• 제목/요약/키워드: Spine angle

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A Surgical Option for Multilevel Anterior Lumbar Interbody Fusion with Ponte Osteotomy to Achieve Optimal Lumbar Lordosis and Sagittal Balance

  • Suh, Loo-Ree;Jo, Dae-Jean;Kim, Sung-Min;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.365-371
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    • 2012
  • Objective : To document lumbar lordosis (LL) of the spine and its change during surgeries with the different height but the same angle setting of the anterior cage. Additionally, we attempted to determine if sufficient LL is achieved at different cage heights and to quantify the change in LL during multi-level anterior lumbar interbody fusion (ALIF). Methods : The medical records and radiographs of 42 patients who underwent more than 2 level ALIFs between 2008 and 2009 were retrospectively reviewed. We evaluated 3 parameters seen on lateral whole spine radiographs : LL, pelvic incidence (PI), and sagittal vertical axis (SVA). The mean follow-up time was 28.1 months and the final follow-up radiographs of all patients were reviewed at least 2 years after surgery. Statistical analysis was performed using the paired t-tests. Results : Lumbar lordosis had changed up to 30 degrees immediately and 2 years after surgery (preoperative mean LL, SVA : 22.45 degrees, 112.31 mm; immediate postoperative mean LL, SVA : 54.45 degrees, 37.36 mm; final follow-up mean LL, SVA : 49.56 degrees, 26.95 mm). Our goal of LL is to obtain as much PI as possible, preoperative mean PI value was $55.38{\pm}3.35$. The pre-operative and two year post-surgery follow-up mean of the Japanese Orthopedic Association score were $9.2{\pm}0.6$ and $13.2{\pm}0.6$ (favorable outcome rate : 95%), respectively. In addition, we were able to obtain good clinical outcomes and sagittal balance with a subsidence rate of 22.7%. Conclusion : We were able to achieve sufficient LL, such that it was similar to the PI, utilizing multi-level ALIF with the use of a tall cage with the same angle setting of the cage. We have found out that achieving sufficient lumbar lordosis and sagittal balance require an anterior lumbar cage with high angle and height.

허리 디스크탈출증 환자의 재위치 감각과 근 피로도에 미치는 안정화운동 프로그램의 영향 (The Effects of Lumbar Repositioning Sense and Muscle Fatigue after Stabilization Exercise Program in Disc Disease Patients)

  • 김명준
    • 대한물리치료과학회지
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    • 제16권3호
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    • pp.11-17
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    • 2009
  • Background: The purpose of this study was designed to find out the effectiveness of reposition sense, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. Method: In this study the reposition sense was measured in 3 angle(60, 30, 12) of 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 Mattress 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. Result: The results of the present study were that the repositioning sense was appeared the most error in 12 angles of lumbar flexion and Men was appeared to decrease an error more than female in average value of 4 angles after 12 weeks. And average error of male was decrease more than female. Thus the effects of lumbosacral stabilization exercise was improved repositioning sense of prorioceptor. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. Conclusion: As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine repositioning sense and vertebra segments stabilization. It was showed the rate of decrease in typically 12 degree angle point of each 3 angle(60, 36, 12). Especially, that spine instability patients will have a risk when in lifting a load or working with slight flexion posture around 12 degree 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.

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Effect of Deep Neck Flexor Performance on the Stability of the Cervical Spine in Subject With and Without Neck Pain

