (Cronbach's ${\alpha}$=0.821-0.984, ICC=0.696-0.969) except for assessing the lordotic angle. Inter-rater reliability was good (Cronbach's ${\alpha}$=0.870-0.958, ICC=0.770-0.919) in assessment for trunk imbalance, rotation of scapulae, thoracic angle, lumbar angle, and kyphotic angle. The kyphotic angle in the Spinal Mouse had a significant correlation icompared with the Back Mapper (r=0.510, p<0.05), and the Cobb's angle from an X-ray had a significant correlation with trunk inclination (r=0.532, p<0.05). Conclusions: These findings provide good intra-reliability of the Back Mapper in healthy subjects, but the Back Mapper requires more experienced practice to have good inter-reliability. Also, the variables of the Back Mapper does not seem as appropriate compared with the Cobb angle by X-ray.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.664-667
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• 2008

Since the advent of pedicle screw fixation system, posterior spinal fusion has markedly increased This intemal fixation system has been reported to enhance the fusion rates, thereby becoming very popular procedure in posterior spinal arthrodesis. Although some previous studies have shown the complications of spinal instruments removal, i.e. loss of correction and spinal collapse in scoliosis or long spine fusion patients, there has been no study describing the benefit or complications in lumbar spinal fusion surgery of one or two level. In order to clarify the effect of removal of instruments on mechanical motion profile, we simulated a finite element model of instrumented posterolateral fused lumbar spine model, and investigated the change of mechanical motion profiles after the removal of instrumentation.

• Journal of Biosystems Engineering
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• v.38 no.1
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• pp.64-71
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• 2013

Purpose: The purpose of this study was to select standing posture parameters that have a significant difference according to the severity of spinal deformity, and to develop a novel Cobb angle prediction model for adolescent girls with idiopathic scoliosis. Methods: Five normal adolescents girls with no history of musculoskeletal disorders, 13 mild scoliosis patients (Cobb angle: $10^{\circ}-25^{\circ}$), and 14 severe scoliosis patients (Cobb angle: $25^{\circ}-50^{\circ}$) participated in this study. Six infrared cameras (VICON) were used to acquire data and 35 standing parameters of scoliosis patients were extracted from previous studies. Using the ANOVA and post-hoc test, parameters that had significant differences were extracted. In addition, these standing posture parameters were utilized to develop a Cobb-angle prediction model through multiple regression analysis. Results: Twenty two of the parameters showed differences between at least two of the three groups and these parameters were used to develop the multi-linear regression model. This model showed a good agreement ($R^2$ = 0.92) between the predicted and the measured Cobb angle. Also, a blind study was performed using 5 random datasets that had not been used in the model and the errors were approximately $3.2{\pm}1.8$. Conclusions: In this study, we demonstrated the possibility of clinically predicting the Cobb angle using a non-invasive technique. Also, monitoring changes in patients with a progressive disease, such as scoliosis, will make possible to have determine the appropriate treatment and rehabilitation strategies without the need for radiation exposure.

• Journal of the Korean Society for Precision Engineering
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• v.23 no.3 s.180
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• pp.187-194
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• 2006

Unexpected postoperative changes, such as growth in rib hump and shoulder unbalance, have been occasionally reported after corrective surgery for scoliosis. However there has been neither experimental data fer explanation of these changes, nor the suggestion of optimal correction method. Therefore, the numerical study was designed to investigate the post-operative changes of vertebral rotation and rib cage deformation after the corrective surgery of scoliosis. A mathematical finite element model of normal spine including rib cage, sternum, both clavicles, and pelvis was developed with anatomical details. In this study, we also developed a special program which could convert a normal spine model to a desired scoliotic spine model automatically. A personalized skeletal deformity of scoliosis model was reconstructed with X-ray images of a scoliosis patient from the normal spine structures and rib cage model. The geometric mapping was performed by translating and rotating the spinal column with an 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.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.4 no.2
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• pp.88-95
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• 2011

In this study, Image Processing Algorithms which can make intervertebral disk images distinct and be easy to apply when measuring X-ray image of spine by using Cobb's angle and can measure the stage of scoliosis pertaining to X-ray image including the whole length of spine by converting to just one spinal functional graph without appling Cobb's angle in every disk are proposed. In addition, The calculated average value of L per $1^{\circ}$ Cobb's angle as to X-ray image of spine results in 0.568 which can be a standard for detecting the stage of scoliosis.

