• Physical Therapy Rehabilitation Science
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• 제5권1호
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• pp.22-28
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• 2016

Objective: The Back Mapper is one type of Rasterstereography and it can be used in the clinic without radiation exposure. The purpose of our study was to prove the reliability and validity of the Back Mapper and to compare it with the Spinal Mouse, which is an assessment tool for spinal curvatures using a wheeled mouse, and the Cobb angle by X-ray. Design: Cross-sectional study. Methods: Twenty healthy adults participated in the test to investigate for the inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with assessment devices for scoliosis such as the Back Mapper, Spinal Mouse and Cobb's angle. Data was analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement for reliability and correlation analysis for validity. Results: Intra-rater reliability of the Back Mapper was good (Cronbach's ${\alpha}$=0.821-0.984, ICC=0.696-0.969) except for assessing the lordotic angle. Inter-rater reliability was good (Cronbach's ${\alpha}$=0.870-0.958, ICC=0.770-0.919) in assessment for trunk imbalance, rotation of scapulae, thoracic angle, lumbar angle, and kyphotic angle. The kyphotic angle in the Spinal Mouse had a significant correlation icompared with the Back Mapper (r=0.510, p<0.05), and the Cobb's angle from an X-ray had a significant correlation with trunk inclination (r=0.532, p<0.05). Conclusions: These findings provide good intra-reliability of the Back Mapper in healthy subjects, but the Back Mapper requires more experienced practice to have good inter-reliability. Also, the variables of the Back Mapper does not seem as appropriate compared with the Cobb angle by X-ray.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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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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• 제47권4호
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• pp.278-281
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• 2010

Objective : For the treatment of osteoporotic vertebral compression fracture, percutaneous vertebroplasty (PVP) is currently widely used as an effective and relatively safe procedure. However, some patients do not experience pain relief after PVP. We performed several additional PVP procedures in those patients who did not have any improvement of pain after their initial PVP and we obtained good results. Our purpose is to demonstrate the effective results of an additional PVP procedure at the same previously treated level. Methods : We reviewed the medical records and the radiologic data of the PVP procedures that were performed at our hospital from November 2005 to May 2008 to determine the patients who had undergone additional PVP. We identified ten patients and we measured the clinical outcomes according to the visual analogue scale (VAS) score and the radiologic parameters, including the anterior body height and the kyphotic angulation. Results : The mean volume of polymethylmethacrylate injected into each vertebrae was 4.3 mL (range: 2-8 mL). The mean VAS score was reduced from 8 to 2.32. The anterior body height was increased from 1.7 cm to 2.32 cm. The kyphotic angulation was restored from 10.14 degrees to 2.32 degrees. There were no complications noted. Conclusion : The clinical and radiologic outcomes suggest that additional PVP is effective for relieving pain and restoring the vertebral body in patients who have unrelieved pain after their initial PVP. Our study demonstrates that additional PVP performed at the previously-treated vertebral levels could provide therapeutic benefit.

• Journal of Korean Neurosurgical Society
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• 제45권6호
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• pp.369-374
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• 2009

Objective : Percutaneous vertebroplasty (VP) can provide immediate stabilization in pathologic fractures of spinal tumors. However, long term follow-up data in cases of pathologic fractures are lacking. The authors report follow-up results of VP in 185 pathologic fractures of 102 spinal tumor patients. Methods : Percutaneous VP was performed at 185 vertebral bodies of 102 patients from 2001 to 2007. Retrospective analysis was done with medical records and radiological data. The change of visual analogue score (VAS), vertebral body (VB) height and kyphotic angle were measured preoperatively and on postoperative one day and at 3, 6, and 12 months. Results : The patients were composed of metastatic spine tumors (81%) and multiple myeloma (19%). Involved spinal segments were between T6 and L5. Mean follow-up period was 12.2 months. VAS for back pain was 8.24 preoperatively, 3.59 (postoperative one day), 4.08 (three months) and 5.22 (one year). VB compression ratio changed from 21.33% preoperatively to 13.82% (postoperative one day), 14.36% (three month), and 16.04% (one year). Kyphotic angle changed from $15.35^{\circ}$ preoperatively to $12.03^{\circ}$ (postoperative one day), $13.64^{\circ}$ (three month), and $15.61^{\circ}$ (one year). Conclusion : Immediate pain relief was definite after VP in pathologic compression fracture of osteolytic spinal disease. Although VAS was slightly increased on one year follow-up, VP effect was maintained without significant change. These results indicate that VP could be a safe and effective procedure as a palliative treatment of the spinal tumor patients.

