흉요추 및 요추 골절의 추체 압박 및 후만 변형 측정

손광현,정남수,전창훈 대한척추외과학회 2010 대한척추외과학회지 Vol.17 No.3

Study Design: A retrospective radiologic study. Objectives: We wanted to compare the compression ratio and kyphosis of thoracolumbar and lumbar fractures according to the radiologic measuring methods and we wanted to analyze their relationship with the stability of fracture. Summary of the Literature Review: There are several methods for measuring the compression ratio and kyphotic angle in thoracolumbar fractures, but no definitive measurements and no different values according to the stability have been established. Materials and Methods: From July 2002 to August 2008, the plain films, CT, MRI and medical records of thoracolumbar and lumbar fracture were reviewed. The compression ratio and kyphotic angle were calculated by several different formulas with using the lateral view of the plain X-ray film, the sagittal reconstruction image of CT and the sagittal image of MRI and the results were compared. Each subject was classified according to both McAfee’s classification and the TLISS classification. Results: Two hundred forty eight vertebral bodies of 205 thoracolumbar fracture patients were analyzed. The compression ratio according to formula 1, which was calculated as 1-anterior vertebral height/posterior vertebral height, was significantly correlated with Cobb’s angle and the local kyphotic angle. There was no significant difference between the Cobb’s angle calculated using the lateral X-ray and that using the sagittal view of CT; however, it was significantly less using the sagittal MRI view. The unstable fractures according to McAfee’s classification showed a significantly higher compression ratio and kyphotic angle compared to those of the stable fractures. Conclusions: The compression ratio formula 1 was most significantly correlated with the kyphotic deformity. The unstable fractures showed a mean compression ratio higher than 30%, a mean Cobb’s angle of 15° and local kyphotic angle of 18°. The sagittally reconstructed CT was a useful measuring method for the evaluation of kyphotic deformity, and it was more accurate than that of the plain film. 연구계획: 후향적 방사선학 연구목적: 흉요추 및 요추 골절에서 측정 방법에 따른 압박률 및 후만각의 차이를 비교하고 골절 안정성과의 상관관계를 분석하고자 하였다. 선행문헌의 요약: 흉요추부 골절에서 압박률과 후만각을 측정하는 여러가지 방법들이 있으나 아직 통일되어 추천되는 방법은 없고, 최근의 흉요추부및 요추골절의 분류에 따른 안정성 여부와의 관계에 대한 연구가 부족하다. 대상 및 방법: 2002년 7월부터 2008년 8월까지 흉요추부 또는 요추의 급성 척추 골절로 진단된 환자들의 단순 방사선 사진과 전산화 단층촬영, 자기공명영상과 의무기록을 분석하고, 여러 가지 측정 방법에 의해 압박률, 후만각을 각각 계산하였다. McAfee 분류 및 thoracolumbar injury severity score(TLISS) 각각에 따른 골절 안정성과의 상관 관계를 분석하였다. 결과: 총 205명 환자의 골절 척추체 248예를 분석하였다. 측면 단순 방사선 검사상 후방 추체 높이에 대한 전방 추체 높이의 비를 계산한 압박률 측정방법 1에서 압박률이 가장 크게 계산되었고, Cobb’s 각도나 국소 후만각과 가장 높은 상관관계를 나타냈다. 시상면 자기공명영상 검사에서는 Cobb’s 각도가 의미 있게 작게 측정되었다. McAfee분류 및 TLISS에 따른 분류에서 안정성 골절보다 불안정성 골절에서 압박률과 후만 변형이 크게 나타났다. 결론: 흉요추 및 요추 골절의 추체 압박률 측정 방법 중 후방 추체 높이에 대한 전방 추체 높이의 비를 계산한 압박률 측정 방법 1이 후만 변형과 가장 높은 상관 관계를 보였다. 불안정성 골절은 측정 방법에 상관없이 30% 이상의 압박률을 보였으며, Cobb’s 각도 15°, 국소 후만각 18°이상을 나타냈다. 시상면 재건 전산화 단층촬영에서 Cobb’s 각도 및 국소 후만각은 단순 방사선 사진에서의 값과 통계적 차이가 없었고 측정 오차가 작았다.

