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Clinical Effectiveness of Artificial Disc Replacement in Comparison With Anterior Cervical Discectomy and Fusion in the Patients With Cervical Myelopathy: Systematic Review and Meta-analysis
Neurospine. 2023;20(3):1047-1060.   Published online September 30, 2023
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Clinical Effectiveness of Artificial Disc Replacement in Comparison With Anterior Cervical Discectomy and Fusion in the Patients With Cervical Myelopathy: Systematic Review and Meta-analysis
Neurospine. 2023;20(3):1047-1060.   Published online September 30, 2023
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Objective
Cervical myelopathy (CM) describes the compressive cervical spinal cord state, often accompanied by serious clinical condition, by herniated disc or hypertrophied spurs or ligament. Anterior cervical discectomy and fusion (ACDF) has been frequently employed as conventional surgical solution for this CM despite its inherent biomechanical handicap. Alternatively, an artificial disc replacement (ADR) preserves cervical motion while still decompressing the spinal canal and neural foramen. This analysis elaborated to clarify the potential benefits of ADR application to CM over ACDF from the conglomerated results of the past references.
Methods
A literature search was performed using MEDLINE, Embase, Cochrane review, and KMbase databases from the studies published until March 2023. Six studies (3 randomized controlled study [RCTs] and 3 non-RCTs) were included in a qualitative and quantitative synthesis. Data were extracted and analyzed using a random effects model to obtain effect size and its statistical significance. Quality assessment and evidence level were established in accordance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology.
Results
Among 6 studies, 2 studies showed that ADR group achieved significantly better clinical improvement than the ACDF group, while the rest 4 studies revealed no significant difference. A meta-analysis showed better clinical outcomes with or without statistical significance. The level of evidence was low because of inconsistency and imprecision.
Conclusion
ADR was superior or at least, not inferior to ACDF in terms of functional recovery. However, its application to the CM patients is merely empowered with weak strength due to low level of evidence.

Citations

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  • ACDF and cervical disc replacement for single-level cervical spine degenerative disease: a frailty driven propensity score-matched comparative analysis
    Nithin Gupta, Omar Sbaih, William DiCiurcio III, Mark Miller, Ruchir Nanavati, Hunter Smith, Blake Delgadillo, Matthew Meade, Aman Singh, Rohin Singh, Christian Bowers
    European Spine Journal.2026;[Epub]     CrossRef
  • Comparison of Hybrid Surgery and Two-Level ACDF in Treating Consecutive Cervical Degenerative Disc Disease: A Systematic Review and Meta-Analysis
    Yihan Yang, Weishi Liang, Duan Sun, Bo Han, Zhangfu Li, Yeqiu Xu, Peng Yin, Xianjun Qu, Yong Hai
    Global Spine Journal.2025; 15(8): 3953.     CrossRef
  • Recent progress in surgical treatment of cervical spine myelopathy – A narrative review
    Jun Ouchida, Hiroaki Nakashima, Sadayuki Ito, Naoki Segi, Ippei Yamauchi, Shiro Imagama
    Journal of Clinical Orthopaedics and Trauma.2025; 68: 103074.     CrossRef
  • Cervical disc replacement versus anterior cervical discectomy and fusion using stand-alone cage for degenerative cervical spondylosis: a systematic review and meta-analysis based on randomized controlled trials
    Yu Zhang, Jidong Ju, Jinchun Wu
    Neurosurgical Review.2025;[Epub]     CrossRef
  • Does the novel artificial cervical joint complex resolve the conflict between stability and mobility after anterior cervical surgery? a finite element study
    Bing Meng, Xiong Zhao, Xin-Li Wang, Jian Wang, Chao Xu, Wei Lei
    Frontiers in Bioengineering and Biotechnology.2024;[Epub]     CrossRef
  • Practical Answers to Frequently Asked Questions in Anterior Cervical Spine Surgery for Degenerative Conditions
    Tejas Subramanian, Austin Kaidi, Pratyush Shahi, Tomoyuki Asada, Takashi Hirase, Avani Vaishnav, Omri Maayan, Troy B. Amen, Kasra Araghi, Chad Z. Simon, Eric Mai, Olivia C. Tuma, Ashley Yeo Eun Kim, Nishtha Singh, Maximillian K. Korsun, Joshua Zhang, Myle
    Journal of the American Academy of Orthopaedic Surgeons.2024; 32(18): e919.     CrossRef
  • Radiographic Characteristics of Caudal Segment in Multilevel Anterior Cervical Discectomy and Fusion: The Bony Buttress Formation
    Chang Hwa Ham, Joo Han Kim, Youn-Kwan Park, Woo-Keun Kwon, Hong Joo Moon
    Neurospine.2024; 21(4): 1241.     CrossRef
  • 14,244 View
  • 242 Download
  • 6 Web of Science
  • 7 Crossref

