• Title/Summary/Keyword: spinal alignment

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Publication Trends in the Pelvic Parameter Related Literature between 1992 and 2022 : A Bibliometric Review

  • Serdar Yuksel;Emre Ozmen;Alican Baris;Esra Circi;Ozan Beytemur
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.50-59
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    • 2024
  • Objective : This study aimed to conduct a bibliometric analysis on pelvic parameter related research over the last 30 years, analyzing trends, hotspots, and influential works within this field. Methods : A comprehensive Web of Science database search was performed. The search yielded 3249 results, focusing on articles and reviews published from 1992 to 2022 in English. Data was analyzed using CiteSpace and VOSviewer for keyword, authorship, and citation burst analysis, co-citation analysis, and clustering. Results : The number of publications and citations related to pelvic parameters has increased exponentially over the last 30 years. The USA leads in publication count with 1003 articles. Top publishing journals include the European Spine Journal, Spine, and Journal of Neurosurgery: Spine, with significant contributions by Schwab, Lafage V, and Protoptaltis. The most influential articles were identified using centrality and sigma values, indicating their role as key articles within the field. Research hotspots included spinal deformity, total hip arthroplasty, and sagittal alignment. Conclusion : Interest in pelvic parameter related research has grown significantly over the last three decades, indicating its relevance in modern orthopedics. The most influential works within this field have contributed to our understanding of spinal deformity, pelvic incidence, and their relation to total hip arthroplasty. This study provides a comprehensive overview of the trends and influential research in the field of pelvic parameters.

Interspinous Implant with Unilateral Laminotomy for Bilateral Decompression of Degenerative Lumbar Spinal Stenosis in Elderly Patients

  • Ryu, Sung-Joo;Kim, In-Soo
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.338-344
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    • 2010
  • Objective : This study assessed the safety and efficacy of one level unilateral laminotomy bilateral decompression (ULBD) with the placement of a device for intervertebral assisted motion (DIAM) compared with one level ULBD only in elderly patients with degenerative lumbar spinal stenosis (DLSS). Methods : A non randomized prospective analysis was performed on 16 patients who underwent one level ULBD with DIAM (Group A) and 20 patients with one level ULBD only (Group B) between February 2007 and March 2008. Radiographic imaging, visual analog scale (VAS) and MacNab outcome scale were obtained before and after surgery at a mean interval of 21 months (range 17-27 months). Results : The disc height, interpedicular distance, slip distance and segmental lordotic angle were similar between two groups. In the group A, there was no significant difference between the pre- and post-operative imaging in terms of the sagittal balance and disc height. Both groups showed significant improvement in the clinical outcomes. In addition, there was significantly less low-back pain in the group A than in the group B at the last follow up, while the clinical improvement of the leg pain and MacNab outcome scale showed no significant difference in the two groups. There were no major complications or DIAM associated complications. Conclusion : ULBD with DIAM is a safe and efficacious treatment for selective elderly patients with DLSS, particularly for relieving low back pain comparing to ULBD. ULBD with DIAM did not alter the disc height or sagittal alignment at the mean 21 months follow-up interval.

Postoperative Flat Back : Contribution of Posterior Accessed Lumbar Interbody Fusion and Spinopelvic Parameters

