Deep Learning Model Based on You Only Look Once Algorithm for Detection and Visualization of Fracture Areas in Three-Dimensional Skeletal Images.

Utilizing "You only look once" (YOLO) v4 AI offers valuable support in fracture detection and diagnostic decision-making. The purpose of this study was to help doctors to detect and diagnose fractures more accurately and intuitively, with fewer errors. The data accepted into the backbone are diversified through CSPDarkNet-53.

Risk factors for unplanned reoperation after corrective surgery for adult spinal deformity.

To determine the major risk factors for unplanned reoperations (UROs) following corrective surgery for adult spinal deformity (ASD) and their interactions, using machine learning-based prediction algorithms and game theory. Patients who underwent surgery for ASD, with a minimum of two-year follow-up, were retrospectively reviewed. In total, 210 patients were included and randomly allocated into training (70% of the sample size) and test (the remaining 30%) sets to develop the machine learning algorithm.

Clinical Effect of Transverse Process Hook with K-Means Clustering-Based Stratification of Computed Tomography Hounsfield Unit at Upper Instrumented Vertebra Level in Adult Spinal Deformity Patients.

Objective: This study aimed to investigate the efficacy of transverse process (TP) hook system at the upper instrumented vertebra (UIV) for preventing screw pullout in adult spinal deformity surgery using the pedicle Hounsfield unit (HU) stratification based on K-means clustering.

Methods: We retrospectively reviewed 74 patients who underwent deformity correction surgery between 2011 and 2020 and were followed up for >12 months. Pre- and post-operative data were used to determine the incidence of screw pullout, UIV TP hook implementation, vertebral body HU, pedicle HU, and patient outcomes.

Which Is More Predictive Value for Mechanical Complications: Fixed Thoracolumbar Alignment (T1 Pelvic Angle) Versus Dynamic Global Balance Parameter (Odontoid-Hip Axis Angle).

Objective: In this study, we investigate about relationship between postoperative global sagittal imbalance and occurrence of mechanical complications after adult spinal deformity (ASD) surgery. In global sagittal balance parameters, odontoid-hip axis (OD-HA) angle and T1 pelvic angle (TPA) were analyzed.

Methods: Between January 2009 and December 2016, 199 consecutive patients (26 males and 173 females) with ASD underwent corrective fusion of more than 4 levels and were followed up for more than 2 years.

Development of a direction-sensitive gamma-ray monitoring system using a gamma camera with a dual-sided collimator: A Monte Carlo study.

Nuclear explosions, sabotage, and dirty bomb materials are considered a security threat. This paper discusses the development of a gamma-ray monitoring system that enables the screening of nuclear materials moving simultaneously on both sides of the system at ports. This direction-sensitive gamma-ray monitoring (DSGM) system consists of a monolithic plastic scintillator surrounded by 28 photomultiplier tubes and dual-sided parallel-hole lead collimators.

Fully automated 3D segmentation and separation of multiple cervical vertebrae in CT images using a 2D convolutional neural network.

Background And Objective: We investigated a novel method using a 2D convolutional neural network (CNN) to identify superior and inferior vertebrae in a single slice of CT images, and a post-processing for 3D segmentation and separation of cervical vertebrae.

Methods: The cervical spines of patients (N == 17, 1684 slices) from Severance and Gangnam Severance Hospitals (S/GSH) and healthy controls (N == 24, 3490 slices) from Seoul National University Bundang Hospital (SNUBH) were scanned by using various volumetric CT protocols. To prepare gold standard masks of cervical spine in CT images, each spine was segmented by using conventional image-processing methods and manually corrected by an expert.

Residence could influence the surgical outcome after corrective surgery in adult spinal deformity: comparison study between urban and rural area in Korea.

Purpose: Numerous factors affect the surgical outcomes in patients with adult spinal deformity (ASD). However, no study has examined the relationship between residence and physical factors and surgical outcomes in patients with ASD. Here, we analysed the impact of residence and physical factors on the post-operative outcomes of patients with ASD residing in urban (U) and rural (R) environments.

