• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.493-500
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• 2001

Objective : Anterior cervical locking plates are the devices for achieving anterior cervical spinal fusion. This study was conducted to evaluate the locking plate system regarding its long-term advantages and disadvantages in the view of interbody fusion rate, hardware-related failures, vertebral change close to the fusion segment and postoperative complications. Method : Eight-six patients, operated from Jan., 1996 to Jun. 1998, were followed-up for more than two years. All of the cases were fused with iliac bone graft and ORION locking plate(Sofamor Danek USA, Inc., Memphis, TN) fixation. The patients were discharged or transferred to rehabilitation department 2-7 days after operation. A comprehensive evaluation of the interbody fusion state, instrument failure, vertebral change and postoperative complications were made by direct interview and cervical flexion-extension lateral plain films. Results : There were 55 male and 31 female with a mean age of 45 years(18-75 years). The mean follow-up period was 29 months(24-43 months). Various disorders that were operated were 40 cervical discs, 6 cervical stenosis including OPLL, 2 infections, and 38 traumas. Fusion level was single in 59 cases, two levels of each disc space in 15 cases, and two levels after one corpectomy in 12 cases. There was no instrument failure. Pseudoarthrosis was observed in two cases(2%) without radiological instability. The other patients(98%) showed complete cervical fusion with stable instrument. Mild settling of interbody graft with upward migration of screws was found in 12 cases(14%). Anterior bony growth at the upper segment was found in 5 cases(6%). Postoperative foreign body sensation or dysphagia was observed in 12 cases(4%), and disappeared within one month in 7 cases and within six months in 4 cases. One patient complained for more than six months and required reoperation to remove paraesophageal granulation tissue. Conclusion : The results show that Orion cervical locking plate has some disadvantages of upward migration of screws, anterior bony growth at the upper segment, or possibility of esophageal compression even though it has advantages of high interbody fusion rate or low instrument failure. Author believe that anterior cervical locking plate in the future should be thinner, and should have short end from the screw hole, and movable screw with adequate stability.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.4-10
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• 2012

Purpose: The objective of this retrospective study was to assess the skeletal stability after orthognathic surgery for patients with cleft lip and palate. The soft tissue changes in relation to the skeletal movement were also evaluated. Methods: Thirty one patients with cleft received orthognathic surgery by one surgeon at the Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Osseous and soft tissue landmarks were localized on lateral cephalograms taken at preoperative (T0), postoperative (T1), and after completion of orthodontic treatment (T2) stages. Surgical movement (T0.T1) and relapse (T1.T2) were measured and compared. Results: Mean anteroposterior horizontal advancement of maxilla at point A was 5.5 mm, and the mean horizontal relapse was 0.5 mm (9.1%). The degree of horizontal relapse was found to be correlated to the extent of maxillary advancement. Mean vertical lengthening of maxilla at point A was 3.2 mm, and the mean vertical relapse was 0.6 mm (18.8%). All cases had maxillary clockwise rotation with a mean of 4.4 degrees. The ratio for horizontal advancement of nasal tip/anterior nasal spine was 0.54/1, and the ratio of A' point/A point was 0.68/1 and 0.69/1 for the upper vermilion/upper incisor tip. Conclusion: Satisfactory skeletal stability with an acceptable relapse rate was obtained from this study. High soft tissue to skeletal tissue ratios were obtained. Two-jaw surgery, clockwise rotation, rigid fixation, and alar cinch suture appeared to be the contributing factors for favorable results.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.3 no.2
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• pp.37-42
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• 2008

