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  • 1
    Online Resource
    Online Resource
    Learning Curve for Minimally Invasive Scoliosis Surgery in Adolescent Idiopathic Scoliosis
    Elsevier BV ; 2023
    In:  World Neurosurgery Vol. 175 ( 2023-07), p. e201-e207
    Details
    In: World Neurosurgery, Elsevier BV, Vol. 175 ( 2023-07), p. e201-e207
    Type of Medium: Online Resource
    ISSN: 1878-8750
    URL: Article
    DOI: 10.1016/j.wneu.2023.03.053
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2530041-6
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  • 2
    Online Resource
    Online Resource
    Adult Spinal Deformity: A Comprehensive Review of Current Advances and Future Directions
    Asian Spine Journal (ASJ) ; 2022
    In:  Asian Spine Journal Vol. 16, No. 5 ( 2022-10-31), p. 776-788
    Details
    In: Asian Spine Journal, Asian Spine Journal (ASJ), Vol. 16, No. 5 ( 2022-10-31), p. 776-788
    Abstract: Owing to rapidly changing global demographics, adult spinal deformity (ASD) now accounts for a significant proportion of the Global Burden of Disease. Sagittal imbalance caused by age-related degenerative changes leads to back pain, neurological deficits, and deformity, which negatively affect the health-related quality of life (HRQoL) of patients. Along with the recognized regional, global, and sagittal spinopelvic parameters, poor paraspinal muscle quality has recently been acknowledged as a key determinant of the clinical outcomes of ASD. Although the Scoliosis Research Society-Schwab ASD classification system incorporates the radiological factors related to HRQoL, it cannot accurately predict the mechanical complications. With the rapid advances in surgical techniques, many surgical options for ASD have been developed, ranging from minimally invasive surgery to osteotomies. Therefore, structured patient-specific management is important in surgical decision-making, selecting the proper surgical technique, and to prevent serious complications in patients with ASD. Moreover, utilizing the latest technologies such as robotic-assisted surgery and machine learning, should help in minimizing the surgical risks and complications in the future.
    Type of Medium: Online Resource
    ISSN: 1976-1902 , 1976-7846
    URL: Article
    DOI: 10.31616/asj.2022.0376
    Language: English
    Publisher: Asian Spine Journal (ASJ)
    Publication Date: 2022
    detail.hit.zdb_id: 2502303-2
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  • 3
    Online Resource
    Online Resource
    Novel Surgical Technique for Adolescent Idiopathic Scoliosis: Minimally Invasive Scoliosis Surgery
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 19 ( 2022-10-02), p. 5847-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 19 ( 2022-10-02), p. 5847-
    Abstract: Despite advancements in instruments and surgical techniques for adolescent idiopathic scoliosis (AIS) surgery, conventional open scoliosis surgery (COSS) is usually required to achieve satisfactory deformity correction using various distinct surgical techniques, such as rod derotation, direct vertebral rotation, facetectomies, osteotomies, and decortication of the laminae. However, COSS is accompanied by significant blood loss and requires a large midline skin incision. Minimally invasive surgery (MIS) has evolved enormously in various fields of spinal surgery, including degenerative spinal diseases. MIS of the spine has some advantages over conventional surgery, such as a smaller incision, less blood loss and postoperative pain, and lower infection rates. Since the introduction of MIS for AIS in 2011, MIS has been reported to have comparable outcomes, including correction rate with some usual advantages of MIS. However, several complications, such as dislodgement of rods, wound infection, and hypertrophic scar formation, have also been reported in the initial stages of MIS for AIS. We devised a novel approach, called the coin-hole technique or minimally invasive scoliosis surgery (MISS), to minimize these complications. This article aimed to introduce a novel surgical technique for AIS and provide a preliminary analysis and up-to-date information regarding MISS.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11195847
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 4
    Online Resource
    Online Resource
    Fusion Length Requiring Spinopelvic Fixation in Lumbosacral Fusion with Anterior Column Support at L5–S1: Assessment of Fusion Status Using Computed Tomography
    XMLink ; 2024
    In:  Clinics in Orthopedic Surgery Vol. 16, No. 1 ( 2024), p. 86-
    Details
    In: Clinics in Orthopedic Surgery, XMLink, Vol. 16, No. 1 ( 2024), p. 86-
    Type of Medium: Online Resource
    ISSN: 2005-291X , 2005-4408
    URL: Article
    DOI: 10.4055/cios23183
    Language: English
    Publisher: XMLink
    Publication Date: 2024
    detail.hit.zdb_id: 2485469-4
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  • 5
    Online Resource
    Online Resource
    Relationship between degree of separation of endplate cartilage and severity of intervertebral disc herniation
    Wiley ; 2022
    In:  Clinical Anatomy Vol. 35, No. 2 ( 2022-03), p. 204-210
    Details
    In: Clinical Anatomy, Wiley, Vol. 35, No. 2 ( 2022-03), p. 204-210