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Conversational Artificial Intelligence for Spinal Pain Questionnaire: Validation and User Satisfaction
Neurospine. 2022;19(2):348-356.   Published online May 12, 2022
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Conversational Artificial Intelligence for Spinal Pain Questionnaire: Validation and User Satisfaction
Neurospine. 2022;19(2):348-356.   Published online May 12, 2022
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Objective
The purpose of our study is to develop a spoken dialogue system (SDS) for pain questionnaire in patients with spinal disease. We evaluate user satisfaction and validated the performance accuracy of the SDS in medical staff and patients.
Methods
The SDS was developed to investigate pain and related psychological issues in patients with spinal diseases based on the pain questionnaire protocol. We recognized patients’ various answers, summarized important information, and documented them. User satisfaction and performance accuracy were evaluated in 30 potential users of SDS, including doctors, nurses, and patients and statistically analyzed.
Results
The overall satisfaction score of 30 patients was 5.5 ± 1.4 out of 7 points. Satisfaction scores were 5.3 ± 0.8 for doctors, 6.0 ± 0.6 for nurses, and 5.3 ± 0.5 for patients. In terms of performance accuracy, the number of repetitions of the same question was 13, 16, and 33 (13.5%, 16.8%, and 34.7%) for doctors, nurses, and patients, respectively. The number of errors in the summarized comment by the SDS was 5, 0, and 11 (5.2%, 0.0%, and 11.6 %), respectively. The number of summarization omissions was 7, 5, and 7 (7.3%, 5.3%, and 7.4%), respectively.
Conclusion
This is the first study in which voice-based conversational artificial intelligence (AI) was developed for a spinal pain questionnaire and validated by medical staff and patients. The conversational AI showed favorable results in terms of user satisfaction and performance accuracy. Conversational AI can be useful for the diagnosis and remote monitoring of various patients as well as for pain questionnaires in the future.