Objectives : One of the most important cause of spondylolisthesis is it's epidemiological structure and L5's stability takes a significant role. The purpose of this study is to assess the difference of the Tuffier's line among of Spondylolythesis patients. Methods : We analyzed the Anterior view of lumbar spine checked at erect position on 60 patients who had been diagnosed as spondylolythesis. We investigated the Tuffier's Line on X-ray film. Results and Conclusions : Age distribution was 15 to 66 and the average was 47.81. Men were 19 cases(31.6%) and women were 41 cases(68.4%). Compared to men, women were more exposed to spondylolisthesis and for the age distribution, 50's showed the biggest portion. Group of normal people showed proportion of 14.3% at L4, 44% at L4/5 and 41.7% at L5 each. And group of patients showed proportion of 48.4% at L4, 35% at L4/5 and 51.6% at L5 each. Comparing these results, significance probability was 0.004(<0.05) which was significant. As the results of comparing the relation between L4/5 and L5/S1 patients, Normal group showed average of 3.33 which were close to L4/5. When there are spondylolisthesis at L4/5, averege was 3.33, placed at lower part of the vertebra body. When there are spondylolisthesis at L5/S1, averege was 3.566, placed between lower part of the veterbra body of L4 and L4/5. The p value of Normal group and L4/5 spondylolisthesis patient group was 0.022(p<0.05) which was significant. But the p value of Normal group and L5/S1 spondylolisthesis patient group was 0.0239 which was not significant. Also p value of L4/5 spcndylolisthesis patient group and L5/S1 spondylolisthesis patient group was 0.721 which was also not significant.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.776-783
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• 2021

Objective : The purpose of this study was to identify risk factors for distal adding on (AO) or distal junctional kyphosis (DJK) in adolescent idiopathic scoliosis (AIS) treated by posterior spinal fusion (PSF) to L3 with a minimum 2-year follow-up. Methods : AIS patients undergoing PSF to L3 by two senior surgeons from 2000-2010 were analyzed. Distal AO and DJK were deemed poor radiographic results and defined as >3 cm of deviation from L3 to the center sacral vertical line (CSVL), or >10° angle at L3-4 on the posterior anterior- or lateral X-ray at ultimate follow-up. New stable vertebra (SV) and neutral vertebra (NV) scores were defined for this study. The total stability (TS) score was the sum of the SV and NV scores. Results : Ten of 76 patients (13.1%) were included in the poor radiographic outcome group. The other 66 patients were included in the good radiographic outcome group. Lower Risser grade, more SV-3 (CSVL doesn't touch the lowest instrumented vertebra [LIV]) on standing and side bending films, lesser NV and TS score, rigid L3-4 disc, more rotation and deviation of L3 were identified risk factors for AO or DJK. Age, number of fused vertebrae, curve correction, preoperative coronal/sagittal L3-4 disc angle did not differ significantly between the two groups. Multiple logistic regression results indicated that preoperative Risser grade 0, 1 (odds ratio [OR], 1.8), SV-3 at L3 in standing and side benders (OR, 2.1 and 2.8, respectively), TS score -5, -6 at L3 (OR, 4.4), rigid disc at L3-4 (OR, 3.1), LIV rotation >15° (OR, 2.9), and LIV deviation >2 cm from CSVL (OR, 2.2) were independent predictive factors. Although there was significant improvement of the of Scoliosis Research Society-22 average scores only in the good radiographic outcome group, there was no significant difference in the scores between the groups. Conclusion : The prevalence of AO or DJK at ultimate follow-up for AIS with LIV at L3 was 13.1%. To prevent AO or DJK following fusion to L3, we recommend that the CSVL touch L3 in both standing and side bending, TS score is -4 or less, the L3/4 disc is flexible, L3 is neutral (<15°) and ≤2 cm from the midline and the patient is ≥ Risser 2.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.609-617
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• 2013