Does minimally invasive fusion technique influence surgical outcomes in isthmic spondylolisthesis?

Objective: To compare the clinical and radiographic results between open transforaminal interbody fusion (TLIF-O) and minimally invasive TLIF (TLIF-M) for single-level low grade isthmic spondylolisthesis (IS).

Methods: This study enrolled 45 patients who underwent single-level TLIF with low grade IS. The patients were divided into two groups according to operative method: TLIF-M (20 patients) and TLIF-O (25 patients).

Herniated Discs at the Cervicothoracic Junction.

Background: Disc herniations at the cervicothoracic junction (C7-T1 level) are unusual, and there have only been a few studies of patients with herniated C7-T1 discs. In addition, previous studies did not focus on the mechanism and causes of solitary cervicothoracic junction disc herniation. The authors investigated the characteristics, symptom duration, clinical course, and biomechanics of cervicothoracic junction disc herniation by comparing patients with C7-T1 disc herniation (C7-T1 group) with control groups.

Surgical Outcomes After Segmental Limited Surgery for Adjacent Segment Disease: The Consequences of Makeshift Surgery.

Background: To minimize surgical morbidity, surgeons may opt to perform segmental limited surgery instead of fusion extension for adjacent segment disease (ASD) after lumbar fusion surgery. This study evaluated clinical outcomes from segmental limited surgery without fusion extension for ASD and assessed which clinical factors were associated with reoperation after segmental limited surgery.

Methods: Medical data of 50 patients who underwent segmental limited surgery for ASD after lumbar fusion surgery between 2005 and 2015 were reviewed.

Clinical relation among dural adhesion, dural ossification, and dural laceration in the removal of ossification of the ligamentum flavum.

Background Context: Dural laceration frequently occurs during surgery in patients with ossification of the ligamentum flavum (OLF), mainly because of dural adhesion (DA) and dural ossification (DO) between the ligamentum flavum and the dura mater. However, the radiological predictive factors of DA in OLF have rarely been reported.

Purpose: The objective of this study was to determine the preoperative radiological signs for predicting intraoperative DA in OLF by using preoperative magnetic resonance imaging (MRI) and computed tomography (CT).

Ossification foci act as stabilizers in continuous-type ossification of the posterior longitudinal ligament: a comparative study between laminectomy and laminoplasty.

Background: In multilevel ossification of the posterior longitudinal ligament (OPLL), laminectomy is an effective surgical technique; however, there is a possibility of kyphotic alignment change after surgery. Nevertheless, in the continuous type of OPLL, the ossification foci are connected and may act as stabilizers preventing alignment change. We here compare the surgical outcome of laminectomy and laminoplasty in continuous-type OPLL of the cervical spine.

A Rare Case of Aggressive Melanotic Schwannoma Occurred in Spinal Nerve of a 59-Year-Old Male.

Melanotic schwannoma (MS) is a rare variant of nerve sheath neoplasm that shows ultrastructural and immunophenotypical features of Schwann cells but also has cytoplasmic melanosomes and is reactive for melanocytic markers as well. Unlike conventional schwannoma, which is totally benign, MS has an unpredictable prognosis and is thought to have low-malignant potential. Herein, we present a rare case of recurrent MS in lumbar spine of a 59-year-old male.

A Nationwide Retrospective Study of Opioid Management Patterns in 2,468 Patients with Spinal Pain in Korea.

Study Design: Retrospective patient data collection and investigator survey.

Purpose: To investigate patterns of opioid treatment for pain caused by spinal disorders in Korea.

Overview Of Literature: Opioid analgesic prescription and adequacy of consumption measures in Korea have markedly increased in the past decade, suggesting changing patterns in pain management practice; however, there is lack of integrated data specific to Korean population.

