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"Dong Hwa Heo"

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Minimally Invasive Surgery

Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging
Ji Yeon Kim, Su Yong Choi, Dong Chan Lee, Hyeun Sung Kim, Dong Hwa Heo
Neurospine 2025;22(3):819-828.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550338.169

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Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging
Neurospine. 2025;22(3):819-828.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550338.169
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Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging
Neurospine. 2025;22(3):819-828.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550338.169
Close
Objective
This study evaluates surgical strategies based on preoperative computed tomography (CT) findings during unilateral biportal endoscopic (UBE) surgery for thoracic ossification of the ligamentum flavum (OLF) with dural ossification.
Methods
This retrospective study included patients undergoing posterior thoracic laminectomy via UBE surgery to treat symptomatic thoracic stenosis due to OLF. Clinical outcomes were assessed using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores, alongside analyses of preoperative CT and intraoperative videos for dural ossification characteristics.
Results
A total of 34 patients participated, showing significant improvements in VAS and JOA scores postoperatively. All focal dural ossifications exhibiting the tram-track sign were effectively excised without significant dural defects. The circumferential floating technique was employed for cases with the bridge sign, whereas wide excision was warranted for those with the comma sign.
Conclusion
UBE surgery effectively manages progressive thoracic OLF associated with dural ossification. Preoperative CT imaging is essential for assessing dural involvement and guiding surgical techniques. Microscopic surgery is recommended for inexperienced surgeons requiring wide dural excision.

Citations

Citations to this article as recorded by  Crossref logo
  • The Safety and Efficacy of Unilateral Biportal Endoscopic Decompression for the Treatment of Thoracic Ossification of Ligamentum Flavum with Occupancy Ratio > 60%: A Retrospective Cohort Study
    Lei Qi, Biteng Xu, Xiangji Guo, Gaoya Yu, Yuxuan Yang, Haozhi Yu, Liang Wang
    Pain and Therapy.2026; 15(1): 379.     CrossRef
  • Biportal endoscopic spinal surgery for thoracic ossification of the ligamentum flavum: a study of different classification types and surgical outcomes
    Honggang Wang, Dongqing He, Ruxing Liu, Jie Yuan, Yongfeng Wang
    Frontiers in Neurology.2026;[Epub]     CrossRef
  • 6,606 View
  • 95 Download
  • 1 Web of Science
  • 2 Crossref

NASS/Neurospine Endoscopic Spine Surgery Special Issue

Biportal Endoscopic Posterior Cervical Foraminotomy for Adjacent 2-Level Foraminal Lesions Using a Single Approach (Sliding Technique)
Dong Hwa Heo, Ji Soo Ha, Jae Won Jang
Neurospine 2023;20(1):92-98.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346144.072

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Biportal Endoscopic Posterior Cervical Foraminotomy for Adjacent 2-Level Foraminal Lesions Using a Single Approach (Sliding Technique)
Neurospine. 2023;20(1):92-98.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346144.072
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Biportal Endoscopic Posterior Cervical Foraminotomy for Adjacent 2-Level Foraminal Lesions Using a Single Approach (Sliding Technique)
Neurospine. 2023;20(1):92-98.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346144.072
Close
Objective
Endoscopic posterior cervical foraminotomy (PCF) using uniportal or biportal endoscopic approach has been performed for cervical foraminal stenosis or foraminal disc herniation. Two-level PCF is possible using a single biportal endoscopic approach. The purpose of this study was to present a technique of biportal endoscopic PCF for contiguous 2-level foraminal lesions using a single approach and its clinical results.
Methods
Patients who received 2-level PCF using a single biportal endoscopic approach were enrolled in this study. We analyzed their clinical data including age, sex, complications, and Neck Disability Index (NDI), and visual analogue scale (VAS) of neck and arm. Postoperative magnetic resonance image was taken on the first postoperative day to determine whether there was sufficient decompression.
Results
We successfully performed biportal endoscopic PCF for adjacent 2-level foraminal lesions using a single approach (sliding technique) in all 12 patients. There were cervical foraminal disc herniation with foraminal stenosis (5 cases) and 2-level foraminal stenosis (7 cases). Preoperative mean NDI and VAS of arm and neck significantly decreased at 12 months after surgery. Postoperative clinical outcomes were excellent in 5 patients, good in 6 patients, and fair in 1 patient. There was no major complication.
Conclusion
Two-level PCF could be performed using a single approach biportal endoscopic surgery with only 2 skin incisions. Clinical outcomes are favorable. This sliding PCF technique using biportal endoscopic approach might be an alternative surgical treatment for contiguous 2-level cervical foraminal pathologic lesions.

