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Commentarys

Clinical Study – Epidemiology

Optimizing Diagnostic Yield: Evidence Against Universal Computed Tomography Angiography for Traumatic Vertebral Artery Injury Screening – A Commentary on “Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Trauma Center”
Jae Taek Hong
Neurospine 2025;22(4):916-917.   Published online December 31, 2025
DOI: https://doi.org/10.14245/ns.2551774.887

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Optimizing Diagnostic Yield: Evidence Against Universal Computed Tomography Angiography for Traumatic Vertebral Artery Injury Screening – A Commentary on “Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Trauma Center”
Neurospine. 2025;22(4):916-917.   Published online December 31, 2025
DOI: https://doi.org/10.14245/ns.2551774.887
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Optimizing Diagnostic Yield: Evidence Against Universal Computed Tomography Angiography for Traumatic Vertebral Artery Injury Screening – A Commentary on “Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Trauma Center”
Neurospine. 2025;22(4):916-917.   Published online December 31, 2025
DOI: https://doi.org/10.14245/ns.2551774.887
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Citations

Citations to this article as recorded by  Crossref logo
  • The Role of Indocyanine Green Videoangiography in Intramedullary Spinal Cord Tumor Surgery: Focus on Lesion Localization Accuracy
    Jungbo SIM, Chang-Hyun LEE, Ayoung YOO, Yunhee CHOI, Woojin KIM, Hosung MYEONG, Hangeul PARK, Jun-Hoe KIM, Chi Heon KIM, Chun Kee CHUNG
    Neurologia medico-chirurgica.2026; 66(7): 426.     CrossRef
  • 1,258 View
  • 21 Download
  • 1 Web of Science
  • 1 Crossref

Deformity

Surgical Strategy for Cervical OPLL with Kyphosis: Balancing Anterior, Posterior, and Combined Approaches – A Commentary on “Long-term Outcomes of Multilevel Anterior Cervical Osteotomy and Posterior Instrumentation for OPLL-Induced Myelopathy With Cervical Kyphosis”
Jae Taek Hong
Neurospine 2025;22(3):631-633.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2551334.667

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Surgical Strategy for Cervical OPLL with Kyphosis: Balancing Anterior, Posterior, and Combined Approaches – A Commentary on “Long-term Outcomes of Multilevel Anterior Cervical Osteotomy and Posterior Instrumentation for OPLL-Induced Myelopathy With Cervical Kyphosis”
Neurospine. 2025;22(3):631-633.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2551334.667
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Surgical Strategy for Cervical OPLL with Kyphosis: Balancing Anterior, Posterior, and Combined Approaches – A Commentary on “Long-term Outcomes of Multilevel Anterior Cervical Osteotomy and Posterior Instrumentation for OPLL-Induced Myelopathy With Cervical Kyphosis”
Neurospine. 2025;22(3):631-633.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2551334.667
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  • 1,954 View
  • 40 Download

Original Articles

Prognostic Factors in Craniocervical Realignment for Craniovertebral Junction Kyphosis With Negative Cervical Imbalance: A Comprehensive Study
Dong Hun Kim, Jae Taek Hong, Jin Young Kim, Kang Bin Koo, Dae Hee Lee, Jung Woo Hur, Ho Jin Lee, Il Sup Kim
Neurospine 2025;22(3):725-736.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550990.495

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Prognostic Factors in Craniocervical Realignment for Craniovertebral Junction Kyphosis With Negative Cervical Imbalance: A Comprehensive Study
Neurospine. 2025;22(3):725-736.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550990.495
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Prognostic Factors in Craniocervical Realignment for Craniovertebral Junction Kyphosis With Negative Cervical Imbalance: A Comprehensive Study
Neurospine. 2025;22(3):725-736.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550990.495
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Objective
To elucidate the clinical outcomes of craniocervical realignment surgery in patients with craniovertebral junction (CVJ) kyphosis accompanied by negative sagittal imbalance, and to identify radiological predictors associated with favorable outcomes.
Methods
A retrospective analysis was performed on 28 patients who underwent craniocervical realignment between 2014 and 2022 for CVJ kyphosis with accompanying negative sagittal imbalance. Clinical outcomes were evaluated using the Neck Disability Index (NDI), visual analogue scale for neck pain, and the Japanese Orthopaedic Association (JOA) score. Radiographic parameters included the C0–2 angle and the C2–7 sagittal vertical axis (SVA). Favorable outcomes were defined as an improvement of more than 20 points in the NDI and a JOA recovery rate exceeding 50%. Multiple linear regression and receiver operating characteristic (ROC) curve analyses were conducted to identify independent predictors and to determine optimal threshold values.
Results
Significant improvements in both clinical outcomes and radiographic alignment were observed in association with craniocervical realignment surgery. Patients who achieved favorable outcomes exhibited greater postoperative changes in the C0–2 angle and the C2–7 SVA. Multivariate analysis identified changesm in the C0–2 angle (p=0.019) and C2–7 SVA (p=0.010) as independent predictors of NDI improvement, while age (p=0.033) and C2–7 SVA change (p=0.037) were independently associated with the JOA recovery rate. ROC curve analysis determined optimal cutoff values of ≥10.65° for C0–2 angle change and ≥19.2 mm for C2–7 SVA change, with corresponding area under the curve values of 0.872 and 0.802, respectively.
Conclusion
Craniocervical realignment appears to be a viable surgical option for patients with CVJ kyphosis and negative sagittal imbalance. Postoperative changes in C0–2 angle and C2–7 SVA were found to be associated with favorable clinical and functional outcomes, suggesting their potential role as prognostic factors.

Citations

Citations to this article as recorded by  Crossref logo
  • Predictive value of C0–C2 and C1–C2 angles for postoperative lower cervical alignment following posterior atlantoaxial fixation and fusion: a retrospective single-center study
    Beiping OuYang, Hongyan Sun, Kaiwei Zhang, Li Zhang
    European Spine Journal.2026;[Epub]     CrossRef
  • 2,375 View
  • 64 Download
  • 2 Web of Science
  • 1 Crossref

Cervical Spine

Retro-Odontoid Pseudotumor in Atlantoaxial Instability: Insights Into Presence, Subtypes, and Postoperative Regression
Dong Hun Kim, Jung Woo Hur, Il Sup Kim, Ho Jin Lee, Jee Yong Kim, Jung Jae Lee, Jong Bum Lee, Jae Taek Hong
Neurospine 2025;22(3):784-793.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550312.156

