• Journal of Korean Medicine Rehabilitation
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• v.15 no.2
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• pp.183-191
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• 2005

Objectives : The 5th lumbar - 1st sacrum facet joint is unstable area from an anatomical viewpoint, so that it is clinically major causes of low back pain. The purpose of this study is to assess the difference of the Van Akkerveeken measurement and intervertebral disc angle, Ferguson angle betwoon the 5th lumbar - 1st sacrum facet syndrome patients and sample group patients.Methods : Van Akkerveeken measurement, intervertebral disc angle and Ferguson angle were measured in 30 patients who had 5th lumbar - 1st sacrum facet syndrome and 31 sample group patients.Results :1. Van Akkerveeken measurement of 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients.2. Intervertebral disc angle of the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients.3. Ferguson angle is the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger than that of sample group patients.Conclusions : These results suggest that Van Akkerveeken measurement and intervertebral disc angle is able to be used for diagnosis of facet syndrome.

• Journal of Korean Foot and Ankle Society
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• v.22 no.1
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• pp.16-20
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• 2018

Purpose: To evaluate the clinical and radiographic results of surgical treatment for patients with sinus tarsi pain due to accessory talar facet impingement. Materials and Methods: Between July 2013 and July 2015, nine patients who underwent surgery for the accessory talar facet impingement were reviewed. The mean follow-up period was 18.6 months (12~36 months), and the mean age was 33.1 years (19~60 years). Previous trauma history, duration of symptom, and types of surgery were analyzed. The clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS). Radiographic results were assessed using Meary's angle, calcaneal pitch angle, heel alignment angle, and heel alignment ratio. Results: All patients had evident trauma history prior to the initial symptom. The mean duration of symptoms was 25.6 months (6~120 months). Four patients received only accessory anterolateral talar facet (AALTF) excision, and four patients received medial sliding calcaneal osteotomy (MSCO). One patient underwent both AALTF excision and MSCO. The AOFAS ankle-hindfoot score was significantly improved from 73 (62~77) preoperatively to 93 (67~100) postoperatively. The VAS score was decreased from 6 (5~7) preoperatively to 1 (0~5) postoperatively. The Meary's angle and calcaneal pitch angle showed no significant difference after surgery. The heel alignment angle and ratio increased from $-3.6^{\circ}$ ($-10^{\circ}{\sim}5^{\circ}$) and 0.22 (-0.15~0.6) preoperatively to $2.8^{\circ}$ ($1^{\circ}{\sim}5^{\circ}$) and 0.42 (0.3~0.6) postoperatively, respectively. Conclusion: If there is persistent sinus tarsi pain in patients with hindfoot valgus, accessory talar facet impingement caused by AALTF could be considered as a cause of chronic sinus tarsi pain.

• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.42-52
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• 2021

Background: The purpose of this study was to investigate the effects of the severity and direction of lumbar disc herniation (LDH) on the facet joints and paraspinal muscles. Design: Cross-sectional design. Methods: The subjects were divided according to the diagnosis for severity of unilateral herniation of L4-L5 disc. The groups consisted of disc protrusion group (n=15), disc extrusion group (n=15), and no disc herniation group (n=15). The asymmetry and angle of facet joints and the cross-sectional area of paraspinal muscles were analyzed and compared using magnetic resonance imaging (MRI). Results: The results showed that the angle of facet tropism was larger in disc extrusion group than the disc protrusion group and the difference was found to be significant difference (p<0.01). In addition, when both left and right angles of patients with unilateral disc herniation were measured, the results showed larger facet joint angle in the herniated area of the disc extrusion group than in the disc protrusion group. When paraspinal muscles were measured according to the severity of disc herniation and the degree of facet joint asymmetry, there was no difference in paraspinal muscles between the disc protrusion and disc extrusion groups. Meanwhile, the multifidus muscle was smaller in the group with facet tropism than the group without facet tropism (p<0.03), while there were no significant differences in the erector spinae and psoas muscles. Conclusion: Progression of disc herniation resulted in increased facet joint tropism, increased angle of the facet joints in the direction of disc herniation, and decreased size of the multifidus muscle.

• Journal of Korean Medicine Rehabilitation
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• v.15 no.2
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• pp.169-181
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• 2005

Objectives : The 5th lumbar - 1st sacrum facet joint is unstable area from an anatomical viewpoint, so that it is clinically major causes of low back pain. The purpose of this study is to assess the difference of the Van Akkerveeken measurement and intervertebral disc angle, Ferguson angle between the 5th lumbar - 1st sacrum facet syndrome patients and sample group patients. Methods : Van Akkerveeken measurement, intervertebral disc angle and Ferguson angle were measured in 30 patients who had 5th lumbar - 1st sacrum facet syndrome and 31 sample group patients. Results : 1. Van Akkerveeken measurement of 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients. 2. Intervertebral disc angle of the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger that of than sample group patients. 3. Ferguson angle is the 5th lumbar - 1st sacrum facet syndrome patients is statistically larger than that of sample group patients. Conclusions : These results suggest that Van Akkerveeken measurement and intervertebral disc angle is able to be used for diagnosis of facet syndrome.

