• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.61-67
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• 2001

Objectives : To demonstrate the preventive effect on post-operative spinal deformity of the laminoplasty compared with laminectomy for spinal cord tumor. Methods : Sixteen patients who underwent laminoplasty and 89 patients who underwent lamenectomy were reviewed retrospectively after removal of spinal cord tumors between February 1981 and December 1999. The mean follow-up period after laminoplasty and laminectomy were 29 months(range, 12-49 months) and 66 months(range, 6-120 months) respectively. Patients were observed neurologically and radiologically. Results : Postoperative kyphosis was observed 17 patients(19%) in the laminectomy group, but was not observed in the laminoplasty group. Postoperative slipping was observed 16 patients(18%) in the laminectomy group, but was not observed in the laminoplasty group. Complications such as postoperative scoliosis, rotation, and swan-neck deformity were observed in the laminectomy group, but were not observed in the laminoplasty group. Conclusions : Laminoplasty prevented postoperative spinal deformities after removal of spinal cord tumors, and afforded anatomic reconstruction of the vertebral arch. Additionally, appropriate patient selection maximizes the chance of optimal neurologic outcomes and minimizes complications. Laminoplasty appears to warrant further evaluation as an alternative to wide laminectomies for exposure of intraspinal tumors.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.738-746
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• 2020

Objectives : The purpose of this study was to evaluate surgical outcomes and complications of spinal deformity associated with neurofibromatosis type-1 (NF-1). Methods : From 2012 to 2018, patients suffering from spinal deformity associated with NF-1 who underwent surgical correction were identified. Demographic data and radiographic measures were retrospectively reviewed. Pre- and postoperative whole spine radiograph images were used to determine both coronal and sagittal Cobb angles. All of patients underwent 3-dimentional computed tomographic scan and magnetic resonance imaging scan to confirm dystrophic features. For evaluation of clinical outcomes, we surveyed the pre- and postoperative scoliosis research society-22r (SRS-22r) score. Results : Seven patients with spinal deformity associated with NF-1 were enrolled in this study. The mean age of patients was 29.5±1.2 years old. The mean follow-up period was 2.8±1.4 years. The apex of the deformity was located in cervicothoracic (n=1), thoracic (n=4), and lumbar region (n=2). Most patients have poor bone quality and decreased bone mineral density with average T-score of -3.5±1.0. All patients underwent surgical correction via posterior approach. The pre- and postoperative mean coronal and sagittal Cobb angle was 61.6±22.6° and 34.6±38.1°, 56.8±18.5° and 40.2±9.1°, respectively. Mean correction rate of coronal and sagittal angle was 44.7% and 23.1%. Ultimate follow-up SRS-22r score (average score, 3.9±0.4) improved comparing to preoperative score (average score, 3.3±0.9). Only one patient received revision surgery due to rod fracture. No serious complication occurred, such as neurological deficit, and viscerovascular injury. Conclusion : The surgical correction of patients having spinal deformity associated with NF-1 is challenging, however the radiographic and clinical outcomes are satisfactory. The all posterior approach can be a safe and effective surgical option for patients having dystrophic curves associated with NF-1.

• Experimental and Molecular Medicine
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• v.50 no.11
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• pp.3.1-3.11
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• 2018

This study aimed to verify the effects of estrogen on the onset and development of adolescent idiopathic scoliosis and the mechanisms associated with these effects by constructing a pubescent bipedal rat model. Experiments were conducted to investigate whether scoliosis progression was prevented by a Triptorelin treatment. One hundred twenty bipedal rats were divided into female, OVX (ovariectomy), OVX + E2, Triptorelin, sham, and male groups. According to a spinal radiographic analysis, the scoliosis rates and curve severity of the female and OVX + E2 groups were higher than those in the OVX, Triptorelin, and male groups. The measurements obtained from the sagittal plane of thoracic vertebrae CT confirmed a relatively slower growth of the anterior elements and a faster growth of the posterior elements between T11 and T13 in the female and OVX + E2 groups than in the OVX and Triptorelin groups. Histomorphometry and immunohistochemistry revealed a significantly longer hypertrophic zone of the vertebral cartilage growth plates that expressed more type X collagen and less type II collagen in the OVX and Triptorelin groups than in the female and OVX + E2 groups. Ki67 immunostaining confirmed an increase in the proliferation of vertebral growth plate chondrocytes in the OVX group compared with the female and OVX + E2 groups. In conclusion, estrogen obviously increased the incidence of scoliosis and curve severity in pubescent bipedal rats. The underlying mechanism may be a loss of coupling of the endochondral ossification between the anterior and posterior columns. Triptorelin decreased the incidence of scoliosis and curve magnitudes in bipedal female rats.

