• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.235-243
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• 2020

Lumbar Lordosis Angle (LLA) is an index that can be used to evaluate the curvature of the lumbar vertebrae. It can measure the structural stability of the lumbar spine and the stability of each segment of the vertebral column at the intervertebral disc angle (IDA). Especially, our data shows it is found to be a strong positive correlation between obesity and the angle of lordosis for lumbar vertebrae. Also, the reason for the large IDA in the case of obesity seems to be the result of the weakening of anatomical structure as well as the gravity effect. And, the obesity interferes with normal sagittal balance and fails to maintain a straight posture with minimal energy. Therefore, the obesity can be an important factor in causing back pain by changing the lumbar lordosis.

• Journal of Acupuncture Research
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• v.27 no.2
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• pp.97-104
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• 2010

Objectives : The authors aimed to determine the presence of relationships between cervical pain and cervical curvature, lumbar curvature, sacral slope and sagittal spinal balance. Methods : Medical records of outpatients who made their first visits to the Department of Acupuncture and Moxibustion in the Spine center at Kyung Hee East-West Neo Medical Center between September 1, 2008 and October 31, 2009 were evaluated. A total of 50 patients visiting within the time period had visited with a chief complaint of cervical pain, and had lateral entire spine X-rays taken. After excluding patients with previous spine operations, 46 patients were selected for the final analysis. The cervical lordotic angle(CLA), lumbar lordotic angle(LLA), Ferguson's angle(FA), and sagittal vertical axis(SVA) were measured on the lateral entire spine X-ray cuts, and the relationships between these values and patient gender, age, chief complaint, and duration of symptoms were assessed. Results : No significant difference was found in relationships between gender and measured values. SVA showed statistically significant correlation between age, but CLA, LLA, and FA was not. There was a significant difference in SVA between patients with only cervical pain and those with both cervical pain and low back pain. Patients with a duration of symptoms longer than 6 months showed a statistically significant difference in SVA with those who had shorter symptoms. Correlation analysis between measured values was statistically significant only between LLA and FA. Conclusions : Evaluation and treatment of sagittal imbalance should be considered in patients presenting with cervical pain if symptoms have persisted for over 6 months or have accompanying low back pain.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1170-1176
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• 2001

Objective : The purpose of the study was to evaluate the clinical and radiological results after discectomy and Lubboc bone graft in the surgical management of the cervical diseases with a new titanium interbody implant and integrated screw fixation(PCB) by anterior approach. Methods : The authors retrospectively analyzed 28 cases of anterior cervical fusion with PCB system and Lubboc bone(xeno graft) from september 1998 to december 2000. Twenty-eight patients with cervical diseases underwent decompression cervical lesion and followed from 5 to 27 months with a mean follow-up of 14 months. There patients were evaluated with clinically and radiologically at immediate postoperative period and at 3, 6, 9, and 12 months. Result : The authors investigated the pre- and postoperative intervertebral disc space, clinical outcomes, radiography fusion rate, and Cobb angle in the fixed segments by anterior approach. The lordotic angles and height of disc space were increased after the operation. The clinical outcome of patients follow-up was good or excellent result based on Odom's criteria with improvement of clinical symptom in about 92.9% of the cervical diseases. Two patients showed loosening of the lower and upper cervical screw of PCB instruments, and two patients showed swallowing difficulty and wound infection Conclusion : The PCB system is a new implant for anterior cervical interbody fusion in the degenerative cervical disease and disc herniations. It provides immediate stability and segment distraction. The results of this study indicate that the PCB system is safe, easy handling of hardware, less complications, high fusion rate, and has provide the keeping the intervertebral disc space height and lordotic angles.

• Journal of Acupuncture Research
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• v.27 no.3
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• pp.93-104
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• 2010

Objectives : The purpose of this study is to observe the effects of work environment and low back pain on the structural and muscle strength changes in lumbar spine to helpful for preventation and cure of low back pain. Methods : Through measuring of lumbosacral angle, lumbar lordotic angle, lumbar gravity line ratio analyzed structure of lumbar spine and using Trunk Extension Flexion Program of CYBEX NORM System(cybex770+TMC, USA) analyzed Flex. PT, Ext. PT, E/F ratio of lumbar spine of company employees given a medical examination. Results : According to work environment, lumbar gravity line ratio is higher in white collar group than in blue collar group, Ext. PT is significantly lower in white collar group than in blue collar group. According to low back pain or not, lumbar gravity line ratio, Ext. PT is lower in low back pain group than in non-low back pain group. Conclusions : Work environment and low back pain effects on the structural and muscle strength changes in lumbar spine.