Critical Values of Facet Joint Angulation and Tropism in the Development of Lumbar Degenerative Spondylolisthesis: An International, Large-Scale Multicenter Study by the AOSpine Asia Pacific Research Collaboration Consortium.

Study Design: An international, multicenter cross-sectional image-based study performed in 33 institutions in the Asia Pacific region.

Objective: The study addressed the role of facet joint angulation and tropism in relation to L4-L5 degenerative spondylolisthesis (DS).

Methods: The study included 349 patients (63% females; mean age: 61.

Is lumbar facet joint tropism developmental or secondary to degeneration? An international, large-scale multicenter study by the AOSpine Asia Pacific Research Collaboration Consortium.

Background: Facet joint tropism is asymmetry in orientation of the bilateral facets. Some studies have shown that tropism may increase the risk of disc degeneration and herniations, as well as degenerative spondylolisthesis (DS). It remains controversial whether tropism is a pre-existing developmental phenomena or secondary to progressive remodeling of the joint structure due to degenerative changes.

WITHDRAWN: Characteristics of patients with herniated discs at the cervicothoracic junction.

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An International Multicenter Study Assessing the Role of Ethnicity on Variation of Lumbar Facet Joint Orientation and the Occurrence of Degenerative Spondylolisthesis in Asia Pacific: A Study from the AOSpine Asia Pacific Research Collaboration Consortium.

Study Design A multinational, multiethnic, cross-sectional image-based study was performed in 33 institutions, representing 10 countries, which were part of the AOSpine Asia Pacific Research Collaboration Consortium. Objective Lumbar facet joint orientation has been reported to be associated with the development of degenerative spondylolisthesis (DS). The role of ethnicity regarding facet joint orientation remains uncertain.

Joint kinematics of surgeons during lumbar pedicle screw placement.

Background: A surgical robot for spine surgery has recently been developed. The objective is to assess the joint kinematics of the surgeon during spine surgery.

Methods: We enrolled 18 spine surgeons, who each performed pedicle screw placement, and used an optoelectronic motion analysis system.

Which iodinated contrast media is the least cytotoxic to human disc cells?

Background: Iodinated contrast media (CM) is commonly used for various intradiscal injections such as in discography and endoscopic spinal surgery. However, CM has been shown to be toxic to renal tissue due to its ionic strength and osmolarity and as a result of iodine-induced cytotoxicity, which has raised concern over whether there are similar negative effects on disc cells.

Purpose: This in vitro study was designed to identify the least cytotoxic iodinated CM to the human disc cell among four different physiochemical iodinated contrast dyes.

Anterior lumbar interbody fusion for the treatment of postoperative spondylodiscitis.

Objective: To analyze the clinical courses and outcomes after anterior lumbar interbody fusion (ALIF) for the treatment of postoperative spondylodiscitis.

Methods: A total of 13 consecutive patients with postoperative spondylodiscitis treated with ALIF at our institute from January, 1994 to August, 2013 were included (92.3% male, mean age 54.

Surgical Treatment in Patients with Cervical Osteomyelitis: Single Institute's Experiences.

Objective: To study practical guidelines and strategies in the treatment of cervical osteomyelitis.

Methods: We retrospectively reviewed 14 patients who underwent surgical treatment for cervical osteomyelitis from May 2000 to July 2008. We investigated their clinical course, antibiotic regimen, surgical methods, and laboratory and radiologic findings including X-ray, CT and MRI.

A Surgical Method for Determining Proper Screw Length in ACDF.

Objective: We describe a surgical tool that uses the distractor pin as a reference for determining proper screw length in ACDF. It is critical that screw purchase depth be as deep as possible without violating or penetrating the posterior cortical wall, which ensures strong pull out strength.

Methods: We enrolled 81 adult patients who underwent ACDF using an anterior cervical plate from 2010 to 2012.

Surgical outcomes after traumatic vertebral fractures in patients with ankylosing spondylitis.

Objective: Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies.