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1.  Validation of the Korean Version of the Neck Pain and Disability Scale 
Asian Spine Journal  2013;7(3):178-183.
Study Design
A prospective study.
Purpose
To evaluate the reliability and validity of the adapted Korean version of the Neck Pain and Disability Scale (NPDS).
Overview of Literature
The validity of Korean version of NPDS has not been completely demonstrated yet.
Methods
Translation/retranslation of the English version of NPDS was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the visual analog scale (VAS) measure of pain, NPDS and the previously validated Short Form-36 (SF-36) were mailed to 91 patients, who had been surgically treated for degenerative cervical disease. Eighty-one patients responded to the first mailing of questionnaires and 69 of the first time responder returned their second survey. Factor analysis and reliability assessment by kappa statistics of agreement for each item, the intraclass correlation coefficient and Cronbach's α were conducted. Concurrent and construct validity were also evaluated by comparing the responses of NPDS with the results of VAS and responses of SF-36.
Results
Factor analysis extracted 3 factors. All items had a kappa statistics of agreement greater than 0.6. The NPDS showed excellent test/re-test reliability. Internal consistency of Cronbach's α was found to be very good. The NPDS was correlated with the VAS. The Korean version of NPDS showed good significant correlation with SF-36 total score and with single SF-36 domains scores.
Conclusions
The adapted Korean version of the NPDS was successfully translated and is considered suitable for outcome assessments in the Korean-speaking patients with neck pain.
doi:10.4184/asj.2013.7.3.178
PMCID: PMC3779768  PMID: 24066212
Neck pain; Neck Pain and Disability Scale; Korean version
2.  Posterior Decompression and Fusion in Patients with Multilevel Lumbar Foraminal Stenosis: A Comparison of Segmental Decompression and Wide Decompression 
Asian Spine Journal  2011;5(2):100-106.
Study Design
This is a prospective study.
Purpose
We compared the outcomes of segmental decompression and wide decompression in patients who had multilevel lumbar foraminal stenosis with back pain.
Overview of Literature
Wide decompression and fusion in patients with multilevel lumbar foraminal stenosis may increase the risk of perioperative complications.
Methods
From March 2005 to December 2007, this study prospectively examined 87 patients with multilevel lumbar foraminal stenosis and who were treated by segmental or wide decompression along with posterior fusion using pedicle screw fixation, and these patients could be followed-up for a minimum of 2 years. Of the 87 patients, 45 and 42 patients were assigned to the segmental decompression group (group 1) and the wide decompression group (group 2), respectively. We compared the clinical and radiological outcomes of the patients in these two groups.
Results
There were no significant differences between groups 1 and 2 in terms of the levels of postoperative pain based on the visual analogue scale, the Oswestry Disability Score, the clinical results based on the Kirkaldy-Willis Criteria, the complication rate or the posterior fusion rate. On the other hand, the mean operating times in groups 1 and 2 were 153 ± 32 minutes and 187 ± 36 minutes, respectively (p < 0.05). The amount of blood loss during surgery and on the first postoperative day was 840 ± 236 ml and 1,040 ± 301 ml in groups 1 and 2, respectively (p < 0.05).
Conclusions
These results suggest that segmental decompression offers promising and reproducible clinical and radiological results for patients suffering from multilevel lumbar foraminal stenosis.
doi:10.4184/asj.2011.5.2.100
PMCID: PMC3095798  PMID: 21629484
Multilevel lumbar foraminal stenosis; Segmental decompression; Wide decompression
3.  Post-operative Changes of Cerebral Glucose Metabolism in Patients with Lumbar Spinal Stenosis with Pre-operative Anxiety: Statistical Parametric Mapping Analysis of F-18 FDG Brain PET 
Asian Spine Journal  2011;5(2):117-124.
Study Design
A prospective study.
Purpose
To assess postoperative changes in cerebral glucose metabolism in anxiety patients with lumbar spinal stenosis (SS).
Overview of Literature
Although an association between preoperative anxiety and abnormal cerebral glucose metabolism may exist, only a limited number of studies using F-18 fluorodeoxyglucose positron emission tomography (FDG PET) have evaluated preoperative to postoperative changes in cerebral glucose metabolism in SS patients in detail.
Methods
The present study was designed to assess preoperative to postoperative changes in cerebral glucose metabolism in anxiety patients with SS. F-18 FDG PET with statistical parametric mapping analyses was used to compare preoperative and postoperative regional brain glucose metabolism in 18 SS patients.
