• 한방재활의학과학회지
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• 제19권4호
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• pp.151-163
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• 2009

Objectives : In the assessment of the lumbar spine by magnetic resonance imaging (hereinafter, "MRI"), changes in the paraspinal muscles are overlooked. The purpose of our study is to examine the correlation between the multifidus muscle atrophy on MRI findings and the clinical findings in low back pain (hereinafter, "LBP") patients. Methods : The retrospective study on 38 LBP patients, presenting either with or without associated leg pains, was undertaken. The MRI findings on the patients were visually analysed to find out a lumbar multifidus muscle atrophy, disc herniation, disc degeneration, spinal stenosis and nerve root compressions. The clinical history in each case was obtained from their case notes and pain drawing charts. Results : The lumbar multifidus muscle atrophy has occurred from more than 80% of the patients with LBP. Most of lumbar multifidus muscle atrophies have increased from lower level of lumbar spine. It was bilateral in the majority of the cases. In addition, multifidus muscle atrophy was correlated to the patient's age, disc degenerations and spinal stenosis. On the contrary, gender, the duration of LBP, referred leg pain, disc herniation and nerve root compressions had no relevance to multifidus muscle atrophies. Therefore, when assessing the MRIs of the lumbar spine, we should have more attetion on multifidus muscle, because it has lot's of information about spinal neuropathy problems. Conclusions : Therefore, the examination of multifidus muscle atrophies should be considered when assessing the MRIs of the lumbar spine. In addition, it helps to evaluate and plan the treatment modalities of LBP. Moreover, it prevents from LBP by discovering the importance between the multifidus muscle and the spine stabilization exercise.

• Journal of Korean Neurosurgical Society
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• 제37권2호
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• pp.154-156
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• 2005

We present a case of chondroblastoma in the thoracic vertebra. A 40-year-old patient with upper back pain and lower extremity weakness was admitted to our clinic. On neurological examination, the patient exhibited lower extremity spastic paraparesis. Magnetic resonance imaging revealed a mass infiltrating the 7th thoracic vertebra and its adjacent structures with concomitant compression of the epidural space. After right upper lung tuberculoma was resected through the transthoracic approach, T7 total corpectomy was done with anterior stabilization using a MESH cage and T7 rib bone graft. Two weeks after the first operation, remained part of vertebra was removed and posterior stabilization was performed using a pedicle screw fixation and cross linkage bar with the assistance of the navigation system. The final pathologic diagnosis of the vertebral lesion was benign chondroblastoma.

• Journal of Korean Neurosurgical Society
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• 제55권5호
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• pp.289-292
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• 2014

A case of total spondyloptosis of the cervical spine at C6-7 level with cord compression is described in a 51-year-old male. Because the bodies of C6 and 7 were tightly locked together, cervical traction failed. Then the patient was operated on by a posterior approach. Posterior stabilization and fusion were performed by C4-5 lateral mass and C7-T1 pedicle screw fixation and rod instrumentation with bridging both C4-5's rods to the C7-T1's extended ones. After C6 total laminectomy and foraminotomy, the C6 body was returned to its proper position. Secondly, anterior stabilization and fusion were performed by C6-7 discectomy with a screw-plate system. A postoperative lateral plain radiograph showed good realignment. In this case, we report the clinical presentation and discuss the surgical modalities of C6-7 total spondyloptosis and the failed close reduction.

• 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.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.221-223
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• 2010

C1 lateral mass and C2 pedicle (C1LM-C2P) fixation is a relatively new technique for atlantoaxial stabilization. Complications from C1LM-C2P fixation have been rarely reported. The authors report unilateral rod migration into the posterior fossa as a rare complication after this posterior C1-C2 stabilization technique. A 23-year-old man suffered severe head trauma and cervical spine injury after vehicle accident. He was unconscious for 2 months and regained consciousness. He underwent C1LM-C2P fixation for stabilization of type II odontoid process fracture described by Harms. The patient recovered without a major complication. Twenty months after operation, brain computed tomogram performed at psychology department for disability evaluation showed rod migration into the right cerebellar hemisphere. The patient had mild occipital headache and dizziness only regarding the misplaced rod. He refused further operation for rod removal. To our knowledge, this complication is the first report regarding rod migration after Harms method. We should be kept in mind the possibility of rod migration, and C1LM-C2P fixation should be performed with meticulous technique and long-term follow-up.

• 대한정형도수물리치료학회지
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• 제26권2호
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• pp.19-27
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• 2020

Background: The purpose of this study was to examine the effects of a multi-modal exercise program for patients with chronic low back with respect to pain intensity, trunk muscle strength and Oswestry disability index. Methods: Thirty patients with chronic low back pain were recruited and divided equally into two groups. The multi-modal training program comprised a series of exercises such as warm-up, stabilization exercises, stretching, endurance exercises, and cool down whereas the control group performed only stabilization exercises. The both group spent an equal amount of time performing 60 minutes per day, three times per week, for five weeks. Results: The experimental group demonstrated statistically significant improvements in range of motion, trunk muscle strength, the visual analogue scale, and the Oswestry Disability Index (p<.05). Intergroup comparison showed a statistically significant difference in the range of motion of the lumbar spine and the degree of disability in the experimental group. Muscle strength and pain were statistically significant in both groups. Conclusion: The multi-modal exercise program is effective for patients with chronic low back pain, as it reduces lower back pain, increases trunk muscles strength, and decrease the potential for becoming disabled.

