The aging population worldwide is experiencing an increasing incidence of degenerative spinal disorders, leading to significant morbidity and diminished quality of life. Traditional open surgical approaches for treating these conditions in older patients often entail substantial risks and prolonged recovery times. However, recent advancements in endoscopic surgical techniques have provided promising alternatives with potentially reduced morbidity and quicker recovery. This paper reviews the current literature regarding full-endoscopic spinal surgery (FESS) for degenerative spinal pathology in older patients. We discuss the evolution of endoscopic techniques, patient selection criteria, surgical indications, outcomes, and complications associated with FESS in older adults. Several studies have reported favorable outcomes of FESS in older patients, including reduced postoperative pain, shorter hospital stays, faster recovery, and comparable or even improved clinical outcomes compared with traditional open surgery. Moreover, FESS offers the advantages of minimal tissue disruption, preservation of spinal stability, and decreased blood loss, which are particularly advantageous in older patients with multiple comorbidities. However, challenges such as a steep learning curve for surgeons, limited visualization, and technical constraints in managing complex pathologies remain significant concerns. Additionally, the long-term durability and effectiveness of FESS in older patients require further investigation. In conclusion, FESS presents a promising minimally invasive option for treating degenerative spinal pathology in older adults. Further research and technological advancements are needed to optimize patient selection, refine surgical techniques, and improve long-term outcomes in this growing demographic category of patients.

Although subacute granulomatous thyroiditis(SGT) is usually diagnosed clinically, papillary carcinoma or other thyroid conditions must be considered in the differential diagnosis. We retrospectively reviewed the clinical and fine-needle aspiration(FNA) cytologic findings seen in 10 SGT cases to decide what are the most reliable cytologic findings and the most helpful molecular tools for reaching a confident cytologic diagnosis. The most representative smear slides were retrieved to perform immunocytochemistry for cytokeratin19(CK19) and Ret protein. Five papillary carcinomas(PTCs) were included as controls. The constant and typical cytologic findings of SGT were multinucleated giant cells(MGCs) (100%), epithelioid granulomas(90%), an inflammatory dirty background(90%) and plump transformed follicular cells(80%) without fire-flare cells, oncocytic cells or transformed lymphocytes. The immunoreactivities for CK19(37.5%) and Ret(10%) of the follicular cells of SGT were less than those(CK19 and Ret:100%) of PTC. CK19 immunoreactivity of the MGCs was seen in only one case of PTC. There was no significant difference between CK19 and Ret immunocytochemical staining for the MGCs of both SGT and PTC. The results of this study demonstrate that the cytological diagnosis of SGT can be improved by employing a combination of the typical and constant diagnostic cytological features and immunocytochemical results.
Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis, Differential ; Factor IX ; Immunohistochemistry ; Lymphocytes ; Retrospective Studies ; Thyroid Gland ; Thyroiditis