• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.9
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• pp.347-355
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• 2017

The purpose of this study was to investigate the effects of pelvic adjustment on low back pain and spino-pelvic parameters in middle-aged women. Thirty-eight middle-aged women with chronic low back pain were randomly assigned to the pelvic adjustment (n = 20) oruntreated control (n = 18) group. Pelvic adjustment interventionswereperformed four times a week for 8 weeksin the former group. At baseline and after 8 weeks, the back pain and back function were evaluated using the visual analogue scale (VAS), Oswestry disability index (ODI), and back flexibility. Additionally, the spino-pelvic radiographic parameters and serum C-reactive protein (CRP) levels were assessed. After 8 weeks, the VAS, ODI, and back flexibility significantly improved in the pelvic adjustment group compared with the control group. It was found that the changes from baseline in the lumbar lordotic angle, sacral slope, pelvic crest unleveling, and femoral head height inequality were significantly greater in the pelvic adjustment group than in the control group. There were no significant changes in the pelvic incidence or serum CRP levels in either group. In conclusion, pelvic adjustment has beneficial effects on chronic low back pain and back function, suggesting that the effects of pelvic adjustment on back pain may at least in part result from changes in the spino-pelvic alignment.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.5
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• pp.346-356
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• 2018

Overweight and abdominal obesity caused by sedentary lifestyle may induce deconditioned and atrophied extensor musculature of the lumbar spine and be a potential risk factor for low back pain (LBP). Therefore, this study was conducted to evaluate the validity of high intensity circuit training (HICT) on weight loss and subsequent alleviation of spine curvature (SC) and visual analog scale (VAS) among middle aged men with abdominal obesity. The training program (1 exercise session for 30 minutes, three times a week for 12 weeks) consisted of 12 different functional exercises based on core strengthening multiple joint circuit training. Portions of the obesity index related to body composition were positively changed, which improved the angles of thoracic kyposis and lumbar lordosis, which appeared to effectively reduce lower back pain. Taken together, HICT specifically designed for LBP effectively decreased obesity related body composition and was superior to other treatments for decreasing aggravation of the spine curvature and LBP caused by abdominal obesity; however, weight loss should be the primary treatment target for LBP patients.

• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.78-86
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• 2000

Objective : Lumbar spinal instability occurs when normal biomechanics support in lumbar vertebrae interrupted. Despite the recent enthusiastic studies, the precise radiological assessment has not been fully established, yet. Therefore, we carefully studied our cases to analyze the radiologic findings in lumbar spinal instability. Patients and Methods : We have put together radiological analysis and assessment based on 38 patients who have been diagnosed and treated for lumbar spinal instabilities from June 1994 to December 1998, Patients who have been diagnosed and treated for trauma were excluded from study. Results : The outcomes are as follows : 1) Lumbar lordotic curve was statistically significant in unstable group by 23.7, compared to the control group ($17.0^{\circ}$). 2) According to the resting x-ray, sagittal plane angulation measured on unstable group was $21.1^{\circ}$, control group $18.0^{\circ}$. Therefore unstable group was noticeably higher(p<0.01). 3) According to the resting x-ray sagittal plane displacement, unstable group had 4.3mm, the comparison had 1.2mm. Therefore measurement from the unstable group were significantly higher(p<0.01). 4) According to stress view, sagittal plane translation was 4.1mm for the unstables and 2.7mm for the comparisons. Therefore unstables were noticeably higher(p<0.01). 5) According to stress view, sagittal plane rotation was $15.1^{\circ}$ at L3-4, $22.0^{\circ}$ at L4-5, $27.9^{\circ}$ at L5S1 for the unstable group and $11.3^{\circ}$, $18.1^{\circ}$, $21.0^{\circ}$ each for the comparison. 6) Facet angle for unstable group, left $29.3^{\circ}-61.5^{\circ}$, right $24.4^{\circ}-63.2^{\circ}$ and the mean for each are $43.1^{\circ}$, $47.2^{\circ}$. The difference between left and right facet angle was $3.5^{\circ}-20.7^{\circ}$ and the mean value $15.3^{\circ}$. Facet angle for the comparisons for the left was $29.3^{\circ}-59.5^{\circ}$, right was in between $25.7^{\circ}-64.5^{\circ}$ range and the each mean are $44.9^{\circ}$ and $47.6^{\circ}$. Also, the difference between left and right facet angle was $4.1^{\circ}-9.3^{\circ}$ and the average was $17.1^{\circ}$. The average and the difference between the left and right angle are found not to have statistic necessity for both unstable and stable measurements(p>0.01). 7) 19 patients were found to have vacuum facet phenomenon among unstable group etc. results were collected. Conclusion : According to above results, we attempted to prepare the application to the patient of radiological analysis and assessment for lumbar spinal instability early checkup.

• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.575-584
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• 2021

Objective : Cervical expansive laminoplasty is an effective surgical method to address multilevel cervical spinal stenosis. During surgery, the spinous processes of C2 and C7 are usually preserved to keep the insertion points of the cervical musculature and nuchal ligament intact. In this regard, dome-like laminectomy (undercutting of C7 lamina) instead of laminoplasty is performed on C7 in selected cases. However, resection of the lamina can weaken the C7 lamina, and stress fractures may occur, but this complication has not been characterized in the literature. The objective of the present study was to investigate the incidence and risk factors for C7 laminar fracture after C7 dome-like laminectomy and its impact on clinical and radiological outcomes. Methods : Patients who underwent cervical open-door laminoplasty combined with C7 dome-like laminectomy (n=123) were classified according to the presence of C7 laminar fracture. Clinical parameters (neck/arm pain score and neck disability index) and radiologic parameters (C2-7 angle, C2-7 sagittal vertical axis, and C7-T1 angle) were compared between the groups preoperatively and at postoperatively at 3, 6, 12, and 24 months. Risk factors for complications were evaluated, and a formula estimating C7 fracture risk was suggested. Results : C7 lamina fracture occurred in 32/123 (26%) patients and occurred at the bilateral isthmus in 29 patients and at the spinolaminar junction in three patients. All fractures appeared on X-ray within 3 months postoperatively, but patients did not present any neurological deterioration. The fracture spontaneously healed in 27/32 (84%) patients at 1 year and in 29/32 (91%) at 2 years. During follow-up, clinical outcomes were not significantly different between the groups. However, patients with C7 fractures showed a more lordotic C2-7 angle and kyphotic C7-T1 angle than patients without C7 fractures. C7 fracture was significantly associated with the extent of bone removal. By incorporating significant factors, the probability of C7 laminar fracture could be assessed with the formula 'Risk score = 1.08 × depth (%) + 1.03 × length (%, of the posterior height of C7 vertebral body)', and a cut-off value of 167.9% demonstrated a sensitivity of 90.3% and a specificity of 65.1% (area under the curve, 0.81). Conclusion : C7 laminar fracture can occur after C7 dome-like laminectomy when a substantial amount of lamina is resected. Although C7 fractures may not cause deleterious clinical outcomes, they can lead to an unharmonized cervical curvature. The chance of C7 fracture should be discussed in the shared decision-making process.