• Journal of Korean Neurosurgical Society
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• v.58 no.4
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• pp.341-345
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• 2015

Objective : To measure the orientation of the facet joints of cervical spine (C-spine) segments in the sagittal plane, known as the pedicle-facet (P-F) angle, and to use these measurements to evaluate the relationship between the P-F angle and the amount of vertebral anterolisthesis in patients with degenerative cervical spondylolisthesis (DCS). Methods : A retrospective case-control study was performed including 30 age- and sex-matched patients with DCS and 30 control participants. Anterior-posterior and lateral view radiographs of the C-spine were obtained in a standing position. The P-F angle at all cervical levels and the amount of anterolisthesis at C4-5 were measured from lateral view plain radiographs. Results : The P-F angles at C4-5 were $141.14{\pm}7.14^{\circ}$ for the DCS group and $130.53{\pm}13.50^{\circ}$ (p=0.012) for the control group, and at C5-6 were $137.46{\pm}8.53^{\circ}$ for the DCS group and $128.53{\pm}16.01^{\circ}$ for the control group (p=0.001). The mean P-F angle at C4-5 did not correlate with the amount of anterolisthesis (p=0.483). The amount of anterior slippage did correlate with age (p<0.001). Conclusion : The P-F angle was intrinsically higher at C4-5, compared to C5-6, in both the DCS and control groups, which might explain the increased likelihood for anterolisthesis of C4. Higher P-F angles in the DCS group may be a predisposing factor to slippage. The P-F angle may interact with age to increase incidence of anterolisthesis with increasing age.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.157-160
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• 2010

Purpose: The purpose of this study is to find out the correlation factors for prognosis of calcaneal fractures. Materials and Methods: 120 cases (feet) of calcaneal fractures, all of them followed up for more than 1 year after surgical procedures, consisted of 101 men (105 feet) and 13 women (15 feet) were reviewed retrospectively. The collected clinical data were as follows : injury mechanism, surgical procedures, time to procedure, time to work and the radiologic data: Bohler angle, heel width, displacement of posterior facet. AOFAS hindfoot score and VAS score were checked. With ANOVA test and multiple regression analysis, the data processed statistically. Results: According Sanders classification, type II was 37 cases (31%), type III 66 cases (55%), and type IV 17 cases (14%). On plane radiography, the Bohler angle improved to average 28.4 degree from 5.6 degree, and the displacement of posterior facet was corrected to average 1.2 mm. AOFAS hindfoot score was checked average 81.7 points postoperatively, and the meaningful difference existed between types of Sanders classification. The Bohler angle represented the outline of the calcaneus had the better correlation with the clinical outcome of calcaneal fractures rather than the anatomical reduction of the posterior facet did. And the width of calcaneus had good correlation with the clinical score. Conclusion: We should also concern about the outline of calcaneus, the width of calcaneus and the Bohler angle representing anatomical reduction, not only the acute reduction of the posterior facet.

• Journal of Korean Foot and Ankle Society
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• v.28 no.2
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• pp.60-67
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• 2024

Purpose: Sinus tarsi syndrome (STS) is caused by various pathologies. However, the exact etiology of STS remains controversial. This study evaluated the imaging and arthroscopic findings of patients who underwent surgical treatment after conservative treatment for STS failed. Materials and Methods: Between December 2014 and August 2018, 20 patients (21 cases) who underwent surgical treatment for STS were included in the study. The clinical results were analyzed using the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional scale. The radiographic results were analyzed using Meary's angle, calcaneal pitch angle, and hindfoot alignment angle. The pathologic conditions of sinus tarsi were confirmed by magnetic resonance imaging (MRI) and subtalar arthroscopy. Synovitis, bone edema, and accessory anterolateral talar facet (AALTF) were evaluated on MRI. Synovial thickening, cartilage damage, interosseous talocalcaneal ligament (ITCL) and cervical ligament rupture, soft tissue impingement, AALTF, and accessory talar facet impingement (ATFI) were evaluated by subtalar arthroscopy. Results: The mean duration of symptoms was 28.7 months (4~120). All patients showed significant improvement in the VAS and AOFAS ankle-hindfoot scale. Significant improvements in hindfoot alignment angle and Meary's angle postoperatively were noted in patients who underwent medial displacement calcaneal osteotomy. MRI confirmed synovitis in all patients, AALTF in 19 cases (90.5%), and ATFI with bone edema in seven cases (33.3%). In subtalar arthroscopy, pathologic conditions were observed in the following order: synovitis in 21 cases (100%), AALTF in 20 cases (95.2%), ITCL partial rupture in nine cases (42.9%), and soft tissue impingement in seven cases (33.3%). All cases had two or more pathological conditions, and 15 (71.4%) had three or more. Conclusion: In cases of STS that do not respond to conservative treatment, a comprehensive examination of the lesions of the tarsal sinus and lesions around the subtalar joint is essential.

