• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.661-668
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• 2018

Among the spinal disorders, the treatment approach for spinal deformities has been discussed least among department of neurosurgery. But nowadays, more and more neurosurgeons are interested in spinal deformities as well as complex spinal disorders and are doing not a few surgeries for these kinds of disease. Nevertheless, it is mandatory to understand the course of spinal deformity, principles of treatment, and surgical outcomes and complications. Understanding of the biology, biomechanics and metallurgy of the spine and instrumentation are also required for successful spinal deformity surgery. We need senior mentors and good surgical and neurophysiologic monitoring team. Knowledge of spinal deformity may be augmented with spine fellowships and surgical experience. Step by step training such as basic knowledge, orthopedic as well as neurosurgical disciplines and surgical skills would be mandatory. Neurosurgeons can have several advantages for spinal deformity surgeries. By high-level technical ability of the spinal cord handling to preserve neurological function and familiarity with microscopic surgery, better synergistic effect could be expected. A fundamental understanding of pediatric spinal deformity and growing spine should be needed for spinal deformity surgery.

• Journal of the Korean Society for Precision Engineering
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• v.27 no.2
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• pp.137-144
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• 2010

In general, spinal fusion surgery takes pressure off the pain induced nerves, by restoring the alignment of the spine. Therefore spinal fixation system is used to maintain the alignment of spine. In this study, a biomechanical study was performed comparing the SROM(Spinal Range Of Motion) of three types of system such as Rigid, Dynesys, and Fused system to analyze the behavior of spinal fixation system inserted in vertebra. Dynesys system, a flexible posterior stabilization system that provides an alternative to fusion, is designed to preserve inter-segmental kinematics and alleviate loading at the facet joints. In this study, SROM of inter-vertebra with spinal fixation system installed in the virtual vertebra from L4 to S1 is estimated. To compare with spinal fixation system, a simulation was performed by BRG. LifeMOD 2005.5.0 was used to create the human virtual model of spinal fixation system. Through this, each SROM of flexion, extension, lateral bending, and axial rotation of human virtual model was measured. The result demonstrates that the movement of Dynesys system was similar to normal condition through allowing the movement of lumbar.

• Journal of Korean Neurosurgical Society
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• v.45 no.5
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• pp.315-317
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• 2009

While syringomyelia is not a rare spinal disorder, syringomyelia associated with a spinal arachnoid cyst is very unusual. Here, we report a 62-year-old man who suffered from gait disturbance and numbness of bilateral lower extremities. Spinal magnetic resonance imaging (MRI) showed the presence of a spinal arachnoid cyst between the 7th cervical and 3rd thoracic vertebral segment and syringomyelia extending between the 6th cervical and 1st thoracic vertebral segment. The cyst had compressed the spinal cord anteriorly. Syringomyelia usually results from lesions that partially obstruct cerebrospinal fluid flow. Therefore, we concluded that the spinal arachnoid cyst was causing the syringomyelia. After simple excision of the arachnoid cyst, the symptoms were relieved. A follow-up MRI demonstrated that the syringomyelia had significantly decreased in size after removal of the arachnoid cyst. This report presents an unusual case of gait disturbance caused by syringomyelia associated with a spinal arachnoid cyst.

• Journal of Yeungnam Medical Science
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• v.37 no.2
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• pp.84-89
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• 2020

Spinal pain is a common patient complaint in clinical practice. Conservative treatment methods include oral medication, physical therapy, injections, and spinal orthoses. The clinical application of orthoses is debated because of potential complications associated with long-term use, such as muscle weakness and joint contracture. We reviewed the orthoses most frequently used to manage spinal pain. We review the use of soft cervical and Philadelphia collars, lumbosacral corsets, and thoracolumbosacral orthosis to manage spinal pain. Spinal orthoses can help reduce pain by protecting the muscles and joints of the injured spinal region, preventing or correcting malformations, and limiting trunk flexion, extension, lateral flexion, and rotation. The short-term use of spinal orthoses is known to improve pain and disability during the treatment period without significant adverse effects. Spinal orthoses are expected to alleviate pain and improve patients' lifestyle.