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Retro-Odontoid Pseudotumor in Atlantoaxial Instability: Insights Into Presence, Subtypes, and Postoperative Regression
Neurospine. 2025;22(3):784-793.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550312.156
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Retro-Odontoid Pseudotumor in Atlantoaxial Instability: Insights Into Presence, Subtypes, and Postoperative Regression
Neurospine. 2025;22(3):784-793.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550312.156
Close
Objective
Retro-odontoid pseudotumor (ROP) is a nonneoplastic mass associated with atlantoaxial instability (AAI). This study compared ROP-positive and ROP-negative AAI patients and evaluated cystic versus granulation-type ROP regarding regression patterns and surgical outcomes.
Methods
We retrospectively analyzed 112 AAI patients who underwent pre- and postoperative imaging and clinical evaluations. Patients were classified as ROP-positive or ROP-negative, with ROP-positive cases further categorized as cystic or granulation-type. Imaging parameters—including atlantodental interval (ADI), ΔADI, and cervical range of motion (ROM) were compared along with regression time and postoperative outcomes.
Results
Among 112 patients, 57 (50.9%) had ROP. The ROP-positive group was older (67.37±13.13 years vs. 56.90±15.15 years, p<0.001) and had lower ADI (5.63±2.77 mm vs. 6.99±2.33 mm, p=0.034), ΔADI (3.01±2.27 mm vs. 3.89±2.07 mm, p=0.006), and C2–7 ROM (30.78°±15.45° vs. 41.73°±16.58°, p<0.001). In ROP subgroups, the cystic group had greater C1–2 ROM (15.69°±6.34° vs. 10.00°±7.72°, p=0.013) and ADI (6.98±2.68 mm vs. 5.14±2.66 mm, p=0.042). Immediate postoperative ROP thickness remained greater in the cystic group (6.85±2.49 vs. 5.21±1.82 mm, p=0.042), while ROP thickness at 3 months and 1 year showed no significant differences. JOA recovery rates were similar.
Conclusion
This study demonstrates that ROP-positive AAI patients exhibit distinct radiological characteristics, with reduced cervical mobility. Furthermore, cystic ROP shows delayed regression following posterior fusion. These findings underscore the importance of ROP subtypes in surgical planning, requiring closer monitoring and possibly earlier intervention.
  • 5,365 View
  • 91 Download
Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine
Dong Hun Kim, Jae Taek Hong, Jung Woo Hur, Il Sup Kim, Ho Jin Lee, Jong Beom Lee
Neurospine 2024;21(2):565-574.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2347270.635

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Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine
Neurospine. 2024;21(2):565-574.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2347270.635
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Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine
Neurospine. 2024;21(2):565-574.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2347270.635
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Objective
To evaluate C2 muscle preservation effect and the radiological and clinical outcomes after C2 recapping laminoplasty.
Methods
Fourteen consecutive patients who underwent C2 recapping laminoplasty around C1–2 level were enrolled. To evaluate muscle preservation effect, the authors conducted a morphological measurement of extensor muscles between the operated and nonoperated side. Two surgeons measured the cross-sectional area (CSA) of obliquus capitis inferior (OCI) and semispinalis cervicis (SSC) muscle before and after surgery to determine atrophy rates (ARs). Additionally, we examined range of motion (ROM), sagittal vertical axis (SVA), neck visual analogue scale (VAS), Neck Disability Index (NDI), and Japanese Orthopaedic Association (JOA) score to assess potential changes in alignment and consequent clinical outcomes following posterior cervical surgery.
Results
We measured the CSA of OCI and SSC before surgery, and at 6 and 12 months postoperatively. Based on these measurements, the AR of the nonoperated SSC was 0.1% ± 8.5%, the AR of the operated OCI was 2.0% ± 7.2%, and the AR of the nonoperated OCI was -0.7% ± 5.1% at the 12 months after surgery. However, the AR of the operated side’s SSC was 11.2% ± 12.5%, which is a relatively higher value than other measurements. Despite the atrophic change of SSC on the operated side, there were no prominent changes observed in SVA, C0–2 ROM, and C2–7 ROM between preoperative and 12 months postoperative measurements, which were 11.8 ± 10.9 mm, 16.3° ± 5.9°, and 48.7° ± 7.7° preoperatively, and 14.1 ± 11.6 mm, 16.1° ± 7.2°, and 44.0° ± 10.3° at 12 months postoperative, respectively. Improvement was also noted in VAS, NDI, and JOA scores after surgery with JOA recovery rate of 77.3% ± 29.6%.
Conclusion
C2 recapping laminoplasty could be a useful tool for addressing pathologies around the upper cervical spine, potentially mitigating muscle atrophy and reducing postoperative neck pain, while maintaining sagittal alignment and ROM.

Citations

Citations to this article as recorded by  Crossref logo
  • The Craniopharyngioma Quality of Life (C-QOL) Index: a preliminary disease-specific, patient-centered tool for assessing patient reported outcomes in adult craniopharyngioma patients
    Saket Myneni, Shaan Bhandarkar, Hanan Akbari, Raquel Mayne, A. Karim Ahmed, Foad Kazemi, João Paulo Almeida, Anand V. Germanwala, Andrew S. Venteicher, Nathan T. Zwagerman, Eric W. Wang, Garret Choby, Erin L. McKean, Carl H. Snyderman, Nicholas R. Rowan,
    Journal of Neuro-Oncology.2026;[Epub]     CrossRef
  • Comparison of Two Posterior Minimally Invasive Approaches for Odontoid Fractures: Midline Nuchal Ligament Approach vs. Paramedian Muscle‐Splitting Approach
    Youcai Qiu, Liang Wang, Yijin Wang, Yang Li, Xuhua Lu
    Orthopaedic Surgery.2026; 18(1): 74.     CrossRef
  • Techniques for Cervical Laminoplasty
    Newton Cho, Ankit I. Mehta, Aditya Vedantam, C. Rory Goodwin, Uzondu F. Agochukwu, Lukas Grassner, Aria Nouri, Bizhan Aarabi, Jefferson R. Wilson, Nathan Evaniew
    Global Spine Journal.2026;[Epub]     CrossRef
  • C2-Involving Cervical Ossification of the Posterior Longitudinal Ligament (OPLL): Dome-like Laminoplasty Versus 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, Joongkyum Shin, Yoon Ha
    Global Spine Journal.2026;[Epub]     CrossRef
  • The skull base chordoma patient reported outcome survey (sbCPROS): a patient-centered, disease-specific tool for assessing quality of life in chordoma patients
    Saket Myneni, Linda Tang, Hanan Akbari, Raquel Mayne, A. Karim Ahmed, Foad Kazemi, Nicolas Dea, Nathan T. Zwagerman, Shirley Y. Su, Garret Choby, Eric W. Wang, Kristin J. Redmond, Erin L. McKean, Carl H. Snyderman, Nicholas R. Rowan, Debraj Mukherjee
    Journal of Neuro-Oncology.2025; 173(1): 157.     CrossRef
  • The Spinal Chordoma Patient Reported Outcome Survey (spCPROS): a patient-centered, disease-specific tool for assessing quality of life in spinal chordoma patients
    Saket Myneni, Linda Tang, Hanan Akbari, Raquel Mayne, Foad Kazemi, Ruiwen Xiong, Kristin J. Redmond, Mark H. Bilsky, Raphaële Charest-Morin, Daniel G. Tobert, Vikram Chakravarthy, Ganesh M. Shankar, Sheng-Fu L. Lo, John H. Shin, Jean-Paul Wolinsky, Daniel
    Journal of Neuro-Oncology.2025; 175(2): 813.     CrossRef
  • 7,130 View
  • 143 Download
  • 7 Web of Science
  • 6 Crossref

