• 대한정형도수물리치료학회지
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• 제28권2호
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• pp.45-55
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• 2022

Background: This study compared the effects of trunk stabilization exercise and hip joint exercises on the range of motion of the lumbar spine, pain severity, and severity of disability in patients with chronic lower back pain. Methods: A total of 30 participants were enrolled and divided into group 1 (n=10), group 2 (n=10), and group 3 (n=10) were performed by each group thrice a week for a total of 8 weeks. Group 1 performed warm-up exercise (15 min), trunk stabilization exercise (25 min), finish-up exercise (15mins). Group 2 performed warm-up exercise (15 min), hip exercise (25 mins, finish-up exercise (15mins). Group 3 warm-up exercise (15 min), trunk stabilization and hip exercise (25 min), Finish-up exercise (15 min). Participants were assessed for the range of motion of the lumbar spine, pain severity (visual analog scale score; VAS), and severity of disability (Oswestry disability index score; ODI) before and after the interventions. Results: All three groups showed a significant increase in the range of motion of the lumbar spine, but there was no significant difference among the groups. Moreover, the severity of pain and ODI were significantly decreased in all groups; however, the intergroup differences were non-significant. Conclusion: The results from this study confirmed the effectiveness of trunk stabilization and hip joint exercise in improving the lumbar range of motion, pain severity, and chronic lower back pain in patients. Thus, trunk and pelvic stabilization exercises and hip joint exercise can be used as clinical practices to treat and prevent chronic lower back pain.

• 대한물리치료과학회지
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• 제13권1호
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• pp.29-38
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• 2006

The purpose of this study lies in finding out the effect that variation of pain and body deflection posture has an influence on the static spinal stabilization after having performed spinal stabilization exercise making degenerative disc disease patients an object over 8 weeks using $CENTAUR^{(R)}$, 3-D spinal stabilization training implement. Subjects : 61 of DDD patients were made as an object of this study (mean age: 45.46 years, SD: ${\pm}12.78$, range: 16-68), their average height was 161.87cm, average weight 60.70kg, 12 males and 49 females were involved. Methods: 8 various investigations were performed and varied values were compared with reinvestigation done after having exercised 8 weeks using 3-D $CENTAUR^{(R)}$. We used VAS(Visual Analog Scale) in order to see the variation of pain intensity, MOS(Modified Oswestry Scale) in order to see activities of daily life. Results VAS was lessened from 7.50 to 2.71, limitation of routine life(MOS) from 20.26 to 9.32, there were remarkable differences statistically(p<0.05). As a result of muscular investigation for static spinal stabilization by 8 variations of body deflection, muscular strength were all increased and there were remarkable differences statistically(p<0.05). Conclusions : It has been turned out that pain and limitation of daily life was lessened as a result of making 61 of degenerative disc disease patients exercised 8 weeks using $CENTAUR^{(R)}$, 3-D spinal stabilization training implement, deep muscular power was increased. Thus it has been turned out that 3-D lumbar stabilization exercise has an effect on the spinal muscles strengthening and alleviation of their pain for degenerative disc disease.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.305-310
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• 2007

Objective : Combined antero-posterior fixation has been a standard method for bilateral interfacetal dislocation in cervical spine. The purpose of this study is to evaluate the efficacy and complication of anterior cervical stabilization in treatment of bilateral interfacetal dislocation. Methods : A total of 65 cases of traumatic bilateral interfacetal dislocation in cervical spine who were managed in our institution, from Mar. 1997 to Feb. 2006, were included in this study. Closed reduction was tried in all cases before operation. If closed reduction was accomplished successfully, only anterior cervical fixation was performed (Group I), and attempted to place screws bicortically as possible with unicortical screws. If failed, posterior open reduction with fixation was first tried, followed by anterior cervical fixation (Group II). All patients were evaluated for neurological outcome and radiological evidence of healing. Results : The Group I included 47 patients and the Group II, 18 patients. The improvement of Frankel grade and increase of mean cervical lordosis angles were not statistically different between two groups. Screw-plate system used did not influence the outcome. On follow up, solid bone fusion was evident and there were no cases of instability in both groups. Conclusion : Our study demonstrated that anterior cervical fixation on BID is safe and effective in comparison with combined antero-posterior cervical fixation.