Citations

Citations to this article as recorded by  Crossref logo
  • Delta large-channel endoscopy versus unilateral biportal endoscopy for cervicothoracic junction disc herniation: a prospective randomized controlled trial
    Huaibin Wang, Hui Li, Rushuo Wei, Hao Yan, Ruzhan Yao, Weiqiang Liu, Ling Li
    Journal of Orthopaedic Surgery and Research.2026;[Epub]     CrossRef
  • Complications in Minimally Invasive Cervical Spine Surgery–Tubular, Uniportal, and Biportal Endoscopic Surgery (2013–2024)
    Noah Willett, Chibuikem A. Ikwuegbuenyi, Sean Inzerillo, Eesha Gurav, Mousa Hamad, Ibrahim Hussain, Alan Hernández-Hernández, Galal Elsayed, Osama Kashlan, Roger Härtl
    Spine.2026; 51(7): E175.     CrossRef
  • Técnica endoscópica interlaminar asistida por navegación para hernia discal C7-T1: abordaje mínimamente invasivo de la unión cervicotorácica. Reporte de caso
    José Carlos Sauri-Barraza, Eduardo Callejas-Ponce, Jorge Daniel Pérez-Ruiz, Luis Enrique Núñez-Alvarado, Luis Alfonso Castillejo-Adalid, Francisco García-Muñoz, Omar Castillejo-Adalid, Adrián Francisco Méndez-Delgado
    Cirugía de Columna.2026; 4(3): 252.     CrossRef
  • CLINICAL AND SURGICAL OUTCOMES OF POSTERIOR ENDOSCOPIC SURGERY ON THE CERVICAL SPINE IN THE TREATMENT OF CERVICAL PATHOLOGIES
    Lina Marcia de Araujo Herval, Kelsen de Oliveira Teixeira, Fernando Flores de Araújo, Edgar Takao Utino, Rangel Roberto de Assis, André Luis Rousselet Lafratta, Diogo Sales Archangel dos Santos, Jorge Luis Garcia Ferrabone, Victor da Silva Pereira, Wilson
    Coluna/Columna.2026;[Epub]     CrossRef
  • Clinical Efficacy and Complications of Spinal Surgery Unilateral Biportal Endoscopy for Cervical Spondylosis: A Systematic Review and Meta-Analysis
    Zhongjie Li, Wenming Zhou, Jian Liang, Qilong He, Yaohong He, Yugang Guo, Xin Zhang, Wende Zhuang, Li Huang, Qiqi Fan, Jinman Liu
    World Neurosurgery.2025; 194: 123386.     CrossRef
  • Transforaminal Endoscopic Thoracic Discectomy Is More Cost-Effective Than Microdiscectomy for Symptomatic Disc Herniations
    Junseok Bae, Pratyush Shahi, Sang-Ho Lee, Han-Joong Keum, Ju-Wan Seok, Yong-Soo Choi, Jin-Sung Kim
    Neurospine.2025; 22(1): 118.     CrossRef
  • The unilateral biportal endoscopy journey: proposing a 10-tier difficulty progression framework for unilateral biportal endoscopy
    Xavier Augusto Santander, Elsa González Pérez, Dae-Jung Choi
    Asian Spine Journal.2025; 19(2): 311.     CrossRef
  • The need for long-term studies to validate endoscopic surgery
    Ju Eun Kim
    Asian Spine Journal.2025; 19(2): I.     CrossRef
  • Assessment of Clinical and Radiologic Outcomes of Biportal Endoscopic Posterior Cervical Inclinatory Foraminotomy : A Retrospective Cohort Study
    Kwan-Su Song, Pius Kim
    Journal of Korean Neurosurgical Society.2025; 68(4): 446.     CrossRef
  • History of endoscopic spine surgery: where did it all begin? Development of indications and techniques
    Dong Hwa Heo, Hyeun Sung Kim, Yoon Ha Whang, Dong Chan Lee, Kangtaek Lim
    The Spine Journal.2025;[Epub]     CrossRef
  • Current role and future perspectives of endoscopic spine surgery: a narrative review
    Hyung-Rae Lee
    Journal of the Korean Medical Association.2025; 68(8): 528.     CrossRef
  • Single-Incision Posterior Endoscopic Cervical Foraminotomy for 2-Level Cervical Radiculopathy
    Florian Wanivenhaus, Christoph Johannes Laux, Sohrab Gollogly, Jin-Sung Kim, Mazda Farshad
    Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(2): 289.     CrossRef
  • Unilateral biportal endoscopic decompression for two-level adjacent lumbar spinal stenosis through a single sliding approach: technical report and early follow-up
    Shuang Xu, Heng Wu, Hao Liu, Junwei Xiang, Jin Yang, Chuanen Wang, Song Wang
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
  • Biportal endoscopic cervical open-door laminoplasty to treat cervical spondylotic myelopathy
    Ji Yeon Kim, Dong Hwa Heo
    Acta Neurochirurgica.2024;[Epub]     CrossRef
  • Endoscopic Posterior Approach for Cervical Myelopathy and Radiculopathy Using Tubular Retractor: Our Experience, Surgical Technique, and Literature Review
    Mukesh Sharma, Nishtha Yadav, Shailendra Ratre, Jitin Bajaj, Arvind Kavishwar, Ketan Hadaoo, Jayant Patidar, Mallika Sinha, Vijay Parihar, Narayan M. Swamy, Yad Ram Yadav
    World Neurosurgery.2024; 190: e622.     CrossRef
  • Posterior Biportal Endoscopic Discectomy for the Treatment of Central Cervical Disc Herniation: Technical Note and Preliminary Results
    Chengyue Zhu, Xiaoting Fu, Susu Sun, Jiaming Liang, Dong Wang, Rongxue Shao, Wei Cheng, Hao Pan, Wei Zhang
    World Neurosurgery.2024; 192: 25.     CrossRef
  • Complications in Minimally Invasive Spine Surgery in the Last 10 Years: A Narrative Review
    Blake I. Boadi, Chibuikem Anthony Ikwuegbuenyi, Sean Inzerillo, Gabrielle Dykhouse, Rachel Bratescu, Mazin Omer, Osama N. Kashlan, Galal Elsayed, Roger Härtl
    Neurospine.2024; 21(3): 770.     CrossRef
  • Clinical Outcomes and Complications of Unilateral Biportal Endoscopic Posterior Cervical Foraminotomy: A Systematic Review and Meta-Analysis With a Comparison to Full-Endoscopic Posterior Cervical Foraminotomy
    Sang Hyub Lee, Junghan Seo, Dain Jeong, Jin Seop Hwang, Jae-Won Jang, Yong Eun Cho, Dong-Geun Lee, Choon Keun Park
    Neurospine.2024; 21(3): 807.     CrossRef
  • New Paradigm of Endoscopic Spine Surgery: Unilateral Biportal Endoscopic Spinal Surgery
    Dong Hwa Heo, Jin Hwa Eum
    Journal of Minimally Invasive Spine Surgery and Technique.2024; 9(2): 81.     CrossRef
  • Comparison of Open Microscopic and Biportal Endoscopic Approaches in Multi-Level Posterior Cervical Foraminotomy: Radiological and Clinical Outcomes
    Hyung Rae Lee, Jae Min Park, In-Hee Kim, Jun-Hyun Kim, Jae-Hyuk Yang
    Journal of Clinical Medicine.2024; 14(1): 164.     CrossRef
  • Enhanced recovery after surgery pathway with modified biportal endoscopic transforaminal lumbar interbody fusion using a large cage. Comparative study with minimally invasive microscopic transforaminal lumbar interbody fusion
    Dong Hwa Heo, Jae Won Jang, Choon Keun Park
    European Spine Journal.2023; 32(8): 2853.     CrossRef
  • Overview and Prevention of Complications During Full-Endoscopic Cervical Spine Surgery
    Young-Rak Kim, Jun-Hoe Kim, Tae-Hwan Park, Hangeul Park, Sum Kim, Chang-Hyun Lee, Kyoung-Tae Kim, Chun Kee Chung, Chi Heon Kim
    Journal of Minimally Invasive Spine Surgery and Technique.2023; 8(2): 153.     CrossRef
  • 8,028 View
  • 318 Download
  • 22 Web of Science
  • 22 Crossref

NASS/Neurospine Endoscopic Spine Surgery Special Issue

The Use of Dual Direction Expandable Titanium Cage With Biportal Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Consideration With Preliminary Results
Don Young Park, Dong Hwa Heo
Neurospine 2023;20(1):110-118.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346116.058

