• 제목/요약/키워드: Lumbar lordotic angle

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경항통과 척추 시상균형 및 만곡의 상관관계에 대한 임상적 연구 (Clinical Study on Cervical Pain with Focus on Sagittal Spinal Balance and Spinal Curvature)

  • 이원일;고필성;조병진;권신애;이정우;송지연;서병관;우현수;백용현;박동석;남상수
    • Journal of Acupuncture Research
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    • 제27권2호
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    • pp.97-104
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    • 2010
  • Objectives : The authors aimed to determine the presence of relationships between cervical pain and cervical curvature, lumbar curvature, sacral slope and sagittal spinal balance. Methods : Medical records of outpatients who made their first visits to the Department of Acupuncture and Moxibustion in the Spine center at Kyung Hee East-West Neo Medical Center between September 1, 2008 and October 31, 2009 were evaluated. A total of 50 patients visiting within the time period had visited with a chief complaint of cervical pain, and had lateral entire spine X-rays taken. After excluding patients with previous spine operations, 46 patients were selected for the final analysis. The cervical lordotic angle(CLA), lumbar lordotic angle(LLA), Ferguson's angle(FA), and sagittal vertical axis(SVA) were measured on the lateral entire spine X-ray cuts, and the relationships between these values and patient gender, age, chief complaint, and duration of symptoms were assessed. Results : No significant difference was found in relationships between gender and measured values. SVA showed statistically significant correlation between age, but CLA, LLA, and FA was not. There was a significant difference in SVA between patients with only cervical pain and those with both cervical pain and low back pain. Patients with a duration of symptoms longer than 6 months showed a statistically significant difference in SVA with those who had shorter symptoms. Correlation analysis between measured values was statistically significant only between LLA and FA. Conclusions : Evaluation and treatment of sagittal imbalance should be considered in patients presenting with cervical pain if symptoms have persisted for over 6 months or have accompanying low back pain.

요통 유무에 따른 경항통 환자의 경추 전만각 퇴행성 변화 비교분석 (Roentgenographic Analysis of Cervical Lordosis and Disc Degeneration in Neck Pain Patients with or without Low Back Pain)

  • 이상호;정석희;이종수;김성수;신현대
    • 대한추나의학회지
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    • 제2권1호
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    • pp.85-92
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    • 2001
  • Objectives : To study the cervical lordosis and disc degeneration in neck pain patients with or without low back pain. Subjects. The study was composed of 57 neck pain patients with low back pain(LBP group) and 40 neck pain patients without low back pain(Non-LBP group). Methods : Radiographic measures of spinal lordosis(cervical and lumbar) and disc degeneration were collected, and statistically analyzed. Results: LBP group showed a significant increase in cervical lordotic angle as compared with Non-LBP group, whereas no significant change in cervical disc degeneration. A relationship was found between cervical and lumbar disc degeneration in LBP $group({\gamma}-0.3064)$. Conclusions : The findings from this study suggest that the curvature of the cervical spine is related to the subject's low back pain.

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Reliability and validity of rasterstereography measurement for spinal alignment in healthy subjects

  • Yi, Yoon-Sil;Yoo, Seul-Ki;Lee, Da-Gam;Park, Dae-Sung
    • 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.

뇌졸중 환자에서 자세정렬변화가 족저압 및 균형에 미치는 영향 (Effects of Changes in Postural Alignment on Foot Pressure and Balance of Patients with Stroke)

