• Title/Summary/Keyword: Spinal stability

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Effects of Sling Exercise on Spinal Flexibility and Dynamic Balance in Adolescent Scoliosis Patients (청소년기 척추측만증 환자에 대한 슬링운동이 척추유연성과 동적 균형에 미치는 영향)

  • Yoo, Dal-young;Choi, Jong-uk;Park, Seong-doo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.26 no.1
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    • pp.19-26
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    • 2020
  • Background: The purpose of this study was compare and analyze the flexibility and dynamic balance in adolescents with idiopathic scoliosis and provide scientific basis for effectively treating idiopathic scoliosis. Methods: The subjects of this study were 20 members of adolescences. To measure the flexibility of the spine, a left buckling instrument was used, and it was measured using a modified sit and reach test. They were randomly divided into core exercise with sling program group (n=10) and general exercise program group (n=10), each consisting 50 minutes each for 4 times per week for 8 weeks. Results: The results of the study are as follows. First, Both groups were increased statistically significantly in spinal flexibility but no significant differences have been found between the two groups after 8 weeks of exercise. Second, Both groups were increased statistically significantly in balance ability of dynamic foot pleasure ratio but no significant differences have been found between the two groups after 8 weeks of exercise. Conclusion: In summarizing the results of this study, sling exercise with core exercise was effective in the decrease of flexibility and stability than general scoliosis exercise in adolescents with idiopathic scoliosis. It is also believed to be applicable to spinal diseases caused by muscular weakness since it is effective in strengthening core muscle strength.

Expandable Cage for Cervical Spine Reconstruction

  • Zhang, Ho-Yeol;Thongtrangan, Issada;Le, Hoang;Park, Jon;Kim, Daniel H.
    • Journal of Korean Neurosurgical Society
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    • v.38 no.6
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    • pp.435-441
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    • 2005
  • Objective : Expandable cage used for spinal reconstruction after corpectomy has several advantages over nonexpendable cages. Here we present our clinical experience with the use of this cage after anterior column corpectomy with an average of one year follow up. Methods : Ten patients underwent expandable cage reconstruction of the anterior column after single-level or multilevel corpectomy for various cervical spinal disorders. Anterior plating with or without additional posterior instrumentation were performed in all patients. Functional outcomes, complications, and radiographic outcomes were determined. Results : There was no cage-related complication. Functionally, neurological examination revealed improvement in 7 of 10 patients and no patient had neurological deterioration after the surgery. Immediate stability was achieved and maintained throughout the period of follow-up. There was minimal subsidence [<2mm] noticeable in three of the cases that underwent a two-level corpectomy. Subsidence was noted in osteoporotic patients and patients undergoing multi-level corpectomies. Average pre-operative kyphotic angle was 9 degrees. This was corrected to an average of 5.4 degrees in lordosis postoperatively. Conclusion : In conclusion, expandable cages are safe and effective devices for vertebral body replacement after cervical corpectomy when used in combination with anterior plating with or without additional posterior stabilization. The advantages of using expandable cages include its ability to easily accommodate itself into the corpectomy defect, its ability to tightly purchase into the end plates after expansion and thus minimizing the potential for migration, and finally, its ability to correct kyphosis deformity via its in vivo expansion properties.

Functional Outcomes of Subaxial Spine Injuries Managed With 2-Level Anterior Cervical Corpectomy and Fusion: A Prospective Study

  • Jain, Vaibhav;Madan, Ankit;Thakur, Manoj;Thakur, Amit
    • Neurospine
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    • v.15 no.4
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    • pp.368-375
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    • 2018
  • Objective: To evaluate the results of operative management of subaxial spine injuries managed with 2-level anterior cervical corpectomy and fusion with a cervical locking plate and autologous bone-filled titanium mesh cage. Methods: This study included 23 patients with a subaxial spine injury who matched the inclusion criteria, underwent 2-level anterior cervical corpectomy and fusion at our institution between 2013 and 2016, and were followed up for neurological recovery, axial pain, fusion, pseudarthrosis, and implant failure. Results: According to Allen and Ferguson classification, there were 9 cases of distractive extension; 4 of compressive extension; 3 each of compressive flexion, vertical compression, and distractive flexion; and 1 of lateral flexion. Sixteen patients had a score of 6 on the Subaxial Injury Classification system, and the rest had a score of more than 6. The mean follow-up period was 19 months (range, 12-48 months). Neurological recovery was observed in most of the patients (78.21%). All patients experienced relief of axial pain. None of the patients received a blood transfusion. Twenty-one patients (91.3%) showed solid fusion and 2 (8.69%) showed possible pseudarthrosis, with no complications related to the cage or plate. Conclusion: Two-level anterior cervical corpectomy and fusion, along with stabilization with a cervical locking plate and autologous bone graft-filled titanium mesh cage, can be considered a feasible and safe method for treating specific subaxial spine injuries, with the benefits of high primary stability, anatomical reduction, and direct decompression of the spinal cord.

