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"Dae-Chul Cho"

Original Article

Trauma

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Impact of Fracture Deficit Volume on Fusion Success in Anterior Odontoid Screw Fixation
Neurospine. 2025;22(3):859-869.   Published online September 30, 2025
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Impact of Fracture Deficit Volume on Fusion Success in Anterior Odontoid Screw Fixation
Neurospine. 2025;22(3):859-869.   Published online September 30, 2025
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Objective
Anterior odontoid screw fixation (AOSF) has several advantages over posterior C1–2 fusion for Grauer type II and shallow type III odontoid fractures. However, the risk factors for fusion failure, particularly in terms of 3-dimensional (3D) measurements, remain unclear. This study investigated the impact of fracture deficit volume (FDV), a novel 3D measurement, on fusion outcomes in patients undergoing AOSF.
Methods
We enrolled 44 patients with Grauer type II or shallow type III odontoid fractures treated with AOSF at a single institution. Radiological assessments included preoperative and postoperative measurements of the fracture gap and fracture displacement on computed tomography (CT) scans. FDV was calculated through 3D CT reconstruction of preoperative and immediate postoperative CT to quantify the spatial gap between the edges of the fractures. Fusion outcomes were defined as solid union, fibrous union, or nonunion. Logistic regression and a generalized additive model (GAM) were used to identify risk factors for fusion failure after AOSF.
Results
Solid fusion was achieved in 77.3% of patients. A reduction in the FDV with respect to the preoperative value was significantly associated with successful fusion (p=0.028), whereas patients presenting an increased FDV postoperatively were more likely to exhibit fusion failure (p=0.006). Age≥65 years, a fracture gap≥2 mm, and an increased FDV postoperatively were significant risk factors for fusion failure. GAM analysis revealed a linear relationship between a reduced FDV and improved fusion rates (adjusted R2=0.186, p=0.018).
Conclusion
The risk of fusion failure is greater in elderly patients, those with a fracture gap greater than 2 mm, and those with an increased FDV postoperatively. Among the modifiable risk factors, FDV had the greatest impact on fusion outcomes after AOSF.
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Commentary

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Commentary on “Comparison of the Clinical Efficacy of Anabolic Agents and Bisphosphonates in the Patients With Osteoporotic Vertebral Fracture: Systematic Review and Meta-analysis of Randomized Controlled Trials”
Neurospine. 2024;21(2):430-431.   Published online June 30, 2024
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Commentary on “Comparison of the Clinical Efficacy of Anabolic Agents and Bisphosphonates in the Patients With Osteoporotic Vertebral Fracture: Systematic Review and Meta-analysis of Randomized Controlled Trials”
Neurospine. 2024;21(2):430-431.   Published online June 30, 2024
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  • 1 Web of Science

Review Article

Special Issue on AI & Robotics

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Navigation-Guided/Robot-Assisted Spinal Surgery: A Review Article
Neurospine. 2024;21(1):8-17.   Published online March 31, 2024
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Navigation-Guided/Robot-Assisted Spinal Surgery: A Review Article
Neurospine. 2024;21(1):8-17.   Published online March 31, 2024
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The development of minimally invasive spinal surgery utilizing navigation and robotics has significantly improved the feasibility, accuracy, and efficiency of this surgery. In particular, these methods provide improved accuracy of pedicle screw placement, reduced radiation exposure, and shortened learning curves for surgeons. However, research on the clinical outcomes and cost-effectiveness of navigation and robot-assisted spinal surgery is still in its infancy. Therefore, there is limited available evidence and this makes it difficult to draw definitive conclusions regarding the long-term benefits of these technologies. In this review article, we provide a summary of the current navigation and robotic spinal surgery systems. We concluded that despite the progress that has been made in recent years, and the clear advantages these methods can provide in terms of clinical outcomes and shortened learning curves, cost-effectiveness remains an issue. Therefore, future studies are required to consider training costs, variable initial expenses, maintenance and service fees, and operating costs of these advanced platforms so that they are feasible for implementation in standard clinical practice.

Citations

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    European Spine Journal.2025; 34(3): 1004.     CrossRef
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    Cheng Zhong, Zhe Han
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  • 417 Download
  • 53 Web of Science
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Editorial

Bone Biology and Osteoporosis Special Issue

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Optimal Strategies for the Treatment of Osteoporotic Spinal Diseases
Neurospine. 2023;20(4):1095-1096.   Published online December 31, 2023
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Optimal Strategies for the Treatment of Osteoporotic Spinal Diseases
Neurospine. 2023;20(4):1095-1096.   Published online December 31, 2023
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Citations

Citations to this article as recorded by  Crossref logo
  • Lumbar fusion surgery in the era of an aging society: analysis of a nationwide population cohort with minimum 8-year follow-up
    Woo-Keun Kwon, Alekos A. Theologis, Joo Han Kim, Hong Joo Moon
    The Spine Journal.2024; 24(8): 1378.     CrossRef
  • 3,453 View
  • 177 Download
  • 1 Web of Science
  • 1 Crossref

Original Articles

Bone Biology and Osteoporosis Special Issue

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Fusion Assessment of Oblique Lumbar Interbody Fusion Using Demineralized Bone Matrix: A 2-Year Prospective Study
Neurospine. 2023;20(4):1205-1216.   Published online December 31, 2023
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Fusion Assessment of Oblique Lumbar Interbody Fusion Using Demineralized Bone Matrix: A 2-Year Prospective Study
Neurospine. 2023;20(4):1205-1216.   Published online December 31, 2023
Close
Objective
Although several studies have reported successful fusion rates after oblique lumbar interbody fusion (OLIF) using allografts or dimerized bone matrix (DBM) instead of autografts, whether OLIF can achieve satisfactory solid fusion without the use of autografts remains unclear. This study investigated the real fusion rates after OLIF using allografts and DBM, which were evaluated using both dynamic radiographs and computed tomography scans.
Methods
We enrolled 79 consecutive patients who underwent minimally invasive OLIF followed by percutaneous pedicle screw fixation. All patients were treated with OLIF between L2 and L5 and underwent radiographic and clinical follow-ups at 12, 18, and 24 months after surgery. Radiographic assessment of fusion was performed using the modified BrantigaSteffee-Fraser (mBSF) scale, which was categorized as follows: grades I (radiographic pseudoarthrosis), II (indeterminate fusion), and III (solid radiographic fusion). Other radiologic and clinical outcomes were evaluated using the following parameters: vertebral slippage distance, disc height, subsidence, Oswestry Disability Index (ODI), and visual analogue scale (VAS).
Results
Clinical outcomes demonstrated significant improvements in the VAS scores for back pain, leg pain, and ODI after surgery. Subsidence was present in 34 cases (35.4%) at 12 months postoperatively, which increased to 47.9% and reached 50.0% at 1.5 years and 2 years after surgery, respectively. The solid fusion rate after OLIF was 32.3% at 1 year, increased to 58.3% at 1.5 years, and reached 72.9% at 2 years. Radiographic pseudoarthrosis was 24.0% at 1 year, which decreased to 6.3% at 1.5 years and 3.1% at 2 years.
Conclusion
OLIF is a safe and effective surgical procedure for the treatment of degenerative lumbar diseases. The mBSF scale, which simultaneously evaluates both dynamic angles and bone bridge formation, offers great reliability for the radiological assessment of fusion. Moreover, OLIF using allografts and DBM, which is performed on one or 2 levels at L2–5, can achieve satisfactory fusion rates within 2 years after surgery.

