• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.21-28
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• 2019

PURPOSE: This study was conducted to compare different standing postures with the use of standing aids for lumbar spine posture and muscle activity, and to identify the most desirable standing posture. METHODS: The lumbopelvic angle was assessed based on static radiographic measurement on the sagittal plane. Lumbar lordosis, lumbosacral lordosis, and the intervertebral joint angle at L1/L5 and L5/S1 were measured using radiography in three standing postures (standing on level ground, standing with one foot on a platform, and standing on a sloped surface). In addition, muscle activity was measured using surface electromyography to examine the co-contraction of the lumbar and hip muscles. RESULTS: Lumbar lordosis, lumbosacral lordosis, and L5/S1 intervertebral joint flexion occurred with one foot on the platform. No significant differences were found between standing on a sloped surface and standing on level ground. However, muscle co-contraction was reduced with the use of standing aids. CONCLUSION: This study demonstrated that standing with a foot on a platform induced lumbar lordosis, but that there was no significant difference between standing on a sloped surface and standing on level ground. However, muscle co-contraction was reduced with the use of standing aids. Based on the motor control pattern as a predictor of LBP, the use of standing aids would help workers during prolonged standing.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.515-521
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• 2009

Objective : The purpose of this study was to compare clinical and radiological outcomes of percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM) for recurrent disc herniation. Methods : Fifty-four patients, who underwent surgery, either PELD (25 patients) or repeated OLM (29 patients), due to recurrent disc herniation at L4-5 level, were divided into two groups according to the surgical methods. Excluded were patients with sequestrated disc, calcified disc, severe neurological deficit, or instability. Clinical outcomes were assessed using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). Radiological variables were assessed using plain radiography and/or magnetic resonance imaging. Results : Mean operating time and hospital stay were significantly shorter in PELD group (45.8 minutes and 0.9 day, respectively) than OLM group (73.8 minutes and 3.8 days, respectively) (p < 0.001). Complications occurred in 4% in PELD group and 10.3% in OLM group in the perioperative period. At a mean follow-up duration of 34.2 months, the mean improvements of back pain, leg pain, and functional improvement were 4.0, 5.5, and 40.9% for PELD group and 2.3, 5.1, and 45.0% for OLM group, respectively. Second recurrence occurred in 4% after PELD and 10.3% after OLM. Disc height did not change after PELD, but significantly decreased after OLM (p = 0.0001). Neither sagittal rotation angle nor volume of multifidus muscle changed significantly in both groups. Conclusion : Both PELD and repeated OLM showed favorable outcomes for recurrent disc herniation, but PELD had advantages in terms of shorter operating time, hospital stay, and disc height preservation.

• Korean Journal of Veterinary Research
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• v.50 no.1
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• pp.37-42
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• 2010

Evaluation of the myelography was studied in miniature pigs. Radiographs and computed tomographic (CT) images of the whole spine were obtained at clinically healthy twelve miniature pigs of 4 (8.7-10 kg) and 12 (26-31 kg) months. The assessments of the spinal cord were made in accordance with the Pavlov's method and compared area ratio [at spinal cord (SC), vertebral canal (VC) and vertebral body (VB)]. The Pavlov's ratio in the cervical spine was significant larger than that of thoracolumbar in radiographic myelography. On CT myelography, the area of the spinal cord had a significant difference between the cervical and thoracolumbar spine. Among the cervical spine, the ratios of spinal cord and vertebral body (SC : VB), vertebral canal and vertebral body (VC : VB) were minimum at the level of 4th cervical spine in both ages, while maximum at the level of 6th cervical spine in both months. In case of lumbar spine, the ratios of spinal cord and vertebral body (SC : VB) were the largest at the level of 4th lumbar spine in 4 months and at the level of 3rd lumbar spine in 12 months. In addition, the ratio of spinal cord and vertebral body (SC : VB) of the cervical spinal cord was significant lower at 4 months but the lumbar spinal cord showed lower pattern at 12 months old miniature pigs.

• 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.

