Reducing Postoperative Neurological Complications in Uniportal Full-Endoscopic Lumbar Interbody Fusion: Efficacy of the GUARD Technique Combined With Delayed Ligamentum Flavectomy.

Objective: Uniportal full-endoscopic transforaminal lumbar interbody fusion (FE-TLIF) carries a unique risk of nerve traction and abrasion injury during cage insertion. This study aims to evaluate the clinical efficacy of the GUARD technique and delayed ligamentum flavectomy in reducing postoperative radicular pain and neurapraxia in patients undergoing uniportal FE-TLIF.

Methods: A retrospective analysis was conducted on 45 patients with an average age of 53.

Innovative Nerve Root Protection in Full-Endoscopic Facet-Resecting Lumbar Interbody Fusion: Controlled Cage Glider Rotation Using the GUARD (Glider Used As a Rotary Device) Technique.

This video presents a case of L4-5 unstable spondylolisthesis treated with full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF), emphasizing the GUARD (Glider Used as a Rotary Device) technique for nerve root protection. This innovative approach involves controlled rotation of the cage glider before cage insertion to minimize the risk of nerve root injury, a significant complication in Endo-TLIF procedures. The GUARD technique, validated in previous cadaveric studies, provides enhanced safety during cage insertion by protecting the nerve root.

How to Prevent Nerve Root Injury in Uniportal Full Endoscopic Lumbar Fusion Surgery? Insights From a Cadaveric Anatomic Study With Simulation Surgery.

Study Design: The study included 2 fresh-frozen cadavers.

Objective: To elucidate the positional relationship between surgical instruments and nerve roots during full endoscopic facet-sparing (FE fs-TLIF) and full endoscopic facet-resecting (FE fr-TLIF) transforaminal lumbar interbody fusion and propose safe instrumentation insertion procedures and recommend cage glider designs aimed at protecting nerve roots.

Background: Endoscopic surgical techniques are increasingly used for minimally invasive lumbar fusion surgery, with FE fr-TLIF and FE fs-TLIF being common approaches.

Near infrared imaging system for preventing blood vision obstruction in endoscopy.

Spinal endoscopy procedure is commonly used in the diagnosis and treatment of various health problems and is effective. Bleeding is one of the most common complications of spinal endoscopy procedures. Blood vision obstruction (BVO), that is, obstruction of the endoscopic camera lens caused by the accumulation of blood in the surgical field, is a serious problem in endoscopic procedures.

Percutaneous endoscopic lumbar discectomy versus open lumbar microdiscectomy for treating lumbar disc herniation: Using the survival analysis.

Objectives: This study compared the risk of symptomatic recurrent disc herniation and clinical outcomes of percutaneous endoscopic lumbar discectomy (PELD) versus open lumbar microdiscectomy (OLM) for lumbar disc herniation with 2 years of follow-up.

Materials And Methods: We analyzed 23 patients who underwent PELD and 32 patients who underwent OLM for lumbar disc herniation. The numeric rating scale of back and leg pain, Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RMDQ) were assessed before and at 12 and 24 months after the surgery.

Full Endoscopic Spine Surgery for Cervical Spondylotic Myelopathy: A Systematic Review.

Background: Cervical spondylotic myelopathy (CSM) may seriously affect quality of life. In the literature, there is scarce evidence of the pros and cons of full endoscopic spine surgery in the treatment of CSM. The main purpose of this study was to conduct a systematic review to elucidate the efficacy of full endoscopic spine surgery in the management of patients with CSM.

Comparison Between Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression and Other Decompression Approaches for Lumbar Spinal Stenosis: A Systematic Review.

Background: Lumbar spinal stenosis affects numerous people globally. Full-endoscopic uniportal interlaminar decompression (FEUID) for lumbar spinal stenosis results in satisfactory outcomes. In this systematic review, we compared technical methods, surgical outcomes, and complications among different types of surgical techniques and discussed the effect of different surgical skill levels.

GFR Estimation in Potential Living Kidney Donors: Race- and Nonrace-based Equations and Measured GFR.

Rationale & Objective: Recent studies evaluated and proposed new race-neutral, creatinine-based glomerular filtration rate (GFR) estimation equations. The performance of these equations in diverse potential living kidney donors requires study.

