Full-Endoscopic Posterior Lumbar Interbody Fusion: A Review and Technical Note.

Remarkable innovations in spinal endoscopic surgery have broadened its applications over the past 20 years. Full-endoscopic fusions have been widely reported, and several full-endoscopic approaches for interbody fusion have been published. In general, full-endoscopic lumbar interbody fusion (LIF) is called Endo-LIF, and facet-preserving Endo-LIF through the transforaminal route is called trans-Kambin's triangle LIF, which has a relatively longer history than facet-sacrificing Endo-LIF via the posterolateral route.

Factors Associated with Successful Response to Balloon Decompressive Adhesiolysis Neuroplasty in Patients with Chronic Lumbar Foraminal Stenosis.

Epidural neuroplasty, often called percutaneous epidural adhesiolysis, is often performed in refractory patients with chronic lumbar radiculopathy or neurogenic claudication. Recent studies have showed that decompressive adhesiolysis with an inflatable balloon catheter (balloon neuroplasty) is efficient in patients who experience refractory pain from epidural steroid injection or even epidural neuroplasty with a balloon-less catheter. However, exact indications or predictive factors for epidural balloon neuroplasty have not been fully evaluated.

Contrast Dispersion on Epidurography May Be Associated with Clinical Outcomes After Percutaneous Epidural Neuroplasty Using an Inflatable Balloon Catheter.

Background: Contrast dispersion pattern on epidurography may be associated with clinical improvement after epidural neuroplasty. However, insufficient evidence supports this theory. The current study aims to evaluate the relevance of contrast dispersion and clinical improvement after percutaneous epidural neuroplasty using an inflatable balloon catheter.

Time Course Observation of Outcomes between Minimally Invasive Transforaminal Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion.

The purpose of this study is to compare the long-term patient-outcomes, spinal fusion, and incidence of adjacent segment degeneration (ASD) between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open posterior lumbar interbody fusion (O-PLIF). We retrospectively reviewed 70 consecutive cases who underwent single-level MIS-TLIF or O-PLIF from March 2010 to July 2013. All the patients achieved a minimum of 5-year follow-up.

Relationship of Success Rate for Balloon Adhesiolysis with Clinical Outcomes in Chronic Intractable Lumbar Radicular Pain: A Multicenter Prospective Study.

Combined balloon decompression and epidural adhesiolysis has been reported to be effective in refractory lumbar spinal stenosis. Many cases of intractable stenosis have symptom-related multiple target sites for interventional treatment. In this situation it may not be possible to perform balloon adhesiolysis, or even only epidural adhesiolysis, for all target sites.

Percutaneous Stenoscopic Lumbar Decompression with Paramedian Approach for Foraminal/Extraforaminal Lesions.

The lumbar foramen is affected by different degenerative diseases, including extraforaminal disc herniation, foraminal stenosis (FS), and degenerative or spondylolytic spondylolisthesis. The purpose of this study was to describe percutaneous stenoscopic lumbar decompression with a paramedian approach (para-PSLD) for foraminal/extraforaminal lesions. All operative procedures were performed using a complete uniportal endoscopic instrument system.

Endoscopic Rescue Technique for Iatrogenic Sacroiliac Joint Syndrome Caused by Sextant Percutaneous Pedicle Screw Fixation System.

Background: The Sextant percutaneous pedicle screw fixation system is a commonly used technique. In this system, the pedicle screw and the sharp rod are placed through stab incisions. The unique mechanism of action of this system may cause unprecedented adverse effects, such as iatrogenic sacroiliac (SI) joint syndrome.

Therapeutic Feasibility of Full Endoscopic Decompression in One- to Three-Level Lumbar Canal Stenosis via a Single Skin Port Using a New Endoscopic System, Percutaneous Stenoscopic Lumbar Decompression.

Study Design: This retrospective study involved 450 consecutive cases of degenerative lumbar stenosis treated with percutaneous stenoscopic lumbar decompression (PSLD).

Purpose: We determined the feasibility of PSLD for lumbar stenosis at single and multiple levels (minimum 1-year follow-up) by image analysis to observe postoperative widening of the vertebral canal in the area.

Overview Of Literature: The decision not to perform an endoscopic decompression might be due to the surgeon being uncomfortable with conventional microscopic decompression or unfamiliar with endoscopic techniques or the unavailability of relevant surgical tools to completely decompress the spinal stenosis.

Double-Layer TachoSil Packing for Management of Incidental Durotomy During Percutaneous Stenoscopic Lumbar Decompression.

Background: Incidental durotomy (ID) during surgery for lumbar herniated disks or lumbar spinal stenosis is a serious complication that requires immediate recognition and repair. The incidence of ID during percutaneous endoscopic lumbar decompression has increased along with the demand for endoscopic spinal surgery. The management of ID during endoscopic surgery is more complicated and difficult than management during open surgery.

Clinical Significance of Epidurography Contrast Patterns after Adhesiolysis during Lumbar Percutaneous Epidural Neuroplasty.

Background: The correlation between epidurography contrast patterns and the clinical outcomes of percutaneous epidural neuroplasty (PEN) remains unclear.

Objective: To analyze the correlation between postadhesiolysis epidurography contrast patterns and the clinical outcomes of patients who undergo lumbar PEN.

Design: This study is a retrospective analysis of 78 consecutive patients who underwent lumbar PEN between April 2012 and March 2013.

Time Course of Radiologic Changes After Lumbar Total Disc Replacement: Experience of Single Institute With Minimum 5-Year Follow-up.