Results
F-18 FDG PET scans showed postoperative activation of several brain clusters in gray matter. These included left parahippocampus, left cerebellar tonsil, left inferior semi-lunar lobule, and right cerebellar tonsil. Areas that were deactivated postoperatively were the right insula, left fusiform gyrus, left orbitofrontal cortex, left inferior frontal gyrus, left middle frontal gyrus, left precuneus, and left inferior frontal gyrus.
Conclusions
SS patients with preoperative anxiety showed altered cerebral glucose metabolism at postoperative follow-up.
doi:10.4184/asj.2011.5.2.117
PMCID: PMC3095801  PMID: 21629487
Lumbar spinal stenosis; Preoperative anxiety; Postoperative change; Cerebral glucose metabolism
4.  Reliability of MRI findings for Symptomatic Extraforaminal Disc Herniation in Lumbar Spine 
Asian Spine Journal  2009;3(1):16-20.
Study Design
A retrospective study
Purpose
This study examined the reliability of the MRI findings in detecting symptomatic extraforaminal disc herniation in the lumbar spine.
Overview of Literature
There are no reports of the characteristics and reliable MRI findings of extraforaminal disc herniation.
Methods
Thirty age-and gender-matched asymptomatic volunteers and 30 patients with symptomatic extraforaminal disc herniation, who underwent surgery between March 2006 and Dec 2008, were enrolled in this study. All subjects underwent spinal MRI. The following parameters were evaluated: the presence or absence of focal eccentricity of the disc, change in the diameter of the nerve root, and displacement of the nerve root at the extraforaminal zones. Radiologic studies were reviewed blindly and independently by 3 spine surgeons.
Results
The overall agreement in determining the presence or absence of a symptomatic extraforaminal disc herniation between the three reviewers was 89.4% (161/180). The consensus showed focal eccentricity of the disc in 33 cases (55%), a change in diameter in the nerve root in 31 cases (51.7%), and a displacement of the nerve root in 23 cases (38.3%). An assessment of the paired intraobserver and interobserver reliability revealed mean Kappa statistics of 0.833 and 0.667 for focal eccentricity of the disc, 0.656 and 0.556 for a change in the diameter of the nerve root, and 0.669 and 0.020 for a displacement of the nerve root, respectively.
Conclusions
There are three possible MRI findings that can be used to determine the presence or absence of symptomatic extraforaminal disc herniation. Among these MRI findings, focal eccentricity of the disc was found to be the most reliable.
doi:10.4184/asj.2009.3.1.16
PMCID: PMC2852038  PMID: 20404941
Extraforaminal; Disc herniation; Lumbar spine; Magnetic resonance imaging; Reliability
5.  Simultaneous Anterior and Posterior Surgery in the Management of Tuberculous Spondylitis with Psoas Abscess in Patients with Neurological Deficits 
Asian Spine Journal  2008;2(2):94-101.
Study Design
This is a retrospective study.
Purpose
We wanted to evaluate the treatment outcomes of performing simultaneous anterior and posterior surgery for patients with tuberculous spondylitis and psoas abscess.
Overview of Literature
Although various treatment options have been used for spinal tuberculosis, there are only a few reports on the treatment of tuberculous spondylitis with psoas abscess.
Methods
Between March 1997 and February 2006, we performed operations on 14 cases of tuberculous spondylitis with psoas abscess. All the cases underwent anterior debridement with an interbody bone graft and posterior fusion with using pedicle screws.
Results
Under the Frankel classification, 1 case improved by two grades, 10 cases improved by 1 grade and 3 cases demonstrated no change. The Kirkaldy-Willis functional outcomes were classified as excellent in 10 cases and good in 4. One year after surgery, bony union was confirmed in all 14 cases. The mean kyphotic angle of the spinal lesion was 12.4° and the mean lordotic angle at the final follow-up was 6.4°. Postoperative complications (superficial wound infections) were encountered in 2 cases.
Conclusions
Our results demonstrate that anterior debridement with interbody bone grafting and posterior instrumented fusion can provide satisfactory results for treating tuberculous spondylitis with psoas abscess in patients with neurological deficits.
doi:10.4184/asj.2008.2.2.94
PMCID: PMC2852085  PMID: 20404963
Tuberculous spondylitis; Psoas abscess; Neurological deficit; Anterior and posterior surgery

Results 1-5 (5)