  • Kim, Jin Kwon;Moon, Byung Gwan;Kim, Deok Ryeng;Kim, Joo Seung
    • Journal of Korean Neurosurgical Society
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    • v.56 no.4
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    • pp.315-322
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    • 2014
  • Objective : Posterior accessed lumbar interbody fusion (PALIF) has a clear objective to restore disc height and spinal alignment but surgeons may occasionally face the converse situation and lose lumbar lordosis. We analyzed retrospective data for factors contributing to a postoperative flat back. Methods : A total of 105 patients who underwent PALIF for spondylolisthesis and stenosis were enrolled. The patients were divided according to surgical type [posterior lumbar inter body fusion (PLIF) vs. unilateral transforaminal lumbar interbody fusion (TLIF)], number of levels (single vs. multiple), and diagnosis (spondylolisthesis vs. stenosis). We measured perioperative index level lordosis, lumbar lordosis, pelvic tilt, sacral slope, pelvic incidence, and disc height in standing lateral radiographs. The change and variance in each parameter and comparative group were analyzed with the paired and Student t-test (p<0.05), correlation coefficient, and regression analysis. Results : A significant perioperative reduction was observed in index-level lordosis following TLIF at the single level and in patients with spondylolisthesis (p=0.002, p=0.005). Pelvic tilt and sacral slope were significantly restored following PLIF multilevel surgery (p=0.009, p=0.003). Sacral slope variance was highly sensitive to perioperative variance of index level lordosis in high sacral sloped pelvis. Perioperative variance of index level lordosis was positively correlated with disc height variance ($R^2=0.286$, p=0.0005). Conclusion : Unilateral TLIF has the potential to cause postoperative flat back. PLIF is more reliable than unilateral TLIF to restore spinopelvic parameters following multilevel surgery and spondylolisthesis. A high sacral sloped pelvis is more vulnerable to PALIF in terms of a postoperative flat back.

Bone Mineral Density and Osteoporotic Vertebral Fractures in Traditional, Unassisted, Free-Diving Women (Haenyeos)

  • Seo, Jun-Yeong;Ha, Kee-Yong;Kim, Young-Hoon;Kim, Seong-Chan;Yoon, Eun-Ji;Park, Hyung-Youl
    • Journal of Korean Medical Science
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    • v.33 no.48
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    • pp.316.1-316.10
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    • 2018
  • Background: Water pressure and muscle contraction may influence bone mineral density (BMD) in a positive way. However, divers experience weightlessness, which has a negative effect on BMD. The present study investigated BMD difference in normal controls and woman free-divers with vertebral fracture and with no fracture. Methods: Between January 2010 and December 2014, traditional woman divers (known as Haenyeo in Korean), and non-diving women were investigated. The study population was divided into osteoporotic vertebral fracture and non-fracture groups. The BMD of the lumbar spine and femoral neck was measured. The radiological parameters for global spinal sagittal balance were measured. Results: Thirty free-diving women and thirty-three non-diving women were enrolled in this study. The mean age of the divers was $72.1{\pm}4.7$ years and that of the controls was $72.7{\pm}4.0$ years (P = 0.61). There was no statistical difference in BMD between the divers and controls. In divers, cervical lordosis and pelvic tilt were significantly increased in the fracture subgroup compared to the non-fracture subgroup (P = 0.028 and P = 0.008, respectively). Sagittal vertical axis was statistically significantly correlated with cervical lordosis (Spearman's rho R = 0.41, P = 0.03), and pelvic tilt (Spearman's rho R = 0.46, P = 0.01) in divers. Conclusion: BMD did not differ significantly between divers and controls during their postmenopausal period. When osteoporotic spinal fractures develop, compensation mechanisms, such as increased cervical lordosis and pelvic tilt, was more evident in traditional woman divers. This may be due to the superior back muscle strength and spinal mobility of this group of women.

Effects of Neck and Pelvic Exercise Using Swiss Ball on Spinal Curve in Adults with Forward Head Posture (전방머리자세 대상자에 대한 목운동과 골반운동이 척추 굽이에 미치는 효과)

