The purpose of this study is to evaluate the flow ability of the thermoplasticized Gutta Percha in different temperatures. Four Gutta Percha products were classified by its hardness (soft, medium, and hard) and were experimented by the Rheometer (Melt flow indexer MFI-10, DAVENPORT, England) measuring apparatus, in (23 ± 2) ℃, and in a relative humidity of (50 ± 5) %, following the guidelines of ISO 1133-1:2011. The heating temperature ranged from 108℃, 160℃ to 200℃, and the load at 2.16 kg and 3.8 kg. The Gutta Percha was cut in 5 mm to be suitable for the rheometer pressurization process. After the experiment was conducted with a preheating time of 5 minutes, a cutting time of 5–240 seconds, and a sample of 10 grams, the Gutta Percha did not show any changes in fluidity for 108℃, 160℃, but showed a change in its flow ability in 200℃. Also, the Gutta Percha did not show any changes in its fluidity when it was pressurized by 2.16 and 3.8 kilograms. Therefore, this experiment shows that the heating temperature and the cut-off time showed a significance while measuring the melt flow rate.
Gutta-Percha ; Hardness ; Heating ; Hot Temperature ; Humidity

Objective: : Oblique lateral interbody fusion (OLIF) is becoming the preferred treatment for degenerative lumbar diseases. As beginners, we performed 143 surgeries over 19 months. In these consecutive cases, we analyzed the learning curve and reviewed the complications in our experience. Methods: : This was a retrospective study; however, complications that were well known in the previous literature were strictly recorded prospectively. We followed up the changes in estimated blood loss (EBL), operation time, and transient psoas paresis according to case accumulation to analyze the learning curve. Results: : Complication-free patients accounted for 43.6% (12.9%, early stage 70 patients and 74.3%, late stage 70 patients). The most common complication was transient psoas paresis (n=52). Most of these complications occurred in the early stages of learning. C-reactive protein normalization was delayed in seven patients (4.89%). The operation time showed a decreasing trend with the cases; however, EBL did not show any significant change. Notable operation-induced complications were cage malposition, vertebral body fracture, injury to the ureter, and injury to the lumbar vein. Conclusion : According to the learning curve, the operation time and psoas paresis decreased. It is important to select an appropriately sized cage along with clear dissection of the anterior border of the psoas muscle to prevent OLIF-specific complications.

Objective: : Oblique lateral interbody fusion (OLIF) is becoming the preferred treatment for degenerative lumbar diseases. As beginners, we performed 143 surgeries over 19 months. In these consecutive cases, we analyzed the learning curve and reviewed the complications in our experience. Methods: : This was a retrospective study; however, complications that were well known in the previous literature were strictly recorded prospectively. We followed up the changes in estimated blood loss (EBL), operation time, and transient psoas paresis according to case accumulation to analyze the learning curve. Results: : Complication-free patients accounted for 43.6% (12.9%, early stage 70 patients and 74.3%, late stage 70 patients). The most common complication was transient psoas paresis (n=52). Most of these complications occurred in the early stages of learning. C-reactive protein normalization was delayed in seven patients (4.89%). The operation time showed a decreasing trend with the cases; however, EBL did not show any significant change. Notable operation-induced complications were cage malposition, vertebral body fracture, injury to the ureter, and injury to the lumbar vein. Conclusion : According to the learning curve, the operation time and psoas paresis decreased. It is important to select an appropriately sized cage along with clear dissection of the anterior border of the psoas muscle to prevent OLIF-specific complications.

The increasing prevalence of pyogenic spondylitis in older adults is primarily driven by Staphylococcus aureus. Cases caused by anaerobic bacteria are rare. This report focuses on a 71-year-old man diagnosed with spondylitis due to an anaerobic bacterial infection. The causative pathogen—Parvimonas micra—is typically found in the oral cavity. Interestingly, the patient had undergone a tooth extraction before the diagnosis. He was successfully treated with antibiotics; therefore, surgery was not necessary. This case is notable for the uncommon infective organism and, along with a concise literature review, this report provides valuable insights for the medical community.

