Publications by authors named "Subum Lee"

Spinal cord injury (SCI) remains a significant clinical challenge, with no fully effective treatment available despite advancements in various therapeutic approaches. This review examines the emerging role of induced neural stem cells (iNSCs) as promising candidates for SCI treatment, highlighting their potential for direct neural regeneration and integration with host tissue. We explore the biology of iNSCs, their mechanisms of action, and their interactions with host tissue, including modulating inflammatory responses, promoting axonal growth, and reconstructing neural circuits.

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Spinal cord injury (SCI) following high-energy trauma often leads to lasting neurologic deficits and severe socioeconomic impact. Effective neurointensive care, particularly in the early stages post-injury, is essential for optimizing outcomes. This review discusses the role of neurointensive care in managing SCI, emphasizing early assessment, stabilization, and intervention strategies based on recent evidence-based practices.

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Spinal cord injury (SCI) frequently results in persistent motor, sensory, or autonomic dysfunction, and the outcomes are largely determined by the location and severity of the injury. Despite significant technological progress, the intricate nature of the spinal cord anatomy and the difficulties associated with neuroregeneration make full recovery from SCI uncommon. This review explores the potential of artificial intelligence (AI), with a particular focus on machine learning, to enhance patient outcomes in SCI management.

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Tuberculous (TB) spondylitis, also known as Pott's disease, was first described by Percivall Pott in 1779. The diagnosis of TB spondylitis is often delayed because of the non-specific nature of the infection, which can lead to severe consequences. Differential diagnosis is especially critical in cancer patients undergoing chemotherapy who present with lymph node or bone metastasis.

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Objective: Cerebrospinal fluid (CSF) leak after resection of intradural spinal tumors (IST) represents a significant postoperative challenge. Although various dura suture techniques and materials have been explored experimentally, direct clinical comparative studies are lacking. This study evaluated the effectiveness of specific suture materials in primary dural closure post-IST resection and identified associated risk factors for CSF leak.

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Article Synopsis
  • - This study investigates the effectiveness of cervical pedicle screw placement (CPS) combined with 5.5-mm rods versus traditional 3.5-mm rods in patients with metastatic cervical spinal tumors (MCSTs).
  • - Analyzed 58 patients who underwent surgery between 2012 and 2022, the study evaluated various factors including pain levels and overall health status pre- and post-surgery.
  • - Results showed that CPS with 5.5-mm rods provided better stability, reduced neck pain more effectively, and resulted in fewer complications compared to the use of 3.5-mm rods.
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Objective: Although several studies have reported successful fusion rates after oblique lumbar interbody fusion (OLIF) using allografts or dimerized bone matrix (DBM) instead of autografts, whether OLIF can achieve satisfactory solid fusion without the use of autografts remains unclear. This study investigated the real fusion rates after OLIF using allografts and DBM, which were evaluated using both dynamic radiographs and computed tomography scans.

Methods: We enrolled 79 consecutive patients who underwent minimally invasive OLIF followed by percutaneous pedicle screw fixation.

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Background: This study aimed to evaluate the efficacy of unilateral pediculectomy and reduction with short-segment pedicle screw fixation for thoracolumbar burst fracture.

Methods: We retrospectively reviewed patients who underwent a unilateral pediculectomy and reduction with short-segment fixation and interbody fusion for thoracolumbar burst fracture. The unilateral pediculectomy created sufficient space to approach the ventral side of the spinal cord for removing bone fragments and insertion of an interbody cage to correct kyphosis.

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Background And Objectives: Ossification of the posterior longitudinal ligament (OPLL) is a potentially catastrophic disease. Laminoplasty (LP) is a common surgical intervention, but postoperative kyphosis progression is a major complication, for which various risk factors have been identified and used in surgical decision-making. Our focus is on the ability of OPLL with specific morphological traits, designated as the true continuous segment (TCS), to stabilize alignment and prevent postoperative kyphosis after LP.

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Article Synopsis
  • The high cervical spine is vital for survival, protecting key neurovascular structures and facilitating head movement, making injuries, particularly to the C2 vertebra, a common concern.
  • The two main types of C2 fractures are odontoid fractures, which can often be treated conservatively or with anterior screw fixation and fusion if needed, and Hangman's fractures, which may require surgery depending on their type and stability.
  • The review emphasizes that there's no clear superiority of surgical approaches (anterior vs. posterior) for fracture treatment, and decisions should be made based on individual patient circumstances.
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Aim: To evaluate the efficacy and safety of total en bloc spondylectomy with autologous sternal structural graft, subaxial pedicle screws, and 5.5 mm titanium rods in primary bone tumor surgery.

Material And Methods: From January 2019 to February 2020, two patients with lower cervical spine (C7) primary bone tumor underwent total en bloc spondylectomy, interbody fusion with sternal structural autograft, and posterior instrumentation using subaxial pedicle screws.

