Prospective comparative analysis of three types of decompressive surgery for lumbar central stenosis: conventional, full-endoscopic, and biportal endoscopic laminectomy.

Conventional open laminectomy has long been considered one of the important surgical options for lumbar central stenosis owing to its positive outcomes. However, newer approaches have emerged as alternatives, including full-endoscopic and biportal endoscopic laminectomy. Therefore, a comparison of the outcomes that are associated with each of these surgical methods is warranted.

Low-Level Environmental Mercury Exposure and Thyroid Cancer Risk Among Residents Living Near National Industrial Complexes in South Korea: A Population-Based Cohort Study.

Previous studies suggested that mercury may be linked to thyroid cancer due to its bioaccumulation in the thyroid gland, but no studies have evaluated the association between mercury exposure and thyroid cancer risk. We examined the relationship between mercury exposure and thyroid cancer risk, with the potential modification of hematological parameters. We performed a secondary analysis of a prospective cohort study among residents living near industrial complexes in South Korea (recruited from 2003 to 2011).

Environmental health survey for children residing near mining areas in South Gobi, Mongolia.

Background: We evaluated the level and factors of heavy metal exposure to children residing in the Togttsetsii, Khanbogd, and Bayandalai soums of South Gobi province, Mongolia.

Methods: A total of 118 children aged 9-12 years were surveyed, and the level of heavy metal exposure in their bodies was investigated. Exposure was investigated by measuring concentrations of heavy metals such as cadmium, lead, and mercury in the blood; mercury concentration in the hair; and total arsenic in the urine.

Toluene concentrations in the blood and risk of thyroid cancer among residents living near national industrial complexes in South Korea: A population-based cohort study.

Background: Toluene is classified as a possible carcinogen, but its role on thyroid cancer is not well established. Vehicle emissions are one of the largest contributed sources of toluene, but no studies evaluating the influence of living near a road on the association between toluene and the incidence of thyroid cancer have been reported. Therefore, we examined potential associations between blood toluene concentrations and incidence risk of thyroid cancer, and an effect modification of living near a road.

Environmental exposure to cadmium and risk of thyroid cancer from national industrial complex areas: A population-based cohort study.

Background: Cadmium is known to act as a thyroid disruptor and carcinogen in humans. Recent evidence suggests that cadmium may play a role as a thyroid carcinogen due to its endocrine-disrupting activity, but this characterization remains unclear.

Objective: We investigated the association between urinary cadmium and primary thyroid cancer, and the modifying effect of diabetes on this association.

The Biportal Endoscopic Posterior Cervical Inclinatory Foraminotomy for Cervical Radiculopathy: Technical Report and Preliminary Results.

The purpose of the current study was to introduce a surgical technique for posterior cervical inclinatory foraminotomy (PCIF) using a percutaneous biportal endoscopic (BE) approach. Consecutive 7 patients underwent BE-PCIF for their cervical radiculopathy. Postoperative radiologic images (x-rays, computed tomography [CT], and magnetic resonance imaging [MRI]) were evaluated postoperatively for optimal neural decompression status and stability.

Technical Considerations in Endoscopic Lumbar Decompression.

With technical development and evolution of endoscopic instruments, endoscopic spinal surgery has become one of the standard treatments for various lumbar spinal diseases ranging from a simple contained disc to complicated cases such as highly migrated disc herniation and other pathology combined with bony degeneration to produce foraminal and canal stenosis. Favorable clinical results of endoscopic decompression for lumbar stenotic disease were reported by several authors. However, studies have also reported limitations, such as steep learning curves and a relatively high complication rate compared with conventional techniques.

Comparison of Short-Term Associations between PM Components and Mortality across Six Major Cities in South Korea.

Association between short-term exposure to fine particulate matter (PM) and mortality or morbidity varies geographically, and this variation could be due to different chemical composition affected by local sources. However, there have been only a few Asian studies possibly due to limited monitoring data. Using nationwide regulatory monitoring data of PM chemical components in South Korea, we aimed to compare the associations between daily exposure to PM components and mortality across six major cities.