Citations

Citations to this article as recorded by  Crossref logo
  • Oblique lateral interbody fusion: role of the elastic modulus of the cage material in mechanically induced osteogenesis
    Teng Lu, Zhongwei Sun, Xijing He
    Computer Methods and Programs in Biomedicine.2026; 276: 109242.     CrossRef
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    Szu-Hsiang Peng, Jwo-Luen Pao
    Diagnostics.2026; 16(1): 140.     CrossRef
  • Understanding Spine Biologics: A Systematic Review of Demineralized Bone Matrix in Spinal Fusion From 2014-2024
    Molly Butler, Blake Martin, Christopher Carr, Muhsin Quraishi, Alexander F. Post, Fernando L. Vale
    Global Spine Journal.2026;[Epub]     CrossRef
  • Incidence and Risk Factors of Postoperative Ileus in Oblique Lumbar Interbody Fusion Surgery: A Retrospective Study
    Young-Seok Lee, Myeong Jin Ko, Seung Won Park
    Neurospine.2025; 22(1): 222.     CrossRef
  • Reduction-First Technique of Unilateral Biportal Endoscopy Lumbar Interbody Fusion for Spondylolisthesis
    JinWoo Jung, Man-Kyu Park, Yong Jin Park, Dae-Chul Cho, Young San Ko
    World Neurosurgery.2025; 198: 124005.     CrossRef
  • Comparative efficacy of autologous iliac bone versus allogeneic demineralized bone matrix in lateral lumbar interbody fusion using a novel minimally invasive iliac bone retrieval tool: a self-controlled study
    Jiaqi Li, Shaorong Li, Shuowen Zhang, Lin Liu, Weijian Wang, Han Wu, Qiang Yang, Wei Zhang
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
  • 7,190 View
  • 231 Download
  • 6 Web of Science
  • 6 Crossref

Spinal Cord Injury INTS-Neurospine Special Issue

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Effects of D-Serine and MK-801 on Neuropathic Pain and Functional Recovery in a Rat Model of Spinal Cord Injury
Neurospine. 2022;19(3):737-747.   Published online September 30, 2022
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Effects of D-Serine and MK-801 on Neuropathic Pain and Functional Recovery in a Rat Model of Spinal Cord Injury
Neurospine. 2022;19(3):737-747.   Published online September 30, 2022
Close
Objective
Neuropathic pain is a common secondary complication of spinal cord injury (SCI). N-methyl-D-aspartate (NMDA) receptor activation is critical for hypersensitivity in neuropathic pain. This activation requires the binding of both glutamate and the D-serine co-agonist to the NMDA glycine site. We evaluated the effects of D-serine on neuropathic pain after SCI and explored the underlying molecular mechanisms.
Methods
Anesthetized rats underwent T9 spinal cord contusion (130 kdyn). D-serine (500 and 1,000 mg/kg) and MK-801 hydrogen maleate (2.0 mg/kg) were injected daily for 2 weeks, starting the day after SCI. Functional outcomes were assessed according to the Basso, Beattie, and Bresnahan scale, while histological outcomes were evaluated based on lesion volume and spared tissue area. Mechanical allodynia and thermal hyperalgesia were evaluated by measuring the withdrawal threshold of a von Frey filament and hot/cold plate latency. Western blotting was performed to determine the expression levels of Trpv1, Nav1.9, calcitonin gene-related peptide (CGRP), and β-actin in damaged tissue.
Results
The withdrawal threshold values and latency of the D-serine group were significantly lower than those of the noninjection group. The MK-801 group showed higher threshold values and latencies than the other groups. Western blotting showed increased Nav1.9 and Trpv1 levels and lower CGRP levels in the D-serine group, whereas the MK-801 group showed the opposite results.
Conclusion
D-serine increases neuropathic pain after traumatic SCI by mediating the NMDA receptor. NMDA receptor antagonists alleviate neuropathic pain after traumatic SCI.

Citations

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Minimally Invasive Spinal Surgery SMISS-Neurospine Special Issue

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Indirect Decompression Using Oblique Lumbar Interbody Fusion Revision Surgery Following Previous Posterior Decompression: Comparison of Clinical and Radiologic Outcomes Between Direct and Indirect Decompression Revision Surgery
Neurospine. 2022;19(3):544-554.   Published online September 30, 2022
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Indirect Decompression Using Oblique Lumbar Interbody Fusion Revision Surgery Following Previous Posterior Decompression: Comparison of Clinical and Radiologic Outcomes Between Direct and Indirect Decompression Revision Surgery
Neurospine. 2022;19(3):544-554.   Published online September 30, 2022
Close
Objective
This study compared the radiological and clinical outcomes with transforaminal lumbar interbody fusion (TLIF) to evaluate the effect of indirect decompression through oblique lumbar interbody fusion (OLIF) as revision surgery.
Methods
We enrolled patients who underwent single-level fusion with revision surgery at the same level as the previous decompression level. We retrospectively reviewed 25 patients who underwent OLIF from 2017 to 2018 and 25 who received TLIF from 2014 to 2018. Radiologic and clinical outcomes were evaluated by cross-sectional area (CSA) of the spinal canal, thickness and area of ligamentum flavum (LF), subsidence, disc height, fusion rate, Oswestry Disability Index (ODI), and visual analogue scale (VAS).
Results
Compared with OLIF, the thickness and area of the LF after surgery were significantly less in TLIF, and the resulting CSA extension was also significantly higher. However, both groups showed improvement in ODI and VAS after surgery, and there was no difference between the groups. Complications related to the posterior approach in TLIF were 4 cases, and in OLIF, there were 2 cases that underwent additional posterior decompression surgery and 6 cases of transient paresthesia.
Conclusion
Since complications associated with the posterior approach can be avoided, OLIF is a safer and useful minimally invasive surgery. Therefore, appropriate indications are applied, OLIF is a good alternative to TLIF when revision surgery is considered.