  • Bae, Won-Sik;Jang, Chel
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.193-201
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    • 2021
  • Purpose : The purpose of this study was to compare the effect of pelvic exercise on the CVA and spinal curve in adults with forward head posture compared to the group using only neck exercise when pelvic exercise was performed in parallel with conventional neck exercise. Methods : GPS 400 and Formetric were used to identify craniovertebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion and were measured by an experienced research manager. Forward head posture (FHP) was selected for people whose angle between the line connecting the ear ball and the seventh cervical spine and the horizontal line is 50 degrees or less. The 30 selected students were randomly divided into 15 experimental groups and 15 control groups. Mackenzie exercise and sling exercise were performed for neck exercise in both the experimental group and the control group, and pelvic exercise using a Swiss ball was additionally performed in the experimental group. All data collected in this study were analyzed using SPSS statistics 21.0. Cervical vetebral angle (CVA), thoracic kyphosis, lumbar lordosis, and pelvic torsion were compared at 0 weeks, 3 weeks, and 6 weeks for each measurement factor using ANOVA with repeated measures. For the statistical significance test, the significance level of α was set to .05. Results : The changes of pelvic torsion, thoracic kyphosis and CVA due to pelvic exercise using Swiss Ball and neck exercise were changed over time, but lumbar lordosis were not changed. And there were no significant differences among the groups. Conclusion : In conclusion, the pelvic correction exercise is considered to be an effective exercise for correcting the FHP and requires regular pelvic correction exercises. We expect the results to be used in clinical trials.

Efficacy and Safety of Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Body Compression Fractures : Compared with Vertebroplasty

  • Yi, Won-Jae;Lee, Jung-Ho;Lee, Hyuk-Gee;Ryu, Kee-Young;Kang, Dong-Gee;Kim, Sang-Chul
    • Journal of Korean Neurosurgical Society
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    • v.42 no.2
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    • pp.112-117
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    • 2007
  • Objective : Kyphoplasty and vertebroplasty are two minimally invasive procedures for osteoporotic vertebral compression fractures. The purpose of this retrospective study was to compare the radiological findings and clinical outcomes between two procedures. Methods : Osteoporotic vertebral fractures were treated in 76 vertebrae, using kyphoplasty (n=35 vertebrae) and using vertebroplasty (n=41 vertebrae). Fractured vertebral bodies were diagnosed by correlating the clinical symptoms with radiologic study. The responses of pain symptoms were measured by a self-reported Visual Analog Scale (VAS) score. Plain X-rays were checked preoperatively and postoperatively at admission and 6 months. The vertebral body height and kyphotic angle were measured to assess the reduction of the sagittal alignment. Results : The mean pain scores were decreased significantly for both procedures postoperatively, but there were no significant differences between two groups. Kyphoplasty led to a significant reduction of the vertebral body height and improvement of kyphotic angle. There were no neurological deficits after kyphoplasty, but one patient experienced paraparesis after vertebroplasty. During the 6 months follow-up both procedures provided stabilization of the sagittal alignment. Conclusion : Kyphoplasty and vertebroplasty are considered effective minimally invasive techniques for the stabilization of osteoporotic vertebral body fractures, leading to a statistically significant reduction in pain. Kyphoplasty significantly restore sagittal alignment. Also, complications and the incidence of bone cement leakage are significantly lesser than vertebroplasty. Therefore, kyphoplasty seems to be reasonable procedure for osteoporotic vertebral body compression fractures when medical treatment fail.

Spontaneous Height Restoration of Vertebral Compression Fracture - A Case Report-

  • Joo, Young;Lee, Pyung-Bok;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • v.24 no.4
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    • pp.235-238
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    • 2011
  • Vertebral compression fractures result in vertebral height loss and alter sagittal spinal alignment, which in turn can lead to increased morbidity and mortality. Acute osteoporotic vertebral compression fractures are known to increase mobility and instability of the spine. There are limited published data correlating the degree of dynamic mobility and the efficacy of kyphoplasty on vertebral compression fractures. Here we report a 73-year-old female with a severe acute osteoporotic L2 compression fracture who obtained total vertebral height restoration following kyphoplasty, with resolution of back pain.