Objective: : Recently, robotic-assisted spine surgery (RASS) has been considered a minimally invasive and relatively accurate method. In total, 495 robotic-assisted pedicle screw fixation (RAPSF) procedures were attempted on 100 patients during a 14-month period. The current study aimed to analyze the accuracy, potential risk factors, and learning curve of RAPSF. Methods: : This retrospective study evaluated the position of RAPSF using the Gertzbein and Robbins scale (GRS). The accuracy was analyzed using the ratio of the clinically acceptable group (GRS grades A and B), the dissatisfying group (GRS grades C, D, and E), and the Surgical Evaluation Assistant program. The RAPSF was divided into the no-breached group (GRS grade A) and breached group (GRS grades B, C, D, and E), and the potential risk factors of RAPSF were evaluated. The learning curve was analyzed by changes in robot-used time per screw and the occurrence tendency of breached and failed screws according to case accumulation. Results: : The clinically acceptable group in RAPSF was 98.12%. In the analysis using the Surgical Evaluation Assistant program, the tip offset was 2.37±1.89 mm, the tail offset was 3.09±1.90 mm, and the angular offset was 3.72°±2.72°. In the analysis of potential risk factors, the difference in screw fixation level (p=0.009) and segmental distance between the tracker and the instrumented level (p=0.001) between the no-breached and breached group were statistically significant, but not for the other factors. The mean difference between the no-breach and breach groups was statistically significant in terms of pedicle width (p<0.001) and tail offset (p=0.042). In the learning curve analysis, the occurrence of breached and failed screws and the robot-used time per screw screws showed a significant decreasing trend. Conclusion : In the current study, RAPSF was highly accurate and the specific potential risk factors were not identified. However, pedicle width was presumed to be related to breached screw. Meanwhile, the robot-used time per screw and the incidence of breached and failed screws decreased with the learning curve.

Objective: This study aimed to assess the degree of interest in robot-assisted spine surgery (RASS) among residents and to investigate the learning curve for beginners performing robotic surgery. Methods: We conducted a survey to assess awareness and interest in RASS among young neurosurgery residents. Subsequently, we offered a hands-on training program using a dummy to educate one resident. After completing the program, the trained resident performed spinal fusion surgery with robotic assistance under the supervision of a mentor. The clinical outcomes and learning curve associated with robotic surgery were then analyzed. Results: Neurosurgical residents had limited opportunities to participate in spinal surgery during their training. Despite this, there was a significant interest in the emerging field of robotic surgery. A trained resident performed RASS under the supervision of a senior surgeon. A total of 166 screw insertions were attempted in 28 patients, with 2 screws failing due to skiving. According to the Gertzbein-Robbins classification, 85.54% of the screws were rated as grade A, 11.58% as grade B, 0.6% as grade C, and 1.2% as grade D. The clinical acceptance rate was approximately 96.99%, which is comparable to the results reported by senior experts and time per screw statistically significantly decreased as experience was gained. Conclusion RASS can be performed with high accuracy within a relatively short timeframe, if residents receive adequate training.

Objective: This study aimed to assess the degree of interest in robot-assisted spine surgery (RASS) among residents and to investigate the learning curve for beginners performing robotic surgery. Methods: We conducted a survey to assess awareness and interest in RASS among young neurosurgery residents. Subsequently, we offered a hands-on training program using a dummy to educate one resident. After completing the program, the trained resident performed spinal fusion surgery with robotic assistance under the supervision of a mentor. The clinical outcomes and learning curve associated with robotic surgery were then analyzed. Results: Neurosurgical residents had limited opportunities to participate in spinal surgery during their training. Despite this, there was a significant interest in the emerging field of robotic surgery. A trained resident performed RASS under the supervision of a senior surgeon. A total of 166 screw insertions were attempted in 28 patients, with 2 screws failing due to skiving. According to the Gertzbein-Robbins classification, 85.54% of the screws were rated as grade A, 11.58% as grade B, 0.6% as grade C, and 1.2% as grade D. The clinical acceptance rate was approximately 96.99%, which is comparable to the results reported by senior experts and time per screw statistically significantly decreased as experience was gained. Conclusion RASS can be performed with high accuracy within a relatively short timeframe, if residents receive adequate training.

