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1.  Surgical Correction of Fixed Kyphosis 
Asian Spine Journal  2007;1(1):12-18.
Study Design
A retrospective review was carried out on 23 patients with rigid fixed kyphosis who underwent surgical correction for their deformity.
Purpose
To report the results of surgical correction of fixed kyphosis according to the surgical approaches or methods.
Overview of Literature
Surgical correction of fixed kyphosis is more dangerous than the correction of any other spinal deformity because of the high incidence of paraplegia.
Methods
There were 12 cases of acute angular kyphosis (6 congenital, 6 healed tuberculosis) and 11 cases of round kyphosis (10 ankylosing spondylitis, 1 Scheuermann's kyphosis). Patients were excluded if their kyphosis was due to active tuberculosis, fractures, or degenerative lumbar changes. Operative procedures consisted of anterior, posterior and combined approaches with or without total vertebrectomy. Anterior procedure only was performed in 2 cases, while posterior procedure only was performed in 8 cases. Combined procedures were used in 13 cases, including 4 total vertebrectomies.
Results
The average kyphotic angle was 71.8° preoperatively, 31.0° postoperatively, and the average final angle was 39.2°. Thus, the correction rate was 57% and the correction loss rate was 12%. In acute angular kyphosis, correction rate of an anterior procedure only was 71%, correction rate of the combined procedures without total vertebrectomy was 49% and correction rate of the combined procedures with total vertebrectomy was 60%. In round kyphosis, correction rate of posterior procedure only was 65% and correction rate of combined procedures was 59%. The clinical results according to the Kirkaldy-Willis scale demonstrated 17 excellent outcomes, 5 good outcomes and one poor outcome.
Conclusions
Our data indicates that the combined approach and especially the total vertebrectomy showed the safety and the greatest correction rate if acute angular kyphosis was greater than 60 degrees.
doi:10.4184/asj.2007.1.1.12
PMCID: PMC2857494  PMID: 20411147
Surgical correction; Fixed kyphosis; Total vertebrectomy
2.  Chronic pure radiculopathy in patient with organizing epidural hematoma around C8 nerve root 
European Spine Journal  2012;21(Suppl 4):450-452.
Spontaneously occurring spinal epidural hematomas are uncommon clinical findings, and the chronic form is the rarest and its most frequent location is the lumbar spine. Pure radicular involvement is far less frequent than myelopathy. We report a case of progressive radiculopathy in a 52-year-old man with spontaneously occurring cervical epidural hematoma (SCEH). The patient had left hand weakness and numbness for 4 months. MRI scan showed small space-occupying lesion around left 8th cervical nerve root. After surgery we confirmed chronic organizing epidural hematoma. To the best of our knowledge, this is the second reported case in the worldwide literature of pure radiculopathy in a patient with chronic SCEH.
doi:10.1007/s00586-011-2071-4
PMCID: PMC3369032  PMID: 22249307
Spontaneous epidural hematoma; Radiculopathy; Chronic
3.  Factors affecting the accurate placement of percutaneous pedicle screws during minimally invasive transforaminal lumbar interbody fusion 
European Spine Journal  2011;20(10):1635-1643.
We retrospectively evaluated 488 percutaneous pedicle screws in 110 consecutive patients that had undergone minimally invasive transforaminal lumbar interbody fusion (MITLIF) to determine the incidence of pedicle screw misplacement and its relevant risk factors. Screw placements were classified based on postoperative computed tomographic findings as “correct”, “cortical encroachment” or as “frank penetration”. Age, gender, body mass index, bone mineral density, diagnosis, operation time, estimated blood loss (EBL), level of fusion, surgeon’s position, spinal alignment, quality/quantity of multifidus muscle, and depth to screw entry point were considered to be demographic and anatomical variables capable of affecting pedicle screw placement. Pedicle dimensions, facet joint arthritis, screw location (ipsilateral or contralateral), screw length, screw diameter, and screw trajectory angle were regarded as screw-related variables. Logistic regression analysis was conducted to examine relations between these variables and the correctness of screw placement. The incidence of cortical encroachment was 12.5% (61 screws), and frank penetration was found for 54 (11.1%) screws. Two patients (0.4%) with medial penetration underwent revision for unbearable radicular pain and foot drop, respectively. The odds ratios of significant risk factors for pedicle screw misplacement were 3.373 (95% CI 1.095–10.391) for obesity, 1.141 (95% CI 1.024–1.271) for pedicle convergent angle, 1.013 (95% CI 1.006–1.065) for EBL >400 cc, and 1.003 (95% CI 1.000–1.006) for cross-sectional area of multifidus muscle. Although percutaneous insertion of pedicle screws was performed safely during MITLIF, several risk factors should be considered to improve placement accuracy.
doi:10.1007/s00586-011-1892-5
PMCID: PMC3175862  PMID: 21720727
Risk factor; Percutaneous; Pedicle screw; Minimally invasive; TLIF

Results 1-3 (3)