• Journal of Korean Neurosurgical Society
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• 제46권6호
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• pp.515-521
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• 2009

Objective : The purpose of this study was to compare clinical and radiological outcomes of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for recurrent disc herniation. Methods : Fifty-four patients, who underwent surgery, either PELD (25 patients) or repeated OLM (29 patients), due to recurrent disc herniation at L4-5 level, were divided into two groups according to the surgical methods. Excluded were patients with sequestrated disc, calcified disc, severe neurological deficit, or instability. Clinical outcomes were assessed using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). Radiological variables were assessed using plain radiography and/or magnetic resonance imaging. Results : Mean operating time and hospital stay were significantly shorter in PELD group (45.8 minutes and 0.9 day, respectively) than OLM group (73.8 minutes and 3.8 days, respectively) (p < 0.001). Complications occurred in 4% in PELD group and 10.3% in OLM group in the perioperative period. At a mean follow-up duration of 34.2 months, the mean improvements of back pain, leg pain, and functional improvement were 4.0, 5.5, and 40.9% for PELD group and 2.3, 5.1, and 45.0% for OLM group, respectively. Second recurrence occurred in 4% after PELD and 10.3% after OLM. Disc height did not change after PELD, but significantly decreased after OLM (p = 0.0001). Neither sagittal rotation angle nor volume of multifidus muscle changed significantly in both groups. Conclusion : Both PELD and repeated OLM showed favorable outcomes for recurrent disc herniation, but PELD had advantages in terms of shorter operating time, hospital stay, and disc height preservation.

• Journal of Preventive Medicine and Public Health
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• 제29권3호
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• pp.565-577
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• 1996

This study was conducted to evaluate the association of work posture with cervical spine abnormality toward 106 microwave-oven assemblers. A self-administered questionnaire was used to obtain a general characteristics and a work history of workers. The posture of neck and shoulder joint of workers were measured with video tape recording and the simple X-ray of cervical spine was checked-up to observe the X-ray abnormality including degenerative change, curvature abnormality, disc space narrowing or disc canal narrowing. The result were as follows. 1. The prevalence of degenerative change among cervicobrachial disorder workers was 44.3% (47 persons), curvature abnormality was 43.4%(46 persons), disc space narrowing was 21.7%(23 persons), and disc canal narrowing was 21.7%(23 persons). 2. The prevalence of degenerative change at cervical spine was increased with the degree of neck flexion(flexed versus neutral, odds ratio [OR]=2.7), the total work posture of neck(mild or severe awkward versus neutral ; OR=1.2, 3.4). 3. The prevalence of degenerative change at cervical spine was increased with the degree of the right shoulder flexion, the heaviness of the materials carried by the right hand and the degree of awkwardness at the total work posture of right shoulder(p<0.05). 4. There was no evidence of association between curvature abnormality, disc space narrowing, disc canal narrowing and work posture. In conclusion the awkward work posture was related with degenerative change of cervical spine among microwave oven assembling workers and the further study in these field must be made to prove the association objectively.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.287-291
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• 2016

Objective : Because elderly patients are undergoing more surgeries, the importance of postoperative cognitive impairment (CI) evaluations is rising, especially for spine surgery, which is related to subjective pain. We investigated the prevalence of undiagnosed CI among elderly patients who underwent spine surgery and the impact of CI on postoperative outcomes. Methods : The preoperative cognitive statuses of 129 patients over 65 who underwent lumbar spine surgery from 2012 to 2014 were determined with the Mini-Mental State Examination, and patients with scores under 24 were diagnosed with CI. The patients were then divided into a CI group (n=49) and non-cognitive impairment (NCI) group (n=80). Results : Among the 129 patients, 49 (38.0%) were diagnosed with CI, and 9 (7.0%) had severe CI. The age of the CI group ($72.88{\pm}6.20years$) was significantly greater than that of the NCI group ($69.96{\pm}4.53years$). In contrast, the postoperative visual analog scale scores and performance statuses did not differ significantly. However, postoperative delirium was more frequent and the hospital stay length was longer in the CI group compared with the NCI group (p<0.05). Conclusion : A high prevalence of undiagnosed CI was discovered among elderly patients undergoing spine surgery. The existence of CI was associated with higher rates of postoperative delirium and prolonged hospital stays, which affected clinical outcomes. Thus, CI assessments should be included in preoperative evaluations of elderly patients prior to spine surgery.

