• Journal of Korean Neurosurgical Society
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• v.48 no.4
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• pp.342-346
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• 2010

Objective : This study assessed the efficacy of anterior cervical discectomy and fusion (ACDF) with cage alone compared with ACDF with plate instrumentation for radiologic and clinical outcomes in two-level cervical degenerative disease. Methods : Patients with cervical degenerative disc disease from September 2004 to December 2009 were assessed retrospectively. A total of 42 patients received all ACDF at two-level cervical lesion. Twenty-two patients who underwent ACDF with cage alone were compared with 20 patients who underwent ACDF with plate fixation in consideration of radiologic and clinical outcomes. Clinical outcomes were assessed using Robinson's criteria and posterior neck pain, arm pain described by a 10 point-visual analog scale. Fusion rate, subsidence, kyphotic angle, instrument failure and the degenerative changes in adjacent segments were examined during each follow-up examination. Results : VAS was checked during each follow-up and Robinson's criteria were compared in both groups. Both groups showed no significant difference. Fusion rates were 90.9% (20/22) in ACDF with the cage alone group, 95% (19/20) in ACDF with the plate fixation group (p = 0.966). Subsidence rates of ACDF with cage alone were 31.81% (7/22) and ACDF with plate fixation were 30% (6/20) (p = 0.928). Local and regional kyphotic angle difference showed no significant difference. At the final follow-up, adjacent level disease developed in 4.54% (1/22) of ACDF with cage alone and 10% (2/20) of ACDF with plate fixation (p= 0.654). Conclusion : In two-level ACDF, ACDF with cage alone would be comparable with ACDF with plate fixation with regard to clinical outcome and radiologic result with no significant difference. We suggest that the routine use of plate and screw in 2-level surgery may not be beneficial.

• Journal of the Ergonomics Society of Korea
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• v.29 no.1
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• pp.67-71
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• 2010

This study examined the field of view of older drivers based on their eye points. The subjects were 25 people whose age was over 65 years and 10 contrasting subjects on their 20s. For the experiment, we expanded the width of the A-pillar of a test vehicle. With a measuring apparatus designed for the study, we analyzed 3 axes of coordinates from glabella to a fixed point of the vehicle that would be used as CAD data of vehicle design. Result shows that average eye point of the older subjects was located significantly farther from the seat than that of the 20s approximately by 31.62mm(p=0.05). It was also found that the Binocular FOV was not significantly different between the older subjects and the 20s(p=0.85), and the effect of the width of the A-pillar on the FOV could not be found. We also measured the left and right side of the Ambinocular FOV of the older subjects. It was found that the older subjects had much wider visual angle than the 20s by 2.84 degree (F=4.78, p=0.01) on the left side, while the 20s showed significantly wider average angle than the older subjects by about 4.88 degree (F=4.78, p<0.05) on the right side. The results of this study can be used to improve the FOV based on the optimal eye points when designing a vehicle for older drivers.

• 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.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.794-805
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• 2020

Objective : Teriparatide is known as an effective anabolic agent not only for severe osteoporosis but also for bone healing and union. We explored the possibility of teriparatide as an alternative treatment option for osteoporotic thoracolumbar (TL) burst fracture. Methods : This retrospective study enrolled 35 female patients with mean age of 73.77±6.71 years (61-88) diagnosed as osteoporotic TL burst fracture with ≥4 of thoracolumbar injury classification and severity (TLICS) score and no neurological deficits. All patients were treated by teriparatide only (12 of group A), teriparatide plus vertebroplasty (12 of group B), or surgical fixation with fusion (11 of group C), and followed up for 12 months. Radiological outcomes were evaluated using radiological parameters including kyphotic angle (KA), segmental vertebral kyphotic angle (SVKA), compression ratio (CR), and vertebral body height (anterior [AH], middle [MH], posterior [PH]). Functional outcomes were evaluated using visual analog scale (VAS) and Macnab classification (MC). Results : There were no statistical significant differences in age, bone mineral density (-3.36±0.73), and TLICS score (4.34±0.48) among the three groups (p>0.05). Teriparatide was administered during 8.63±2.32 months in group A and B. In 12-month radiological outcomes, there were significant restoration in SVKA, CR, AH, and MH of group B and KA, SVKA, CR, AH, and MH of group C compared to group A with no radiological changes (p<0.05). All groups showed similar significant improvements in 12-month functional outcomes, although group B and C showed a better 1-month VAS, 1-month MC, 3-month MC compared to group A (p<0.05). Conclusion : Non-surgical treatment with teriparatide showed similar 12-month functional outcomes compared to surgical fixation with fusion. The additional vertebroplasty to teriparatide and surgical fixation with fusion were more helpful to improve short-term functional outcomes with structural restoration compared to teriparatide only.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.374-378
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• 2016

