• 제목/요약/키워드: Spine

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Endoscopic Spine Surgery

  • Choi, Gun;Pophale, Chetan S;Patel, Bhupesh;Uniyal, Priyank
    • Journal of Korean Neurosurgical Society
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    • 제60권5호
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    • pp.485-497
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    • 2017
  • Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Advantages of endoscopic spine surgeries are less tissue dissection and muscle trauma, reduced blood loss, less damage to the epidural blood supply and consequent epidural fibrosis and scarring, reduced hospital stay, early functional recovery and improvement in the quality of life & better cosmesis. With precise indication, proper diagnosis and good training, the endoscopic spine surgery can give equally good result as open spine surgery. Initially, endoscopic technique was restricted to the lumbar region but now it also can be used for cervical and thoracic disc herniations. Previously endoscopy was used for disc herniations which were contained without migration but now days it is used for highly up and down migrated disc herniations as well. Use of endoscopic technique in lumbar region was restricted to disc herniations but gradually it is also used for spinal canal stenosis and endoscopic assisted fusion surgeries. Endoscopic spine surgery can play important role in the treatment of adolescent disc herniations especially for the persons who engage in the competitive sports and the athletes where less tissue trauma, cosmesis and early functional recovery is desirable. From simple chemonucleolysis to current day endoscopic procedures the history of minimally invasive spine surgery is interesting. Appropriate indications, clear imaging prior to surgery and preplanning are keys to successful outcome. In this article basic procedures of percutaneous endoscopic lumbar discectomy through transforaminal and interlaminar routes, percutaneous endoscopic cervical discectomy, percutaneous endoscopic posterior cervical foraminotomy and percutaneous endoscopic thoracic discectomy are discussed.

방사선 일반 정면검사에서 허리뼈 추간판 계측 값에 따른 입사각 적용 (Application of Incidence Angle on Lumbar Spine Anteroposterior General Radiography Image according to Measured Intervertebral Disc Angle)

  • 문슬지아;김경립;조희정;성순기;곽종혁
    • 한국콘텐츠학회논문지
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    • 제19권6호
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    • pp.471-480
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    • 2019
  • 정상인을 대상으로 체질량지수, 전만각도에 따른 L-spine 3~4, L-spine 4~5, L-spine 5~Sacrum 1의 각각의 추간판각도를 비교 분석하여 입사각을 제시하였다. 체질량지수의 L-spine 3~4, L-spine 4~5, L-spine 5~Sacrum 1의 정면 입사각도는 머리 쪽 방향으로 5.66도, 13.23도, 29.13도였으며, 전만각도의 L-spine 3~4, L-spine 4~5, L-spine 5~Sacrum 1의 정면 입사각도는 머리 쪽 방향으로 6.32도, 16.09도, 35.36도였다. 체질량지수, 전만각도에 따른 정면 입사각도에 따라 적용한 팬텀의 일반 전후방향 영상의 왜곡정도를 면적비율로 비교한 결과 L-spine 4~5, L-spine 5~Sacrum 1의 추간판각도에서 유의미한 차이가 있었고(p<0.05), 전만각도와 추간판각도는 양의 상관관계를 보였다(p<0.05). 팬텀의 전만각도에 따른 추간판각도 계측 값을 머리 쪽 방향으로 입사각을 L4는 11도, L5는 26도로 적용하여 영상의 유용성을 평가한 결과, 왜곡비율면적은 L4에서 14.90%에서 12.11%로 줄어들었고, L5에서는 15.25%에서 13.72%로 줄어들었다. 계측된 추간판 각도에 따른 입사각을 적용한 허리뼈 일반 전후방향 영상에서 허리뼈 4번, 5번을 목적으로 하는 허리뼈 정면 영상에서 왜곡을 줄여, 정확한 구조의 정면 추체상과 인접하는 관절 간 영상을 얻을 수 있었고, 목적하는 부위의 영상의 질과 진단적 정보를 향상시킬 수 있었다.

