• Journal of International Academy of Physical Therapy Research
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• v.9 no.1
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• pp.1393-1397
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• 2018

The purpose of this study was to examine the effects of combined respiratory physical therapy on respiratory function, spinal curve and spinal mobility for community-dwelling elderlies with restrictive lung diseases. In total, 10 patients participated in an 8-week intervention program of thoracic cage mobilization and breathing exercise in combination. The results of the study are as follows: for respiratory function, the forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC), and FEV1/FVC were significantly improved to $.30{\pm}0.31{\ell}$, $.46{\pm}.42{\ell}$, and $18.10{\pm}11.39%$, respectively (p<.05). For spinal curve, the thoracic curve and the lumbar curve were improved significantly to $-2.20{\pm}1.40^{\circ}$ and $-1.20{\pm}1.14^{\circ}$, respectively (p<.01). For spinal mobility, the thoracic flexion ($3.40{\pm}2.99^{\circ}$), thoracic extension ($3.50{\pm}1.43^{\circ}$), lumbar flexion ($4.50{\pm}4.74^{\circ}$), and lumbar extension($-1.50{\pm}1.84^{\circ}$) were all significantly improved (p<.05). These findings indicate that thoracic cage mobilization and breathing exercise in combination improve the respiratory function, spinal alignment, and spinal mobility in elderly people with restrictive lung diseases.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.500-507
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• 2018

Background: The sagittal alignment of the spine and pelvis is not only closely related to the overall posture of the body but also to the evaluation and treatment of spine disease. In the last few years, the EOS imaging system, a new low-dose radiation X-ray device, became available for sagittal alignment assessment. However, there has been little research on the reliability of EOS. The purpose of this study was to evaluate the intrarater and interrater reliability of EOS for the sagittal alignment assessment of the spine and pelvis. Methods: Records of 46 patients were selected from the EOS recording system between November 2016 and April 2017. The exclusion criteria were congenital spinal anomaly and deformity, and previous history of spine and pelvis operation. Sagittal parameters of the spine and pelvis were measured by three examiners three times each using both manual and EOS methods. Means comparison t-test, Pearson bivariate correlation analysis, and reliability analysis by intraclass correlation coefficients (ICCs) for intrarater and interrater reliability were performed using R package "irr." Results: We found excellent intrarater and interrater reliability of EOS measurements. For intrarater reliability, the ICC ranged from 0.898 to 0.982. For interrater reliability, the ICC ranged from 0.794 to 0.837. We used a paired t-test to compare the values measured by manual and EOS methods: there was no statistically significant difference between the two methods. Correlation analysis also showed a statistically significant positive correlation. Conclusions: EOS showed excellent reliability for assessment of the sagittal alignment of the spine and pelvis.

• Journal of the Korean Applied Science and Technology
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• v.37 no.6
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• pp.1556-1566
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• 2020

The purpose of this study was to investigate the effect of Nurida-Ball exercise on isokinetic muscle function, spinal alignment, and dynamic balance capacity in middle-aged men. All middle-aged men(n=16) were divided into 2 groups: Ball exercise(BE, n=8) and control(CON, n=8) group. BE group performed the Nurida-Ball exercise(30 min/day, 3 days/week, 8 weeks) and isokinetic knee and trunk muscle function, spinal alignment, and dynamic balance capacity were measured. All of the measured variables calculated the mean and standard deviation and verified normality using the Shapiro-Wilk test. The independent t-test method and the Paired t-test method were then analyzed to identify differences between groups. This study found that isokinetic knee and trunk muscle function was significantly strengthened in the BE compared with CON group by increasing peak torque(PT) of right and left knee extension(60°/sec, p<0.01, respectively), average power(AP) of right and left knee extension(60°/sec, p<0.05, p<0.01, respectively), and PT of right knee flexion(180°/sec, p<0.05) and AP of right knee extension(180°/sec, p<0.05). In the change of isokinetic trunk muscle function, only PT of trunk extension(180°/sec) was increased in the BE compared with the CON group(p<0.05). In addition, Nurida-ball exercise can improve the spinal alignment by reducing the trunk inclination(p<0.05) in the BE compared with the CON group. Finally, dynamic balance capacity was also enhanced in the BE compared with the CON group by decreasing the score of overall balance index(OBI, p<0.01) and Antero-posterior balance index(p<0.05) in the Stage-6, and OBI(p<0.05) in the Stage-1. This result demonstrated that Nurida-ball exercise may improve spinal alignment, dynamic balance capacity, and isokinetic muscle function, which might be an effective way for the improvement of health-related fitness in middle-aged men.