Objective : A modified surgical technique of posterior cervical foramintomy called posterior cervical inclinatory foraminotomy (PCIF) was introduced in previous preliminary article. PCIF allows better preservation of facet joint and capsule than conventional techniques. The authors conducted a study to investigate long-term outcomes of PCIF. Methods : We retrospectively reviewed demographic, radiologic, and clinical data from the patients who underwent PCIFs at our institution. Criteria included a minimum of 48 month follow-up and PCIFs for patients with radiculopathy from foraminal stenosis (C2-T1; single or multilevel) with persistent or recurrent root symptoms despite conservative treatment for more than 3 months. Patients who had undergone previous cervical operation were excluded. The visual analogue scale (VAS) score was used for clinical follow-up, and radiologic follow-up was performed to compare the changes of cervical sagittal alignment, focal angle and disc-space height of treated segment. Results : The PCIFs were performed between April 2007 and March 2011 on 46 patients (32 males and 14 females) with a total of 73 levels affected. The average duration of follow-up was 74.4 months. Improvements in radiculopathic pain were seen in 39 patients (84.7%), and VAS score decreased from $6.82{\pm}1.9$ to $2.19{\pm}1.9$. Posterior neck pain also improved in 25 patients (71.4%) among 35 patients, and VAS score decreased from $4.97{\pm}2.0$ to $2.71{\pm}1.9$. The mean disc-space heights of treated segment were $5.41{\pm}1.03mm$ preoperatively and decreased to $5.17{\pm}1.12mm$ postoperatively. No statistically significant changes in cervical sagittal alignment, focal angle were seen during the follow-up period (Cox proportional hazards analysis and Student t-test, p>0.05). Conclusion : The PCIF is highly effective in treating patients with cervical spondylotic radiculopathy, leading to long-lasting relief in pain. Long-term radiologic follow-up showed no significant spinal angular imbalance.

• Journal of the Korean Institute of Landscape Architecture
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• v.30 no.5
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• pp.31-38
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• 2002

This study attempts to grasp the correlation between the image of bridges and bridge landscapes with their surroundings during day and nighttime viewing, and to understand the psychological influence of nighttime lighting through quantitative analysis. In addition, it presents a design to construct bridges in order to increase viewers enjoyment of bridge landscapes lit at night. To attain this objective and contrive generalization of the results, this paper selects 8 of 9 bridges with lightings in Seoul and excludes bridges constructed by 2004. The criteria for selection of the viewpoints is that each must be within easy reach of bridges, and must allow viewers to recognize surrounding landscape details both in daylight and at night. As well, the pictures of bridges are taken in the terraced land by the riverside. The study selects 16 pictures, judged to be of similar quality and angle, to establish the conditions of luminosity, color, definition and angle. The results are as follows. First, viewers preferences of night landscapes are higher than day landscapes due to the effect of lighting. By day, viewers preferred bridges with various structures such as cable-stayed bridges and arch bridges more than simple bridges like girder bridges. Viewers also indicated preferences for lightings which feature a unique color and which are harmonized with their surroundings. Second, components representing the images of bridge landscape are classified into three types, 'beauty', 'system' and 'agreeableness'. Third, the factors affecting preference are the shape of bridge by day and lighting at night. Esthetic appeal is the most important factor in visual preference so each bridges own esthetic appeal and surroundings must be considered. Thus, a complete plan must be created which considers safety, beauty and the local surroundings. In addition, when the lighting of a bridge is selected, the design of the bridge landscape must consider various lighting schemes to harmonize the upper and lower parts of the structure. At this point, the study reveals the basic elements of bridge planning in order to increase appreciation of the bridge landscape.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.1 no.2
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• pp.11-20
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• 2006