• Journal of radiological science and technology
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• v.39 no.1
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• pp.1-11
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• 2016

The purpose of this study was to provide resources for medical exposure reduction through evaluation of organ dose and image resolution for lumbar spine around according to the size of the collimator in DR system. The size of the collimator were varied from $8^{\prime\prime}{\times}17^{\prime\prime}$ to $14^{\prime\prime}{\times}17^{\prime\prime}$ by 1" in AP and lateral projection for the lumbar spine radiography with RANDO phantom. The organ dose measured for liver, stomach, pancreas, kidney and gonad by the glass dosimeter. The image resolution was analyzed using the Image J program. The organ dose of around lumbar spine were reduced as the size of the collimator is decreased in AP projection. There were no significant changes decreasing rate whenever the size of the collimator were reduced 1" in the gonad. The organ dose showed higher on liver and kidney near the surface in lateral projection. There were decreasing rate of less than 5% in liver and kidney, but decreasing rate was 24.34% in the gonad whenever the size of the collimator were reduced 1". Organ dose difference for internal and external of collimator measured $549.8{\mu}Gy$ in the liver and $264.6{\mu}Gy$ in the stomach. There were no significant changes organ dose difference that measured $1,135.1{\mu}Gy$ in the gonad. Image Quality made no difference because SNR and PSNR were over than 30 dB when the collimator size is less than $9^{\prime\prime}{\times}17^{\prime\prime}$ on AP projection and $10^{\prime\prime}{\times}17^{\prime\prime}$ on lateral projection. Therefore, we are considered that the recommendations criterion for control of collimator were suggested in order to reduce unnecessary X-ray exposure and to obtain good image quality because lumbar spine radiography contains a lot of peripheral organs rather than other area radiography.

• Korean Journal of Digital Imaging in Medicine
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• v.14 no.2
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• pp.63-67
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• 2012

Calcium density in human bones decreases as people are getting older due to the interior or exterior environmental factors. Bone aging forms osteoporosis. And this can bring out various spine fractures which develops a complications. Thus the prediction of seniliy is one of the important factors in spine diseases. Once spine aged, diverse fractures occur such as compression fracture and micro fracture. Side images of the spine by the digital radiography (DR) were prepared, and pixel arbitrary unit with Image J was measured from one spot in the lumbar bone part. By calculating pixel arbitrary unit of the simple contrast, it was obtained that the value of pixel arbitrary unit decreased as seniliy of bones increased. By simply applying Image J to the seniliy of patient's spine, the seniliy of bones predicts the level of danger with only digital radiography(2D) image. consequently we show that Image J value of pixel arbitrary unit index for predicts the level of precaution of osteoporosis patient.

• Journal of Korean Neurosurgical Society
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• v.41 no.6
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• pp.377-381
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• 2007

Objective : The aim of this study was to evaluate the morphometric changes in neuroforamen in grade I isthmic spondylolisthesis by anterior lumbar interbody fusion [ALIF]. Methods : Fourteen patients with grade I isthmic spondylolisthesis who underwent single level ALIF with percutaneous pedicle screw fixation were enrolled. All patients underwent standing lateral radiography and magnetic resonance imaging [MRI] before surgery and at 1 week after surgery. For quantitative analysis, the foraminal height, width, epidural foraminal height, epidural foraminal width, and epidural foraminal area were evaluated at the mid-portion of 28 foramens using T2-weighted sagittal MRI. For qualitative analysis, degree of neural compression in mid-portion of 28 foramens was classified into 4 grades using T2-weighted sagittal MRI. Clinical outcomes were assessed using Visual Analogue Sale [VAS] scores for leg pain and Oswestry disability index before surgery and at 1 year after surgery. Results : The affected levels were L4-5 in 10 cases and L5-S1 in 4. The mean foraminal height was increased [p<0.001], and the mean foraminal width was decreased [p=0.014] significantly after surgery. The mean epidural foraminal height [p<0.001], epidural foraminal width [p<0.001], and epidural foraminal area [p<0.001] showed a significant increase after surgery. The mean grade for neural compression was decreased significantly after surgery [p<0.001]. VAS scores for leg pain [p=0.001] and Oswestry disability index [p=0.001] was decreased significantly at one year after surgery. Conclusion : Foraminal stenosis in grade I isthmic spondylolisthesis may effectively decompressed by ALIF with percutaneous pedicle screw fixation.

• Korean Journal of Veterinary Research
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• v.62 no.1
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• pp.8.1-8.6
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• 2022

The aim of this prospective study was to investigate the effects of focal spot size of X-ray tube on sharpness of clinical radiographic images of dogs and cats. Radiographic images of 24 stifle joints, 15 carpi, 18 lumbar spines, 61 thoraxes, and 47 abdomens of 102 dogs and 4 cats were obtained in the present study, using 2 X-ray tubes with nominal focal spots of 2.0 mm and 0.6 mm, respectively. The sharpness of specific anatomical structures in all the images of 5 projections was assessed. The radiographic sharpness of various anatomical structures of lumbar spine and cortex of stifle with fine focal spot was increased significantly compared with broad focal spot images. In addition, the blurred motion was significantly higher in the fine focal spot images of thorax. In conclusion, our study suggests that a selective use of fine foci for imaging of lumbar spine or cortex of stifle enhanced radiographic sharpness.