Formetric Ⅲ를 이용한 기계체조 선수들의 척추변형에 관한 연구

권순성,한충식,김현태 한국스포츠학회 2011 한국스포츠학회지 Vol.9 No.2

This study aimed to investigate the study of vertebra transforms of professional gymnasts by Formetric Ⅲ. Thirty gymnasts(male=20, female=10) volunteered to participated in this study as subjects. The vertebra transforms by Formetric Ⅲ were measured in Trunk imbalance, Pelvic tilt, Pelvic torsion, Surface rotation, Lateral deviation, Kyphotic angle and Lordotic angle. Main results of the study were as follow: Trunk Imbalance in male and female were shown to -7.50±3.14mm and -6.00±2.07mm respectively compared to base line. Pelvic Tilt in male and female were shown to 4.35±2.93mm, 6.70±2.17mm. Pelvic Torsion in male and female were shown to 2.05±1.19°, 3.50±1.59°. Surface Rotation in male and female were shown to4.10±1.81°, 3.50±1.65°. Lateral Deviation in male and female were shown to 8.36±3.64mm, 7.60±3.20mm. Kyphotic Angle in male and female were shown to 37.80±8.50°, 38.10±4.53°. Lordotic Angle in male and female were shown to 23.15±7.79°, 27.90±7.67° respectively. These results show that wrong or improper position and repetitive one-sided gymnasts practice lead a significant transforms in the vertebra. Therefore, the program for correct position and education for professional gymnasts should be needed and applied.

거북목 증상을 가진 성인들에게 적용한 체성기법이 두개척추각 및 흉부후만각 개선에 미치는 효과

김경철(Kim, Kyung Chul),권병안(Kwon, Byong An) 한국웰니스학회 2020 한국웰니스학회지 Vol.15 No.1

본 연구의 목적은 거북목 증상을 가진 20대 이상 성인들에게 체성기법을 적용한 후 두개척추각 및 흉부후만각 개선에 대한 효과를 연구하는 것이다. 연구 기간은 2019년 2월 15일∼2019년 3월 15일까지 4주간 실시하였으며, 거북목 증상이 있는 30명의 피험자를 실험군 15명과 대조군 15명으로 무작위 배치하였다. 연구대상자들은 1회에 7분, 1주일에 3일씩 4주간 총 12회 실험에 참가하였다. 본 연구에서 수집된 자료는 대응표본 t-test로 사전-사후 점수의 차이를 검증 하였으며, 유의수준은 0.05로 설정하였다. 연구결과 실험군에서 두개척추각(CVA)은 평균 2.53±4.07˚, 흉부후만각(TKA)은 평균 1.83±2.05˚감소하였으며, 사전과 사후 검사의 평균 간 차는 유의미하였다(p<.001). 하지만 대조군은 유의미하지 않았다. 결론적으로 체성기법은 거북목증후군을 가진 정상 성인들에게 긍정적인 효과를 주는 것으로 나타났다. 추후 연구에서는 체성기법 적용 후 지속 효과를 연구할 필요성이 있다. The purpose of this study was to investigated the effect of somatic technique on the improvement of turtle neck symptoms in adults with Craniovertebral Angle and thoracic kyphotic angle. The study period was 4 weeks from February 15, 2019 to March 15, 2019. Thirty subjects with turtle neck symptoms were randomly assigned to 15 experimental groups and 15 control groups. The subjects participated in a total of 12 tests for 4 weeks, 7 minutes at a time and 3 days a week. The data collected in this study were validated by paired t-tests to identify differences in pre-tests. Also p-value was set to 0.05. As a result, CVA was decreased by 2.53 ± 4.07˚, TKA was 1.83 ± 2.05˚and the mean difference between pre and post test was significant (p<.001). However, the control group was not significant. In conclusion, the somatic technique had a positive effect on adults with Turtle Neck Syndrome. In future studies, it is necessary to study the long-lasting effects of somatic techniques.