Objective: This study aimed to assess the degree of interest in robot-assisted spine surgery (RASS) among residents and to investigate the learning curve for beginners performing robotic surgery. Methods: We conducted a survey to assess awareness and interest in RASS among young neurosurgery residents. Subsequently, we offered a hands-on training program using a dummy to educate one resident. After completing the program, the trained resident performed spinal fusion surgery with robotic assistance under the supervision of a mentor. The clinical outcomes and learning curve associated with robotic surgery were then analyzed. Results: Neurosurgical residents had limited opportunities to participate in spinal surgery during their training. Despite this, there was a significant interest in the emerging field of robotic surgery. A trained resident performed RASS under the supervision of a senior surgeon. A total of 166 screw insertions were attempted in 28 patients, with 2 screws failing due to skiving. According to the Gertzbein-Robbins classification, 85.54% of the screws were rated as grade A, 11.58% as grade B, 0.6% as grade C, and 1.2% as grade D. The clinical acceptance rate was approximately 96.99%, which is comparable to the results reported by senior experts and time per screw statistically significantly decreased as experience was gained. Conclusion RASS can be performed with high accuracy within a relatively short timeframe, if residents receive adequate training.

Objective: This study aimed to assess the degree of interest in robot-assisted spine surgery (RASS) among residents and to investigate the learning curve for beginners performing robotic surgery. Methods: We conducted a survey to assess awareness and interest in RASS among young neurosurgery residents. Subsequently, we offered a hands-on training program using a dummy to educate one resident. After completing the program, the trained resident performed spinal fusion surgery with robotic assistance under the supervision of a mentor. The clinical outcomes and learning curve associated with robotic surgery were then analyzed. Results: Neurosurgical residents had limited opportunities to participate in spinal surgery during their training. Despite this, there was a significant interest in the emerging field of robotic surgery. A trained resident performed RASS under the supervision of a senior surgeon. A total of 166 screw insertions were attempted in 28 patients, with 2 screws failing due to skiving. According to the Gertzbein-Robbins classification, 85.54% of the screws were rated as grade A, 11.58% as grade B, 0.6% as grade C, and 1.2% as grade D. The clinical acceptance rate was approximately 96.99%, which is comparable to the results reported by senior experts and time per screw statistically significantly decreased as experience was gained. Conclusion RASS can be performed with high accuracy within a relatively short timeframe, if residents receive adequate training.

Objective: This study aimed to assess the degree of interest in robot-assisted spine surgery (RASS) among residents and to investigate the learning curve for beginners performing robotic surgery. Methods: We conducted a survey to assess awareness and interest in RASS among young neurosurgery residents. Subsequently, we offered a hands-on training program using a dummy to educate one resident. After completing the program, the trained resident performed spinal fusion surgery with robotic assistance under the supervision of a mentor. The clinical outcomes and learning curve associated with robotic surgery were then analyzed. Results: Neurosurgical residents had limited opportunities to participate in spinal surgery during their training. Despite this, there was a significant interest in the emerging field of robotic surgery. A trained resident performed RASS under the supervision of a senior surgeon. A total of 166 screw insertions were attempted in 28 patients, with 2 screws failing due to skiving. According to the Gertzbein-Robbins classification, 85.54% of the screws were rated as grade A, 11.58% as grade B, 0.6% as grade C, and 1.2% as grade D. The clinical acceptance rate was approximately 96.99%, which is comparable to the results reported by senior experts and time per screw statistically significantly decreased as experience was gained. Conclusion RASS can be performed with high accuracy within a relatively short timeframe, if residents receive adequate training.