• Journal of Korean Neurosurgical Society
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• 제43권6호
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• pp.294-299
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• 2008

Objective : To evaluate the clinical characteristics and surgical outcomes of the patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy. Methods : The authors reviewed the clinical and neurodiagnostic findings, surgical managements and outcomes in six consecutive patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy who had been treated with surgical decompression and fusion procedures between January 1999 and December 2005. The mean age of the 6 patients (four women and two men) at the time of surgery was 42.8 years (range, 31-55 years). The mean follow-up period was 56.5 months (range, 17-112 months). The neurological outcome was evaluated before and after operations (immediately, 6 months after and final follow-up) using grading systems of the walking ability, brachialgia and deltoid power. Results : At immediate postoperative period, after 6 months, and at final follow-up, all patients showed apparent clinical improvements in walking ability, upper extremity pain and deltoid muscle strength. Late neurological deterioration was not seen during follow-up periods. There were no serious complications related to surgery. Conclusion : Surgical decompression and stabilization in patients with cervical spondylotic myelopathy associated with athetoid cerebral palsy have been challenging procedure up to now. Our results indicate that early diagnosis and appropriate surgical procedure can effectively improve the clinical symptoms and neurological function in patients with cervical spondylotic myelopathy and athetoid cerebral palsy, even in those with severe involuntary movements.

• Journal of Korean Neurosurgical Society
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• 제44권1호
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• pp.8-14
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• 2008

Objective : The purpose of this study was to determine the efficacy of short segment fixation following postural reduction for the re-expansion and stabilization of unstable burst fractures in patients with osteoporosis. Methods : Twenty patients underwent short segment fixation following postural reduction using a soft roll at the involved vertebra in cases of severely collapsed vertebrae of more than half their original height. All patients had unstable burst fracture with canal compromise, but their motor power was intact. The surgical procedure included postural reduction for 2 days and bone cement-augmented pedicle screw fixations at one level above, one level below and the fractured level itself. Imaging and clinical findings, including the level of the vertebra involved, vertebral height restoration, injected cement volume, local kyphosis, clinical outcome and complications were analyzed. Results : The mean follow-up period was 15 months. The mean pain score (visual analogue scale) prior to surgery was 8.1, which decreased to 2.8 at 7 days after surgery. The kyphotic angle improved significantly from $21.6{\pm}5.8^{\circ}$ before surgery to $5.2{\pm}3.7^{\circ}$ after surgery. The fraction of the height of the vertebra increased from 35% and 40% to 70% in the anterior and middle portion. There were no signs of hardware pull-out, cement leakage into the spinal canal or aggravation of kyphotic deformities. Conclusion : In the management of unstable burst fracture in patients with severe osteoporosis, short segment pedicle screw fixation with bone cement augmentation following postural reduction can be used to reduce the total levels of pedicle screw fixation and to correct kyphotic deformities.

• Journal of Korean Neurosurgical Society
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• 제46권4호
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• pp.305-311
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• 2009

Objective : The purpose of this study was to determine the efficacy, radiological findings, clinical outcomes and complications in patients with lumbar stenosis and osteoporosis after the use of polymethylmethacrylate (PMMA) augmentation of a cannulated pedicle screw. Methods : Thirty-seven patients with degenerative spinal stenosis and osteoporosis (T-score < -2.5) underwent lumbar fusion using the Dream Technology Pedicle Screw ($DTPS^{TM}$, Dream Spine Total Solutions, Dream STS, Seoul. Korea) between 2005 and 2007. The clinical outcomes were evaluated by using the visual analog scale (VAS) and the Prolo scale. Radiologic findings were documented through computed tomography (CT) and plain films. Results : Thirty-seven patients were evaluated and included, 2 males and 35 females with an average bone mineral density (BMD) of $0.47g/cm^2$. The average age of the patients was 68.7 (range, 57-88). The preoperative VAS for low back and leg pain ($7.87{\pm}0.95$ and $8.82{\pm}0.83$) were higher as compared with postoperative VAS ($2.30{\pm}1.61$ and $1.42{\pm}0.73$) with statistical significance (p = 0.006, p = 0.003). According to the Prolo scale, 11, 22, one and three patients were in excellent, good, fair and poor conditions, respectively. The average amount of the injected cement per one cannulated screw was $1.83{\pm}0.11\;mL$. Conclusion : The results show favorable outcome both clinically and radiographically for 37 patients who underwent lumbar fusion using $DTPS^{TM}$ and PMMA. Based on the results, the use of this surgical method can be a safe and effective option for the operation on the osteoporotic spine.