Citations

Citations to this article as recorded by  Crossref logo
  • Artificial intelligence in spine surgery: a scoping review
    Anis Choucha, Morgane Evin, Matteo de Simone, Guillaume Dannhoff, Henry Dufour, Valentin Avinens, Kaissar Farah, Florian Saby, Stephane Fuentes
    Neurochirurgie.2026; 72(1): 101764.     CrossRef
  • Artificial Intelligence (AI) Agents Versus Agentic AI: What’s the Effect in Spine Surgery?
    Wongthawat Liawrungrueang
    Neurospine.2025; 22(2): 473.     CrossRef
  • Intuitive tests to validate machine learning models against physics and domain knowledge
    M.Z. Naser
    Digital Engineering.2025; 7: 100057.     CrossRef
  • AI in Medical Questionnaires: Scoping Review
    Xuexing Luo, Yiyuan Li, Jing Xu, Zhong Zheng, Fangtian Ying, Guanghui Huang
    Journal of Medical Internet Research.2025; 27: e72398.     CrossRef
  • NAIA: A Multi-Technology Virtual Assistant for Boosting Academic Environments—A Case Study
    Adrián Pabón Mendoza, Kenneth J. Barrios Quiroga, Samuel D. Solano Celis, Christian M. Quintero
    IEEE Access.2025; 13: 141461.     CrossRef
  • Anomaly Detection in Elderly Health Monitoring via IoT for Timely Interventions
    Cosmina-Mihaela Rosca, Adrian Stancu
    Applied Sciences.2025; 15(13): 7272.     CrossRef
  • EverydAI: Virtual Assistant for Decision-Making in Daily Contexts, Powered by Artificial Intelligence
    Carlos E. Pardo B., Oscar I. Iglesias R., Maicol D. León A., Christian G. Quintero M.
    Systems.2025; 13(9): 753.     CrossRef
  • Satisfaction with Artificial Intelligence Among Patients and Physicians: A Scoping Review
    Timothy Hoff, Aliya Kitsakos, Jasmine Silva
    Journal of Healthcare Management.2025; 70(6): 435.     CrossRef
  • Evaluation framework for conversational agents with artificial intelligence in health interventions: a systematic scoping review
    Hang Ding, Joshua Simmich, Atiyeh Vaezipour, Nicole Andrews, Trevor Russell
    Journal of the American Medical Informatics Association.2024; 31(3): 746.     CrossRef
  • Roles, Users, Benefits, and Limitations of Chatbots in Health Care: Rapid Review
    Moustafa Laymouna, Yuanchao Ma, David Lessard, Tibor Schuster, Kim Engler, Bertrand Lebouché
    Journal of Medical Internet Research.2024; 26: e56930.     CrossRef
  • Assessing usability of intelligent guidance chatbots in Chinese hospitals: Cross-sectional study
    Yanni Yang, Siyang Liu, Ping Lei, Zhengwei Huang, Lu Liu, Yiting Tan
    DIGITAL HEALTH.2024;[Epub]     CrossRef
  • Human-Robot Interaction and Social Robot: The Emerging Field of Healthcare Robotics and Current and Future Perspectives for Spinal Care
    In Ho Han, Dong Hwan Kim, Kyoung Hyup Nam, Jae Il Lee, Kye-Hyung Kim, Jong-Hwan Park, Ho Seok Ahn
    Neurospine.2024; 21(3): 868.     CrossRef
  • The Impact of Backchannel in Medical-Questionnaire Robot on User Perception
    Da-Young Kim, Min-Gyu Kim, Sang-Seok Yun
    Journal of information and communication convergence engineering.2024; 22(4): 322.     CrossRef
  • I Asked a ChatGPT to Write an Editorial About How We Can Incorporate Chatbots Into Neurosurgical Research and Patient Care…
    Randy S. D'Amico, Timothy G. White, Harshal A. Shah, David J. Langer
    Neurosurgery.2023; 92(4): 663.     CrossRef
  • Development and Validation of an Online Calculator to Predict Proximal Junctional Kyphosis After Adult Spinal Deformity Surgery Using Machine Learning
    Chang-Hyun Lee, Dae-Jean Jo, Jae Keun Oh, Seung-Jae Hyun, Jin Hoon Park, Kyung Hyun Kim, Jun Seok Bae, Bong Ju Moon, Chang-Kyu Lee, Myoung Hoon Shin, Hyun Jun Jang, Moon-Soo Han, Chi Heon Kim, Chun Kee Chung, Seung-Myung Moon
    Neurospine.2023; 20(4): 1272.     CrossRef
  • 10,033 View
  • 243 Download
  • 13 Web of Science
  • 15 Crossref

Technical Note

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Virtual Preoperative Simulation for Excision of Spinal Tumors: Surgeon Processing of Medical Computer-Assisted Design Software
Korean J Spine. 2017;14(4):170-174.   Published online December 31, 2017
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Virtual Preoperative Simulation for Excision of Spinal Tumors: Surgeon Processing of Medical Computer-Assisted Design Software
Korean J Spine. 2017;14(4):170-174.   Published online December 31, 2017
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As medical computer-aided design (CAD) has improved, virtual 3-dimensional medical images have been gaining more easily without any special practice. These images can be applied to various clinical fields. This article illustrates virtual preoperative simulation for excision of spinal tumors using medical CAD software. The software was used directly by the surgeon. The process of virtual preoperative simulation for spinal tumor surgery was found to be not inordinately complicated. And, virtual simulation was helpful in determining surgical steps as well as under-standing the surgical anatomy.