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The Use of Dual Direction Expandable Titanium Cage With Biportal Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Consideration With Preliminary Results
Neurospine. 2023;20(1):110-118.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346116.058
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The Use of Dual Direction Expandable Titanium Cage With Biportal Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Consideration With Preliminary Results
Neurospine. 2023;20(1):110-118.   Published online March 31, 2023
DOI: https://doi.org/10.14245/ns.2346116.058
Close
Objective
Expandable cage technology has emerged for lumbar interbody fusion to restore intervertebral disc space height and alignment through a narrow surgical corridor. The purpose of this study is to present the technique of biportal endoscopic transforaminal lumbar interbody fusion (TLIF) using dual direction expandable cage and provide early clinical results.
Methods
We performed the biportal endoscopic TLIF using a dual direction expandable titanium cage for height restoration and a larger footprint in 10 patients. Clinical parameters including Oswestry Disability Index (ODI), visual analogue scale (VAS), and complications were retrospectively analyzed. Also, we investigated radiologic parameters using preoperative and postoperative x-ray images.
Results
We successfully inserted dual direction expandable cages during biportal endoscopic TLIF. There was no significant subsidence or collapse of the expandable cages during the 6-month follow-up period. Lumbar lordosis and disc height were significantly increased after surgery. ODI and VAS scores were significantly improved at 6 months after surgery.
Conclusion
In this report, we describe the first use of a dual direction expandable interbody TLIF cage that expands in both width and height in biportal endoscopic TLIF surgery. Early clinical and radiographic outcomes of this TLIF technique may be favorable in early 6-month follow-up.

Citations

Citations to this article as recorded by  Crossref logo
  • Evidence-Based Guidelines for the Surgical Management of Degenerative Lumbar Spondylolisthesis
    Harrison J. Howell, Nathan J. Winans, Dean Chou, Andrew K. Chan
    Neurosurgery Clinics of North America.2026; 37(1): 1.     CrossRef
  • Meta-Analysis of Complications in Minimally Invasive Spine Surgery (2013–2024)
    Sean Inzerillo, Eesha Gurav, Chibuikem A. Ikwuegbuenyi, Noah Willett, Mousa Hamad, Ibrahim Hussain, Alan Hernández-Hernández, Galal Elsayed, Roger Härtl, Osama Kashlan
    Spine.2026; 51(3): E47.     CrossRef
  • Sagittal Alignment and Clinical Outcomes After Biportal Endoscopic Transforaminal Lumbar Interbody Fusion Using a Single Expandable Cage: One Year Follow-up
    Sub-Ri Park, Namhoo Kim, Ji-Won Kwon, Kyung-Soo Suk, Hak-Sun Kim, Seong-Hwan Moon, Si-Young Park, Byung Ho Lee, Jae-Won Shin, Jin-Oh Park
    World Neurosurgery.2026; 205: 124698.     CrossRef
  • Clinical and radiologic outcomes of expandable versus static cages in biportal endoscopic TLIF: focus on endplate injury and subsidence
    Tae Hoon Kang, Geumho Lee, Byungjun Kang, Jeongwoon Han, Hyun-jin Park, Minjoon Cho, Jae Hyup Lee
    Journal of Orthopaedic Surgery and Research.2026;[Epub]     CrossRef
  • Posterior and Transforaminal Lumbar Interbody Fusion
    Arpan A. Patel, Shaarada Srivatsa, Mark A. Davison, Michael P. Steinmetz
    Neurosurgery Clinics of North America.2025; 36(1): 11.     CrossRef
  • An Analysis of the Complication Reports of Expandable Lumbar Interbody Cages in the Food and Drug Administration Manufacturer and User Facility Device Experience Database
    William ElNemer, Andrew Kim, Juan Silva-Aponte, Micheal Raad, Tej Azad, Wesley M. Durand, Hamid Hassanzadeh, Khaled Kebaish, Amit Jain
    Orthopedics.2025;[Epub]     CrossRef
  • Expandable interbody cages for lumbar spinal fusion: a systematic review
    Daniel Orr, Ron Anderson, Anna Jensen, Tyler Peterson, John Edwards, Anton E. Bowden
    The Spine Journal.2025; 25(8): 1773.     CrossRef
  • Safety and Utility of Bilateral-contralateral Decompression for Adjacent Segment Stenosis After Lumbar Interbody Fusion Using Unilateral Biportal Endoscopy
    Dong Hyun Lee, Choon Keun Park, Jae-Won Jang, Dong-Geun Lee
    Clinical Spine Surgery.2025; 38(10): E488.     CrossRef
  • Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion with an Expandable Cage for the Treatment of Degenerative Lumbar Spinal Stenosis with Instability
    Xiaokang Cheng, Qiaoling Chen, Bin Chen, Jiaguang Tang
    World Neurosurgery.2025; 197: 123876.     CrossRef
  • Novel Design of Expandable Spinal Cage for Efficient Lumbar Spine Fusion Operation
    Chanwoo Park, Than Trong Khanh Dat, Sung-Jun Park, Dong-Sik Chae, Sung Hoon Choi, Jonghun Yoon
    Applied Sciences.2025; 15(11): 6323.     CrossRef
  • History of endoscopic spine surgery: where did it all begin? Development of indications and techniques
    Dong Hwa Heo, Hyeun Sung Kim, Yoon Ha Whang, Dong Chan Lee, Kangtaek Lim
    The Spine Journal.2025;[Epub]     CrossRef
  • Advancements in biomaterials and bioactive solutions for lumbar spine fusion cages: Current trends and future perspectives
    Iulian Antoniac, Veronica Manescu (Paltanea), Gheorghe Paltanea, Aurora Antoniac, Marco Fosca, Dan Laptoiu, Julietta V. Rau
    Bioactive Materials.2025; 53: 656.     CrossRef
  • Clinical outcome and complications comparison between expandable and static cages in open TLIF surgery: A 2-year retrospective study
    Ta-Wei Lai, Po-Ming Chen, Chi-Huan Li, Cheng-Jung Chan, Po-Cheng Cheng, Chun-Hsien Huang, Li-Ching Kuo, Ming-Chou Ku
    Medicine.2025; 104(34): e44042.     CrossRef
  • Expandable Cage in Minimally Invasive Transforaminal Lumbar Interbody Fusion: Comparative Data with Static Cage from a Single Institution and a Single Surgeon
    Dongkyu Kim, Hyun Jun Jang, Bong Ju Moon, Kyung Hyun Kim, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim, Jeong Yoon Park
    World Neurosurgery.2025; 202: 124428.     CrossRef
  • Biportal Endoscopic Lumbar Interbody Fusion Using the Oblique Lumbar Interbody Fusion Cage: Technical Note and Case Illustration
    Tran Vu Hoang Duong, Phan Quang Son, Le Tan Bao, Luc Dinh Phuong, Phan Dinh Thanh
    Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(2): 303.     CrossRef
  • Comparative Clinical and Radiological Outcomes of Banana-Shaped Versus Straight Cages in Biportal Endoscopic Transforaminal Lumbar Interbody Fusion: A Retrospective Cohort Study
    Nguyen Ngoc Thoi, Nguyen Le Hoang Tuan, Le Tuong Vien, Nguyen Thanh Nhan, Hoang Nguyen Anh Tuan, Nguyen Van Thanh, Tran Nguyen Phuong, Bui Hong Thien Khanh
    Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(2): 172.     CrossRef
  • Novel Unilateral Biportal Endoscopy-Assisted Lumbar Fusion With Dual Hybrid Cage Insertion: A Technical Note With Case Presentation
    Jisoo Ha, Kuldeep Bansal, Chang-Wook Kim, Do-Hyoung Kim, Shreenidhi Kulkarni, Hee-Don Han
    Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(2): 230.     CrossRef
  • Improved Clinical and Radiological Outcomes with Double-Cage Biportal Endoscopic Transforaminal Lumbar Interbody Fusion: A Comparative CT-Based Study
    Yu-Hao Huang, Jwo-Luen Pao
    Diagnostics.2025; 15(20): 2652.     CrossRef
  • Therapeutic Approaches for Enhancing Spinal Fusion in Low Back Pain: A Review With a Focus on the Elderly
    Shuimu Chen, Zhen Li, Sebastian F. Bigdon, Sonja Häckel, Christoph E. Albers, Benjamin Gantenbein
    JOR SPINE.2025;[Epub]     CrossRef
  • A Comparison of 2 Cage Sizes in Biportal Endoscopic Transforaminal Lumbar Interbody Fusion
    Ju-Eun Kim, Hyunwoo Kim, Eugene J. Park, Daniel K. Park
    Clinical Spine Surgery.2024; 37(10): E464.     CrossRef
  • Expandable Cages for Lumbar Interbody Fusion: A Narrative Review
    Soo-Bin Lee, Jonghun Yoon, Sung-Jun Park, Dong-Sik Chae
    Journal of Clinical Medicine.2024; 13(10): 2889.     CrossRef
  • A novel endoscope-port unit for lumbar microendoscopic surgery: a single-center case series review
    Vicente de Paulo Martins Coelho Junior, Anthony M. Alvarado, Richard G. Fessler
    Neurosurgical Review.2024;[Epub]     CrossRef
  • New Paradigm of Endoscopic Spine Surgery: Unilateral Biportal Endoscopic Spinal Surgery
    Dong Hwa Heo, Jin Hwa Eum
    Journal of Minimally Invasive Spine Surgery and Technique.2024; 9(2): 81.     CrossRef
  • Comparative Outcomes of Biportal Endoscopic Decompression, Conventional Subtotal Laminectomy, and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Central Stenosis
    Mu Ha Lee, Hyun Jun Jang, Bong Ju Moon, Kyung Hyun Kim, Dong Kyu Chin, Keun Su Kim, Jeong-Yoon Park
    Neurospine.2024; 21(4): 1178.     CrossRef
  • Enhanced recovery after surgery pathway with modified biportal endoscopic transforaminal lumbar interbody fusion using a large cage. Comparative study with minimally invasive microscopic transforaminal lumbar interbody fusion
    Dong Hwa Heo, Jae Won Jang, Choon Keun Park
    European Spine Journal.2023; 32(8): 2853.     CrossRef
  • Utilization of Dual Expandable Cages in Lateral Lumbar Interbody Fusion Surgery
    Emmanuel Omosor, Brandon M Edelbach, Hammad Amer, Namath S Hussain
    Cureus.2023;[Epub]     CrossRef
  • The Endoscopic Lumbar Interbody Fusion: A Narrative Review, and Future Perspective
    Phattareeya Pholprajug, Vit Kotheeranurak, Yanting Liu, Jin-Sung Kim
    Neurospine.2023; 20(4): 1224.     CrossRef
  • 14,552 View
  • 295 Download
  • 31 Web of Science
  • 27 Crossref

