• 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.

• Journal of Korean Neurosurgical Society
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• v.42 no.2
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• pp.112-117
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• 2007

Objective : Kyphoplasty and vertebroplasty are two minimally invasive procedures for osteoporotic vertebral compression fractures. The purpose of this retrospective study was to compare the radiological findings and clinical outcomes between two procedures. Methods : Osteoporotic vertebral fractures were treated in 76 vertebrae, using kyphoplasty (n=35 vertebrae) and using vertebroplasty (n=41 vertebrae). Fractured vertebral bodies were diagnosed by correlating the clinical symptoms with radiologic study. The responses of pain symptoms were measured by a self-reported Visual Analog Scale (VAS) score. Plain X-rays were checked preoperatively and postoperatively at admission and 6 months. The vertebral body height and kyphotic angle were measured to assess the reduction of the sagittal alignment. Results : The mean pain scores were decreased significantly for both procedures postoperatively, but there were no significant differences between two groups. Kyphoplasty led to a significant reduction of the vertebral body height and improvement of kyphotic angle. There were no neurological deficits after kyphoplasty, but one patient experienced paraparesis after vertebroplasty. During the 6 months follow-up both procedures provided stabilization of the sagittal alignment. Conclusion : Kyphoplasty and vertebroplasty are considered effective minimally invasive techniques for the stabilization of osteoporotic vertebral body fractures, leading to a statistically significant reduction in pain. Kyphoplasty significantly restore sagittal alignment. Also, complications and the incidence of bone cement leakage are significantly lesser than vertebroplasty. Therefore, kyphoplasty seems to be reasonable procedure for osteoporotic vertebral body compression fractures when medical treatment fail.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.173-180
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• 2018

Purpose: This study examined the effects of sling exercise therapy on vertebral alignment, VAS, muscle activity, and multifidus of patients with chronic low back pain. Methods: Simple random sampling was used to divide the patients (n=116) into the sling exercise therapy group (SETG) and conservative physical therapy group (CPTG), with each group provided a intervention program in 3 sessions a week for 12 weeks. The lumbar lordosis angle (LLA), lumbar intervertebral disc angle (LIVDA) for vertebral alignment, lumbar muscle activity, and multifidus atrophy were measured before and after the intervention. Results: SETG showed significant changes in LLA, LIVDA of rate of change (delta score), and in relieving pain. The right-left balance gap for the lumbar dynamic muscle activity decreased after the intervention. The SETG showed significant changes in the grade of lumbar multifidus atrophy. Conclusion: The sling exercise therapy program is an effective exercise therapy method on vertebral alignment, muscle activity, recovery from multifidus atrophy, and pain relief for patients with chronic low back pain.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1810-1817
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• 2019

Background: Effect of cervical and lumbar tractions on the reduction in the angle of curvature and the effect of a correction exercise or a general traction method on balance, muscle strength, pain, and body alignment, however insufficient research has been undertaken on self traction exercises targeting patients with scoliosis. Purpose: To determine the effect of cervical and lumbar tractions on the reduction in the angle of curvature and the effect of a correction exercise or a general traction method on balance, muscle strength, pain, and body alignment. Design: Randomized controlled clinical trial (single blinded) Methods: Twelve adults(20s) with scoliosis were included in this study and performed a traction program that was composed of a 5-min warm-up exercise, a 15-min main exercise, and a 5-min cool-down exercise (25 minutes in total), three times a week for four weeks. The Chiro traction machine was used for the self-traction exercise. Vertebral alignment, muscle strength, and flexibility were compared before and after the intervention using the paired T-test. Results: The scoliosis angle, pelvic torsion, and lumbar extensor were significantly changed by intervention; however, there was no significant difference in flexibility. Conclusion: The results revealed that self-traction exercise activated blood flow through the extension and contraction of muscles, effectively increasing the function of the muscles around the vertebrae.

• 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.