• Journal of Acupuncture Research
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• 제25권1호
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• pp.131-138
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• 2008

Objectives : Spine decompression therapy has recently become a popular academic field as it has proven to be a great alternative to the limitations of Western medical treatment. However, little study examined spine decompression therapy for lumbago. Thus, this study aimed to investigate the sense of improvement and satisfaction from the lumbago patients reported after being treated with spine decompression therapy. Methods : A total of 80 subjects that consists of lumbago patients were participated in this study. The experimental group(50 subjects) was treated with spine decompression therapy and acupuncture, and the control group(30 subjects) was treated with acupuncture. All the subjects were asked to complete the VAS(visual analogue scale) and ODI(Oswestry disability index) before and after the treatment. Results : A comparison of VAS and ODI results of the two groups shows that the spine decompression and acupuncture treatment group reported more effective relief from lumbago than the acupuncture treatment group.

• The Journal of Korean Physical Therapy
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• 제13권1호
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• pp.97-105
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• 2001

본 연구는 2000년 7월 14일부터 8월 24일까지 대구광역시에 소재한 가톨릭병원 건강검진센타에서 골다공증 검사를 시행한 여성 36명을 대상으로 폐경후 여성의 골밀도차이를 비교하기 위해 실시하였다. 연령의 증가에 따라 요추부의 평균골밀도는 감소되었고, 신장이 증가할수록, 교육수준이 높을수록 평균골밀도는 증가했으며, 독신(이혼, 사별, 별거), 활동적인 직업 , 요통이 없다, 육류의 항목에서 평균골밀도는 각각 증가했지만 유의한 차이는 없었다. 골밀도의 표준편차인 T 값은 -2.5이하의 골다공증군이 41.7%로 가장 많았고, 골밀도 (BMD)는 평균 0.77g/c$m^2$로 나타났다. 가족중 골절시 연령이 증가할수록, 운동횟수, 운동시간이 증가할수록, 분만횟수가 증가할수록, 각각 골밀도는 높게 나타났지만 유의한 차이는 없었다. 자궁 절제술은 안했다가, 혈액형은 A형의 항목에서 골밀도는 높게 나타났지만 유의한 차이는 없었다. 폐경후 골밀도에 영향을 미치는 관련성이 있는 요인은 골밀도의 표준편차인 T 값이다(p<0.05). 본 연구는 폐경후 적성의 골밀도 관련요인에 대한 많은 변수를 고려한 전향적인 연구가 필요할 것으로 사료된다.

• 한국운동역학회지
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• 제23권4호
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• pp.369-376
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• 2013

The purposes of this study were to assess dynamic stability toward pelvis-spine column distortion during running and to compare the typical three-dimensional angular kinematics of the trunk motion; cervical, thoracic, lumbar segment spine and the pelvis from the multi-segmental spine model between exercise group and non-exercise group. Subjects were recruited as exercise healthy women on regular basis (group A, n=10) and non-exercise idiopathic scoliosis women (group B, n=10). Data was collected by using a vicon motion capture system (MX-T40, UK). The pelvis, spine segments column and lower limbs analysiaed through the 3D kinematic angular ROM pattern. There were significant differences in the time-space variables, the rotation motion of knee joint in lower limbs and the pelvis variables; obliquity in side bending, inter/outer rotation in twisting during running leg movement. There were significant differences in the spinal column that is lower-lumbar, upper-lumbar, upper-thoracic, mid-upper thoracic, mid-lower thoracic, lower thoracic and cervical spine at inclination, lateral bending and twist rotation between group A and group B (<.05, <.01 and <.001). As a results, group B had more restrictive motion than group A in the spinal column and leg movement behaved like a 'shock absorber". And the number of asymmetry index (AI) showed that group B was much lager unbalance than group A. In conclusion, non-exercise group was known to much more influence the dynamic stability of equilibrium for bilateral balance. These finding suggested that dynamic stability aimed at increasing balance of the trunk ROM must involve methods and strategies intended to reduce left/right asymmetry and the exercise injury.