• 한국산학기술학회논문지
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• 제15권2호
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• pp.934-939
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• 2014

본 논문은 네발기기 자세에서 사지의 각도 변화에 따른 몸통 근육들의 두께를 알아보고 근육활성의 차이를 비교하여 네발기기에서 행하는 척추 안정화를 위한 효과적인 자세를 선택하는데 필요한 자료를 제공하고자 한다. 연구대상은 건강한 대학생 29명으로 하였다. 실험을 위해서 배가로근과 배속빗근, 배곧은근과 배바깥빗근을 측정하였다. 근육의 두께측정 및 디지털 영상분석을 위한 초음파 영상 수집은 초음파 영상장치(Mylav25gold, Esaote, Italy)를 사용하였다. 연구결과 왼쪽 배바깥빗근과 배속빗근, 배가로근 간 두께 변화와 오른쪽 배가로근의 두께 변화에 각도 간의 유의한 차이가 있는 것으로 나타났다. 이 연구는 근육활성의 정도와 몸통 근육들을 활성화하기 위해 네발기기자세에서의 운동이 각도에 따라 다양한 결과를 보인다는 것을 나타낸다.

• 한국전문물리치료학회지
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• 제29권4호
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• pp.282-288
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• 2022

Background: Pilates exercises are used for body shape correction because they can achieve correct posture alignment through spinal stabilization. Objects: This study aimed to determine whether the use of reformers increases the effectiveness of Pilates core exercises on body alignment in standing. Methods: The study included 30 women without known diagnoses of musculoskeletal and neurological disorders or cancer. Those who had taken more than 10 Pilates lessons were excluded. The participants were randomly assigned to either the reformer exercise group or the mat exercise group, and interventional Pilates exercises were performed for 60 minutes a day, three times a week, for a total of 8 weeks. Ten movements of the reformer and mat Pilates core exercise programs were included. Exbody^® 9100 MOMI musculoskeletal analysis equipment (Exbody Inc.) was used to assess the alignment of the standing posture in the frontal plane. Results: As a result of comparing the differences within and between the groups before and after the intervention using the two-way mixed analysis of variance test, height differences in the head, pelvis, left and right, shoulders, scapulas, knees, and ankles in the frontal plane after the intervention were found in both groups. For example, the left-right symmetry of the body alignment in the standing posture was significantly improved within each group (p < 0.05). However, no significant difference was found between the groups (p > 0.05). Conclusion: Both the reformer and mat Pilates core exercises were effective for standing posture alignment, which has clinical significance. If an exercise program is developed based on the analysis of movements necessary for posture improvement and the target muscles to be strengthened, the same effect can be achieved only with mat exercise without using the reformer equipment at the beginner stage.

• 대한정형도수물리치료학회지
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• 제28권2호
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• pp.67-75
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• 2022

