Publications by authors named "Chi-Heon Kim"

The efficacy of preoperative radiotherapy combined with surgery (preRT + S) for primary retroperitoneal sarcoma (RPS) remains unclear. This study aimed to compare preRT + S with surgery alone (SA) in patients with RPS. Core databases were searched for directly comparative studies depending on preRT.

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Oblique lumbar interbody fusion (OLIF) is a minimally invasive lateral lumbar fusion technique and patients are discharged 1-2 days after surgery. Because OLIF utilizes a retroperitoneal approach close to the superior hypogastric plexus, postoperative urinary retention (POUR) may not be an uncommon problem. The purpose of this study was to present the incidence and outcomes of POUR with a systematic care protocol.

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We investigated the regulation of histone deacetylases (HDACs) by miR-2861 in the osteoblastic differentiation of human mesenchymal stem cells (MSCs) and miR-2861 binding site by CRISPR activation (CRISPRa). Transfection of miR-2861 into human MSCs was performed and the effect on osteoblast differentiation was analyzed. Using catalytically inactive Cas12a, the CRISPRa system induced targeted overexpression of endogenous miRNA and repressed the luciferase activities of reporters that contained functional miRNA target sites.

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Objective: Classification guides the surgical approach and predicts prognosis. However, existing classifications of spinal schwannomas often result in a high 'unclassified' rate. Here, we aim to develop a new comprehensive classification for spinal schwannomas based on their presumed origin.

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Article Synopsis
  • Patients after cervical laminoplasty may not need regular follow-ups if their symptoms improve significantly; this study aimed to use machine learning to predict long-term outcomes at the 2-year mark based on initial postoperative results.
  • A total of 80 patients’ progress was tracked using Japanese Orthopedic Association (JOA) scores over the first year, and eight machine learning algorithms were developed, with the LSTM algorithm showing the highest accuracy in predicting which patients would achieve a satisfactory symptom state (PASS) by 24 months.
  • Despite a small patient sample, the findings suggest that past outcomes can inform future predictions, potentially helping optimize follow-up schedules and allocate medical resources more efficiently.
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Background Context: Numerous prognostic models are utilized for surgical decision and prognostication in metastatic spine tumors. However, these models often fail to consider the whole-body tumor burden into account, which may be crucial for the prognosis of metastatic cancers. A potential surrogate marker for tumor burden, whole-body metabolic tumor burden (wMTB), can be calculated from total lesion glycolysis (TLG) obtained from F-Fludeoxyglucose positive emission tomography (F-FDG PET) images.

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  • The study evaluated the effectiveness of the Erector Spinae Plane Block (ESPB) for improving postoperative quality of recovery (QoR) in patients undergoing transforaminal lumbar interbody fusion (TLIF) or oblique lumbar interbody fusion (OLIF).
  • Patients were divided into two groups: one receiving ESPB and the other as a control, with QoR measured before surgery and on days 1 and 3 after surgery.
  • Results showed no significant difference in QoR-15 scores between the groups, but the ESPB group reported lower pain scores during ambulation and ambulated sooner after surgery, indicating some benefits in pain management rather than overall recovery quality.
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Dual-position oblique lumbar interbody fusion with fluoroscopy (D-OLIF) requires repositioning the patient to a prone position for pedicle screw insertion. Recently, single-position surgery with navigation has been introduced. However, there are concerns regarding pedicle screw accuracy and achieving appropriate sagittal balance in single-position OLIF with navigation (S-OLIF).

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Article Synopsis
  • * Analyzed data from 43 patients showed that IOUS effectively confirmed tumor locations, aided in minimizing neural injury, and helped identify hidden lesions, leading to better surgical outcomes.
  • * The findings suggest that IOUS is a beneficial tool in spinal surgeries, as it improves the accuracy of tumor removal and reduces the risk of complications.
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Background And Objectives: In cases where dumbbell-shaped cervical schwannoma encases the vertebral artery (VA), there is a risk of VA injury during surgery. The objective of this study is to propose a strategy for preserving the VA during the surgical excision of tumors adjacent to the VA through the utilization of anatomic layers.

Methods: A retrospective analysis was conducted on 37 patients who underwent surgery for dumbbell-shaped cervical schwannoma with contacting VA from January 2004 to July 2023.

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  • The study examined trends in degenerative lumbar spinal surgeries in South Korea during the first year of the COVID-19 pandemic, focusing on three epidemic waves in 2020.
  • Surgeries decreased after the first two waves, but patient numbers rebounded in later months, with the third wave not impacting surgical volumes.
  • Despite a reduction in average length of hospital stay and a rise in costs, the study found decreased transfer and readmission rates, suggesting that surgical care adapted well during the pandemic.
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  • Lumbar spinal stenosis (LSS) and spondylolisthesis (SPL) are similar degenerative spinal conditions that have different recommendations regarding exercise, making it challenging to study the impact of physical activity on them.
  • This study examined the effects of restricted physical activity due to social distancing during the pandemic on healthcare visits and costs for patients with LSS and SPL, comparing data from the pandemic period to pre-pandemic.
  • Results showed a significant decrease in hospital visits for both LSS and SPL patients after the implementation of social distancing, with LSS patients also experiencing a notable reduction in medical costs, while SPL patients did not see a significant change in costs.
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This study aimed to compare the long-term effects of flexion- and extension-based lumbar exercises on chronic axial low back pain (LBP). This was a 1-year follow-up of a prospective, assessor-blind, randomized controlled trial. Patients with axial LBP (intensity ≥ 5/10) for > 6 months allocated to the flexion or extension exercise group.

