• 척추신경추나의학회지
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• 제6권1호
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• pp.53-61
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• 2011

Objective: The purpose of this study is to evaluate the disc block subluxation for lumbar scoliosis and herniation of nucleus pulpous (HNP). Methods: We used AP & Lateral view X-ray for patients. And we measured of disc wedge angle, vertebral body rotation to evaluate the typical and atypical disc block subluxation. Results: On the analysis of the lateral view X-ray, 4th lumbar intervertebral disc angle (I.V.D angle) showed $4^{\circ}$, $5^{\circ}$, $3^{\circ}$, $0^{\circ}$ in the cases. On the 4th lumbar analysis of the AP view X-ray, lumbar scoliosis showed right disc wedge angle was $11^{\circ}$ (case 1), $17^{\circ}$ (case 2) and left vertebral body rotation was 13mm, 6mm. Lumbar HNP showed left disc wedge angle was $5^{\circ}$ (case 3), $4^{\circ}$ (case 4) and left vertebral body rotation was 2mm, 4mm. Conclusions: Disc block subluxation has been in lumbar scoliosis, but not been in lumbar HNP.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2005년도 춘계학술대회 논문집
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• pp.907-910
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• 2005

Although several artificial disc designs have been developed for the treatment of discogenic low back pain, biomechanical change with its implantation was rarely studied. To evaluate the effect of artificial disc implantation on the biomechanics of functional spinal unit, nonlinear three-dimensional finite element model of L4-L5 was developed with 1-mm CT scan data. Two models implanted with artificial discs, SB $Charit\acute{e}$ or Prodisc, via anterior approach were also developed. The implanted model predictions were compared with that of intact model. Angular motion of vertebral body, force on spinal ligaments and facet joint, and the stress distribution of vertebral endplate for flexion-extension, lateral bending, and axial rotation with a compressive preload of 400 N were compared. The implanted model showed increased flexion-extension range of motion and increased force in the vertically oriented ligaments, such as ligamentum flavum, supraspinous ligament and interspinous ligament. The increase of facet contact force on extension were greater in implanted models. The incresed stress distribution on vertebral endplate for implanted cases indicated that additinal bone growth around vertebral body and this is matched well with clinical observation. With axial rotation moment, relatively less axial rotation were observed in SB $Charit\acute{e}$ model than in ProDisc model.

• 한국정밀공학회지
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• 제23권4호
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• pp.176-182
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• 2006

Although several artificial disc designs have been developed for the treatment of discogenic low back pain, biomechanical changes with its implantation were rarely studied. To evaluate the effect of artificial disc implantation on the biomechanics of functional spinal unit, a nonlinear three-dimensional finite element model of L4-L5 was developed with 1-mm CT scan data. Biomechanical analysis was performed for two different types of artificial disc having constrained and unconstrained instant center of rotation(ICR), ProDisc and SB Charite III model. The implanted model predictions were compared with that of intact model. Angular motion of vertebral body, forces on the spinal ligaments and facet joint, and stress distribution of vertebral endplate for flexion-extension, lateral bending, and axial rotation with a compressive preload of 400N were compared. The implanted model showed increased flexion-extension range of motion compared to that of intact model. Under 6Nm moment, the range of motion were 140%, 170% and 200% of intact in SB Charite III model and 133%, 137%, and 138% in ProDisc model. The increased stress distribution on vertebral endplate for implanted cases could be able to explain the heterotopic ossification around vertebral body in clinical observation. As a result of this study, it is obvious that implanted segment with artificial disc suffers from increased motion and stress that can result in accelerated degenerated change of surrounding structure. Unconstrained ICR model showed increased in motion but less stress in the implanted segment than constrained model.

• 한국정밀공학회지
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• 제23권3호
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• pp.187-194
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• 2006

Unexpected postoperative changes, such as growth in rib hump and shoulder unbalance, have been occasionally reported after corrective surgery for scoliosis. However there has been neither experimental data fer explanation of these changes, nor the suggestion of optimal correction method. Therefore, the numerical study was designed to investigate the post-operative changes of vertebral rotation and rib cage deformation after the corrective surgery of scoliosis. A mathematical finite element model of normal spine including rib cage, sternum, both clavicles, and pelvis was developed with anatomical details. In this study, we also developed a special program which could convert a normal spine model to a desired scoliotic spine model automatically. A personalized skeletal deformity of scoliosis model was reconstructed with X-ray images of a scoliosis patient from the normal spine structures and rib cage model. The geometric mapping was performed by translating and rotating the spinal column with an amount analyzed from the digitized 12 built-in coordinate axes in each vertebral image. By utilizing this program, problems generated in mapping procedure such as facet joint overlapping, vertebral body deformity could be automatically resolved.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2004년도 추계학술대회 논문집
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• pp.1154-1159
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• 2004

Unexpected postoperative changes, such as growth in rib hump, has been occasionally reported after corrective surgery for scoliosis. However there has been experimental data for explanation of these changes, nor the suggestion of optimal correction method. This numerical study was designed to investigate the main correlating elements in operative kinematics with post-operative changes of vertebral rotation and rib cage deformation in the corrective surgery of scoliosis. To develop a scoliotic spine model automatically, a special program for converting normal spine model to scoliotic spine model was developed. A mathematical finite element model of normal spine including rib cage, sternum, both clavicles, and pelvis was developed with anatomical details. The skeletal deformity of scoliosis was reconstructed, by mapping the X-ray images of a scoliosis into this three dimensional normal spine and rib cage model. The geometric mapping was performed by translating and rotating the spinal colume with the amount analyzed from the digitized 12 built-in coordinate axes in each vertebral image. By utilizing this program, problems generated in mapping procedure such as facet joint overlapping, vertebral body deformity could be automatically resolved.