• 척추신경추나의학회지
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• 제10권1호
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• pp.107-116
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• 2015

Objectives : The purpose of these clinical cases is to evaluate the effectiveness of Korean medical therapy on neck pain with cervical syringomyelia Methods : These are case reports on 2 patients admitted to Daejeon jaseng Hospital of Korean Medicine with neck pain and diagnosis of cervical syringomyelia by Cervical spine Magnetic Resonance Imaging, were observed during hospitalization. They were analyzed according to pain and Cervical spine Range of Motion. All patients received a combination of treatments including Acupunture, Chuna, Pharmacopunture, Herbal medication. Pain scales(Number Rating Scale, Neck Disability Index) and Cervical spine Range of Motion were used during hospitalization. Results : After 3 weeks for these patients, Cervical spine Number Rating Scales decreased from 7 to 3 and from 9 to 4 respectively. And Trapezius muscle Number Rating Scales decreased from 7 to 3 and from 2 to 1 respectively. Also Cervical spine Range of Motion improved to the normal. Conclusions : Korean medical therapy might be effective in reducing pain and improving range of motion for patients with neck pain. And we hope this study further confirmed the effectiveness of Korean medical therapy on neck pain with cervical syringomyelia.

• Journal of Korean Neurosurgical Society
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• 제54권1호
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• pp.34-37
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• 2013

Objective : The purposes of this study were to evaluate the prevalence, types, and locations of Modic changes (MCs) in the thoracic spine in a large number of subjects, and to investigate the relation between the distributions of MCs and disc herniations (DHs) in the thoracic spine. Methods : Two experienced musculoskeletal radiologists assessed the presence of MCs and DHs by consensus in the thoracic MRIs of 144 patients with non-specific back pain. Patient ages ranged from 22 to 88 years (mean=$53.3{\pm}14.66$ years), and 72 were female (50%). The prevalence, distribution, relation of MCs and DHs was recorded. Results : MC was observed in 8 of the 144 patients (5.6%) and 10 of 1728 segments (0.58%). The most common MC was type II. Of the 8 patients exhibiting MC, 6 had type II (75.0%), and 2 had mixed MCs (type I/II or type II/III). MCs were distributed mainly at the mid-thoracic level (from T5/6 to T9/10). DH was detected in 18 patients (12.5%), 36 of 1728 segments (2.1%). Of the 10 segments exhibiting MC, 5 had DHs at the same level (50.0%). Accordingly, DH was strongly associated with MC (p=0.000). Conclusion : A low prevalence of MC was observed in the thoracic spine, and type II MC predominated. The low prevalence of MC in the thoracic spine suggests that it was caused by a relative lack of mobility as compared with the cervical and lumbar spines. And DHs were found to be strongly associated with MCs even in the thoracic spine.

• Journal of Korean Neurosurgical Society
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• 제56권4호
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• pp.310-314
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• 2014

Objective : To analyze the clinical courses and outcomes after anterior lumbar interbody fusion (ALIF) for the treatment of postoperative spondylodiscitis. Methods : A total of 13 consecutive patients with postoperative spondylodiscitis treated with ALIF at our institute from January, 1994 to August, 2013 were included (92.3% male, mean age 54.5 years old). The outcome data including inflammatory markers (leukocyte count, C-reactive protein, erythrocyte sedimentation rate), the Oswestry Disability Index (ODI), the modified Visual Analogue Scale (VAS), and bony fusion rate using spine X-ray were obtained before and 6 months after ALIF. Results : All of the cases were effectively treated with combination of systemic antibiotics and ALIF with normalization of the inflammatory markers. The mean VAS for back and leg pain before ALIF was $6.8{\pm}1.1$, which improved to $3.2{\pm}2.2$ at 6 months after ALIF. The mean ODI score before ALIF was $70.0{\pm}14.8$, which improved to $34.2{\pm}27.0$ at 6 months after ALIF. Successful bony fusion rate was 84.6% (11/13) and the remaining two patients were also asymptomatic. Conclusion : Our results suggest that ALIF is an effective treatment option for postoperative spondylodiscitis.

• 척추신경추나의학회지
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• 제1권2호
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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.