• 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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.13 no.2
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• pp.12-20
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• 2007

The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after applying program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, (-) value was increased between lumbar vertebra segment when was the load on spine. And so applying stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

• Journal of Korean Physical Therapy Science
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• v.13 no.4
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• pp.7-16
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• 2006

The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.181-188
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• 2019

Purpose: This study was performed to determine the effects of a gluteus maximus strengthening exercise on both spinal alignment and dynamic balance in subjects with kyphosis. Methods: We measured the kyphosis angle of 150 subjects and selected those whose kyphosis angle was > $50^{\circ}$. The participants included 10 male and 12 female college students. After a gluteus maximus strengthening exercise was applied, the subjects were measured by the formetric 4D and Biorescue systems. The collected data were analyzed by a paired t-test with the SPSS (Ver. 21) program for spinal alignment and dynamic balance comparisons both before and after the gluteus maximus strengthening exercise was completed. Results: The results regarding spinal alignment showed statistically significant decreases in pelvic tilt, kyphotic angle, and lordotic angle after the intervention (p < .05). However, trunk imbalance, pelvic torsion, surface rotation, and lateral deviation were not significantly different after the exercise. The results of the dynamic balance showed statistically significant increases in limits of stability after the exercise (p < .05). Conclusion: The above results suggest that the implemented gluteus maximus strengthening exercise may be effective for spinal alignment and dynamic balance in subjects with kyphosis.

• Journal of Korean Neurosurgical Society
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• v.29 no.11
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• pp.1484-1490
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• 2000

Objectives : In spinal metastasis and myeloma, percutaneous vertebroplasty could be an effective treatment method to provide spinal stabilization and to relief pain for early rehabilitation. The authors report twenty-five cases the clinical results of percutaneous vertebroplasty for twenty-five cases of spinal metastasis and myeloma. Materials and Methods : From September 1998 to December 1999, seventy percutaneous vertebroplasties(PVP) were performed for spinal metastases and myeloma in 25 patients, sixteen women and nine men ranging in age from 34 to 74. The primary malignancies were 6 multiple myelomas, and in metastatic tumore from various origin. All patients complained of severe pain and had osteolytic vertebral body destructions without spinal cord compression. To evaluate clinical improvement, suObjective verbal analogue pain score(VAS) and Karnofsky performance scale(KPS) were used. Thin sliced(2mm-thickness) sectional computed tomography(CT) was performed before and after PVP. Plain X-ray film was followed up every 1 month to assess the vertebral column stability. Results : In 25 patients, a total of seventy PVPS were performed successfully : 6 cervical, 33 thoracic and 31 lumbar vertebrae. Most patients had clear improvement of pain after PVP ; mean as score was 8.1 and 2.9 before and after PVP, respectively. Improvement was maintained in most patients. No further collapse of treated vertebrae was observed(mean follow-up, 7 months). Leakage of PMMA was notod in the spinal canal(13 levels), neural foramen (2 levels), adjacent disk(15 levels), paravertebral soft tissue(14 levels) and vein(8 levels). Pulmonary embolism was detected in three patients after the procedure, but was not associated with clinical symptoms. Conclusion : These results indicate that percutaneous vertebroplasty can be valuable treatment method in osteolytic spinal metastasis and myeloma, providing immediate pain relief and spinal stabilization and contributing to early rehabilitation.

• Journal of the Korean Society for Precision Engineering
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• v.27 no.2
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• pp.130-136
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• 2010

For stability analysis of the lumbar spine, the hypothesis presented is that the disc has stress sensors driving feedback mechanism, which could react to the imposed loads by adjusting the contraction of the muscles. Fusion in the motion segment of the lumbar spinal column is believed to alter the stability of the spinal column. To identify this effect finite element (FE) models combined with optimization technique was applied and quantify the role of each muscle and reaction forces in the spinal column with respect to the fusion level. The musculoskeletal FE model was consisted with detailed whole lumbar spine, pelvis, sacrum, coccyx and simplified trunk model. Vertebral body and pelvis were modeled as a rigid body and the rib cage was constructed with rigid truss element for the computational efficiency. Spinal fusion model was applied to L3-L4, L4-L5, L5-S1 (single level) and L3-L5 (two levels) segments. Muscle architecture with 46 local muscles was used as acting directions. Minimization of the nucleus pressure deviation and annulus fiber average axial stress deviation was selected for cost function. As a result, spinal fusion produced reaction changes at each motion segment as well as contribution of each muscle. Longissimus thoracis and psoas major muscle showed dramatic changes for the cases of L5-S1 and L3-L5 level fusion. Muscle force change at each muscle also generated relatively high nucleus pressure not only at the adjacent level but at another level, which can explain disc degeneration pattern observed in clinical study.