Bone Biology and Osteoporosis Special Issue

Screw Insertional Torque Measurement in Spine Surgery: Correlation With Bone Mineral Density and Hounsfield Unit
Byeong Ho Oh, Jee Yong Kim, Jong Beom Lee, Jae Taek Hong, Jae Hoon Sung, Khoi D. Than, Ho Jin Lee, Il Sup Kim
Neurospine 2023;20(4):1177-1185.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346830.415

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Screw Insertional Torque Measurement in Spine Surgery: Correlation With Bone Mineral Density and Hounsfield Unit
Neurospine. 2023;20(4):1177-1185.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346830.415
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Screw Insertional Torque Measurement in Spine Surgery: Correlation With Bone Mineral Density and Hounsfield Unit
Neurospine. 2023;20(4):1177-1185.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346830.415
Close
Objective
Achieving successful fusion during spine surgery is dependent on rigid pedicle screw fixation. To assess fixation strength, the insertional torque can be measured during intraoperative screw fixation. This study aimed to explore the technical feasibility of measuring the insertional torque of a pedicle screw, while investigating its relationship with bone density.
Methods
Thoraco-lumbar screw fixation fusion surgery was performed on 53 patients (mean age, 65.5 ± 9.8 years). The insertional torque of 284 screws was measured at the point passing through the pedicle using a calibrated torque wrench, with a specially designed connector to the spine screw system. The Hounsfield units (HU) value was determined by assessing the trabecular portion of the index vertebral body on sagittal computed tomography images. We analyzed the relationship between the measured insertional torque and the following bone strength parameters: bone mineral density (BMD) and HU of the vertebral body.
Results
The mean insertion torque was 105.55 ± 58.08 N∙cm and T-score value (BMD) was -1.14 ± 1.49. Mean HU value was 136.37 ± 57.59. Screw insertion torque was positively correlated with BMD and HU in whole patients. However, in cases of osteopenia, all variables showed very weak correlations with insertional torque. In patients with osteoporosis, there was no statistically significant correlation between BMD and torque strength; HU showed a significant correlation.
Conclusion
The insertional torque of screw fixation significantly correlated with bone density (BMD and HU). HU measurements showed greater clinical significance than did BMD values in patients with osteoporosis.

Citations

Citations to this article as recorded by  Crossref logo
  • Femoral Bone Mineral Density Shows Stronger Correlation With Pedicle Screw Insertional Torque than Lumbar Bone Mineral Density or Hounsfield Units: A Retrospective in Vivo Study
    Yoji Ogura, Taisei Kato, Yuichiro Nishiyama, Keisuke Otsuka, Kenta Fujimura, Arya Varthi, Yoshihisa Suzuki
    Global Spine Journal.2026;[Epub]     CrossRef
  • 3D printing enabled biomechanical evaluation of a novel expandable wedge spacer for atlantoaxial reduction
    Chih-Chang Chang, Shao-Fu Huang, Rong-Chen Lin, Chun-Li Lin
    3D Printing in Medicine.2026;[Epub]     CrossRef
  • Pre-Operative Bone Health in Elective Spine Surgery, From Risk Assessment to Optimization Strategies: A Narrative Review
    Mitchell K. Ng, Morgan Hitchner, Jonathan Dalton, Yulia Lee, William A. Green, Gregorio Baek, Joshua Mathew, Yasmine K. Eichbaum, Alan S. Hilibrand, Alexander R. Vaccaro, Gregory D. Schroeder, Christopher K. Kepler
    Global Spine Journal.2026;[Epub]     CrossRef
  • Response to Letter to the Editor for “Femoral Bone Mineral Density Shows Stronger Correlation With Pedicle Screw Insertional Torque than Lumbar Bone Mineral Density or Hounsfield Units: A Retrospective in Vivo Study”
    Yoji Ogura
    Global Spine Journal.2026;[Epub]     CrossRef
  • A clinically applicable energy-based approach for evaluating bone strength
    Qiushi Bai, Jiahao Li, Chi Ma, Gengyu Cao, Yuanyi Wang, Da He, Sheng Lu, Qiang Yang, Yongchang Gao, Jingjing Tian, Kun Cheng, Yu Zhao
    Bone & Joint Research.2026; 15(5): 437.     CrossRef
  • Design and Additive Manufacturing of a Rod Holding and Placement Instrument for Spinal Rehabilitative Surgery
    Motaz Hassan, Amanpreet Singh Wasir, Sumeer Lal, Ajay Mahajan
    Journal of Medical Devices.2026;[Epub]     CrossRef
  • Influence of Lateral Perforation on the Biomechanical Stability of Thoracic Pedicle Screws
    Benno Bullert, Viktor Gupta, Mareike Schonhoff, Sebastian Jaeger, J. Philippe Kretzer, Paul A. Gruetzner, Sven Y. Vetter, Jula Gierse
    Global Spine Journal.2026;[Epub]     CrossRef
  • The Correlation Analysis Between the Pedicle Screw Placement Palpation and Torque
    Dongping Wang, Jiamin Yang, Haishan Li, Wei Lin, Shenglin Lei, Yuxian Chen, Yawen You, Chang Liu, Yongxian Li, Yuewei Lin, Huizhi Guo, Guoye Mo, Yongchao Tang, Kai Yuan, Bin Mai, Zhen Zhang, Shuncong Zhang
    World Neurosurgery.2025; 194: 123439.     CrossRef
  • Visuohaptic Feedback in Robotic-Assisted Spine Surgery for Pedicle Screw Placement
    Giuseppe Loggia, Fedan Avrumova, Darren R. Lebl
    Journal of Clinical Medicine.2025; 14(11): 3804.     CrossRef
  • Ageing and BMI in Focus: Rethinking Risk Assessment for Vertebral Fragility and Pedicle Screw Loosening in Older Adults
    Jun Li, André Strahl, Beate Kunze, Stefan Krebs, Martin Stangenberg, Lennart Viezens, Patrick Strube, Marc Dreimann
    Journal of Clinical Medicine.2025; 14(15): 5296.     CrossRef
  • Comparative analysis of 3D CT values for different lumbar pedicle screw trajectories
    Yuanpeng Yue, Ce Dong, Anhang Zhang, Zhenyu Wang
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
  • Long Fiber Type Carbon Fiber Reinforced Plastic Pedicle Screws Exhibit High Strength, Comparable to Titanium-Alloy Screws, and Are Resistant to Loosening
    Kohei Morita, Hiroki Ohashi, Kenji Tsuchida, Yasuhiro Furuta, Satoshi Tani, Kostadin Karagiozov, Yuichi Murayama
    Neurospine.2025; 22(3): 774.     CrossRef
  • Analysis of the performance of different screws in the presence of bone density variability
    Zhirui Lu, Zhongshu Shan, Shuangshuang Ma, Wenxu Xu, Zhibin Liu, Dedong Gao
    Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine.2025; 239(11-12): 1121.     CrossRef
  • Does Resistance Indicate Malposition? A Standardized Comparison of Pedicle Screw Placement
    Sascha Kurz, Benjamin Fischer, Janine Schultze, Florian Metzner, Toni Wendler, Christoph-Eckhard Heyde, Stefan Schleifenbaum
    Bioengineering.2025; 12(11): 1254.     CrossRef
  • 7,682 View
  • 346 Download
  • 14 Web of Science
  • 14 Crossref