• Clinics in Shoulder and Elbow
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• 제18권1호
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• pp.13-20
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• 2015

Background: The purpose of this study is to assess the range of shoulder motion using an indirect evaluation method without physical examinations of patients based on questionnaires regarding several specific arm postures referenced by patient's own body parts. Methods: Nine criteria of specific shoulder motion including 4 forward flexion, 2 external rotation, and 3 internal rotation were decided as reference position which can represent a certain shoulder motion. Flexion contains postures such as lifting arm to waist-height, shoulder-height, eye-height, and raising arm above head with arm touching ears. External rotation comprises grasping ears and placing hands on back of the head. Vertebral height in internal rotation is determined by calculating the samples' motions, which are holding on to trouser belts, opposite-elbow, and scapula. These postures are included in questionnaires for patients to evaluate the validity and effectiveness of this indirect method. Results: The range of flexion was $77^{\circ}$ ($60^{\circ}$ to $100^{\circ}$), $96^{\circ}$ ($87^{\circ}$ to $115^{\circ}$), $135^{\circ}$ ($115^{\circ}$ to $150^{\circ}$), and $167^{\circ}$ ($150^{\circ}$ to $175^{\circ}$) when arms go up to waist, shoulder, eye, and high vertically. Range of external rotation was $39.6^{\circ}$ ($30^{\circ}$ to $50^{\circ}$) when grasping ears and $69.2^{\circ}$ ($60^{\circ}$ to $80^{\circ}$) with the hands on the back of the head. Range of internal rotation was L4 when placing trouser belts, T12 for holding opposite elbow, and T9 for reaching scapula. The mismatch rates of flexion, external rotation, and internal rotation were 11.6%, 9.6%, and 7.8%. Conclusions: The range of shoulder motion using this method is expected to be applied to an established shoulder scoring system which included shoulder motion evaluation item.

• 척추신경추나의학회지
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• 제18권2호
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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 Acupuncture Research
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• 제17권2호
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• pp.41-51
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• 2000

Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

• 한국정밀공학회지
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• 제24권8호통권197호
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• pp.122-129
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• 2007

To evaluate the effect of artificial disc implantation and fusion on the biomechanics of adjacent motion segment, a nonlinear three-dimensional finite element model of whole lumbar spine (L1-S1) was developed. Biomechanical analysis was performed for two different types of artificial disc, ProDisc and SB $Charit{\acute{e}}$ III model, inserted at L4-L5 level and these results were also compared with fusion case. Angular motion of vertebral body, forces on the spinal ligaments and facet joint under sagittal plane loading with a compressive preload of 150 N at a nonlinear three-dimensional finite element model of Ll-S1 were compared. The implant did not significantly alter the kinematics of the motion segment adjacent to the instrumented level. However, $Charit{\acute{e}}$ III model tend to decrease its motion on the adjacent levels, especially in extension motion. Contrast to motion and ligament force changes, facet contact forces were increased in the adjacent levels as well as implanted level for constrained instantaneous center of rotation model, i.e. ProDisc model.

• 대한추나의학회지
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• 제2권1호
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• pp.121-132
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• 2001

Objectives The present study retrospectively investigated clinical outcome of patients with structual scoliosis during Chuna treatment. Methods : The study population consisted of 34 patients(14 patients of adolescent and 20 patients of adult) who were diagnosised as scoliosis with radiological finding. All patients were treated with Chuna treatment, and after treatment, evaluated with radiological measurement by calculating the scoliosis correction angle from the Initial and follow-up spine AP and lateral views. Also the evaluation of clinical outcome was done twice pre and post treatment during this study. Results : The results were summarized as follows ; 1) The 85.3 percent of patients complained physical pain. and adult group had various painful lesion compared with adolescent group. 2) Adult group had treated $18.0{\pm}7.2$ times and adolescent group treated $13.5{\pm}5.7$ times with Chuna treatment. 3) Scoliotic angle is reduced in 92.9 percent of adolescent group and had all of adult group after Chuna treatment, especially, statistically significance appeared in adult group. 4) Adult group was superior to adolescent group in correctability and scoliotic angle change. 5) Correction effect was better in the group which initial scoliotic angle was lessor, or had more time of treatment. 6) According to grade of vertebral body rotation, scoliotic angle is larger and correctability was lower. Conclusions : Chuna treatment was efficacious against scoliosis. And it is necessary for adolescent scoliosis patient to be more carefully treated and observed.