Minimally Invasive Spinal Surgery SMISS-Neurospine Special Issue

Comparative Analysis With Modified Inclined Technique for Posterior Endoscopic Cervical Foraminotomy in Treating Cervical Osseous Foraminal Stenosis: Radiological and Midterm Clinical Outcomes
Ji Yeon Kim, Dong Hwa Heo, Dong Chan Lee, Tae Hyun Kim, Choon Keun Park
Neurospine 2022;19(3):603-615.   Published online September 30, 2022
DOI: https://doi.org/10.14245/ns.2244268.134

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Comparative Analysis With Modified Inclined Technique for Posterior Endoscopic Cervical Foraminotomy in Treating Cervical Osseous Foraminal Stenosis: Radiological and Midterm Clinical Outcomes
Neurospine. 2022;19(3):603-615.   Published online September 30, 2022
DOI: https://doi.org/10.14245/ns.2244268.134
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Comparative Analysis With Modified Inclined Technique for Posterior Endoscopic Cervical Foraminotomy in Treating Cervical Osseous Foraminal Stenosis: Radiological and Midterm Clinical Outcomes
Neurospine. 2022;19(3):603-615.   Published online September 30, 2022
DOI: https://doi.org/10.14245/ns.2244268.134
Close
Objective
We compared the midterm clinical and radiological outcomes between 2 types of full endoscopic posterior cervical foraminotomy, including conventional posterior endoscopic cervical foraminotomy (PECF) and modified inclined technique for PECF.
Methods
One of the 2 types of PECF surgery was performed for defined cervical foraminal stenosis. The foraminal expansion ratio and facet resection rate and foraminal stenosis grade were measured using magnetic resonance imaging. Visual analogue scale (VAS) scores for neck and arm pain, neck disability index, MacNab criteria, operation time, hospital stay, and complications, including postoperative dysesthesia, were assessed. Clinical and radiological parameters were compared between the 2 surgical groups.
Results
There were 49 and 46 patients in the PECF and modified-PECF groups, respectively. The modified-PECF group showed significantly higher expansion of distal foraminal diameter and foraminal height, and a lower facet resection rate compared to PECF group (in all, p < 0.001). The modified-PECF group displayed significantly lower VAS score for neck pain at 1 day and 1 week after surgery and lower arm pain VAS score after 6-month follow-up (p = 0.002, p = 0.001, p = 0.002, respectively).
Conclusion
Compared with the PECF, the modified inclined technique has radiologic benefits, including enhanced facet joint preservation, restoration of the natural course of nerve roots, and prevention of restenosis by expanding the superior articular process base, especially in grade 2 foraminal stenosis. Furthermore, the modified inclined technique significantly improved the postoperative VAS score for neck pain within the 1-week follow-up and that of arm pain after 6-month follow-up.

Citations

Citations to this article as recorded by  Crossref logo
  • Full-endoscopic posterior cervical foraminotomy: Case-series and technical nuances
    Sameer Nazeeruddin, Jean-Yves Fournier, Alexandre Simonin
    World Neurosurgery: X.2026; 29: 100559.     CrossRef
  • Clinical Outcomes and Future Directions of Endoscopic Cervical Spine Surgery: A Systematic Review With Narrative Insights
    Ryan Wang, Satheeshram Tamilselvan, Ji Soo Ha, Aditya Vedantam, Courtney Rory Goodwin, Nathan Evaniew, Uzondu F. Agochukwu, Konstantinos Margetis, Yoon Ha, Michael Fehlings, Jefferson R. Wilson, Ankit I. Mehta
    Global Spine Journal.2026;[Epub]     CrossRef
  • Algorithmic Approach to Combined Standard and Inclinatory Foraminotomy via Unilateral Biportal Endoscopy for Cervical Foraminal Stenosis Using Sagittal-Oblique Computed Tomography
    Malcolm Darayes Pestonji, Sharvari Rajendra Gunjotikar, Sucheta Tirpude, Kai-Uwe Lewandrowski
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Review and Technical Note

Technique of Biportal Endoscopic Transforaminal Lumbar Interbody Fusion
Dong Hwa Heo, Young Ho Hong, Dong Chan Lee, Hun Jae Chung, Choon Keun Park
Neurospine 2020;17(Suppl 1):S129-S137.   Published online July 31, 2020
DOI: https://doi.org/10.14245/ns.2040178.089

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Technique of Biportal Endoscopic Transforaminal Lumbar Interbody Fusion
Neurospine. 2020;17(Suppl 1):S129-S137.   Published online July 31, 2020
DOI: https://doi.org/10.14245/ns.2040178.089
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Technique of Biportal Endoscopic Transforaminal Lumbar Interbody Fusion
Neurospine. 2020;17(Suppl 1):S129-S137.   Published online July 31, 2020
DOI: https://doi.org/10.14245/ns.2040178.089
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Biportal endoscopic transforaminal lumbar interbody fusion (TLIF) may have advantages of minimally invasive fusion surgery as well as those of endoscopic surgery. The purpose of this study was to present the biportal endoscopic TLIF technique along with video presentations and a review of the literature on this technique. Basically, the biportal endoscopic TLIF technique is similar to minimally invasive TLIF with a tubular retractor. There were 2 options in the biportal endoscopic TLIF procedures. The first was the insertion of one long TLIF cage and the other was the insertion of 2 short posterior lumbar interbody fusion (PLIF) cages. After the interbody fusion procedures, percutaneous pedicles screw fixation was performed. Biportal endoscopic TLIF achieved complete neural decompression through laminectomy and facetectomy like conventional TLIF. Endplate preparation was performed completely under a clear and magnified endoscopic view. It was also feasible to insert a large TLIF cage or 2 cages for PLIF without exiting nerve root injury. Biportal endoscopic TLIF might have the advantages of endoscopic surgery as well as minimally invasive fusion surgery. Direct neural decompression, endplate preparation under endoscopic guidance, and the insertion of a large TLIF cage or 2 PLIF cages may be the merits of biportal endoscopic lumbar fusion procedures.

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Original Articles

Comparative Finite Element Analysis of Lumbar Cortical Screws and Pedicle Screws in Transforaminal and Posterior Lumbar Interbody Fusion
Dong Ah Sin, Dong Hwa Heo
Neurospine 2019;16(2):298-304.   Published online April 12, 2019
DOI: https://doi.org/10.14245/ns.1836030.015

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Comparative Finite Element Analysis of Lumbar Cortical Screws and Pedicle Screws in Transforaminal and Posterior Lumbar Interbody Fusion
Neurospine. 2019;16(2):298-304.   Published online April 12, 2019
DOI: https://doi.org/10.14245/ns.1836030.015
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Comparative Finite Element Analysis of Lumbar Cortical Screws and Pedicle Screws in Transforaminal and Posterior Lumbar Interbody Fusion
Neurospine. 2019;16(2):298-304.   Published online April 12, 2019
DOI: https://doi.org/10.14245/ns.1836030.015
Close
Objective
Lumbar cortical screw fixation (CSF), rather than pedicle screw fixation (PSF), has recently been attempted in lumbar interbody fusion. The purpose of our study was to evaluate the biomechanical stability of lumbar CSF using a finite element (FE) model.
Methods
A 3-FE model, including the L1 to S1 levels, was designed to evaluate and compare the biomechanical stability of lumbar CSF and PSF in single-level lumbar interbody fusion at L4–5. Cortical or pedicle screws were inserted bilaterally, and posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) were modeled at L4–5, respectively. We compared the stability of CSF to that of PSF in these 2 different anatomic variations of PLIF, as well as in TLIF.
Results
Lumbar CSF showed less stability than PSF in PLIF when the midline posterior ligaments were not preserved, but demonstrated similar stability when the ligaments were preserved. The range of motion (ROM) at the treated level in CSF was larger than that observed for PSF, in all PLIF and TLIF models. Furthermore, the ROM in the posterior ligament-sacrificing PLIF with CSF model was larger than the ROM in the posterior ligament-preserving PLIF with CSF or PSF model.
Conclusion
Based on our FE analysis, the stability of CSF is comparable to that of PSF in PLIF and TLIF when the midline posterior ligaments are preserved.