• Transactions of the Korean Society of Mechanical Engineers
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• v.14 no.6
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• pp.1523-1532
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• 1990

The objective of this study is to develope an optimized multi-facet drill (MFD). The principal factors that affect drilling performance are its geometry and the cutting conditions. In particular, the helix angle in the total twist angle of the twist drill, affects much morgen influence on the dynamic and static stiffness and on determining the characteristics of the chip disposal capacity of the drill. In this study, considering the helix angle as a major parameter, the model was developed. From this model, the deformation of transverse direction was simulated with the bending forces applied. The performance of a drill largely depends upon drilling forces. Comprehensive models for predicating the drilling thrust and torque are developed for the different drill geometries. The effects of MFD geometric parameters on thrust and torque are also deduced from the prediction models, from which an optimal drill geometry is found with the emphasis on minimum drilling forces.

• Journal of Korean Neurosurgical Society
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• v.47 no.6
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• pp.446-453
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• 2010

Objective : The purpose of this study was to analyze the biomechanical effects of three different constrained types of an artificial disc on the implanted and adjacent segments in the lumbar spine using a finite element model (FEM). Methods : The created intact model was validated by comparing the flexion-extension response without pre-load with the corresponding results obtained from the published experimental studies. The validated intact lumbar model was tested after implantation of three artificial discs at L4-5. Each implanted model was subjected to a combination of 400 N follower load and 5 Nm of flexion/extension moments. ABAQUS$^{TM}$ version 6.5 (ABAQUS Inc., Providence, RI, USA) and FEMAP version 8.20 (Electronic Data Systems Corp., Plano, TX, USA) were used for meshing and analysis of geometry of the intact and implanted models. Results : Under the flexion load, the intersegmental rotation angles of all the implanted models were similar to that of the intact model, but under the extension load, the values were greater than that of the intact model. The facet contact loads of three implanted models were greater than the loads observed with the intact model. Conclusion : Under the flexion load, three types of the implanted model at the L4-5 level showed the intersegmental rotation angle similar to the one measured with the intact model. Under the extension load, all of the artificial disc implanted models demonstrated an increased extension rotational angle at the operated level (L4-5), resulting in an increase under the facet contact load when compared with the adjacent segments. The increased facet load may lead to facet degeneration.

• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.78-86
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• 2000

Objective : Lumbar spinal instability occurs when normal biomechanics support in lumbar vertebrae interrupted. Despite the recent enthusiastic studies, the precise radiological assessment has not been fully established, yet. Therefore, we carefully studied our cases to analyze the radiologic findings in lumbar spinal instability. Patients and Methods : We have put together radiological analysis and assessment based on 38 patients who have been diagnosed and treated for lumbar spinal instabilities from June 1994 to December 1998, Patients who have been diagnosed and treated for trauma were excluded from study. Results : The outcomes are as follows : 1) Lumbar lordotic curve was statistically significant in unstable group by 23.7, compared to the control group ($17.0^{\circ}$). 2) According to the resting x-ray, sagittal plane angulation measured on unstable group was $21.1^{\circ}$, control group $18.0^{\circ}$. Therefore unstable group was noticeably higher(p<0.01). 3) According to the resting x-ray sagittal plane displacement, unstable group had 4.3mm, the comparison had 1.2mm. Therefore measurement from the unstable group were significantly higher(p<0.01). 4) According to stress view, sagittal plane translation was 4.1mm for the unstables and 2.7mm for the comparisons. Therefore unstables were noticeably higher(p<0.01). 5) According to stress view, sagittal plane rotation was $15.1^{\circ}$ at L3-4, $22.0^{\circ}$ at L4-5, $27.9^{\circ}$ at L5S1 for the unstable group and $11.3^{\circ}$, $18.1^{\circ}$, $21.0^{\circ}$ each for the comparison. 6) Facet angle for unstable group, left $29.3^{\circ}-61.5^{\circ}$, right $24.4^{\circ}-63.2^{\circ}$ and the mean for each are $43.1^{\circ}$, $47.2^{\circ}$. The difference between left and right facet angle was $3.5^{\circ}-20.7^{\circ}$ and the mean value $15.3^{\circ}$. Facet angle for the comparisons for the left was $29.3^{\circ}-59.5^{\circ}$, right was in between $25.7^{\circ}-64.5^{\circ}$ range and the each mean are $44.9^{\circ}$ and $47.6^{\circ}$. Also, the difference between left and right facet angle was $4.1^{\circ}-9.3^{\circ}$ and the average was $17.1^{\circ}$. The average and the difference between the left and right angle are found not to have statistic necessity for both unstable and stable measurements(p>0.01). 7) 19 patients were found to have vacuum facet phenomenon among unstable group etc. results were collected. Conclusion : According to above results, we attempted to prepare the application to the patient of radiological analysis and assessment for lumbar spinal instability early checkup.