Background: Scapular winging is a rare disorder that is commonly caused by nerve damage of the dorsal scapular nerve, spinal accessory nerve, or the long thoracic nerve. This affects the scapulohumeral rhythm which may cause abnormal kinetic motion of the shoulder. The purpose of this case report is to describe a self-exercise oriented management incorporating shoulder strengthening to reduce symptoms in a shoulder pain patient with winging scapular. Methods: A 45 year old male patient complained of pain in his both shoulders without any trauma. Shoulders were treated with steroid injections for supraspinatus tendonitis, but although pain improved to some extent, pain and disability continued for 3 months. Both shoulders had pain, decreased active range of motions, muscles weakness, and scapular winging. The patient underwent 9 interventional sessions over 3 months and was managed mainly by self-exercise. The intervention method involved push up plus, sling, muscle strengthening, and stabilization exercises. Loads were increased as symptoms improved. Results: Clinical outcomes were measured at every session. Pain in both shoulders reduced to 0 on a numerical pain rate scale by the 4th session, and the active range of motion was fully recovered. During the 9th session, the strength of the serratus anterior had improved from grade P to G on the right side and grade G to N grade on the left. Conclusion: In this case study, the self-exercise program was effective in reducing pain, increasing active range of motion, and improving muscle strength in subjects with scapular winging.

• 산업과 과학
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• 제2권2호
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• pp.16-24
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• 2023

목적:본 연구는 복부 할로잉 운동과 복부 브레이싱 운동을 통해 동적 균형에 미치는 즉각적 효과를 알아 보고자 실시하였다. 방법: 성인 남녀 학생 90명을 대상으로 하였고, Y-균형검사와 기능적 팔 뻗기 검사를 이용하여 측정하였다. 결과: 그룹 간의 동적 균형 검사에서, 특히 복부 할로잉 운동을 실시한 그룹과 대조군 사이에 통계적으로 유의한 차이가 있었다. 결론: 대표적인 척추안정화 운동 복부 할로잉 운동과 복부 브레이싱 운동 모두 동적균형의 증가에 있어 유의미하지만, 즉각적 효과라는 측면에서 어떠한 방법이 더 효과적이라고 제시하는 것은 어렵다.

• Journal of Yeungnam Medical Science
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• 제14권1호
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• pp.209-219
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• 1997

포항 성모병원 정형외과에서 실시한 경추 전방유합술 및 A-O금속판 고정술을 병행하여 치료하고 13개월이상(평균 20개월) 추시가 가능하였던 경추 추간판 탈출증 환자 11례 및 외상환자 3례를 대상으로 관찰하여 다음과 같은 결과를 얻었다. 1. 경추 추간판 탈출 환자 11례 중 상지 방사통을 호소한 경우가 8례이었으며 감각 둔화 및 근력약화를 호소한 환자가 3례이었다. 2. 외상의 기전으로는 굴곡 회전손상 3례이었다. 3. 고정범위는 1개 분절고정이 12례, 두개 분절고정이 2례이었으며 술후 분절수에 관계없이 필라델피아 보조기를 이용해 조기 보행을(평균 2일) 시작하였으며 이러한 조기 보행으로 인한 불편함의 호소는 없었다. 4. 골유합은 이종골을 사용한 1례에서의 불유합을 보였으나, 동종골을 사용한 13례에서는 전례 모두 유합(평균 12주)을 보임으로 이종골 보다는 동종골의 이식에서 높은 유합율을 보였다. 5. 추간판 탈출환자 전례에서 증상의 호전이 있었으며 불완전 마비가 있었던 외상환자 3례에서도 술후 추시 기간 중 Frankel분류상 B에서 C등급으로 호전되었다. 6. 술후 합병증은 금속판 파열 1례 및 일시적인 사성 2례를 제외한 환부 혈종이나 나사못 파열 등의 다른 합병증은 관찰되지 않았다. 이상의 결과를 종합해 보면 전방 도달법에 의한 전방유합술 및 물림나사와 금속판을 이용해 시술한 경추 추간판 탈출증 및 외상 환자에 있어서 수술적 치료가 안전하고 압박된 신경에 대한 감압, 충분한 안정성 확보로 인한 외고정 기간의 단축 및 신속한 골유합을 기대할 수 있는 방법이며 기존의 금속판과 달리 후방 피질골을 관통하지 않기 때문에 척수의 손상을 피할수 있으며 수술중 방사선 피폭량도 줄일수 있어 권장할 만한 방법으로 사료된다.

