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Journal of the Korean Academy of Rehabilitation Medicine 2006;30(1):57-61.
Dynamic Changes of Pelvis and Lower Extremities after Operation in Lumbar Degenerative Kyphosis.
Lee, Su Seop , Yoo, Jong Yoon , Rhim, Seung Chul , Lee, Jung Woo , Byun, Jae Hyun
1Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine. Jyyoo@amc.seoul.kr
2Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine.
3Department of Rehabilitation Medicine, Chungbuk National University School of Medicine.
요부 변성 후만증에 대한 수술 전후 골반, 하지의 역학적 변화
이수섭, 유종윤, 임승철1, 이정우, 변재현2
울산대학교 의과대학 서울아산병원 재활의학교실, 1신경외과학교실, 2충북대학교 의과대학 재활의학교실
Abstract
Objective
Gait pattern in patients with lumbar degenerative kyphosis (LDK) is disturbed because trunk bends forward due to decreased lumbar lordosis. Surgical therapy in LDK is required when conservative management fails. We investigated kinematic and kinetic changes of the pelvis, hip, and knee joints on the sagittal plane in patients with LDK before and after operation.
Method
Fifteen patients underwent operations between March 1999 and September 2003. Gait analysis was performed for all patients.
Results
Total lumbar lordotic angle increased from 10.50o⁑11.22o to 26.71o⁑8.80o postoperation. In gait analysis, anterior pelvic tilting angle increased from maximum 7.86o⁑9.69o, minimum 4.40o⁑9.82o to maximum 12.61o⁑5.36o, minimum 9.68o⁑5.63o (p<0.05). Maximum hip flexion angle changed from 31.39o⁑11.71o to 35.83o⁑5.84o (p<0.05). Maximum knee flexion angle in terminal stance phase decreased from 13.32o⁑7.34o to 8.30o⁑6.38o (p<0.05).
Conclusion
After corrective operation, an increase of lumbar spine lordosis and anterior pelvic tilt with decrease of knee flexion were observed. However, an increase of maximum hip flexion secondary to increased anterior pelvic tilting influenced ambulation negatively. Therefore, stretching of the hip flexor and strengthening of the hip extensor are required before and after operation. (J Korean Acad Rehab Med 2006; 30: 57-61)
Key Words: Lumbar degenerative kyphosis, Gait disturbance, Lumbar lordosis


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