• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.661-668
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• 2018

Among the spinal disorders, the treatment approach for spinal deformities has been discussed least among department of neurosurgery. But nowadays, more and more neurosurgeons are interested in spinal deformities as well as complex spinal disorders and are doing not a few surgeries for these kinds of disease. Nevertheless, it is mandatory to understand the course of spinal deformity, principles of treatment, and surgical outcomes and complications. Understanding of the biology, biomechanics and metallurgy of the spine and instrumentation are also required for successful spinal deformity surgery. We need senior mentors and good surgical and neurophysiologic monitoring team. Knowledge of spinal deformity may be augmented with spine fellowships and surgical experience. Step by step training such as basic knowledge, orthopedic as well as neurosurgical disciplines and surgical skills would be mandatory. Neurosurgeons can have several advantages for spinal deformity surgeries. By high-level technical ability of the spinal cord handling to preserve neurological function and familiarity with microscopic surgery, better synergistic effect could be expected. A fundamental understanding of pediatric spinal deformity and growing spine should be needed for spinal deformity surgery.

• Fashion & Textile Research Journal
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• v.1 no.2
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• pp.137-147
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• 1999

The purpose of this study was to classify female students' somatotypes, to investigate the relationship between five somatotypes obtained from anthropometric measurements and to examine the relationship between the spinal deformity and somatotypes. The subjects for anthropometric measurements were 844 female middle and high school students. The data were analyzed by cluster analysis, correspondence analysis, Duncan test, and T-test. The results were as follows. Cluster analysis on the factors extracted from directly measured items classified subjects into five types (middle height and a little slim type (39.6%), low height and a little slim type (13.1%), middle height and a little fat type (18.0%), tall and very fat type (7.7%), and very tall and standard type (21.6%). In examining the relationship between the normal people and those of the spinal deformity, the normal showed higher mean value in almost all the items of the girth, the depth, and the length. High school students had more spinal deformity in number than middle school students. The degree of deformity was higher in the right spinal deformity than in the left spinal deformity as the age increased. In terms of the distribution of the spinal deformity classified by the somatotype, Type 1 (middle height and a little slim type) and Type 5 (very tall and standard type) appeared the highest.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.327-333
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• 2016

Adult spinal deformity (ASD) is one of the most challenging spinal disorders associated with broad range of clinical and radiological presentation. Correct selection of fusion levels in surgical planning for the management of adult spinal deformity is a complex task. Several classification systems and algorithms exist to assist surgeons in determining the appropriate levels to be instrumented. In this study, we describe our new simple decision making algorithm and selection of fusion level for ASD surgery in terms of adult idiopathic idiopathic scoliosis vs. degenerative scoliosis.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.167-179
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• 2018

The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration. Increasingly positive sagittal imbalance has been shown to correlate with poor functional outcome and poor self-image along with poor psychological function. Compensatory mechanisms attempt to maintain sagittal balance through pelvic rotation, alterations in lumbar lordosis as well as knee and ankle flexion at the cost of increased energy expenditure. Restoring normal spinopelvic alignment is paramount to the treatment of complex spinal deformity with sagittal imbalance. Posterior osteotomies including posterior column osteotomies, pedicle subtraction osteotomies, and posterior vertebral column resection, as well anterior column support are well known to improve sagittal alignment. Understanding of whole spinal alignment and dynamics of spinopelvic alignment is essential to restore sagittal balance while minimizing the risk of developing sagittal decompensation after surgical intervention.

• 제어로봇시스템학회:학술대회논문집
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• 1995.10a
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• pp.244-247
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• 1995

A technique is presented for evaluating spinal deformity of a human back by extracting a spinal line based on 3-D topograpic reconstruction of the back from its moire image. A given moire image is differentiatedby DOG filter to extract moire stripes. The stripes are then assigned labels and the labels are interpolated by the Lagrange polynomial to yield the undulation of the back which gives a relative 3-D shape of the back. A valley is searched on the undulation near the middle part of the back and the valley line is finally extracted as an approximated spinal line. The mean differenceand the variance between the spinal line and the middle line are calculated and reported. Experiment is performed employing real moire images ofjunior-high school students' backs and some of the results are shown with discussion.

• Journal of Korean Neurosurgical Society
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• v.65 no.2
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• pp.173-179
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• 2022

