• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.39-44
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• 1985

상복부 수술후 진통을 위하여 경막외 narcotics 주입시 임상에서 경막외강 천자가 가장 많이 시술되고 있는 부위 안 요부 경막외강에 morphine과 demerol을 각각 주입하여 진통 효과를 관찰하였다. 전신 마취하에서 상복부 수술을 받은 환자 20명을 대상으로 하여서 morphine 1 mg을 주입한 10명의 I군, demerol 10mg을 주입한 10명의 II군에서의 진통 효과를 관찰하였던 바 다음과 같은 결론을 얻었다. 1. Morphine 을 주입한 I군에서는 평균 진통 시간이 29.4시간이었다. 2. Demerol을 주입한 II군에서는 평균 진통 시간이 4.0시간이었다. 3. Morphine을 주입한 I군이 Demerol을 주입한 II군보다 진통 시간이 훨씬 길었으며 통계학적으로 유의하였다. (P<0.05) 이상의 결과로 보아 상복부 수술후 진통 목적으로 마약제를 경막외강에 투여시 시술이 안전한 요부 경막외강내로 투여하여도 우수한 진통효과를 얻을 수 있으며 마약제로는 morphine의 투여가 demerol의 투여보다 더욱 진통 효과가 우수한 것으로 사료된다.

• The Journal of Korean Physical Therapy
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• 제13권2호
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• pp.467-475
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• 2001

The purpose of this study was to evaluate changes of static lumbar lordosis by different heel heights in normal adults and patients with herniation of nucleus pulposus(HNP). The lumbar lordosis was examined while standing on barefoot, on heel support with 4cm heel, and with 8cm heel in 10 normal adults and 10patients with HNP. Standing lumbar lateral view was performed by 20 minutes adaptation with corresponding shoe types. The angle of lumbar lordosis was taken with Wiltse and Winter's method(angles between upper margin of 1 st lumbar body and upper margin of 5th lumbar body). The results of this study were as follow: 1. Significant statistical decrease in lumbar lordosis was observed as heel heights were increased from barefoot to 8cm high heel in normal adults(p<0.05). 2. There were no significant differences in lumbar lordosis according to three different heel heights in patients with HNP(p>0.05). 3. In comparison of barefoot, There were statistically significant decrease in HNP patients compared with normal adults in terms of lumbar lordosis(p<0.05).

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.196-201
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• 2005

Objective : Among upper lumbar disc herniations, L1-2 disc herniations are especially rare. We present the specific clinical features of L1-2 disc herniation and compared results of different surgical options. Methods : The authors undertook a retrospective single institution review of the patients who underwent surgery for L1-2 disc herniation. Thirty patients who underwent surgery for isolated L1-2 disc herniations were included. Results : Buttock pain was more frequent than anterior or anterolateral thigh pain. Standing and/or walking intolerance was more common than sitting intolerance. The straight leg raising test was positive only in 15 patients [50%]. Iliopsoas weakness was more frequent than quadriceps weakness. Percutaneous discectomy group demonstrated worse outcome than laminectomy group or lateral retroperitoneal approach group. Conclusion : Standing and/or walking intolerance, positive femoral nerve stretch test, and iliopsoas weakness can be useful clues to the diagnosis of L1-2 disc herniation. Posterior approach using partial laminectomy and medial facetectomy or minimally invasive lateral retroperitoneal approach seems like a better surgical option for L1-2 disc herniation than percutaneous endoscopic discectomy.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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• pp.206-210
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• 2014