• Journal of Korean Neurosurgical Society
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• v.66 no.6
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• pp.611-617
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• 2023

The cervical spine plays a critical role in supporting the skull, maintaining horizontal gaze, and facilitating walking. Its unique characteristics, including the widest range of motion among spinal segments, have led to extensive research on cervical sagittal alignment. Various parameters have been proposed to evaluate cervical alignment, with studies investigating their clinical significance, correlation with symptoms, and implications for surgical interventions. Recent findings suggest that cervical sagittal alignment not only impacts the cervical spine but also influences global spine-pelvic alignment through compensatory mechanisms. This comprehensive review examines classical and new parameters of cervical sagittal alignment and considers the dynamic and muscular factors associated with it.

• Journal of Korean Neurosurgical Society
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• v.53 no.1
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• pp.49-51
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• 2013

A case of traumatic spondyloptosis of the cervical spine at the C6-C7 level is reported. The patient was treated succesfully with a anterior-posterior combined approach and decompression. The patient had good neurological outcome after surgery. A-51-year-old female patient was transported to our hospital's emergency department after a vehicle accident. The patient was quadriparetic (Asia D, MRC power 4/5) with severe neck pain. Plain radiographs, computerize tomography and spinal magnetic resonance imaging (MRI) showed C6-7 spondyloptosis and C5, C6 posterior element fractures. Gardner-Wells skeleton traction was applied. Spinal alignment was reachived by traction and dislocation was decreased to a grade 1 spondylolisthesis. Then the patient was firstly operated by anterior approach. Anterior stabilization and fusion was firstly achieved. Seven days after first operation the patient was operated by a posterior approach. The posterior stabilization and fusion was achieved. Postoperative lateral X-rays and three-dimensional computed tomography showed the physiological realignment and the correct screw placements. The patient's quadriparesis was improved significantly. Subaxial cervical spondyloptosis is a relatively rare clinical entity. In this report we present a summary of the clinical presentation, the surgical technique and outcome of this rarely seen spinal disorder.

• Progress in Medical Physics
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• v.24 no.4
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• pp.290-294
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• 2013

Stereotactic Radiosurgery require high accuracy and precision of patient positioning and target localization. We evaluate the real time positioning accuracy of isocenter using optic guided patient positioning system, ExacTrac (BrainLab, Germany), during spinal radiosurgery procedure. The system is based on real time detect multiple body markers attached on the selected patient skin landmarks. And a custom designed patient positioning verification tool (PPVT) was used to check the patient alignment and correct the patient repositioning before radiosurgery. In this study, We investigate the selected 8 metastatic spinal tumor cases. All type of tumors commonly closed to thoracic spinal code. To evaluate the isocenter positioning, real time patient alignment and positioning monitoring was carried out for comparing the current 3-dimensional position of markers with those of an initial reference positions. For a selected patient case, we have check the isocenter positioning per every 20 millisecond for 45 seconds during spinal radiosurgery. In this study, real time average isocenter positioning translation were $0.07{\pm}0.17$ mm, $0.11{\pm}0.18$ mm, $0.13{\pm}0.26$ mm, and $0.20{\pm}0.37$ mm in the x (lateral), y (longitudinal), z (vertical) directions and mean spatial error, respectively. And body rotations were $0.14{\pm}0.07^{\circ}$, $0.11{\pm}0.07^{\circ}$, $0.03{\pm}0.04^{\circ}$ in longitudinal, lateral, table directions and mean body rotation $0.20{\pm}0.11^{\circ}$, respectively. In this study, the maximum mean deviation of real time isocenter positioning translation during spinal radiosurgery was acceptable accuracy clinically.

