• 대한정형도수물리치료학회지
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• 제27권2호
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• pp.9-15
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• 2021

Background: This study investigated the effects of sustained natural apophyseal glides (SNAGS) technique on lower back pain and pain disability among university students with lower back pain. Methods: A total thirty 20~30 year old university students with lower back pain were divided into two groups. A lumbar flexibility exercise was applied to the control group (n=15). The SNAGS technique group (n=15) received L1~L4 segment mobilization using SNAGS technique. Intervention was implemented for 20 minutes, 3 times a week for 3 weeks. The SNAGS were performed using belt with flexion and extension, whereas lumbar flexibility exercise included lumbar flexion and extension. Lower back disability was measured using the Korean Oswestry disability index (KODI), and pain sensitivity was measured by pain pressure threshold (PPT). The groups were assessed for lower back pain disability and pain, before and after the intervention. Results: There were significant improvements in both the KODI and PPT of the SNAGS technique group (p<.05), while the lumbar flexibility exercise group showed no significant change (p>.05). In addition, the SNAGS technique group had a statistically significant difference in KODI and PPT compared to the lumbar flexibility exercise group (p<.05). Conclusion: SNAGS technique is more effective than lumbar spine joint flexibility exercise in the improvement of lower back pain disability and pain among university students with lower back pain.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1055-1062
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• 2000

Objectives : Burst fracture of the lower lumbar spine(L3-L5) is rare and has some different features compare to that of thoracolumbar junction. Lower lumbar spine is flexible segments located deeply, and has physiologic lordosis. All of these contribute to making surgical approach difficult. Generally, lower lumbar burst fracture is managed either anteriorly or posteriorly with various fixation and fusion methods. But there is no general guideline or consensus regarding the proper approach for such lesion. We have tried to find out the influencing factors for selecting the surgical approach through the analysis of lower lumbar burst fractures treated for last 4 years(1994.3-1998.3). Method : This study includes 15 patients(male : 10, female : 5, age range 20-59 years with mean age of 36.7 years, L3 : 8 cases, L4 : 5 cases, L5 : 2 cases). Patients were classified into anterior(AO) and posterior operated(PO) groups. We investigated clinical findings, injured column, operation methods, and changes in follow-up radiologic study (kyphotic angle) to determine the considerable factors in selecting the surgical approaches. Results : There were 5 AO and 10 PO patients. Anterior operation were performed with AIF with Kaneda or Z-plate and posterior operation were done with pedicle screw fixation with PLIF with cages or posterolateral fusion. Canal compression was 46.6% in AO and 38.8% in PO. The degree of kyphotic angle correction were 10.7 degree(AO) and 8.5 degree(PO), respectively. There was no statistical difference between anterior and posterior operation group. All patients showed good surgical outcome without complications. Conclusion : Anterior operation provided good in kyphotic angle correction and firm anterior strut graft, but it difficulty arose in accessing the lesions below L4 vertebra. While posterior approach showed less correction of kyphotic angle, it required less time and provided better results for accompanied adjacent lesion and pathology such as epidural hematoma. The level of injury, canal compression, biomechanics, multiplicity, and pathology are considered to be important factors in selection of the surgical approach.

• 척추신경추나의학회지
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• 제4권2호
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• pp.109-120
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• 2009

Objectives : We already know the importance of stability and flexibility on the vertebra. It is important to keep the lumbar lordosis for stability and flexibility. We hope to reduce lower back pain and low extremity pain by changing the angle of the Lumbar Kyphosis through conservative treatment. We have evaluated the effect of conservative treatment with Saamchimbeop Pejeonggyeok by experimenting one patient suffering from Lumbar Kyphosis with lower back pain and low extremity pain. Methods : One patients were diagnosed as Lumbar Kyphosis through X-ray examination. We used conservative treatment, especially Pejeonggyeok Treatment to the patients and measured NRS((Numerical Rating Scale), rating scale for low back pain, low extremity pain and SLR(Straight Leg Raising) test and walking time in whole term of admission, and we also measured flexion, extension angle and lumbar kyphosis using lumbar x-ray lateral view after diganosing by Lumbar Kyphosis. Results and Conclusions : After treating conservative therapy, We figured out that the patient were on the mend, and we found out the angle change in flexion, extension and lumbar Kyphosis. These results suggest that Pejeonggyeok Treatment were effective to improved Lumbar Kyphosis and reduced the low back pain.

• Journal of Acupuncture Research
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• 제27권3호
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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 Korean Journal of Pain
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• 제14권2호
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• pp.271-275
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• 2001

Buerger's disease is a nonatherosclerotic occlusive inflammatory disease of the small and medium arteries, and veins of the distal leg or arm. Percutaneous lumbar sympathectomy is used to lower extremity occlusive vascular disease as well as Buerger's disease. Lumbar sympathectomy improves blood flow and provides pain relief in the lower extremity. We report two cases of lumbar sympathectomy using radiofrequency thermocoagulation in patients with Buerger's disease. After no paresthesia and muscle contracture at 50 Hz, 1 volt and 2 Hz, 3 volts, respectively, radiofrequency lesioning was performed for 90 sec at $80^{\circ}C$. After the procedure, both patients showed skin temperature increases greater than $2^{\circ}C$ on the affected extremity. Both patients received relief from pain and symptoms without complications. We consider that lumbar sympathectomy using radiofrequency thermocoagulation is a safe and effective procedure that can relieve pain in patients with Buerger's disease.