• The Journal of Korean Physical Therapy
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• v.26 no.4
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• pp.226-233
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• 2014

Purpose: This study was conducted in order to investigate the exercise limit that may occur depending on changes in postural alignment by examining the significance of postural alignment changes, foot pressure, and balance of patients with stroke. Methods: In this study, 50 patients diagnosed with a stroke were selected as subjects. Imbalance of postural alignment of the trunk, pelvic tilt of trunk rotation of the body, angle of kyphotic curving of the thoracic, and angle of lordotic curving of the lumbar vertebra were measured. Foot pressure was examined by measuring average pressure and weight bearing. Balance was examined by measuring the center of pressure and limit of stability. Results: The significance of postural alignment, foot pressure, and weight bearing of the non-paretic side was examined. In addition, the significance between postural alignment and balance was examined. Conclusion: It is thought that limits of foot pressure and balance in the standing position can be caused by postural alignment. Thus, both a therapeutic intervention program and postural alignment training should be provided together in order to improve the function of patients with stroke.

• Journal of Korean Medicine Rehabilitation
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• v.20 no.2
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• pp.199-208
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• 2010

Objectives : To study the cervical lordosis and roentgenographic analysis of cervical disc space in neck pain with or without temporomandibular disorder(TMD). Methods : Radiographic measures of cervical lordosis, cervical disc space narrowing were collected, statiscally analyzed. Results : TMD group showed a significant increase in cervical lordotic angle as compared with non-TMD group, whereas no significant change in cervical disc degeneration. Conclusions : The findings from this study suggest that the curvature of the cervical spine is related to the subject's TMD.

• Journal of Korean Neurosurgical Society
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• v.37 no.6
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• pp.422-426
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• 2005

Objective: Different types of interbody fusion cages are available for use in the surgical treatment of degenerative cervical diseases. The purpose of this study is to assess the technical feasibility, clinical efficacy and radiological results of intervertebral fusion with a carbon composite Osta-Pek frame cage (Co-Ligne AG, Switzerland) following anterior cervical discectomy. Methods: 41 patients (25males and 16females) with minimum 6months follow-up were included in the study. Disc height, cervical lordotic angle, segmental angle, and fusion rate were assessed by lateral radiographs. In this retrospective analysis, clinical outcome was assessed as evaluated according to Odom's criteria. Results: Fifty-four cages were implanted in 30 single-level, 9 two-level, and 2 three-level procedures. The mean disc height, cervical lordosis angle, segmental angle were $4.2{\pm}1.8mm,\;23.5{\pm}7.2^{\circ},\;2.3{\pm}3.3^{\circ}$ pre-operatively and $5.3{\pm}2.1mm,\;24.2{\pm}8.3^{\circ},\;3.8{\pm}3.5^{\circ}$ at 6months after the surgery. Six months after surgery, there was radiographic evidence of fusion in 92.7% (38/41) of the patients. According to Odom's criteria, 37 of 41 (90.2%) patients experienced good to excellent functional recovery. Conclusion: These clinical and radiological results suggest that the carbon composite Osta-Pek frame cages are safe and effective alternative to autologous bone graft after anterior cervical discectomy for treatment of degenerative cervical disease.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.532-537
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• 2009

