• Title/Summary/Keyword: Spine alignment

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Polyetheretherketone Cage with Demineralized Bone Matrix Can Replace Iliac Crest Autografts for Anterior Cervical Discectomy and Fusion in Subaxial Cervical Spine Injuries

  • Kim, Soo-Han;Lee, Jung-Kil;Jang, Jae-Won;Park, Hyun-Woong;Hur, Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.211-219
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    • 2017
  • Objective : This study aimed to compare the clinical and radiologic outcomes of patients with subaxial cervical injury who underwent anterior cervical discectomy and fusion (ACDF) with autologous iliac bone graft or polyetheretherketone (PEEK) cages using demineralized bone matrix (DBM). Methods : From January 2005 to December 2010, 70 patients who underwent one-level ACDF with plate fixation for post-traumatic subaxial cervical spinal injury in a single institution were retrospectively investigated. Autologous iliac crest grafts were used in 33 patients (Group I), whereas 37 patients underwent ACDF using a PEEK cage filled with DBM (Group II). Plain radiographs were used to assess bone fusion, interbody height (IBH), segmental angle (SA), overall cervical sagittal alignment (CSA, C2-7 angle), and development of adjacent segmental degeneration (ASD). Clinical outcome was assessed using a visual analog scale (VAS) for pain and Frankel grade. Results : The mean follow-up duration for patients in Group I and Group II was 28.9 and 25.4 months, respectively. All patients from both groups achieved solid fusion during the follow-up period. The IBH and SA of the fused segment and CSA in Group II were better maintained during the follow-up period. Nine patients in Group I and two patients in Group II developed radiologic ASD. There were no statistically significant differences in the VAS score and Frankel grade between the groups. Conclusion : This study showed that PEEK cage filled with DBM, and plate fixation is at least as safe and effective as ACDF using autograft, with good maintenance of cervical alignment. With advantages such as no donor site morbidity and no graft-related complications, PEEK cage filled with DBM, and plate fixation provide a promising surgical option for treating traumatic subaxial cervical spine injuries.

The Experimental Study on GCM(General Coordinative Manipulation) which has been studied on the basis of Spine & Limb Extremity (인체 사지 및 척추관절의 운동증감패턴에 따른 전신교정치료에 관한 실증적 연구)

  • Moon, Sang-Eun
    • Journal of Korean Physical Therapy Science
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    • v.6 no.2
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    • pp.1041-1062
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    • 1999
  • This study is to stimulate the model of which top notch muscle stimuli physical therapy has been made on the basis of GCM. GCM has been studied on the hypermobility & hypomobility pattern on the part of spine & extremity, and the body characteristics of four body types, which is the tilting of seal scapular & ilium. The purpose of this study is to analysize the type of GCM which has been focused on the spine & extremity for the patients having dysfunctions of neuromuscular system, being analysized the movement. The result of this study is as following; 1) The First hypothesis: The hypermobility & hypomobility pattern assorted by the tilting of scapular & ilium, as does the former study analysize was claimed that it would be in line with the pattern for hypermobility hypomobility and physical characteristics according to each body type at the percentage of at least 60(p<.001). 2) The 2nd hypothesis : Stimuli therapy of muscle dealing with physical characteristics and joint hypermobility hypomobility has the important role in restoring the deformity and keeping anatomical postural plumb alignment also it would a highly effects on correcting the body even though the stimuli area was limited to four areas and it was lack of time compared with those applied by general physical therapy(p<.001). As above the result, the top-notch type for physical therapy based on hypermobility hypomobility pattern by 4 body types which has been studied on tilting of scapular & ilium is more specificed and specialized than those of general physical therapy technologies. So this study will be believed to dedicate to restoration ideal anatomical postural plumb alignment based on spinal Manipulation and the concept of whole person as well as to being simple and effective to apply.

