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Ann Rehabil Med : Annals of Rehabilitation Medicine

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"Lumbar spine"

Original Articles
Biomechanical Adjustments in Lumbar Spine Associated with Sudden Upper Limb Loading.
Park, Kwang Hong , Hwang, Ji Hye , Lee, Yong Taek , Park, Won Hah , Roh, Kyung Sun , Kwon, Tae Kyu
J Korean Acad Rehabil Med 2007;31(6):718-724.
Objective
To investigate the response of back muscle, the flexion moment and the kinematic change of lumbar spine during sudden upper limb loading between expected and unexpected conditions. Method: 23 healthy young subjects (13 male and 10 female, mean age 26.6±3.3) were recruited. We measured the latency of paraspinal muscle contraction (erector spinae and lumbar multifidus), flexion moment of lumbar spine, and kinematic change of lumbar spine during sudden upper limb loading by using surface EMG system, motion analysis system, and force platform. 6 trials with 3 eye opened and 3 eye closed were performed randomly. Results: The latency of paraspinal muscle contractions was significantly slower during eyes closed condition than during eyes opened condition after sudden upper limb loading (p＜0.05). The flexion moment and the flexion change of lumbar spine increased significantly during eyes closed condition compared with eyes opened condition (p＜0.05). Conclusion: The response of paraspinal muscle was significantly slower and the flexion moment and the flexion change of lumbar spine was higher during unexpected condition than during expected condition after sudden upper limb loading. Therefore, the spinal stability is more decreased during unexpected condition than expected condition. (J Korean Acad Rehab Med 2007; 31: 718-724)
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Clinical Significance of Magnetic Resonance Image Findings according to the Lumbar Spine Instability of Patients with Lower Back Pain.
Park, Gi Young , Kim, Young Hyun , Lee, Sung Moon
J Korean Acad Rehabil Med 2006;30(1):40-44.
Objective
The purpose of this study was to examine the clinical significance of magnetic resonance(MR) image findings according to the lumbar spine instability of patients with lower back pain. Method: Total 35 patients with lower back pain underwent lateral flexion and extension radiographs of the lumbar spine as well as MR image. The L3-4, L4-L5, and L5-S1 levels were examined. Horizontal and angular displacements in dynamic radiograph of lumbar spine were used to assess the instability of lumbar spine. MR images were used to evaluate the abnormalities of intervertebral disc, change of adjacent bone marrow, annular tear, disc herniation, and presence of osteophyte.Results: Of the 105 segments, 64 (61.0%) were unstable. Among the 64 unstable segments, 28 were at the L5-S1 level and 21 were at the L4-5 level, respectively. These unstable segments showed higher degree of disc degeneration and more traction osteophyte than the stable segments. No correlation was found between segmental lumbar instability and other findings of MR image. Conclusion: For the assessment of lumbar spine instability, dynamic radiographs should be considered in patients with higher degree of disc degeneration or presence of traction osteophyte seen in MR image. (J Korean Acad Rehab Med 2006; 30: 40-44)
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The Classification of Lumbar Interspinous Ligament in Relation to Herniated Intervertebral Disc and Spinal Degeneration of Korean.
Kim, Jong Cheol , Jang, Ki Un , Kim, Sung Sik , Park, Dong Sik
J Korean Acad Rehabil Med 2002;26(4):449-455.

Objective: To classify the findings of magnetic resonance imaging of the lumbar interspinous ligaments in relation to the lumbar disc herniation, disc degeneration, and lordosis.

Method: The subjects were 45 herniated intervertebral disc (HIVD) patients and 35 normal subjects on MRI finding. The magnetic resonance features of the interspinous ligament were classified into five categories according to their signal intensities: type 1A (low intensity on T1- and T2- weighted images without hypertrophy of spinal process); type 1B (same signal pattern as in type 1A with hypertrophy of spinal process); type 2 (low intensity on T1- and high intensity on T2-weighted images); type 3 (high intensity on T1-weighted images); type 4 (others).

Results: The most common type in both HIVD patients and normal subjects was type 3. The mean age and disc degeneration grade of the type 1B ligaments were significantly higher. Lordosis of type 1B of L5-S1 interspinous ligament was increased with significant difference.

Conclusion: The classification of the MRI findings of interspinous types didn't show statistical difference between HIVD patients and normal subjects, but was helpful in assessing the degree of the degeneration of the intervertebral disc and age. (J Korean Acad Rehab Med 2002; 26: 449- 455)

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Clinico-radiologic Findings of the Whole Spine in Patients with Chronic Low Back Pain.
Kim, Kweon Young
J Korean Acad Rehabil Med 2000;24(1):137-145.

Objective: The purpose of this study was to evaluate the whole spine of the patients with chronic low back pain.

Method: The cervico-thoraco-lumbar spine were evaluated in 128 patients with chronic low back pain. We analyzed radiologic and clinical findings of the cervico-lumbar spine and electrodiagnostic findings.

Results: Most of all cases showed abnormal findings in plain radiography and electrodiagnostic study. The radiologic findings were as follow: cervical X-ray with straightening of cervical lordotic curve in 85 cases; thoracic X-ray with scoliosis in 55 cases; lumbar X-ray with disc space narrowing in 85 cases. The electrodiagnostic study revealed lumbosacral radiculopathy in 87 cases. There were significant positive relationship between increased lumbosacral angle and straightening of cervical lordotic curve, and between lumbar scoliosis and thoracic scoliosis.

Conclusion: Cervico-thoracic spinal abnormalities were shown in most of the patients with chronic low back pain. Therefore, The evaluation of whole spine would be needed comprehensive rehabilitation approach for the patients with chronic low back pain.

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