Citations

Citations to this article as recorded by  Crossref logo
  • Three-dimensional simulation/printing-assisted surgery for symptomatic metastatic epidural spinal cord compression of posterior column: efficacy assessment based on 2-year follow-up
    Zhicheng Sun, Runze Jia, Xiyang Wang, Xiaoyang Pang
    Frontiers in Surgery.2023;[Epub]     CrossRef
  • Current and Future Advances in Spinal Surgery
    Hiroyuki Nakase, Yasuhiro Takeshima, Ichiro Nakagawa
    Japanese Journal of Neurosurgery.2020; 29(6): 427.     CrossRef
  • Bone Flap Changes after Cranioplasty Using Frozen Autologous Bone Flaps: A Three-Dimensional Volumetric Reconstruction Study
    Jung Hwan Lee, Chung Kee Chough, Hyuk Jin Choi, Jun Kyeung Ko, Won Ho Cho, Seung Heon Cha, Chang Hwa Choi, Young Ha Kim
    Yonsei Medical Journal.2019; 60(11): 1067.     CrossRef
  • Is NF2 a Key Player of the Differentially Expressed Gene Between Spinal Cord Ependymoma and Intracranial Ependymoma?
    Ki Tae Kim, Chang-Hyun Lee, Chun Kee Chung, Ju Han Kim
    World Neurosurgery.2018; 118: e906.     CrossRef
  • 10,053 View
  • 215 Download
  • 4 Crossref

Clinical Article

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Cervical Pedicle Screw Placement Using Medial Funnel Technique
Korean J Spine. 2017;14(3):84-88.   Published online September 30, 2017
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Cervical Pedicle Screw Placement Using Medial Funnel Technique
Korean J Spine. 2017;14(3):84-88.   Published online September 30, 2017
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Objective:
Cervical pedicle screw (CPS) placement is very challenging due to high risk of neurovascular complications. We devised a new technique (medial funnel technique) to improve the accuracy and feasibility of CPS placement. Methods: We reviewed 28 consecutive patients undergoing CPS instrumentation using the medial funnel technique. Their mean age was 51.4 years (range, 30-81 years). Preoperative diagnosis included degenerative disease (n=5), trauma (n=22), and infection (n=1). Screw perforations were graded with the following criteria: grade 0 having no perforation, grade 1 having<25%, grade 2 having 25%-50% and grade 3 having >50% of screw diameter. Grades 0 and 1 were considered as correct position. The degree of perforation was determined by 2 junior neurosurgeons and 1 senior neurosurgeon. Results: A total of 88 CPSs were inserted. The rate of correct placement was 94.3%; grade 0, 54 screws; grade 1, 29 screws; grade 2, 4 screws; and grade 3, 1 screw. No neurovascular complications or failure of instrumentation occurred. In perforated screws (34 screws), lateral perforations were 4 and medial perforations were 30. Conclusion: We performed CPS insertion using medial funnel technique and achieved 94.3% (83 of 88) of correct placement. And it can decrease lateral perforation.