• Journal of Korean Neurosurgical Society
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• v.64 no.1
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• pp.4-12
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• 2021

Spinal metastases can present with varying degrees of mechanical instability. The Spinal Instability Neoplastic Score (SINS) was developed as a tool to assess spinal neoplastic-related instability while helping to guide referrals among oncology specialists. Some previous papers suggested that the SINS was accurate and reliable, while others disagreed with this opinion. We performed a systematic review regarding the SINS to evaluate its accuracy and precision in predicting vertebral compression fractures (VCFs). The 21 included studies investigated a total of 2118 patients. Thirteen studies dealt with the accuracy of SINS to predict post-radiotherapy VCFs, and eight dealt with the precision. Among 13 studies, 11 agreed that the SINS categories showed statistically significant accuracy in predicting VCF. Among eight studies, body collapse was effective for predicting VCFs in six studies, and alignment and bone lesion in two studies. Location has no statistical significance in predicting VCFs in any of the eight studies. The precision of SINS categories was substantial to excellent in six of eight studies. Among the six components of the SINS, the majority of the included studies reported that location showed near perfect agreement; body collapse, alignment, and posterolateral involvement showed moderate agreement; and bone lesion showed fair agreement. Bone lesion showed significant accuracy in predicting VCFs in half of eight studies, but displayed fair reliability in five of seven studies. Although location was indicated as having near perfect reliability, the component showed no accuracy for predicting VCFs in any of the studies and deleting or modifying the item needs to be considered. The SINS system may be accurate and reliable in predicting the occurrence of post-radiotherapy VCFs for spinal metastasis. Some components seem to be substantially weak and need to be revised.

• Journal of Convergence for Information Technology
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• v.9 no.8
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• pp.243-247
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• 2019

The purpose of this study was to determine the effect of climbing exercise program on the spinal alignment and balance ability of students in 20's. The subjects of this study were 30 university students. Experimental group was performed climbing program combined with upper and lower extremity pattern for three times per week, during six weeks. A Self-efficacy questionnaire was used assess the self-confidence, individdual confidence, or belifes in specific tasks. The results of comparison of variations in each group showed that there was a significant difference in the training group(p<0.05). Climbing exercise program combined with upper and lower extremity pattern is effective for improvement of the self-efficay. So, these study results will be useful as reference date for improvement of the self-efficay.

• Journal of Korean Neurosurgical Society
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• v.53 no.6
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• pp.356-369
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• 2013

Objective : We performed a retrospective analysis of medical records and radiographic images of patients who never underwent spinal treatment including diagnosis. The objective of this study is to explain the biomechanical and physiologic characteristics of cervical alignment related to thoracic inlet angle including T1 slope changes in each individual. Methods : We reviewed the cervical CT radiographs of 80 patients who visited ENT outpatient clinic without any symptom, diagnosis and treatment of cervical spine from January 2011 to September 2012. All targeted people were randomized without any prejudice. We assessed the data-T1 slope, Cobb's angle C2-7, neck tilt, sagittal vertical axis (SVA) C2-7 and thoracic inlet angle by the CT radiographs. Results : The relationships between each value were analyzed and we concluded that Cobb's angle C2-7 gets higher as the T1 slope gets higher, while the SVA C2-7 value decreases. Conclusion : We propose that the T1 slope is background information in deciding how much angle can be made in the cervical spinal angle of surgical lordotic curvature, especially severe cervical deformity.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.677-692
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• 2021

Many studies have focused on pre-operative sagittal alignment parameters which could predict poor clinical or radiological outcomes after laminoplasty. However, the influx of too many new factors causes confusion. This study reviewed sagittal alignment parameters, predictive of clinical or radiological outcomes, in the literature. Preoperative kyphotic alignment was initially proposed as a predictor of clinical outcomes. The clinical significance of the K-line and K-line variants also has been studied. Sagittal vertical axis, T1 slope (T1s), T1s-cervical lordosis (CL), anterolisthesis, local kyphosis, the longitudinal distance index, and range of motion were proposed to have relationships with clinical outcomes. The relationship between loss of cervical lordosis (LCL) and T1s has been widely studied, but controversy remains. Extension function, the ratio of CL to T1s (CL/T1s), and Sharma classification were recently proposed as LCL predictors. In predicting postoperative kyphosis, T1s cannot predict postoperative kyphosis, but a low CL/T1s ratio was associated with postoperative kyphosis.