• 한국어병학회지
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• 제34권1호
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• pp.117-121
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• 2021

An ayu (Plecoglossus altivelis) farm in Korea recently experienced an epidemic of vertebral column deformities where about 90% of fry displayed a vertebral column that was grossly opaque along either the cranial part of the column or its entire length. Abnormal fish were lordotic, scoliotic and/or kyphotic about midway down the spine. Examination of serial sections of whole fish showed only histological lesions in the vertebral column and suggested some disturbance in the early development of the vertebral centrum. Such abnormalities included a frayed spinal or notochord sheaths with irregular thickening and compression, mal-absorbed notochord cells, thickening of around cell layer and hypercellularity on both facets of the notochord sheath. No parasites, fungi, or bacteria were detected. While this lesion has only been reported once in the past, this is the first report of histopathological findings.

• 대한정형외과학회지
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• 제56권3호
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• pp.208-214
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• 2021

목적: 급성 골다공증성 요추 골절 환자에서 척추 변형의 진행을 예측할 수 있는 여러 인자들 중 척추의 자기공명영상 촬영에서 척추 주변 근육의 정량적 분석을 통해 척추 기립근 및 다열근의 감소와 후만각의 변형의 상관관계를 알아보고자 한다. 대상 및 방법: 이 연구는 2007년 1월부터 2018년 3월까지 단일 분절의 급성 요추 골절로 진단되어 보존적 치료 중인 환자를 대상으로 하였다. 다열근 및 척추 기립근의 감소는 지방으로 변성된 비율을 통해 확인하였고 이는 진단 당시 촬영한 요추 자기공명영상 촬영을 사용하여 측정되었으며, 지방으로 변성된 비율은 총 지방 침윤율로 정의하였다. 1년 추적 관찰에서 요추의 측면 방사선 사진에 기초하여 추체 압박률, 콥스각 및 쐐기각을 측정하였다. 피어슨 상관 계수를 분석하여 통계적 유의성을 확인하였다. 결과: 연구 대상은 129명으로 30명은 남자, 99명은 여자를 대상으로 하였다. 평균 연령은 71.28±9.55세, 평균 BMD 점수는 -3.53±0.79 g/cm², 평균 지방 침윤율은 15.20%±11.99%였다. 지방침투율은 수상 당시 나이(R=0.373, p<0.001)와 양의 상관 관계가 있었지만, BMD 점수(R=-0.252, p=0.004)와는 음의 상관 관계를 보였다. 1년 후 추적관찰하여 확인한 결과에서 지방 침윤율은 추체 압박률(R=0.369, p<0.001) 및 콥스각(R=0.386, p<0.001)과 양의 상관 관계를 보였다. 요추 골절이 아래 분절로 내려 갈수록 추체 압박률(R=-0.191, p=0.030) 및 후만각(R=-0.428, p<0.001)은 감소하는 경향이 있었다. 결론: 급성 골다공증 요추 골절 환자에서 지방 침윤율은 보존적 치료를 위한 중요한 예측 인자가 될 수 있다. 지방 침윤율이 높은 환자의 예후는 환자 교육 과정에서 설명을 해야 하며 단기 외래 환자 후속 조치를 통해 환자를 면밀한 모니터링이 필요하다.

• Journal of Korean Neurosurgical Society
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• 제46권6호
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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.