  • Kwon, Oh-Yun;Lee, Won-Hwee;Jung, Sung-Dae;Kim, Si-Hyun;Jung, Do-Heon
    • 한국전문물리치료학회지
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    • 제18권4호
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    • pp.1-10
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    • 2011
  • This study compared the stability of the cervical spine according to the presence of neck pain and deep neck flexor performance. Thirty subjects with neck pain, and thirty subjects without neck pain were recruited for this study. The Cranio-cervical flexion (CCF) test was applied using a pressure biofeedback unit to classify the subjects into four subgroups; no cervical pain and good deep neck flexor performance (NG group), no cervical pain and poor deep neck flexor performance (NP group), cervical pain and good deep neck flexor performance (PG group), and cervical pain and poor deep neck flexor performance (PP group). The head sway angle was measured using a three-dimensional motion analysis system. A 3-kg weight was used for external perturbation with the subject sitting in a chair in the resting and erect head positions with voluntary contraction of the deep neck flexors. A one-way analysis of variance (ANOVA) was performed with a Bonferroni post hoc test. The deep neck flexor performance differed significantly among the four groups (p<.05). The NG group had significantly greater deep neck flexor performance than NP and PP groups. The stability of the cervical spine also differed significantly among the four groups in the resting head position (p<.05). The head sway angle was significantly smaller in NG group as compared with the other groups. The PP group had the greatest head sway angle in the resting head position. However, there was no significant difference in the stability of the cervical spine among the groups in the erect head position with voluntary contraction of deep neck flexors (p=.57). The results of this study suggest that the deep neck flexor performance is important for maintaining the stability of cervical spine from external perturbation.

여가성 운동이 요추의 역학적 기능에 미치는 영향 (The Change of Lumbar Mechanical Functions Caused by Recreational Exercise)

  • 오덕원;윤희중;유지선;오재근
    • 한국전문물리치료학회지
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    • 제6권1호
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    • pp.23-34
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    • 1999
  • The purposes of this study were to investigate biomechanical variables of the lumbar spine for women who enjoy recreational exercises regularly, and to determine the factors that influence these variables. These variables were determined by the X-ray pictures of the lumbar area of 80 housewives who visited the department of rehabilitation at the Y Hospital from October 1997 to March 1998. The sacral inclination angle, the sacrohorizontal angle, the lumbosacral joint angle, and the lumbar lordotic angle were analysed. The t-test, correlation analysis, and multiple regression analysis were used to determine the significant differences and relationships among variables. The result were as follows: 1) There was a significant difference in the sacral inclination angle (p<0.01), the sacrohorizontal angle (p<0.05) and the lumbar lordotic angle (p<0.05) between the bilateral and the unilateral exercise group. 2) With the sacral inclination angle, the sacrohorizontal angle, the lumbosacral joint angle and the lumbar lordotic angle, correlation was found between the sacral inclination angle and the sacrohorizontal angle (p<0.01), the sacral inclination angle and the lumbosacral joint angle (p<0.05), the sacral inclination angle and the lumbar lordotic angle (p<0.05), and the sacrohorizontal angle and the lumbosacral joint angle (p<0.01). 3) In the bilateral exercise group, the sacral inclination angle correlated with age (p<0.01). The sacrohorizontal angle correlated with age (p<0.01) and exercise time (p<0.01). The lumbar lordotic angle correlated with age (p<0.05) and exercise duration (p<0.05). In the unilateral exercise group, the sacral inclination angle correlated with age (p<0.01), while the sacrohorizontal angle correlated with age (p<0.01) and exercise duration (p<0.05). The lumbar lordotic angle correlated with age (p<0.05).

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척추의 만곡과 족저부 압력 분포 및 발각도의 상관성 연구 - 족부 진단기의 임상적 활용 가능성 검토를 위한 예비연구 - (A Study of the Correlation between Spinal Curvatures, Plantar Pressure and Foot Angles)

  • 은영준;송윤경;임형호
    • 척추신경추나의학회지
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    • 제2권2호
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    • pp.1-16
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    • 2007
  • Objectives : The purpose of this study was to identify spinal curvatures, plantar pressure and foot angles in a walking. Methods : 19 outpatients under 19 years old were included. Plantar pressure and foot angle in a walking were measured by using Gaitview AFA-50. Spinal curvatures were measured by using radiograph. Results : The cervical lordotic angle is significantly difference with left and right plantar pressure(p=0.027). The thoracic kyphotic angle is significantly difference with left and right plantar pressure(p=0.026). Cobb's angle is significantly difference with left and right plantar pressure(p=0.027). The other plantar pressure were no difference from spinal curvatures and foot angle in a walking. Conclusion : There were no correlation between plantar pressure, spinal curvatures and foot angle. We consider that needed more additional study.