Objective : Lumbar spinal stenosis is a common degenerative spine disease that requires surgical intervention. Currently, there is interest in minimally invasive surgery and various technical modifications of decompressive lumbar laminectomy without fusion. The purpose of this study was to present the author's surgical technique and results for decompression of spinal stenosis. Methods : The author performed surgery in 57 patients with lumbar spinal stenosis between 2006 and 2010. Data were gathered retrospectively via outpatient interviews and telephone questionnaires. The operation used in this study was named central decompressive laminoplasty (CDL), which allows thorough decompression of the lumbar spinal canal and proximal two foraminal nerve roots by undercutting the lamina and facet joint. Kyphotic prone positioning on elevated curvature of the frame or occasional use of an interlaminar spreader enables sufficient interlaminar working space. Pain was measured with a visual analogue scale (VAS). Surgical outcome was analyzed with the Oswestry Disability Index (ODI). Data were analyzed preoperatively and six months postoperatively. Results : The interlaminar window provided by this technique allowed for unhindered access to the central canal, lateral recess, and upper/lower foraminal zone, with near-total sparing of the facet joint. The VAS scores and ODI were significantly improved at six-month follow-up compared to preoperative levels (p<0.001, respectively). Excellent pain relief (>75% of initial VAS score) of back/buttock and leg was observed in 75.0% and 76.2% of patients, respectively. Conclusion : CDL is easily applied, allows good field visualization and decompression, maintains stability by sparing ligament and bony structures, and shows excellent early surgical results.

• Journal of Korean Neurosurgical Society
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• 제46권4호
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• pp.285-291
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• 2009

Objective : This study examined the change of range of motion (ROM) at the segments within the dynamic posterior stabilization, segments above and below the system, the clinical course and analyzed the factors influencing them. Methods : This study included a consecutive 27 patients who underwent one-level to three-level dynamic stabilization with Bioflex system at our institute. All of these patients with degenerative disc disease underwent decompressive laminectomy with/without discectomy and dynamic stabilization with Bioflex system at the laminectomy level without fusion. Visual analogue scale (VAS) scores for back and leg pain, whole lumbar lordosis (from L1 to S1), ROMs from preoperative, immediate postoperative, 1.5, 3, 6, 12 months at whole lumbar (from L1 to S1), each instrumented levels, and one segment above and below this instrumentation were evaluated. Results : VAS scores for leg and back pain decreased significantly throughout the whole study period. Whole lumbar lordosis remained within preoperative range, ROM of whole lumbar and instrumented levels showed a significant decrease. ROM of one level upper and lower to the instrumentation increased, but statistically invalid. There were also 5 cases of complications related with the fixation system. Conclusion : Bioflex posterior dynamic stabilization system supports operation-induced unstable, destroyed segments and assists in physiological motion and stabilization at the instrumented level, decrease back and leg pain, maintain preoperative lumbar lordotic angle and reduce ROM of whole lumbar and instrumented segments. Prevention of adjacent segment degeneration and complication rates are something to be reconsidered through longer follow up period.

• 대한물리의학회지
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• 제4권1호
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• pp.9-14
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• 2009

Purpose : The purpose of this study is change of lumbar multifidus muslce recorded simultaneously by ultrasound imaging during upper extremity functional movement in chronic low back pain patients. The subject were consisted of 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women. Methods : 10 women patients with chronic low back pain and healthy asymptomatic subject 10 women is voluntary participated for the research. Subjects were positioned in standing. Multifidus size were measured from L4 vertebral segement. The ultrasound imaging apparatus(Sonoace 6000, Medison, Korea) was epuipped with a 5-MHz convex array transducer. The upper extremity lifting movement used to activate the multifidus was then measured. Results : Results of the analysis showed that at the L4 vertebral leves, healthy asymptomatic subjects had significantly larger multifidus muscle compared with chronic LBP subjects. Conclusion : This study will be used as treatment method of patient with chronic LBP. The multifidus muscle in chronic LBP patients clinical significance. Most of chronic LBP patients have multifidus contraction pattern. Especially multifidus contraction in L4 vertebral segement. So chronic LBP patients necessary multifidus muscle release treatment.