Editorial

CSRS Special Issue

Evaluation of Cervicomedullary Compression Around the Craniovertebral Junction: Commentary on “Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy”
Jae Taek Hong
Neurospine 2022;19(4):896-898.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2245048.524

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Evaluation of Cervicomedullary Compression Around the Craniovertebral Junction: Commentary on “Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy”
Neurospine. 2022;19(4):896-898.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2245048.524
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Evaluation of Cervicomedullary Compression Around the Craniovertebral Junction: Commentary on “Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy”
Neurospine. 2022;19(4):896-898.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2245048.524
Close

Citations

Citations to this article as recorded by  Crossref logo
  • Occipitocervical surgery rescue: The “Catcher’s Mitt” technique
    Samuel Adida, Roberta K. Sefcik, Ricardo J. Fernández de-Thomas, Ananya Sen, Edward G. Andrews, Nitin Agarwal, Paul A. Gardner, D. Kojo Hamilton
    Journal of Craniovertebral Junction and Spine.2025; 16(2): 254.     CrossRef
  • Prognostic Factors in Craniocervical Realignment for Craniovertebral Junction Kyphosis With Negative Cervical Imbalance: A Comprehensive Study
    Dong Hun Kim, Jae Taek Hong, Jin Young Kim, Kang Bin Koo, Dae Hee Lee, Jung Woo Hur, Ho Jin Lee, Il Sup Kim
    Neurospine.2025; 22(3): 725.     CrossRef
  • 5,613 View
  • 145 Download
  • 2 Web of Science
  • 2 Crossref

Original Articles

Regular Issue

Surgical Versus Conservative Management for Treating Unstable Atlas Fractures: A Multicenter Study
Jun Jae Shin, Kwang-Ryeol Kim, Joongkyum Shin, Jiin Kang, Ho Jin Lee, Tae Woo Kim, Jae Taek Hong, Sang-Woo Kim, Yoon Ha
Neurospine 2022;19(4):1013-1025.   Published online October 23, 2022
DOI: https://doi.org/10.14245/ns.2244352.176

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Surgical Versus Conservative Management for Treating Unstable Atlas Fractures: A Multicenter Study
Neurospine. 2022;19(4):1013-1025.   Published online October 23, 2022
DOI: https://doi.org/10.14245/ns.2244352.176
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Surgical Versus Conservative Management for Treating Unstable Atlas Fractures: A Multicenter Study
Neurospine. 2022;19(4):1013-1025.   Published online October 23, 2022
DOI: https://doi.org/10.14245/ns.2244352.176
Close
Objective
This multicenter study compared radiological parameters and clinical outcomes between surgical and nonsurgical management and investigated treatment characteristics associated with the successful management of unstable atlas fractures.
Methods
We retrospectively evaluated 53 consecutive patients with unstable atlas fracture who underwent halo-vest immobilization (HVI) or surgical fixation. Clinical outcomes were assessed using neck visual analogue scale and disability index. The radiological assessment included total lateral mass displacement (LMD) and the anterior atlantodental interval (AADI).
Results
Thirty-two patients underwent surgical fixation and 21 received HVI (mean follow-up, 24.9 months). In the surgical fixation, but not in the HVI, LMD, and AADI showed statistically significant improvements at the last follow-up. The osseous healing rate and time-to-healing were 100% and 14.3 weeks with surgical fixation, compared with 71.43% and 20.0 weeks with HVI, respectively. Patients treated with HVI showed poorer neck pain and neck disability outcomes than those who received surgical treatment. LMD showed an association with osseous healing outcomes in nonoperative management. Clinical outcomes and osseous healing showed no significant differences according to Dickman’s classification of transverse atlantal ligament injuries.
Conclusion
Surgical internal fixation had a higher fusion rate, shorter fracture healing time, more favorable clinical outcomes, and a more significant reduction in LMD and AADI compared to nonoperative management. The pitfalls of external immobilization are inadequate maintenance and a lower probability of reducing fractured lateral masses. Stabilization by surgical reduction with interconnected fixation proved to be a more practical management strategy than nonoperative treatment for unstable atlas fractures.