Study Design: This was a retrospective observatory analysis study.

Objective: The purpose of this study was to evaluate long-term safety and therapeutic effectiveness of the lumbar total disc replacement (TDR) using ProDisc-L by analyzing the radiologic changes at the index and adjacent levels in minimum 5-year follow-up.

Summary Of Background Data: Early successful clinical results of lumbar TDR have been reported.

Cold Allodynia after C2 Root Resection in Sprague-Dawley Rats.

Objective: The purpose of this study was to evaluate pain-related behaviors after bilateral C2 root resection and change in pain patterns in the suboccipital region in rats.

Methods: Male Sprague-Dawley rats were randomly assigned to three groups (n=25/group); näive, sham, and C2 resection. Three, 7, 10, and 14 days after surgery, cold allodynia was assessed using 20 μL of 99.

Are Controversial Issues in Cervical Total Disc Replacement Resolved or Unresolved?: A Review of Literature and Recent Updates.

Since the launch of cervical total disc replacement (CTDR) in the early 2000s, many clinical studies have reported better outcomes of CTDR compared to those of anterior cervical discectomy and fusion. However, CTDR is still a new and innovative procedure with limited indications for clinical application in spinal surgery, particularly, for young patients presenting with soft disc herniation with radiculopathy and/or myelopathy. In addition, some controversial issues related to the assessment of clinical outcomes of CTDR remain unresolved.

Inflammation in the Prediction of Type 2 Diabetes and Hypertension in Healthy Adults.

Background: While inflammation is associated with obesity and insulin resistance, their inter-relationships in the development of type 2 diabetes or hypertension are not clear.

Aim Of The Study: To evaluate inflammatory markers in prediction of type 2 diabetes and hypertension.

Methods: The study population of this retrospective cohort study consisted of individuals who participated in a comprehensive health screening program with measurement of white blood cell count and C-reactive protein from 2002-2010 (N = 96,606) in nondiabetic and normotensive Koreans.

A Prospective Study with Cage-Only or Cage-with-Plate Fixation in Anterior Cervical Discectomy and Interbody Fusion of One and Two Levels.

Objective: The authors prospectively analyzed the effect of one-level or two-level anterior cervical discectomy and fusion (ACDF), comparing stand-alone cages and cage-with-plate fixation constructs with respect to clinical outcomes and radiologic changes.

Methods: A total of 84 patients who underwent one-level (n=52) or two-level ACDF (n=32) for cervical disc disease and who completed 2 years of follow-up were included in this study. The patients were divided by cervical level and grouped into ACDF-Cage-only and ACDF-Cage-with-plate groups.

Clinical Course of Cervical Percutaneous Epidural Neuroplasty in Single-Level Cervical Disc Disease with 12-Month Follow-up.

Background: Cervical disc disease is a common and occasionally disabling condition, occurring as a natural consequence of aging in the vast majority of the adult population. Percutaneous epidural neuroplasty (PEN) has been used to deliver highly concentrated drugs for chronic neck pain and to prevent scarring in cases refractory to conventional epidural blocks. However, the clinical course after PEN in cervical disc disease is not well-documented.

Comparison of Root Images between Post-Myelographic Computed Tomography and Magnetic Resonance Imaging in Patients with Lumbar Radiculopathy.

Objective: To evaluate the diagnostic value of computed tomography-myelography (CTM) compared to that of magnetic resonance imaging (MRI) in patients with lumbar radiculopathy.

Methods: The study included 91 patients presenting with radicular leg pain caused by herniated nucleus pulposus or lateral recess stenosis in the lumbar spine. The degree of nerve root compression on MRI and CTM was classified into four grades.

Inter- and Intra-Observer Variability of the Volume of Cervical Ossification of the Posterior Longitudinal Ligament Using Medical Image Processing Software.

Objective: Computed tomography (CT)-based method of three dimensional (3D) analysis (MIMICS, Materialise, Leuven, Belgium) is reported as very useful software for evaluation of OPLL, but its reliability and reproducibility are obscure. This study was conducted to evaluate the accuracy of MIMICS system, and inter- and intra-observer reliability in the measurement of OPLL.

Methods: Three neurosurgeons independently analyzed the randomly selected 10 OPLL cases with medical image processing software (MIMICS) which create 3D model with Digital Imaging and Communication in Medicine (DICOM) data from CT images after brief explanation was given to examiners before the image construction steps.

Artificial Disk Replacement Combined With Fusion Versus 2-Level Fusion in Cervical 2-Level Disk Disease With a 5-Year Follow-up.

Study Design: Prospective study.

Objective: The purpose of this study was to compare the long-term clinical and radiologic outcomes of hybrid surgery (HS) and 2-level anterior cervical discectomy and fusion (2-ACDF) in patients with 2-level cervical disk disease.

Summary Of Background Data: In a previous study with a 2-year follow-up, HS was shown to be superior to 2-ACDF, with a better Neck Disability Index (NDI) score, less postoperative neck pain, faster C2-C7 range of motion (ROM) recovery, and less adjacent ROM increase.

Sacral Reconstruction with a 3D-Printed Implant after Hemisacrectomy in a Patient with Sacral Osteosarcoma: 1-Year Follow-Up Result.

Pelvic reconstruction after sacral resection is challenging in terms of anatomical complexity, excessive loadbearing, and wide defects. Nevertheless, the technological development of 3D-printed implants enables us to overcome these difficulties. Here, we present a case of sacral osteosarcoma surgically treated with hemisacrectomy and sacral reconstruction using a 3D-printed implant.

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.