• 대한정형도수물리치료학회지
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• 제7권2호
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• pp.23-39
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• 2001

Dysfunction of the anterior and dorsal muscles of the trunk have been studied in relation to low back pain of many years. Many muscles of the trunk are capable of contributing to the stabilization and protection of the lumbar spine, recent evidence has suggested that transversus abdominis may be critically involved and has been the focus of rehabilitation. The delay in onset of contraction of trunk muscles associated with movement of the upper or lower limb in patients with low back pain indicates a significant deficit in the automatic motor command for control of disturbance to the spine. The function of transversus abdominis has been largely ignored in the evaluation of spinal stabilization and protection. The most essential stabilizing muscles for the lumbar column are the transversus abdominis and the multifidus. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensorimotor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovasc+ular exercises, group exercise, personal exercise at home. Sensorimotor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercises on an unstable surface, thereby achieving optimum stimulation of the sensorimotor apparatus.

• Journal of Korean Neurosurgical Society
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• 제58권1호
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• pp.43-49
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• 2015

Objective : $Dynesys^{(R)}$ is one of the pedicle-based dynamic lumbar stabilization systems and good clinical outcome has been reported. However, the cylindrical spacer between the heads of the screws undergoes deformation during assembly of the system. The pre-strain probably change the angle of instrumented spine with time and oblique-shaped spacer may reduce the pre-strain. We analyzed patients with single-level stabilization with $Dynesys^{(R)}$ and simulated oblique-shaped spacer with finite element (FE) model analysis. Methods : Consecutive 14 patients, who underwent surgery for single-level lumbar spinal stenosis and were followed-up more than 24 months (M : F=6 : 8; age, $58.7{\pm}8.0$ years), were analyzed. Lumbar lordosis and segmental angle at the index level were compared between preoperation and postoperative month 24. The von Mises stresses on the obliquely-cut spacer ($5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, $25^{\circ}$, and $30^{\circ}$) were calculated under the compressive force of 400 N and 10 Nm of moment with validated FE model of the L4-5 spinal motion segment with segmental angle of $16^{\circ}$. Results : Lumbar lordosis was not changed, while segmental angle was changed significantly from $-8.1{\pm}7.2^{\circ}$ to $-5.9{\pm}6.7^{\circ}$ (p<0.01) at postoperative month 24. The maximum von Mises stresses were markedly decreased with increased angle of the spacer up to $20^{\circ}$. The stress on the spacer was uneven with cylindrical spacer but it became even with the $15^{\circ}$ oblique spacer. Conclusion : The decreased segmental lordosis may be partially related to the pre-strain of Dynesys. Further clinical and biomechanical studies are required for relevant use of the system.

• Journal of Korean Neurosurgical Society
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• 제53권3호
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• pp.174-179
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• 2013

Objective : Many studies have investigated paraspinal muscle changes after posterior lumbar surgery, including lumbar fusion. However, no study has been performed to investigate back muscle changes after pedicle based dynamic stabilization in patients with degenerative lumbar spinal diseases. In this study, the authors compared back muscle cross sectional area (MCSA) changes after non-fusion pedicle based dynamic stabilization. Methods : Thirty-two consecutive patients who underwent non-fusion pedicle based dynamic stabilization (PDS) at the L4-L5 level between February 2005 and January 2008 were included in this retrospective study. In addition, 11 patients who underwent traditional lumbar fusion (LF) during the same period were enrolled for comparative purposes. Preoperative and postoperative MCSAs of the paraspinal (multifidus+longissimus), psoas, and multifidus muscles were measured using computed tomographic axial sections taken at the L4 lower vertebral body level, which best visualize the paraspinal and psoas muscles. Measurements were made preoperatively and at more than 6 months after surgery. Results : Overall, back muscles showed decreases in MCSAs in the PDS and LF groups, and the multifidus was most affected in both groups, but more so in the LF group. The PDS group showed better back muscle preservation than the LF group for all measured muscles. The multifidus MCSA was significantly more preserved when the PDS-paraspinal-Wiltse approach was used. Conclusion : Pedicle based dynamic stabilization shows better preservation of paraspinal muscles than posterior lumbar fusion. Furthermore, the minimally invasive paraspinal Wiltse approach was found to preserve multifidus muscles better than the conventional posterior midline approach in PDS group.