Objectives: The aim of this study is to investigate clinical effects of Chuna treatment on the neck pain patient with hypolordotic cervical spine. Methods: From June 2006 to August 2006, 20 cases of neck pain patient with hypolordotic cervical spine were divided into 2 groups. Control group(n=10) was treated only acupuncture therapy, and sample group(n=10) was treated Chuna after acupuncture therapy same as control group. Degrees of pain were measured with Visual Analogue Scale(VAS), and the change of cervical curvature was assessed Depth of cervical curve, Method of Jochumsen, and Angle of cervical curve. Results: 1. After 3th and 5th treatment, there was statistical significance between control and sample group in VAS. 2. After 5th treatment, there was not statistical significance between control and sample group in Depth of cervical curve, Method of Jochumsen, and Angle of cervical curve. Conclusions: On treating the neck pain patient with hypolordotic cervical spine, Chuna treatment is more effective than only acupuncture therapy in reducing neck pain, but Chuna treatment for short-term is not more effective than only acupuncture therapy in restoring cervical curvature.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.85-90
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• 2009

Purpose: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. Materials and Methods: 4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. Results: The mean talocalcaneal height was 6.94 cm (range, 5.9${\sim}$7.6 cm) preoperatively and 7.34 cm (range, 6.0${\sim}$8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6${\sim}$8 degrees) preoperatively and 13.1 degrees (range, 5.7${\sim}$21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14${\sim}$36) and 4 (range, 3${\sim}$6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54${\sim}$68) and 3 (range, 2${\sim}$4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). Conclusion: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.55-59
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• 2009

Purpose: We tried to evaluate the usefulness of the arthroscopy in the operative treatment of intra-articular calcaneal fracture. Materials and Methods: Between March 2005 and May 2008, 9 patients with intra-articular calcaneal fractures（Tongue type or Sanders type IIC) were treated with arthroscopically assisted percutaneous reduction and screw fixation. American orthopedic foot and ankle society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS), preoperative and postoperative Bohler's angle and the rate of complication were evaluated. Results: AOFAS score at postoperative 1 year was 88.2 (range, 71-92), and mean VAS score was 2.8 (range, 1-4). Bohler angle was improved from preoperative mean $16.2^{\circ}$ to postoperative mean $29.7^{\circ}$. There were no complications such as wound problem, infection or nerve injury. Conclusion: Subtalar arthroscopy provides precise view of posterior facet during the operation. Therefore, it can be a useful tool in treating intra-articular calcaneus fractures, especially tongue type and Sanders type IIC fractures.

• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.93-108
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• 2006

Purpose : To evaluate effects of McKenzie exercise on the functional recovery and forward head posture of chronic neck pain patients. Methods : The subjects were consisted of fifteen patients who had abnormal neck posture, mild neck pain (28 males, 17 females; mean aged 21.9) from 19 to 33 years of age(mean age 21.9). All subjects were received McKenzie exercise for 35 minutes with clinical massage per day three times a week during 4 weeks period. Neck disability index was used to measure functional disability level. Visual analogue scale(VAS) was used to measure subjective pain level. craniovetebral angle(CVA), cranial rotation angle(CRA) was used to measure forward head posture with digital camera. All measurements of each patients were measured at pre-treatment and after 2 week, after 4 week, post-treatment on 2 week. Result : The VAS of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The Neck Disability Index of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The CVA of McKenzie exercise was significantly reduced between pre-treatment and post-treatment (p<.05) and effects of pain reduce was continued follow 2 weeks. The CRA of McKenzie exercise was not significantly reduced between pre-treatment and post-treatment (p<.05). Conclusion : McKenzie exercise improved pain and function of Chronic neck pain patients.