Citations

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    Brain and Spine.2026; 6: 106043.     CrossRef
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    Satoshi Hattori, Satoru Matsutani
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    Ruixin Zhen, Jiaqi Li, Shaorong Li, Han Wu, Wei Zhang
    Frontiers in Surgery.2025;[Epub]     CrossRef
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    BMC Musculoskeletal Disorders.2025;[Epub]     CrossRef
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    Yanxiao Liu, Hua Wang, Lei Li
    Neurosurgical Review.2025;[Epub]     CrossRef
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    Seung-Yeon Jeong, Hyun-Jin Park, Jin-Ho Park, Gab-Lae Kim
    Journal of Advanced Spine Surgery.2025; 15(2): 84.     CrossRef
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    Jiaqi Li, Bingyi Zhao, Weijian Wang, Yafei Xu, Haoyu Wu, Wei Zhang
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    Hangeul Park, Juhee Lee, Yunhee Choi, Jun-Hoe Kim, Sum Kim, Young-Rak Kim, Chang-Hyun Lee, Sung Bae Park, Kyoung-Tae Kim, John M. Rhee, Chi Heon Kim
    Scientific Reports.2024;[Epub]     CrossRef
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    Orthopaedic Surgery.2023; 15(10): 2701.     CrossRef
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Review Article

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Curcumin as a Promising Neuroprotective Agent for the Treatment of Spinal Cord Injury: A Review of the Literature
Neurospine. 2022;19(2):249-261.   Published online June 30, 2022
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Curcumin as a Promising Neuroprotective Agent for the Treatment of Spinal Cord Injury: A Review of the Literature
Neurospine. 2022;19(2):249-261.   Published online June 30, 2022
Close
Curcumin is a polyphenolic chemical derived from the rhizomes of Curcuma longa. It has been used throughout the Indian subcontinent for medicinal purposes, religious events, and regional cuisine. It has various pharmacological benefits owing to its anti-inflammatory and antioxidant properties. Its neuroprotective effects on the brain and peripheral nerves have been demonstrated in several in vivo neuronal tissue studies. Because of these functional properties of curcumin, it is considered to have great potential for use in the treatment of spinal cord injuries (SCIs). Numerous immunopathological and biochemical studies have reported that curcumin can help prevent and alleviate subsequent secondary injuries, such as inflammation, edema, free radical damage, fibrosis, and glial scarring, after a primary SCI. Furthermore, following SCI, curcumin administration resulted in better outcomes of neurological function recovery as per the Basso, Beattie, and Bresnahan locomotor rating scale. However, to date, its utility in treating SCIs has only been reported in laboratories. More studies on its clinical applications are needed in the future for ensuring its bioavailability across the blood-brain barrier and for verifying the safe dose for treating SCIs in humans.

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Original Articles

Minimally Invasive Spinal Surgery SMISS-Neurospine Special Issue

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The Change of Spinal Canal According to Oblique Lumbar Interbody Fusion in Degenerative Spondylolisthesis: A Prospective Observational Study
Neurospine. 2022;19(3):492-500.   Published online May 13, 2022
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The Change of Spinal Canal According to Oblique Lumbar Interbody Fusion in Degenerative Spondylolisthesis: A Prospective Observational Study
Neurospine. 2022;19(3):492-500.   Published online May 13, 2022
Close
Objective
Oblique lumbar interbody fusion (OLIF) involves inserting large cages into the interbody disc space. This expands the spinal canal and neural foramen by stretching the ligament flavum and releasing the facet joint, resulting in indirect neural decompression. Our objective was to investigate the changes in the spinal canal and ligament flavum over time after OLIF.
Methods
This was a prospective observational study involving 30 patients who underwent OLIF L4–5 between 2015 and 2018. In total, 27 of the 30 patients underwent preoperative, early follow-up ( < 5 days), and late follow-up (10–14 months) magnetic resonance imaging to measure the area of the spinal canal and ligament flavum. Based on the results, the patients were divided into subsidence and nonsubsidence groups for further analysis.
Results
After OLIF, the spinal canal area gradually increased during the preoperative, early postoperative, and late postoperative periods (p < 0.001). The thickness and area of the ligament flavum decreased gradually over the same periods (p < 0.001). Low-grade subsidence (2–4.4 mm) did not influence the effects on the spinal canal and ligament.
Conclusion
After OLIF, the spinal canal and ligament flavum gradually change, which is effective for indirect neural decompression. In addition, the effects of low-grade subsidence on the remodeling of the spinal canal and ligament flavum are insignificant.