Citations

Citations to this article as recorded by  Crossref logo
  • Accuracy and Safety of a Triad-Dependent Technique for Subaxial Cervical Pedicle Screw Placement: A Prospective Cohort Study
    Mohamed El-Meshtawy, Mahmoud Abdelrahman Saleh, Mariam A. Ibrahim, Belal Elnady, Mahmoud Fouad Ibrahim
    Global Spine Journal.2026;[Epub]     CrossRef
  • Accuracy and safety assessment of subaxial cervical pedicle screw instrumentation: a systematic review
    Yasin Irmak, Fabian Peter, Manuel Moser, Dominik Baschera, Gregory Jost, Cristina Goga, Ulf Schneider, Edin Nevzati
    The Spine Journal.2025; 25(12): 2667.     CrossRef
  • Application of 3D Slicer for preoperative planning in upper cervical posterior fixation with vertebral artery variations
    Jia-xuan Zhang, Zhen-yong Ke, Guo-sheng Zhao, Yang Liu, Dian Zhong, Shan Wu, Hai-juan Wu, Yang Wang
    Scientific Reports.2025;[Epub]     CrossRef
  • Modified Tap-drilling Technique for Mid-cervical Pedicle Screw Placement
    Hasan Kâmil Sucu, İsmail Ertan Sevin, Gökhan Gürkan
    Clinical Spine Surgery.2024; 37(6): E269.     CrossRef
  • Subaxial Cervical Pedicular Screw Insertion via the Nonanatomic Axis: Identification of Entry Point and Trajectory Based on a Radiographic Study and Workshop
    Yingbo Wang, Bo Hu, Jian Wu, Wei Chen, Zhong Wang, Jun Zhu, Weili Fan, Mingyong Liu, Jianhua Zhao, Peng Liu
    Global Spine Journal.2023; 13(2): 360.     CrossRef
  • The role of cervical pedicle screw in cervical spine trauma: A single-center retrospective study
    Igor Ebert Cechin, Alderico Girão Campos De Barros, Ahsan Ali Khan, Luis Eduardo Carelli Teixeira Da Silva
    Journal of Craniovertebral Junction and Spine.2023; 14(3): 299.     CrossRef
  • Medial Pedicle Pivot Point Using Preoperative Computed Tomography Morphometric Measurements for Cervical Pedicle Screw Insertion: A Novel Technique and Case Series
    Ji-Won Kwon, Edward O. Arreza, Anthony A. Suguitan, Soo-Bin Lee, Sahyun Sung, Yung Park, Joong-Won Ha, Tae Hyung Kim, Seong-Hwan Moon, Byung Ho Lee
    Journal of Clinical Medicine.2022; 11(2): 396.     CrossRef
  • Accuracy of Subaxial Cervical Pedicle Screw Placement Using Direct Visualization Versus Computed Tomography–Based Navigation
    S. Harrison Farber, Jakub Godzik, Randall J. Hlubek, James J. Zhou, Corey T. Walker, U. Kumar Kakarla, Juan S. Uribe, Jay D. Turner
    Clinical Spine Surgery.2022; 35(1): E104.     CrossRef
  • Validation of Freehand Cervical Pedicle Screw Placement in Subaxial Spine Using the “Burcev Technique”: A Cadaveric Study
    Mantu Jain, Rabi N. Sahu, Manisha R. Gaikwad, Sashikanta Panda, Amit Tirpude, Nerbadyswari D. Bag
    Journal of Neurosciences in Rural Practice.2021; 12: 555.     CrossRef
  • The comparative accuracy and safety of fluoroscopic and navigation-based techniques in cervical pedicle screw fixation: systematic review and meta-analysis
    Ahmad M. Tarawneh, Shahnawaz Haleem, Daniel D’Aquino, Nasir Quraishi
    Journal of Neurosurgery: Spine.2021; 35(2): 194.     CrossRef
  • The “slide technique”—a novel free-hand method of subaxial cervical pedicle screw placement
    Bin Liu, Xiangyang Liu, Xiongjie Shen, Guoping Wang, Yixin Chen
    BMC Musculoskeletal Disorders.2020;[Epub]     CrossRef
  • Techniques of cervical pedicle screw insertion in lower cervical spine - A review
    Bidre Upendra, Rao Raghavendra
    Journal of Clinical Orthopaedics and Trauma.2020; 11(5): 794.     CrossRef
  • Epidemiology of Iatrogenic Vertebral Artery Injury in Cervical Spine Surgery: 21 Multicenter Studies
    Chang-Hyun Lee, Jae Taek Hong, Dong Ho Kang, Ki-Jeong Kim, Sang-Woo Kim, Seok Won Kim, Young Jin Kim, Chun Kee Chung, Jun Jae Shin, Jae Keun Oh, Seong Yi, Jung Kil Lee, Jun Ho Lee, Ho Jin Lee, Hyoung-Joon Chun, Dae-Chul Cho, Yong Jun Jin, Kyung-Chul Choi,
    World Neurosurgery.2019; 126: e1050.     CrossRef
  • 12,554 View
  • 289 Download
  • 13 Crossref