Anterolateral Surgical Decompression and Instrumentation in Thoracolumbar Bursting Fracture (외상성 흉요추접합부 파열골절의 전측방경유법에 의한 신경감압 및 기구고정술)

  • Bae, Jang-Ho
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.234-242
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    • 1996
  • Ten patients with a thoracolumbar spine fractures were treated with Kaneda internal fixation device through anterolateral approach during last 1 year. In all cases, spinal decompression, internal instrument fixation and hone fusion with rib were performed. No patient showed neurological deterioration after surgery and 6(60%) patients improved postoperatively with entering the next Frankel subgroup. Follwo-up patient evaluation showed the correction of the fracture deformity with good bony fusion, but 3 patient arc remained back pain. According to above results we concluded that anterolateral internal fixation combined with hone fusion using rib was good mechanical stability and decompression of protruding ventral bone fragments above conus medullaris level.

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The Modified Outside-In Technique for Meniscal Suture - Technical Note - (변형된 Outside-In 기법을 이용한 반월상 연골판 봉합술 - 수술 수기 -)

  • Lee Kee-Byoung;Kwon Duck-Joo;Lee Young-Gyun;Song Young-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.96-99
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    • 2003
  • As arthroscopy is more advanced and the importance of meniscal function is more emphasized, there have been more advanced en meniscal repair technique. However conventional technique require the use of special instruments and extensive skin incision to protect the neurovasculatures and soft tissues. Also these have the potential problem of damage in articular surfaces by the knot. So, we develop a modified outside-in technique using spinal needles and nylon loops. Our method have many advantages not only in stability but simplicity, and there is no need of additional skin incision.

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Biomechanical Evaluation of SMA Dynamic Stabilization for Spinal fusion (척추고정용 형상기억합금 동적안정기기의 생체역학적 성능 평가)

  • Kim Y.H.;Park W.M.;Kim K.;Park H.K.;Joo J.W.;Park K.W.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2006.05a
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    • pp.517-518
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    • 2006
  • In this study, a commercial fixation device, BioFlex, which was designed with shape memory alloy(SMA) for dynamic stabilization of spine was biomechanically evaluated. The finite element model of intact lumbar spine from L1 to S was developed using CT images. Also, low FE models of 2-level(L4-L5-S) and 3-level(L3-L4-L5-S) posteriori fixation using titanium(Ti) rod and BioFlex(SMA) rod. The rotations of bone segments in the intact model and four models were predicted. Although the rotations of the BioFlex fixation model were smaller than those of the intact model, they were relatively larger than those of Ti fixation. The present can be applied for not only evaluation of the stability of interbody fixator, but also development of new implant.

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Design and Control of a Dynamic PLS of the Biped Walking RGO for a Trainning of Rehabilitation considering Human Vibration (인체진동을 고려한 재활훈련용 이족보행 RGO 보조기의 생체역학적 해석 <인체진동 응력해석과 FEM을 중심으로>)

  • 장대진;김명회;양현석;백윤수;박영필;박창일
    • Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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    • 2002.05a
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    • pp.752-759
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    • 2002
  • This paper presented a design and a control of a biped walking RGO and walking simulation by this system. The biped walking RGO was distinguished from the other one by which had a very light-weight and a new RGO type with 12-servo motors. The vibration evaluation of the dynamic PLS on the biped walking RGO was used to access by the 3-axis accelerometer with a low frequency vibration for the spinal cord injuries. The gait of a biped walking RGO depended on the constrains of mechanical kinematics and the initial posture. The stability of dynamic walking was investigated by a ZMP (Zero Moment Point) of the biped walking RGO. It was designed according to a human wear type and was able to accomodate itself to a human environments. The joints of each leg were adopted with a good kinematic characteristics. To test of the analysis of joint kinematic properties, we did the strain stress analysis of the dynamic PLS and the analysis study of FEM with a dynamic PLS. It will be expect that the spinal cord injury patients are able to recover effectively with a biped walking RGO.