골다공증 척추 골절에서 전방 감압술 및 기기 이용 전방 유합술

하기용,류승준,윤형문 대한척추외과학회 2003 대한척추외과학회지 Vol.10 No.3

턱관절장애 환자의 목뼈 뒤굽음 각과 통증 및 기능장애 수준 간에 상관성 연구

In-su Lee,김선엽 한국전문물리치료학회 2020 한국전문물리치료학회지 Vol.27 No.2

Background: There is an opinion that improper postures of the head and cervical spine are associated with temporomandibular joint (TMJ) disorders (TMDs). Objects: The aim of this study was to investigate the proportions among the cervical kyphotic angle, physical symptoms including the pain intensity level of the TMJ, and severity of TMD disability in patients diagnosed with TMD. Methods: Sixty-two subjects participated in the study. The evaluation tools included mea-surements of the cervical kyphotic angle based on the Ishihara index, pressure pain threshold (PPT) on the TMJ, maximal mouth opening (MMO) without pain, current pain intensity level of the TMJ measured using the Quadruple Visual Analogue Scale (QVAS), Korean TMD (KTMD) disability index, KTMD Symptom Frequency/Intensity Scales (SFS/SIS), and Korean Headache Impact Test-6. Correlation analysis was conducted to investigate the correlations between the cervical kyphotic angle and parameters related to TMJ symptoms. Results: Variables that were significantly correlated with the cervical kyphotic angle were the PPT around the TMJ (r = 0.259, p < 0.05), current pain intensity level of the TMJ based on the QVAS (r = –0.601, p< 0.01), and usual pain intensity level based on the SIS (r = –0.379, p < 0.01). The level of TMD functional disability was significantly correlated with the degree of headache (r = 0.551, p < 0.01), level of PPT of the TMJ (r = –0.383, p < 0.01), pain-free MMO (r = –0.515, p < 0.01), pain intensity level of the TMJ based on the QVAS (r = 0.393, p < 0.01), TMD symptom frequency (r = 0.739, p < 0.01), usual pain intensity of the TMJ (r = 0.624, p < 0.01), and most severe pain intensity of the TMJ (r = 0.757, p < 0.01). Conclusion: There is a positive correlation between the cervical kyphotic angle and PPT and a negative correlation between the current and usual pain intensity levels of the TMJ. The cervical kyphotic angle was a predictor of the pain level, tenderness threshold, and intensity of pain in the TMJ.

Impact of Screw Type on Kyphotic Deformity Correction after Spine Fracture Fixation: Cannulated versus Solid Pedicle Screw

Mahmood Ali Arbash,Ashik Mohsin Parambathkandi,Abdul Moeen Baco,Abduljabbar Alhammoud 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.6

Study Design: Retrospective review. Purpose: To detect the effect of cannulated (poly-axial head) and solid (mono-axial head) screws on the local kyphotic angle, vertebral body height, and superior and inferior angles between the screw and the rod in the surgical management of thoracolumbar fractures. Overview of Literature: Biomechanics studies showed that the ultimate load, yield strength, and cycles to failure were significantly lower with cannulated (poly-axial head) pedicle comparing to solid core (mono-axial head). Methods: The medical charts of patients with thoracolumbar fractures who underwent pedicle screw fixation with cannulated or solid pedicle screws were retrospectively reviewed; the subjects were followed up from January 2011 to December 2015. Results: Total 178 patients (average age, 36.1±12.4 years; men, 142 [84.3%]; women, 28 [15.7%]) with thoracolumbar fractures who underwent surgery and were followed up at Hamad Medical Corporation were classified, based on the screw type as those with cannulated screws and those with solid screws. The most commonly affected level was L1, followed by L2 and D12. Surgical correction of the local kyphotic angle was significantly different in the groups; however, there was no significant difference in the loss of correction of the local kyphotic angle of the groups. Surgical correction of the reduction in the vertebral body height showed statistical significance, while the average loss of correction in the reduction of the vertebral body height was not significantly different. The measurement of the angles made by the screws on the rods was not significantly different between the cannulated (poly-axial head) and solid (mono-axial head) screw groups. Conclusions: Solid screws were superior in terms of providing increased correction of the kyphotic angle and height of the fractured vertebra than the cannulated screws; however, no difference was noted between the screws in the maintenance of the superior and inferior angles of the screw with the rod.