    Abstract: Degeneration of intervertebral disc and fissures in the anulus was caused by compression and distraction, which lead to nucleus pulposus herniation. However, controversy remains regarding the exact mechanism behind disc herniation. The aim of this study is to analyze histologically the differences between the three types of disc herniations in an attempt to infer the underlying mechanism. Disc samples extracted from 49 patients who underwent discectomy of the lumbar region were studied by histological analysis. The severity of disc herniation was classified as bulging, protrusion, extrusion, or sequestration based on preoperative magnetic resonance imaging measurements. For comparative analysis of sequestration characteristics, 49 patients were classified into either the sequestration or the non‐sequestration group (i.e., protrusion and extrusion) according to disc herniation type. Forty of the 49 patients had cartilage present in their disc samples upon histological analysis. The endplate cartilage‐containing samples included two of four (50%) protruded disc patients, 22 of 29 (75.9%) extruded disc patients, and 16 of 16 (100%) sequestrated disc patients and had statistical significance ( p  = 0.019). There were no significant differences in age, sex, body mass index, length of hospital stays, injection history, surgical methods, and Visual Analog Scale between the sequestration and non‐sequestration group (all p   〉  0.05). Separation of endplate cartilage increased with the severity of disc herniation. Therefore, the mechanism of disc herniation should consider the connection with endplate cartilage as an initiating link in the mechanical failure of intervertebral discs.
    Type of Medium: Online Resource
    ISSN: 0897-3806 , 1098-2353
    URL: Issue
    URL: Article
    DOI: 10.1002/ca.v35.2
    DOI: 10.1002/ca.23816
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2004511-6
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  • 6
    Online Resource
    Online Resource
    The Efficacy of Single-Stage Correction by Posterior Approach for Neglected Congenital Scoliosis: Comparative Analysis According to the Age of Surgical Intervention
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 9 ( 2022-04-19), p. 2278-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 9 ( 2022-04-19), p. 2278-
    Abstract: Background: A single-stage correction for congenital scoliosis through a posterior-only approach is a commonly used surgical technique. However, there are few studies on the surgical treatment effect of posterior single-stage correction in patients with neglected congenital scoliosis. Methods: Patients who underwent a single-stage posterior correction for congenital scoliosis with a minimum follow-up of 2 years were divided into three groups based on age: Group A (7–11 years), B (12–18 years) and C ( 〉 18 years). A comparison of surgical, radiological, and clinical outcomes was performed for three groups. Results: The Cobb angle changed form 75 ± 18° to 37 ± 18° with a correction rate of 53%. Group A showed a significantly higher correction rate than Group B and C (all p 〈 0.001). The amount of blood loss in Groups B and C was significantly larger than that of Group A (p = 0.015). Pulmonary complications were significantly higher in Group C (p = 0.007). Conclusions: A single-stage correction with pedicle screws through a posterior-only approach achieved a significant correction with improved outcomes, even in neglected cases. However, the early correction for younger patients was still more beneficial in terms of bleeding loss, complications, and flexible curve correction.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11092278
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 7
    Online Resource
    Online Resource
    Long-Term Influence of Paraspinal Muscle Quantity in Adolescent Idiopathic Scoliosis Following Deformity Correction by Posterior Approach
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 20 ( 2021-10-19), p. 4790-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 20 ( 2021-10-19), p. 4790-
    Abstract: Pedicle screw instrumentation (PSI) through posterior approach has been the mainstay of deformity correction for adolescent idiopathic scoliosis (AIS). However, changes in the quantity of paraspinal muscles after AIS surgery has remained largely unknown. The aim of this study was to investigate long-term follow-up changes in paraspinal muscle volume in AIS surgery via a posterior approach. Forty-two AIS patients who underwent deformity correction by posterior approach were analyzed through a longitudinal assessment of a cross-sectional area (CSA) in paraspinal muscles with a minimum five-year follow-up. The CSA were measured using axial computed tomography images at the level of the upper endplate L4 by manual tracing. The last follow-up CSA ratio of the psoas major muscle (124.5%) was significantly increased compared to the preoperative CSA ratio (122.0%) (p 〈 0.005). The last follow-up CSA ratio of the multifidus and erector spine muscles significantly decreased compared to the preoperative CSA ratio (all p 〈 0.005). The CSA ratio of the erector spine muscle was correlated with the CSA ratio of the psoas major (correlation coefficient = 0.546, p 〈 0.001). Therefore, minimizing the injury to the erector spine muscle is imperative to maintaining psoas major muscle development in AIS surgery by posterior approach.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm10204790