수중운동과 슬링운동이 척주옆굽음증을 가진 젊은 성인의 척추각과 유연성에 미치는 영향 (Effects of Aquatic Exercise versus Sling Exercise on Spinal Angle and Flexibility in Young Adults with Scoliosis)

  • 남기원
    • 대한물리의학회지
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    • 제14권4호
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    • pp.183-193
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    • 2019
  • PURPOSE: This study assessed the exercise programs for improving the spinal angle and trunk flexibility by applying the aquatic exercise and sling exercise to young adults with scoliosis. METHODS: The subjects were 14 participants diagnosed with scoliosis. They were assigned randomly either to an aquatic exercise group (n=7) that received the WATSU exercise program or to a sling exercise group (n=7) that received a sling exercise program. The exercise program was 50 minutes once, three times a week, 12 times for four weeks. The spinal angle and flexibility were measured using the Cobb's angle and modified sit and reach test, respectively. Two variables were analyzed before and after the intervention, and the aquatic exercise group and sling exercise group were compared. RESULTS: After the intervention, the Cobb's angle decreased significantly, and the flexibility increased significantly in both groups (p<.05). A larger increase in flexibility was observed in the aquatic exercise group than in the sling exercise group (p<.05). CONCLUSION: These results showed that the two exercise programs improved the spine angle and flexibility. The increased flexibility showed that aquatic exercise was more effective than the sling exercise. Therefore, aquatic exercise and sling exercise can be used in the treatment and prevention of scoliosis.

청소년의 집중력이 척추건강에 미치는 영향: 인지강도에 의해 조절된 스마트폰 과몰입의 매개효과 (The effect of attention on spinal health of adolescents: The mediating effect of smartphone overindulgence moderated by cognitive strength)

  • 이진;김상우;이병희
    • 대한물리치료과학회지
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    • 제29권3호
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    • pp.29-47
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    • 2022
  • Purpose: This study was conducted to find out the mediated effects of smartphone overindulgence in the relationship between attention and spinal health of adolescents and to find out how cognitive strength moderates these relationships. Design: Cross-sectional study. Methods: All subjects measured attention, cognition strength, spinal angle, and smartphone overindulgence by measuring the ratio of SMR and mid-beta power to the power of the brain wave, amplitude variation of Cognitive Gamma-Peak, forward slope angle of the cervical spine, and the scale of diagnosis of smartphone addiction. Results: As a result, it shows a significant correlation between Attention, spinal angle, cognitive strength, and smartphone overindulgence(p<.05). In addition, attention was significantly mediated on the spinal angle through smartphone overindulgence(p<.001), and cognitive strength was significantly mediated in relation to smartphone overindulgence and spinal angle(p<.05). Conclusion: This result indicates that the mediation effect of overindulgence of a Smartphone is mediated according to its cognitive strength in relation to its effect of attention on the spine angle.

The Change of Adjacent Segment and Sagittal Balance after Thoracolumbar Spine Surgery

  • Kim, Kang-San;Hwang, Hyung-Sik;Jeong, Je-Hoon;Moon, Seung-Myung;Choi, Sun-Kil;Kim, Sung-Min
    • Journal of Korean Neurosurgical Society
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    • 제46권5호
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    • pp.437-442
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    • 2009
  • Objective : To characterize perioperative biomechanical changes after thoracic spine surgery. Methods : Fifty-eight patients underwent spinal instrumented fusions and simple laminectomies on the thoracolumbar spine from April 2003 to October 2008. Patients were allocated to three groups; namely, the laminectomy without fusion group (group I, n = 17), the thoracolumbar fusion group (group II, n = 27), and the thoracic spine fusion group (group III, n = 14). Sagittal (ADS) and coronal (ADC) angles for adjacent segments were measured from two disc spaces above lesions at the upper margins, to two disc spaces below lesions at the lower margins. Sagittal (TLS) and coronal (TLC) angles of the thoracolumbar junction were measured from the lower margin of the 11th thoracic vertebra body to the upper margin of the 2nd lumbar vertebra body on plane radiographs. Adjacent segment disc heights and disc signal changes were determined using simple spinal examinations and by magnetic resonance imaging. Clinical outcome indices were determined using a visual analog scale. Results : The three groups demonstrated statistically significant differences in terms of angle changes by ANOVA (p<0.05). All angles in group I showed significantly smaller angles changes than in groups II and III by Turkey's multiple comparison analysis. Coronal Cobb's angles of the thoracolumbar spine (TLC) were not significantly different in the three groups. Conclusion : Postoperative sagittal balance is expected to change in the adjacent and thoracolumbar areas after thoracic spine fusion. However, its prevalence seems to be higher when the thoracolumbar spine is included in instrumented fusion.

