• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.350-358
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• 2012

Objective : Life expectancy for humans has increased dramatically and with this there has been a considerable increase in the number of patients suffering from lumbar spine disease. Symptomatic lumbar spinal disease should be treated, even in the elderly, and surgical procedures such as fusion surgery are needed for moderate to severe lumbar spinal disease. However, various perioperative complications are associated with fusion surgery. The aim of this study was to examine perioperative complications and assess risk factors associated with lumbar spinal fusion, focusing on geriatric patients at least 70 years of age in the Republic of Korea. Methods : We retrospectively investigated 489 patients with various lumbar spinal diseases who underwent lumbar spinal fusion surgery between 2003 and 2007 at our institution. Three fusion procedures and the number of fused segments were analyzed in this study. Chronic diseases were also evaluated. Risk factors for complications and their association with age were analyzed. Results : In this study, 74 patients experienced complications (15%). The rate of perioperative complications was significantly higher in patients 70 years of age or older than in other age groups (univariate analysis, p=0.001; multivariate analysis, p=0.004). However, perioperative complications were not significantly associated with the other factors tested (sex, comorbidities, operation procedures, fusion segments involved). Conclusion : Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery whereas other factors were not significant. We recommend good clinical judgment and careful selection of geriatric patients undergoing lumbar spinal fusion surgery.

• Physical Therapy Korea
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• v.25 no.4
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• pp.27-36
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• 2018

Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.39-48
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• 2015

PURPOSE: This study aimed to compare the degree of lumbopelvic rotation during the active straight leg raise (ASLR) test in chronic low back pain with and without lumbar segmental instability. METHODS: A total of 71 patients with chronic low back pain were recruited for this study. The subjects who tested positive for more than three of the five lumbar segmental instability tests (prone lumbar instability, lumbar passive extension test, anterior posterior mobility test, passive straight leg raise, age) were categorized into the lumbar segmental instability positive group. Patients who tested positive for less than three of the five tests were categorized into the lumbar segmental instability negative group. The lumbopelvic rotation was measured three times during ASLR and a mean was determined. Subjective heaviness during the ASLR was measured on 6 point scale. RESULTS: There was a statistically significant difference in the lumbopelvic rotation angle between the groups with and without lumbar segmental instability (p<.01). There was no significant difference in the subjective heaviness during ASLR. The mean lumbopelvic rotation angle during ASLR was $13.54{\pm}2.86^{\circ}$, and $8.81{\pm}2.47^{\circ}$ in the positive and negative groups, respectively (p<.01). The cut-off value of the lumbopelvic rotation during was $10.5^{\circ}$, the sensitivity was 82.9%, and the specificity was 80.6%. CONCLUSION: These results suggest that lumbopelvic rotation is more prevalent in patients without lumbar segmental instability. Clinically, this important when diagnosing chronic low back pain with lumbar segmental instability, as the lumbopelvic rotation angle during the ASLR test can be used to aid in diagnosis.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.2
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• pp.289-302
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• 2009

Objectives : This study was performed in order to investigate the relation of body composition analysis and radiological parameter(lumbosacral angle, lumbar lordortic angle, lumbar gravity line). Methods : This study was carried out with the data from comprehensive medical testing. 75 subject aged 20-59 performed the segmental bioelectrical impedance analysis, questionnaire. And lumbosacral angle, lumbar lordortic angle and lumbar gravity line were measured in the standing position x-ray. Then we analyzed the data. Results : Low back pain(LBP) prevalence in high obesity index(Body Mass Index(BMI), Percentage of Body Fat(PBF), Waist Hip Ratio(WHR)) group was higher than LBP prevalence in normal obesity index group(p<0.01). In LBP group, lumbosacral angle, lumbar lordortic angle were significantly lager than Non-LBP group(p<0.001). And 75% of LBP group indicated abnormal lumbar gravity line ratio(0.67 < Normal lumbar gravity line ratio <1.00). When it comes to analyze relation between obesity index and radiological parameter, no-significant change was seen. Conclusions : This study carried as following research after the study on relation of obesity, LBP and trunk muscle strength. Results from this investigation showed positive correlation between obesity and LBP prevalence. But obesity index didn't indicate significant correlation with structural changes of lumbar vertebrae. When considering prior research, trunk muscle strength changes were more related to LBP prevelence in obese people. This results are expected to explain causes of LBP in obese group.