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The Comparison Study of Ankle Joint Mobilization and Elongation on the Difference of Weight-bearing Load, Low Back Pain and Flexibility in Flat-foots Subjects (편평족에 대한 관절가동술과 자가신장이 요부의 신장성, 요통과 하지 체중부하 차이에 대한 비교 연구)

  • Park, Sung-doo;Yu, Dal-yeong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.23 no.2
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    • pp.9-16
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    • 2017
  • Background: The purpose of this study was to investigate the relationship between the spine and the flat-foot, the stability and the alignment of the posture of the neck to prevent the alignment of the ankle joint operation and the lower back flexibility of the lumbar region according to the type of treatment using active stretching of the triceps, back pain, and to see how they affect weight bearing differences. Methods: The subjects of this study were 24 chronic low back pain patients. They were randomly divided into experimental group and control group. In the experimental group, ankle joint mobilization and active scraping of triceps were performed three times a week for a total of 6 weeks. The control group was performed in the same way without articulation. The range of flexion and extension motion of the lumbar spine and pain degree and difference of weight-bearing were measured before and after the experiment. Results: The model of ankle joint mobilization and calf muscle elongation of flat foot significantly improved the range of flexion and extension motion of the vertebrae (p<.05) and the VAS and distribution of weight-bearing were decreased in both of two groups (p<.05). In other words, the exercise and mobilization help to recover of the balance of the whole musculoskeletal, the vertebrae. Conclusions: The active exercise of the triceps muscle of the lower leg in this study It affects the flexibility of the lumbar spine, the pain and the difference in the weight support of the lower extremities, when we performed ankle joint mobilization for exercise and cramping, pain and the difference in weight support between the two lower limbs.

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Change of Craniovertebral Angle and Scapula Alignment in Adults with Forward Head Posture by Shoulder and Abdominal Stabilization Exercise (어깨 안정화운동과 복부 안정화 운동에 의한 전방머리자세 성인의 머리척추각도와 어깨뼈 정렬 변화)

  • Kim, Jae-Hyun;Rhee, Min-Hyung
    • PNF and Movement
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    • v.19 no.2
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    • pp.251-260
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    • 2021
  • Purpose: This study aimed to adjust the craniovertebral angle and shoulder alignment through shoulder and abdominal stabilization exercises in adults with a forward head posture. Methods: The study participants were 29 adults with a forward head posture, and they were randomly divided into the following groups: 14 participants in a combined exercise group that used shoulder and abdominal stabilization exercises and 15 participants in a shoulder exercise group that used just shoulder stabilization exercises. The participants performed the stabilization exercises for 30 minutes per day, three times a week for five weeks. Results: There were significant differences in the craniovertebral angle after intervention in the shoulder stabilization exercise group (p < 0.05). There were significant differences in the craniovertebral angle and location of the right root of the spine and both inferior angles before and after intervention in the shoulder and abdominal stabilization exercise group (p < 0.05). There was a significant difference in the location of the right root of the spine and the left inferior angle between the groups at the post-test (p < 0.05), and there was a larger change in the shoulder and abdominal stabilization exercise group. Conclusion: There was a significant difference in the craniovertebral angle and a partially significant difference in shoulder alignment before and after intervention in both groups.

The Effects of a Horseback Riding Simulation Exercise on the Spinal Alignment of Children with Cerebral Palsy

  • Choi, Hyun-Jin;Kim, Ki-Jong;Nam, Ki-Won
    • The Journal of Korean Physical Therapy
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    • v.26 no.3
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    • pp.209-215
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    • 2014
  • Purpose: The purpose of this study is to examine the effects of postural control training using a horseback riding simulation on the spinal alignment of children with cerebral palsy. Methods: This study was conducted with 30 children with cerebral palsy at levels I~IV in the Gross Motor Function Classification System (GMFCS), and they were randomly divided into a control group and a hippotherapy group. Both the control group and the experimental group received NDT for 30 minutes per session, four times per week for ten weeks, while the experimental group also received hippotherapy 15 minutes per session, four times per week for ten weeks, after the neurodevelopmental treatment (NDT). The horseback riding simulators (JOBA, EU7805, Panasonic) used in this study simulated actual horse movements. Trunk imbalance, pelvic torsion, and pelvic tilt were measured in each group before the exercise and five weeks and ten weeks after the beginning of the exercise using a spinal structure analysis system (ABW Mapper). Results: The Intra-group effects on trunk imbalance, pelvic torsion, and pelvic tilt according to the exercise periods after the hippotherapy were tested, and the results showed significant interaction effects between the groups and the periods (p<0.05). Conclusion: The horseback riding simulation exercise was shown to be effective for the spinal alignment of children with cerebral palsy. Therefore, additional studies should be conducted with more children with CP divided by type.