  • 양대중;박승규;강정일;박성빈
    • The Journal of Korean Physical Therapy
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    • 제26권4호
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    • pp.226-233
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    • 2014
  • Purpose: This study was conducted in order to investigate the exercise limit that may occur depending on changes in postural alignment by examining the significance of postural alignment changes, foot pressure, and balance of patients with stroke. Methods: In this study, 50 patients diagnosed with a stroke were selected as subjects. Imbalance of postural alignment of the trunk, pelvic tilt of trunk rotation of the body, angle of kyphotic curving of the thoracic, and angle of lordotic curving of the lumbar vertebra were measured. Foot pressure was examined by measuring average pressure and weight bearing. Balance was examined by measuring the center of pressure and limit of stability. Results: The significance of postural alignment, foot pressure, and weight bearing of the non-paretic side was examined. In addition, the significance between postural alignment and balance was examined. Conclusion: It is thought that limits of foot pressure and balance in the standing position can be caused by postural alignment. Thus, both a therapeutic intervention program and postural alignment training should be provided together in order to improve the function of patients with stroke.

The Effects of Spinopelvic Parameters and Paraspinal Muscle Degeneration on S1 Screw Loosening

  • Kim, Jin-Bum;Park, Seung-Won;Lee, Young-Seok;Nam, Taek-Kyun;Park, Yong-Sook;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • 제58권4호
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    • pp.357-362
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    • 2015
  • Objective : To investigate risk factors for S1 screw loosening after lumbosacral fusion, including spinopelvic parameters and paraspinal muscles. Methods : We studied with 156 patients with degenerative lumbar disease who underwent lumbosacral interbody fusion and pedicle screw fixation including the level of L5-S1 between 2005 and 2012. The patients were divided into loosening and non-loosening groups. Screw loosening was defined as a halo sign larger than 1 mm around a screw. We checked cross sectional area of paraspinal muscles, mean signal intensity of the muscles on T2 weight MRI as a degree of fatty degeneration, spinopelvic parameters, bone mineral density, number of fusion level, and the characteristic of S1 screw. Results : Twenty seven patients showed S1 screw loosening, which is 24.4% of total. The mean duration for S1 screw loosening was $7.3{\pm}4.1$ months after surgery. Statistically significant risk factors were increased age, poor BMD, 3 or more fusion levels (p<0.05). Among spinopelvic parameters, a high pelvic incidence (p<0.01), a greater difference between pelvic incidence and lumbar lordotic angle preoperatively (p<0.01) and postoperatively (p<0.05). Smaller cross-sectional area and high T2 signal intensity in both multifidus and erector spinae muscles were also significant muscular risk factors (p<0.05). Small converging angle (p<0.001) and short intraosseous length (p<0.05) of S1 screw were significant screw related risk factors (p<0.05). Conclusion : In addition to well known risk factors, spinopelvic parameters and the degeneration of paraspinal muscles also showed significant effects on the S1 screw loosening.

Interspinous Implant with Unilateral Laminotomy for Bilateral Decompression of Degenerative Lumbar Spinal Stenosis in Elderly Patients

  • Ryu, Sung-Joo;Kim, In-Soo
    • Journal of Korean Neurosurgical Society
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    • 제47권5호
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    • pp.338-344
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    • 2010
  • Objective : This study assessed the safety and efficacy of one level unilateral laminotomy bilateral decompression (ULBD) with the placement of a device for intervertebral assisted motion (DIAM) compared with one level ULBD only in elderly patients with degenerative lumbar spinal stenosis (DLSS). Methods : A non randomized prospective analysis was performed on 16 patients who underwent one level ULBD with DIAM (Group A) and 20 patients with one level ULBD only (Group B) between February 2007 and March 2008. Radiographic imaging, visual analog scale (VAS) and MacNab outcome scale were obtained before and after surgery at a mean interval of 21 months (range 17-27 months). Results : The disc height, interpedicular distance, slip distance and segmental lordotic angle were similar between two groups. In the group A, there was no significant difference between the pre- and post-operative imaging in terms of the sagittal balance and disc height. Both groups showed significant improvement in the clinical outcomes. In addition, there was significantly less low-back pain in the group A than in the group B at the last follow up, while the clinical improvement of the leg pain and MacNab outcome scale showed no significant difference in the two groups. There were no major complications or DIAM associated complications. Conclusion : ULBD with DIAM is a safe and efficacious treatment for selective elderly patients with DLSS, particularly for relieving low back pain comparing to ULBD. ULBD with DIAM did not alter the disc height or sagittal alignment at the mean 21 months follow-up interval.

