• Korean Journal of Acupuncture
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• v.24 no.4
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• pp.37-45
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• 2007

Objectives : Temporomandibular joint (TMJ) balance is known to be intricately integrated with nervous system, cervical spine, and meridian system balance. This retrospective study with one-group pretest-posttest design reviewed cervical spine imaging data to provide evidence of spinal alignment improving effect of TMJ balance treatment. Methods : Cervical spine imaging data including computed tomography and simple x-ray of 25 cases with painful condition were reviewed to explore any change in cervical alignment on wearing the intraoral device for TMJ balance treatment of functional cerebrospinal therapy. Results : Cervical spine alignment significantly improved on wearing the intraoral device. Conclusions : TMJ balance treatment improves cervical spinal alignment, which may be a firm basis to proceed with further research of TMJ balance therapy as a way of balancing the whole-body meridian system.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.611-617
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• 2023

The cervical spine plays a critical role in supporting the skull, maintaining horizontal gaze, and facilitating walking. Its unique characteristics, including the widest range of motion among spinal segments, have led to extensive research on cervical sagittal alignment. Various parameters have been proposed to evaluate cervical alignment, with studies investigating their clinical significance, correlation with symptoms, and implications for surgical interventions. Recent findings suggest that cervical sagittal alignment not only impacts the cervical spine but also influences global spine-pelvic alignment through compensatory mechanisms. This comprehensive review examines classical and new parameters of cervical sagittal alignment and considers the dynamic and muscular factors associated with it.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.2
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• pp.459-463
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• 2008

Postural balance of temporomandibular joint (TMJ) reflects the neuromuscular balance. TMJ posture treatment for meridian yinyang balance has been asserted to have an impact upon cervical spine alignment with an episodic good clinical result for refractory torticollis cases. A retrospective study with one-group pretest-posttest design was conducted to review cervical spine imaging data and clinical symptom changes in cervical dystonia cases to explore the effect of TMJ balance treatment. Review of clinical symptoms and cervical spine imaging data including computed tomography and simple x-ray of 9 cervical dystonia cases revealed significant improvement of cervical spine alignment and clinical symptoms. Improvement of cervical spine alignment may be an underlying mechanism of TMJ balance treatment, as a way of balancing the whole-body meridian system.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.167-179
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• 2018

The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration. Increasingly positive sagittal imbalance has been shown to correlate with poor functional outcome and poor self-image along with poor psychological function. Compensatory mechanisms attempt to maintain sagittal balance through pelvic rotation, alterations in lumbar lordosis as well as knee and ankle flexion at the cost of increased energy expenditure. Restoring normal spinopelvic alignment is paramount to the treatment of complex spinal deformity with sagittal imbalance. Posterior osteotomies including posterior column osteotomies, pedicle subtraction osteotomies, and posterior vertebral column resection, as well anterior column support are well known to improve sagittal alignment. Understanding of whole spinal alignment and dynamics of spinopelvic alignment is essential to restore sagittal balance while minimizing the risk of developing sagittal decompensation after surgical intervention.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.2
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• pp.135-149
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• 2010

Objectives : This study was designed to observe the effect of Chuna manual therapy on the asymmetrical alignment. Methods : To analyze static structural alignment, posterior inferior ilium deviation(PI), inflare change of pelvis were checked from full spine AP X-ray. And Cobb's angle of spine and height of shoulder girdle were analyzed. To evaluate the pain visual analogue score(VAS) was scored. Chuna therapy treated 8-10 times for 1 month. Results and Conclusions : In 3 cases, VAS was improved significantly. Full spine AP X-ray shows improvement of structural imbalace. Shoulder height difference, cobb's angle, pelvic insufficiency improved considerably. These results suggest that Chuna therapy might be effective for malalignment patients.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.2
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• pp.89-99
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• 2010

Objectives : This study was designed to analyze the pattern of asymmetrical alignment. Methods : This study was carried out with the data from comprehensive medical testing. 91 subjects aged 30-39 were evaluated by full spine AP X-ray. For pelvis, innominate measurement(IM), off centering measurement(OCM), ilium shadow measurement(ISM), major axis of obturator foramen(MaF), minor axis of obturator foramen(MiF) were analyzed. Spinal curvature and height of shoulder girdle were analyzed. Results : 1. In pelvis, It. posterior-inferior and it. inflare combination pattern was 38 cases(42.8%). 2. In spinal curvature, "reverse S" curve was 45 cases(49.4%) and "reverse C" curve was 30 cases(33%). 3. In shoulder girdle, It. superior pattern was 42 cases(46.1 %) and It. superior pattern was 39 cases(42.9%). 4. In whole body analysis, It. posterior-inferior and It. inflare pelvis, "reverse S" spinal curvature and It. superior shoulder girdle combination patten was 11 cases(12.1 %). This pattern is similar to Kendall's right handedness pattern and Zink's common compensatory pattern. Conclusions : Results from this investigation showed asymmetrical alignment in 30-39 years-old adults. This results are expected to contribute to classifying the alignment pattern in clinic and systemic treatment.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.500-507
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• 2018