운동습관 유・무에 따른 20대 여성의 신체조성 및 척추만곡 비교 연구

최승욱 한국체육과학회 2022 한국체육과학회지 Vol.31 No.4

As a result of conducting a comparative study on body composition and spinal curvature between groups according to the presence or absence of regular exercise habits for women in their 20s in this study, skeletal muscle mass (kg) and body fat mass (kg) were found in the exercise habit group and the non-exercise habit group. was 0.61kg and 0.54kg higher than that of the exercise habit group, and the amount of lean body mass (kg) was about 0.92kg higher than that of the non-exercise habit group, and the body fat percentage (%) was about 0.23% higher in the exercise habit group than the non-exercise habit group. As for the lateral deviation, the exercise habit group was closer to 0 mm numerically than the non-exercise habit group, so the curvature of the spine was less occurred. As for Thoracic Angle, the non-exercise habit group had a larger angle than the exercise habit group, and the alignment of the thoracic vertebrae was more deviated from the vertical line. As for Lumbar Angle, the non-exercise habit group had a larger angle than the exercise habit group, indicating that the alignment of the lumbar spine was more deviating from the vertical line. The kyphotic angle did not fall within the normal angle range in both groups. Lordotic Angle was included in the normal angle of lordotic curvature in the exercise habit group. Through these results, it can be seen that exercise is a factor that has a positive effect on body composition and curvature of the spine. However, in this study, the type, intensity, frequency, and time of exercise were not considered, and the nutritional aspect was not considered. In the future, it is thought that follow-up studies considering all of the above factors should be continued, and it is considered that it is necessary to develop an appropriate exercise program based on meaningful basic data for the prevention and improvement of spinal diseases in women.

경추 후만에 대한 낙차 교정기법을 이용한 추나치료 치험례

박장우,황재필,김민균,오민석,허동석,Park, Jang-Woo,Hwang, Jae-Pil,Kim, Min-Kyun,Oh, Min-Seok,Heo, Dong-Seok 척추신경추나의학회 2006 척추신경추나의학회지 Vol.1 No.2

Objectives: This study is performed to evaluate the clinical effect of chuna therapy on the neck pain associated with kyphotic cervical curvature. Methods: This study carried out on three patients with neck pain & kyphotic cervical curvature who have received treatment in Depar1ment of Oriental Rehabilitation Medicine, Daejon Oriental Hospital of Daejon University from 28th July 2006 to 3th November 2006. Pre and post treatment, We evaluated the cervical angle, Jackson's angle, Jochumsen method, Ishihara index, VAS and effective score of treatment. Results & Conclusions: Two patients who received Chuna treatment recovered cervical curvature and improved neck pain. But One patient who dosen't received Chuna treatment was no improvement in cervical curvature & neck pain.

