• Title/Summary/Keyword: Lumbar Lordosis

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The Effects of Segmental Instability and Muscle Fatigue after Applying Sabilization Exercise Program In Degenerated Disc Disease Patients of Aged (노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향)

  • Kim, Hee-Ra
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.2
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    • pp.12-20
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    • 2007
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after applying program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, (-) value was increased between lumbar vertebra segment when was the load on spine. And so applying stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

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The Effects of Segmental Instability and Muscle Fatigue after Stabilization Exercise Program in Degenerated Disc Disease Patients of Aged (노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향)

  • Kim, Hee-Ra
    • Journal of Korean Physical Therapy Science
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    • v.13 no.4
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    • pp.7-16
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    • 2006
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

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Application of Incidence Angle on Lumbar Spine Anteroposterior General Radiography Image according to Measured Intervertebral Disc Angle (방사선 일반 정면검사에서 허리뼈 추간판 계측 값에 따른 입사각 적용)

  • Moon, Seul-Ji-A;Kim, Gyeong-Rip;Cho, Hee-Jung;Sung, Soon-Ki;Kwak, Jong-Hyeok
    • The Journal of the Korea Contents Association
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    • v.19 no.6
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    • pp.471-480
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    • 2019
  • L-spine 3~4, L-spine 4~5, and L-spine 5~Sacrum 1 intervertebral disc(IVD) angle according to gender, age, body mass index(BMI), lumbar lordosis angle(LLA) were compared and analyzed. The anteriorposterior incidence angle of L-spine 3 ~ 4, L-spine 4 ~ 5 and L-spine 5~Sacrum 1 in body mass index were 5.66, 13.23 and 29.13 degrees in the head direction and L-spine 3 4, L-spine 4 ~ 5, L-spine 5~Sacrum 1 had 6.32 degrees, 16.09 degrees and 35.36 degrees in the head direction. The distortion area ratio comparison was performed with the phantom image using the proposed incidence angle. There was a significant difference in L-spine 4~5 and L-spine 5~Sacrum 1 IVD angle relative to body mass index and LLA(p<0.05), IVD angle and LLA were positively correlated(p<0.05).As a result of evaluating the usefulness of the image by applying the incidence angles of the disc angles according to the phantom angle of deviation to the head direction as 11 degrees for L4 and 26 degrees for L5, the distortion ratio area decreased from 14.90% to 12.11% in L4, And from 15.25% to 13.72% in L5. In anteriorposterior image of the Lumbar spine applying the incidence angle according to the measured disc angle, it is possible to reduce the distortion to purpose L4, L5. And improved the quality and diagnostic information of the target site.

Factors in Selection of Surgical Approaches for Lower Lumbar Burst Fractures (하부 요추 방출 골절의 수술방법 결정시 고려 요인들)

  • Jahng, Tae-Ahn;Kim, Jong-Moon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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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.

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Comparison of Transforaminal Lumbar Interbody Fusion with Direct Lumbar Interbody Fusion : Clinical and Radiological Results

  • Lee, Young Seok;Kim, Young Baeg;Park, Seung Won;Chung, Chan
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.469-474
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    • 2014
  • Objective : The use of direct lumbar interbody fusion (DLIF) has gradually increased; however, no studies have directly compared DLIF and transforaminal lumbar interbody fusion (TLIF). We compared DLIF and TLIF on the basis of clinical and radiological outcomes. Methods : A retrospective review was performed on the medical records and radiographs of 98 and 81 patients who underwent TLIF and DLIF between January 2011 and December 2012. Clinical outcomes were compared with a visual analog scale (VAS) and the Oswestry disability index (ODI). The preoperative and postoperative disc heights, segmental sagittal/coronal angles, and lumbar lordosis were measured on radiographs. Fusion rates, operative time, estimated blood loss (EBL), length of hospital stay, and complications were assessed. Results : DLIF was superior to TLIF regarding its ability to restore disc height, foraminal height, and coronal balance (p<0.001). As the extent of surgical level increased, DLIF displayed significant advantages over TLIF considering the operative time and EBL. However, fusion rates at 12 months post-operation were lower for DLIF (87.8%) than for TLIF (98.1%) (p=0.007). The changes of VAS and ODI between the TLIF and DLIF were not significantly different (p>0.05). Conclusion : Both DLIF and TLIF are less invasive and thus good surgical options for treating degenerative lumber diseases. DLIF has higher potential in increasing neural foramina and correcting coronal balance, and involves a shorter operative time and reduced EBL, in comparison with TLIF. However, DLIF displayed a lower fusion rate than TLIF, and caused complications related to the transpsoas approach.