Citations

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  • Motion preserving C1 ring lateral mass screw fixation with transverse rod for isolated unstable Jefferson fracture of atlas vertebra: a multicentric study
    Nathan Beucler, Anis Choucha, Kaissar Farah, Mikael Meyer, Arnaud Dagain, Stéphane Fuentes
    European Spine Journal.2026; 35(2): 936.     CrossRef
  • Anatomical basis for a new method of atlas osteosynthesis in unstable C1 vertebra fractures
    V.N. Rashidov, I.Yu. Lisitskii, A.V. Lychagin, R.L. Kambiev, K.M. Kulakov, A.Yu. Zarov, A.L. Korkunov, V.G. Cherepanov, I.A. Vyazankin, E.Yu. Tselischeva
    Burdenko's Journal of Neurosurgery.2026; 90(2): 37.     CrossRef
  • Clinical study of three internal fixation systems via transoral approach for motor function preservation in atlas fractures
    Yinghua He, Hu Chen, Hanmo Gu, Yansong Liu, Zhongbiao Liang, Xiangyang Ma, Jinahua Wang, Kai Zhang, Qiang Tu
    Journal of Orthopaedic Surgery and Research.2026;[Epub]     CrossRef
  • Original surgical technique of unstable atlas fracture osteosynthesis: case series analysis
    I. Yu. Lisitsky, V. N. Rashidov, A. V. Lychagin, A. Yu. Zarov, A. L. Korkunov, V. G. Cherepanov, I. A. Vyazankin, E. Yu. Tselishcheva
    Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika).2025; 22(1): 53.     CrossRef
  • Perioperative outcomes and technical and patient-reported success of rigid occipitocervical fusions in adults: a systematic review and meta-analysis
    Alexander O. Aguirre, Mohamed A.R. Soliman, Isabelle G. Stockman, Gaitree R. Boojraj, Esteban Quiceno, Asham Khan, Kyungduk Rho, John Pollina, Jeffrey P. Mullin
    European Spine Journal.2025; 34(8): 3408.     CrossRef
  • More postoperative complications and revision surgery after occipitocervical fusion than after atlantoaxial fusion: a retrospective multicenter cohort study
    Koji Uotani, Angel Oscar Paz Flores, Masato Tanaka, Shashank J Ekade, Shinya Arataki, Tadashi Komatsubara, Yoshiaki Oda, Kensuke Shinohara, Toshifumi Ozaki
    Asian Spine Journal.2025; 19(3): 444.     CrossRef
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    Andrei Fernandes Joaquim, Klaus John Schnake, Richard J. Bransford, Harvinder Singh Chabbra, Sebastian F. Bigdon, Mohammad El-Sharkawi, Gregory D. Schroeder
    Journal of Clinical Orthopaedics and Trauma.2025; 71: 103223.     CrossRef
  • Radiological and Clinical Outcomes of Monoaxial versus Polyaxial Screw Constructs in C1 Jefferson Fracture Osteosynthesis: A Retrospective Study
    Jae Taek Hong, Dong Hoon Kim, Jin Young Kim, Jung Woo Hur, Ho Jin Lee, Il Sup Kim
    World Neurosurgery.2025; 204: 124578.     CrossRef
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    Thiago Magalhães De Souza, Lucas Dos Santos Pavesi, Andrei Fernandes Joaquim
    Clinical Spine Surgery.2025;[Epub]     CrossRef
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    Chang Kyu Park, Man Kyu Choi
    Acta Neurochirurgica.2024;[Epub]     CrossRef
  • Design of a novel lateral mass screw–plate system for the treatment of unstable atlas fractures: a finite element analysis
    He-Gang Niu, Jing-Jing Zhang, Yi-Zhu Yan, Cheng-Kun Zhao, Kun Yang, Yin-Shun Zhang
    Journal of Orthopaedic Surgery and Research.2024;[Epub]     CrossRef
  • Comparison of Transoral Anterior Jefferson-Fracture Reduction Plate and Posterior Screw-Rod Fixation in C1-Ring Osteosynthesis for Unstable Atlas Fractures
    Mandi Cai, Yifeng Wu, Rencai Ma, Junlin Chen, Zexing Chen, Chenfu Deng, Xinzhao Huang, Xiangyang Ma, Xiaobao Zou
    Neurospine.2024; 21(2): 544.     CrossRef
  • C1-ring оsteosynthesis as a functionally preserving operation for unstable atlas fractures
    I. V. Basankin, Abram Akopovich Giulzatyan, I. M. Magomedov, K. K. Takhmazyan, M. I. Tomina, S. B. Malakhov, A. A. Afaunov, V. A. Porkhanov
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  • Commentary on “Surgical Versus Conservative Management for Treating Unstable Atlas Fractures: A Multicenter Study”
    Toshiyuki Takahashi
    Neurospine.2022; 19(4): 1026.     CrossRef
  • 14,035 View
  • 797 Download
  • 9 Web of Science
  • 14 Crossref
Analysis of Associating Radiologic Parameters With Clinical Outcomes After Posterior C1–2 Fusion
Jong-Hyeok Park, Jong Tae Kim, Il Sup Kim, Jae Taek Hong
Neurospine 2022;19(2):402-411.   Published online May 15, 2022
DOI: https://doi.org/10.14245/ns.2143312.656

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Analysis of Associating Radiologic Parameters With Clinical Outcomes After Posterior C1–2 Fusion
Neurospine. 2022;19(2):402-411.   Published online May 15, 2022
DOI: https://doi.org/10.14245/ns.2143312.656
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Analysis of Associating Radiologic Parameters With Clinical Outcomes After Posterior C1–2 Fusion
Neurospine. 2022;19(2):402-411.   Published online May 15, 2022
DOI: https://doi.org/10.14245/ns.2143312.656
Close
Objective
To evaluate which radiologic parameters affect clinical outcomes in patients underwent posterior C1–2 fusion for atlantoaxial dislocation.
Methods
From January 2014 to December 2017, among 98 patients underwent C1–2 posterior fusion, patients with previous cervical surgery or extending to subaxial spine or basilar invagination were excluded. Finally, 38 patients were included. O–C2, C1–2, C1–C7, C2–C7 cobb angle (CA), T1 slope, C1–7, C2–7 sagittal vertical axis (SVA), and posterior atlantodental interval (PADI) were measured at preoperative and postoperative 1 year. The difference between postoperative and preoperative values for each parameter was designated as Δvalue. Postoperative subaxial kyphosis (PSK) was defined to decrease ≥ 10° at subaxial spine. Visual analogue scale (VAS), Japanese Orthopedic Association (JOA) score, Neck Disability Index (NDI) were used to evaluate clinical outcomes.
Results
Mean age was 54.4 ± 15.9. Male to female was 14 to 24. Of radiologic parameters, C1–7 SVA and PADI were significantly changed from 26.4 ± 12.9 mm, 17.1 ± 3.3 mm to 22.6 ± 13.0 mm, 21.6 ± 3.4 mm. ΔC1–2 CA was correlated with ΔC1–7 CA and ΔC2–7 SVA. ΔPADI correlates with ΔO–C2 CA. VAS correlates with ΔC1–7 CA (p = 0.03). JOA score also correlates with ΔC2–7 SVA (p = 0.02). NDI was associated with ΔPADI (p < 0.01). The incidence of PSK was 23.7%, and not significant with clinical outcomes.
Conclusion
ΔC1–2 CA was correlated with ΔC1C7 CA, ΔC2–7 SVA. ΔC1–7 CA, ΔC2–7 SVA, and ΔPADI were the key radiologic parameters to influence clinical outcomes. Postoperative C1–2 angle should be carefully determined as a factor affecting clinical outcomes and cervical sagittal alignment.