흉요추부 골절에서 후방 고정술식에 따른 설상각 교정이 후만의 진행에 미치는 영향

김석곤,김명호,이성호,민상혁,이진원 대한척추외과학회 2009 대한척추외과학회지 Vol.16 No.3

Study design: Retrospective study Objectives: To examine the effect of transpedicular screw fixation on fractured vertebrae about the vertebral wedge angle (VWA) after posterior instrumentation of the thoracolumbar fracture, determine the effect of reduced VWA on the change in the Kyphotic angle (KA), and minimize loss of reduction of KA. Summary of the literature review: Maintenance of the KA of a thoracolumbar fracture after surgery is important for the radiologic and functional outcome. Materials and methods: Forty patients, who had undergone posterior instrumentation in a thoracolumbar fracture between February 2006 and February 2008 and followed-up for more than one year, were enrolled in this study. The patients were divided into two groups according to transpedicular screw fixation (Group A) or not (Group B) including fractured vertebrae. The evaluation was performed by measuring the changes in the KA and VWA taken after the injury, immediate after surgery and 1 year after surgery. Results: There was correlation between groups A (transpedicular screw fixation on fractured vertebrae) and B (no transpedicular screw fixation on the fractured vertebrae) regarding the correction of the VWA and the loss of correction KA, (p<0.05). Conclusions: Reduction of the VWA is an important factor for preventing reduction loss of the KA, and transpedicular screw fixation including fractured vertebrae would help reduce the VWA. Therefore, the operator must pay attention to the increase in VWA to maintain the KA through short segment transpedicular screw fixation including fractured vertebrae. 연구계획: 후향적 연구 연구목적: 흉요추부 골절에서 후방 기기 고정술시 골절 추체부를 포함한 척추경 나사못 고정이 설상각 교정에 미치 는 영향을 찾고 교정된 설상각의 유지가 척추 후만의 진행에 미치는 영향을 분석하여 교정 소실을 최소화하고자 하 였다. 대상 및 방법: 2006년 2월부터 2008년 2월까지 흉요추부 골절 환자 중 단분절 후방 기기 고정술을 시행하고 최소 1 년 이상 추시가 가능했던 40례를 대상으로 하였고 이 중 골절 추체부의 척추경 나사못 고정 여부에 따라 두 군(A, B 군)으로 분류하였으며 수술 전의 설상각과 수술 직후 설상각의 회복 정도 및 최소 1년 추시상 설상각과 후만각의 교 정 소실 정도를 측정하였다. 결과: 골절 추체부를 포함한 척추경 나사못 고정을 시행한 군(A군)이 시행하지 않은 군(B군)보다 설상각의 교정 정 도가 통계적으로 유의하게 컸으며(p<0.05) 술 후 추시상 B군보다 A군에서 후만각의 교정 소실 정도 또한 유의하게 작았다(p<0.05). 결론: 흉요추부 골절에서 후방 고정술시 후만 변형의 진행을 방지하는데 있어 설상각 교정이 중요한 변수로 작용하 며, 골절 추체부를 포함하는 척추경 나사못 고정이 설상각 교정에 도움을 주고 후만 변형방지에 도움이 될 것으로 생 각된다.

단측 도달법과 양측 도달법을 이용한 경피적 척추 성형술에서 골시멘트 분포 및 누출 비교

이재협 ( Jae Hyup Lee ),윤강섭 ( Kang Sup Yoon ),강승백 ( Seung Baik Kang ),조현철 ( Hyun Chul Jo ),이상기 ( Sang Ki Lee ),장봉순 ( Bong Soon Chang ),이춘기 ( Choon Ki Lee ),이지호 ( Ji Ho Lee ) 대한골절학회 2006 대한골절학회지 Vol.19 No.4