Citations

Citations to this article as recorded by  Crossref logo
  • Evaluation of the porosity and structural stability of 3D-printed porous titanium pedicle screws using finite element analysis
    Kwang Hyeon Kim, Junsu Bae, Kyeong-Joo Yoo, Seonghoon Jeong, Byung-Jou Lee
    Biomedical Engineering Letters.2026; 16(1): 55.     CrossRef
  • Clinical evaluation and finite element analysis of bone cement-augmented anterolateral screw fixation versus percutaneous bilateral pedicle screw fixation co-applied with oblique lumbar interbody fusion for single-level lumbar degenerative diseases with o
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    Frontiers in Bioengineering and Biotechnology.2025;[Epub]     CrossRef
  • Biomechanical effects of transforaminal endoscopic lumbar discectomy combined with spinal dynamic stabilization system use on adjacent segments: a finite element analysis
    Rongbin Chen, Yan Dou, Canjin Peng, Yihao Liang, Jianquan Chen, Shunping Li, Zhaotian Wu, Yong Li
    BMC Musculoskeletal Disorders.2025;[Epub]     CrossRef
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    Liu Yu-Hsin, Chen Chia-Hsien
    Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(Suppl 2): S210.     CrossRef
  • Biomechanics of Cage for Stand-alone Oblique Lumbar Interbody Fusion
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Endoscopic Treatment of Extraforaminal Entrapment of L5 Nerve Root (Far Out Syndrome) by Unilateral Biportal Endoscopic Approach: Technical Report and Preliminary Clinical Results
Dong Hwa Heo, Sagar Sharma, Choon Keun Park
Neurospine 2019;16(1):130-137.   Published online March 31, 2019
DOI: https://doi.org/10.14245/ns.1938026.013

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Endoscopic Treatment of Extraforaminal Entrapment of L5 Nerve Root (Far Out Syndrome) by Unilateral Biportal Endoscopic Approach: Technical Report and Preliminary Clinical Results
Neurospine. 2019;16(1):130-137.   Published online March 31, 2019
DOI: https://doi.org/10.14245/ns.1938026.013
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Endoscopic Treatment of Extraforaminal Entrapment of L5 Nerve Root (Far Out Syndrome) by Unilateral Biportal Endoscopic Approach: Technical Report and Preliminary Clinical Results
Neurospine. 2019;16(1):130-137.   Published online March 31, 2019
DOI: https://doi.org/10.14245/ns.1938026.013
Close
Objective
Far out syndrome is compression and entrapment of the L5 nerve root in the extraforaminal area between the hypertrophied L5 transverse process and the sacral ala. The purpose of this study was to describe the technique of unilateral biportal endoscopic decompression for far out syndrome and to analyze early clinical results after endoscopic decompression.
Methods
The authors consecutively performed operative treatments for 16 patients with unilateral extraforaminal entrapment of the L5 nerve root (far out syndrome) using percutaneous biportal endoscopies. We included only patients who were followed more than six months after surgery. Demographic characteristics, operative time, concomitant herniated disc, and surgical complications were investigated. Clinical outcomes were evaluated using modified MacNab criteria, the visual analogue scale (VAS) for legs, and the Oswestry Disability Index (ODI).
Results
Among 16 patients, a total of 14 cases with 4 males and 10 females were included in the study. The mean leg VAS and the ODI were significantly improved after unilateral biportal endoscopic surgery. Concomitant extraforaminal disc herniation was associated with a favorable outcome (p<0.05). Abdominal pain in the immediate postoperative period occurred in 2 patients. Abdominal pain was completely resolved with conservative management in both patients.
Conclusion
We were able to achieve successful decompression of unilateral extraforaminal entrapment of the L5 nerve root using unilateral biportal endoscopic surgery. A unilateral biportal endoscopic approach may be considered as an alternative surgical treatment for far out syndrome.

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    Dong Hwa Heo, Ji Soo Ha, Dong Chan Lee, Hyeun Sung Kim, Hoon Jae Chung
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    Chun-Jen Chang, You-Pen Chiu, Hui-Ru Ji, Chang-Hung Chu, Cheng-Di Chiu
    BMC Surgery.2022;[Epub]     CrossRef
  • Clinical Experiences of 3-Dimensional Biportal Endoscopic Spine Surgery for Lumbar Degenerative Disease
    Dong Hwa Heo, Ji Yeon Kim, Jeong-Yoon Park, Jin Sung Kim, Hyeun Sung Kim, Jeffrey Roh, Choon Keun Park, Hungtae Chung
    Operative Neurosurgery.2022; 22(4): 231.     CrossRef
  • Risk factors for hidden blood loss in unilateral biportal endoscopic lumbar spine surgery
    Sijia Guo, Haining Tan, Hai Meng, Xiang Li, Nan Su, Linjia Yu, Jisheng Lin, Ning An, Yong Yang, Qi Fei
    Frontiers in Surgery.2022;[Epub]     CrossRef
  • How I do it: biportal endoscopic paraspinal approach for recurrent lumbar disc herniation following percutaneous endoscopic lumbar discectomy
    Sung Cheol Park, Min-Seok Kang, Jae Hyuk Yang, Wonjik Ju
    Acta Neurochirurgica.2022; 164(11): 3057.     CrossRef
  • Full Endoscopic Decompression for a Misdiagnosed Far-Out Syndrome (L5/S1 Extraforaminal Stenosis) in an Elderly Patient with L5 Radiculopathy: Case Report
    Seung Jin Choi, Chang Hwa Ham, Hong Joo Moon, Joo Han Kim, Youn-Kwan Park, Woo-Keun Kwon
    Asian Journal of Pain.2022; 8: 1.     CrossRef
  • Indications, Contraindications, and Complications of Biportal Endoscopic Decompressive Surgery for the Treatment of Lumbar Stenosis: A Systematic Review
    Dong Hwa Heo, Don Young Park, Hyun Jin Hong, Young Ho Hong, Hungtae Chung
    World Neurosurgery.2022; 168: 411.     CrossRef
  • Dural Injury in Unilateral Biportal Endoscopic Spinal Surgery
    Han Gyu Lee, Moo Sung Kang, So Yeon Kim, Kwang Chun Cho, Young Cheol Na, Jin Mo Cho, Byung Ho Jin
    Global Spine Journal.2021; 11(6): 845.     CrossRef
  • Modified far lateral endoscopic transforaminal lumbar interbody fusion using a biportal endoscopic approach: technical report and preliminary results
    Dong Hwa Heo, Jin Hwa Eum, Jae Young Jo, Hungtae Chung
    Acta Neurochirurgica.2021; 163(4): 1205.     CrossRef
  • Biportal endoscopic unilateral laminotomy with bilateral decompression for the treatment of cervical spondylotic myelopathy
    Jiyeon Kim, Dong Hwa Heo, Dong Chan Lee, Hung Tae Chung
    Acta Neurochirurgica.2021; 163(9): 2537.     CrossRef
  • Contralateral sublaminar approach for decompression of the combined lateral recess, foraminal, and extraforaminal lesions using biportal endoscopy: a technical report
    Ji Yeon Kim, Dong Hwa Heo
    Acta Neurochirurgica.2021; 163(10): 2783.     CrossRef
  • Early results of full-endoscopic decompression of lumbar central canal stenosis by outside-in technique
    Hyeun-Sung Kim, Sagar B. Sharma, Harshavardhan D. Raorane, Kyeong-Rae Kim, Il-Tae Jang
    Medicine.2021; 100(39): e27356.     CrossRef
  • 3D MRI Models of the Musculoskeletal System
    Mohammad Samim
    Seminars in Musculoskeletal Radiology.2021; 25(03): 388.     CrossRef
  • Unilateral Biportal Endoscopy for Decompression of Extraforaminal Stenosis at the Lumbosacral Junction: Surgical Techniques and Clinical Outcomes
    Man-Kyu Park, Sang-Kyu Son, Weon Wook Park, Seung-Hyun Choi, Dae Young Jung, Dong Han Kim
    Neurospine.2021; 18(4): 871.     CrossRef
  • Commentary on “Unilateral Biportal Endoscopy for Decompression of Extraforaminal Stenosis at the Lumbosacral Junction: Surgical Techniques and Clinical Outcomes”
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  • Endoscopic Unilateral Laminotomy with Bilateral Discectomy Using Biportal Endoscopic Approach: Technical Report and Preliminary Clinical Results
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    World Neurosurgery.2020; 137: 31.     CrossRef
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    Dong Hwa Heo, Dong Keun Lee, Dong Chan Lee, Hyeun Sung Kim, Choon Keun Park
    Brain Sciences.2020; 10(6): 363.     CrossRef
  • Technique of Biportal Endoscopic Transforaminal Lumbar Interbody Fusion
    Dong Hwa Heo, Young Ho Hong, Dong Chan Lee, Hun Jae Chung, Choon Keun Park
    Neurospine.2020; 17(Suppl 1): S129.     CrossRef
  • A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery
    Pang Hung Wu, Hyeun Sung Kim, Il-Tae Jang
    Neurospine.2020; 17(Suppl 1): S20.     CrossRef
  • Current and Future of Endoscopic Spine Surgery: What are the Common Procedures we Have Now and What Lies Ahead?
    Hyeun Sung Kim, Pang Hung Wu, Il-Tae Jang
    World Neurosurgery.2020; 140: 642.     CrossRef
  • 14,412 View
  • 488 Download
  • 58 Web of Science
  • 64 Crossref