PURPOSE: This study aims to provide effects of therapeutic techniques as well as basic materials of safety by comparing and analyzing the effects of hamstring flexibility and dynamic stability of lower lumbar according to Stretching and Massage Techniques to adults with reduced the flexibility of hamstring. METHODS: This study conducted differential diagnosis through sit and reach test(SRT) and Schober test to select subjects who have shortened hamstring without any spinal problem. Selected subjects were divided into two groups randomly; HSG(Hamstring Stretching Group, n=8) and HMG(Hamstring Massage Group, n=8) and they received treatment for 2 weeks. To take statistics, SRT and dynamic view using x-ray were used. RESULTS: On SRT, HSG and HMG showed significant difference between pre and post test. A comparison of the difference value between HSG and HMG, HSG($9.73{\pm}1.78$) has more remarkable outcome than HMG($2.78{\pm}0.56$). Lower lumbar intervertebral disc length test for Intervertebral disc length(IDL)L45 and IDLL5S1 did not show significant differences between two groups and difference value. CONCLUSION: This study showed that stretching is more effective to improve hamstring flexibility than massage technique. Especially, flexibility increase of the hamstring in vertebral stabilization cannot affect improvement possibility will make a flexibility in order and the intervention and stabilization exercise of the spine.

• Physical Therapy Korea
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• v.27 no.4
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• pp.257-263
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• 2020

Background: The hip muscle plays various roles. Several types of functional performance tests are used for the assessment of patients with various lower extremity injuries. Hip muscle functions are important to test the performance of maintaining the spine, pelvic, and leg during bridging exercise. We designed a novel functional performance test tool, which we named close kinetic chain dynamic lower extremity stability (CKCLE) test to assess hip muscle functions. Objects: The purpose of this study was to determine the relationship between CKCLE test and hip extensor, external rotator, and abductor strengths. Methods: Twenty-two subjects were recruited in the present study (13 males and 9 females). The hip extensor, external rotator, and abductor muscle strengths were measured using a Smart KEMA strength sensor. When the examiner said "Go", the subject performed the CKCLE test by moving one leg from the floor and touching the opposite knee and then return to the floor while maintaining the bridging position. The subjects attempted as many "touches" as possible in the allotted time (20 seconds) during the maximal tests. The correlation between the hip muscle (extensor, external rotator, and abductor) strength of the supporting leg and the number of CKCLE tests performed in 20 seconds was determined using the Pearson correlation. Results: Hip extensor (r = 0.626, p < 0.05), hip external rotator (r = 0.616, p < 0.05), and hip abductor muscle strengths (r = 0.475, p < 0.05) positively correlated with the number of CKCLE tests performed. Conclusion: We designed a CKCLE test and found that performance in the test correlated with hip extensor, external rotator, and abductor muscle strengths. The result suggests that the CKCLE test can be applied as a performance test to assess the functions of the hip extensor, external rotator, and hip abductor muscles.

• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.235-243
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• 2020

Lumbar Lordosis Angle (LLA) is an index that can be used to evaluate the curvature of the lumbar vertebrae. It can measure the structural stability of the lumbar spine and the stability of each segment of the vertebral column at the intervertebral disc angle (IDA). Especially, our data shows it is found to be a strong positive correlation between obesity and the angle of lordosis for lumbar vertebrae. Also, the reason for the large IDA in the case of obesity seems to be the result of the weakening of anatomical structure as well as the gravity effect. And, the obesity interferes with normal sagittal balance and fails to maintain a straight posture with minimal energy. Therefore, the obesity can be an important factor in causing back pain by changing the lumbar lordosis.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.12 no.2
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• pp.52-65
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• 2006