• Asian Spine Journal
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• v.12 no.6
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• pp.1037-1042
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• 2018

Study Design: Retrospective study. Purpose: This study aimed to investigate whether segmental lumbar hyperlordosis of the affected vertebra in patients with spondylolysis occurs only at L5 or also occurs at L4. Overview of Literature: To the best of our knowledge, increase in segmental lordosis of the spondylolytic vertebrae has only been investigated in bilateral L5 spondylolysis; it has not been examined at different levels of bilateral spondylolysis. According to the characteristics of segmental lordosis in bilateral L5 spondylolysis, patients with bilateral L4 spondylolysis may also have increased segmental lordosis of the L4 vertebra. Methods: Patients with bilateral spondylolysis of the L5 or L4 vertebra in 2013-2015 were retrospectively identified from the hospital database. Standing lateral lumbar radiographs were assessed for the angle of segmental lordosis of the L5 and L4 vertebra, sacral slope, and lumbar lordosis. The differences in segmental lordosis of the L5 and L4 vertebra, sacral slope, and lumbar lordosis were determined using non-paired Student t-test. Results: Overall, 15 cases of bilateral L4 spondylolysis and 41 cases of bilateral L5 spondylolysis satisfied the inclusion and exclusion criteria. Lordosis of the L4 vertebra was significantly greater in the bilateral L4 spondylolysis group ($24.2^{\circ}{\pm}7.0^{\circ}$) than that in the L5 spondylolysis group ($20.3^{\circ}{\pm}6.1^{\circ}$, p=0.047). Lordosis of the L5 vertebra was significantly lower in the L4 spondylolysis group ($27.7^{\circ}{\pm}8.2^{\circ}$) than that in the L5 spondylolysis group ($32.5^{\circ}{\pm}7.3^{\circ}$, p=0.040). The sacral slope and lumbar lordosis did not significantly differ between the groups. Conclusions: Adolescent patients with bilateral spondylolysis have segmental hyperlordosis of the affected vertebra not only at the L5 level but also at the L4 level.

• Korean Journal of Digital Imaging in Medicine
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• v.14 no.2
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• pp.23-31
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• 2012

There are AEC mode and fix mode to exposure when the whole spine antero-posterior radiography is done by using DR equipment. This study compared the utility of fix mode to AEC mode, by evaluating organ dose and effective dose and by examining the quality of radiographic image. GE DEFINIUM 8000 and ART-200X Rando Phantom manufactured by Flukebiometical were used for this study. The Rando phantom was set in front of wall detector of X-rays equipment. AEC mode was set at 80kVp and Fix mode was set at 80kVp, 25mAs, 32mAs, 40mAs, and 50mAs. Whole spine AP image were aquired by combining C, T-L and L-S spine images obtained through 3 exposures. When obtaining C, T-L and L-S spine images, were checked for Air kerma (mGy) value calculated by UNFORS Xi meter attached at the phantom surface of center of radiation field. The effective and organ doses were compared by PCXMC program (PC-Based Monte Carlo Program). The quality of obtained radiographic image was evaluated visually by 3 radiologists using resolution chart. When the effective doses was calculated based on tissue weighting factor of ICRP-103, 1.278mSv was measured by AEC mode, and Fix mode measured 0.405mSv at 25mAs, 0.518mSv at 32mAs, 0.649mSv at 40mAs, and 0.810mSv at 50mAS. In addition, the organ dose measured with esposure at 25mAs by Fix mode was almost equivalent to the organ dose by AEC mode, at the esophagus, thyroid, oral mucosa, salivaly glands located at the cervical spine part, while the organ dose by Fix mode was in general lower than the organ dose by AEC mode at the other organs. When Fix mode at 32mAs, 40mAs, and 50mAs was compared to AEC mode for organ dose in 26 organs, AEC mode had higher measurement in 21 organs but not for than brain, trachea, thyroid, oral mucosa, and salivaly glands which are located at the cervical spine part. The image quality evaluated by resolution test chart was much higher with AEC mode than the quality with Fix mode at all exposure conditions. However, while the image quality of cervical spine exposured at 50mAs by Fix mode was lower than the quality of AEC mode, thoraco-lumbar spine and lumbo-sacral spine were calculated and the quality was similar to AEC mode. Scoliosis occurs mainly at thoraco-lumbar and lumbo-sacral spine, not at cervical spine. Compared to AEC mode, Using the appropriate protocol (80kVp, 50mAs) of fix mode for whole spine AP radiography was thought to be useful because the image quality of the thoraco-lumar and lumbo-sacral spine was similar on AEC mode, Also organ and effective doses can be decreased with Fix mode. Therefore, It is considered that fix mode can be used properly with AEC mode for whole spine AP radiography when considering patient's body posture.