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Analysis of Lumbosacral-Pelvic Parameters in Low Back Pain Patients (요통 환자의 요천추 및 골반 지표 분석)

  • Lee, Jin-Hyun;Jo, Dong-Chan;Kim, Chang-Gon;Moon, Su-Jeong;Park, Tae-Yong;Ko, Youn-Suk;Lee, Su-Kyung;Song, Yung-Sun;Lee, Jung-Han
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.2
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    • pp.139-149
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    • 2013
  • Objectives : The aim of this study was to investigate the characteristic of low back pain(LBP) and lumbosacral-pelvic alignments, and the relationship between them, depending on the presence and the duration of LBP. Methods : Ninety six patients were classified into the no LBP group(n=31), the acute LBP group(n=33) and the chronic LBP group(n=32), based on the presence and duration of LBP. In each group, lumbosacral-pelvic indicators were measured. The data were analysed by one way analysis of variance(ANOVA) and pearson correlation. Results : 1. The chronic LBP group showed the lower mean value in Ferguson angle, Lumbar lordosis angle, Pelvic Incidence and difference between left and right iliac height, being compared to acute LBP group. 2. There was not significant correlation between lumbosacral-pelvic alignments and LBP in every group. 3. A positive correlation was found among period of LBP and visual analogue scale(VAS), Oswestry disability index(ODI). Conclusions : For presence and duration of LBP, there were different characteristic values in descriptive statistics. And period of LBP is the most important factor for the degree of LBP. These results show that the lumbosacral-pelvic alignments and LBP have distinctive relationships depending on the duration of LBP.

Test-retest Reliability and Intratest Repeatability of Measuring Lumbar Range of Motion Using Inertial Measurement Unit (관성측정장치를 이용한 요추 가동범위 측정방법의 반복성 및 검사자 내 검사-재검사 신뢰도 연구)

  • Ahn, Ji Hoon;Kim, Hyun Ho;Youn, Woo Suck;Lee, Sun Ho;Shin, You Bin;Kim, Sang Min;Park, Young Jae;Park, Young Bae
    • Journal of Acupuncture Research
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    • v.31 no.1
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    • pp.61-73
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    • 2014
  • Objectives : The purpose of this study is to estimate the test-retest reliability and the intratest repeatability in measuring the lumbar range of motion of healthy volunteers with wireless microelectromechanical system inertial measurement unit(MEMS-IMU) system and to discuss the feasibility of this system in the clinical setting to evaluate the lumbar spine movement. Methods : 19 healthy male volunteers were participated, who got under 21 points at oswestry disability index(ODI) were adopted. Their lumbar motion were measured with IMU twice in consecutive an hour for the test-retest reliability study. Intratest repeatability was calculated in the two tests separately. The calculated intraclass correlation coefficients(ICC) were discussed and compared with the those of the previous studies. Results : Lumbar range of motion of flexion $41.45^{\circ}$, extension $16.34^{\circ}$, right lateral bending $16.41^{\circ}$ left lateral bending $13.63^{\circ}$ right rotation $-2.47^{\circ}$, left rotation $-0.61^{\circ}$. ICCs were 0.96~1.00(intratest repeatability) and 0.61~0.92(test-retest reliability). Conclusion : This study shows that MEMS-IMU system demonstrates a high test-retest reliability and intratest repeatability by calculated intraclass correlation coefficients. The results of this study represents that wireless inertial sensor measurement system has portable and economical efficiency. By MEMS-IMU system, we can measures lumbar range of motion and analyze lumbar motion effectively.