The Effects of Pelvis, Lumbar Spine and Cervical Spine Manipulation on Joint Position Sense in Healthy Adults

  • Gong, Wontae
    • 국제물리치료학회지
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    • 제9권1호
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    • pp.1381-1386
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    • 2018
  • The purpose of this study is to investigate the effect of pelvic, Lumbar spine and Cervical spine manipulation on the joint position sense in normal adults. Thirty normal adults were divided into an experimental group of 15 subjects and a control group of 15 subjects. The experimental group was treated with pelvic, Lumbar spine and Cervical spine manipulation with massage, whereas the control group received only massage. Both groups were evaluated in terms of joint position errors (JPEs) using a digital dual clinometer before and after the experiment. The comparison of the JPEs of the experimental group and the control group before and after the experiment showed that the experimental group's cervical spine results were significantly different in the flexion, left lateral flexion, and right rotation (p < .05) and lumbar spine results were significantly different in the flexion and extension (p < .05), but the control group's results were not statistically significant in all items (p > .05). The pelvic, lumbar spine and cervical spine manipulation makes an effect on the joint position sense in normal adults. The findings of this study suggest that the pelvis, lumbar spine and cervical spine manipulation improve the motor ability in people with low joint position sense.

스마트폰 사용시간이 목뼈 및 허리뼈의 굽힘각도와 목뼈의 재현오차에 미치는 영향 (Influence of the Duration of Smartphone Usage on Flexion Angles of the Cervical and Lumbar Spine and on Reposition Error in the Cervical Spine)

  • 김양곤;강민혁;김지원;장준혁;오재섭
    • 한국전문물리치료학회지
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    • 제20권1호
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    • pp.10-17
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    • 2013
  • The purpose of this study was to assess the influence of the duration of smartphone usage on cervical and lumbar spine flexion angles and reposition error in the cervical spine. The study included 18 healthy smartphone users (7 males and 11 females). We measured the kinematics of the upper and lower cervical and lumbar spine flexion angles and the reposition error of the upper and lower cervical spine after 3 s and 300 s smartphone use in sitting. A paired t-test was used to compare the effects of the duration of smartphone usage on the kinematics of cervical and lumbar spine flexion angles and reposition error. The flexion angles of the lower cervical and lumbar spine and the reposition error in the upper and lower cervical spine were significantly increased after 300 s smartphone of use (p<.05). However, the flexion angle of the upper cervical spine was not significantly different between the 3 s and 300 s smartphone of use (p>.05). These findings suggest that prolonged use of smartphones can induce changes in cervical and lumbar spine posture and proprioception in the cervical spine.

상지의 움직임과 저항 적용에 따른 Formetric 4D를 이용한 척추의 3차원적 분석 (Three-dimensional Analysis of the Spine using Formetric 4D according to Upper Limb Movement and Resistance Application)

  • 김현진;신원섭
    • 대한물리의학회지
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    • 제15권3호
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    • pp.69-77
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    • 2020
  • PURPOSE: The aim of this study was to measure changes in spine inclination and thoracolumbar structure and morphology according to upper-extremity movements with and without resistance in order to evaluate the spine stability in workers. METHODS: Forty-eight middle-aged male workers (mean age, 40.48 ± 6.27 years) participated in this study. Using the spine analysis system, changes in the inclination of the spine and structure as well as shape of the thoracolumbar spine were measured. For posture measurement, the postures of standing, lifting the right and left arms (shoulder joint 90° flexion), and lifting with both arms were measured in random order. In addition, variables were measured using a resistance of 3 kg for each posture. The statistical significance level was set at α = .05 for all variables. RESULTS: There were statistically significant differences between the front and back inclinations of the spine, kyphotic curve of the thoracic spine, lordotic curve of the lumbar spine, rotation changes in the thoracolumbar spine, and rotation changes in the T4 vertebra (p < .05). However, there was no significant difference in the left and right tilts of the spine. In the post-hoc analysis, rotation changes in the T4 vertebra showed a significant difference in posture when resistance was applied to the left and right sides CONCLUSION: Causes of musculoskeletal diseases include excessive thoracic spine rotation, torsion, and hyperlordosis of the lumbar spine. Therefore, it is necessary to improve the working environment in order to ensure a healthy posture and prevent musculoskeletal diseases that can reduce the ability to carry various and/or excessive loads.