Diagnosis of Spondylopathy Using Mahalanobis Taguchi System (Mahalanobis Taguchi System을 이용한 척추질환 환자의 진단에 관한 연구)

  • Hong, Jung Eui
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.35 no.4
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    • pp.10-15
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    • 2012
  • The Mahalanobis-Taguchi System is a diagnosis and predictive method for analyzing patterns in multivariate cases. The goal of this study is diagnosis of the spondylolisthesis from biomedical data that is derived from the shape and orientation of the pelvis and lumbar spine. The data set has six attributes including pelvic incidence, pelvic tilt, lumbar lordosis angle, sacral slope, pelvic radius and grade of spondylolisthesis and two class including normal and abnormal. From University of California at Irvine machine learning repository, 100 normal and 150 spondylolisthesis patient's data were used for this study. Mahalanobis Taguchi System (MTS) application process and the diagnosis results were described in this paper.

The Effect of Heel-height on the Lumbosacral Region Angle of Young Ladies (구두 굽 높이가 20대 여성의 요천추부 각도에 미치는 영향)

  • Kim, Byoung-Gon;Gong, Won-Tae;Kim, Han-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.2 no.1
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    • pp.49-59
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    • 2007
  • Objective : To purpose of this study was the most of the ladies wear high-heeled shoes at lease 4 to 5 day a week but the effect of it's height on the lumbo-sacral legion angle has not been clearly defined. Method : Subject were 20 young ladies, who had majored in physical therapy of the Dae-gu Health College. Method 1. PACS system X-ray was used to measure the lumbo-sacral legion angle under the condition of bare foot, 3cm, 7cm high-heeled at standing position. 2. Spinal Mouse was used to measure the spinal segment motion angle and length under the condition of bare foot, 3cm, 7cm high-heeled at being Flexion-Extension position Result : The result of this study were as follow I. Significant statistical increase in lumbar lordosis was observed as the heel height was increased from bare foot to 7cm high-heeled(p<.05), but there was no significant difference in the lumbo-sacral angle & sacral angle(p>.05). 2. The Height and the weight of the subjects, their preference on the shoes didn't affect the lumbo-sacral lesion angle(p>.05) 3. The variation of the heel height didn't affect the spinal segment motion angle and length(p>.05). Conclusion : There is strong relationship between the high of heel with increasing the lumbar lordosis(p<.05).

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Relationship between Spinopelvic Parameters and Hip Function in Patients with Femoroacetabular Impingement at Diagnosis: A Cross-Sectional Study

  • Bernardo Aguilera-Bohorquez;Pablo Corea;Cristina Siguenza;Jochen Gerstner-Saucedo;Alvaro Carvajal;Erika Cantor
    • Hip & pelvis
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    • v.35 no.1
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    • pp.6-14
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    • 2023
  • Purpose: The aim of this study was to determine correlation between the spinopelvic parameters in sitting and standing positions (sacral slope [SS], lumbar lordosis [LL], spinopelvic tilt [SPT], pelvic incidence [PI], and pelvic femoral angle [PFA]), with hip function assessed using the modified Harris hip scores (mHHs) in patients with symptomatic femoroacetabular impingement (FAI) at diagnosis. Materials and Methods: A retrospective study of 52 patients diagnosed with symptomatic FAI was conducted. Evaluation of the spinopelvic complex in terms of SS, LL, SPT, PI and PFA was performed using lateral radiographs of the pelvis and lumbosacral spine in standing and sitting positions. Assessment of hip function at diagnosis was performed using the mHHs. Calculation of spinopelvic mobility was based on the difference (Δ) between measurements performed in standing and sitting position. Results: The median time of pain evolution was 11 months (interquartile range [IQR], 5-24 months) with a median mHHs of 66.0 points (IQR, 46.0-73.0) at diagnosis. The mean change of LL, SS, SPT, and PFA was 20.9±11.2°, 14.2±8.6°, 15.5±9.0°, and 70.7±9.5°, respectively. No statistically significant correlation was observed between spinopelvic parameters and the mHHs (P>0.05). Conclusion: Radiological parameters of the spinopelvic complex did not show correlation with hip function at the time of diagnosis in patients with symptomatic FAI. Conduct of further studies will be required in the effort to understand the effect of the spinopelvic complex and its compensatory mechanics, primarily between the hip and spine, in patients with FAI before and after hip arthroscopy.