• PNF and Movement
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• v.12 no.4
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• pp.243-248
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• 2014

Purpose: The transverse abdominis and themultifidus muscle are located in the core. They surround one's trunk and help in body stabilization. Specifically, they control spine articulation to maintain posture and balance. Therefore, weakened deep muscle in the trunk may cause spinal malalignment. This study aims to compare the correlation between the thickness of the transverse abdominis and the multifidus muscle and the spine alignment among college students in their 20s. Methods: This study measured the thickness of the transverse abdominis and the multifidus muscle of 42 healthy college students in their 20s using ultrasonic waves. The thickness of the muscle was measured for the length of the cross-section except for fascia. The thickness of the left and right muscles was measured, and the mean value was calculated. As the thickness of the transverse abdominis can increase because of pressure during exhalation, it was measured at the last moment of exhalation. Spinal alignment was measured by the kyphosis angle, lordosis angle, pelvic tilt, trunk inclination, lateral deviation, trunk imbalance, and surface rotation using Formetric III, which is a three-dimensional imaging equipment. They were measured for three times, and the mean values were calculated. The general characteristics of the subjects were analyzed using descriptive statistics. The correlations between each factor were analyzed using Pearson's correlation analysis. Results: The transverse abdominis showed asignificant correlation with trunk inclination (p<.05). The multifidus muscle showed a significant positive correlation with pelvic tilt and a negative correlation with surface rotation (p<.05). Conclusion: The thickness of transverse abdominis and the multifidus muscle appears to influence spinal alignment. Specifically, the multifidus muscle, which plays an important role on the sagittal plane, influences surface rotation, thus making it an important muscle for scoliosis patients. Therefore, a strengthening training program for the transverse abdominis and the multifidus muscle is necessary according to specific purposes among adults with spinal malalignment.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.489-493
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• 1999

The pectus carinatum or anterior protrusion of the sternum is a less common than pectus excavatum. It occurs more frequently in boys than girls and associated musculoskeletal abnormalities, spinal scoliosis is most common. Ravitch first reported correction of chondromanubrial prominence in 1952, resecting the multiple deformed costal cartilages and performing a double osteotomy on sternum. We have experienced one case of pectus carinatum and obtained satisfactory postoperative results. The deformity was corrected by the subchondral resection of multiple deformed costal cartilage, bilaterally, with single osteotomy on sternum and fracture of the posterior cortex to correct anterior angulation. Postoperative course was uneventful. We report this case with brief review of the literature.

• The Journal of Korea CHUNA Manual Medicine
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• v.2 no.1
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• pp.51-84
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• 2001

Objective : The therapeutic exercise on low back found In the literatures mostly have adopted methods that are applied to only certain muscles. The purpose of this paper to classify various low pains and to Investigate an active physical treatment can be applied to certain low back pain. Methods : By exploring the journals and medical publications. Results and Conclusions 1. A goal of low back exercise is reinforcement and extension of muscles in order to control pains. 2 Low back exercise which causes the movement of the spinal joint and disk can control pains. 3. Flexion exercise of lumbar spine can be generally applied to any low back pains except kyposis. 4. Extension exercise of lumbar spine can be applied to any low back pains except facet joint syndrome or hyperlordosis. 5. Rotation exercise of lumbar spine can be applied to any low back pains except facet joint syndrome. 6. Lateral bending exercise of lumbar spine can be applied to HNP. facet Joint syndrome, scoliosis.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.2
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• pp.33-41
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• 2010