Outcome and Efficacy of Height Gain and Sagittal Alignment after Kyphoplasty of Osteoporotic Vertebral Compression Fractures

  • Lee, Tae-One;Jo, Dae-Jean;Kim, Sung-Min
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.271-275
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    • 2007
  • Objective : Although a significant correction of local kyphosis has been reported previously, only a few studies have investigated whether this correction leads to an improved overall sagittal alignment. The study objective was to determine whether an improvement in the local kyphotic angle improves the overall sagittal alignment. We examined and compared the effects of thoracic and lumbar level kyphoplasty procedures on local versus overall sagittal alignment of the spine. Methods : Thirty-eight patients with osteoporotic vertebral compression fractures who showed poor response to conventional, palliative medical therapy underwent single-level kyphoplasty. The pertinent clinical data of these patients, from June 2006 to November 2006, were reviewed retrospectively. We measured preoperative and postoperative vertebral body heights, which were classified as anterior, middle, or posterior fractured vertebral body heights. Furthermore, the local and overall sagittal angles after polymethylmethacrylate deposition were measured. Results : More height was gained at the thoracic level, and the middle vertebral height regained the most. A significant local kyphosis correction was observed at the fractured level, and the correction at larger spanning segments decreased with the distance from the fractured level. Conclusion : The inflatable balloon kyphoplasty procedure was the most effective in regaining the height of the thoracic fractured vertebra in the middle vertebral body. The kyphosis correction by kyphoplasty was mainly achieved in the fractured vertebral body. Sagittal angular correction decreased with an increase in the distance from the fractured vertebra. No significant improvement was observed in the overall sagittal alignment after kyphoplasty. Further studies in a larger population are required to clarify this issue.

Spontaneous Height Restoration of Vertebral Compression Fracture - A Case Report-

  • Joo, Young;Lee, Pyung-Bok;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • v.24 no.4
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    • pp.235-238
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    • 2011
  • Vertebral compression fractures result in vertebral height loss and alter sagittal spinal alignment, which in turn can lead to increased morbidity and mortality. Acute osteoporotic vertebral compression fractures are known to increase mobility and instability of the spine. There are limited published data correlating the degree of dynamic mobility and the efficacy of kyphoplasty on vertebral compression fractures. Here we report a 73-year-old female with a severe acute osteoporotic L2 compression fracture who obtained total vertebral height restoration following kyphoplasty, with resolution of back pain.

The Study of Pain-Increased Factors on Cervical and Shoulder Pain by 3 Dimensional Moire Scanner (3차원 체형 측정기를 통한 경.견부 통증요인 분석)

  • Yang, Hoe-Song;Heo, Ja-Eun;Kim, Bo-Young;Seo, Dong-Yong;An, Chang-Heon;Yang, Hun-Kyung;Jeong, Chan-Ju;Lee, Hyoung-Soo
    • Journal of Korean Physical Therapy Science
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    • v.12 no.3
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    • pp.27-34
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    • 2005
  • The purpose of this study is to find out factors(shoulder level, acromion-occipital length, spine alignment, spine-scapula inferior angle length) of pain of neck & shoulder by 3 Dimensional Moire Scanner. 50 female student s aged 20 to 25 years old participated who lived in Sun-cheon si Jeonnam. They were examined with three measurement methods(Visual Analogue Scale : VAS, Algometer, 3 Dimensional Moire Scanner(IBS-2000). According to the results of multiple regression analysis. 1) There was a significant difference with shoulder level and spine-scapula inferior angle based on VAS. 2) There was a significant difference with shoulder level based of Algometer measurement value in Rhomboid muscles.