Citations

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  • Oblique Lateral Interbody Fusion With Lateral Vertebral Screw Fixation Versus Transforaminal Lumbar Interbody Fusion for Severe Lumbar Stenosis: Results of a Multicenter Randomized Controlled Trial
    Xuefeng Li, Cheng Lin, Tangyiheng Chen, Renjie Li, Dapeng Li, Sheng Song, Huilin Yang, Genlei Chu, Weimin Jiang, Yijie Liu
    Neurosurgery.2026;[Epub]     CrossRef
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    Kyle M M Behrens, Hossein Elgafy
    World Journal of Orthopedics.2025;[Epub]     CrossRef
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    Young-Seok Lee, Myeong Jin Ko, Seung Won Park
    Neurospine.2025; 22(1): 222.     CrossRef
  • Reduction-First Technique of Unilateral Biportal Endoscopy Lumbar Interbody Fusion for Spondylolisthesis
    JinWoo Jung, Man-Kyu Park, Yong Jin Park, Dae-Chul Cho, Young San Ko
    World Neurosurgery.2025; 198: 124005.     CrossRef
  • Is Congenital Lumbar Spinal Canal Stenosis a Contraindication for Indirect Decompression by Lateral Lumbar Interbody Fusion (LLIF)?
    Weerasak Singhatanadgige, Thada Nashinoros, Teerachat Tanasansomboon, Wicharn Yingsakmongkol, Vit Kotheeranurak, Worawat Limthongkul
    Global Spine Journal.2025;[Epub]     CrossRef
  • Efficacy observation of oblique lateral interbody fusion (OLIF) in treating severe spinal stenosis
    Yiliya Yilihamu, Jun Mo, Zhanjun Ma, Jianjiang Li, Yifei Huang
    BMC Surgery.2025;[Epub]     CrossRef
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    Jiaqi Li, Bingyi Zhao, Weijian Wang, Yafei Xu, Haoyu Wu, Wei Zhang
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  • A Comprehensive Analysis of Potential Complications after Oblique Lumbar Interbody Fusion : A Review of Postoperative Magnetic Resonance Scans in Over 400 Cases
    Kang-Hoon Lee, Su-Hun Lee, Jun-Seok Lee, Young-Ha Kim, Soon-Ki Sung, Dong-Wuk Son, Sang-Weon Lee, Geun-Sung Song
    Journal of Korean Neurosurgical Society.2024; 67(5): 550.     CrossRef
  • Intraoperative Facet Joint Block Reduces Pain After Oblique Lumbar Interbody Fusion
    Sung Hyeon Noh, Sang-Woo Lee, Jong-moon Hwang, JinWoo Jung, Eunyoung Lee, Dae-Chul Cho, Chi Heon Kim, Kyoung-Tae Kim
    Journal of Bone and Joint Surgery.2024;[Epub]     CrossRef
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    Joonsoo Lim, Jangyeob Lim, Asfandyar Khan, Chang-Hyun Lee, Jun-Hoe Kim, Sejin Choi, Tae-Shin Kim, Yunhee Choi, Chun Kee Chung, Sangwook T. Yoon, Kyoung-Tae Kim, Chi Heon Kim
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  • Mini-Open Intercostal Retroperitoneal Approach for Upper Lumbar Spine Lateral Interbody Fusion
    Su Hun Lee, Dong Wuk Son, Sung Hyun Bae, Jun Seok Lee, Young Ha Kim, Soon Ki Sung, Sang Weon Lee, Geun Sung Song
    Neurospine.2023; 20(2): 553.     CrossRef
  • Perioperative Clinical Features and Long-term Prognosis After Oblique Lateral Interbody Fusion (OLIF), OLIF With Anterolateral Screw Fixation, or OLIF With Percutaneous Pedicle Fixation: A Comprehensive Treatment Strategy for Patients With Lumbar Degenera
    Xiangyu Zhang, Yutian Wang, Weikang Zhang, Shaocheng Liu, Zhenlei Liu, Kai Wang, Hao Wu
    Neurospine.2023; 20(2): 536.     CrossRef
  • Commentary on “Mini-Open Intercostal Retroperitoneal Approach for Upper Lumbar Spine Lateral Interbody Fusion”
    Alexander E. Ropper
    Neurospine.2023; 20(2): 564.     CrossRef
  • Letter to the Editor : Classifying the Anatomical Location of the Ureter after Retroperitoneal Dissection
    Su-Hun Lee, Dong-Wuk Son, Jun-Seok Lee, Geun-Sung Song
    Journal of Korean Neurosurgical Society.2023; 66(5): 605.     CrossRef
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    Junghoon Han, Chang-Min Ha, Woon Tak Yuh, Young San Ko, Jun-Hoe Kim, Tae-Shin Kim, Chang-Hyun Lee, Sungjoon Lee, Sun-Ho Lee, Asfandyar Khan, Chun Kee Chung, Chi Heon Kim, Mohamed El-Sayed Abdel-Wanis
    PLOS ONE.2023; 18(9): e0291114.     CrossRef
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    Tae-Hwan Park, Yunhee Choi, Tae-Shin Kim, Jun-Hoe Kim, Chang-Hyun Lee, Sum Kim, Young Rak Kim, Yong San Ko, Woon Tak Yuh, John M. Rhee, Kyoung-Tae Kim, Chun Kee Chung, Chi Heon Kim
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  • Fusion Assessment of Oblique Lumbar Interbody Fusion Using Demineralized Bone Matrix: A 2-Year Prospective Study
    Sangseok Lee, Jin Woo Jung, Sang-Woo Lee, Kyoung-Tae Kim, Heum-Dai Kwon, Subum Lee, Young San Ko, Pius Kim, Dae-Chul Cho
    Neurospine.2023; 20(4): 1205.     CrossRef
  • An Expanded Surgical Corridor of Oblique Lateral Interbody Fusion at L4–5: A Magnetic Resonance Imaging Study
    Worawat Limthongkul, Pakawas Praisarnti, Teerachat Tanasansomboon, Natavut Prasertkul, Vit Kotheeranurak, Wicharn Yingsakmongkol, Weerasak Singhatanadgige
    Neurospine.2023; 20(4): 1450.     CrossRef
  • 7,857 View
  • 325 Download
  • 17 Web of Science
  • 18 Crossref

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Intraoperative Monitoring for Cauda Equina Tumors: Surgical Outcomes and Neurophysiological Data Accrued Over 10 Years
Neurospine. 2021;18(2):281-289.   Published online June 30, 2021
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Intraoperative Monitoring for Cauda Equina Tumors: Surgical Outcomes and Neurophysiological Data Accrued Over 10 Years
Neurospine. 2021;18(2):281-289.   Published online June 30, 2021
Close
Objective
Cauda equina tumors affect the peripheral nervous system, and the validities of triggered electromyogram (tEMG) and intraoperative neurophysiologic monitoring (IOM) are unclear. We sought to evaluate the accuracy and relevance of tEMG combined with IOM during cauda equina tumor resection.
Methods
Between 2008 and 2018, an experienced surgeon performed cauda equina tumor resections using tEMG at a single institution. A cauda equina tumor was defined as an intradural-extramedullary or intradural-extradural tumor at the level of L2 or lower. The clinical presentation, extent of resection, pathology, recurrence, postoperative neurological outcomes, and intraoperative tEMG mapping and IOM data were retrospectively analyzed.
Results
One hundred three patients who underwent intraoperative tEMG were included; 38 underwent only tEMG (tEMG-only group), and 65 underwent a combination of tEMG and multimodal IOM (MIOM group). There were no significant differences between the neurologic outcomes, extents of resection, or recurrence rates of the 2 groups. No significant therapeutic benefit was observed; however, the accuracy of intraoperative predetection improved with the combination of IOM and tEMG (accuracy: tEMG-only group, 86.8%; MIOM group, 92.3%). When the involved rootlet was resected despite the positive tEMG result, motor function worsened in 3 of 8 cases. The sensitivity and specificity of tEMG were 37.5% and 94.7%, respectively.
Conclusion
tEMG is an essential adjunctive surgical tool for deciding on and planning for rootlet resection. If the tEMG finding is negative, complete resection, involving the rootlet, may be safe. The accuracy may be further improved by using a combination of tEMG and IOM.