Study Design: Cross-sectional study.

Cauda equina syndrome caused by the application of DuraSeal in a microlaminectomy surgery: A case report.

Background: The management of dural tears is important. While a massive dura can be repaired with absorbable suture lines, cerebrospinal fluid leakage can be attenuated by dural sealant when an unintended tiny durotomy occurs intraoperatively. DuraSeal is often used because it can expand to seal tears.

Correlation between corneal dynamic responses and keratoconus topographic parameters.

Objective: To investigate the correlation between corneal biomechanical properties and topographic parameters using machine learning networks for automatic severity diagnosis and reference benchmark construction.

Methods: This was a retrospective study involving 31 eyes from 31 patients with keratonus. Two clustering approaches were used (i.

Comparison of anterior cervical discectomy and fusion versus artificial disc replacement for cervical spondylotic myelopathy: a meta-analysis.

Objective: Anterior cervical discectomy and fusion (ACDF) has long been regarded as a gold standard in the treatment of cervical myelopathy. Subsequently, cervical artificial disc replacement (c-ADR) was developed and provides the advantage of motion preservation at the level of the intervertebral disc surgical site, which may also reduce stress at adjacent levels. The goal of this study was to compare clinical and functional outcomes in patients undergoing ACDF with those in patients undergoing c-ADR for cervical spondylotic myelopathy (CSM).

The Influence of Nordic Walking on Spinal Posture, Physical Function, and Back Pain in Community-Dwelling Older Adults: A Pilot Study.

Nordic walking is an increasingly popular form of exercise among the elderly. Using poles is thought to facilitate a more upright posture; however, previous studies primarily investigated the effects of Nordic walking on respiratory function and physical fitness. The aims of this study were to investigate the influence of Nordic walking on spinal posture, physical functions, and back pain in community-dwelling older adults.

COVID-19 Manifesting as Renal Allograft Dysfunction, Acute Pancreatitis, and Thrombotic Microangiopathy: A Case Report.

Coronavirus disease 2019 (COVID-19) is associated with high morbidity and mortality worldwide in both the general population and kidney transplant recipients. Acute kidney injury is a known complication of COVID-19 and appears to most commonly manifest as acute tubular injury on renal biopsy. Coagulopathy associated with COVID-19 is a known but poorly understood complication that has been reported to cause thrombotic microangiopathy on rare occasions in native kidneys of patients with COVID-19.

Outcome analysis of lumbar endoscopic unilateral laminotomy for bilateral decompression in patients with degenerative lumbar central canal stenosis.

Background Context: Lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) has been reported as an alternative treatment for degenerative lumbar central canal stenosis (DLCS).

Purpose: To investigate the outcomes of LE-ULBD for different types of DLCS, including simple DLCS, DLCS with degenerative spondylolisthesis (DSL), and DLCS with degenerative scoliosis (DSC).

Study Design/setting: Prospective cohort study.

Full endoscopic interlaminar discectomy (FEID) for recurrent lumbar disc herniation: surgical technique, clinical outcome, and prognostic factors.

Background: The objective of this study is to determine the effectiveness and prognostic factors of revisional full endoscopic interlaminar discectomy (FEID) for recurrent herniation after conventional open disc surgery. The major concerns of the repeated discectomy for recurrent lumbar disc herniation (RLDH) are the epidural scar and postoperative segmental instability. Compared to open discectomy, endoscopic method has advantages of less tissue traumatization, clearer visualization and better tissue identification.

Clinicopathologic Characteristics of JC Virus Nephropathy in Kidney Transplant Recipients.

Background: The vast majority of polyomavirus nephropathy (PVN) is due to BK virus, but rare cases result from JC virus reactivation. To date, only a handful of biopsy-proven JC-PVN cases have been reported. Here, we describe the clinical and pathologic findings in 7 patients with biopsy-proven JC-PVN.

A rare complication of ipsilateral femoral neck fracture after removal of the long Gamma nail in a healed intertrochanteric fracture.

Ipsilateral femoral neck fracture after hardware removal in healed trochanteric fracture is a rare complication. We reported a case of a 79-year-old woman who had undergone open reduction and internal fixation for her left intertrochanteric fracture with a long Gamma nail about 1 year ago. She asked for implants removal due to local irritation.