Citations

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  • Risk Factors for Radiologic Subaxial Cervical Pathology After C1-2 Posterior Fusion
    Chungwon Bang, Kee-won Rhyu, Young-Yul Kim, Joonghyun Ahn, Ji-hyun Ryu, Hyung-Youl Park, You Seung Chun, Kihyun Kwon, Sang-Il Kim, Hyoung Ju Seo, Young-Hoon Kim
    Journal of Clinical Medicine.2026; 15(5): 1852.     CrossRef
  • Anatomical Feasibility and Early Radiographic Outcomes of Freehand C1 Pedicle Screw Fixation in a Malaysian Cohort: A Preliminary Single-Center Study
    Mohd Daniel Djamalludin, Marazuki Perwira
    Journal of Spine Practice.2026; 5(2): 82.     CrossRef
  • Salvage Posterior C1–C2 Fusion for Odontoid Nonunion After Failed Nonoperative Management: A Propensity Score-Matched Comparison with Primary Fusion
    Sapan Patel, Hershil A. Patel, Rohan I. Suresh, Jake Carbone, Gerald Kidd, Abel K. Lindley, Ethan Yang, Antoan Koshar, Ryan Curto, Husni Alasadi, Usman Zareef, Evan Honig, Alexander Padovano, Louis Bivona, Daniel Cavanaugh, Eugene Koh, Steven C. Ludwig, J
    Journal of Clinical Medicine.2026; 15(10): 3887.     CrossRef
  • Comparison of multistage and single-stage framework for automated landmark localization and radiologic measurement: a case of the C1-2 complex on cervical spine lateral radiographs
    Wounsuk Rhee, Jeuk Lee, Ihnseok Chae, Beom-Su Kim, Sung Cheol Park, Sam Yeol Chang, Bong-Soon Chang, Hyoungmin Kim
    BMC Medical Imaging.2026;[Epub]     CrossRef
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    Taiyi Chen
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  • Prognostic Determinants in Basilar Invagination Surgery: Current Advances
    Taiyi Chen, Hao Deng, Yating Liu, Yi Yan
    Journal of Contemporary Medical Practice.2025; 7(2): 155.     CrossRef
  • Prognostic Factors in Craniocervical Realignment for Craniovertebral Junction Kyphosis With Negative Cervical Imbalance: A Comprehensive Study
    Dong Hun Kim, Jae Taek Hong, Jin Young Kim, Kang Bin Koo, Dae Hee Lee, Jung Woo Hur, Ho Jin Lee, Il Sup Kim
    Neurospine.2025; 22(3): 725.     CrossRef
  • Analysis of sagittal parameters for easier and more accurate determination of cervical spine alignment
    Byeong Ho Oh, Jee Yong Kim, Jong Beom Lee, Il Sup Kim, Jae Taek Hong, Jae Hoon Sung, Ho Jin Lee
    Medicine.2023; 102(41): e35511.     CrossRef
  • 8,319 View
  • 247 Download
  • 6 Web of Science
  • 8 Crossref

Review Articles

Evaluation and Surgical Planning for Craniovertebral Junction Deformity
Jae Taek Hong, Il Sup Kim, Ho Jin Lee, Jong Hyuk Park, Jeong Woo Hur, Jong Beom Lee, Jeong Jae Lee, Sang Hyo Lee
Neurospine 2020;17(3):554-567.   Published online September 30, 2020
DOI: https://doi.org/10.14245/ns.2040510.255

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Evaluation and Surgical Planning for Craniovertebral Junction Deformity
Neurospine. 2020;17(3):554-567.   Published online September 30, 2020
DOI: https://doi.org/10.14245/ns.2040510.255
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Evaluation and Surgical Planning for Craniovertebral Junction Deformity
Neurospine. 2020;17(3):554-567.   Published online September 30, 2020
DOI: https://doi.org/10.14245/ns.2040510.255
Close
Craniovertebral junction (CVJ) deformity is a challenging pathology that can result in progressive deformity, myelopathy, severe neck pain, and functional disability, such as difficulty swallowing. Surgical management of CVJ deformity is complex for anatomical reasons; given the discreet relationships involved in the surrounding neurovascular structures and intricate biochemical issues, access to this region is relatively difficult. Evaluation of the reducibility, CVJ alignment, and direction of the mechanical compression may determine surgical strategy. If CVJ deformity is reducible, posterior in situ fixation may be a viable solution. If the deformity is rigid and the C1–2 facet is fixed, osteotomy may be necessary to make the C1–2 facet joint reducible. C1–2 facet release with vertical reduction technique could be useful, especially when the C1–2 facet joint is the primary pathology of CVJ kyphotic deformity or basilar invagination. The indications for transoral surgery are becoming as narrow as a treatment for CVJ deformity. In this article, we will discuss CVJ alignment and various strategies for the management of CVJ deformity and possible ways to prevent complications and improve surgical outcomes.