고강도서키트트레이닝에 의한 신체조성의 변화가 복부비만 중년남성의 척추만곡도와 요부통증에 미치는 영향 (The Effects of Changes In Body Composition Through High Intensity Circuit Training On Spine Curvature And Low Back Pain Among Middle-Aged Men With Abdominal Obesity)

  • 김채원;김정훈
    • 한국산학기술학회논문지
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    • 제19권5호
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    • pp.346-356
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    • 2018
  • 좌식 생활 및 신체활동의 부족에서 발생하는 과체중 및 복부비만은 요추 신전근의 약화 및 위축으로 인하여 요부통증(Low back Pain, LBP)의 위험요인으로 추정된다. 그러므로 이 연구는 LBP를 소유하고 있는 복부비만 중년남성(n=80)에게 체중감량에 효과가 있는 고강도서키트트레이닝(High Intensity Circuit Training, HICT)을 적용했을 때 신체조성의 변화가 척추만곡도(Spine Curvature, SC) 및 시각적통증척도(Visual Analog Scale, VAS)에 미치는 영향을 관찰하고자 한다. 운동 프로그램으로는 체간 중심의 운동을 포함한 전신의 근육을 동원할 수 있는 다관절 형태의 12가지 종목으로 구성된 HICT(1회 운동 30분, 격일제 주당 3회)를 12주간 적용하였다. 그 결과, 비만관련 신체조성에서 긍정적인 변화가 관찰되었으며, 흉추후만도(Kypotic Angle, KA) 및 요추전만도(Lordotic Angle, LA)가 정상치에 가깝게 이동하였다. 이것은 궁극적으로 요부통증의 척도인 VAS의 지표가 낮아지는 결과를 보여 주었다. 결국, 복부비만에 의한 비정상적인 흉추후만도, 요추전만도 및 요부통증의 개선은 본 연구에서 적용된 고강도의 운동트레이닝에 의한 신체조성의 변화가 척추만곡도와 요부통증의 개선을 유도하는 것으로 생각된다.

골반교정이 중년 여성의 만성요통과 척추골반지표에 미치는 영향 (Effect of pelvic adjustment on chronic low back pain and spino-pelvic parameters in middle-aged women)

  • 서윤교;김재희
    • 한국산학기술학회논문지
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    • 제18권9호
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    • pp.347-355
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    • 2017
  • 본 연구의 목적은 골반 교정이 중년 여성의 만성 요통과 척추 골반 지표들에 미치는 영향을 규명하는데 있다. 이를 위하여 만성 요통이 있는 중년 여성 38명을 실험군(20명)과 무처치 대조군(18명)에 무선 할당하여 실험군에게는 골반 교정을 주 4회, 8주 간 시술하였다. 시술 전과 8주 후에 요통은 시각적 상사 척도와 Oswestry 요통 장애 지수로 측정하였고, 그 외 요부 유연성, 염증인자인 혈중 C-reactive protein (CRP) 및 척추 골반 지표들을 평가하였다. 처치 8주 후 대조군에 비하여 골반 교정군에서 요통 강도, 요통 장애 지수 및 요부 유연성 모두가 유의하게 향상되었으며, 혈중 CRP의 유의한 변화는 없었다. 척추 골반 지표들을 분석한 결과 골반 교정군에서 대조군에 비해 요추전만각, 천골경사 및 골반균형지표는 유의하게 변화된 반면, 골반입사각의 변화가 뚜렷하지 않았다. 따라서 골반 교정은 요통 환자의 통증 경감과 기능 향상에 효과적일 것이며, 척추 골반 정렬의 변화의 결과일 것이다.