• Journal of Korean Physical Therapy Science
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• v.13 no.4
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• pp.7-16
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• 2006

The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, 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(Matthiass 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. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture 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.

• The Journal of Korean Obstetrics and Gynecology
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• v.34 no.1
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• pp.93-103
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• 2021

Objectives: The purpose of this study was to report a case of a pregnant woman diagnosed with lumbar disc herniation that improved in lumbar pain and radiating leg pain through combined korean medical treatment including pharmacopuncture at lumbar facet joints in situations surgical and pharmacological treatment is limited due to pregnancy. Methods: A combination of treatment including pharmacopuncture at lumbar facet joints, acupuncture, cupping, and herbal medicine was provided for 1 month to a woman at 21 weeks pregnant who was diagnosed with lumbar disc herniation. Her progress was assessed with Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5Dimension (EQ-5D) before and after treatment. Results: After the treatment, the pain decreased and the quality of life was enhanced. No adverse events were observed. Conclusions: The findings indicate that combined korean medical treatment including pharmacopuncture at lumbar facet joints can be safe and effective alternative to treat lumbar disc herniation during pregnancy.

• 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.

• The Journal of the Korea Contents Association
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• v.11 no.12
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• pp.800-806
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• 2011

The objective of this study was to identify the effect of lumbar lordotic curve adjustment on head and neck posture in older adults. Methods Twenty healthy older participants (mean age 71.32) were photographed while watching monitor in sitting with or without lumbar roll support(length 28cm, diameter 10cm). The upper cervical angle and lower cervical angle were measured using the NIH ImageJ 1.32. Comparisons between upper and lower cervical angle with or without lumbar roll support were made using paired-t test analysis. Results Subjects demonstrated a significant difference in the mean upper and lower cervical angle. Mean difference of the upper cervical angle was about $2.83^{\circ}$ with and without lumbar roll support(p<0.005). Mean difference of the lower cervical angle was about $4.44^{\circ}$ with and without lumbar roll support(p<0.0001). Conclusions This study showed that healthy older adults demonstrated more ability to maintain an upright posture of cervical spine during lumbar lordotic curve maintenance with lumbar roll support than without lumbar roll support. When the clinicians consider improvement of the head and neck posture in older adults, they must incorporate adjustment in the lumbar region.

• Journal of Korean Physical Therapy Science
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• v.15 no.1
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• pp.87-95
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• 2008

Pelvic floor muscles positively affect not only urinary incontinence but also lumbar stabilization by generating intra－abdominal pressure through interaction with muscles around the trunk. Especially, contracting pelvic floor muscles consistently and gently at low intensity is one of the most effective methods to separate and contract transverse abdominis which plays an important role in lumbar stabilization. The purpose of this study was to reexamine the importance of pelvic floor muscles which had not been used much in the treatment of lumbago and to introduce pelvic floor muscle exercises that can be utilized in the treatment of lumbago by examining literature on the relationship between pelvic floor muscles and lumbar stabilization. It is expected that this study will help apply lumbar stabilization exercise to patients with lumbago more variously and effectively.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.271-275
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• 2001

Buerger's disease is a nonatherosclerotic occlusive inflammatory disease of the small and medium arteries, and veins of the distal leg or arm. Percutaneous lumbar sympathectomy is used to lower extremity occlusive vascular disease as well as Buerger's disease. Lumbar sympathectomy improves blood flow and provides pain relief in the lower extremity. We report two cases of lumbar sympathectomy using radiofrequency thermocoagulation in patients with Buerger's disease. After no paresthesia and muscle contracture at 50 Hz, 1 volt and 2 Hz, 3 volts, respectively, radiofrequency lesioning was performed for 90 sec at $80^{\circ}C$. After the procedure, both patients showed skin temperature increases greater than $2^{\circ}C$ on the affected extremity. Both patients received relief from pain and symptoms without complications. We consider that lumbar sympathectomy using radiofrequency thermocoagulation is a safe and effective procedure that can relieve pain in patients with Buerger's disease.