과소전만된 경항통 환자에 대한 추나요법 임상연구 (Clinical Study for Chuna Treatment on Neck Pain Patient with Hypolordotic Cervical Spine)

  • 류헌식;전성하;박동수;이수길
    • 척추신경추나의학회지
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    • 제1권2호
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    • pp.11-20
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    • 2006
  • Objectives: The aim of this study is to investigate clinical effects of Chuna treatment on the neck pain patient with hypolordotic cervical spine. Methods: From June 2006 to August 2006, 20 cases of neck pain patient with hypolordotic cervical spine were divided into 2 groups. Control group(n=10) was treated only acupuncture therapy, and sample group(n=10) was treated Chuna after acupuncture therapy same as control group. Degrees of pain were measured with Visual Analogue Scale(VAS), and the change of cervical curvature was assessed Depth of cervical curve, Method of Jochumsen, and Angle of cervical curve. Results: 1. After 3th and 5th treatment, there was statistical significance between control and sample group in VAS. 2. After 5th treatment, there was not statistical significance between control and sample group in Depth of cervical curve, Method of Jochumsen, and Angle of cervical curve. Conclusions: On treating the neck pain patient with hypolordotic cervical spine, Chuna treatment is more effective than only acupuncture therapy in reducing neck pain, but Chuna treatment for short-term is not more effective than only acupuncture therapy in restoring cervical curvature.

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교통사고 후 응급실에 내원한 경항통 환자의 경추 만곡 연구 (The Cervical Spine Curvature of Posterior Neck Pain Patients Who Visited Emergency Room After Whiplash Injury by Traffic Accident)

  • 조준영;이선행
    • 척추신경추나의학회지
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    • 제6권2호
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    • pp.121-132
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    • 2011
  • Objectives : The purpose of this study is to investigate the cervical spine curvature after whiplash injury by traffic accident. Methods : The cervical lateral radiographs of 102 outpatients who visited emergency room in Kyung-Hee university hospital at Gangdong after whiplash injury by road traffic accident were reviewed to measure the cervical spine angle using C1-7, C2-7 Cobb method, Sagittal tangent method, Jochumsen method and the Ishihara index by two oriental medical doctors. For statistics, we used SPSS version 17.0 for windows. Results : Means of cervical angle are $37.63{\pm}11.34^{\circ}$, $12.92{\pm}9.13^{\circ}$, $16.19{\pm}10.62^{\circ}$, $1.78{\pm}3.37$ and $8.51{\pm}9.78$ by C1-C7 Cobb Method, C2-C7 Cobb Method, Sagittal tangent method, Jochumsen method and Ishihara index, respectively. Hypolordosis is most numeral in patients by C1-C7 Cobb Method(n=40; 39.22%), Sagittal tangent method(n=68; 66.67%). And Straight is the most by Jochumsen method(n=54; 52.94%), but Normal is the most by Ishihara index(n=53; 51.96%). And Female has smaller curvature in cervical spine than male significantly by C2-C7 Cobb method and Sagittal tangent method(P<0.05). Conclusions : Whiplash injury tends to make hypolordosis or straight. And female has more vulnerable curvature than male in whiplash injury.

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