목적: 본 연구의 목적은 척추 성형술에서 단측 도달법과 양측 도달법의 골시멘트 분포양상 및 누출 등 방사선학적 결과를 비교하는 것이다. 대상 및 방법: 2002년 5월부터 2006년 1월까지 본 교실에서 척추 성형술을 시행하고 3개월 이상 추시 가능하였던 100추체 중 단측 도달법 (1군)을 이용한 55추체와 양측 도달법 (2군)을 이용한 45추체에 수술 시간, 주입한 골시멘트 양, 전방 추체 높이 회복, 후만각, 골시멘트의 추체 단면 분포, 골시멘트 누출 등의 결과를 비교하였다. 결과: 수술 시간은 1추체 수술 시 1군이 평균 28분, 2군이 평균 29이있다. 주입한 골시멘트 양은 1군이 3.9 cc, 2군이 5.1 cc로 2군이 유의하게 많았다 (p=0.016). 전방 추체 높이비는 1군이 수술 전 71.8%에 비해 수술 후 3개월째 76.1%였고, 2군이 수술 전 78.3%에서 수술 후 3개월째 77.7%였다. 후만각은 1군이 수술 전 10.7도에서 수술 후 3개월에 11.3도였으며 2군은 수술 전 1.5도에서 수술 후 3개월에 3.6도로 양 군에 유의한 차이는 없었다. 골시멘트 분포는 8개 구역 이상에 분포하는 비율은 2군이 유의하게 (p=0.014) 높았으나 전방 추체 전체나 7개 구역 이상에 분포하는 비율은 유의한 차이가 없었다. 골시멘트 누출은 1군이 25추체 (45.5%)였고 2군이 25추체 (55.6%)로 유의한 차이가 없었다. 결론: 단측 도달법을 이용한 경피적 척추 성형술은 양측 도달법에 비해 주입되는 골시멘트양이 적지만 골시멘트의 추체내 분포나 누출이 양측 도달법과 큰 차이가 없으며 3개월 추시상 방사선학적 지표도 유사하여 골다공증성 추체 골절에 사용할 수 있는 유용한 수술법으로 사료된다. Purpose: To evaluate the differences of radiological outcomes of uniportal and biportal vertebroplasty in the point of bone cement distribution and leakage. Materials and Methods: A retrospective study reviewing the period between May 2002 and January 2006 investigated 100 vertebrae which underwent vertebroplasty and followed for more than three months by uniportal approach (55 vertebrae, group 1) and biportal approach (45 vertebrae, group 2). The operative time, the amount of bone cement injected, anterior vertebral height restoration. kyphotic angle, bone cement distribution, and bone cement leakage were evaluated. Results: The amount of injected bone cement of group 1 (3.9 cc) was statistically smaller than that of group 2 (5.1 cc) (p=0.016). There were no significant differences in the operative time, anterior vertebral height reatoration, kyphotic angle in both groups. The rate of bone cement distribution over 8 zones was significantly higher in group 2 than in group 1(p=0.014). However, the rate of bone cement distribution over 7 zones and the rate of bone cement distributed on whole anterior vertebral body were not significantly different in both groups. The cement leakage was not also significantly different in both groups. Conclusion: Although the amount of injected bone cement was smaller in uniportal vertebroplasty, the radiological results and cement leakage were similar to biportal vertebroplasty. These findings suggest that uniportal vertebroplasty can be the operative options in osteoporotic vertebral fracture.Purpose: To evaluate the differences of radiological outcomes of uniportal and biportal vertebroplasty in the point of bone cement distribution and leakage. Materials and Methods: A retrospective study reviewing the period between May 2002 and January 2006 investigated 100 vertebrae which underwent vertebroplasty and followed for more than three months by uniportal approach (55 vertebrae, group 1) and biportal approach (45 vertebrae, group 2). The operative time, the amount of bone cement injected, anterior vertebral height restoration. kyphotic angle, bone cement distribution, and bone cement leakage were evaluated. Results: The amount of injected bone cement of group 1 (3.9 cc) was statistically smaller than that of group 2 (5.1 cc) (p=0.016). There were no significant differences in the operative time, anterior vertebral height reatoration, kyphotic angle in both groups. The rate of bone cement distribution over 8 zones was significantly higher in group 2 than in group 1 (p=0.014). However, the rate of bone cement distribution over 7 zones and the rate of bone cement distributed on whole anterior vertebral body were not significantly different in both groups. The cement leakage was not also significantly different in both groups. Conclusion: Although the amount of injected bone cement was smaller in uniportal vertebroplasty, the radiological results and cement leakage were similar to biportal vertebroplasty. These findings suggest that uniportal vertebroplasty can be the operative options in osteoporotic vertebral fracture.