Effects of the Latest Robotic Horse-riding for Low Back Pain : Narrative Review

  • LEE, Jae-Hyuk
    • Journal of Wellbeing Management and Applied Psychology
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    • v.4 no.4
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    • pp.31-34
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    • 2021
  • Purpose: The purpose of this study is to review health-care program using the recent robotic horse-riding technology and its clinical effects for chronic low back pain. Research design, data and methodology: Recent clinical articles were determined under three inclusion criteria for in-depth review: 1) article that is published within 1 year, 2) article that includes the detailed explanation of health-care program using robotic horse-riding, 3) the article that deals with chronic low back pain during more than 6 months. Results: As a result, the finally-determined two articles demonstrated the clinical effects of robotic horse-riding statistically on pain intensity, low back muscle strength, spinal alignment, and fear-avoidance belief. Conclusions: After in-depth review, I concluded that health-care program using robotic horse-riding for chronic low back pain needs to be provided at low-intensity (e.g. less than 6km/h horse walking program) in the beginning of health-care for improving their motor control ability, then, at the increased intensity for strengthening core muscles.

The Study on Correlation between the Forward Head Posture and Spinal Alignment (전방머리자세(Forward Head Posture)의 정도와 척추 만곡 변형의 상관관계)

  • Jung, Hyun-Woo;Shin, Woo-Suk;Kim, Doo-Hee;Park, Won-Hyung;Cha, Yun-Yeop;Ko, Youn-Seok;Lee, Jung-Han;Chung, Won-Suk;Shin, Byung-Cheul;Song, Yun-Kyung;Go, Ho-Yeon;Sun, Seong-Ho;Jeon, Chan-Yong;Jang, Bo-Hyoung;Ko, Seong-Gyu
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.195-202
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    • 2013
  • Objectives This study was designed to investigate the correlation between the forward head posture and the spinal alignment. Methods We examined the whole spine x-rays of the 144 student sample. We measured the Craniovertebral angle (CVA), Cervical angle (CA), Thoracic kyphotic angle (TKA), lumbar lordosis angle (LLA) and Ferguson's angle (FA) of the students. We then analyzed the relationship between these angles. Results CVA had correlation with CA, but it was weak. There was significant correlation between CVA and TKA. There were no significant correlation among CVA, LLA and FA. Conclusions According to above results, there is a negative relationship between the CVA and the TKA - in that higher CVAs yielded lower TKAs. But CVA had no significant correlation with LLA or FA.

Targeting a Safe Entry Point for C2 Pedicle Screw Fixation in Patients with Atlantoaxial Instability

  • Chun, Hyoung-Joon;Bak, Koang-Hum
    • Journal of Korean Neurosurgical Society
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    • v.49 no.6
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    • pp.351-354
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    • 2011
  • Objective : This investigation was conducted to evaluate a new, safe entry point for the C2 pedicle screw, determined using the anatomical landmarks of the C2 lateral mass, the lamina, and the isthmus of the pars interarticularis. Methods : Fifteen patients underwent bilateral C1 lateral mass-C2 pedicle screw fixation, combined with posterior wiring. The C2 pedicle screw was inserted at the entry point determined using the following method : 4 mm lateral to and 4 mm inferior to the transitional point (from the superior end line of the lamina to the isthmus of the pars interarticularis). After a small hole was made with a high-speed drill, the taper was inserted with a 30 degree convergence in the cephalad direction. Other surgical procedures were performed according to Harm's description. Preoperatively, careful evaluation was performed with a cervical X-ray for C1-C2 alignment, magnetic resonance imaging for spinal cord and ligamentous structures, and a contrast-enhanced 3-dimensional computed tomogram (3-D CT) for bony anatomy and the course of the vertebral artery. A 3-D CT was checked postoperatively to evaluate screw placement Results : Bone fusion was achieved in all 15 patients (100%) without screw violation into the spinal canal, vertebral artery injury, or hardware failure. Occipital neuralgia developed in one patient, but this subsided after a C2 ganglion block. Conclusion : C2 transpedicular screw fixation can be easily and safely performed using the entry point of the present study. However, careful preoperative radiographic evaluation, regardless of methods, is mandatory.