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Article Synopsis
  • * Using data from the National Health Insurance Service-National Sample Cohort in South Korea, 3,881 patients who underwent surgery for various lumbar spine conditions were analyzed.
  • * Results showed that patients who had secondary surgery incurred higher costs, both for surgery ($1,829.59 vs. $1,618.40) and interim expenses, indicating that tracking these costs can help identify patients who may need further procedures.
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Objective: Although adult spinal deformity (ASD) surgery aims to restore and maintain alignment, proximal junctional kyphosis (PJK) may occur. While existing scoring systems predict PJK, they predominantly offer a generalized 3-tier risk classification, limiting their utility for nuanced treatment decisions. This study seeks to establish a personalized risk calculator for PJK, aiming to enhance treatment planning precision.

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Although the role of plain radiographs in diagnosing lumbar spinal stenosis (LSS) has declined in importance since the advent of magnetic resonance imaging (MRI), diagnostic ability of plain radiographs has improved dramatically when combined with deep learning. Previously, we developed a convolutional neural network (CNN) model using a radiograph for diagnosing LSS. In this study, we aimed to improve and generalize the performance of CNN models and overcome the limitation of the single-pose-based CNN (SP-CNN) model using multi-pose radiographs.

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  • The study investigates the effectiveness of the comprehensive Enhanced Recovery After Surgery (ERAS) protocol on spine surgery patients, focusing on both primary spine tumors (PSTs) and degenerative spinal diseases (DSDs).
  • Through a retrospective analysis of 7143 surgical procedures performed at a hospital from 2003 to 2021, the study compares outcomes before and after the full implementation of the ERAS protocol.
  • Results indicate that the ERAS protocol significantly reduced the length of hospital stay and medical costs by 22% overall, with a more notable 28% reduction in the PST group compared to a 16% reduction in the DSD group.
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Background Context: Electrical stimulation is a noninvasive treatment method that has gained popularity in the treatment of spinal cord injury (SCI). Activation of spinal cord-derived neural stem/progenitor cell (SC-NSPC) proliferation and differentiation in the injured spinal cord may elicit considerable neural regenerative effects.

Purpose: This study aimed to explore the effect of electrical stimulation on the neurogenesis of SC-NSPCs.

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Conventional cage and plate (CCP) implants usually used in ACDF surgery, do have limitations such as the development of postoperative dysphagia, adjacent segment degeneration, and soft tissue injury. To reduce the risk of these complications, zero-profile stand-alone cage were developed. We used finite-element modeling to compare the total von Mises stress applied to the bone, disc, endplate, cage and screw when using CCP and ZPSC implants.

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Background And Objectives: Oblique lumbar interbody fusion (OLIF) procedures involve anterior insertion of interbody cage in lateral position. Following OLIF, insertion of pedicle screws and rod system is performed in a prone position (OLIF-con). The location of the cage is important for restoration of lumbar lordosis and indirect decompression.

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Background: The clinical healing environment after a posterior spinal arthrodesis surgery is one of the most clinically challenging bone-healing environments across all orthopedic interventions due to the absence of a contained space and the need to form de novo bone. Our group has previously reported that sclerostin in expressed locally at high levels throughout a developing spinal fusion. However, the role of sclerostin in controlling bone fusion remains to be established.

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Background Context: C3 laminectomy in cervical laminoplasty is a modified laminoplasty technique that can preserve the semispinalis cervicis muscle attached to the C2 spinous process. Several previous studies have shown that this technique can lead to better outcomes of postoperative axial neck pain and C2-C3 range of motion (ROM) than conventional cervical laminoplasty. However, there is still a lack of understanding of total and proportional postoperative cervical sagittal alignment outcomes.

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Objective: Surgery for spinal giant cell tumors (GCTs) is challenging because these tumors often exhibit a poor clinical course owing to their locally aggressive features. This study aimed to investigate the prognostic factors of GCT recurrence in the spine by focusing on surgical factors.

Methods: We retrospectively reviewed patients who underwent surgery for spinal GCTs between January 2005 and December 2016.

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Purpose: Spinal schwannomas often require laminectomy for gross total resection. However, laminectomy may not be necessary due to the unique anatomy of epidural schwannomas at the C1-2 level, even with the intradural part. This study aimed to determine the need for laminectomy by comparing factors between patients who underwent laminectomy and those who did not and to identify the benefits of not performing laminectomy.

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