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 8
    Online Resource
    Online Resource
    Safe Optimal Tear Drop View for Spinopelvic Fixation Using a Three-Dimensional Reconstruction Model of the Pelvis
    XMLink ; 2023
    In:  Clinics in Orthopedic Surgery Vol. 15, No. 3 ( 2023), p. 436-
    Details
    In: Clinics in Orthopedic Surgery, XMLink, Vol. 15, No. 3 ( 2023), p. 436-
    Type of Medium: Online Resource
    ISSN: 2005-291X , 2005-4408
    URL: Article
    DOI: 10.4055/cios22360
    Language: English
    Publisher: XMLink
    Publication Date: 2023
    detail.hit.zdb_id: 2485469-4
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  • 9
    Online Resource
    Online Resource
    Clinical and radiological efficacy of spino-pelvic fixation in the treatment of neuromuscular scoliosis
    Springer Science and Business Media LLC ; 2023
    In:  Scientific Reports Vol. 13, No. 1 ( 2023-06-20)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2023-06-20)
    Abstract: Pelvic fixation is performed to obtain proper coronal and sagittal alignment when the pelvic obliquity is more than 15º in patients with neuromuscular scoliosis (NMS). Since many NMS patients were wheelchair or bed-ridden status, there has been controversy on the effect of pelvic fixation. Therefore, the purpose of this study is to analyze the effects of pelvic fixation on correction of spinal deformity and quality of life (QoL) in NMS patients. A total of 77 NMS patients who underwent deformity correction were divided into three groups and retrospectively analyzed preoperatively, postoperatively, and at 2-year follow-up: pelvic fixation group (Group A, n = 16), fixed to S1 (Group B, n = 33), and fixed to L5 (Group C, n = 28). The correction rate of scoliosis was 60.0%, 58.0%, and 56.7% in groups A, B, and C, respectively, with no statistical difference ( P   〉  0.05). The correction rate of pelvic obliquity was 61.3%, 42.8%, and 57.5% in respective groups A, B, and C, with no significance ( P   〉  0.05). The correction loss of scoliosis and pelvic obliquity showed no statistical significance between three groups for 2-year follow-up (all P s  〉  0.05). There were no significant differences regarding clinical outcomes and postoperative complications among the three groups (all P s  〉  0.05). Therefore, pelvic fixation using iliac screws is not substantially influencing radiological and clinical outcomes in the patients with NMS.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-023-36981-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2615211-3
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  • 10
    Online Resource
    Online Resource
    Long-term Outcomes of Posterior Multilevel Crack Osteotomy: Revisional Surgery for Scoliosis With a Fusion Mass
    The Korean Spinal Neurosurgery Society ; 2023
    In:  Neurospine Vol. 20, No. 3 ( 2023-09-30), p. 989-996
    Details
    In: Neurospine, The Korean Spinal Neurosurgery Society, Vol. 20, No. 3 ( 2023-09-30), p. 989-996
    Abstract: Objective: Osteotomies are required for the mobilization of spinal segments in patients with revisional scoliosis surgery with a fusion mass; however, only a few techniques have shown efficacy and safety, and their mid- and long-term outcomes remain unelucidated. This study aimed to analyze long-term outcomes of the posterior multilevel crack osteotomy (PMCO) technique for revisional surgery for scoliosis with a fusion mass.Methods: Data from 18 patients who underwent revisional scoliosis surgery using PMCO between 2009 and 2015 and had more than 5-year follow-up were retrospectively reviewed. The Cobb angle and coronal and sagittal balance parameters were examined preoperatively, postoperatively, and during the final follow-up. Perioperative parameters and complications were also assessed.Results: Preoperative and postoperative Cobb angles were 60.5° and 29.9°, respectively (p 〈 0.001); this improvement was maintained until the final follow-up (33.4°, p = 0.058). The difference in preoperative and postoperative coronal balance was statistically significant (15.9 mm and 9.2 mm, respectively; p 〈 0.001); this was maintained until the final follow-up (p = 0.071). There was no change in sagittal balance parameters over the 3 measurement periods. Only 1 patient showed PMCO-related motor weakness, but he spontaneously recovered 3 months after postsurgery. Pseudarthrosis was not observed during the follow-up period.Conclusion: Incomplete osteotomy using PMCO provided satisfactory deformity correction without severe complications during revisional surgery for scoliosis with a fusion mass. It may be a less invasive procedure that maintains cortical continuity, preserves soft tissues, and provides sufficient mobility for the correction of spinal segments.
    Type of Medium: Online Resource
    ISSN: 2586-6583 , 2586-6591
    URL: Article
    DOI: 10.14245/ns.2346568.284
    Language: English
    Publisher: The Korean Spinal Neurosurgery Society
    Publication Date: 2023
    detail.hit.zdb_id: 3031654-6
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