Citations

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    Burdenko's Journal of Neurosurgery.2026; 90(1): 21.     CrossRef
  • C1 lateral mass and C2 pedicle screw rod fixation for mobile atlantoaxial dislocation: An institutional experience and review of literature
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    Journal of Neurosciences in Rural Practice.2026; 0: 1.     CrossRef
  • Basilar Invagination Diagnosis, Classification, and Radiology
    Onur Yaman, Mehmet Zileli, İdris Avci, Zan Chen, June Ho Lee, Geraldo Sá-Carneiro, Francesco Costa, Said Ait Ben Ali, Fernando Dantas, Joachim Oertel, Massimiliano Visocchi, Jutty Parthiban, Atul Goel, Ricardo Botelho, Oscar L. Alves
    Spine.2025; 50(11): E200.     CrossRef
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    Balaji Vaithialingam, Varadarajan Bhadrinarayan, Satish Rudrappa
    Journal of Anaesthesiology Clinical Pharmacology.2025; 41(3): 410.     CrossRef
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    Qiu-Qi Zhang, Shangguan Wen-ji, Jia Song, Zhi-Hui Liang, Fu-Chao Zhou, Hai-Tao Liu, Jiang Shao, Yue-Hui Zhang
    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
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    Ajay Sebastian Carvalho, Vijay Kumar Gupta, Subir De
    Egyptian Journal of Neurosurgery.2025;[Epub]     CrossRef
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    V. V. Stepanenko, V. A. Shamanin, A. V. Trashin, Yu. A. Shulev
    Russian journal of neurosurgery.2025; 27(2): 90.     CrossRef
  • Prognostic Factors in Craniocervical Realignment for Craniovertebral Junction Kyphosis With Negative Cervical Imbalance: A Comprehensive Study
    Dong Hun Kim, Jae Taek Hong, Jin Young Kim, Kang Bin Koo, Dae Hee Lee, Jung Woo Hur, Ho Jin Lee, Il Sup Kim
    Neurospine.2025; 22(3): 725.     CrossRef
  • Transoral Approach to the Craniovertebral Junction: A Case Series of Three Rare Pathologies
    Morteza Sadeh, Hadeel Mansour, Javed Iqbal, Gabriel Gonzales-Portillo, John Souter, Sergey Neckrysh, Nicholas Callahan, Gursant Atwal
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    Takeshi Hongo, Yusuke Morinaga, Sotaro Oshida, Shunsuke Shibao, Ryu Kurokawa, Yasuhiro Tsunemi, Takashi Kashiwagi, Tsuguhisa Nakayama, Hiroyoshi Akutsu
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    Dong Hun Kim, Jung Woo Hur, Il Sup Kim, Ho Jin Lee, Jee Yong Kim, Jung Jae Lee, Jong Bum Lee, Jae Taek Hong
    Neurospine.2025; 22(3): 784.     CrossRef
  • Radiological and Clinical Outcomes of Monoaxial versus Polyaxial Screw Constructs in C1 Jefferson Fracture Osteosynthesis: A Retrospective Study
    Jae Taek Hong, Dong Hoon Kim, Jin Young Kim, Jung Woo Hur, Ho Jin Lee, Il Sup Kim
    World Neurosurgery.2025; 204: 124578.     CrossRef
  • Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine
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  • Craniovertebral Junction Deformity Diagnosed by Computed Tomography: A Case Report
    Anjali Kumari, Gaurav V Mishra, Pratapsingh Parihar, Shivali V Kashikar, Sakshi S Dudhe, Rakshanda Agrawal, Paritosh N Bhangale
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    Baraa Dabboucy, Wissem Lahiani, Damien Bresson, Nouman Aldahak
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    Xiang Yin, Keyu Luo, Yufei Jin, Yaoyao Liu, Yinbo Wang, Mingyong Liu, Peng Liu
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    Mohammad Zubair, Sachin Kansal, Sudipto Mukherjee
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  • The Optimal Time between Embolization and Surgery for Hypervascular Spinal Metastatic Tumors : A Systematic Review and Meta-Analysis
    Woon Tak Yuh, Junghoon Han, Chang-Hyun Lee, Chi Heon Kim, Hyun-Seung Kang, Chun Kee Chung
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    Enrico Tessitore, Ciro Mastantuoni, Ivan Cabrilo, Claudio Schonauer
    Acta Neurochirurgica.2023; 165(10): 3027.     CrossRef
  • Head Fixation in Head Frame in Surgeries of Unstable Craniovertebral Junction through Midline Posterior Approach
    Deepak Kumar Jha, Ashutosh Jha, Mayank Garg, Jaskaran Singh Gosal, Mohit Agrawal, Raghavendra Kumar Sharma, Pushpinder Singh Khera
    Journal of Spinal Surgery.2023; 10(4): 152.     CrossRef
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    Mohammad Zubair, Sachin Kansal, Sudipto Mukherjee
    Robotica.2022; 40(6): 2031.     CrossRef
  • Ideal entry point and trajectory for C2 pedicle screw placement in basilar invagination patients with high-riding vertebral artery based on 3D computed tomography
    Lu-Ping Zhou, Ren-Jie Zhang, Zhen-Fei Jiang, Er-Xu Tao, Jin Shang, Cai-Liang Shen
    The Spine Journal.2022; 22(8): 1281.     CrossRef
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    Jinpeng Du, Xiangcheng Gao, Yunfei Huang, Xiaobin Yang, Bolong Zheng, Zhongkai Liu, Hua Hui, Lin Gao, Jiayuan Wu, Zhigang Zhao, Baorong He, Liang Yan, Dingjun Hao
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  • Evaluation of Cervicomedullary Compression Around the Craniovertebral Junction: Commentary on “Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy”
    Jae Taek Hong
    Neurospine.2022; 19(4): 896.     CrossRef
  • Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy
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    Neurospine.2022; 19(4): 889.     CrossRef
  • 18,907 View
  • 458 Download
  • 22 Web of Science
  • 25 Crossref
SOF System; A New Nomenclature System for the Surgical Techniques of Cervical Spine Deformity
Jae Taek Hong, Heiko Koller, Kuniyoshi Abumi, Wen Yuan, Asdrubal Falavigna, Ho Jin Lee, Jong Beom Lee, Jean-Charles Le Huec, Jong Hyuk Park, Il Sup Kim
Neurospine 2020;17(3):505-512.   Published online September 30, 2020
DOI: https://doi.org/10.14245/ns.2040472.236

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SOF System; A New Nomenclature System for the Surgical Techniques of Cervical Spine Deformity
Neurospine. 2020;17(3):505-512.   Published online September 30, 2020
DOI: https://doi.org/10.14245/ns.2040472.236
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SOF System; A New Nomenclature System for the Surgical Techniques of Cervical Spine Deformity
Neurospine. 2020;17(3):505-512.   Published online September 30, 2020
DOI: https://doi.org/10.14245/ns.2040472.236
Close
Although cervical spinal deformity (CSD) can have a profoundly negative impact on an individual’s quality of life and there have been many advances in surgical treatment of CSD in recent years, there exists no comprehensive classification system of surgical treatment that categorizes anterior and posterior surgery separately according to the grade of surgery. The objective of this study is to introduce the new classification system of various surgical treatments for CSD. We developed a new classification system (SOF system) for CSD surgery that describes the sequence of surgical approach (S), the grade of osteotomy (O), and the information of fixation (F) using alphanumeric codes. This new classification system can provide a consistent description of the various osteotomies performed in CSD surgery. Especially, regarding research, there has been a clear benefit to this classification. Having a standardized classification that allows for common frame for cervical deformity correction surgery, communication between surgeons and the evaluation of the CSD surgeries make it possible to conduct global comparative research about surgical outcome.
  • 7,986 View
  • 196 Download

Original Article

Epidemiology of C5 Palsy after Cervical Spine Surgery: A 21-Center Study
Jae Keun Oh, Jae Taek Hong, Dong Ho Kang, Sang-Woo Kim, Seok Won Kim, Young Jin Kim, Chun Kee Chung, Jun Jae Shin, Seong Yi, Jung Kil Lee, Jun Ho Lee, Chang-Hyun Lee, Ho Jin Lee, Hyoung-Joon Chun, Dae-Chul Cho, Yong Eun Cho, Yong Jun Jin, Kyung-Chul Choi, In Ho Han, Seung-Jae Hyun, Jung-Woo Hur, Ki-Jeong Kim
Neurospine 2019;16(3):558-562.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938142.071

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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
DOI: https://doi.org/10.14245/ns.1938142.071
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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
DOI: https://doi.org/10.14245/ns.1938142.071
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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  • 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.2026; 16(6): 2671.     CrossRef
  • 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
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Editorial

APCSS special Topic-Craniovertebral Junction Surgery

Human Craniovertebral Alignment as a “Tertiary Curvature”
Jae Taek Hong
Neurospine 2019;16(2):251-254.   Published online June 30, 2019
DOI: https://doi.org/10.14245/ns.19edi.010

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Human Craniovertebral Alignment as a “Tertiary Curvature”
Neurospine. 2019;16(2):251-254.   Published online June 30, 2019
DOI: https://doi.org/10.14245/ns.19edi.010
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Human Craniovertebral Alignment as a “Tertiary Curvature”
Neurospine. 2019;16(2):251-254.   Published online June 30, 2019
DOI: https://doi.org/10.14245/ns.19edi.010
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Citations