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Treatment Effects of Upper Body Traction (V-trac) for the HIVD (요추추간판 탈충증에 대한 상체견인(V-trac)의 치료효과 연구)

  • Kim, Myung-Joon;Park, Ji-Whan
    • Journal of Korean Physical Therapy Science
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    • v.2 no.4
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    • pp.749-761
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    • 1995
  • The purpose of this study was to analyze the effects of V-trac on the clinical characteristics of patients who suffered from HIVD. The data were collected from 500 cases who had lumbar disc problems, from August, 1993 to July, 1995. The results of study were as follows; 1. Total patients statistics; mean age is 38 years, average duration of symptom is 5.4 years. 2. Symptomatic effects; HNP is 89.5 %, spinal stenosis is 55.1 %, and mean effects of total symptom is 80.0 %. 3. Pain relief effects; 1st session is 85.0 %, 7 th sessions are 89.3 %. 4. Back muscle improved effects; 10 sessions are 25.6 % rather than 1st session patients. 5. Sciatic scoliosis correction effect; Corrected scoliosis is improved 86.6 % by the 14 sessions V-trac. 6. Psychological effects; mental vigour is 51.2 %, emotional stability is 57.4 %, well-being is 72.5 %, comfortable sleeping is 60.2 %. 7. Follow-up states after V-trac therapy; Good conditions are 72.0 %, less conditions are 28.0 % after 1 month.

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Analysis of Spinal Stability Affected by Working Height, Safety Handrail and Work Experience in Using Movable Scaffold (이동식 틀비계 사용 작업 시 작업대 높이, 안전난간 유무, 숙련도에 따른 척추 안정성 분석)

  • Kim, Jung-Yong;Min, Seung-Nam;Sung, Si-Hoon
    • Journal of the Ergonomics Society of Korea
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    • v.29 no.3
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    • pp.347-356
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    • 2010
  • The purpose of this study is to analyze the spine stability by comparing muscle activation in various scaffold working conditions. The independent working conditions were designed by two levels of working height, existence and absence of safety handrail, and the two levels of expertise. The corresponding activities of the agonist and antagonist muscles of spine were simultaneously recorded by using EMG. As results, novice worker showed increased muscle activity while doing the task on the 2nd floor, absence of handrail. And expert showed the increase of co-contraction while working on the 2nd floor without handrail. Such co-contraction was found to increase the spine stability when the working condition become risky. On the other hand, the co-contraction was prolonged, the spine muscle fatique and disc pressure could be increased, which would increase the risk of musculo-skeletal disorder. The results of co-contraction in this study indicates that the motor control system responds to maintain the stability of the spine particularly when workers cognitively recognize the danger of falling or imbalance. This study also quantitatively accounted for the biomechanical cause of LBP among workers who has to prevent themselves from falling. Therefore, if can be said that safe environment preventing falling can also prevent workers from MSDs as well. Such knowledge can be applied to design ergonomic workplace environment as well as movable scaffold.

Follow-up Results of Z-plate Fixation in the Thoracolumbar Burst Fracture (흉요추 방출성 압박골절의 Z-plate를 이용한 고정술후 추적검사 결과)

  • Shim, Byeoung-Su;Kim, Keun-Su;Lee, Jung-Chung
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.763-771
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    • 2000
  • Objectives : Thoracolumbar burst fractures(TBLF) result in not only compressive deformity of vertebral body but also spinal cord compression by bony fragments. Many thoracolumbar burst fractures demand both anterior decompression and intervertebral fusion. Most of spinal surgeons use anterior instrumentation for anteior intervertebral bony fusion. The use of Z-plate has been increased recently, however there has been only a few reports regarding its clinical long-term strength. We studied nineteen patients with TBLF to find out the long-term stability of Z-plate. Methods : We have operated 19 patients from March 1996 to August 1998. They were treated with anterior decompression through either a transthoracic, retroperitoneal extrapleural or retroperitoneal approach. Retropulsed bony fragments were removed completely by corpectomy. Iliac bone graft was used for interbody fusion in all of the cases. They were evaluated by plain X-ray films including flexion and extention lateral films. Cobbs angle was used to evaluate kyphotic and lateral wedging deformity. Results : Burst fractured sites were T11 in two, three T12, nine L1, and five L2. Mean follow-up duration was fifteen months. Preoperative average kyphotic angle was 23.7 degree. Immediate postoperative kyphotic angle was 10.2 degree. Follow-up resluts of average kyphotic angles revealed 14 degrees. Four patients(21%), including two spinal 3-column injury, showed increasement of kyphotic angle more than 5 degree or breakage of intrumentation. Two patients showed the difference of kyphotic angle more than 3 degree. Five patients(26%) revealed lateral wedging deformity more than 3 degrees. Postoperative complications were two meralgia parestheticas, one pulmonary atelectasis and two donor site infections. Four of the eight patients, who initially showed incomplete spinal cord deficits, were nerologically improved by Frankel's grade. Conclusion : Z-plate fixation and iliac bone graft after anterior decompression in thoracolumbar burst fractures is a safe and easy method. Immediate postoperative results revealed excellent correction of posttraumatic kyphosis, but long-term follow-up evalution showed insufficient strength. Therefore we believe that use of Z-plate should be carefully decided, especially in the case of large lumbar fracture or 3-column injury.

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