• Journal of Korean Neurosurgical Society
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• v.53 no.3
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• pp.174-179
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• 2013

Objective : Many studies have investigated paraspinal muscle changes after posterior lumbar surgery, including lumbar fusion. However, no study has been performed to investigate back muscle changes after pedicle based dynamic stabilization in patients with degenerative lumbar spinal diseases. In this study, the authors compared back muscle cross sectional area (MCSA) changes after non-fusion pedicle based dynamic stabilization. Methods : Thirty-two consecutive patients who underwent non-fusion pedicle based dynamic stabilization (PDS) at the L4-L5 level between February 2005 and January 2008 were included in this retrospective study. In addition, 11 patients who underwent traditional lumbar fusion (LF) during the same period were enrolled for comparative purposes. Preoperative and postoperative MCSAs of the paraspinal (multifidus+longissimus), psoas, and multifidus muscles were measured using computed tomographic axial sections taken at the L4 lower vertebral body level, which best visualize the paraspinal and psoas muscles. Measurements were made preoperatively and at more than 6 months after surgery. Results : Overall, back muscles showed decreases in MCSAs in the PDS and LF groups, and the multifidus was most affected in both groups, but more so in the LF group. The PDS group showed better back muscle preservation than the LF group for all measured muscles. The multifidus MCSA was significantly more preserved when the PDS-paraspinal-Wiltse approach was used. Conclusion : Pedicle based dynamic stabilization shows better preservation of paraspinal muscles than posterior lumbar fusion. Furthermore, the minimally invasive paraspinal Wiltse approach was found to preserve multifidus muscles better than the conventional posterior midline approach in PDS group.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.3
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• pp.271-278
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• 2014

PURPOSE: This study researched the effects of different types of high heels on the muscles surrounding the cervical spine, the thoracic spine, and the lumbar spine by analyzing muscle activation of the paraspinal muscles during walking while wearing high heels. The high heels were all of the same height: 8cm. METHODS: The 28 subjects in this experiment were females in their 20s with a foot size of 225-230mm. To measure the muscle activation of the paraspinal muscles, EMG electrodes were attached on the paraspinal muscles around C6, T7, and L5. The muscle activation during walking while wearing 8cm high wedge heels, setback heels, and french heels was measured. The measurements were performed 3 times each and the mean value of the result was used for analysis. Two kinds of velocity were used in this study. One of the velocity was 2.5 m/s. The other was 3.5 m/s. RESULTS: The muscle activation of paraspinal muscles increased significantly according to increase of walking velocity. But there was no significant difference according to the heel types. CONCLUSION: In view of the results, the height of heels and the velocity of walking are more convincing variables than the width of the heels on the muscle activation of paraspinal muscles. So wearing high heels is not recommended for those who have pain or functional problem of cervical and lumbar vertebrae.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.1
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• pp.51-62
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• 2022

Objectives Objective of this study is to investigate the role of paraspinal muscles by examining the correlation between slip percentage (SP) of spondylolisthesis and fatty infiltration of lumbar paraspinal muscle. Methods Retrospective analysis was performed on 45 patients diagnosed with spondylolisthesis based on medical records. Using T2-weighted axial magnetic resonance imaging, cross-sectional areas (CSAs) of psoas major (PM), multifidus (MU) and erector spinae (ES) were calculated and divided by CSA of lower level vertebral body (VB). SP was measured using sagittal T2-weighted images. Correlation of SP with muscle relative cross-sectional area (RCSA) and muscle fatty infiltration by Goutallier classification was respectively analyzed using Spearman correlation. Statistic assessment conducted by Wilcoxon signed rank test and paired t-test using program GraphPad prism 5 (GraphPad Software, Inc., San Diego, CA, USA). Results Spondylolisthesis forward slip percentage by Taillard's method was negatively associated with both side MU RCSAs. No significant correlation was found between PM RCSA, ES RCSA and SP. Forward slippage was significantly correlated with fatty infiltration of lumbar paraspinal muscle measured by Goutallier classification. Conclusions This study is to understand the role of paraspinal muscle affecting spinal instability by investigating correlation between statistical deviation of lumbar muscle characters (RCSA, fatty infiltration of lumbar muscle) and SP. We found that spondylolisthesis SP is positively related to fatty infiltration of lumbar paraspinal muscle. and is negatively associated with both side MU RCSAs.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2012.05a
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• pp.743-744
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• 2012

• Journal of Korean Medicine Rehabilitation
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• v.26 no.3
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• pp.109-117
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• 2016

Objectives The purpose of this study was to investigate the correlation between walking ability of lumbar spinal stenosis patients and the cross-sectional area (CSA) of lumbar paraspinal muscles. Methods This study was carried out on 62 lumbar spinal stenosis patients who had limited walking abilities because of neurogenic claudication (NC). All patients received more than 2 weeks of complex treatment at Mokhuri Neck&Back Hospital. CSA of lumbar paraspinal muscles was measured from axial T2-weighted MRI and divided by CSA of adjacent vertebral body to avoid influence of body statues (RCSA-Relative CSA). Pain Free Walking Distance and Numerical Rating Scale (NRS) was measured before and after treatment. Results The Pain Free Walking Distance had significantly increased in patients who had bigger RCSA of psoas muscle (r=0.313, p<0.05). Conclusions The psoas muscle can be a predictive factor for restoring walking ability of lumbar spinal stenosis patients who have limitations walking.