The Clinical Case of Oriental Medical Treatment at Tender Point for Patient with Lower Back Pain Suggesting of Amyotrophic Lateral Sclerosis (요통을 호소하는 ALS환자에 대한 한의학적 치료 효과 증례 보고)

  • Yeon, Chang-Ho;Pak, Hyun-Gun;Jo, Yoong-Ki;Jung, Jae-Young;Lee, Sang-Min;Kim, Sung-Soo
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.103-111
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    • 2010
  • Objectives : This study was performed to report the effect of oriental medical treatment in the lower back pain(LBP) with amyotrophic lateral sclerosis(ALS). Methods : A 32-years-old man who diagnosed as ALS was admitted with LBP. We treated him by burning acupuncture, herbal medicine, acupuncture, electroacupuncture, moxibustion, cupping therapy and physical therapy from 11th May 2010 to 10th June 2010. Results : After treatment, there was improvement in LBP. Pain Intensity estimated by visual analog scale(VAS) as percentile Pain Intensity Difference(PID), Korean Owestry Disbility Index(KODI) was also improved. Korean version of Amyotrophic lateral sclerosis Functional rating scale-revised(K-ALSFRS-R) shows that the patient's physical ability has been improved. Conclusions : Our study suggests that oriental medical treatment are significantly effective in the LBP due to ALS. And further studies will be aid to identify underlying mechanism of treatment.

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Development of New Prototype of Mechanical Quality Assurance for Clinical Linear Accelerator (의료용 선형가속기의 기계적 점검을 위한 새로운 정도관리 프로토콜의 개발)

  • 윤형근;신교철;김기환;오영기;김진기;정동혁;김정기;조문준;박인규
    • Progress in Medical Physics
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    • v.13 no.3
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    • pp.109-113
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    • 2002
  • In recent years, the radiotherapy equipment has become much more sophisticated, and with the complication comes an increased set of quality assurance (QA) responsibilities. Today's computer controlled linear accelerator requiring QA of not only the radiation integrity, but also the mechanical accuracy of the linear accelerator. The existing QA sheets are adequate for acceptance testing and commissioning but those sheets are somewhat descriptive form for routine QA. establishing the QA sheets for a facility are more efficient if the sheets could estimate the long-term stability for the result of QA. We are going to develope new prototype of mechanical QA sheet to visualize and to verify long-term stability of mechanical QA for clinical linear accelerator. The items included in mechanical QA sheet were 1) gantry rotation, 2) collimator rotation, 3) couch rotation, 4) optical distance indicator (ODI), and 5) laser alignment. We compared new prototype sheet with conventional sheet for several hospitals in Korea for those items. The QA acceptance criteria in this study mainly followed published recommendations. The contents of test for mechanical QA are the following. Confirm that the digital and/or mechanical gantry angle readouts are correct. Verify that digital and/or mechanical readouts of collimator angle agree with the true angle, as determined with the protractor. Measure the light field using a graph paper and compare with the digital readouts. Confirm digital readout accuracy. Verify that the sagittal laser, the left and right lasers, and the ceiling laser intersect at the isocenter. In the design of new QA sheet, we emphasized the representation of the long-term stability of mechanical QA by using Excel program. By using the new prototype QA sheet, we simplified and visualized the mechanical QA process, and could estimate the long-term stability of mechanical error of linear accelerator.

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The comparison of Effectiveness between Bee Venom and Sweet Bee Venom Therapy on Chronic Lower Back Pain. (만성요통환자에 대한 Bee Venom과 Sweet Bee Venom의 치료효능 비교 연구)

  • Kim, Jae-Hong;Jang, Sun-Hee;Yoon, Hyun-Min;Jang, Kyung-Jun;Ahn, Chang-Beohm;Kim, Cheol-Hong;Song, Choon-Ho;Choi, Han-Na
    • Journal of Pharmacopuncture
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    • v.11 no.4
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    • pp.15-24
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    • 2008
  • Objective The aim of this study is to investigate if Sweet Bee Venom(SBV) Therapy has the equal effect in comparison with Bee Venom (BV) Therapy on Chronic Lower Back Pain. Methods Clinical studies were conducted to 39 patients who were treated Chronic Lower Back Pain in Dept. of Acupuncture and Moxibustion, Dongeui University from March 1 to June 30, 2008. Subjects were randomly devided into 2 groups : BV treated group(Group A, n=19), SBV treated group(Group B, n=20) In BV treated group(Group A), we treated patients with dry needle acupuncture and BV Therapy. In SBV treated group(Group B), we treated patients with dry needle acupuncture and SBV Therapy. All process of treatment were performed by double blinding method. 1. To estimate the efficacy of venom in controlling pain, we have checked Visual Analog Scale(VAS). 2. For evaluating functional changes of patients, we have checked Oswestry Lower Back Disability Questionnaire(ODI). 3. To estimate Itching which is the most prominent symptom of allergic reaction, we have checked Visual Analog Scale(VAS). Results 1. In controlling pain, the results of BV treated group(Group A) is more effective than that of SBV treated group(Group B). 2. In promoting function, the results of BV treated group (Group A) is more effective than that of SBV treated group(Group B). 3. In controlling itching, the results of SBV treated group(Group B) is more effective than that of BV treated group(Group A). Conclusions According to the study, SBV Therapy shows more effective result than BV Therapy in controlling itching. But BV Therapy is more effective than SBV Therapy in controlling pain and promoting function.