Case Report

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Postlaminectomy Bilateral Lumbar Intraspinal Synovial Cysts
Korean J Spine. 2016;13(3):157-159.   Published online September 30, 2016
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Postlaminectomy Bilateral Lumbar Intraspinal Synovial Cysts
Korean J Spine. 2016;13(3):157-159.   Published online September 30, 2016
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Lumbar intraspinal synovial cysts are included in the difference diagnosis of lumbar radiculopathy. Developing imaging modalities has result in increased reporting about these lesions. However, the case of bilateral new lumbar intraspinal synovial cysts after laminectomy has been rarely reported. We report of a rare case with bilateral lumbar intraspinal synovial cysts after laminectomy, requiring surgical excision.

Citations

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  • Diagnostic challenge between hemorrhagic facet cyst and spontaneous spinal epidural hematoma: a case report and literature review
    Huseyin Sarikaya, Behrad Aras Nasehi, Mustafa Umut Etli, Mazlum Isik, Ali Erhan Kayalar, Semra Isik, Ali Fatih Ramazanoglu
    Egyptian Journal of Neurosurgery.2026;[Epub]     CrossRef
  • A challenge diagnosis of lumbar synovial facet cyst. A case report
    Zayed Filali, Amine Briki, Souad Ferjani, Yassine Aloui, Oubaidallah Moulahi, Naoufel Haddad
    International Journal of Surgery Case Reports.2024;[Epub]     CrossRef
  • Bilateral ganglion cysts at L4/5 causing central canal stenosis and producing sciatica and neurogenic claudication: a case report
    CM Allison, G Bonanos, A Varma
    The Annals of The Royal College of Surgeons of England.2022; 104(2): e41.     CrossRef
  • Transforaminal Epiduroscopic Laser Ablation for Removal of a Postlaminectomy Synovial Cyst: A Case Report
    Hee Yong Kang, So Yeon Kim, Chung Hun Lee, Sung Wook Park
    Medicina.2020; 56(5): 209.     CrossRef
  • Juxta Facet Cyst Associated with Lumbar Laminectomy
    Yoshiyuki Takaishi, Hirofumi Iwahashi, Naoto Nakamura, Takeshi Kondoh, Atsushi Uyama, Atsushi Arai
    Spinal Surgery.2018; 32(3): 311.     CrossRef
  • Hemorrhagic Lumbar Synovial Cyst after Microscopic Discectomy
    Hak Sung Kim, Seok Won Kim
    Korean Journal of Spine.2017; 14(3): 93.     CrossRef
  • 9,906 View
  • 110 Download
  • 6 Crossref

Clinical Article

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Hinge Fracture during Cervical Open-door Laminoplasty: Does it Affect Clinical and Radiographic Outcomes?
Korean J Spine. 2014;11(2):45-51.   Published online June 30, 2014
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Hinge Fracture during Cervical Open-door Laminoplasty: Does it Affect Clinical and Radiographic Outcomes?
Korean J Spine. 2014;11(2):45-51.   Published online June 30, 2014
Close
Objective

The purpose of this study was to determine whether the status of the hinge gutter affected clinical and radiographic outcomes of cervical open door laminoplasty.

Methods

We retrospectively analyzed 43 patients who had undergone cervical open door laminoplasty. 23 CT scans were performed at 2 days post-operation. The number of CT scans at 3, 6, 12 and 24 months were 16, 12, 21 and 11, respectively. We collected perioperative and follow-up data, including clinical and radiographic results.

Results

There were 7 patients without a hinge fracture and 16 patients with one or more hinge fractures at 2 days postoperation. There were 90 hinges, and the rate of ideal greenstick deformation of the hinge was 63% on 2-day-postoperative CT scans. Postoperative VAS scores of neck pain (p=0.012) in patients without a hinge fracture were higher than in patients with hinge fractures. The hinge healing rates were 37% at 3 months, 57.4% at 6 months, 86.4% at 12 months, and 85.4% at 24 months. Among the patients, 14 patients had healed hinges, and 7 patients had one or more hinge(s) that was/were not healed at 12 months post-operation. However, in clinical and radiographic outcomes, there was no difference between these patients.