Citations

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  • A Case of Normal-pressure Hydrocephalus Caused by Cauda Equina Capillary Malformation
    Tetsuo OTA, Daisu ABE, Hiroshi SHINTAKU, Motoki INAJI, Yoji TANAKA, Taketoshi MAEHARA
    NMC Case Report Journal.2025; 12: 103.     CrossRef
  • The Improvement of Intraoperative Motor Evoked Potential after Decompression in Cervical Compressive Myelopathy: Its Significance and Related Factors
    Jong Yun Kwon, Dong Hwan Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han
    The Nerve.2024; 10(2): 80.     CrossRef
  • Free running and triggered electromyography for surgical planning during spinal cord tumor removal: a case report
    Jinyoung Park, Yura Goh, Dawoon Kim, Hyosik Eom, Yejin Lee, Joo Eun Park, Yoon Ghil Park
    Journal of Intraoperative Neurophysiology.2024; 6(2): 9.     CrossRef
  • Sacrifice of Involved Nerve Root during Surgical Resection of Foraminal and/or Dumbbell Spinal Neurinomas
    Alberto Vandenbulcke, Ginevra Federica D’Onofrio, Gabriele Capo, Wassim Baassiri, Cédric Y. Barrey
    Brain Sciences.2023; 13(1): 109.     CrossRef
  • The efficacy of intraoperative neuromonitoring, including triggered electromyography, in intradural extramedullary spine tumors: a successful case study
    Joo Eun Park, Yoon Ghil Park, Dawoon Kim, Hyosik Eom, Jinyoung Park, Myungeun Yoo
    Journal of Intraoperative Neurophysiology.2023; 5(2): 43.     CrossRef
  • Mechanical Failure After Total En Bloc Spondylectomy and Salvage Surgery
    Shin Won Kwon, Chun Kee Chung, Young Il Won, Woon Tak Yuh, Sung Bae Park, Seung Heon Yang, Chang Hyun Lee, John M. Rhee, Kyoung-Tae Kim, Chi Heon Kim
    Neurospine.2022; 19(1): 146.     CrossRef
  • Another Milestone for Spinal Intramedullary Tumor Treatment
    Chi Heon Kim
    Neurospine.2022; 19(1): 30.     CrossRef
  • Prediction of Post-operative Long-Term Outcome of the Motor Function by Multimodal Intraoperative Neuromonitoring With Transcranial Motor-Evoked Potential and Spinal Cord-Evoked Potential After Microsurgical Resection for Spinal Cord Tumors
    Shinsuke Yamada, Satoshi Kawajiri, Hidetaka Arishma, Makoto Isozaki, Takahiro Yamauchi, Ayumi Akazawa, Masamune Kidoguchi, Toshiaki Kodera, Yoshinori Shibaike, Hideto Umeda, Yu Tsukinowa, Ryota Hagihara, Kenichiro Kikuta
    Frontiers in Surgery.2022;[Epub]     CrossRef
  • Long-term recurrence after surgery for schwannoma of the cauda equina
    Hirotomo Tanaka, Yoshiyuki Takaishi, Shinichi Miura, Takashi Mizowaki, Takeshi Kondoh, Takashi Sasayama
    Surgical Neurology International.2022; 13: 272.     CrossRef
  • Feasibility and efficacy of spinal microtubular technique for resection of lumbar dumbbell-shaped tumors
    Rui Wang, Zeyan Liang, Yan Chen, Xiongjie Xu, Chunmei Chen
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Description of the Diversity in Surgical Indication and Surgical Strategies for Primary Spinal Cord Tumors: A Nationwide Survey by the Neurospinal Society of Japan
    Yasukazu Hijikata, Shigeo Ueda, Takao Yasuhara, Daisuke Umebayashi, Toshiki Endo, Toshihiro Takami, Masaki Mizuno, Kazutoshi Hida, Minoru Hoshimaru
    Neurospine.2022; 19(4): 1122.     CrossRef
  • Impact of general anaesthesia on parameters of bulbocavernosus reflex
    D. E. Malyshok, A. Yu. Orlov, M. V. Aleksandrov
    Medical alphabet.2021; (36): 37.     CrossRef
  • 9,546 View
  • 176 Download
  • 7 Web of Science
  • 12 Crossref

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Development of Neuromonitoring Pedicle Screw - Results of Electrical Resistance and Neurophysiologic Test in Pig Model
Neurospine. 2021;18(1):117-125.   Published online November 18, 2020
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Development of Neuromonitoring Pedicle Screw - Results of Electrical Resistance and Neurophysiologic Test in Pig Model
Neurospine. 2021;18(1):117-125.   Published online November 18, 2020
Close
Objective
To analyze the electrical resistance of a newly developed neuromonitoring pedicle screw (Neuro-PS) and to verify the electrophysiologic properties of the Neuro-PS in a pig model.
Methods
We developed 2 types of the Neuro-PS in which a gold lead was located internally (type I) and externally (type II). We measured the electrical resistance of the Neuro-PS and the conventional screw and analyzed the electrical thresholds of triggered EMG (t-EMG) of each screw by intentionally penetrating the medial pedicle wall and contacting the exiting nerve root in a pig model.
Results
The electrical resistances of the Neuro-PS were remarkably lower than that of the conventional screw. In electrophysiologic testing, only the type II Neuro-PS under the leadnerve contact condition showed a significantly lower stimulation threshold as compared to the conventional screw.
Conclusion
The Neuro-PS demonstrated lower electrical resistances than the conventional screw. The type II Neuro-PS under the lead-nerve contact condition showed a significantly lower stimulation threshold compared to that of the other screws in the t-EMG test.

