• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.73-91
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• 2002

Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1047-1051
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• 1994

Airway obstruction may be caused by extreme mediastinal shift and rotation after right pneumonecotmy or after left pneumonecotomy in the presence of right aortic arch.We experienced such a complication after right pneumonectomy, so called right postpneumonectomy syndrome. The patient was 28 years old female, and 4 month ago she had undergone right pneumonecotomy via video assisted thoracoscopic surgery[VATS] for endobronchial tuberculus dissemination and secondary pulmonary infection. She was treated by mediastinal repositioning which were composed of substernal fixation of pericardium and insertion of expandable prosthesis of 1000 cc capacity. She had good postoperative course and now she feels no obstructive symptoms.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.18 no.2
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• pp.1-8
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• 2023

Objectives This study aimed to propose biomarkers for diagnosing Chuna manual therapy (CMT) based on X-ray images in the thoracic and lumbar spines. Methods Through a literature review and expert consensus process, diagnostic biomarkers for CMT were selected based on the listing system in thoracic and lumbar radiograph anterior-posterior (AP) and lateral views. Results 1. Diagnostic biomarkers were derived from four points on the outer contour of the vertebral body in the thoracic and lumbar spine radiograph lateral view, enabling the diagnosis of flexion and extension malposition. 2. Additional diagnostic biomarkers were identified in the thoracic and lumbar radiographAP view, utilizing points on the outer contour of the vertebral body. These biomarkers facilitate the diagnosis of lateral bending. Moreover, biomarkers derived from the innermost point of the pedicle contour allow for the diagnosis of rotation malposition. 3. Furthermore, through the biomarkers proposed in this study, all malpositions of the thoracolumbar spines and complex Type I and II malpositions can be diagnosed in CMT. Conclusions The biomarkers reported in this study consist of minimal points to determine the position of the vertebral body, providing the advantage of simplicity while minimizing potential errors during the CMT diagnostic process. Further clinical research and the development of related programs should be pursued to expand the evidence for CMT.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.2
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• pp.396-403
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• 2020

This study evaluated the effect of self thoracic mobilization exercise (STME) on shoulder pain, disability and shoulder function in patients with shoulder dysfunction. Thirty-two patients with shoulder dysfunction were randomly assigned to the STME group and the control group. The visual analog scale, shoulder dysfunction, and shoulder range of motion were evaluated before and after intervention. Sixteen STME intervention patients used a foam roller and quadripedal position flexion and extension. Sixteen controls received placebo effects using electrotherapy pads. The two groups performed 20 minutes for three times per week for four weeks. The STME group showed significant improvement in pain and dysfunction compared to that of the control group (p <0.05), and their range of motion of the shoulder was significantly improved in flextion, abduction, and external rotation compared to that of the placebo group (p <0.05). Therefore, STME is effective in resolving shoulder pain and dysfunction, and will be able to educate patients with shoulder pain in an easier approach and mediate social treatment costs.

• Physical Therapy Korea
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• v.25 no.4
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• pp.1-8
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• 2018

Background: Round shoulder posture, results from excessive flexed posture of the thorax, is defined as a position of scapular protraction, anterior tipping, and downward rotation. However, previous studies have focused on only passive position of the thorax during scapular posterior tilting (SPT) and have not reported on SPT combined with correction of flexed posture. Objects: The aim of this study was to compare effects of SPT and SPT with prone trunk extension (SPT + PTE) on activities of the lower trapezius, serratus anterior, and thoracic erector spinae and degree of posture in subjects with round shoulder and flexed posture. Methods: Fifteen subjects with round shoulder and flexed posture were recruited. The caliper was used to measure the degree of round shoulder and flexed posture. Electromyography was performed to collect data of muscle activities. Paired t-test was used to compare two exercise (${\alpha}=.05$). Results: When SPT + PTE was applied, the degree of round shoulder posture (p=.001) and flexed posture (p=.039) significantly decreased compared with that when SPT was applied. The lower trapezius activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.026). There were no significant differences in serratus anterior activity between SPT + PTE and SPT. The thoracic erector spinae activity significantly increased in the SPT + PTE condition compared with that in the SPT condition (p=.014). Conclusion: SPT + PTE might be one of the effective methods to enhance activities of lower trapezius and thoracic erector spinae, and to reduce round shoulder posture and flexed posture in subjects with round shoulder and flexed posture.

