• 국제물리치료학회지
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• 제9권1호
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• pp.1393-1397
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• 2018

The purpose of this study was to examine the effects of combined respiratory physical therapy on respiratory function, spinal curve and spinal mobility for community-dwelling elderlies with restrictive lung diseases. In total, 10 patients participated in an 8-week intervention program of thoracic cage mobilization and breathing exercise in combination. The results of the study are as follows: for respiratory function, the forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC), and FEV1/FVC were significantly improved to $.30{\pm}0.31{\ell}$, $.46{\pm}.42{\ell}$, and $18.10{\pm}11.39%$, respectively (p<.05). For spinal curve, the thoracic curve and the lumbar curve were improved significantly to $-2.20{\pm}1.40^{\circ}$ and $-1.20{\pm}1.14^{\circ}$, respectively (p<.01). For spinal mobility, the thoracic flexion ($3.40{\pm}2.99^{\circ}$), thoracic extension ($3.50{\pm}1.43^{\circ}$), lumbar flexion ($4.50{\pm}4.74^{\circ}$), and lumbar extension($-1.50{\pm}1.84^{\circ}$) were all significantly improved (p<.05). These findings indicate that thoracic cage mobilization and breathing exercise in combination improve the respiratory function, spinal alignment, and spinal mobility in elderly people with restrictive lung diseases.

• Clinics in Orthopedic Surgery
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• 제10권4호
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• pp.500-507
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• 2018

Background: The sagittal alignment of the spine and pelvis is not only closely related to the overall posture of the body but also to the evaluation and treatment of spine disease. In the last few years, the EOS imaging system, a new low-dose radiation X-ray device, became available for sagittal alignment assessment. However, there has been little research on the reliability of EOS. The purpose of this study was to evaluate the intrarater and interrater reliability of EOS for the sagittal alignment assessment of the spine and pelvis. Methods: Records of 46 patients were selected from the EOS recording system between November 2016 and April 2017. The exclusion criteria were congenital spinal anomaly and deformity, and previous history of spine and pelvis operation. Sagittal parameters of the spine and pelvis were measured by three examiners three times each using both manual and EOS methods. Means comparison t-test, Pearson bivariate correlation analysis, and reliability analysis by intraclass correlation coefficients (ICCs) for intrarater and interrater reliability were performed using R package "irr." Results: We found excellent intrarater and interrater reliability of EOS measurements. For intrarater reliability, the ICC ranged from 0.898 to 0.982. For interrater reliability, the ICC ranged from 0.794 to 0.837. We used a paired t-test to compare the values measured by manual and EOS methods: there was no statistically significant difference between the two methods. Correlation analysis also showed a statistically significant positive correlation. Conclusions: EOS showed excellent reliability for assessment of the sagittal alignment of the spine and pelvis.

• 한국응용과학기술학회지
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• 제37권6호
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• pp.1556-1566
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• 2020

본 연구는 8주간의 누리다 볼 운동이 중년 남성들의 등속성 근기능, 척추 정렬 및 동적 균형 능력에 미치는 영향을 규명하는데 있다. 본 연구의 대상자는 중년 남성(n=16)을 공 운동 그룹(BE, n=8)과 비교 그룹(CON, n=8)으로 구분하였으며 BE 그룹은 하루 30분, 주 3회, 총 8주간 누리다 볼 운동을 실시하여 등속성 슬관절 및 체간의 근 기능, 척추 정렬 및 동적 균형 능력을 측정하였다. 측정된 모든 변인들은 평균과 표준편차를 산출하고, Shapiro-Wilk test를 이용하여 정규성 검증을 확인하였다. 이후 집단 간의 차이를 확인하기 위해서 독립(Independant) t-test 방법과 대응(Paired) t-test 방법을 이용하여 분석하였다. 본 연구의 결과, 등속성 슬관절 및 체간 근 기능은 CON 그룹과 비교하여 BE 그룹에서 좌측과 우측의 슬관절 신전근의 피크파워(%BW, 60°/sec, p<.001, respectively), 좌측과 우측 슬관절 신전근의 평균파워(%BW, 60°/sec, p<.05, p<.001, respectively), 우측 슬관절 굴골근의 피크파워(%BW, 180/sec, p<.05) 및 우측 슬관절 신전근의 평균파워(%BW, 180°/sec, p<.05)가 유의하게 증가하는 것으로 나타났다. 등속성 체간의 근 기능 변화량은 CON 그룹과 비교하여 BE 그룹에서 신전근의 피크토크(%BW, 180/sec, p<.05)가 유의하게 증가하는 것으로 나타났다. 또한, 누리다 볼 운동은 몸통 앞뒤 기울기를 감소시켜 척추 정렬을 일부 개선한 것으로 나타났다(p<0.05). 마지막으로 CON 집단과 비교하여 BE 집단에서 동적 균형 능력은 6 단계의 전체균형지수(p<0.01), 전후균형지수(p<0.05) 및 1단계의 전체균형지수(p<0.05)를 유의하게 감소시켰다. 따라서 연구를 종합해 보면 누리다 볼 운동은 중년 남성들에게 있어 등속성 근 기능, 척추 정렬 및 동적 균형 능력과 같은 건강 관련 체력을 향상 시킬 수 있는 효과적인 운동 기구라고 사료되며, 향후 운동의 형태(강도, 빈도 등)를 다양하게 적용한 후속 연구가 필요할 것이다.