The Biomechancial Effects of an Interspinous Spacer Implant on 3-D Motions for the Treatment of Lumbar Spinal Stenosis (요추부 척추관 협착증 치료를 위한 극돌기간 삽입술의 3차원 분석을 통한 생체역학적 효과 분석)

  • 이희성;신규철;문수정;정태곤;이권용;이성재
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2004.10a
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    • pp.1207-1210
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    • 2004
  • As many humans age, degenerative lumbar spinal stenosis (DLSS) becomes a major cause of lower limb discomfort and disability. By surgical treatment method of DLSS, the existing surgical treatment methods using internal fixation have showed degeneration changes of an adjacent vertebrae and loss of lumbar spine lordosis-kyphosis due to eliminating a motion. For solving the problems of internal fixation, a novel interspinous spacer has been developed to treat DLSS by surgical treatment method. In this study, we evaluated the biomechanical effects of the interspinous spacer on the kinematics of the porcine lumbar spine before and after insertion of the implant. For this purpose, a device that is capable of measuring 3-D motions were built based on direct linear transformation (DLT) algorithm written with MATLAB program. Results showed that in extension, a change of the mean angle between the intact and the implanted specimens at L4-L5 was 1.87 degree difference and the implant reduced the extension range of motion of the L4-L5 (p&lt;0.05). But the range of motion in flexion, axial rotation and lateral bending at the adjacent segments was not statistically affected by the implant. In conclusion, we thought that interspinous spacer may have remedical value for DLSS by flexing human lumbar spine.

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Sagittal Sacropelvic Morphology and Balance in Patients with Sacroiliac Joint Pain Following Lumbar Fusion Surgery

  • Cho, Dong-Young;Shin, Myung-Hoon;Hur, Jung-Woo;Ryu, Kyeong-Sik;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.201-206
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    • 2013
  • Objective : To investigate the sagittal sacropelvic morphology and balance of the patients with SIJ pain following lumbar fusion. Methods : Among 452 patients who underwent posterior lumbar interbody fusion between June 2009 and January 2013, patients with postoperative SIJ pain, being responded to SIJ block were enrolled. For a control group, patients matched for sex, age group, the number of fused level and fusion to sacrum were randomly selected. Patients were assessed radiologic parameters including lumbar lordosis, pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). To evaluate the sagittal sacropelvic morphology and balance, the ratio of PT/PI, SS/PI and PT/SS were analyzed. Results : A total of 28 patients with SIJ pain and 56 patients without SIJ pain were assessed. Postoperatively, SIJ pain group showed significantly greater PT (p=0.02) than non-SIJ pain group. Postoperatively, PT/PI and SS/PI in SIJ pain group was significantly greater and smaller than those in non-SIJ pain group respectively (p=0.03, 0.02, respectively) except for PT/SS (p=0.05). SIJ pain group did not show significant postoperative changes of PT/PI and SS/PI (p=0.09 and 0.08, respectively) while non-SIJ pain group showed significantly decrease of PT/PI (p=0.00) and increase of SS/PI (p=0.00). Conclusion : This study presents different sagittal sacropelvic morphology and balance between the patients with/without SIJ pain following lumbar fusion surgery. The patients with SIJ pain showed retroversed pelvis and vertical sacrum while the patients without SIJ pain have similar morphologic features with asymptomatic populations in the literature.