Citations

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  • Feasibility of Using Intraoperative Neurophysiological Monitoring for Detecting Bone Layer of Cervical Spine Surgery
    Weiyang Zuo, Lingjia Yu, Haining Tan, Xiang Li, Bin Zhu, Yuquan Liu, Xuan Peng, Yong Yang, Qi Fei
    Clinical Spine Surgery.2024; 37(10): E480.     CrossRef
  • Intraoperative triggered electromyographic monitoring of pedicle screw efficiently reduces the lumbar pedicle breach and re-operative rate-a retrospective analysis based on postoperative computed tomography scan
    Tong Yongjun, Zhao Yuntian, Chen Biao, Jiang Zenghui
    BMC Musculoskeletal Disorders.2023;[Epub]     CrossRef
  • 11,143 View
  • 260 Download
  • 2 Web of Science
  • 2 Crossref

Editorial

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In the Era of COVID-19: The Role of Spine Surgeons at the Epicenter of the Outbreak
Neurospine. 2020;17(2):337-338.   Published online May 18, 2020
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In the Era of COVID-19: The Role of Spine Surgeons at the Epicenter of the Outbreak
Neurospine. 2020;17(2):337-338.   Published online May 18, 2020
Close

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  • Trends in degenerative lumbar spinal surgery during the early COVID-19 pandemic in Republic of Korea: A national study utilizing the national health insurance database
    Woon Tak Yuh, Jinhee Kim, Mi-Sook Kim, Jun-Hoe Kim, Young Rak Kim, Sum Kim, Chun Kee Chung, Chang-Hyun Lee, Sung Bae Park, Kyoung-Tae Kim, John M. Rhee, Young San Ko, Chi Heon Kim, Kentaro Yamada
    PLOS ONE.2024; 19(6): e0305128.     CrossRef
  • Loss of Moral Values During Business-Like Transformations in Healthcare Services
    Naci Balak, Tiit I. Mathiesen
    World Neurosurgery.2024; 191: 149.     CrossRef
  • 7,092 View
  • 101 Download
  • 2 Web of Science
  • 2 Crossref

Original Article

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Epidemiology of C5 Palsy after Cervical Spine Surgery: A 21-Center Study
Neurospine. 2019;16(3):558-562.   Published online September 30, 2019
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Epidemiology of C5 Palsy after Cervical Spine Surgery: A 21-Center Study
Neurospine. 2019;16(3):558-562.   Published online September 30, 2019
Close
Objective
C5 palsy is a severe complication after cervical spine surgery, the pathophysiology of which remains unclear. This multicenter study investigated the incidence of C5 palsy following cervical spine surgery in Korea.
Methods
We conducted a retrospective multicenter study involving 21 centers from the Korean Cervical Spine Study Group. The inclusion criteria were cervical spine surgery patients between 2012 and 2016, excluding cases of neck surgery. In patients with C5 palsy, the operative methods, disease category, onset time of C5 palsy, recovery time, C5 manual muscle testing (MMT) grade, and post-C5 palsy management were analyzed.
Results
We collected 15,097 cervical spine surgery cases from 21 centers. C5 palsy occurred in 88 cases (0.58%). C5 palsy was more common in male patients (p=0.019) and after posterior approach procedures (p<0.001). C5 palsy usually occurred within 3 days after surgery (77 of 88, 87.5%) and most C5 palsy patients recovered within 6 months (51 of 88, 57.95%). Thirty C5 palsy patients (34.09%) had motor weakness, with an MMT grade≤2. Only four C5 palsy patients (4.5%) did not recover during follow-up. Posterior cervical foraminotomy was performed in 7 cases (7.95%), and steroids were used in 56 cases (63.63%). Twenty-six cases (29.55%) underwent close observation only.
Conclusion
The overall incidence of C5 palsy was relatively low (0.58%). C5 palsy was more common after posterior cervical surgery and in male patients. C5 palsy usually developed within 3 days after surgery, and more than half of patients with C5 palsy recovered within 6 months.