Objective : Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. The study was designed to evaluate early surgical outcome and radiological effects of $Bryan^{(R)}$ cervical disc prosthesis. Methods : The authors retrospectively reviewed radiographic and clinical outcomes in 52 patients who received the $Bryan^{(R)}$ Cervical Disc prosthesis, for whom follow-up data were available. Static and dynamic radiographs were measured by computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of functional spine unit (FSU), and the C2-7 Cobb angle. The range of motion (ROM) was also determined radiographically, whereas clinical outcomes were assessed using Odom's criteria, visual analogue pain scale (VAS) and neck disability index (NDI). Results : A total of 71 $Bryan^{(R)}$ disc were placed in 52 patients. A single-level procedure was performed in 36 patients, a two-level procedure in 13 patients, and a three-level procedure in 3. Radiographic and clinical assessments were made preoperatively. Mean follow-up duration was 29.2 months, ranging from 6 to 36 months. All of the patients were satisfied with the surgical results by Odom's criteria, and showed significant improvement by VAS and NDI score (p < 0.05). The postoperative ROM of the implanted level was preserved without significant difference from preoperative ROM of the operated level (p < 0.05). 97% of patients with a preoperative lordotic sagittal orientation of the FSU were able to maintain lordosis. The overall sagittal alignment of the cervical spine was preserved in 88.5% of cases at the final follow up. Interestingly, preoperatively kyphotic FSU resulted in lordotic FSU in 70% of patients during the late follow up, and preoperatively kyphotic overall cervical alignment resulted in lordosis in 66.6% of the patients postoperatively. Conclusion : Arthroplasty using the $Bryan^{(R)}$ disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although the early results are promising, this is a relatively new approach, therefore long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.

• Journal of Korean Neurosurgical Society
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• v.44 no.5
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• pp.303-307
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• 2008

Objective: The authors reviewed clinical and radiological outcomes in patients with three column injury of the cervical spine who had undergone posterior cervical fixation using Nitinol shape memory alloy loop in the anterior-posterior combined approach. Materials: Nine patients were surgically treated with anterior cervical fusion using an iliac bone graft and dynamic plate-screw system, and the posterior cervical fixation using Nitinol shape memory loop ($Davydov^{TM}$) at the same time. A retrospective review was performed. Clinical outcomes were assessed using the Frankel grading method. We reviewed the radiological parameters such as bony fusion rate, height of iliac bone graft strut, graft subsidence, cervical lordotic angle, and instrument related complication. Results: Single-level fusion was performed in five patients, and two-level fusion in four. Solid bone fusion was presented in all cases after surgery. The mean height of graft strut was significantly decreased from $20.46{\pm}9.97mm$ at immediate postoperative state to $18.87{\pm}8.60mm$ at the final follow-up period (p<0.05). The mean cervical lordotic angle decreased from $13.83{\pm}11.84^{\circ}$ to $11.37{\pm}6.03^{\circ}$ at the immediate postoperative state but then, increased to $24.39{\pm}9.83^{\circ}$ at the final follow-up period (p<0.05). There were no instrument related complications. Conclusion: We suggest that the posterior cervical fixation using Nitinol shape memory alloy loop may be a simple and useful method, and be one of treatment options in anterior-posterior combined approach for the patients with the three column injury of the cervical spine.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.723-729
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• 2020

Objective : The use of oblique lateral interbody fusion at the L5-S1 level (OLIF51) is increasing, but no study has directly compared OLIF51 and transforaminal lumbar interbody fusion (TLIF) at the L5-S1 level. We evaluated the usefulness of OLIF51 by comparing clinical and radiologic outcomes with those of TLIF at the same L5-S1 level. Methods : We retrospectively reviewed and compared 74 patients who underwent OLIF51 (OLIF51 group) and 74 who underwent TLIF at the L5-S1 level (TLIF51 group). Clinical outcomes were assessed with the visual analogue scale for back pain and leg pain and the Oswestry Disability Index. Mean disc height (MDH), foraminal height (FH), disc angle (DA), fusion rate, and subsidence rate were measured for radiologic outcomes. Results : The OLIF51 group used significantly higher, wider, and larger-angled cages than the TLIF51 group (p<0.001). The postoperative MDH and FH were significantly greater in the OLIF51 group than in the TLIF51 group (p<0.001). The postoperative DA was significantly larger in the OLIF51 group than in the TLIF51 group by more than 10º (p<0.001). The fusion rate was 81.1% and 87.8% at postoperative 6 months in the OLIF51 and TLIF51 groups, respectively, and the TLIF51 group showed a higher fusion rate (p<0.05). The subsidence rate was 16.2% and 25.3% in the OLIF51 and TLIF51 groups, respectively, and the OLIF51 group showed a lower subsidence rate (p<0.05). Conclusion : OLIF51 was more effective for the indirect decompression of foraminal stenosis, providing strong mechanical support with a larger cage, and making a greater lordotic angle with a high-angle cage than with TLIF.