Objectives : This study is designed to find out the relationship of scoliotic curve, cervical lordosis, lumbar lordosis and Ferguson's angle. Method : The study was composed of 46 scoliosis patients who had single curvature(Group I) on their lumbar spine(Group I-A) or thoracic spine(Group I-B) and 38 patients who had double curvature(Group II) on their lumbar and thoracic spine. The patients were evaluated with X-ray findings of full spine AP and Lateral views and statistically analyzed. Results : 1. Group II showed a significant increase in scoliotic curve angle as compared with Group I(P<0.05). 2. Scoliotic curve has a negative relationship with cervical lordosis in group II. Conclusion : 1. The patients who has double curvature of spine had higher scoliotic curve angle compared with who has single curvature. 2. The Scoliotic curve and cervical lordosis was statistically concerned on patients who has double curvature of spine.

• Asian Spine Journal
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• v.12 no.6
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• pp.1010-1016
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• 2018

Study Design: Retrospective cohort study. Purpose: To report on spinal fusion assessment using computed tomography (CT) after adult spinal deformity (ASD) surgery using ultra-low dose recombinant human bone morphogenetic protein 2 (RhBMP-2). Overview of Literature: The reported dose of RhBMP-2 needed for successful spinal posterolateral fusion in ASD ranges from 10 to 20 mg per spinal level. This study reports the use of ultra-low dose of RhBMP-2 (0.07 mg per facet) to achieve spinal fusion in multilevel ASD surgery. Methods: Consecutive patients who underwent ASD surgery using ultra-low dose RhBMP-2 were recruited. Routine postoperative CT analysis for spinal fusion was performed by two spine surgeons. Inter-observer agreement was calculated for facet fusion (FF) and interbody fusion (IBF) at 6 and 12 months after the procedure. Results: Six consecutive ASD patients with a mean age of 62 years (28-72 years) were examined. Each patient received a total dose of 12 mg with an average dose of $0.69{\pm}0.2mg$ (0.42-1 mg) per single FF and $1.38{\pm}0.44mg$ (0.85-2 mg) for IBF. Total 131 FF and 15 IBF were examined in the study, with 88 FFs and nine IBFs being analyzed specifically at 6 months after the surgery. FF and IBF reported by surgeons A and B at 6 months were 97.7% vs. 91.9% FF, respectively (${\kappa}=0.95$) and 100% vs. 100% IBF, respectively (${\kappa}=1$). Two patients underwent longitudinal follow-up CT at 12 months, and the FF rates reported by surgeons A and B were 100% vs. 95.8%, respectively (${\kappa}=0.96$). Five out of nine facet (56%) non-unions were identified at the cross-links. The remaining four facet pseudarthrosis were noted at 1-2 spinal levels caudal to the cross-links. At the final clinical follow-up, there was no rod breakage, deformity progression, neurological deficit, or symptom recurrence. The Oswestry Disability Index improved by an average of $32.8{\pm}6.3$, while the mental component summary of the 36-item Short-Form Health Survey improved by an average of $4.7{\pm}2.1$, and physical component summary improved by an average of $10.5{\pm}2.1$. Conclusions: To our knowledge, this is the first study to report a CT that defined 92%-98% FF and 100% IBF using the lowest reported dose of RhBMP-2 in multilevel ASD surgery. The use of ultra-low dose RhBMP-2 reduces the RhBMP-2 related complications and healthcare costs.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.2
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• pp.309-318
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• 2011

Objectives : To evaluate the effect of foot orthotic in patient with chronic pain and pelvic obliquity in standing. Methods : Four cases of functional spinal scoliosis, were investigated for the changes in the calcaneal stance position angle, pelvic height, pelvic angle, Cobb's angle and walking pattern. Standing full spine X-ray for measuring the pelvic height, pelvic angle, Cobb's angle were checked before and after application of foot orthosis. The foot orthosis was composed of polyprophylen and chamude cover. Results : 1. There was no change in resting calcaneal stance position. 2. Difference of pelvic height and pelvic angle was reduced after application of a foot orthosis. 3. Cobb's angle in 2 cases was reduced after application of a foot orthosis. 4. Walking balance was improved. 5. Visual analogue scale was decreased. Conclusions : The study showed that foot orthosis seemed to be effective for chronic pain, spinal curve, pelvic obliquity and walking balance.

• 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.