• Journal of Korean Clinical Nursing Research
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• v.22 no.3
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• pp.345-351
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• 2016

Purpose: The specific aims of this study were to investigate the incidence, time of occurrence, intervention methods and related causes of abdominal discomfort after scoliosis corrective surgery. Methods: A retrospective review was carried out on all patients with diagnosis of adolescent idiopathic scoliosis (n=420) who received a posterior spinal fusion between January 2012 and December 2014. Logistic regression analysis was used to identify significant related factors. Results: One hundred eighty five of the patients in the study (44.0%) reported abdominal discomfort (AD group). The discomfort was worst on 2nd days after operation (31.4%), and 3rd days (27.0%). Ninety seven patients (52.4%) in the AD group received enema treatment. Significant related factors for developing abdominal discomfort were distal fusion levels (OR=2.43, p<.006) and increased operative blood loss (OR=1.03, p<.001). Conclusion: The incidence of abdominal discomfort after scoliosis corrective surgery in this study was 44%. Abdominal discomfort, therefore, is a main concern in reference to scoliosis corrective surgery, and solutions need to be searched and reported in future research.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.279-282
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• 2008

Purpose: It is known that the chronic absence of unilateral breast can cause spine curvature. The artificial breast manufactures take up the position of that possibility. This study was designed to evaluate the influence of the mastectomy on the spine and appearance of scoliosis among women who wanted delayed breast reconstruction. ted delayed breast reconstruction. Methods: The study population consisted of 47 women who underwent delayed breast reconstruction at our Department of Plastic Surgery from April 2001 to May 2007. The whole spine anteroposterior and lateral X-ray was taken to evaluate the Cobb's angle. As a general rule a Cobb angle of 10 is regarded as a minimum angulation to define scoliosis. We evaluated Cobb's angle and drew a correlation between the duration of the mastectomy state and the weight of the mastectomy specimen. Results: There were no family history of scoliosis, and no numbness or weakness in the upper or lower extremities. They had normal reflex and experienced no tenderness of the perispinal area. The Spearman Correlation Coefficient between Cobb's angle and the period that took time from the mastectomy to the X-rays and analysis between Cobb's angle and specimen weight was 0.032 and-0.115. there were no correlation between Cobb's angle and time, or between Cobb's angle and specimen weight. Conclusion: lthough the patients attribute their back pain and distorted posture to having received an one-sided mastectomy, it is unlikely that one-sided mastectomy causes spinal deformity and scoliosis.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.1
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• pp.11-23
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• 2014

PURPOSE: The purpose of this study suggests the exercise programs for improving the function and structure by applying the Schroth exercise method and sling exercise method to the scoliosis patient. METHODS: The subjects were 16 patients who were diagnosed with scoliosis. They were randomly assigned either to a Schroth exercise group (n=8) that received Schroth exercise program or to a sling exercise group (n=8) that received sling exercise program. Flexibility, static balance, dynamic balance, and spinal angles were measured by using the modified sit and reach test, one leg standing with closed eyes, functional reach test, and Cobb's angle, respectively. The chest expansion were calculated using differences of chest circumference between maximum inspiration and maximum expiration measured under armpits, at the junction between the sternum and xiphoid process, and at the waist. RESULT: Schroth group before and after the intervention there was a difference in the static balance, spine angle, chest expansion (p<.05). sling group before and after the intervention there was a difference in the flexibility, static balance, spine angle, chest expansion (p<.05). There were significantly differences between the both groups for chest expansion thoracic level inspiratory variables at post-exercise. CONCLUSION: These results revealed that two exercise program improved flexibility, static standing balance, spine angle, chest expansion level and ability used as scoliosis management and intervention. Therefore, it is expected to be used as a method for the treatment and prevention in the process of rehabilitation of patients with scoliosis.

• Korean Journal of Applied Biomechanics
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• v.22 no.3
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• pp.365-371
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• 2012

We aimed to analyze the muscle activity of adolescent patients with idiopathic scoliosis during gait and develop the wearing of musculo-skeletal functional garment by applying the principle of sports taping based on the result of the analysis. We selected 20 male students between the ages of 13 and 18 and divided them into 2 groups: one group consisted of 10 patients with idiopathic scoliosis <20 degrees of Cobb's Angle: the other group had 10 normal students. Using, we measured and analyzed the muscle activity of 8 different regions: left and right latissimus dorsi, left and right thoracolumbar fascia, left and right gluteus medius, and left and right biceps femoris during gait. Our results can be summarized as follows: Firstly, in patients with idiopathic scoliosis, the gait showed a significantly low activity of the right latissimus dorsi muscle when the left foot was supported on the ground(p<.05). Secondly, in the overall gait cycle, the patients showed a higher activity of the right thoracolumbar fascia and right gluteus medius than that seen in the normal students: however, this difference was not statistically significant. Thirdly, by applying sports taping on the bisis of the results, this study developed the wearing of musculo-skeletal functional garment that could maximize the stimuli of the right latissimus dorsi and alleviate muscle contraction of the right thoracolumbar fascia and right gluteus medius, while expanding the spinal line upward and downward, by focusing on the difference between left and right muscular strength of the muscle activity of the bright latissimus dorsi. Overall, we expect that by wearing of musculo-skeletal functional garment, the muscular functions in adolescents with idiopathic scoliosis.