• The Journal of Korean Physical Therapy
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• v.25 no.1
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• pp.10-15
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• 2013

Purpose: Low back pain occurs and frequently recurs in many people. An imbalance of paraspinal muscle activity can cause low back pain. Mulligan's concept of mobilizations with sustained natural apophyseal glides (SNAG) is a common method for treating low back pain. The purpose of this study was to investigate the effects of this method on paraspinal muscle activity in patients with chronic low back pain. Methods: Twenty-one patients with low back pain participated in this study. Patients were classified using the Oswestry disability index. The subjects' paraspinal muscles were measured by surface electromyography both before and after the SNAG mobilization. We measured the root mean square value of the paraspinal muscles during lumbar flexion and extension. Results: Paraspinal muscle activity in patients with chronic low back pain was different between the right and left sides. Importantly, paraspinal muscle activity significantly decreased after using the SNAG mobilization method. Conclusion: This study shows a difference between paraspinal muscle activity in chronic low back pain patients and finds that the Mulligan's concept of SNAG mobilization is effective at reducing imbalances in paraspinal muscle activity in low back pain patients.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.130-134
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• 2018

A 36-year-old male patient developed diffuse low back pain. His past medical history was unremarkable and had no family history of neuromuscular disease. He had no bladder and bowel problems. Creatine kinase was 172 U/L (normal < 170). Other fluid and blood chemistry tests were normal. Manual muscle test grades of extremities and sensory examination were normal. Muscle stretch reflexes were normal. Fasciculations and myotonia were not detected. Straight leg raising test was negative. There was no spinal root compression, spinal stenosis, or signal intensity change of spinal cord on magnetic resonance imaging (MRI). Fatty change and atrophy of the cervical, thoracic and lumbar paraspinal muscles were noted on MRI. Nerve conduction studies were normal. Electromyography showed 1+ positive sharp waves in the lumbar paraspinal muscles. Electromyography of upper and lower extremity muscles revealed no abnormal spontaneous activity. We report a rare case of severe paraspinal muscle atrophy with fatty degeneration in a Young Adult.

• Physical Therapy Rehabilitation Science
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• v.11 no.3
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• pp.329-334
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• 2022

Objective: Low back pain (LBP) is a symptom that accounts for a large proportion of musculoskeletal pain. Among them, non-specific LBP (NSLBP) means that the pathological cause is unknown, and belongs to the most common LBP. Studies on the mechanism of muscle control in LBP are insufficient, and quantitative studies are needed. Design: Observational cross-sectional study design Methods: A Thirty participants with NSLBP symptoms were enrolled, and their pressure pain thresholds (PPT) and muscle and fat thickness were measured. Participants measured the paraspinal muscles (PM) of the thoracic and lumbar spine and medial hamstring (semitendinosus) on the dominant and non-dominant sides in the prone position. Results: Among the variables that were significant in the correlation analysis, PM of the thoracic and lumbar spine showed a significant relationship in the PPT ([thoracic spine PM]=1.141+0.912 [lumbar spine PM]). Also, there was a significant relationship between the lumbar spine PM in the PPT and the thoracic spine PM in the muscle thickness ([lumbar spine PM of PPT]=4.057+0.117 [thoracic spine PM of muscle thickness]) Conclusions: Although there was no muscle imbalance according to the dominant and non-dominant side, there is a correlation between the pressure pain threshold and the muscle thickness between the paraspinal muscles of the thoracic spine and the lumbar spine.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2008.11a
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• pp.205-206
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• 2008

• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.42-52
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• 2021

Background: The purpose of this study was to investigate the effects of the severity and direction of lumbar disc herniation (LDH) on the facet joints and paraspinal muscles. Design: Cross-sectional design. Methods: The subjects were divided according to the diagnosis for severity of unilateral herniation of L4-L5 disc. The groups consisted of disc protrusion group (n=15), disc extrusion group (n=15), and no disc herniation group (n=15). The asymmetry and angle of facet joints and the cross-sectional area of paraspinal muscles were analyzed and compared using magnetic resonance imaging (MRI). Results: The results showed that the angle of facet tropism was larger in disc extrusion group than the disc protrusion group and the difference was found to be significant difference (p<0.01). In addition, when both left and right angles of patients with unilateral disc herniation were measured, the results showed larger facet joint angle in the herniated area of the disc extrusion group than in the disc protrusion group. When paraspinal muscles were measured according to the severity of disc herniation and the degree of facet joint asymmetry, there was no difference in paraspinal muscles between the disc protrusion and disc extrusion groups. Meanwhile, the multifidus muscle was smaller in the group with facet tropism than the group without facet tropism (p<0.03), while there were no significant differences in the erector spinae and psoas muscles. Conclusion: Progression of disc herniation resulted in increased facet joint tropism, increased angle of the facet joints in the direction of disc herniation, and decreased size of the multifidus muscle.