Full Endoscopic Uniportal Unilateral Laminotomy for Bilateral Decompression in Degenerative Lumbar Spinal Stenosis: Highlight of Ligamentum Flavum Detachment and Survey of Efficacy and Safety in 2 Years of Follow-up.

Objective: Conventional laminectomy for spine decompression involves inherent complications resulting from perioperative traumatization of posterior structures. Minimally invasive decompression was developed to address these issues. Full endoscopic spine surgery has shifted the paradigm from disc pathology to spinal stenosis by overcoming the limitation of bony procedures with evolving endoscopic instruments.

Topically Applied Cross-Linked Hyaluronan Attenuates the Formation of Spinal Epidural Fibrosis in a Swine Model of Laminectomy.

Epidural fibrosis is an inevitable aspect of the postoperative healing process which is one of the causes of failed back surgery syndrome following spinal surgery. The aim of the present study was to examine the inhibitory effect of 1,4-butanediol diglycidyl ether-crosslinked hyaluronan (cHA) on spinal epidural fibrosis in a swine model. Epidural fibrosis was induced through conduction of hemi-laminotomy (L2 and L3) or laminectomy (L4 and L5), while L1 was assigned as the control group in six pigs.

Efficacy of therapeutic plasma exchange on angiotensin II type-1 receptor antibodies on two kidney transplant recipients.

Background: Angiotensin II type-1 receptor antibody (AT1RAb) has been reported to cause antibody mediated rejection (AMR) in kidney transplant recipients possibly by contraction of renal arteries. We here report 2 kidney transplant recipients with elevated AT1RAbs and negative HLA donor specific antibodies (DSA) and anti-major histocompatibility complex class I chain-related gene A (MICA) Abs who received therapeutic plasma exchange (TPE) treatment followed by IVIG. CASE 1: Thirty-eight-year-old patient received second kidney transplant for end stage renal disease (ESRD) with chronic rejection.

Technique using the modified rolling hitch for split peroneus brevis tendon transfer in lateral ankle stabilization.

We report our technique for split peroneus brevis lateral ankle stabilization using the modified rolling hitch for tendon graft fixation. Applying the modified rolling hitch for tendon grasping in this procedure was useful, and it could decrease the surgical time and avoid the tendon injury caused by the needle.

Understanding Trends in Kidney Function 1 Year after Kidney Transplant in the United States.

Lower eGFR 1 year after kidney transplant is associated with shorter allograft and patient survival. We examined how practice changes in the past decade correlated with time trends in average eGFR at 1 year after kidney transplant in the United States in a cohort of 189,944 patients who received a kidney transplant between 2001 and 2013. We calculated the average eGFR at 1 year after transplant for the recipient cohort of each year using the appropriate Modification of Diet in Renal Disease equation depending on the prevailing methodology of creatinine measurement, and used linear regression to model the effects of practice changes on the national post-transplant eGFR trend.

Use of complement binding assays to assess the efficacy of antibody mediated rejection therapy and prediction of graft survival in kidney transplantation.

Background: The Luminex® single antigen bead assay (SAB) is the method of choice for monitoring the treatment for antibody-mediated rejection (AMR). A ⩾50% reduction of the dominant donor-specific antibody (IgG-DSA) mean fluorescence intensity (MFI) has been associated with improved kidney allograft survival, and C1q-fixing DSA activity is associated with poor outcomes in patients with AMR. We aimed to investigate if C1q-DSA can be used as a reliable predictor of response to therapy and allograft survival in patients with biopsy-proven AMR.

Protocol Biopsies: Utility and Limitations.

As both T cell and antibody-mediated rejection can have a subclinical phase, protocol biopsies provide an early opportunity to intervene before the onset of clinical allograft dysfunction. Protocol biopsies are usually done after reperfusion to establish baseline, between 3 and 6 months to identify subclinical rejection, and at 6-12 months to assess chronicity and persistent inflammation that have prognostic implication. Treatment of both subclinical T cell and antibody-mediated rejection prevents progression of rejection and development of interstitial fibrosis/tubular atrophy or transplant glomerulopathy.