• 한국콘텐츠학회논문지
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• 제11권12호
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• pp.800-806
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• 2011

본 연구는 요추 지지대가 노인의 머리와 목 자세에 미치는 영향을 분석하고자 하였다. 20명의 신체 건강한 노인(평균 나이 71.32세)을 대상으로 측정하였으며, 앉은 자세에서 모니터를 시청하는 동안 요추만곡을 요추 지지대 사용 유무에 따라 조절하였다. 측정은 측면에서 사진을 촬영하였다. NIH ImageJ 1.32 프로그램을 사용하여 상부경추 굴곡 각도와 하부경추 굴곡 각도를 측정하였고 분석은 대응 t 검정을 사용하였다. 그 결과, 상부경추 굴곡 각도와 하부경추 굴곡 각도는 요추 지지대 적용 여부에 따라 유의한 차이가 있었다. 상부경추 평균 굴곡 각도는 요추 지지대 적용할 때가 적용하지 않을 때보다 약 $2.83^{\circ}$ 증가하였다(p<0.005). 하부경추 평균 굴곡 각도 역시 요추 지지대를 적용할 때 약 $4.44^{\circ}$ 증가되었다(p<0.0001). 이는 요추 지지대를 적용하였을 때 상부경추와 하부경추 굴곡을 증가시킴으로 머리와 목 자세에 좋은 영향을 주는 것을 의미한다. 따라서 노인의 머리와 목 자세 개선시 요추만곡 조절을 고려해야 할 것이다.

• 한국정밀공학회지
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• 제25권11호
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• pp.107-118
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• 2008

In this study, lower extremity joint kinematics and kinetics and lumbar lordosis were investigated for two different symmetrical lifting techniques(squat and stoop) using the three-dimensional motion analysis. Twenty-six male volunteers lifted boxes weighing 5, 10 and 15kg by both squat and stoop lifting techniques. There were not significant differences in maximum lumbar joint moments between the two techniques. The hip and ankle contributed the most part of the support moments during squat lifting, and the knee flexion moment played an important role in stoop lifting. The hip, ankle and lumbar joints generated power and only the khee joint absorbed power in the squat lifting. The knee and ankle joints absorbed power, the hip and lumbar joints generated power in the stoop lifting. The bi-articular antagonist muscles' co-contraction around the knee joint during the squat lifting and the eccentric co-contraction of the gastrocnemius and semitendinosus were found to be important for straightening up during the stoop lifting. At the time of lordotic curvature appearance in the squat lifting, there were significant correlations in all three lower extremity joint moments with the lumbar joint. Differently, only the hip moment had significant correlation with the lumbar joint in the stoop lifting. In conclusion, the knee extension which is prominent kinematics during the squat tilling was produced by the contributions of the kinetic factors from the hip and ankle joints(extensor moment and power generation) and the lumbar extension which is prominent kinematics during the stoop lifting could be produced by the contributions of the knee joint kinetic factors(flexor moment, power absorption, bi-articular muscle function).

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.25-31
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• 2010

Purpose: The purpose of this study is to provide an efficient and scientific basis for muscle activity (%MVIC) of RA, EO, VL, HS muscles and balance in soccer players through dynamic lumbar stability exercise and static lumbar stability exercise. Methods: This study included 23 soccer players belonging to D University of J province who attended the program for 30 minutes at a time and three times a week for 4 weeks. Of these 13 attended the dynamic lumbar stability exercise (DLSE) program and 10 the static lumbar stability exercise (SLSE) program. The differences between the effects of the dynamic lumbar stability exercise program and static lumbar stability exercise program were analyzed. Results: To increase muscle activity (%MVIC) and balance (WPL), the dynamic lumbar stability exercise program was more effective than was the static lumbar stability exercise program. 1) The %MVIC of trunk muscle (RA &EO) and lower extremitys muscle (VL & HS) increased from before training to after training in the case of the participants who performed the dynamic lumbar stability exercise. 2) The whole path length (WPL) decreased from before the training to after the training. The 2 groups significantly differed in this regard. Conclusion: Dynamic lumbar stability exercise program helps to improve the balancing ability and muscle activity in a soccer players who requires both muscle activity and balance than does any other players.

• 한국전문물리치료학회지
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• 제20권1호
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• pp.10-17
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• 2013

The purpose of this study was to assess the influence of the duration of smartphone usage on cervical and lumbar spine flexion angles and reposition error in the cervical spine. The study included 18 healthy smartphone users (7 males and 11 females). We measured the kinematics of the upper and lower cervical and lumbar spine flexion angles and the reposition error of the upper and lower cervical spine after 3 s and 300 s smartphone use in sitting. A paired t-test was used to compare the effects of the duration of smartphone usage on the kinematics of cervical and lumbar spine flexion angles and reposition error. The flexion angles of the lower cervical and lumbar spine and the reposition error in the upper and lower cervical spine were significantly increased after 300 s smartphone of use (p<.05). However, the flexion angle of the upper cervical spine was not significantly different between the 3 s and 300 s smartphone of use (p>.05). These findings suggest that prolonged use of smartphones can induce changes in cervical and lumbar spine posture and proprioception in the cervical spine.

• Journal of Korean Neurosurgical Society
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• 제53권3호
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• pp.145-149
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• 2013

Objective : We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. Methods : We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. Results : PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were $3.6{\pm}2.9$ and $5.4{\pm}6.4$ in the unresected PARS group, $5.8{\pm}2.1$ and $11.3{\pm}7.1$ in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. Conclusion : The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.