• 패션비즈니스
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• 제27권4호
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• pp.125-140
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• 2023

This study aimed to develop a smart wearable device for assessing the risk angle associated with turtle neck syndrome in patients with Video Display Terminal (VDT) syndrome. Turtle neck syndrome, characterized by forward head posture resulting from upper cross syndrome, leads to thoracic kyphosis. In this research, a stretch sensor was used to monitor the progression of turtle neck syndrome, and the sensor data was analyzed using a Universal Testing Machine (UTM) and the Gauge Factor (GF) calculation method. The scapula and cervical spine angles were measured at five stages, with 15-degree increments from 0° to 60°. During the experimental process, the stretch sensor was attached to the thoracic spine in three different lengths: 30mm, 50mm, and 100mm. Among these, the attachment method yielding the most reliable data was determined by measuring with three techniques (General Trim Adhesive, PU film, and Heat Transfer Machine), and clothing using the heat transfer machine was selected. The experimental results confirmed that the most significant change in thoracic kyphosis occurred at approximately 30° of forward head posture. Prolonged deformity can lead to various issues, highlighting the need for textile sensor solutions. The developed wearable device aims to provide users with real-time feedback on their turtle neck posture and incorporate features that can help prevent or improve the condition.

• 대한통합의학회지
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• 제4권4호
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• pp.101-108
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• 2016

Purpose : The purpose of this study was to determine the effect of selective thoracic extensor strengthening exercises in the sitting position using a foam-roller by investigating the electromyographic(EMG) activities of the thoracic and lumbar extensors. Methods : Eighteen healthy subjects with no medical history of back pain were recruited. EMG activity was recorded from thoracic extensor(TE) and lumbar extensor(LE) while subjects performed three thoracic extension exercises: prone thoracic extension(PTE), prone thoracic extension with abdominal draw-in maneuver(PTE-ADIM), and sitting thoracic extension using a foam-roller(STE). TE and LE EMG activity, and TE/LE EMG activity ratio were analyzed by one-way repeated-measures analysis of variance(ANOVA). Where a significant difference was identified, a Bonferroni correction was performed(p<.017, .05/3). Results : TE and LE EMG activity, and TE/LE EMG activity ratio differed significantly among the three exercises(p<.05). Post hoc pair-wise comparison with Bonferroni correction showed that TE muscle activity in the STE exercise was significantly different from PTE and PTE-ADIM exercises(p<.017). There was no significant difference between TE muscle activity for PTE and PTE-ADIM exercises(p>.017). LE muscle activity and TE/LE ratios were significantly different among the three exercises p<.017). Conclusion : TE/LE ratio showed superior selective thoracic extensor strengthening for the STE exercise than PTE and PTE-ADIM exercises. Therefore, we recommend STE exercise for selective thoracic extensor strengthening.

• 대한통합의학회지
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• 제10권3호
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• pp.221-232
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• 2022

Purpose : In this study, rectus abdominis relaxation intervention was administered to office workers who were experiencing low back pain due to sitting for extended periods of time in an incorrect posture. This study aimed to develop an effective treatment program for individuals who experience low back pain. This was done by verifying changes using the Korean Oswestry Disability Index (K-ODI) and considering kyphosis. Both factors are related to low back pain. Methods : This study included 39 office workers with low back pain. The participants were randomly assigned to three groups. 1) The functional massage and self-stretching (FAS) group (n=14). 2) The diaphragmatic breathing and self-stretching (DAS) group (n=13). 3) The self-stretching (S) group (n=12). All groups applied the intervention for 30 minutes a day, thrice a week for four weeks. All participants were evaluated using the K-ODI and thoracic kyphosis measurements before and after the intervention. Results : The findings of this study are as follows. All three groups had improved K-ODI scores after the intervention. The FAS and DAS groups showed a greater effect than the S group. However, there was no difference in effect between the FAS and DAS groups. Kyphosis was not improved in any of groups after the intervention, and there was no difference between the three groups. Conclusion : This study showed that the FAS, DAS, and S programs were effective relaxation interventions that improved the K-ODI for office workers with low back pain. The FAS and DAS programs were more effective than the S program. Therefore, it is recommended to combine relaxation and stretching of the rectus abdominis muscle for office workers who experience low back pain. Clinically, a relaxation intervention that is most appropriate for the patient, depending on his or her condition, should be.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.293-299
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• 2007