• 대한통합의학회지
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• 제7권2호
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• pp.121-131
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• 2019

Purpose : Lower back pain is a common disorder experienced by approximately 90-% of the population at least once in a lifetime. This study examines changes in the thicknesses and ratios of the deep and superficial fibers of the multifidus according to the lumbar stabilization exercise used for spinal stabilization. Methods : Ten different lumbar stabilization exercises were implemented by 20 healthy men in random order, and the thickness of multifidus muscle was measured ultrasound image during each exercise. Results : The surface muscle fibers of the multifidus muscles significantly increased in the exercise method in which the arms and legs were lifted (p<.05), while the deep muscle fibers of the multifidus muscles increased significantly in the exercise in which the arms and legs were not lifted (p<.05). The ratio of the thickness of surface muscle fibers to the total thickness of muscle fibers was higher in the exercise method in which the arms and legs were lifted (p<.05), while the ratio of the thickness of deep muscle fibers to the total thickness of muscle fibers was higher in the hollowing and bracing exercise method in which the arms and legs were not lifted (p<.05). Conclusion : When lumbar stabilization exercise should be performed at clinics to strengthen the deep muscle fibers of the multifidus muscles that have larger effects on the stability of spinal segments, taking the stability of the spine into consideration indicates that, hollowing and bracing exercise methods that do not that cause isotonic extension to the spine are appropriate.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2011년도 춘계학술대회 논문집
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• pp.1407-1408
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• 2011

• Asian Spine Journal
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• 제12권6호
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• pp.1017-1027
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• 2018

Study Design: This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015. Purpose: This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach. Literature Review: AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described. Methods: We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds' outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required. Results: The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds' outcome analysis score at the latest follow-up revealed goodto-excellent outcomes in all patients. Conclusions: ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.

• 감성과학
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• 제24권2호
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• pp.81-92
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• 2021

본 연구의 목적은 해부학적 근거로 제작한 5가지의 EMS 요추 복압 벨트가 요추 안정화에 미치는 영향을 연구하는 것이다. 본 연구는 요방형근, 척추세움근, 내복사근, 외복사근, 대요근으로 총 5가지의 코어 근육을 선정하여 이에 맞는 근육 모양과 통증 유발점인 압통점을 고려해 전도성 원단으로 패턴을 설계하여 복압 벨트에 결합했다. 총 4가지 동작으로 실험을 진행하여 각각 다른 EMS복압 벨트가 요추 안정화에 미치는 영향을 알아보았다. 건강한 신체의 20대 남성 5명을 대상으로 진행하였고 선정 조건은 최근 3개월 동안 요통 과거력이 없고 사전 검사를 통해 제한되는 동작이 없고, 체간의 근력이 정상등급에 속한 대상이다. 실험 동작의 순서는 하지직거상 검사, 좌전굴, 체전굴, 배근력으로 다음 동작에 제한되지 않게 선정하였다. 동작 간의 휴식은 2분으로 진행하였고, EMS복압 벨트를 착용 후 실험을 진행할 때는 혈류량 증가와 근 활성화를 위해 전기자극을 10분씩 적용하고 진행하였다. 실험 결과의 통계는 비모수 검정으로 윌콕슨 검정과 프리드만 검정을 실시함으로 구체적인 차이를 분석하였다. 본 연구의 결과 5가지의 패턴 중 5,4,3,1,2 순으로 Type별 순위 결과를 확인할 수 있었으며 각 근육의 움직임과 연관성이 있는 실험 동작에 조금 더 유의미한 결과를 확인할 수 있었다. 본 연구의 결론은 해부학적 근거로 제작된 패턴으로 인해 각 근육에 각기 다른 모양으로 전기자극을 전달하였을 때 구분되는 효과를 확인할 수 있었으며 일반인 대상으로 일상생활이나 트레이닝에 있어 요추 안정화를 향상할 수 있을 것으로 기대된다.