Citations

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  • What is the probability of recovery of C5 palsy after cervical spine surgery over time? A systematic review and meta-analysis
    Nienke A. Krijnen, Alexander J. Comerci, Christopher J. Fedor, Hamid Alahmari, James C. Bayley, Teun Teunis
    The Spine Journal.2026; 26(5): 853.     CrossRef
  • Risk factors for C5 nerve root palsy following surgery for cervical degenerative disease : a systematic review and meta-analysis
    Mingzhu Huang, Kang Chen, Yujin Zhang, Lanxin Zhang, Changyu Liu, Xuan Liu, Xiangzhuo Liu, Ningyuan Li, Ying Lu, Mingjiang Luo, Zhihong Xiao, Liquan Li
    Neurosurgical Review.2026;[Epub]     CrossRef
  • C5 Palsy After Cervical Decompression: A 10-Year Single-Institution Study Highlighting Early Onset, High Bilaterality, and Poor Recovery
    Sargunan B, Vishnu Prasath, Karthik Sudhakar, Thomas John
    Cureus.2026;[Epub]     CrossRef
  • De novo C5 palsy in the absence of prior surgery: a retrospective study of surgical management and outcomes in the United States
    Wesley Manz, Sameer Khawaja, Corey Spencer, Dale Segal, Zach Grabel, Doug Weinberg, Eli Garrard, John Rhee
    Asian Spine Journal.2026; 20(1): 34.     CrossRef
  • Incidence and prognostic factors of postoperative C5 palsy after cervical OPLL surgery: a nationwide prospective multicenter study
    Satoru Egawa, Takashi Hirai, Kenichiro Sakai, Kazuo Kusano, Shunji Tsutsui, Yu Matsukura, Kentaro Yamada, Hiroaki Onuma, Kanichiro Wada, Keiichi Katsumi, Masao Koda, Atsushi Kimura, Takeo Furuya, Satoshi Maki, Norihiro Nishida, Yukitaka Nagamoto, Yasushi
    Scientific Reports.2026;[Epub]     CrossRef
  • Preoperative Imaging Predictors of Postoperative C5 Palsy
    Jonathan Dalton, Rachel Huang, Michael Carter, Robert J. Oris, Joydeep Baidya, Joshua Mathew, Rajkishen Narayanan, Andrew Kim, Sebastian Fras, Jonah Blas, Anthony LaBarbiera, Matthew Ruiz, Evgeniy Uvarov, Keyur Patel, Mark F. Kurd, Ian David Kaye, Jose A.
    Spine.2026; 51(10): 692.     CrossRef
  • Increased Change in Cervical Lordosis Is Associated With Decreased Rate of Recovery in Patients With C5 Palsy
    Joseph N. Frazzetta, Nathan Pecoraro, Ignacio Jusue-Torres, Paul M. Arnold, Ryan Hofler, G. Alexander Jones, Russ Nockels
    Clinical Spine Surgery.2025; 38(3): E152.     CrossRef
  • Phrenic Nerve Palsy After Posterior Cervical Fusion
    Thomas Falconiero, Anthony Viola, Mark LaGreca, Caleb M. Yeung, Jeffrey Rihn
    Clinical Spine Surgery.2025; 38(5): 217.     CrossRef
  • Biceps involvement and degree of motor deficit at diagnosis are independently predictive of timing of postoperative C5 palsy recovery
    Gregory Toci, Jonathan Dalton, Rachel Huang, Michael Carter, Robert J. Oris, Rajkishen Narayanan, Andrew Kim, Julienne Jeong, Brady Stallman, Kenneth McCall, Mark F. Kurd, Ian D. Kaye, Barrett I. Woods, Jeffrey A. Rihn, Jose A. Canseco, Alan S. Hilibrand,
    The Spine Journal.2025; 25(11): 2441.     CrossRef
  • Cord-lamina angle and foraminal diameter as key predictors of C5 palsy after anterior cervical decompression and fusion surgery
    Wenchao Zhou, Baifeng Sun, Zichuan Wu, Aochen Xu, Hanlin Song, Xuhong Zhang, Junbin Liu, Junzhe Sheng, Yang Liu
    Open Medicine.2025;[Epub]     CrossRef
  • C5 Nerve Palsy After Posterior Instrumentation and Decompression in Cervical Spine Surgery: A Review of the Literature
    Konstantinos Zygogiannis, Pavlos Gerasimidis, Spyridon Komaitis, Savvas Moschos, Georgios C Thivaios, Aikaterini Tsatsaragkou, Dimitrios Koulalis
    Cureus.2025;[Epub]     CrossRef
  • Transient C5 Palsy After Full‐Endoscopic Posterior Cervical Foraminotomy
    João Paulo Machado Bergamaschi, Ariel Falbel Lugão, Rangel Roberto de Assis, Kelsen de Oliveira Teixeira, Fernando Flores de Araújo, Thiago Queiroz Soares, Gustavo Vitelli Depieri, Álvaro Dowling, Robson Cruz de Oliveira, Fernanda Wirth, Fábio da Silva Fo
    Case Reports in Orthopedics.2025;[Epub]     CrossRef
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    Vibhu Krishnan Viswanathan, Guna Pratheep Kalanchiam, Akilan Chinnappan, Sathish Muthu
    Asian Spine Journal.2025; 19(6): 1059.     CrossRef
  • Contralateral C7 nerve root transfer for post-stroke prolonged flaccid paralysis — Two cases report
    Shuai Zhu, Feng-Chi Sun, Xiang-Meng Su, Si-Wei Xu, Jun-Tao Feng, Hua-Wei Yin, Wen-Dong Xu, Yun-Dong Shen
    Hand Surgery and Rehabilitation.2025; 44(5): 102261.     CrossRef
  • Flexion K-Line Status Predicts Surgical Strategy in Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: A Multicenter Comparison of Laminoplasty and Laminectomy With Fusion
    Jun Jae Shin, Sun Joon Yoo, Se Jun Park, Dong Kyu Kim, Hyun Jun Jang, Bong Ju Moon, Kyung Hyun Kim, Jeong Yoon Park, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim, Yong Eun Cho, Chang Kyu Lee, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Joongkyum Shin, Yoon Ha
    Neurospine.2025; 22(4): 937.     CrossRef
  • Risk Factors and Clinical Outcomes of Perioperative Complications Following Cervical Spine Surgery
    Narihito Nagoshi, Junichi Yamane, Toshiki Okubo, Yosuke Horiuchi, Yasuhiro Kamata, Norihiro Isogai, Hitoshi Kono, Yoshiomi Kobayashi, Reo Shibata, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Morio Matsumoto, Masaya Nakamura, Kota Watanabe
    Global Spine Journal.2025;[Epub]     CrossRef
  • Comparison of Anterior Cervical Decompression and Fusion and Posterior Laminoplasty for Four-Segment Cervical Spondylotic Myelopathy: Clinical and Radiographic Outcomes
    Liang Shi, Tao Ding, Fang Wang, Chengcong Wu
    Journal of Neurological Surgery Part A: Central European Neurosurgery.2024; 85(04): 331.     CrossRef
  • A rare case of phrenic nerve palsy after cervical spine surgery
    Shubham Sanjay Lodha, Akash Vishnu Mane, Mandar Borde, K V Menon
    Indian Spine Journal.2024; 7(1): 100.     CrossRef
  • A systematic review of risk factors and adverse outcomes associated with anterior cervical discectomy and fusion surgery over the past decade
    Vikramaditya Rai, Vipin Sharma, Mukesh Kumar, Lokesh Thakur
    Journal of Craniovertebral Junction and Spine.2024; 15(2): 141.     CrossRef
  • Cervical kinematic change after posterior full-endoscopic cervical foraminotomy for disc herniation or foraminal stenosis
    Seungyoon Paik, Yunhee Choi, Chun Kee Chung, Young Il Won, Sung Bae Park, Seung Heon Yang, Chang-Hyun Lee, John Min Rhee, Kyoung-Tae Kim, Chi Heon Kim, Thamer Hamdan
    PLOS ONE.2023; 18(2): e0281926.     CrossRef
  • Posterior Preventive Foraminotomy before Laminectomy Combined with Pedicle Screw Fixation May Decrease the Incidence of C5 Palsy in Complex Cervical Spine Surgery in Patients with Severe Myeloradiculopathy
    Yong-Ho Lee, Mahmoud Abdou, Ji-Won Kwon, Kyung-Soo Suk, Seong-Hwan Moon, You-Gun Won, Tae-Jin Lee, Byung-Ho Lee
    Journal of Clinical Medicine.2023; 12(6): 2227.     CrossRef
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    Vasudeva G Iyer, Lisa B Shields, Yi Ping Zhang, Christopher B Shields
    Cureus.2023;[Epub]     CrossRef
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    Glenn A. Gonzalez, Jingya Miao, Guilherme Porto, James Harrop
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    ·阿不力肯 阿不都沙拉木
    Advances in Clinical Medicine.2023; 13(10): 16813.     CrossRef
  • Management of Cerebrospinal Fluid Leakage by Pump-Regulated Volumetric Continuous Lumbar Drainage Following Anterior Cervical Decompression and Fusion for Ossification of the Posterior Longitudinal Ligament
    Sun Woo Jang, Sang Hyub Lee, Hong Kyung Shin, Sang Ryong Jeon, Sung Woo Roh, Jin Hoon Park
    Neurospine.2023; 20(4): 1421.     CrossRef
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  • Defining postoperative C5 palsy and recovery: a systematic review
    Nachiket Deshpande, Amro M. Stino, Brandon W. Smith, Ann A. Little, Lynda J. S. Yang, Paul Park, Yamaan S. Saadeh
    Journal of Neurosurgery: Spine.2022; : 1.     CrossRef
  • Use of electromyography to predict likelihood of recovery following C5 palsy after posterior cervical spine surgery
    Daniel Lubelski, Zach Pennington, Ryan F. Planchard, Ahmet Hoke, Nicholas Theodore, Daniel M. Sciubba, Allan J. Belzberg
    The Spine Journal.2021; 21(3): 387.     CrossRef
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    Guoliang Chen, Weicheng Huang, Mengxian Jia, Jiajin Lin, Yadong Sheng, Chaowei Lin, Kelun Huang, Honglin Teng
    Clinical Neurology and Neurosurgery.2021; 200: 106384.     CrossRef
  • A new nomenclature system for the surgical treatment of cervical spine deformity, developing, and validation of SOF system
    Jae Taek Hong, Heiko Koller, Kuniyoshi Abumi, Wen Yuan, Asdrubal Falavigna, Ho Jin Lee, Jong Beom Lee, Jean-Charles Le Huec, Jong-Hyeok Park, Il Sup Kim
    European Spine Journal.2021; 30(6): 1670.     CrossRef
  • C5 palsy after cervical laminectomy: natural history in a 10-year series
    Ryan C. Hofler, Joseph Frazzetta, Jehad Zakaria, Amany Aziz, William Adams, G. Alexander Jones
    The Spine Journal.2021; 21(9): 1473.     CrossRef
  • Preoperative Radiological Parameters to Predict Clinical and Radiological Outcomes after Laminoplasty
    Su Hun Lee, Dong Wuk Son, Jun Jae Shin, Yoon Ha, Geun Sung Song, Jun Seok Lee, Sang Weon Lee
    Journal of Korean Neurosurgical Society.2021; 64(5): 677.     CrossRef
  • Phrenic nerve palsy after cervical laminectomy and fusion
    Andrew S. Moon, Jeffrey M. Pearson, Jason L. Pittman
    North American Spine Society Journal (NASSJ).2020; 4: 100022.     CrossRef
  • 24,567 View
  • 467 Download
  • 31 Web of Science
  • 33 Crossref

