• Journal of Korean Neurosurgical Society
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• v.58 no.2
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• pp.112-118
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• 2015

Objective : Thoracic ossification of the ligamentum flavum (OLF) is a relatively rare disease. Because of ambiguous clinical symptom, it is difficult for early diagnosis of OLF and subsequent treatment can be delayed or missed. Therefore, the purpose of this study is to comprehensively assess the prevalence and distribution of thoracic OLF by magnetic resonance imaging (MRI) and coexisting spinal disease in Korean patients with back pain or leg pain. Methods : The sample included 2134 Korean patients who underwent MRI evaluation for back pain. The prevalence and distribution of thoracic OLF were assessed using lumbar MRI with whole spine sagittal images. Additionally, we examined the presence of coexisting lumbar and cervical diseases. The presence of thoracic OLF as well as clinical parameters such as age, sex, and surgery were retrospectively reviewed. Results : The prevalence of thoracic OLF in total patients was 16.9% (360/2134). The prevalence tended to increase with aging and was higher in women than in men. The lower thoracic segment of T10-11 was the most frequently affected segment. Of the 360 patients with OLF, 31.9% had coexisting herniated thoracic discs at the same level. Approximately 74% of the patients with OLF had coexisting lumbar and cervical disease. Nine (2.5%) of 360 OLF patients underwent surgery for thoracic lesion. Conclusion : The prevalenceof thoracic OLF was relatively higher than those of previous reports. And coexisting lumbar and cervical disease were very frequent. Therefore, we should check coexisting spinal diseases and the exact diagnostic localization of ossification besides lumbar disease.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.350-358
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• 2012

Objective : Life expectancy for humans has increased dramatically and with this there has been a considerable increase in the number of patients suffering from lumbar spine disease. Symptomatic lumbar spinal disease should be treated, even in the elderly, and surgical procedures such as fusion surgery are needed for moderate to severe lumbar spinal disease. However, various perioperative complications are associated with fusion surgery. The aim of this study was to examine perioperative complications and assess risk factors associated with lumbar spinal fusion, focusing on geriatric patients at least 70 years of age in the Republic of Korea. Methods : We retrospectively investigated 489 patients with various lumbar spinal diseases who underwent lumbar spinal fusion surgery between 2003 and 2007 at our institution. Three fusion procedures and the number of fused segments were analyzed in this study. Chronic diseases were also evaluated. Risk factors for complications and their association with age were analyzed. Results : In this study, 74 patients experienced complications (15%). The rate of perioperative complications was significantly higher in patients 70 years of age or older than in other age groups (univariate analysis, p=0.001; multivariate analysis, p=0.004). However, perioperative complications were not significantly associated with the other factors tested (sex, comorbidities, operation procedures, fusion segments involved). Conclusion : Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery whereas other factors were not significant. We recommend good clinical judgment and careful selection of geriatric patients undergoing lumbar spinal fusion surgery.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.2
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• pp.129-136
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• 2014

The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been confirmed to be effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willams's flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So we selected 24 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 20 mode, 30 mode, and 40 mode. And then, we classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, we assorted them by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that "WuQinXi" exercise be a exercise therapy for lumbar spinal disease at an oriental medical clinic in this way. Oriental medical doctors will be able to teach easily patients "WuQinXi" exercise's motions at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.1
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• pp.93-99
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• 2007

Purpose : The aim of this study is to consider degenerative spine disease theoretically and compare plain radiography which is a basic study for low back pain with MRI in cases of degenerative lumbar spine disease to find out whether the abnormalities agree with each other. Methods : In 4 cases of lumbar degenerative disease, we studied the relation of the abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis and osteophytes on plain radiography with those on MRI of HIVD, spinal stenosis and spondylolisthesis. Results : Many abnormalities such as disc space narrowing, spinal space narrowing, loss of lordosis, osteophytes and change of cortex & bone marrow on plain radiography suggest HIVD, spinal stenosis, spondylolysis or spondylolisthesis on MRI. Conclusion : For low back pain patients, plain radiography is a basic study in diagnosis of HIVD, spinal stenosis, spondylolysis or spondylolisthesis but MRI or CT scan is necessary to develop(build) a treatment plan like an operation.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.3
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• pp.280-288
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• 2013

Hua-Tuo(145-208) created five "WuQinXi" exercise by imitating the movements of a tiger, a deer, a bear, a monkey and a bird. The "WuQinXi" exercise, one of the medical Qi-gongs, is an exercise maximizing human's self healing power and has been effective significantly at several modern researches. There are many exercise therapies in western medcine, such as Willamss flexion exercise, Mckenzie's extension exercise, vertebral stabilization exercise and so on. However, there isn't a special exercise therapy which can be applied for medical practice in oriental medicine. So We selected some motions from "WuQinXi" exercise, which are suitable for lumbar spinal disease, and analyzed them. After that, We assorted them by kinds of lumbar spinal disease. First, We selected 22 motions which are related with lumbar movements from 3 type "WuQinXi" exercises ; 10 mode, 15 mode, 18 mode. And then, We classified them according to lumbar movements as flexion, extention, lateral bending and rotation, and also functions as stabilization and rubbing. Next, with these classifications, We assorted those motions by kinds of lumbar spinal disease as HIVD(herniation of intervertebral disc), spinal stenosis, spondylolysis and spondylolisthesis, facet joint syndrome, compression fracture and spondylosis. We expect that trying "WuQinXi" exercise at clinic in this way, the particular exercise therapy of oriental medicine, "WuQinXi" exercise will become more popular. And Oriental medical doctors will be able to teach patients "WuQinXi" exercise's motions easily at clinic, depending on kinds of lumbar spinal disease each patient suffers from. We plan to study more about 20 mode, 30 mode, 40 mode and the effect of "WuQinXi" exercise by comparing patients who do the "WuQinXi" exercise with the patients who do the western medical exercise therapy.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.1
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• pp.1393-1397
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• 2018