Background: The sagittal alignment of the spine and pelvis is not only closely related to the overall posture of the body but also to the evaluation and treatment of spine disease. In the last few years, the EOS imaging system, a new low-dose radiation X-ray device, became available for sagittal alignment assessment. However, there has been little research on the reliability of EOS. The purpose of this study was to evaluate the intrarater and interrater reliability of EOS for the sagittal alignment assessment of the spine and pelvis. Methods: Records of 46 patients were selected from the EOS recording system between November 2016 and April 2017. The exclusion criteria were congenital spinal anomaly and deformity, and previous history of spine and pelvis operation. Sagittal parameters of the spine and pelvis were measured by three examiners three times each using both manual and EOS methods. Means comparison t-test, Pearson bivariate correlation analysis, and reliability analysis by intraclass correlation coefficients (ICCs) for intrarater and interrater reliability were performed using R package "irr." Results: We found excellent intrarater and interrater reliability of EOS measurements. For intrarater reliability, the ICC ranged from 0.898 to 0.982. For interrater reliability, the ICC ranged from 0.794 to 0.837. We used a paired t-test to compare the values measured by manual and EOS methods: there was no statistically significant difference between the two methods. Correlation analysis also showed a statistically significant positive correlation. Conclusions: EOS showed excellent reliability for assessment of the sagittal alignment of the spine and pelvis.

• The Journal of Korean Physical Therapy
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• v.25 no.6
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• pp.405-410
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• 2013

Purpose: Most studies have reported that the abdominal muscle thickness differs according to gender but none of these studies reported a gender difference in the thickness of the multifidus and erector spine. The spinal alignment is affected by the left and right balance in the trunk muscle. The aim of this study was to identify the trunk muscle symmetry according to gender and the correlations of the trunk muscle thickness with spinal alignment. Methods: Forty three subjects(27 males and 16 females) were enrolled in this study. The trunk muscle thickness was measured by ultrasonography. The trunk muscle, which consisted of the rectus abdominis (RA), external oblique abdominis (EOA), internal oblique abdominis (IOA), transverse abdominis (TrA), erector spine (ES), and multifidus (MF), was measured. The spinal alignment was measured by Formetric-III 3D analysis. The dependent variables of the spinal alignment were the trunk imbalance, trunk inclination, lateral deviation, and surface rotation. Results: The muscle thickness of the EOA muscle increased more significantly in the right side than the left side (p<0.05). Each left and right difference in the muscle thickness between the male and female group showed a significant difference (p<0.05) except for the TrA thickness. Significant positive correlations were observed between the ES and lateral deviation and between the TrA with trunk imbalance. Conclusion: These results suggest that asymptomatic men have a greater trunk muscle thickness than women but there was no difference between the left and right in healthy adults. The trunk muscle thickness of ES, TrA is related by the spinal alignment.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.340-345
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• 2023

Objective: The purpose of this study was to investigate the effect of thoracic spine and ankle joint alignment on trunk and upper limb muscle activity during trunk forward lean exercise using a sling. Methods: 25 subjects participated in this study. All subjects performed trunk forward lean exercise using a sling under four conditions according to the alignment of the thoracic spine and ankle joints. Trials were performed 3 times in each condition. Muscle activity of the trunk and upper extremity was measured using electromyography. Results: In the dorsiflexion, the thoracic kyphosis condition showed significantly higher muscle activity in the pectoralis major, rectus abdominis, latissimus dorsi, transverse abdominis than dorsiflexion(p<0.05). In the plantar flexion, thoracic kyphosis condition showed significantly higher muscle activity in pectoralis major, transverse abdominis, latissimus dorsi muscle activity than dorsiflexion(p<0.05). Conclusions: Regardless of ankle alignment, thoracic kyphosis condition increased the activity of the pectoralis major, transverse abdominis, latissimus dorsi. Therefore, regardless of the alignment of the ankle, it is recommended to perform the trunk forward lean exercise using a sling in thoracic kyphosis.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.843-852
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• 2021

The purpose of this review was to synthesize the research on global spinal alignment and reciprocal changes following cervical or thoracolumbar reconstruction surgery. We carried out a search of PubMed, EMBASE, and Cochrane Library for studies through May 2020, and ultimately included 11 articles. The optimal goal of a truly balanced spine is to maintain the head over the femoral heads. When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. Historically, deformity correction has focused on correcting scoliosis and preventing scoliotic curve progression. Following substantial correction of a spinal deformity, reciprocal changes take place in the flexible segments proximal and distal to the area of correction. Restoration of lumbar lordosis following surgery to correct a thoracolumbar deformity induces reciprocal changes in T1 slope, cervical lordosis, pelvic shift, and lower extremity parameters. Patients with cervical kyphosis exhibit different patterns of reciprocal changes depending on whether they have head-balanced or trunk-balanced kyphosis. These reciprocal changes should be considered to in order to prevent secondary spine disorders. We emphasize the importance of evaluating the global spinal alignment to assess postoperative changes.