• The Journal of Korean Physical Therapy
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• v.31 no.5
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• pp.279-285
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• 2019

Purpose: This study examined the effects of spinal stabilization exercises using visual feedback on the gross motor function and balance of the sitting posture in children with cerebral palsy. Methods: The subjects were 18 children with cerebral palsy aged 8-15 years in the I-III stages of the Gross Motor Function Classification System. The subjects were divided into an experimental group (n=9) and control group (n=9). The experimental group was treated with 30 minutes of neurodevelopmental treatment and 20 minutes of spinal stabilization exercises using visual feedback. The control group was treated with 30 minutes of neurodevelopmental treatment and 20 minutes of spinal stabilization exercises without visual feedback. Both groups participated in the experiment twice a week for eight weeks. The Gross Motor Function Measurement was performed to evaluate the changes between pre- and the post-intervention in gross motor function. The Seated Limit of Stability Surface Area was measured to evaluate the changes in trunk balance. Results: Both experimental and control groups showed a significant increase in the gross motor function and trunk balance (p<0.05). The experimental group showed a significant increase in gross motor function compared to the control group (p<0.05). The experimental group showed a significant increase in the dynamic trunk balance in all directions when measuring the Seated Limit of Stability Surface Area (p<0.05). Conclusion: Spinal stabilization exercises using visual feedback for the neurodevelopmental treatment of children with cerebral palsy can improve their gross motor function and trunk balance when in a sitting posture more effectively.

• Journal of the Korean Society for Precision Engineering
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• v.28 no.1
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• pp.115-122
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• 2011

Recently, we have proposed a hypothesis that spinal structures have a stress sensor driving feedback mechanism, In the human spine, spinal structure could react to modify muscular action in such a way so as to equalize stress at the disc, therefore reduce the risk of injury, In this analysis, abdominal muscle and abdominal pressure, which were not included in the previous study, were added to identify those effects in spine stability during upright stance posture for the case where the intervertebral disc plays the role of mechanoreceptor, The musculoskeletal FE model was consisted with detailed whole lumbar spine, pelvis, sacrum, coccyx and simplified trunk model. Muscle architecture with 46 local muscles containing paraspinal muscle and 6 rectus abdominal muscles were assigned according to the acting directions. The magnitude of 4kPa was considered for abdominal pressure. Minimization of the nucleus pressure deviation and annulus fiber average tension stress deviation was chosen for cost function. Developed model provide nice coincidence with in-vivo measurement (nucleus pressure). Analysis was conducted according to existence of co-activation of abdominal muscle and abdominal pressure. Antagonistic activity of abdominal muscle produced stability of spinal column with relatively small amount of total muscle force. In contrast to the abdominal muscle, effect of abdominal pressure was not clear that was partly depending on the assumption of constant abdominal pressure.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.293-299
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• 2007

Objective : Thoracoscopic spinal surgery provides minimally invasive approaches for effective vertebral decompression and reconstruction of the thoracic and thoracolumbar spine, while surgery related morbidity can be significantly lowered. This study analyzes clinical results of thoracoscopic spinal surgery performed at our institute. Methods : Twenty consecutive patients underwent video-assisted thoracosopic surgery (VATS) to treat various thoracic and thoracolumbar pathologies from April 2000 to July 2006. The lesions consisted of spinal trauma (13 cases), thoracic disc herniation (4 cases), tuberculous spondylitis (1 case), post-operative thoracolumbar kyphosis (1 case) and thoracic tumor (1 case). The level of operation included upper thoracic lesions (3 cases), midthoracic lesions (6 cases) and thoracolumbar lesions (11 cases). We classified the procedure into three groups: stand-alone thoracoscopic discectomy (3 cases), thoracoscopic fusion (11 cases) and video assisted mini-thoracotomy (6 cases). Results : Analysis on the Frankel performance scale in spinal trauma patients (13 cases), showed a total of 7 patients who had neurological impairment preoperatively : Grade D (2 cases), Grade C (2 cases), Grade B (1 case), and Grade A (2 cases). Four patients were neurologically improved postoperatively, two patients were improved from C to E, one improved from grade D to E and one improved from grade B to grade D. The preoperative Cobb's and kyphotic angle were measured in spinal trauma patients and were $18.9{\pm}4.4^{\circ}$ and $18.8{\pm}4.6^{\circ}$, respectively. Postoperatively, the angles showed statistically significant improvement, $15.1{\pm}3.7^{\circ}$ and $11.3{\pm}2.4^{\circ}$, respectively(P<0.001). Conclusion : Although VATS requires a steep learning curve, it is an effective and minimally invasive procedure which provides biomechanical stability in terms of anterior column decompression and reconstruction for anterior load bearing, and preservation of intercostal muscles and diaphragm.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.1
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• pp.80-97
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• 2000

The purpose of this study is to identify and describe a process of sexual adjustment of individuals with spinal cord injury: and to describe and explore positive and negative influences on the adjustment process. This qualitative study was conducted with 10 Korean individuals with spinal cord injury who had been physically disabled for more than one year. Data were collected and analysed at a same time using grounded theory method. Major categories of this study showed a process how the individuals with spinal cord injury adjust to their individual life as sexual beings. The process included and individual responses to the behavioral efforts including and . Initially physical aspects of sexuality seemed to be affected by spinal cord injuries. The changed physical aspects then influenced other aspects of their sexual life. Life satisfaction of each individual as a sexual being revealed as very subjective. It could be defined according to how the individual approved their sexual life no matter what and how much behavioral effort the person had done. In this study 3 types of sexual adjustment aspects were explored: 'Active adjustment' 'Passive adjustment' 'Maladjustment'. There were negative and positive factors influencing the adjustment process of individuals with spinal cord injury. Those factors might come from themselves, from families, or from social situations. Findings of this study suggested that sexual life of individuals with spinal cord injury should not be understood as a physical or behavioral matter. It was a combination of physical, psychological and social aspects of life. Therefore, appropriate rehabilitation programs for the sexual adjustment of individuals with spinal cord injury need to concern heterogeneous life values of them and obtain individualized services for each individual at a different stage of the sexual adjustment process.