Comparative Analysis between Three Different Lumbar Decompression Techniques (Microscopic, Tubular, and Endoscopic) in Lumbar Canal and Lateral Recess Stenosis: Preliminary Report.

Purpose: The purpose of our study is to compare the results of spinal decompression using the full-endoscopic interlaminar technique, tubular retractor, and a conventional microsurgical laminotomy technique and evaluate the advantages and clinical feasibility of minimally invasive spinal (MIS) lumbar decompression technique in the lumbar canal and lateral recess stenosis.

Methods: The authors retrospectively reviewed clinical and radiological data from 270 patients who received microsurgical (group E: 72 patients), tubular (group T: 34 patients), or full-endoscopic decompression surgery (group E: 164 patients) for their lumbar canal and lateral recess stenosis from June 2016 to August 2017. Clinical (VAS, ODI, and Mcnab criteria), radiologic (spinal canal diameter, segmental dynamic angle, and disc height), and surgical outcome parameters (CPK level, Operative time, blood loss, and hospital stay) were evaluated pre- and postoperatively and compared among the three groups by means of statistical analysis.

Biportal Endoscopic Spinal Surgery for Bilateral Lumbar Foraminal Decompression by Switching Surgeon's Position and Primary 2 Portals: A Report of 2 Cases With Technical Note.

Total facetectomy with/without fusion and facet-preserving microforaminotomy have been performed as conventional surgical treatments for lumbar foraminal stenosis (LFS). Recently, endoscopic spinal surgery has been introduced as a minimally invasive therapeutic modality of LFS by several authors. We report two cases of bilateral LFS at lumbosacral junction level successfully treated with a novel biportal endoscopic spine surgery (BES) technique using primary 2 portals.

Percutaneous Endoscopic Decompression in Lumbar Canal and Lateral Recess Stenosis - The Surgical Learning Curve.

Objective: The purpose of this study is to characterize the learning curve of endoscopic lumbar decompression based on peri- and postoperative parameters and to suggest the potential of full endoscopic decompression as a primary treatment option for lumbar canal and lateral recess stenosis.

Methods: The records of 223 consecutive patients who underwent percutaneous endoscopic decompression by a single surgeon for their lumbar canal and lateral recess stenosis were reviewed. Patients were stratified into group 1 (n=100) and group 2 (n=123), depending on their case number.

The Usefulness of Percutaneous Endoscopic Technique in Multifocal Lumbar Pathology.

The multifocal lumbar pathology including disc herniation and stenosis in the spinal canal or foramen has been considered the most difficult to approach surgically. It often requires mandatory dual approaches and/or fusion techniques. Traditional percutaneous endoscopic lumbar transforaminal and interlaminar approach has been focused on unifocal disc herniation.

Surgical Treatment of Extraforaminal Gas-Containing Pseudocyst Compressing L5 Nerve Root by Using Unilateral Biportal Endoscopy.

Background: Most gaseous lumbar pseudocysts have been previously reported to be located in the spinal canal and successfully treated by several therapeutic methods. By comparison, a gas-containing pseudocyst in the lumbar extraforaminal area is rare. Here, the authors report a case of symptomatic gas-containing cyst located in the lumbar foramen.

Synthesis and Characterization of Co-Mn (O)OH Nanosheets Assembled Structure Covered of Reduced Graphene Oxide Hybrid Structures by Hydrothermal Method.

In this study, we prepared cobalt-manganese (oxy) hydroxide nanosheets assembled structure covered of reduced graphene oxide hybrid structure (Co-Mn (O)OH NAS@rGO HS) via reduction and hydroxylation of MnCo[Co(CN)]₂@graphene oxide (GO). Obtained precursors were optimized at 15 mg GO, and these are hybrid structures in which nanocubes 200-400 nm in size were fully covered by multi-layered GO. The functional group (-COOH, -OH, C-O-C) of GO was removed through reduction by L-ascorbic acid.