• Journal of Biomedical Engineering Research
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• v.25 no.1
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• pp.71-76
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• 2004

In order to investigate the Post-operative changes in scoliotic spine according to selection of fusion level a mathematical finite element model of King-Moe type II scoliotics spine system was developed. By utilizing this finite element scoliosis model surgical correction simulation procedures of pedicle fixation and derotation were simulated. In consequence of the calculation by changing the fusion Levels, postoperative changes like Cobb angle, apical vertebrae axial rotation (AVAR), thoracic kyphosis, and rib hump were Qualitatively analyzed. In the analysis of operative kinematics, the decrease or Cobb angle was most prominent in distraction than in deroation. Applying the rod derotation only was not effective in decrease of Cobb angle but just caused increase of At AR and rib hump. From the operative simulation, co-action or distraction and translation during rod insertion has major impact on Cobb angle decrease and maintenance of kyphosis. With rod rotation, Cobb angle decrease was obtained, but combined increase of AVAR and rib hump was simulation observed as well. The case of most extended instrumentation range with 60o rod rotation produced double decrease of Cobb angle, but the increase of rib hump and AYAR occurred corresponding1y. The optimum selection of fusion level was proved as one level less than inflection position of the thoracic spine curvature.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.1
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• pp.93-101
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• 2017

PURPOSE: The purpose of this study was to describe the effects of short term Schroth exercise on the Cobb angle, angle of trunk rotation (ATR), cosmetic appearance, and quality of life (QOL) in idiopathic scoliosis patients. METHODS: Five subjects with idiopathic scoliosis, (female, 3; male, 2) curvature type: thoracic, 2; lumbar, 3 underwent short term Schroth exercise for seven days. The exercise was performed for 3 h long sessions per day. The Cobb angle and QOL were measured before and after the intervention. ATR and cosmetic appearance were measured once. Sessions consisted of one baseline, seven intervention and three follow-up phases. The sessions were conducted with a one day interval. RESULTS: After the intervention, the Cobb angle was found to be significantly improve (p <.05), while the QOL did not differ (p>.05). The ATR showed decreased trends in the intervention phase. Data points during the intervention and follow-up phases showed a decrease in comparison with data points at the baseline, indicating that Schroth exercise might be effective in reducing the ATR and that these effects can be maintained after the intervention. Cosmetic appearance did not showed changed trends during the Schroth exercise intervention phase. CONCLUSION: Our results suggest that short term Schroth exercise may be valuable in improving the Cobb angle and ATR in patients with idiopathic scoliosis.

• Progress in Medical Physics
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• v.9 no.4
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• pp.247-257
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• 1998

For effective radiotherapy, it should always be considered that calculation of different dose distribution in heterogenous tissue is important particularly on lung which has low density and large volume. To take precise dose distribution of 6MV X-ray in the thoracic cage, the authors had made a tissue equivalent phantom for thorax, measured dose distribution by thermoluminescent dosimeter and mm dosimeter, and derived methmetical equation coincided with provided theoretical formula. In comparision with isodose curve on case of homogeneous soft tissue, dose of heterogeneous lung tissue had been shown increase about 4% per cm depth on one and multiportal field, less than 15% difference on rotation field for esophagus, and around 20% difference on rotation field for lung according to the degree of rotation angle that must be corrected by dose compensation.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.765-769
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• 2006

Background: Nuss procedure is a minimally invasive technique for correcting the pectus excavatum. But there are some limitations of correcting the complex anomaly or grown-up patients. Material and Method: we retrospectively reviewed 135 consecutive patients who underwent repair of pectus excavatum by the Nuss procedure and its modifications between November 1999 and December 2004. We analyzed the computed tomography, age on operation, operative technique, and complications. Result: We operated 135 patients of pectus excavatum during 62 months. Total number of operations about Nuss procedure is 216, including bar removal procedure of 64 cases, redo Nuss procedures of 47 cases. We modified the point of bar insertion to the hinge point, made a shoulder in the bar to prevent a displacement. And then we changed the fixation material from Vicryl to steel wire. If the patients are old, we retract the sternum during bar rotation and fixation. Until 2002, the number of redo Nuss operations were 17, complications were 23. but, after modifications, the number of redo Nuss operation were 0, complications were 2. Conclusion: This result indicates that our modifications of Nuss operation is effective, and could decrease the number of redo Nuss operation and complications.

• Journal of Korean Physical Therapy Science
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• v.31 no.2
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• pp.15-29
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• 2024

Background: This study investigated the effects on the range of motion, pain, disability index, and quality of life when applying thoracic mobility exercise in middle-aged women with chronic back pain. Design: pretest-posttest control group design Methods: The study subjects were 32 patients with chronic back pain of 3 months or more among middle-aged women divided 2 groups. All groups were tested thrice a week for 30 minutes per session for four weeks. Each subject was evaluated using the thoracic rotation Range of Motion, the numerical pain rating scale and pressure pain threshold, Disability Index(Oswestry Disability Index), the Quality of Life(SF-36) before and after treatment. Results: As a result of the study, the range of motion at T1 and T2 of the exercise group to which thoracic mobility exercise was applied was significantly increased in both left and right rotations(p<0.05). In the evaluation of pain, the number pain rating scale(NPRS) score decreased significantly(p<0.05), and the pressure pain threshold was significantly increased (p<0.05), but there was no significant difference from the control group. In the evaluation of the disorder index, the Oswestry disorder index decreased significantly after the experiment (p<0.05), and there was a significant difference in group comparison with the control group (p<0.05). In quality of life, there was a significant increase in PCS of SF-36(p<0.05), but there was no significant difference from the control group. Conclusion: Through this study, thoracic mobility exercise can be used as an effective exercise therapy intervention method to improve and promote physical factors of range of motion, pain and disability index, and physical components of quality of life when treating middle-aged women with chronic back pain in the future.