• Journal of Applied Reliability
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• v.14 no.4
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• pp.243-247
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• 2014

The Spinal cage is the cage-shaped implantable medical device used to treat structural abnormalities caused by degenerative intervertebral disks. In order to secure enough space to provide the mechanical stability and the intervertebral fusion, after removing the intervertebral disc, the Spinal cage is transplanted between the intervertebral space. A hammer is used to push the spinal cage into a narrow space during the spinal cage transplant surgery. Due to the impact and pressure, damage occurs frequently on the spinal cage. In this study, a test model is constructed to measure the value of impulse generally applied on the Spinal cage. The figures of internal impulse before and after the improvement of the Spinal cage are then compared to suggest direction to improve the reliability of the spinal cage.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.7 no.1
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• pp.15-20
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• 2012

Objectives : The aims of this study were to introduce the theory of traditional Chinese orthopedic theory(整脊理論) and to analyze the guideline of diagnosis and treatment of common spinal disorders by treating Chinese spinal manipulation technique(常見病中醫整脊指南). Methods : We have searched the web sites of traditional Chinese orthopedics association (整脊學會), a branch of the China academy of traditional Chinese medicine (TCM), and related articles. Additionally, we analyzed the guideline of diagnosis and treatment of common spinal disorders by treating Chinese spinal manipulation technique which was introduced by that association at 7th academic conference in China in 2011. Results : The guideline was prepared by 2 year project leaded by professor Yi-zhong Wei who was a person in charge of the spinal manipulation guideline of national standardization committee of TCM in China. It was a summary of the whole theory of China spinal manipulation therapy in TCM and contained 22 common spinal disorders by the treatment of traditional Chinese Tuina methods. Spinal manipulation theory was summarized by one doctrine, two theories, and two important view points. The treatment method was abstracted as 8 major Tuina techniques. Conclusions : The guideline will be a way of advance of Chinese spinal manipulation technique. This will be a good reference to Korea Chuna manipulation for improving their techniques.

• Korean Journal of Applied Biomechanics
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• v.29 no.1
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• pp.23-32
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• 2019

Objective: The aim of this study was to provide kinematic data on the characteristics of spinal disease patients by comparing and analyzing kinematic variables related to foot balance and gait pattern of spinal disease. Method: The subjects of the study included 40 adult men and 60 adult women who visited the hospital in Busan. Patients who were diagnosed with spinal disease by a physician through X-ray examination were selected as subjects for the diagnosis of vertebral disc herniation, spinal stenosis, spinal disease diagnosed with spinal disease and the general public. Left and right foot pressure and contact area were checked by Gaitview pro meter. X-ray photographs were taken with a Zen-2090 mobile fluoroscopy under physicians' direct participation. One-way ANOVA was performed to compare the differences between the kinematic variables and post-hoc was performed by the Duncan method. Results: The difference in contact area between the left foot and the right foot was $115.30{\pm}14.15cm^2$ in the left side and $124.25{\pm}13.65cm^2$ in the left side in the spinal disease patients. The difference in pressure between the left and right side of the spinal disease patients was wider than that of the general people. Especially, the right side of the spinal disease patients showed a larger area of left foot contact than the general population. Conclusion: Spinal disease patients have wider contact area of the left foot than those of the general population. In the case of right spinal disease, the left foot support area is widened due to pain. In the gait, women showed slightly more posterior body center than men, and the upper body muscle imbalance and immobilization due to the spinal disease caused imbalance of the muscles moving to the lower limb, It was analyzed to inhibit movement.