Percutaneous Endoscopic Laminotomy with Flavectomy by Uniportal, Unilateral Approach for the Lumbar Canal or Lateral Recess Stenosis.

Objective: To evaluate clinical feasibility and safety of percutaneous endoscopic decompression by a uniportal, unilateral approach for lumbar canal or lateral recess stenosis.

Methods: In this retrospective study, the procedure was performed with endoscopic instruments in the same way as conventional microscopic laminotomy and flavectomy. Clinical outcomes (visual analog scale, Oswestry Disability Index, modified MacNab criteria) were evaluated.

Increase in nitrite content and functionality of ethanolic extracts of Perilla frutescens following treatment with atmospheric pressure plasma.

This study investigated the effect of atmospheric pressure plasma (APP) treatment on nitrite content and functionality of plant extracts. Ethanolic extracts of Perilla frutescens (EEP) were prepared and treated with APP for 60min. Nitrite content increased from 0 to 45.

Which Approach Is Advantageous to Preventing Development of Adjacent Segment Disease? Comparative Analysis of 3 Different Lumbar Interbody Fusion Techniques (ALIF, LLIF, and PLIF) in L4-5 Spondylolisthesis.

Objective: The purpose of this study was to compare radiologic and clinical outcomes in patients with L4-5 lumbar spondylolisthesis who have undergone either instrumented anterior lumbar interbody fusion (ALIF), lateral lumbar interbody fusion (LLIF), or posterior lumbar interbody fusion (PLIF), especially with regard to the development of adjacent segment disease (ASD).

Methods: Eighty-two patients with preoperative L4-5 spondylolisthesis and minimal ASD who underwent instrumented L4-5 fusion were divided into 3 groups according to the surgical approach used for treatment (ALIF: 27 patients, LLIF: 24 patients, PLIF: 31 patients). Radiographic measurements including preoperative and postoperative foraminal and disk height, segmental and lumbar lordosis, percentage of vertebral slippage, and reduction rate were reviewed.

Foraminoplastic Superior Vertebral Notch Approach with Reamers in Percutaneous Endoscopic Lumbar Discectomy : Technical Note and Clinical Outcome in Limited Indications of Percutaneous Endoscopic Lumbar Discectomy.

To describe the details of the foraminoplastic superior vertebral notch approach (FSVNA) with reamers in percutaneous endoscopic lumbar discectomy (PELD) and to demonstrate the clinical outcomes in limited indications of PELD. Retrospective data were collected from 64 patients who underwent PELD with FSVNA from August 2012 to April 2014. Inclusion criteria were high grade migrated disc, high canal compromised disc, and disc protrusion combined with foraminal stenosis.

Radicular compression by intraspinal epidural gas bubble occurred in distant two levels after lumbar microdiscectomy.

The authors report a case of symptomatic epidural gas accumulation 2 weeks after the multi-level lumbar surgery, causing postoperative recurrent radiculopathy. The accumulation of epidural gas compressing the dural sac and nerve root was demonstrated by CT and MRI at the distant two levels, L3-4 and L5-S1, where vacuum in disc space was observed preoperatively and both laminectomy and discectomy had been done. However, postoperative air was not identified at L4-5 level where only laminectomy had been done in same surgical field, which suggested the relationship between postoperative epidural gas and the manipulation of disc structure.

Morphometric Relationship between the Cervicothoracic Cord Segments and Vertebral Bodies.

Objective: The objective of this study was to investigate the morphologic characteristics between the vertebral body and the regions of the cervical and thoracic spinal cords where each rootlets branch out.

Methods: Sixteen adult cadavers (12 males and 4 females) with a mean age of 57.9 (range of 33 to 70 years old) were used in this study.

Anesthetic experience of a patient with hereditary factor XI deficiency (Hemophilia C) : A case report.

Factor XI deficiency (also called Hemophilia C) rarely occurs among ethnicities other than Ashkenazi Jews. A boy was scheduled for frontoethmoidectomy due to bilateral chronic rhinosinusitis. He was incidentally found to have factor XI deficiency due to prolonged aPTT on preoperative laboratory finding.