• Physical Therapy Rehabilitation Science
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• 제12권3호
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• pp.268-277
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• 2023

Objective: The purpose of this study was to investigate the effects of Pilates breathing exercises on functional disability and lumbar flexibility in patients with non-specific chronic low back pain. Design: A randomized controlled trial. Methods: 30 patients with non-specific low back pain were selected and classified into an experimental group (n=15) and a control group (n=15). Both groups were assessed for functional disability using the Oswestry Disability Index and flexibility of the lumbar spine using the modified-modified Schober test before and after the intervention. The intervention was applied twice a week for four weeks. The experimental group performed Pilates breathing exercises followed by spinal stabilization exercises, while the control group only performed spinal stabilization exercises. Results: Both groups showed significant improvements in functional disability and lumbar flexibility after the intervention. However, when comparing between the two groups, the experimental group showed a more significant effect than the control group. Conclusions: The combination of Pilates breathing exercises and spinal stabilization exercises can be considered an effective approach to improve low back pain and prevent chronic pain in patients with non-specific chronic low back pain.

• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.277-281
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• 2018

Objective : Craniovertebral junctional anomalies constitute a technical challenge. Surgical opening of atlantoaxial joint region is a complex procedure especially in patients with nuchal deformity like basilar invagination. This region has actually very complicated anatomical and functional characteristics, including multiple joints providing extension, flexion, and wide rotation. In fact, it is also a bottleneck region where bones, neural structures, and blood vessels are located. Stabilization surgery regarding this region should consider the fact that the area exposes excessive and life-long stress due to complex movements and human posture. Therefore, all options should be considered for surgical stabilization, and they could be interchanged during the surgery, if required. Methods : A 53-year-old male patient applied to outpatients' clinic with complaints of head and neck pain persisting for a long time. Physical examination was normal except increased deep tendon reflexes. The patient was on long-term corticosteroid due to an allergic disease. Magnetic resonance imaging and computed tomography findings indicated basilar invagination and atlantoaxial dislocation.The patient underwent C0-C3-C4 (lateral mass) and additional C0-C2 (translaminar) stabilization surgery. Results : In routine practice, the sites where rods are bound to occipital plates were placed as paramedian. Instead, we inserted lateral mass screw to the sites where occipital screws were inserted on the occipital plate, thereby creating a site where extra rod could be bound.When C2 translaminar screw is inserted, screw caps remain on the median plane, which makes them difficult to bind to contralateral system. These bind directly to occipital plate without any connection from this region to the contralateral system.Advantages of this technique include easy insertion of C2 translaminar screws, presence of increased screw sizes, and exclusion of pullout forces onto the screw from neck movements. Another advantage of the technique is the median placement of the rod; i.e., thick part of the occipital bone is in alignment with axial loading. Conclusion : We believe that this technique, which could be easily performed as adjuvant to classical stabilization surgery with no need for special screw and rod, may improve distraction force in patients with low bone density.

• Physical Therapy Rehabilitation Science
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• 제4권1호
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• pp.49-54
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• 2015

Objective: Cervical stabilization exercises are frequently to improve strength and endurance of cervical muscles. The purpose of this study was to identify changes in head repositioning accuracy (HRA) and neck proprioception through cervical stabilization exercises in healthy adults. Design: One group pretest-posttest design. Methods: Thirteen participants with no previous history of neck pain or injury to the cervical spine were recruited. HRA was measured by equipment including laser pointer, helmet, eye patch and marking pens. The distance between the spot where the beam had stopped and the center of the graph paper was measured three times with the averaged value used as the head repositioning accuracy. Neck proprioception was measured by a cervical range of motion device (CROM). Subjects wore the CROM tester and were to look straight ahead while bending his/her neck. Subjects were instructed to perform extension, lateral flexion and rotation, and the values were then measured and recorded. The measurements were performed pre-intervention, and after cervical stabilization exercise. Results: There was no significant difference on HRA after intervention. In addition, there was no significant difference on neck proprioception compared with pre-intervention. Conclusions: The present study did not identify any effect on HRA and neck proprioception of cervical stabilization exercise. Further investigations are required to elucidate this in old aged participants and patients with neck pain.

• 대한통합의학회지
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• 제12권3호
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• pp.71-81
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• 2024

Purpose : In this study, we compared the effects of ankle, McKenzie, and cervical stabilization exercises in individuals with a forward head posture. Outcome measures investigated included the neck disability index, craniovertebral angle (CVA), cranial rotation angle (CRA), and thickness of the longus colli muscle (LC) and carotid artery (CA) post-intervention. Methods : The study included 20 individuals with a forward head posture, who were assigned to an experimental group (EG, individuals performed ankle exercises) or control group (CG, individuals performed McKenzie and cervical stabilization exercises). The EG intervention was specifically designed to enhance proprioception in the ankle joint and strengthen the ankle muscles to improve overall stability and function. In contrast, CG interventions aimed to improve neck muscle balance and cervical spine alignment. Paired t-tests were used to analyze intragroup changes and independent t-tests to determine intergroup differences pre-and post-intervention. The significance level for all statistical tests was set at α=.05. Results : We observed significant post-intervention improvements in both groups, specifically, in the CVA, CRA, and LC and CA thickness (p<.05). These results indicate that ankle, McKenzie, and cervical stabilization exercises were useful for neck posture correction, improved muscle balance, and enhanced blood flow to the neck. Conclusion : This study underscores the positive effects of ankle, McKenzie, and cervical stabilization exercises in individuals with a forward head posture. Our study highlights the benefits of these exercises for posture correction and overall neck health and the clinical effectiveness and usefulness of ankle exercises as an important intervention to improve forward head posture.