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Tuberculous spondylitis often develops catastrophic bone destruction with uncontrolled inflammation. Because anti-tuberculous drugs do not have a role in bone formation, a combination drug therapy with a bone anabolic agent could help in fracture prevention and promote bone reconstruction. This study aimed to investigate the influence of teriparatide on the effect of anti-tuberculous drugs in tuberculous spondylitis treatment.

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Article Synopsis
  • The study aimed to identify criteria for successful atlantoaxial (AA) fusion by analyzing the outcomes of patients who underwent the procedure, using follow-up imaging.
  • Out of 161 patients analyzed, 49 were included based on having at least a year of follow-up; 91.8% achieved successful bone fusion, while 28.6% exhibited screw halos, which did not significantly affect fusion failure rates.
  • A notable finding was that a larger segmental angle (SA) gap during flexion-extension dynamic radiographs correlated with an increased risk of fusion failure, specifically when the SA gap exceeded 2.62°.
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Objective: Neuropathic pain is a common secondary complication of spinal cord injury (SCI). N-methyl-D-aspartate (NMDA) receptor activation is critical for hypersensitivity in neuropathic pain. This activation requires the binding of both glutamate and the D-serine co-agonist to the NMDA glycine site.

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Article Synopsis
  • The study aimed to compare the outcomes of two types of spinal fusion surgeries: Transforaminal Lumbar Interbody Fusion (TLIF) and Oblique Lumbar Interbody Fusion (OLIF) in patients undergoing revision surgery.
  • It involved 50 patients (25 OLIF, 25 TLIF) and assessed various metrics, including spinal canal cross-sectional area and patient-reported pain and disability levels post-surgery.
  • The findings suggested that while both methods improved patient outcomes, OLIF had fewer complications and may be a safer minimally invasive alternative to TLIF for revision surgeries.
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Ligamentum flavum hypertrophy (LFH) is a known contributor to lumbar spinal canal stenosis (LSCS). However, the clinical significance and quantitative role of LFH compared to other components, such as disc bulging and facet hypertrophy, have not yet been examined. We investigated the correlation between the quantitative radiological factors, clinical symptoms, and outcomes in patients with LSCS.

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Background Context: Although the surgical corridor used for oblique lateral interbody fusion (OLIF) protects the intrapsoas nerves by causing minimal compression, transient weakness remains the most commonly reported postoperative complication.

Purpose: Using a dynamometer to evaluate how the hip flexor strength changes following OLIF.

Study Design/setting: A prospective observational study.

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The incidence of spinal metastasis is increasing as cancer patients live longer owing to the improvement of cancer treatments. However, traditional surgery (TS) which fixates at least 2 levels above and 2 levels below the affected vertebrae is sometimes difficult to perform as it is burdensome to the patients. In this article, we introduce our experience and strategy in treating spinal metastasis, focusing particularly on challenging cases.

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Curcumin is a polyphenolic chemical derived from the rhizomes of Curcuma longa. It has been used throughout the Indian subcontinent for medicinal purposes, religious events, and regional cuisine. It has various pharmacological benefits owing to its anti-inflammatory and antioxidant properties.

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Article Synopsis
  • This study examines the differences in spinal stress during various movements (flexion-extension, lateral bending, and axial rotation) between osteoporotic and normal spines using a 3D finite element model.
  • Findings show that osteoporotic spines experience higher von Mises stress in the nucleus pulposus and certain annulus fibrosus areas during all movements compared to normal spines.
  • The results suggest that increased stress in the lumbar region, particularly in osteoporotic vertebrae, may help explain disc-related pain and degeneration.
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Spinal epidural arteriovenous fistula (SEDAVF) is a rare vascular malformation. Due to the mass effect of enlarged epidural veins and venous hypertension, progressive radiculopathy and myelopathy are likely to occur. A 33-year-old female presented with right upper extremity weakness for a month.

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Background: Many studies have described different C1-2 fusion techniques that have evolved over time. We introduced an easy and effective C1-2 fusion technique using local bone chips combined with atlantoaxial instrumentation.

Objective: To identify the efficacy of interfacetal fusion using local bone combined with atlantoaxial instrumentation by assessment of clinical outcomes and fusion rate.

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We have analyzed and compared the publication trends in 4 representative spinal journals [Spine, European Spinal Journal (EUS), The Spine Journal (TSJ), and the Journal of Neurosurgery - Spine (JNS spine)] from 2016 to 2018.A total of 3784 articles were published in the 4 representative journals: 1358, 1128, 685, and 613 articles in Spine, EUS, TSJ, and JNS spine, respectively. We compared and analyzed each periodical for the time taken (days) for the publication process, the distribution of specialties of the corresponding author, multicity of the investigative institutions, main disease entity, study type, and design.

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Objective: Cerebrospinal fluid leakage related complications (CLC) occasionally occur after intradural spinal surgery. We sought to investigate the effectiveness of early ambulation after intradural spinal surgery and analyze the risk factors for CLC.

Methods: For this retrospective cohort study, we enrolled 314 patients who underwent intradural spinal surgery at a single institution.

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