Beck Depression Inventory Score and Associated Factors in Korean Patients with Lumbar Spinal Stenosis (척주관협착증 환자의 Beck Depression Inventory 점수와 이와 관련된 요인들의 분석)

  • Kim, Ae Ra;Seo, Bo Byoung;Kim, Jin Mo;Bae, Jung In;Jang, Young Ho;Lee, Yong Cheol;Kang, Chul Hyung;Jung, Sung Won;Hong, Ji Hee
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.138-142
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    • 2007
  • Background: Depression is a frequent comorbid disease of chronic pain patients. This study was conducted to evaluate the prevalence of depression and to correlate associated factors and depression in patients with lumbar spinal stenosis. Methods: The data of this survey was collected from 97 patients that visited our pain clinic for the management of lumbar spinal stenosis. Depression was examined by a self-reported survey using the Korean version of the Beck Depression Inventory (BDI). The Oswestry Disability Index (ODI) and the life satisfaction scale score were also obtained. Demographic and clinical characteristics (including spouse status, employment status, smoking status, the number of patients with multiple painful areas, the number of patients with combined disease, pain duration, visual analogue scale, Roland 5-point scale and walking distance) were obtained from an interview with the patient. The patients were divided into group N ($BDI{\leq}14$, n = 43) and group 0 (BDI > 14, n = 54) according to the BDI scale. Of the 97 patients, 55,7% had a high BDI score. Results: The patients in group N had a higher rate of employment (48.0%, P < 0.05) and had higher life satisfaction scale scores ($9.4{\pm}2.5$, P < 0.01) as compared to group D patients. The BDI score showed a close correlation with employment status and the life satisfaction scale. Conclusions: Many lumbar spinal stenosis patients had high BDI scores. Employment status and the life satisfaction scale were closely correlated with the BDI score.

Effect of Mechanical Thermal Massage Inducing Gradual Spinal Segmentation on the Improvement of Pain (단계적 척추 분절운동을 유도하는 기계식 온열 마사지가 통증 개선에 미치는 영향)

  • Hyeun-Woo, Choi;Do-Hyun, Ahn;Kyung-Mi, Jung;Na-Young, Kim;Ji-Eun, Lee;Jong-Min, Lee
    • Journal of the Korean Society of Radiology
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    • v.16 no.7
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    • pp.879-887
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    • 2022
  • In this study, we tried to confirm whether the mechanical sequential elevation method of the body pressure measuring bed actually induces segmental motion for each part of the spine. To this end, a lateral X-ray examination was performed, and it was confirmed that the sequential pressure device induces a step-wise segmentation of the spine by mechanically lifting each part of the spine vertically. Then, pain, walking ability, and depression scale were measured and analyzed in subjects who were aware of back pain. VAS(p<0.05) and ODI(p<0.05) for 10 days tended to decrease in average after bed use. In the gait ability test(p<0.05), as the number of times of bed use increased, the moving time in the test decreased and the moving distance increased. In addition, GSDDF(p<0.05) decreased after bed use. As a result, it was confirmed that the spinal segmentation caused by the heat and acupressure provided by the bed affected gait and depression as well as pain relief.

