• The Korean Journal of Pain
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• v.21 no.3
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• pp.197-201
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• 2008

Background: Kyphoplasty is a minimally invasive procedure that can stabilize osteoporotic and neoplastic vertebral fractures. We retrospectively evaluated the clinical outcomes of kyphoplasty for the treatment of vertebral compression fractures in cancer patients. Methods: We reviewed the clinical data of 27 cancer patients who were treated with kyphoplasty (55 vertebral bodies) between May 2003 and Feb 2008. The clinical parameters, using a visual analog 10 point scale (VAS) and the mobility scores, as well as consumption of analgesic, were evaluated preoperatively and at 1 week after kyphoplasty. Results: A total 55 cases of thoracic and lumbar kyphoplasties were performed without complications. The mean age of the patients was 66 years. All the patients experienced a significant improvement in their subjective pain and mobility immediately after the procedures. The pain scores (VAS), mobility scores and other functional evaluations using the Oswestry disability score and the SF-36 showed significant differences between the pre- and postoperational conditions. Conclusions: Kyphoplasty is an effective, minimally invasive procedure that can relieve the pain of patients with vertebral compression fractures and these fractures are the result of metastasis.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.755-762
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• 2017

Objective : The purpose of this study is to describe the detailed surgical technique and short-term clinical and radiological outcomes of lateral lumbar interbody fusion (LLIF) and in situ lateral screw fixation using a conventional minimally invasive screw fixation system (MISF) for revision surgery to treat rostral lumbar adjacent segment disease. Methods : The medical and radiological records were retrospectively reviewed. The surgery was indicated in 10 consecutive patients with rostral adjacent segment stenosis and instability. After the insertion of the interbody cage, lateral screws were inserted into the cranial and caudal vertebra using the MISF through the same LLIF trajectory. The radiological and clinical outcomes were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively. Results : The median follow-up period was 13 months (range, 3-48 months). Transient sensory changes in the left anterior thigh occurred in 3 patients, and 1 patient experienced subjective weakness; however, these symptoms normalized within 1 week. Back and leg pain were significantly improved (p<0.05). In the radiological analysis, both the segmental angle at the operated segment and anterior disc height were significantly increased. At 6 months postoperatively, solid bony fusion was confirmed in 7 patients. Subsidence and mechanical failure did not occur in any patients. Conclusion : This study demonstrates that LLIF and in situ lateral screw fixation may be an alternative surgical option for rostral lumbar adjacent segment disease.

• Journal of Biomedical Engineering Research
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• v.40 no.5
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• pp.206-214
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• 2019

Surgical methods and associated precision systems have been developed, but surgical procedures that require precise location and fine manipulation of the lesion remain a limitation. The combination of precision robot manipulation technology and 3D medical image navigation technology overcomes the limitations of minimally invasive surgery (MIS) and enables a more stable and successful operation. Surgical robots are surgical robots such as da Vince, and surgical robots using industrial robotic arms. There are various developments and researches of medical robots. In recent medical robot development, a new type of surgical robot based on an industrial robot arm capable of easily replacing the end effector according to the user's needs is being actively developed at home and abroad. Therefore, in this study, we developed safety and performance evaluation guideline for micro - surgical robots based on open robot platform using general purpose robot arm to help quality control of the medical device.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.304-314
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• 2021

Background: The study investigated virtual reality (VR) immersion in alleviating procedure-related pain in patients with chronic pain undergoing fluoroscopy-guided minimally-invasive intervention in a prone position at an outpatient clinic. Methods: In this prospective randomized controlled study, 38 patients undergoing lumbar sympathetic ganglion block were randomized into either the VR or the control group. In the VR group, procedure-related pain was controlled via infiltration of local anesthetics while watching a 30-minute VR hypnotic program. In the control group, the skin infiltration alone was used, with the VR device switched off. The primary endpoint was an 11-point score on the numerical rating scale, indicating procedure-related pain. Patients' satisfaction with pain control, anxiety levels, the need for additional local anesthetics during the procedure, hemodynamic stability, and any adverse events were assessed. Results: Procedure-related pain was significantly lower in the VR group (3.7 ± 1.4) than in the control group (5.5 ± 1.7; P = 0.002). Post-procedural anxiety was lower in the VR group than in the control group (P = 0.025), with a significant reduction from pre-procedural anxiety (P < 0.001). Although patients' satisfaction did not differ significantly (P = 0.158) between the groups, a higher number of patients required additional local anesthetics in the control group (n = 13) than in the VR group (n = 4; P = 0.001). No severe adverse events occurred in either group during the study. Conclusions: VR immersion can be safely used as a novel adjunct to reduce procedural pain and anxiety during fluoroscopic pain intervention.