Citations to this article as recorded by  Crossref logo
  • Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine
    Dong Hun Kim, Jae Taek Hong, Jung Woo Hur, Il Sup Kim, Ho Jin Lee, Jong Beom Lee
    Neurospine.2024; 21(2): 565.     CrossRef
  • Anatomical Evaluation of the Atlas and Analysis of Accuracy for Freehand C1 Screw Placement
    Jin Young Kim, Byeong Ho Oh, Kyung Soo Min, Mou Seop Lee, Jong Beom Lee
    The Nerve.2023; 9(2): 144.     CrossRef
  • Analysis of Associating Radiologic Parameters With Clinical Outcomes After Posterior C1–2 Fusion
    Jong-Hyeok Park, Jong Tae Kim, Il Sup Kim, Jae Taek Hong
    Neurospine.2022; 19(2): 402.     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
  • Evaluation and Surgical Planning for Craniovertebral Junction Deformity
    Jae Taek Hong, Il Sup Kim, Ho Jin Lee, Jong Hyeok Park, Jeong Woo Hur, Jong Beom Lee, Jeong Jae Lee, Sang Hyo Lee
    Neurospine.2020; 17(3): 554.     CrossRef
  • 9,230 View
  • 154 Download
  • 4 Web of Science
  • 5 Crossref

Clinical Article

Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach
Woong Bae Park, Jae Taek Hong, Sang Won Lee, Jae Hoon Sung, Seung Ho Yang, IL Sub Kim
Korean J Spine 2016;13(2):41-46.   Published online June 30, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.2.41

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Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach
Korean J Spine. 2016;13(2):41-46.   Published online June 30, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.2.41
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Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach
Korean J Spine. 2016;13(2):41-46.   Published online June 30, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.2.41
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Objective

To compare the clinical and radiological outcome of both sides using the unilateral approach.

Methods

Unilateral laminotomy was performed to achieve bilateral decompression. Thirty-nine patients who underwent this procedure were analyzed prospectively using the Oswestry Disability Index (ODI), the visual analog scale (VAS) pain score to evaluate symptoms in both legs, and the radiological morphometric index to calculate the anteriorposterior diameter and midcanal width. The incidence of complications from this approach was then evaluated.

Results

The mean follow-up time was 12.2 months. The mean ODI was 48.4 preoperatively and 14.2 postoperatively. The mean dural sac widening of the ipsilateral side (187.0%) was significantly larger (p<0.01) than that of the the contralateral side (145.6%). The VAS improvement ratio ([preoperative VAS score-postoperative VAS score]/[preoperative VAS score]×100) for the pain in each leg was 75.4%(ipsilateral side) and 73.7%(contralateral side). While the VAS improvement ratio for pain in each side was significantly reduced, the difference in the VAS ratio between sides was statistically insignificant (p=0.64). There were 2 cases (5.1%) of dural tearing during the procedure, 1 case (2.6%) of transient paresthesia of nerve roots, and 2 cases (5.1%) of transient paresthesia of the contralateral nerve root. The transient paresthesias of nerve roots never lasted more than 2 weeks.

Conclusion

This technique allows for significant decompression of the contralateral canal and excellent clinical outcomes without troublesome complications. Although ipsilateral the dural sac widening was significantly larger than contralateral side, the difference in the clinical outcome between sides was statistically insignificant.

Citations

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  • Radiological Outcomes of Unilateral Laminotomy for Bilateral Decompression in Lumbar Spinal Stenosis With and Without Discectomy
    Hyun-Seo Cho, Se-Hoon Kim, Jeong Su Han, Bum-Joon Kim
    World Neurosurgery.2023; 175: e1307.     CrossRef
  • Comparative Cohort Study for Expansion of Lateral Recess and Facet Joint Injury after Biportal Endoscopic Ipsilateral Decompression and Contralateral Decompression
    Yip-kan Yeung, Cheol-woong Park, Su Gi Jun, Jung-hoon Park, Andy Choi-yeung Tse
    Asian Spine Journal.2022; 16(4): 560.     CrossRef
  • Facet-Sparing Decompression of Lumbar Spinal Stenosis: The Minimally Invasive Bilateral Crossover Approach
    Jan Helge Klingler, Ulrich Hubbe, Christoph Scholz, Marie T. Krüger
    Journal of Neurological Surgery Part A: Central European Neurosurgery.2021; 82(03): 278.     CrossRef
  • Unilateral Bi-portal Endoscopic Decompression via the Contralateral Approach in Asymmetric Spinal Stenosis: A Technical Note
    Jin-Sung Kim, Cheol-Woong Park, Yip-Kan Yeung, Tsz-King Suen, Su Gi Jun, Jung-Hoon Park
    Asian Spine Journal.2021; 15(5): 688.     CrossRef
  • Lomber Dar Kanalda Iki Taraflı Mikrodekompresyon İçin Tek Taraflı Yaklaşım: Klinik ve Radyolojik Değişikliklerin Detaylı Araştırılması
    İsmail İŞTEMEN, Ali ARSLAN, Semih Kivanc OLGUNER, Ali ÖKTEN, Kemal AFŞER, Vedat AÇIK, Emre BİLGİN
    Pamukkale Medical Journal.2020;[Epub]     CrossRef
  • SOF System; A New Nomenclature System for the Surgical Techniques of Cervical Spine Deformity
    Jae Taek Hong, Heiko Koller, Kuniyoshi Abumi, Wen Yuan, Asdrubal Falavigna, Ho Jin Lee, Jong Beom Lee, Jean-Charles Le Huec, Jong Hyuk Park, Il Sup Kim
    Neurospine.2020; 17(3): 505.     CrossRef
  • Long-term Clinical and Radiological Outcomes after Central Decompressive Laminoplasty for Lumbar Spinal Stenosis
    Jun-Hwan Kim, Young-Joon Kwon
    Korean Journal of Spine.2017; 14(3): 71.     CrossRef
  • 11,435 View
  • 162 Download
  • 7 Crossref

Case Report

Spontaneous Resolution of Spinal Epidural Hematoma: A Case Report.
Hyun Jun Park, Il Sup Kim, Sang Won Lee, Byung Chul Son, Jae Hoon Sung, Jae Taek Hong, Seung Ho Yang
Korean J Spine 2008;5(2):107-109.

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Spontaneous Resolution of Spinal Epidural Hematoma: A Case Report.
Korean J Spine. 2008;5(2):107-109.
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Spontaneous Resolution of Spinal Epidural Hematoma: A Case Report.
Korean J Spine. 2008;5(2):107-109.
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Spinal epidural hematoma(SEH) is not common in lumbar spine disorders and can be developed spontaneously without direct trauma. According to the neurologic deficit and clinical condition of patient, surgical intervention can be required. Authors report a case of spontaneous lumbar SEH resolved spontaneously without surgery. A 59-year-old man had suffered back pain and left leg pain for three weeks without trauma while working on his farm. Magnetic resonance imaging MRI demonstrated a lumbar epidural hematoma at L3/4 level. After 3 months of conservative treatment, his clini- cal symptoms were disappeared completely without neurologic deficit, and the follow-up myelocomputed tomogram(CT) showed complete resolution of the SEH. The primary treatment modality of SEH is surgical evacuation of hema- toma in case of neurologic deterioration, but conservative treatment may be considered if the patient has no neurologic deficit.
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