Conclusion

Cervical open door laminoplasty was safe and provided stable reconstruction of laminar expansion. In radiographs, the difference between hinges that had healed and hinges that had not healed was statistically negligible. Hinge fractures might not influence the clinical and radiographic outcomes of cervical open door laminoplasty.

Citations

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  • Radiologic and Clinical Importance of Lamina Hinge Fractures After Open-Door Cervical Laminoplasty
    Gumin Jeong, Sehan Park, Jae Hwan Cho, Chang Ju Hwang, Ji-Ho Jeong, Dong-Ho Lee
    Clinical Spine Surgery.2026; 39(4): 130.     CrossRef
  • Safety and Efficacy of Combined Imbrication Axle Reconstruction and Z-Type Titanium Plate Fixation for Hinge Fracture Displacement During Open-Door Laminoplasty
    Fa-jing Liu, Ning Li, Yi Chai, Xiao-kun Ding, Hai-yun Yang, Peng-fei Li
    Journal of Neurological Surgery Part A: Central European Neurosurgery.2024; 85(05): 513.     CrossRef
  • Laminoplasty in Motion: Evolving Techniques and Complications
    Ian M. Singleton, Amit S. Piple, Ben Crawford, Ashish Mittal, Alexander A. Rosinski, Dimitriy G. Kondrashov
    Journal of Neurological Surgery Part A: Central European Neurosurgery.2024; 85(02): 171.     CrossRef
  • Effects of intraoperative hinge fracture on postoperative cervical spine alignment in double door cervical laminoplasty
    Yu Chung Wong, Wai Wang Chau, Kin On Kwok, Sheung Wai Law
    Journal of Orthopaedics, Trauma and Rehabilitation.2024; 31(2): 216.     CrossRef
  • Influence of fixed titanium plate position on the effectiveness of open-door laminoplasty for cervical spondylotic myelopathy
    Fa-jing Liu, Xiao-kun Ding, Yi Chai, Su-hong Qi, Peng-fei Li
    Journal of Orthopaedic Surgery and Research.2022;[Epub]     CrossRef
  • Biomechanics optimisation of the laminoplasty groove size and position: A numerical study
    Ales Hrouda, Lukas Capek, Jan Hradil, Zdenek Horak
    Journal of Clinical Neuroscience.2022; 105: 45.     CrossRef
  • Open-door servikal laminoplasti tekniğine bağlı hinge fraktürü (menteşe kırığı) komplikasyonu gelişmesini etkileyen risk faktörlerinin değerlendirilmesi
    Gökhan GÜRKAN, İsmail KAYA, Murat ATAR, İnan UZUNOGLU, İlker Deniz CİNGOZ, Murat SAYIN, Nurullah YÜCEER
    Ege Tıp Dergisi.2021; 60(3): 281.     CrossRef
  • The opening size of the laminoplasty is dependent on the groove size: A numerical study
    Jan Hradil, Zdenek Horak, Petr Henys, Lukas Capek
    Clinical Biomechanics.2021; 89: 105479.     CrossRef
  • The Efficacy of Ultrasonic Bone Scalpel for Unilateral Cervical Open-Door Laminoplasty: A Randomized Controlled Trial
    Chi Heon Kim, Chun Kee Chung, Yunhee Choi, Calvin C Kuo, Urim Lee, Seung Heon Yang, Chang-Hyun Lee, Jong-Myung Jung, Sung Hwan Hwang, Dong Hwan Kim, Joon Ho Yoon, Seoi Paik, Hwa Jin Lee, Sunhyang Jung, Sung Bae Park, Kyoung-Tae Kim, Hee-Pyoung Park
    Neurosurgery.2020; 86(6): 825.     CrossRef
  • Motion Preservation at All Costs? Multilevel Hinge Nonunion, Plate Breakage, and Intradural Plate Migration After Cervical Laminoplasty: A Case Report and Literature Review
    Alexander Rosinski, Khalid Odeh, Jeremi Leasure, Dimitriy Kondrashov
    World Neurosurgery.2020; 135: 80.     CrossRef
  • Surgical decision-making for ossification of the posterior longitudinal ligament versus other types of degenerative cervical myelopathy: anterior versus posterior approaches
    Suzanna Sum Sum Kwok, Jason Pui Yin Cheung
    BMC Musculoskeletal Disorders.2020;[Epub]     CrossRef
  • Risk Factors for Hinge Fracture Associated with Surgery Following Cervical Open-Door Laminoplasty
    Jung Hwan Lee, Chung Kee Chough
    Korean Journal of Neurotrauma.2018; 14(2): 118.     CrossRef
  • Cervical Open-Door Laminoplasty by Hydroxyapatite Implant Insertion Without Suturing
    Yoshifumi Kawanabe, Motoaki Fujimoto, Tsukasa Sato
    Neurospine.2018; 15(4): 362.     CrossRef
  • 9,416 View
  • 95 Download
  • 13 Crossref