Objective : Thoracoscopic spinal surgery provides minimally invasive approaches for effective vertebral decompression and reconstruction of the thoracic and thoracolumbar spine, while surgery related morbidity can be significantly lowered. This study analyzes clinical results of thoracoscopic spinal surgery performed at our institute. Methods : Twenty consecutive patients underwent video-assisted thoracosopic surgery (VATS) to treat various thoracic and thoracolumbar pathologies from April 2000 to July 2006. The lesions consisted of spinal trauma (13 cases), thoracic disc herniation (4 cases), tuberculous spondylitis (1 case), post-operative thoracolumbar kyphosis (1 case) and thoracic tumor (1 case). The level of operation included upper thoracic lesions (3 cases), midthoracic lesions (6 cases) and thoracolumbar lesions (11 cases). We classified the procedure into three groups: stand-alone thoracoscopic discectomy (3 cases), thoracoscopic fusion (11 cases) and video assisted mini-thoracotomy (6 cases). Results : Analysis on the Frankel performance scale in spinal trauma patients (13 cases), showed a total of 7 patients who had neurological impairment preoperatively : Grade D (2 cases), Grade C (2 cases), Grade B (1 case), and Grade A (2 cases). Four patients were neurologically improved postoperatively, two patients were improved from C to E, one improved from grade D to E and one improved from grade B to grade D. The preoperative Cobb's and kyphotic angle were measured in spinal trauma patients and were $18.9{\pm}4.4^{\circ}$ and $18.8{\pm}4.6^{\circ}$, respectively. Postoperatively, the angles showed statistically significant improvement, $15.1{\pm}3.7^{\circ}$ and $11.3{\pm}2.4^{\circ}$, respectively(P<0.001). Conclusion : Although VATS requires a steep learning curve, it is an effective and minimally invasive procedure which provides biomechanical stability in terms of anterior column decompression and reconstruction for anterior load bearing, and preservation of intercostal muscles and diaphragm.

• The Korean Journal of Pain
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• 제18권2호
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• pp.142-145
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• 2005

Background: Vertebroplasty that is performed in the upper and middle thoracic spine presents technical challenges that are different from those in the lower thoracic or lumbar region due to the small pedicle size and angular severity for thoracic kyphosis. We report the results of percutaneous vertebroplasty and review its effectiveness in treating intractable osteoporotic compression fractures in the upper and middle thoracic spine. Methods: Patients who underwent vertebroplasty due to painful osteoporotic compression fractures at T3 T8 were retrospectively analyzed. The compression rate, volume of injected cement, clinical outcome (VAS score) and complications were analyzed. Results: Forty-three vertebral bodies from 41 patients (32 females and 9 males, age from 64 to 78 years old) underwent vertebroplasty. The mean compression rate improved from 35% to 17%. Bipedicular injections of bone cement were performed at 3 levels of 2 patients, and unipedicular injections were performed in 40 levels of 39 patients. The mean VAS score prior to surgery was 7.7, which improved to 2.4 within 48 hours after surgery, and the mean VAS score after 6 months was 1.5, which was significantly lower. All patients recovered uneventfully, and the neurological examination revealed no deficits. Cement leakage to the adjacent disc (9 levels) and paravertebral soft tissues (10 levels) developed. However, there were no significant complications related to the procedure such as a pneumothorax or pulmonary embolism. Conclusions: Transpedicular vertebroplasty is a safe and effective treatment for the upper and middle thoracic regions, and has a low complication rate.