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Positional uncertainties of cervical and upper thoracic spine in stereotactic body radiotherapy with thermoplastic mask immobilization

  • Jeon, Seung Hyuck;Kim, Jin Ho
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.122-128
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    • 2018
  • Purpose: To investigate positional uncertainty and its correlation with clinical parameters in spine stereotactic body radiotherapy (SBRT) using thermoplastic mask (TM) immobilization. Materials and Methods: A total of 21 patients who underwent spine SBRT for cervical or upper thoracic spinal lesions were retrospectively analyzed. All patients were treated with image guidance using cone beam computed tomography (CBCT) and 4 degrees-of-freedom (DoF) positional correction. Initial, pre-treatment, and post-treatment CBCTs were analyzed. Setup error (SE), pre-treatment residual error (preRE), post-treatment residual error (postRE), intrafraction motion before treatment (IM1), and intrafraction motion during treatment (IM2) were determined from 6 DoF manual rigid registration. Results: The three-dimensional (3D) magnitudes of translational uncertainties (mean ${\pm}$ 2 standard deviation) were $3.7{\pm}3.5mm$ (SE), $0.9{\pm}0.9mm$ (preRE), $1.2{\pm}1.5mm$ (postRE), $1.4{\pm}2.4mm$ (IM1), and $0.9{\pm}1.0mm$ (IM2), and average angular differences were $1.1^{\circ}{\pm}1.2^{\circ}$ (SE), $0.9^{\circ}{\pm}1.1^{\circ}$ (preRE), $0.9^{\circ}{\pm}1.1^{\circ}$ (postRE), $0.6^{\circ}{\pm}0.9^{\circ}$ (IM1), and $0.5^{\circ}{\pm}0.5^{\circ}$ (IM2). The 3D magnitude of SE, preRE, postRE, IM1, and IM2 exceeded 2 mm in 18, 0, 3, 3, and 1 patients, respectively. No association were found between all positional uncertainties and body mass index, pain score, and treatment location (p > 0.05, Mann-Whitney test). There was a tendency of intrafraction motion to increase with overall treatment time; however, the correlation was not statistically significant (p > 0.05, Spearman rank correlation test). Conclusion: In spine SBRT using TM immobilization, CBCT and 4 DoF alignment correction, a minimum residual translational uncertainty was 2 mm. Shortening overall treatment time and 6 DoF positional correction may further reduce positional uncertainties.

The Effect of Neck and Shoulder Self-Stretching Exercise Using Audiovisual Media on Neck Pain, Postural Alignment, and Joint Position Error in Women with Chronic Neck Pain (시청각 매체를 활용한 목, 어깨 자가신장운동이 만성 목통증 여성의 통증, 자세정렬과 관절위치감각에 미치는 영향)

  • Jeong, Yeon-woo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.1
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    • pp.39-51
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    • 2022
  • Background: The purpose of this study is to investigate the effect of neck and shoulder self-stretching exercise using audiovisual media on neck pain, postural alignment, and joint position error in women with chronic neck pain. Methods: The subjects included 20 women that gave consent to participate in the study voluntarily. They performed the self-stretching exercises using audiovisual media was carried out 20 minutes 5 times a week during 3 weeks. Neck disability index (NDI) and visual analogue scale (VAS) were used to measure the functional disability and pain, A pressure pain threshold was measured using an algometer, and a cervical range of motion (CROM) measurement tool was used to measure the range of motion and error of proprioceptive position sense of the cervical spine. To assess posture alignment, forward head angle (FHA), forward shoulder angle (FSA) were measured using image J software. Results: The neck pain intensity was statistically significantly within group (p<.05). Neck and shoulder functional disability were a statistically significant difference within group (p<.05). Splenius capitis and upper trapezius pressure pain threshold were statistically significant difference in within group (p<.05). The postural alignment was statistically significantly within group (p<.05). The cervical range of motion in neck extension, right and left lateral flexion were statistically significantly within group (p<.05). The joint position error in neck flexion, extension, right and left lateral flexion decreased statistically significantly within group (p<.05). Conclusion: Self-stretching exercise using audiovisual media increased the mobility of the neck, decreased neck pain and joint position error, and improved posture alignment. As a result, there was a positive effect by applying the self-stretching exercise using audiovisual media to people with neck pain. Based on this, it is thought that it can be used as the basis for research related to home training programs for healthy self-management.