Disabilities can emerge due to traumatic spinal fractures. In terms of sacrococcygeal spine, because of its unique anatomic structure with minimal movement, the possibility for it to have a disability is relatively low. In Korea, unlike most disability criteria, private insurance companies acknowledge angular deformities caused by vertebral fractures as disabilities according to their degree, so there were several cases where patients required compensation, arguing angular deformity caused by sacrococcygeal fracture, which in some cases led to legal conflicts. Except the Act Welfare of Persons with Disabilities which recognizes only severe angular deformity affecting internal organs as disability and the industrial accident disability evaluation which does not recognize coccygeal fracture as disability but rarely recognizes sacral vertebra deformity equivalent to compressive deformation, there is little or no case where angular deformity is recognized as disability. Given the impairment evaluation standards in social insurance, McBride system, American Medical Association (AMA) guides, and newly proposed standards by the Korean Academy of Medical Sciences (KAMS), the most contentious point in the general terms and conditions of private insurance is spinal deformity. To overcome controversy over disability evaluation, the private insurance sector is now applying criteria for axial skeleton to sacrococcygeal vertebrae through revision of standards. Under these circumstances, it is fair to recognize sacrococcygeal fracture as impairment in terms of the pelvis only when the fracture leaves serious deformity and neurological symptoms with clear relevancy. Though it may not be easy to develop accurate disability evaluation standards, improvement is necessary to remove any irrationalities and make the standards as objective as possible.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.75-81
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• 2017

Objective : Spinal deformity surgery has the potential risk of massive blood loss. To reduce surgical bleeding, the use of tranexamic acid (TXA) became popular in spinal surgery, recently. The purpose of this study was to determine the effectiveness of intra-operative TXA use to reduce surgical bleeding and transfusion requirements in spinal deformity surgery. Methods : A total of 132 consecutive patients undergoing multi-level posterior spinal segmental instrumented fusion (${\geq}5$ levels) were analyzed retrospectively. Primary outcome measures included intraoperative estimated blood loss (EBL), transfusion amount and rate of transfusion. Secondary outcome measures included postoperative transfusion amount, rate of transfusion, and complications associated with TXA or allogeneic blood transfusions. Results : The number of patients was 89 in TXA group and 43 in non-TXA group. There were no significant differences in demographic or surgical traits between the groups except hypertension. The EBL was significantly lower in TXA group than non-TXA group (841 vs. 1336 mL, p=0.002). TXA group also showed less intra-operative and postoperative transfusion requirements (544 vs. 812 mL, p=0.012; 193 vs. 359 mL, p=0.034). Based on multiple regression analysis, TXA use could reduce surgical bleeding by 371 mL (37 % of mean EBL). Complication rate was not different between the groups. Conclusion : TXA use can effectively reduce the amount of intra-operative bleeding and transfusion requirements in spinal deformity surgery. Future randomized controlled study could confirm the routine use of TXA in major spinal surgery.

• Journal of Korean Neurosurgical Society
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• v.59 no.6
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• pp.655-658
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• 2016

Parkinson's disease (PD) patients frequently have several spinal deformities leading to postural instabilities including camptocormia, myopathy-induced postural deformity, Pisa syndrome, and progressive degeneration, all of which adversely affect daily life activities. To improve these postural deformities and relieve the related neurologic symptoms, patients often undergo spinal instrumentation surgery. Due to progressive degenerative changes related to PD itself and other complicating factors, patients and surgeons are faced with instrument failure-related complications, which can ultimately result in multiple revision surgeries yielding various postoperative complications and morbidities. Here, we report a representative case of a 70-year-old PD patient with flat back syndrome who had undergone several revision surgeries, including anterior and posterior decompression and fusion for a lumbosacral spinal deformity. The patient ultimately benefitted from a relatively short segment fixation and corrective fusion surgery.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.10 no.1
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• pp.45-52
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• 2012

Purpose : This study is carried out to investigate the effect of asymmetric exercises on soccer players' vertebral abnormality and weight bearing. Methods : A total of 40 soccer players were divided into either a group of 20 players who use a unilateral foot or a group of 20 players who use both feet. 3-dimensional spine structure analyzer was used to analyze body inclination, pelvic inclination, pelvic torsion, turning of spinal segment, spinal curvature, thoracic kyphosis curvature, lumbar lordosis curvature, left/right weight distribution, and front/back weight distribution. Results : The result of the two groups showed that there were significant differences (p<0.05) for every item except turning of spinal segment and lumbar lordosis curvature. Conclusion : From this result, we can find that spinal and pelvic deformity and body weight are unilaterally supported for soccer players with asymmetric exercises.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.843-852
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• 2021

The purpose of this review was to synthesize the research on global spinal alignment and reciprocal changes following cervical or thoracolumbar reconstruction surgery. We carried out a search of PubMed, EMBASE, and Cochrane Library for studies through May 2020, and ultimately included 11 articles. The optimal goal of a truly balanced spine is to maintain the head over the femoral heads. When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. Historically, deformity correction has focused on correcting scoliosis and preventing scoliotic curve progression. Following substantial correction of a spinal deformity, reciprocal changes take place in the flexible segments proximal and distal to the area of correction. Restoration of lumbar lordosis following surgery to correct a thoracolumbar deformity induces reciprocal changes in T1 slope, cervical lordosis, pelvic shift, and lower extremity parameters. Patients with cervical kyphosis exhibit different patterns of reciprocal changes depending on whether they have head-balanced or trunk-balanced kyphosis. These reciprocal changes should be considered to in order to prevent secondary spine disorders. We emphasize the importance of evaluating the global spinal alignment to assess postoperative changes.