Effect of Vertically Rising Pressure Providing Spinal Canal Segment Motion on Symptom Relief in Patients with Parkinson's Disease (척추관 분절운동을 제공하는 수직 상승 압력이 파킨슨병 환자의 증상 완화에 미치는 영향)

  • Do-Hyun, Ahn;Hyeun-Woo, Choi;Kyung-Mi, Jung;Na-Young, Kim;Jong-Min, Lee
    • Journal of the Korean Society of Radiology
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    • v.16 no.6
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    • pp.787-797
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    • 2022
  • The purpose of this study was to confirm the reduction of pain and symptom relief of Parkinson's disease by vertically stimulating the spine through the application of a mechanical bed capable of thermal and massage stimulation. For this purpose, after confirming the segmental motion of the spine due to the use of a medical combination stimulation bed for Parkinson's disease patients, VAS, ODI, gait ability, and spiral drawing tests were performed, and the relationship between the variables was identified. In the 10-day visual analog scale and evaluation of low back pain dysfunction, the average trend of decreasing after bed use was confirmed. For walking ability, a decrease in the moving time and an increase in the moving distance were observed. In the spiral drawing test, the mean test time after using bed was significantly lower than before. As a result, it suggested the possibility of using it as an auxiliary method for recovery and pain relief of Parkinson's disease patients due to spinal segmental movement with mechanical heating and massage. However, this study is a preliminary study, and there is a small number of subjects, so additional research is needed that considers the number and condition of future subjects in detail.

Value of Additional Instrumented Fusion in the Treatment of Thoracic Ossification of the Ligamentum Flavum

  • Hwang, Sung Hwan;Chung, Chun Kee;Kim, Chi Heon;Yang, Seung Heon;Choi, Yunhee;Yoon, Joonho
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.719-729
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    • 2022
  • Objective : The ossification of the ligamentum flavum (OLF) is one of the major causes of thoracic myelopathy. Surgical decompression with or without instrumented fusion is the mainstay of treatment. However, few studies have reported on the added effect of instrumented fusion. The objective of this study was to compare clinical and radiological outcomes between surgical decompression without instrumented fusion (D-group) and that with instrumented fusion (F-group). Methods : A retrospective review was performed on 28 patients (D-group, n=17; F-group, n=11) with thoracic myelopathy due to OLF. The clinical parameters compared included scores of the Japanese Orthopedic Association (JOA), the Visual analogue scale of the back and leg (VAS-B and VAS-L), and the Korean version of the Oswestry disability index (K-ODI). Radiological parameters included the sagittal vertical axis (SVA), the pelvic tilt (PT), the sacral slope (SS), the thoracic kyphosis angle (TKA), the segmental kyphosis angle (SKA) at the operated level, and the lumbar lordosis angle (LLA; a negative value implying lordosis). These parameters were measured preoperatively, 1 year postoperatively, and 2 years postoperatively, and were compared with a linear mixed model. Results : After surgery, all clinical parameters were significantly improved in both groups, while VAS-L was more improved in the F-group than in the D-group (-3.4±2.5 vs. -1.3±2.2, p=0.008). Radiological outcomes were significantly different in terms of changes in TKA, SKA, and LLA. Changes in TKA, SKA, and LLA were 2.3°±4.7°, -0.1°±1.4°, and -1.3°±5.6° in the F-group, which were significantly lower than 6.8°±6.1°, 3.0°±2.8°, and 2.2°±5.3° in the D-group, respectively (p=0.013, p<0.0001, and p=0.037). Symptomatic recurrence of OLF occurred in one patient of the D-group at postoperative 24 months. Conclusion : Clinical improvement was achieved after decompression surgery for OLF regardless of whether instrumented fusion was added. However, adding instrumented fusion resulted in better outcomes in terms of lessening the progression of local and regional kyphosis and improving leg pain. Decompression with instrumented fusion may be a better surgical option for thoracic OLF.

The Therapeutic Effect of Postganglionic Nerve Block for Symptomatic Schmorl Nodule: A Retrospective Case Series (증후성 쉬모를 결절에 대한 신경절 이후 신경차단술의 치료 효과: 후향적 증례 분석)

  • Son, In Seok;Hwang, Suk Hyun;Lee, Suk Ha;Kang, Min Seok
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.147-153
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    • 2018
  • Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.