• Journal of Mechanical Science and Technology
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• v.17 no.1
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• pp.32-39
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• 2003

In this study we examined connections between vertebral motion and patterns of muscle activation during voluntary head tracking movements. A Rhesus (Maraca mulatta) monkey was trained to produce sinusoidal tracking movements of the head in the sagittal plane while seated. Radio-opaque markers were placed in the cervical vertebrae, and intramuscular patch electrodes were implanted to record from eight neck muscles. Videofluoroscopic images of cervical vertebral motion, and EMG (electromyographic) responses were simultaneously re-corded. Experimental results demonstrated that head and vertebrae moved synchronously and that motion occurred primarily at skull-C$_1$, C$\_$6/-C$\_$7/ and Csub 7/-C$_1$. Our findings illustrate that although the biomechanical constraints of each species may limit the number of solutions available, it is the task requirements that appear to govern CNS (central nervous system) selection of movement behaviors.

• 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.

• Korean Journal of Applied Biomechanics
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• v.25 no.4
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• pp.423-429
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• 2015

Objective : The purpose of this study was to investigate the effects of a body alignment correction program on asymmetrically developed squash players. Method : 30 experienced squash players who showed asymmetric body development, after evaluation of moire topography contour line shape, were involved in the experiment. All of them were right-handed and had more than five years of experience playing squash. Variables of body composition, moire topography and EMG were statistically compared between pre- and post- application of the 12-week body alignment correction program. The program consisted of 10-minute, left-handed forehand and backhand drive movements and 36 minutes performing 12 different yoga postures. Results : First, the body alignment correction program showed significant effects on the total weight, body fat percentage, and body mass index of the participants. Second, a decrease of right side inclined angles and an increase of left side inclined angles might result in a higher left-right symmetry rate and a better left-right balance; however the data was not statistically significant. Third, the EMG left-right deviation of erector spinae and latissimus decreased and the erector spinae muscle was thought to be more essential for vertebral movement and left-right asymmetry correction. Conclusion : A body alignment correction program, including yoga and opposite side exercises, could reduce left-right asymmetry.

• Journal of Korean Medical Science
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• v.33 no.48
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• pp.316.1-316.10
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• 2018

Background: Water pressure and muscle contraction may influence bone mineral density (BMD) in a positive way. However, divers experience weightlessness, which has a negative effect on BMD. The present study investigated BMD difference in normal controls and woman free-divers with vertebral fracture and with no fracture. Methods: Between January 2010 and December 2014, traditional woman divers (known as Haenyeo in Korean), and non-diving women were investigated. The study population was divided into osteoporotic vertebral fracture and non-fracture groups. The BMD of the lumbar spine and femoral neck was measured. The radiological parameters for global spinal sagittal balance were measured. Results: Thirty free-diving women and thirty-three non-diving women were enrolled in this study. The mean age of the divers was $72.1{\pm}4.7$ years and that of the controls was $72.7{\pm}4.0$ years (P = 0.61). There was no statistical difference in BMD between the divers and controls. In divers, cervical lordosis and pelvic tilt were significantly increased in the fracture subgroup compared to the non-fracture subgroup (P = 0.028 and P = 0.008, respectively). Sagittal vertical axis was statistically significantly correlated with cervical lordosis (Spearman's rho R = 0.41, P = 0.03), and pelvic tilt (Spearman's rho R = 0.46, P = 0.01) in divers. Conclusion: BMD did not differ significantly between divers and controls during their postmenopausal period. When osteoporotic spinal fractures develop, compensation mechanisms, such as increased cervical lordosis and pelvic tilt, was more evident in traditional woman divers. This may be due to the superior back muscle strength and spinal mobility of this group of women.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.6
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• pp.468-474
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• 2020

The aim of this study was to compare the effect of a horseback riding simulator, Slings and Kendall Exercise on a cranio-vertebral angle and the neck pain of the Forward Head Posture. This study included 30 young people with forward head posture. They were randomly divided into three groups. Each group performed the exercises for six weeks three times a week from September 2018 to November 2018. The variations of cranio-vertebral angle and neck pain were analyzed using paired t-tests and a one-way ANOVA test. The results of the study are as follows. Three groups showed significant variations of cranio-vertebral angle and neck pain (p < 0.05). But comparison of cranio-vertebral angle and neck pain between the groups showed no significant difference (p > 0.05). This study found that each exercise group for forward head posture was effective for inducing normal cervical alignment and neck pain relief. Therefore, various exercises can improve the forward head posture.