• 한국운동역학회지
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• 제23권4호
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• pp.369-376
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• 2013

The purposes of this study were to assess dynamic stability toward pelvis-spine column distortion during running and to compare the typical three-dimensional angular kinematics of the trunk motion; cervical, thoracic, lumbar segment spine and the pelvis from the multi-segmental spine model between exercise group and non-exercise group. Subjects were recruited as exercise healthy women on regular basis (group A, n=10) and non-exercise idiopathic scoliosis women (group B, n=10). Data was collected by using a vicon motion capture system (MX-T40, UK). The pelvis, spine segments column and lower limbs analysiaed through the 3D kinematic angular ROM pattern. There were significant differences in the time-space variables, the rotation motion of knee joint in lower limbs and the pelvis variables; obliquity in side bending, inter/outer rotation in twisting during running leg movement. There were significant differences in the spinal column that is lower-lumbar, upper-lumbar, upper-thoracic, mid-upper thoracic, mid-lower thoracic, lower thoracic and cervical spine at inclination, lateral bending and twist rotation between group A and group B (<.05, <.01 and <.001). As a results, group B had more restrictive motion than group A in the spinal column and leg movement behaved like a 'shock absorber". And the number of asymmetry index (AI) showed that group B was much lager unbalance than group A. In conclusion, non-exercise group was known to much more influence the dynamic stability of equilibrium for bilateral balance. These finding suggested that dynamic stability aimed at increasing balance of the trunk ROM must involve methods and strategies intended to reduce left/right asymmetry and the exercise injury.

• 한국전문물리치료학회지
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• 제30권1호
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• pp.23-31
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• 2023

Background: Several factors contribute to shoulder pain, including abnormal neck posture, repeated use of the upper limbs, work involving raising the upper limbs above the head, and the effects of vibration. However, previous study has reported that constant vibration exposure could impact improvement of the stability on joints related with muscle recruitment and activation. For this difference reason, we need to verify for the complex study of relationship with repetitive upper limb movements, poor head posture, and constant vibration exposure. Objects: Our study was made to investigate the influence of vibration exposure on the shoulder muscle activity during forward-head and over-head tasks with isometric shoulder flexion. Methods: In a total of 22 healthy subjects, surface electromyography (EMG) data were collected from shoulder muscles (upper/lower trapezius, serratus anterior, and lumbar erector spinae) on tasks (neutral-head task [NHT], forward-head task [FHT], and over-head task [OHT]) with and without vibration exposure. Results: In all tasks, the EMG data of the upper trapezius and serratus anterior significantly increased with vibration exposure (p < 0.05). Furthermore, the EMG data of the lumbar erector spinae significantly increased with vibration exposure in the NHT and FHT (p < 0.05). Conclusion: We suggest that continuous vibration exposure during the use of hand-held tools in the tasks could be associated with harmful effects in the workplace. Lastly, we clinically need to examine the guidelines regarding the optimal posture and vibration exposure.

• 대한물리의학회지
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• 제7권3호
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• pp.303-308
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• 2012

Purpose : The purpose of this study is to define the change of lumbar asymmetry multifidus muscles when upper extremity PNF pattern. Methods : For this research, twenty-nine asymptomatic participants were voluntary attended. Under the identical conditions, Multifidus muscles were measured standing position and on L4,L5 vertebral level by MyLabOne (ESAOTE, Netherland with a 3.5MHz covex array transducer). The upper extrimity PNF pattern used to activate the multifidus ipsilateral and cotralateral. Results : Results of analysis showed that at the L4, L5 vertebral level, healthy asymtomativ subjects had asymmetry multifidus muscles size. The depth of the multifidus muscles were significantly increased at contralateral upper extrimity PNF pattern, but no significant differences were comparison ipsilateral with contralateral. Conclusion : The multifidus muscle in asymptomatic subjects clinical significance asymmetry. Contralateral upper extrimity PNF pattern seems to be the most suitable exercise for strenthen the smaller size of the multifidus. This study will be used as a prevention method of LBP.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2008년도 추계학술대회 논문집
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• pp.205-206
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• 2008