• Journal of Korean Neurosurgical Society
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• 제66권6호
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• pp.611-617
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• 2023

The cervical spine plays a critical role in supporting the skull, maintaining horizontal gaze, and facilitating walking. Its unique characteristics, including the widest range of motion among spinal segments, have led to extensive research on cervical sagittal alignment. Various parameters have been proposed to evaluate cervical alignment, with studies investigating their clinical significance, correlation with symptoms, and implications for surgical interventions. Recent findings suggest that cervical sagittal alignment not only impacts the cervical spine but also influences global spine-pelvic alignment through compensatory mechanisms. This comprehensive review examines classical and new parameters of cervical sagittal alignment and considers the dynamic and muscular factors associated with it.

• Journal of Korean Neurosurgical Society
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• 제53권1호
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• pp.49-51
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• 2013

A case of traumatic spondyloptosis of the cervical spine at the C6-C7 level is reported. The patient was treated succesfully with a anterior-posterior combined approach and decompression. The patient had good neurological outcome after surgery. A-51-year-old female patient was transported to our hospital's emergency department after a vehicle accident. The patient was quadriparetic (Asia D, MRC power 4/5) with severe neck pain. Plain radiographs, computerize tomography and spinal magnetic resonance imaging (MRI) showed C6-7 spondyloptosis and C5, C6 posterior element fractures. Gardner-Wells skeleton traction was applied. Spinal alignment was reachived by traction and dislocation was decreased to a grade 1 spondylolisthesis. Then the patient was firstly operated by anterior approach. Anterior stabilization and fusion was firstly achieved. Seven days after first operation the patient was operated by a posterior approach. The posterior stabilization and fusion was achieved. Postoperative lateral X-rays and three-dimensional computed tomography showed the physiological realignment and the correct screw placements. The patient's quadriparesis was improved significantly. Subaxial cervical spondyloptosis is a relatively rare clinical entity. In this report we present a summary of the clinical presentation, the surgical technique and outcome of this rarely seen spinal disorder.

• 한국의학물리학회지:의학물리
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• 제24권4호
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• pp.290-294
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• 2013

방사선수술은 고 용량의 방사선을 병소의 목표점에 정확하게 주위의 정상조직을 보호하면서 한 번에 혹은 수 차에 거쳐 전달하는 방법이므로 병소 국재에 대한 오차의 크기는 방사선수술에 직접적인 영향을 끼치게 된다. 본 연구에서는 영상유도 국재 장비인 ExacTrac (BrainLab, Germany)을 이용한 척추방사선수술에서 병소 목표점 국재의 오차를 평가하였다. 국재 오차를 최소화 하기위하여 방사선수술 전 '환자위치 확인장치(PPVT)'를 고안하여 부가적으로 사용하였다. 실시간 목표점오차 평가를 위하여 흉추에 전이된 종양에 대한 방사선수술 8례를 대상으로 평가하였다. 그 결과 isocenter 목표점 오차는 횡단면(lateral) 축 방향, 종단면(longitudinal) 축 방향, 수직면(vertical) 축 방향으로 각각 $0.07{\pm}0.17$ mm, $0.11{\pm}0.18$ mm, $0.13{\pm}0.26$ mm이었으며 평균 공간오차는 $0.20{\pm}0.37$ mm이었다. 병소 isocenter의 회전오차(body rotation)는 종단면(longitudinal) 축 방향 $0.14{\pm}0.07^{\circ}$, 횡단면(lateral) 축 방향 $0.11{\pm}0.07^{\circ}$, 환자테이블 각 이동 $0.03{\pm}0.04^{\circ}$로 평균오차는 $0.20{\pm}0.11^{\circ}$이었다. 본 연구결과 영상유도 국재방법을 이용한 척추방사선수술에서의 병소목표점 국재 평균오차는 임상적으로 허용할 수 있는 오차범위 이내 임을 확인하였다.

• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.4-12
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• 2021

Spinal metastases can present with varying degrees of mechanical instability. The Spinal Instability Neoplastic Score (SINS) was developed as a tool to assess spinal neoplastic-related instability while helping to guide referrals among oncology specialists. Some previous papers suggested that the SINS was accurate and reliable, while others disagreed with this opinion. We performed a systematic review regarding the SINS to evaluate its accuracy and precision in predicting vertebral compression fractures (VCFs). The 21 included studies investigated a total of 2118 patients. Thirteen studies dealt with the accuracy of SINS to predict post-radiotherapy VCFs, and eight dealt with the precision. Among 13 studies, 11 agreed that the SINS categories showed statistically significant accuracy in predicting VCF. Among eight studies, body collapse was effective for predicting VCFs in six studies, and alignment and bone lesion in two studies. Location has no statistical significance in predicting VCFs in any of the eight studies. The precision of SINS categories was substantial to excellent in six of eight studies. Among the six components of the SINS, the majority of the included studies reported that location showed near perfect agreement; body collapse, alignment, and posterolateral involvement showed moderate agreement; and bone lesion showed fair agreement. Bone lesion showed significant accuracy in predicting VCFs in half of eight studies, but displayed fair reliability in five of seven studies. Although location was indicated as having near perfect reliability, the component showed no accuracy for predicting VCFs in any of the studies and deleting or modifying the item needs to be considered. The SINS system may be accurate and reliable in predicting the occurrence of post-radiotherapy VCFs for spinal metastasis. Some components seem to be substantially weak and need to be revised.

• 융합정보논문지
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• 제9권8호
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• pp.243-247
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• 2019

본 연구는 6주간 20대의 일반 대학생을 대상으로 척추 정렬과 균형능력에 대한 클라이밍 운동 프로그램이 자기효능감에 미치는 영향에 대해 알아보았으며, 실험대상자는 총 30명이었으며, 6주간 주 3회 씩 상지와 하지에 대한 클라이밍 운동프로그램을 실시하였고, 결과는 다음과 같았다. 자기효능감의 군내 비교에서는 훈련군에서 유의한 차이가 있었다. 따라서, 클라이밍 운동이 자기효능감에 정상성인의 동기부여를 향상하는데 영향을 줄 수 있다는 것을 알 수 있었다. 결론적으로 추후 다양한 실험자들에게 클라이밍 운동을 실시할 시 참고 자료로 사용될 수 있을 것이라 사료된다.

• Journal of Korean Neurosurgical Society
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• 제53권6호
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• pp.356-369
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• 2013

Objective : We performed a retrospective analysis of medical records and radiographic images of patients who never underwent spinal treatment including diagnosis. The objective of this study is to explain the biomechanical and physiologic characteristics of cervical alignment related to thoracic inlet angle including T1 slope changes in each individual. Methods : We reviewed the cervical CT radiographs of 80 patients who visited ENT outpatient clinic without any symptom, diagnosis and treatment of cervical spine from January 2011 to September 2012. All targeted people were randomized without any prejudice. We assessed the data-T1 slope, Cobb's angle C2-7, neck tilt, sagittal vertical axis (SVA) C2-7 and thoracic inlet angle by the CT radiographs. Results : The relationships between each value were analyzed and we concluded that Cobb's angle C2-7 gets higher as the T1 slope gets higher, while the SVA C2-7 value decreases. Conclusion : We propose that the T1 slope is background information in deciding how much angle can be made in the cervical spinal angle of surgical lordotic curvature, especially severe cervical deformity.

• Journal of Korean Neurosurgical Society
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• 제64권5호
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• pp.677-692
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• 2021

Many studies have focused on pre-operative sagittal alignment parameters which could predict poor clinical or radiological outcomes after laminoplasty. However, the influx of too many new factors causes confusion. This study reviewed sagittal alignment parameters, predictive of clinical or radiological outcomes, in the literature. Preoperative kyphotic alignment was initially proposed as a predictor of clinical outcomes. The clinical significance of the K-line and K-line variants also has been studied. Sagittal vertical axis, T1 slope (T1s), T1s-cervical lordosis (CL), anterolisthesis, local kyphosis, the longitudinal distance index, and range of motion were proposed to have relationships with clinical outcomes. The relationship between loss of cervical lordosis (LCL) and T1s has been widely studied, but controversy remains. Extension function, the ratio of CL to T1s (CL/T1s), and Sharma classification were recently proposed as LCL predictors. In predicting postoperative kyphosis, T1s cannot predict postoperative kyphosis, but a low CL/T1s ratio was associated with postoperative kyphosis.