• Journal of Acupuncture Research
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• 제29권5호
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• pp.187-195
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• 2012

Objectives : Amyotrophic lateral sclerosis(ALS) is a progressive and incurable disease that causes degeneration of the motor neurons of the brain stem and spinal cord. The purpose of this study was to report the effectiveness of Sa-am acupuncture treatment on ALS patient. Methods : Following the stabilization period, a ALS patient respiratory figures(Et $C_{O2}$, Sp $_{O2}$, RR, pulse) were measured by using capnography & pulse oximetry for 30 minutes before acupuncture treatment. Acupuncture treatment such as lung tonification($SP_3(+){\cdot}LU_9(+){\cdot}HT_8(-){\cdot}LU_{10}(-)$), heart tonification($HT_9(+){\cdot}LR_1(+){\cdot}SI_8(-){\cdot}KI_{10}(-)$), liver tonification ($KI_{10}(+){\cdot}LR_8(+){\cdot}LU_8(-){\cdot}LR_4(-)$) were conducted for 5 days. Each Sa-am acupuncture treatment conducted at AM 7 : 00, AM 11 : 00, PM 4 : 30 of the day. During acupuncture treatment, the patient respiratory figures were measured equally for 30 minutes. The patient was treated by using Dong-bang acupuncture needles($0.30{\times}4.0$) and also stimulated using infra red. Results : The value of Et $C_{O2}$ has decreased more after Sa-am acupuncture lung tonification treatment than others. The value of pulse has decreased more after Sa-am acupuncture heart tonification treatment than others. The value of raspiration rate has decreased more after Sa-am acupuncture liver tonification treatment than others. And the value of Sp $O_2$ has increased more after Sa-am acupuncture liver tonification treatment than others. Conclusions : Although this study was subject to a few limitations, but it shows that Sa-am acupuncture treatment for ALS patients has a meaningful effect. This study needs to be developed further using a larger sample size to obtain more valuable and meaningful data.

• Journal of Korean Neurosurgical Society
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• 제49권5호
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• pp.267-272
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• 2011

Objective : Although iliac crest autograft is the gold standard for lumbar fusion, the morbidity of donor site leads us to find an alternatives to replace autologous bone graft. Ceramic-based synthetic bone grafts such as hydroxyapatite (HA) and b-tricalcium phosphate (b-TCP) provide scaffolds similar to those of autologous bone, are plentiful and inexpensive, and are not associated with donor morbidity. The present report describes the use of Polybone$^{(R)}$ (Kyungwon Medical, Korea), a beta-tricalcium phosphate, for lumbar posterolateral fusion and assesses clinical and radiological efficacy as a graft material. Methods : This study retrospectively analyzed data from 32 patients (11 men, 21 women) who underwent posterolateral fusion (PLF) using PolyBone$^{(R)}$ from January to August, 2008. Back and leg pain were assessed using a Numeric Rating Scale (NRS), and clinical outcome was assessed using the Oswestry Disability Index (ODI). Serial radiological X-ray follow up were done at 1, 3, 6 12 month. A computed tomography (CT) scan was done in 12 month. Radiological fusion was assessed using simple anterior-posterior (AP) X-rays and computed tomography (CT). The changes of radiodensity of fusion mass showed on the X-ray image were analyzed into 4 stages to assess PLF status. Results : The mean NRS scores for leg pain and back pain decreased over 12 months postoperatively, from 8.0 to 1.0 and from 6.7 to 1.7, respectively. The mean ODI score also decreased from 60.5 to 17.7. X-rays and CT showed that 25 cases had stage IV fusion bridges at 12 months postoperatively (83.3% success). The radiodensity of fusion mass on X-ray AP image significantly changed at 1 and 6 months. Conclusion: The present results indicate that the use of a mixture of local autologous bone and PolyBone$^{(R)}$ results in fusion rates comparable to those using autologous bone and has the advantage of reduced morbidity. In addition, the graft radiodensity ratio significantly changed at postoperative 1 and 6 months, possibly reflecting the inflammatory response and stabilization.