• Journal of Korean Neurosurgical Society
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• 제42권5호
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• pp.363-366
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• 2007

Objective : Kyphoplasty performed in the middle thoracic spine presents technical challenges that differ from those in the lower thoracic or lumbar region due to small pedicle size and angular severity for thoracic kyphosis. The purpose of this study was to evaluate the efficacy of balloon kyphoplasty through extrapedicular approach for the treatment of intractable osteoporotic compression fractures in the middle thoracic spine. Methods : The patients who were performed with one level balloon kyphoplasty through extrapedicular approach due to painful osteoporotic compression fractures at T5-T8 from June 2003 to July 2005 were retrospectively analyzed. Imaging and clinical features were analyzed including involved vertebrae level, vertebral height, Injected cement volume, clinical outcome and complications. Results : Eighteen female patients (age ranged from 60 to 77 years old) were included in this study. The average amount of the implanted cement was $4.2{\pm}1.5\;cc$. The mean cobb angle and compression rate were improved from $12.1{\pm}6.5^{\circ}$ to $8.5{\pm}7.2^{\circ}$ and from 30% to 15%, respectively. The mean pain score (visual analogue scale) prior to kyphoplasty was 7.9 and it decreased to 3.0 after the procedure. Cement leakage to the adjacent disc (2 cases) and paravertebral soft tissues (1 case) were seen but there were no major complications such as pneumothorax, segmental arte 이 Injury, pulmonary embolism, or epidural leakage. Conclusion : Balloon kyphoplasty through extrapedicular approach is considered as a safe and effective in treating the middle thoracic regions with low complication rate.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.96-105
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• 2019

Objective : The aims in the management of thoracolumbar spinal fractures are not only to restore vertebral column stability, but also to obtain acceptable alignment of the thoracolumbar junction (T-L junction) to prevent complications. However, insufficient surgical correction of the thoracolumbar spine would be likely to cause late progression of abnormal kyphosis. Therefore, we identified the surgical factors that affected unfavorable radiologic outcomes of the thoracolumbar spine after surgery. Methods : This study was conducted in a single institution from January 2007 to December 2013. A total of 98 patients with unstable thoracolumbar spine fracture were included. In these patients, fixation was done through transpedicular screws with rods by three surgical patterns. We reviewed digital radiographs and analyzed the images preoperatively and postoperatively during follow-up visits to compare the change of the thoracolumbar Cobb angle with radiologic parameters and clinical outcomes. The unfavorable radiologic group was defined as the patients who were measured as having greater than 20 degrees of thoracolumbar Cobb angle on the last follow-up, or who underwent kyphotic progression of thoracolumbar Cobb angle greater than 10 degrees from the immediate postoperative state to final follow-up, or who had overt instrument failure with/without additional surgery. We assessed the risk factors that affected the unfavorable radiologic outcomes. Results : We had 43 patients with unfavorable radiologic outcomes, including 35 abnormal thoracolumbar alignments and 14 instrumental failures with/without additional surgery. The multivariate logistic regression test showed that immediate postoperative T-L junction Cobb angle less than 10.5 degrees was a statistically significant risk factor, as well as the presence of osteoporosis (p=0.017 and 0.049, respectively). Conclusion : Insufficient correction of thoracolumbar kyphosis was considered to be a major factor of an unfavorable radiological outcome. The spinal surgeon should consider that having a T-L junction Cobb angle larger than 10.5 degrees immediately after surgery could result in an unfavorable radiological outcome, which is related to a poor clinical outcome.