Clinical Article

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The Therapeutic Effects of Combination Therapy with Curcumin and Alendronate on Spine Fusion Surgery in the Ovariectomized Rats
Korean J Spine. 2017;14(2):35-40.   Published online June 30, 2017
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The Therapeutic Effects of Combination Therapy with Curcumin and Alendronate on Spine Fusion Surgery in the Ovariectomized Rats
Korean J Spine. 2017;14(2):35-40.   Published online June 30, 2017
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Objective
The purpose of this study was to evaluate the therapeutic effects of combination therapy with curcumin and alendronate on spine fusion surgery in ovariectomized rats. Methods: Thirty-two female Sprague-Dawley rats (12 weeks old) underwent bilateral ovariectomy (OVX). Eight weeks after surgery, animals underwent intertransverse spine fusion at L4-5. The rats were randomly distributed amongst 4 groups; untreated OVX group, curcumin administered group, alendronate administered group, and the combination therapy group. At 8 weeks after fusion surgery, the animals were sacrificed and the fusion mass was assessed by manual palpation, radiographic scan, and micro-computed tomographic scan. In addition, mechanical strength was determined by a 3-point bending test. Results: Based on the results of manual palpation testing and 3-dimensional micro-computed tomography scanning, solid bone fusion rate was 50% (4 of 8) in the OVX group, 75% (6 of 8) in the alendronate-only and curcumin-only group, and 87.5% (7 of 8) in the combination therapy group, respectively. The combination therapy group had a higher fusion rate compared with the other treatment groups, though not statistically significantly (p>0.05). And the combination therapy group had a significant increase in fusion volume at 8 weeks after spine fusion surgery compared with curcumin-only group (p=0.039). The 3-point bending test showed that combination therapy group had a significantly greater maximal load value compared to that of curcumin-only group (p=0.024). Conclusion: The present study demonstrated that additional treatment of curcumin and alendronate after spine fusion surgery in rat can promote higher fusion volume, and improve bone mechanical strength.

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Repair of Inaccessible Ventral Dural Defect in Thoracic Spine: Double Layered Duraplasty
Korean J Spine. 2016;13(2):87-90.   Published online June 30, 2016
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Repair of Inaccessible Ventral Dural Defect in Thoracic Spine: Double Layered Duraplasty
Korean J Spine. 2016;13(2):87-90.   Published online June 30, 2016
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We propose a double layered (intradural and epidural patch) duraplasty that utilizes Lyoplant and Duraseal. We examined a 47-year-old woman after decompression for thoracic ossification of posterior longitudinal ligament was performed in another hospital. On postoperative day 7, she complained of weakness in both legs. Postoperative magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) collection with cord compression. In the operative field, we found 2 large dural defects on the ventral dura mater. We performed a conventional fat graft with fibrin glue. However, the patient exhibited neurologic deterioration, and a postoperative MRI again showed CSF collection. We performed dorsal midline durotomy and inserted a intradural and epidural Lyoplant patch. She immediately experienced diminishing back pain postoperatively. Her visual analog scale and motor power improved markedly. Postoperative MRIs performed at 2 and 16 months showed no spinal cord compression or CSF leakage to the epidural space. We describe a new technique for double layered duraplasty. Although we do not recommend this technique for all dural repairs, double-layered duraplasty may be useful for repairing large inaccessible dural tears in cases of persistent CSF leakage refractory to conventional management.

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  • 17,978 View
  • 212 Download
  • 8 Crossref