• Archives of Plastic Surgery
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• v.48 no.1
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• pp.98-106
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• 2021

Background Hand fractures can be treated using various operative or nonoperative methods. When an operative technique utilizing fixation is performed, early postoperative mobilization has been advocated. We implemented a protocol involving controlled active exercise in the early postoperative period and analyzed the outcomes. Methods Patients who were diagnosed with proximal phalangeal or metacarpal fractures of the second to fifth digits were included (n=37). Minimally invasive open reduction and internal fixation procedures were performed. At 3 weeks postoperatively, controlled active exercise was initiated, with stress applied against the direction of axial loading. The exercise involved pain-free active traction in three positions (supination, neutral, and pronation) between 3 and 5 weeks postoperatively. Postoperative radiographs and range of motion (ROM) in the interphalangeal and metacarpophalangeal joints were analyzed. Results Significant improvements in ROM were found between 6 and 12 weeks for both proximal phalangeal and metacarpal fractures (P<0.05). At 12 weeks, 26 patients achieved a total ROM of more than 230° in the affected finger. Postoperative radiographic images demonstrated union of the affected proximal phalangeal and metacarpal bones at a 20-week postoperative follow-up. Conclusions Minimally invasive open reduction and internal fixation minimized periosteal and peritendinous dissection in hand fractures. Controlled active exercise utilizing pain-free active traction in three different positions resulted in early functional exercise with an acceptable ROM.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.296-303
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• 2022

Background In recent years thread lift has become widespread; however, existing methods need to improve their long-term outcome, which requires considering topographic anatomy of face and neck, especially the ligamentous apparatus. This study aims to assess the effectiveness and safety of an innovative method of one-time three-step thread facelift, which provides an additional support to the ligamentous structures of the upper, middle, and lower thirds of the face and neck. Methods The study included 357 patients aged 32 to 67 years with various morphotypes of aging. The original method of thread lift was applied, and its effectiveness was followed up for to 2 years. The Wrinkle Severity Rating Score (WSRS) and Global Aesthetic Improvement Scale (GAIS) scores were used for assessment by investigators, independent observers, and patients. Statistical significance was determined using paired t-test and chi-square test. Results The mean WSRS score was 3.88 ± 0.88 before the thread lift, 1.93 ± 0.81 one month after the procedure, and 2.36 ± 0.85 after 2 years of follow-up. The mean GAIS was 4.80 ± 0.04 one month after thread lift, and 4.01 ± 0.04 after 2 years, while in the patients' assessment Global Satisfaction Scale was 4.86 ± 0.02 and 4.10 ± 0.02, respectively. There were no clinically significant complications throughout the observation period. Conclusion The new method of one-time three-step thread fixation of the soft tissues of the face and neck demonstrated a high degree of satisfaction by both experts and patients after 2 years of follow-up. It showed high efficacy and safety, including in the group of patients with pronounced age-related changes of the skin of face and neck.