The purpose of this study was to examine the effects of combined respiratory physical therapy on respiratory function, spinal curve and spinal mobility for community-dwelling elderlies with restrictive lung diseases. In total, 10 patients participated in an 8-week intervention program of thoracic cage mobilization and breathing exercise in combination. The results of the study are as follows: for respiratory function, the forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC), and FEV1/FVC were significantly improved to $.30{\pm}0.31{\ell}$, $.46{\pm}.42{\ell}$, and $18.10{\pm}11.39%$, respectively (p<.05). For spinal curve, the thoracic curve and the lumbar curve were improved significantly to $-2.20{\pm}1.40^{\circ}$ and $-1.20{\pm}1.14^{\circ}$, respectively (p<.01). For spinal mobility, the thoracic flexion ($3.40{\pm}2.99^{\circ}$), thoracic extension ($3.50{\pm}1.43^{\circ}$), lumbar flexion ($4.50{\pm}4.74^{\circ}$), and lumbar extension($-1.50{\pm}1.84^{\circ}$) were all significantly improved (p<.05). These findings indicate that thoracic cage mobilization and breathing exercise in combination improve the respiratory function, spinal alignment, and spinal mobility in elderly people with restrictive lung diseases.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.2
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• pp.1006-1010
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• 2016

This study aimed to examine the effects of thoracic cage mobilization on the respiratory function, spinal curve and spinal movement in patients with restrictive lung diseases. The subjects were ten community-dwelling elderly with a restrictive lung diseases when measured using a spirometer($FEV1/FVC{\leq}65%$, FVC<80%). They received an intervention over an eight-week period: three times a week and for 30 minutes a day. SPSS for Windows(ver. 19.0) was used to analyze all the collected data. Independent t-tests were used to examine changes before and after the intervention. The study's results showed statistically significant improvement(p<.05) in forced expiratory volume in 1 second(chage rate: .$24{\pm}.25$), thoracic curve(chage rate: $-2.50{\pm}2.76$), lumbar curve(chage rate: $-.80{\pm}1.32$), thoracic flexion(chage rate: $2.10{\pm}1.52$), thoracic extension(chage rate: $-2.00{\pm}1.25$), lumbar flexion(chage rate: $2.40{\pm}3.13$) and lumbar extension(chage rate: $-1.30{\pm}1.42$). The results of this study suggest that the thoracic cage mobilization contribute to improve pulmonary function in patients with restrictive lung disease.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.383-387
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• 2012

Spinal epidural abscess, if especially caused by Brucellosis is a very rare disease which is usually a consequence of spondylodiscitis. The spinal column can be affected at any joint; however, the lumbar spine is the most common region, especially at the level of the L4-5 and L5-S1. The frequency of spinal involvement usually seen at the lumbar, thoracic and cervical spine respectively. As an occupational disease in farmers, veterinaries, butchers, laboratory staff and shepherds, brucellosis can also occur by direct contact to animals and infected materials or ingestion of raw cheese, milk or unpasteurized milk products. In this study, we presented two cases with cervical spinal epidural abscess caused by brucella melitensis, which was successfully treated by surgical approach. Initial treatment was combined with antibiotic therapy after the surgery for 3 months.

• Journal of Korean Neurosurgical Society
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• v.56 no.3
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• pp.206-210
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• 2014

Objective : Lumbar spinal stenosis is a common degenerative spine disease that requires surgical intervention. Currently, there is interest in minimally invasive surgery and various technical modifications of decompressive lumbar laminectomy without fusion. The purpose of this study was to present the author's surgical technique and results for decompression of spinal stenosis. Methods : The author performed surgery in 57 patients with lumbar spinal stenosis between 2006 and 2010. Data were gathered retrospectively via outpatient interviews and telephone questionnaires. The operation used in this study was named central decompressive laminoplasty (CDL), which allows thorough decompression of the lumbar spinal canal and proximal two foraminal nerve roots by undercutting the lamina and facet joint. Kyphotic prone positioning on elevated curvature of the frame or occasional use of an interlaminar spreader enables sufficient interlaminar working space. Pain was measured with a visual analogue scale (VAS). Surgical outcome was analyzed with the Oswestry Disability Index (ODI). Data were analyzed preoperatively and six months postoperatively. Results : The interlaminar window provided by this technique allowed for unhindered access to the central canal, lateral recess, and upper/lower foraminal zone, with near-total sparing of the facet joint. The VAS scores and ODI were significantly improved at six-month follow-up compared to preoperative levels (p<0.001, respectively). Excellent pain relief (>75% of initial VAS score) of back/buttock and leg was observed in 75.0% and 76.2% of patients, respectively. Conclusion : CDL is easily applied, allows good field visualization and decompression, maintains stability by sparing ligament and bony structures, and shows excellent early surgical results.

• Journal of Korean Neurosurgical Society
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• v.49 no.4
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• pp.234-236
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• 2011

Lumbar spinal stenosis (LSS) is a common spinal disease in the elderly. The cardinal symptom of LSS is neurogenic claudication, but not all patients present with such typical symptom. The clinical symptoms are often confused with symptoms of peripheral neuropathy, musculo-skeletal disease and other medical conditions in elderly patients. In particular, LSS presenting with rapid progression of leg weakness must be distinguished from other combined diseases. We report a case of rapid progressive leg weakness in a patient with LSS and iatrogenic adrenal insufficiency that was induced by obscure health supplement.