• 한방재활의학과학회지
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• 제23권4호
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• pp.195-202
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• 2013

Objectives This study was designed to investigate the correlation between the forward head posture and the spinal alignment. Methods We examined the whole spine x-rays of the 144 student sample. We measured the Craniovertebral angle (CVA), Cervical angle (CA), Thoracic kyphotic angle (TKA), lumbar lordosis angle (LLA) and Ferguson's angle (FA) of the students. We then analyzed the relationship between these angles. Results CVA had correlation with CA, but it was weak. There was significant correlation between CVA and TKA. There were no significant correlation among CVA, LLA and FA. Conclusions According to above results, there is a negative relationship between the CVA and the TKA - in that higher CVAs yielded lower TKAs. But CVA had no significant correlation with LLA or FA.

• 한국산학기술학회논문지
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• 제20권12호
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• pp.224-229
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• 2019

본 연구는 고등학교 야구선수를 대상으로 신체정렬과 족저압 분포 분석하여 올바른 자세지도와 스포츠 손상 및 부상 예방 프로그램에 참고 자료를 제공하는데 그 목적이 있다. 연구 대상자 32명을 대상으로 실시하였다. 신체정렬은 척추에서 몸통의 좌우기울기, 등뼈의 뒤굽음각, 허리뼈의 앞굽음각, 골반에서는 골반의 기울기, 골반의 뒤틀림을 측정하였고 족저압은 각 발의 좌우 체중분포, 각 발의 최대압력을 측정하였다. 측정항목에 대한 평균과 표준편차를 산출하여 도표화하였고, 신체정렬과 족저압 분포의 상관관계를 알아보기 위해 pearson's cerrelation analysis를 사용하여 분석하였다. 모든 통계학적 유의 수준은 0.05로 설정하였다. 신체정렬과 족저압 분포 간의 상관관계를 분석한 결과 척추에서 허리뼈의 앞굽음각과 좌우 최대압력에서 양의 상관관계가 나타났다. 몸통의 좌우기울기, 등뼈의 뒤굽음각, 골반의 기울기, 골반의 뒤틀림과 각 발의 좌우 체중분포, 각 발의 최대압력에서는 상관관계가 나타나지 않았다. 본 연구를 통해 허리뼈의 앞굽음각이 증가될수록 발의 한쪽에 힘이 더 실리게 되어 최대압력이 증가하는 양의 상관관계를 나타내는 것을 알 수 있었다. 향후 운동선수들의 신체정렬과 족저압 분포에 대한 운동프로그램의 참고 자료가 될 것으로 사료된다.

• 한국산학기술학회논문지
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• 제15권2호
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• pp.962-969
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• 2014

본 연구는 한국의 건강한 청소년을 대상으로 Rasterstereography를 이용하여 성별에 따른 척추-골반 정렬 패턴을 분석하여 특성을 확인하고, 각 변수의 상관관계를 확인하기 위하여 수행하였다. 2013년 5월부터 10월까지 정상 청소년 61명(남 31명, 여 30명)을 대상으로 실시하였고, 평균 나이는 $16.40{\pm}2.20$세였다. 그 결과 PSIS비율이 남자 $21.15{\pm}2.40$%, 여자 $23.41{\pm}3.28$%로 유의한 차이가 있었으며(p<.01), 요추전만각에서 남자 $33.44{\pm}8.46^{\circ}$, 여자 $38.96{\pm}8.11^{\circ}$로 유의한 차이가 있었으나(p<0.01), 그 외의 변수에서 성별에 따른 유의한 차이는 없었다(p>.05). 요추전만각은 골반기울기(r=.348), 흉추후만각(r=.609)과 유의한 상관관계가 있었다. 척추회전각은 흉추후만각(r=-.278), 요추전만각(r=-.256), 척추옆치우침(r=.493)과 유의한 상관관계를 보였다. 본 연구 결과는 한국 청소년의 성별에 따른 Rasterstereography를 이용한 척추-골반 정렬 분석의 기초자료가 될 것이고, 척추 및 골반에 구조적 질환을 가진 청소년과 비교할 수 있는 자료로 활용할 수 있을 것이다.