• Journal of Korean Neurosurgical Society
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• 제41권3호
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• pp.166-170
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• 2007

Objective : The purpose of this study is to evaluate the clinical outcome of the two-stage operation for thoracic tuberculous spondylitis. Methods : Eleven patients [4 male, 7 female] with thoracic tuberculous spondylitis were treated with two-stage operation. First stage consisted of anterior debridement and interbody fusion using rib graft and second with posterior instrumentation with fusion. Mean age was 46 years, and mean follow-up period was 18 months. All patients were treated with 12 months of antituberculotic medication postoperatively, and evaluated before and after surgery with respect to pain level, neurological status, associated lesions, hematological parameters and change of kyphotic angle. Results : The associated lesions were pulmonary tuberculosis in 4 cases. There were no recurrences of infection and bone union was obtained within 6 months of the operation in all cases. Changes in the pain severity, neurological status, and hematological parameters demonstrated significant clinical improvement in all patients. The mean kyphotic angle was corrected from $17.8^{\circ}$ to $9.8^{\circ}$ after surgery. The most recent follow-up of the mean kyphotic angle was $12.3^{\circ}$, with a loss of correction of $2.5^{\circ}$. The preoperative VAS averaged to be 7.18 [range, 4-10]. It decreased significantly an average of 1.45 [p <0001]. Conclusion : These results indicate that two-stage surgical treatment for thoracic tuberculous spondylitis provid safe and satisfactory results. Spine instability and kyphosis can be also prevented by two-stage operation.

• 한국운동역학회지
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• 제22권3호
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• pp.341-348
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• 2012

The purpose of this study was to compare the muscle activities of the thoracic extensor(TE) and lumbar extensor(LE) during trunk lift (TL) exercise according to exercise position. Seventeen healthy subjects with no medial history of back pain were recruited for this study. Subjects performed the TL exercise in prone, quadruped and heel-sitting positions. The activities of the TE and LE were measured using surface electromyography during TL exercise in each exercise position. A one-way repeated-measures analysis of variance (ANOVA) was used to compare the normalized muscle activities of the TE and LE and the TE/LE ratio. The results showed that there was not significant effect of exercise position on the muscle activities of TE(p>.05). However, there was significant effect of exercise position on the muscle activities of LE and the TE/LE ratio(p>.05). Post hoc pair-wise comparisons with Bonferroni correction showed that both muscle activities of LE and TE/LE ratio in prone position were significantly different in those in heel-sitting and quadruped positions, during TL exercise, respectively. The TE/LE ratio was the greatest for TL exercise in heel-sitting position. Therefore, for selective activation of the TE muscle, we recommend performing the TL exercise in heel-sitting or quadruped position.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.175-179
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• 2010

Purpose: Sternal fractures after blunt thoracic trauma can cause significant pain and disability. They are relatively uncommon as a result of direct trauma to the sternum and open reduction is reserved for those with debilitating pain and fracture displacement. We reviewed consecutive 11 cases of open reduction and fixation of sternum and tried to find standard approach to the traumatic sternal fractures with severe displacement. Methods: From December 2008 to August 2010, the medical records of 11 patients who underwent surgical reduction and fixation of sternum for sternal fractures with severe displacement were reviewed. We investigated patients' characteristics, chest trauma, associated other injuries, type of open reduction and fixation, combined operations, preoerative ventilator support and postoperative complications. Results: The mean patient age was 59.3years (range, 41~79). The group comprised 6 male and 5 female subjects. Among 11 patients who underwent open reduction and fixation for sternal fracture with severe displacement, 6 cases had isolated sternal fractures and the other 5 patients had associated other injuries. Sternal fractures were caused by car accidents (9/11, 81.8%), falling down (1/11, 9.1%) and direct blunt trauma to the sternum (1/11, 9.1%), respectively. 3 of the 7 patients (42.9%) who underwent sternal plating with longitudinal plates showed loosening of fixation. Otherwise, none of the 4 patients who underwent surgical fixation using T-shaped plate had stable alignment of the fracture. Conclusion: Sternal fractures with severe displacement need to be repaired to prevent chronic pain, instability of the anterior chest wall, deformity of the sternum, and even kyphosis. In the present study, a T-shaped plate with a compression-tension mechanism constitutes the treatment of choice for displaced sternal fractures.