Sling exercises therapy can speak as appliable comprehensive exercises therapy technique efficiently in general exercise field for injured worker's rehabilitation process and health improvement patient or athlete, injury or disease that have pain or dysfunction to neuromuscular system using that shake. At 1990 an early stage, because physical therapist and doctors of medical treatment developed country norway of north europe cooperate sling exercises therapy's concept trend spreading worldwide establishing theory newly based on scientific basic be. Musculoskeletal system, old man and young child's nervous system injurer's treatment and exercise and industry worker's rehabilitation process, athlete's rehabilitation etc. several fields introduced in early 2000s to Korea apply. Sling exercises therapy neuromuscular system disease continuous abatement as general concept of active exercise and treatment that use sling exercises equipment by purpose know can. This review article wishes to introduce about neuromuscular activation, "Neurac" technique that can speak as step developed more concept based on application principle etc, of basic sling exercises effort's change by suspension point's change that is concept, stability exercises principle, open kinetic chain exercises and closed kinetic chain exercises. Arranged about Plateau potential's characteristic and working mechanism and Neurac technique's application method that can say as Neurac technique's neuro-physiologic base, and presented treatment method of lumbar part disease and cervical part, shoulder joint part disease to application example. Because plateau potential forward player that induce using Neurac technique in part muscles that act role that keep spine surrounding stability in this article keeps muscle's contraction continuously, between global and local muscles, presented several study findings that can cause affirmative change in insufficient muscle adjustment state such as imbalance of muscles' action order. Expect that case studies that use this Neurac technique here after consist continuously.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.2
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• pp.27-36
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• 2021

Background : Prone hip extension (PHE) is commonly used for exercises and tests in patients with low back pain. Previous studies have shown that pelvic compression belts (PCB) and non-elastic taping (NET) contribute greatly to improvements in lumbopelvic stability. This study aimed to compare the effect of two lumbopelvic stability methods such as PCB and NET on the trunk and hip extensor muscle activities during PHE tests. Methods: Subjects who experienced low back pain (low back pain group, LBPG; n=20) and those who did not experience low back pain (non-LBPG; n=20) participated in this study. The subjects were instructed to perform PHE with and without a PCB and NET. PHE tests were performed in the condition wherein the two stabilization methods were applied, and the actions of the muscles at that time were measured using surface electromyography (EMG). EMG data were collected from the hamstring, gluteus maximus, erector spine (ES), and multifidus (MF) muscles. The data were collected three times for 5 s with a 1-min rest between each of the three sets. Results: In the LBPG, EMG of the ES muscle was significantly reduced when NET or a PCB was applied (p<.05). There was no difference in the change in the ES muscle activity when NET and a PCB were applied. The ratio of MF/ES muscleactivity showed a significant increase in the LBPG with NET (p<.05). Conclusion: Both NET and PCB applied to subjects who experienced low back pain significantly reduced the ES muscle activity during PHE exercises and helped control the balance of the superficial and deep trunk extensor muscles.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.2
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• pp.73-83
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• 2022

Purpose : Low back pain (LBP) is reported as a risk of experiencing musculoskeletal disorders due to muscle stiffness and hypokinetics. The lumbar spine in an unstable state causes imbalance and lumbar instability. Therefore, This study examined the effects of lumbar stabilization exercise and self-complex exercise program on pain, function, psychosocial level, static balance ability, and transverse abdominal muscle (TrA) thickness and contraction ratio in patients with lumbar instability. Methods : The design of this is a randomized controlled trial (RCT). Twenty-six LBP patients participated in this study. Screening tests were performed and assigned to the experimental group (n=13) and control group (n=13) using a random allocation program. Both groups underwent a lumbar stabilization exercise program. In addition, the experimental group implemented the self-complex exercise program. All interventions were applied three times per week for four weeks. The quadruple visual analog (QVAS), the Korean version of the Oswestry disability index (K-ODI), Korean version of fear-avoidance belief questionnaire (FABQ), static balance ability, TrA thickness, and contraction ratio were compared to evaluate the effect on intervention. Statistical significance was set at 𝛼=.05. Results : Both groups showed significant differences before and after the intervention in QVAS, K-ODI, FABQ, static balance ability, and TrA thickness in contraction (p<.05). In addition, significant differences in K-ODI and FABQ were observed between the experimental group and control group (p<.05). Conclusion : A lumbar stabilization exercise and self-complex exercise program resulted in reduced dysfunctions, psychosocial stability in patients with lumbar instability. Therefore, Lumbar stabilization exercise and self-complex exercise program for patients with lumbar instability are effective method with clinical significance in improving the function and psychosocial stability.