Clinical Article

Efficacy and Safety of Sodium Hyaluronate with 1,4-Butanediol Diglycidyl Ether Compared to Sodium Carboxymethylcellulose in Preventing Adhesion Formation after Lumbar Discectomy
Gyu Yeul Ji, Chang Hyun Oh, Byung Gwan Moon, Seong Yi, In Bo Han, Dong Hwa Heo, Ki-Tack Kim, Dong Ah Shin, Keung Nyun Kim
Korean J Spine 2015;12(2):41-47.   Published online June 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.2.41

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Efficacy and Safety of Sodium Hyaluronate with 1,4-Butanediol Diglycidyl Ether Compared to Sodium Carboxymethylcellulose in Preventing Adhesion Formation after Lumbar Discectomy
Korean J Spine. 2015;12(2):41-47.   Published online June 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.2.41
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Efficacy and Safety of Sodium Hyaluronate with 1,4-Butanediol Diglycidyl Ether Compared to Sodium Carboxymethylcellulose in Preventing Adhesion Formation after Lumbar Discectomy
Korean J Spine. 2015;12(2):41-47.   Published online June 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.2.41
Close
Objective

Epidural injection of hyaluronic acid may prevent adhesion formation after spine surgery, but the compounds used to stabilize hyaluronidase could interfere with its anti-adhesion effects. The present study was conducted as a clinical trial to evaluate the efficacy and safety of an experimental medical gel in preventing adhesion formation.

Methods

This study was designed as a multicenter, randomized, double-blind, and comparative controlled clinical trial with an observation period of 6 weeks. Subjects were randomly assigned into two groups: group A with sodium hyaluronate + 1,4-butanediol diglycidyl ether (BDDE) and group B with sodium hyaluronate + sodium carboxymethylcellulose (CMC). Visual analogue scale (VAS) of back and leg pain and the Oswestry disability index (ODI) and scar score ratings were assessed after surgery.

Results

Mean scar grade was 2.37±1.13 in group A and 2.75±0.97 in group B, a statistically significant difference (p=0.012). VAS of back and leg pain and ODI scores decreased significantly from baseline to 3 and 6 weeks postoperatively in both groups (p<0.001). However, VAS and ODI scores were not statistically different between groups A and B at baseline or at 3 and 6 weeks after operation (p>0.3). The number of adverse reactions related to the anti-adhesion gels was not statistically different (p=0.569), but subsequent analysis of nervous adverse reactions showed group B was superior with a statistically difference (p=0.027).

Conclusion

Sodium hyaluronate with BDDE demonstrated similar anti-adhesion properties to sodium hyaluronate with CMC. But, care should be used to nervous adverse reactions by using sodium hyaluronate with BDDE.