Original Article

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Pyogenic Spondyliodiscitis with Negative Culture Result: A Comparative Study of Clinical Course Versus Positive Culture Result.
Korean J Spine. 2008;5(3):184-189.
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Pyogenic Spondyliodiscitis with Negative Culture Result: A Comparative Study of Clinical Course Versus Positive Culture Result.
Korean J Spine. 2008;5(3):184-189.
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OBJECTIVE
This study is performed to compare the clinical courses (feature, treatment and outcomes) in patients with negative versus positive culture result in pyogenic spondylodiscitis.
METHODS
From January 2001 to December 2006, we reviewed clinical data in 26 consecutive patients with pyogenic spondylodiscitis retrospectively. We exclude patients that underwent surgical irrigation or debridement with biopsy. We measured clinical outcomes, length of antibiotic administration, recurrence rate, laboratory studies (CRP, ESR and leukocyte counts) and complications between two groups. Clinical outcomes were rated with Macnab's criteria.
RESULTS
Causative organisms were confirmed in 6 cases and the other 20 cases had negative culture result. Mean follow-up duration was 13 months. Mean intravenous antibiotics administration duration of patients having negative culture result was 8.4 weeks and oral was 5 months. On the other hand, in cases of positive culture result, mean intravenous duration was 8.7 weeks and oral was 5.2 months. Initial mean ESR and CRP were elevated, and decreased in both groups according to antibiotics medication (p<0.001 and p=0.001). But initial mean WBC count was normal range. There was no difference in tendencies of decrement of ESR and CRP between two groups (p=0.61 and p=0.571). Clinical outcomes (p=0.231) and complications (p=0.558) were not significantly different. There were no recurrence case for followup period.
CONCLUSION
Negative culture results did not significantly affect the clinical course of pyogenic spondylodiscitis when we compared the clinical courses of both groups.
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Case Report

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Symptomatic Spinal Epidural Lipomatosis Induced by Repeated Epidural Steroid Injections.
Korean J Spine. 2009;6(3):218-220.
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Symptomatic Spinal Epidural Lipomatosis Induced by Repeated Epidural Steroid Injections.
Korean J Spine. 2009;6(3):218-220.
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We present a very rare case of symptomatic spinal epidural lipomatosis(SEL) induced by repeated epidural steroid injections. A 59-year-old woman presented with severe neurogenic claudication and bilateral radiating leg pain aggravated for 1 year. She had undergone epidural triamcinolone injections 19 times for 3 years in a local clinic for chronic low back pain. At first, there had been no symptoms of lumbar stenosis such as leg pain or claudication. During the period of injections, radiating leg pain and claudication appeared newly and were gradually aggravated. Hormonal study and physical examination confirmed iatrogenic Cushing's syndrome. Magnetic resonance imaging(MRI) revealed extensive epidural fat deposition compressing cauda equnina from L3 to S1. Therefore, we concluded that multiple epidural steroid injections caused iatrogenic Cushing's syndrome and SEL. We performed debulking of epidural fat and bilateral neural decompression via left unilateral partial hemilaminectomy at L3-4-5-S1 in order to preserve stability considering preexisting multiple compression fractures. After operation, the patient's neurogenic claudication and radiating pain were completely disappeared.
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