• Journal of Trauma and Injury
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• v.35 no.1
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• pp.34-42
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• 2022

Purpose: Percutaneous iliosacral (IS) screw fixation for pelvic ring injuries is a minimally invasive technique that reduces the amount of blood loss and shortens the procedure time. Moreover, two unilateral IS S1 screws exhibit superior stability to a single IS screw and are also safer for neurological injuries than an S2 screw. Therefore, this study aimed to evaluate fixation using percutaneous two unilateral IS S1 screws for pelvic ring injuries and its subsequent clinical outcomes. Methods: We retrospectively reviewed 38 patients who underwent percutaneous two unilateral IS S1 screw fixation for pelvic ring injuries. The procedure time, blood loss, achievement of bone union, radiological outcomes (Matta and Tornetta grade), and postoperative complications were evaluated. Results: The mean procedure time, hemoglobin loss, bone union rate, and time to union were 40.1 minutes (range, 18-102 minutes), 0.6 g/dL (range, 0.3-1.0 g/dL), 100%, and 153.2 days (range, 61-327 days), respectively. The Matta and Tornetta grades were excellent, good, and fair in 24 (63.1%), 11 (28.9%), and three patients (7.9%), respectively, and the postoperative complications were S1 screw loosening, widening of the symphysis pubis (2.3 and 2.5 mm), lumbosacral plexopathy, and S1 radiculopathy in one (2.6%), two (5.3%), one (2.6%), and one patient (2.6%), respectively. However, all neurological complications recovered spontaneously. Conclusions: Percutaneous two unilateral IS S1 screw fixation was useful for treating pelvic ring injuries. In particular, it involved a short procedure time with little blood loss and also led to 100% bone union and good radiological outcomes.

• Korean Journal of Veterinary Service
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• v.47 no.2
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• pp.61-72
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• 2024

This study aimed to evaluate the feasibility of percutaneous endoscopic foraminotomy (PEF) for the treatment of intervertebral disc herniation of the thoracolumbar spine in large-breed dogs by comparing it with open hemilaminectomy (OH). Six large-breed canine cadavers were used in the present study. A barium and agarose mixture (BA-gel) simulating intervertebral disc herniation was injected into the spinal canal at two intervertebral spaces (T12-T13, L2-L3) of the thoracolumbar spine in each cadaver. PEF and OH were randomly allocated to the sites in each cadaver. Computed tomography was performed pre- and postoperatively. The incision length, vertebral window size, procedure time, and amount of simulated disc material removed were recorded to compare PEF and OH. Both procedures clearly exposed the simulated disc material and spinal cord. The size of the incision and vertebral window created after PEF was much smaller than those after OH. The surgical duration of PEF was longer than that of OH. However, no significant difference (P>0.05) was observed in the amount of BA-gel removed between PEF and OH. Thus, PEF could be used as an effective surgical option for intervertebral disc herniation of the thoracolumbar region in large-breed dogs in that it could lead to less tissue damage as well as sufficient removal of the simulated disc material.

• Journal of Periodontal and Implant Science
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• v.49 no.6
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• pp.355-365
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• 2019

Purpose: The modified minimally invasive surgical technique (M-MIST) has been successfully employed to achieve periodontal regeneration. Platelet-rich fibrin (PRF) is known to enhance wound healing through the release of growth factors. This study aimed to observe the outcomes of periodontal surgery when M-MIST was used with or without PRF for the treatment of isolated intrabony defects. Methods: This randomized clinical trial was conducted on 36 systemically healthy patients, who had chronic periodontitis associated with a single-site buccal probing pocket depth (PPD) and clinical attachment level of ≥5 mm. Patients were randomly divided into 2 groups: the test group treated with M-MIST and PRF, and the control group treated with M-MIST alone. The primary periodontal parameters analyzed were PPD, relative attachment level (RAL), and relative gingival margin level. The radiographic parameters analyzed were change in alveolar crest position (C-ACP), linear bone growth (LBG), and percentage bone fill (%BF). Patients were followed up to 6 months post-surgery. Results: Intragroup comparisons at 3 and 6 months showed consistently significant improvements in PPD and RAL in both the groups. In intergroup comparisons, the improvement in PPD reduction, gain in RAL, and the level of the gingival margin was similar in both groups at 3 and 6 months of follow-up. Furthermore, an intergroup comparison of radiographic parameters also demonstrated similar improvements in C-ACP, LBG, and %BF at 6 months of follow-up. Conclusions: M-MIST with or without PRF yielded comparable periodontal tissue healing in terms of improvements in periodontal and radiographic parameters. Further investigation is required to confirm the beneficial effects of PRF with M-MIST.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.539-548
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• 2022

Objective : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669-35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941-41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.