• PNF and Movement
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• v.7 no.2
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• pp.1-10
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• 2009

This research measures the conditions of spinal scoliosis of college students and analyses the factors that affect spinal scoliosis. From September 15, 2008 to October 30, 2008, the study was conducted with 142 C College students and measured the degrees of spinal scoliosis. The analysis was evaluated according to the Pneumex Analysis program. The collected data was compiled into statistics using the SPSS PC+ 12.0 program. The results were as follows: 1. It appeared that in the cases of C curve, reverse C curve, S curve, and the normal, there was a statistical significance(p=.010) between the conditions of spinal scoliosis of the two genders. 2. It appeared that the comparison among the three groups according to the characteristics of the subjects showed a statistical significance in spinal length(p=.000) in the C curve group, age(p=.019) and spinal length(p=.004) in the reverse C curve group, and spinal length (p=.035), difference in apparent leg length(p=.019), and difference in true leg length(p=.012) in the S curve group. 3. It appeared that in the normal group without spinal scoliosis, the results of comparing the differences in apparent true leg length and spinal length according to the characteristics of the subjects showed a statistical significance in spinal length and gender(p=.000), age (p=.008), height(p=.000), and whether or not there was a regular exercise over once per week(p=.001). 4. On the correlations between C curve, reverse C curve, and S curve and differences in apparent true leg length and spinal length, it appeared that: (a) As the difference in apparent leg length gets bigger the difference in true leg length gets big in C curve(r=.551, p=.000). (b) As the difference in apparent leg length gets bigger the difference in true leg length gets big in reverse C curve(r=.511, p=.006). (c) There is no correlation in S curve.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.195-200
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• 2011

Objective : To present the profiles of spinal cord tumors that can be removed through a unilateral hemilaminectomy and to demonstrate its usefulness for benign spinal cord tumors that significantly occupy the spinal canal. Methods : From June 2004 to October 2010, 25 spinal cord tumors were approached with unilateral hemilaminectomy. We calculated the cross-sectional occupying ratio (CSOR) of tumor to spinal canal before and after the operations. Results : The locations of the tumors were intradural extramedullary in 20 cases, extradural in 2, and intramedullary in 3. The levels of the tumors were lumbar in 12, thoracic 9, and cervical 4. In all cases, the tumor was removed grossly and totally without damaging spinal cord or roots. The mean height and width of the lesions we195re 17.64 mm (3-47.5) and 12.62 mm (4-32.7), respectively. The mean CSOR was 69.40% (range, 27.8-96.9%). Postoperative neurological status showed improvement in all patients except one whose neurologic deficit remained unchanged. Postoperative spinal stability was preserved during the follow-up period (mean, 21.5 months) in all cases. Tumor recurrence did not develop during the follow-up period. Conclusion : Unilateral hemilaminectomy combined with microsurgical technique provides sufficient space for the removal of diverse spinal cord tumors. The basic profiles of the spinal cord tumors which can be removed through the unilateral hemilaminectomy demonstrate its role for the surgery of the benign spinal cord tumors in various sizes.

• Neurospine
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• v.15 no.4
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• pp.388-393
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• 2018

Objective: Computed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological patterns of the AMF on CTM and investigated the significance and mechanisms of contrast dye flow into the AMF. Methods: Morphological patterns of the AMF on CTM were examined in 79 patients. Group A (24 patients) underwent surgery because of symptomatic cervical myelopathy. Group B (43 patients) had no clinical symptoms but showed spinal cord compression on CTM. Group C (12 patients), who showed neither clinical symptoms nor cord changes, underwent CTM for lumbar lesion evaluation. AMF patterns were classified into 4 types according to their configurations on CTM (reversed T, Y, V, and O types). Results: In group B, the reversed T type and Y type appeared significantly more often near the compressed portion (p<0.001). A similar tendency was seen in group A. The V and O types were most frequently observed in group C (p<0.001). Conclusion: On CTM, contrast dye tends to flow into the AMF of the cervical cord when the spinal cord is compressed. We speculate that there may be 3 possible mechanisms for this phenomenon: deformation of the epipial layer of the AMF due to cervical cord compression, AMF dilatation due to atrophy of the anterior funiculus or anterior horn, and temporary AMF dilatation when it becomes an alternative route for cerebrospinal fluid circulation.