Citations

Citations to this article as recorded by  Crossref logo
  • Are We Overlooking Harms of BDDE-Cross-Linked Dermal Fillers? A Scoping Review
    Marta Wojtkiewicz, Albert Stachura, Bartłomiej Roszkowski, Natalia Winiarska, Karolina Kazimierska, Kamilla Stachura
    Aesthetic Plastic Surgery.2024; 48(23): 5147.     CrossRef
  • Evaluation of the optimal dose for maximizing the anti-adhesion performance of a self-degradable dextran-based material
    Woogi Hyon, Suong-Hyu Hyon, Kazuaki Matsumura
    Carbohydrate Polymer Technologies and Applications.2022; 4: 100255.     CrossRef
  • MORPHOLOGICAL PATTERNS OF DEVELOPMENT AND PREVENTION OF EXPERIMENTAL EPIDURAL FIBROSIS
    I.A. SHURYGINA, A.P. ZHIVOTENKO, O.A. GOLDBERG, V.A. SOROKOVIKOV
    AVICENNA BULLETIN.2022; 24(2): 176.     CrossRef
  • Therapeutic niche of hyaluronic acid derivatives in osteoarthritis
    I. G. Krasivina, L. N. Dolgova, N. V. Dolgov
    Meditsinskiy sovet = Medical Council.2021; (10): 123.     CrossRef
  • Using cross-linked hyaluronic acid gel to prevent postoperative lumbar epidural space adhesion: in vitro and in vivo studies
    Kun Wang, Xiao long Li, Jinbo Liu, Xiaoliang Sun, Huilin Yang, Xin Gao
    European Spine Journal.2020; 29(1): 129.     CrossRef
  • Antiadhesion effect of the C17 glycerin ester of isoprenoid-type lipid forming a nonlamellar liquid crystal
    Takahide Murakami, Ichiro Hijikuro, Kota Yamashita, Shigeru Tsunoda, Kenjiro Hirai, Takahisa Suzuki, Yoshiharu Sakai, Yasuhiko Tabata
    Acta Biomaterialia.2019; 84: 257.     CrossRef
  • Advances in biomaterials for preventing tissue adhesion
    Wei Wu, Ruoyu Cheng, José das Neves, Jincheng Tang, Junyuan Xiao, Qing Ni, Xinnong Liu, Guoqing Pan, Dechun Li, Wenguo Cui, Bruno Sarmento
    Journal of Controlled Release.2017; 261: 318.     CrossRef
  • Efficacy of hyaluronic acid and hydroxyethyl starch in preventing adhesion following endoscopic sinus surgery
    Su-Jong Kim, Jae-Min Shin, Eun Jung Lee, Il-Ho Park, Heung-Man Lee, Kyung-Su Kim
    European Archives of Oto-Rhino-Laryngology.2017; 274(10): 3643.     CrossRef
  • A glance at … dietary emulsifiers, the human intestinal mucus and microbiome, and dietary fiber
    Michael J. Glade, Michael M. Meguid
    Nutrition.2016; 32(5): 609.     CrossRef
  • Dual crosslinked hyaluronic acid nanofibrous membranes for prolonged prevention of post-surgical peritoneal adhesion
    Chialin Sheu, K. T. Shalumon, Chih-Hao Chen, Chang-Yi Kuo, Yi Teng Fong, Jyh-Ping Chen
    Journal of Materials Chemistry B.2016; 4(41): 6680.     CrossRef
  • 11,939 View
  • 156 Download
  • 10 Crossref

Original Article

Pedicle Screw-based Dynamic Stabilization with a Hinged Screw Head System in the Treatment of Lumbar Degenerative Disorders.
Jin Seo Yang, Dong Hwa Heo, Suk Hyung Kang, Yong Jun Cho
Korean J Spine 2011;8(2):102-105.
DOI: https://doi.org/10.14245/kjs.2011.8.2.102

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Pedicle Screw-based Dynamic Stabilization with a Hinged Screw Head System in the Treatment of Lumbar Degenerative Disorders.
Korean J Spine. 2011;8(2):102-105.
DOI: https://doi.org/10.14245/kjs.2011.8.2.102
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Pedicle Screw-based Dynamic Stabilization with a Hinged Screw Head System in the Treatment of Lumbar Degenerative Disorders.
Korean J Spine. 2011;8(2):102-105.
DOI: https://doi.org/10.14245/kjs.2011.8.2.102
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OBJECTIVE
Lumbar dynamic stabilization systems have been developed for the treatment of lumbar degenerative diseases. However, the clinical results of dynamic stabilization systems are still not well established. The purpose of this study is to assess the clinical and radiologic outcomes of lumbar dynamic stabilization using a hinged screw head system(Cosmic(R)).
METHODS
Eighteen patients were followed for more than 1 year after dynamic stabilization with the Cosmic system. The following parameters were reviewed: age, sex, visual analog scale (VAS) for the leg and back, the Oswestry Disability Index (ODI), complications related to the operation, range of motion (ROM) of the adjacent segments, implantation segment and the whole lumbar spine. We compared the preoperative ODI, VAS, and ROM of the adjacent segments, implantation segment and the whole lumbar spine with the 1-year postoperative follow-up results.
RESULTS
The mean preoperative ODI and VAS scores were significantly decreased after the operation (p<0.05). ROM at both the cranial and caudal adjacent segments did not change significantly postoperatively (p>0.05). The mean preoperative ROM of the implantation segment was decreased postoperatively. However, the mean ROM of the whole lumbar spine did not change significantly postoperatively (p>0.05).
CONCLUSION
According to our preliminary results, lumbar dynamic stabilization using a hinged screw head system did not influence adjacent segment motion, and had improved clinical outcomes for a 1-year postoperative follow-up period.

Citations

Citations to this article as recorded by  Crossref logo
  • Biomechanical comparisons of dynamic fixators with rod-rod and screw-spacer joints on lumbar hybrid fixation
    Yu-Kun Xu, Pei-Wei Weng, Shih-Hao Chen, Shang-Chih Lin
    Clinical Biomechanics.2023; 104: 105943.     CrossRef
  • Kinematic and Mechanical Comparisons of Lumbar Hybrid Fixation Using Dynesys and Cosmic Systems
    Chen-Ying Chien, Yi-Jie Kuo, Shang-Chih Lin, Wen-Hsien Chuang, Yuan-Ping Luh
    Spine.2014; 39(15): E878.     CrossRef
  • 5,366 View
  • 26 Download
  • 2 Crossref

Case Report

Motion Preserving Surgery in Two Cases of Brown-Sequard Syndrome Caused by Herniated Cervical Discs.
Jin Suh Yang, Dong Hwa Heo, Sung Min Cho, Yong Jun Cho
Korean J Spine 2011;8(1):52-54.
DOI: https://doi.org/10.14245/kjs.2011.8.1.52

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Motion Preserving Surgery in Two Cases of Brown-Sequard Syndrome Caused by Herniated Cervical Discs.
Korean J Spine. 2011;8(1):52-54.
DOI: https://doi.org/10.14245/kjs.2011.8.1.52
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Motion Preserving Surgery in Two Cases of Brown-Sequard Syndrome Caused by Herniated Cervical Discs.
Korean J Spine. 2011;8(1):52-54.
DOI: https://doi.org/10.14245/kjs.2011.8.1.52
Close
We described two cases of Brown-Sequard syndrome caused by cervical disc herniation that were treated by cervical artificial disc replacement. Two patients presented Brown-Sequard syndrome. Computed tomography scanning and magnetic resonance imaging showed a massive soft disc herniation compressing the spinal cord. We performed a total discectomy to remove the ruptured disc particle and replace it with an artificial disc. The neurologic symptoms of two patients were resolved after the surgery. We suggest that cervical arthroplasty can also be used to treat more severe forms of cervical myelopathy such as Brown-Sequard syndrome.
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  • 22 Download
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