경추 일자목 변형에 대한 경추 후인과 신전 움직임이 경추 시상면의 형태학적 변화에 미치는 영향: 사례연구 (Effect on Morphological Change of Cervical Spine to Apply to Neck Retraction and Extension Regarding the Straight Deformity of Cervical Spine: Case Study)

  • 최신현;김한일;이주홍
    • 대한정형도수물리치료학회지
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    • 제23권1호
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    • pp.73-78
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    • 2017
  • Background: The purpose of this study was to identify the effects of morphological Change of cervical spine to apply to neck retraction and extension regarding the straight deformity of cervical spine. Methods: A 40-year male subject with straight deformity of cervical spine participated in this study. The study subject underwent a cervical lateral radiography on the static position, neck retraction and neck extension on standing. Measurement method were using computer-based digital radiogram on a picture achieving computer system forthe centroid method, Cobb's angle and Jackson's angle. Results: Neck retraction was increased kyphosis on the C2-4 with lordosis on the C5-7. Neck extension was increased lordosis on the C2-7. Conclusions: These findings suggest that neck retraction was increased kyphosis and neck extension was increased lordosis based on the straight deformity of cervical spine. Therefore, we should be consider that neck extension exercise when increased lordosis for the patients of straight deformity of cervical spine.

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감압요법을 이용한 요추 추간판 탈출증 치료 3례 (Case Report of L-spine HIVD treated with Spine Decompression)

  • 이기하;김창연;김기역;남항우;정영훈;고영탁
    • 척추신경추나의학회지
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    • 제2권1호
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    • pp.39-47
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    • 2007
  • Objectives : This study reported 3 cases of L-spine HIVD which was treated with spine decompression, as a new medical treatment alleviates lumbago by non-surgical treatment, and oriental medicine treatment. Methods : Each patient has been treated with spine decompression and oriental medicine treatment, and the degree of improvement has been evaluated by VAS and Rating scale for LBP. Results : Through the result, the medical treatment proved to have valid effect for L-spine HIVD, but patients did not become healthy enough restored to their job before. Conclusions : At the result of this, every case can be certified to give appropriate effect, and there needs more research into synergy between spine decompression and oriental medicine treatment.

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스파인코 보조기의 척추 측만증에 대한 효과 고찰 (Review of Flexible brace(SpineCor Brace) in Pubmed, CNKI and Journal of Korean Oriental Medicine ; RCTs(Randomized controlled trials) Review)

  • 김성태;나은지;권민구;황춘호;김민성;박진우;성인형;조희근;설재욱
    • 척추신경추나의학회지
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    • 제10권1호
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    • pp.35-45
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    • 2015
  • Objectives : To evaluate the clinical effectiveness of Flexible brace(SpineCor Brace). Methods : CNKI, PubMed databases and Korean Journal of Oriental Medicine in 1999-2014 were searched for studies on SpineCor. This study researched 4 randomized controlled trial studies. Results : The results suggested that the SpineCor brace reduced the probability of the progression of early idiopathic scoliosis comparing with its natural history or rigid brace. But some studies showed that there is no significant difference between SpineCor and rigid brace. Conclusions : These results indicate that SpineCor have obvious effects on treatment of scoliosis and no adverse reactions, therefore we need to study more researches on SpineCor.

Correlation Analysis of Pressure Pain Threshold and Muscle Thickness in Individuals with Non-Specific Low Back Pain

  • Kim, Hyun-Joong;Moon, Seoyoung
    • Physical Therapy Rehabilitation Science
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    • 제11권3호
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    • pp.329-334
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    • 2022
  • Objective: Low back pain (LBP) is a symptom that accounts for a large proportion of musculoskeletal pain. Among them, non-specific LBP (NSLBP) means that the pathological cause is unknown, and belongs to the most common LBP. Studies on the mechanism of muscle control in LBP are insufficient, and quantitative studies are needed. Design: Observational cross-sectional study design Methods: A Thirty participants with NSLBP symptoms were enrolled, and their pressure pain thresholds (PPT) and muscle and fat thickness were measured. Participants measured the paraspinal muscles (PM) of the thoracic and lumbar spine and medial hamstring (semitendinosus) on the dominant and non-dominant sides in the prone position. Results: Among the variables that were significant in the correlation analysis, PM of the thoracic and lumbar spine showed a significant relationship in the PPT ([thoracic spine PM]=1.141+0.912 [lumbar spine PM]). Also, there was a significant relationship between the lumbar spine PM in the PPT and the thoracic spine PM in the muscle thickness ([lumbar spine PM of PPT]=4.057+0.117 [thoracic spine PM of muscle thickness]) Conclusions: Although there was no muscle imbalance according to the dominant and non-dominant side, there is a correlation between the pressure pain threshold and the muscle thickness between the paraspinal muscles of the thoracic spine and the lumbar spine.