Objective: Unilateral biportal endoscopic (UBE) treatment for lumbar disc herniation (LDH) is an advanced surgical procedure that has recently gained popularity. Numerous reports from developed countries have demonstrated the effectiveness of this minimally invasive technique. We evaluated the initial outcomes of UBE at a healthcare facility with limited resources. Methods: Clinical and radiographic data of 82 patients with LDH treated between July 2022 and June 2023 using UBE discectomy techniques, including the ipsilateral interlaminar approach, contralateral sublaminar approach, and paraspinal approach, were reviewed. Outcomes were analyzed in terms of the modified MacNab criteria, Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS), with a mean follow-up of 3.1 months. Results: At the final follow-up, the mean VAS for low back pain improved from 4.5±1.0 to 1.2±0.4 and the VAS for leg pain improved from 7.8±0.9 to 1.6±0.5. The mean JOA score improved from 13.5±2.4 to 24.2±2.1. The modified MacNab criteria were excellent in 56 patients (68.3%), good in 22 (26.9%), and fair in 4 (4.8%). In total, 106 levels of LDH were treated. L4–5 disc herniation was performed in 55 patients (51.9%), L5–S1 in 36 (34.0%), L3–4 in 8 (7.5%), L2–3 in 6 (5.7%), and L1–2 in 1 (0.9%). The ipsilateral interlaminar approach was performed in 93 patients (87.7%), the contralateral sublaminar approach in 7 (6.6%), and the paraspinal approach in 6 (5.7%). Operative time significantly improved after performing 20 cases. In the early stage (1–20 cases), the operation time per level was 102.0±28.2 min, while in the next stage (21–82 cases) it was 78.1±20.4 minutes. No serious complications, including cauda equine syndrome or root palsy, were observed. Three patients had dural tears (2.8%), and 1 had epidural hematoma (0.9%). Conclusion UBE discectomy may be performed safely and effectively for the treatment of LDH in limited-resource settings.

OBJECTIVE: In Korea, direct lateral interbody fusion (DLIF) was started since 2011, using standard cage (6degrees lordotic angle, 18mm width). Recently, a new wider cage with higher lordotic angle (12degrees, 22mm) was introduced. The aim of our study is to compare the clinical and radiologic outcomes of the two cage types. METHODS: We selected patients underwent DLIF, 125 cases used standard cages (standard group) and 38 cases used new cages (wide group). We followed them up for more than 6 months, and their radiological and clinical outcomes were analyzed retrospectively. For radiologic outcomes, lumbar lordotic angle (LLA), segmental lordoic angle (SLA), disc angle (DA), foraminal height change (FH), subsidence and intraoperative endplate destruction (iED) were checked. Clinical outcomes were compared using visual analog scale (VAS) score, Oswestry disability index (ODI) score and complications. RESULTS: LLA and SLA showed no significant changes postoperatively in both groups. DA showed significant increase after surgery in the wide group (p<0.05), but not in the standard group. Subsidence was significantly lower in the wide group (p<0.05). There was no difference in clinical outcomes between the two groups. Additional posterior decompression was done more frequently in the wide group. Postoperative change of foraminal height was significantly lower in the wide group (p<0.05). The iED was observed more frequently in the wide group (p<0.05) especially at the anterior edge of cage. CONCLUSION: The new type of cage seems to result in more DA and less subsidence. But indirect foraminal decompression seems to be less effective than standard cage. Intraoperative endplate destruction occurs more frequently due to a steeper lordotic angle of the new cage.
Decompression ; Humans ; Korea ; Retrospective Studies ; Visual Analog Scale

This study was conducted to determine the prevalence and characteristics of pathogenic Escherichia (E.) coli strains from diarrheic calves in Vietnam. A total of 345 E. coli isolates obtained from 322 diarrheic calves were subjected to PCR and multiplex PCR for detection of the f5, f41, f17, eae, sta, lt, stx1, and stx2 genes. Of the 345 isolates, 108 (31.3%) carried at least one fimbrial gene. Of these 108 isolates, 50 carried genes for Shiga toxin and one possessed genes for both enterotoxin and Shiga toxin. The eae gene was found in 34 isolates (9.8%), 23 of which also carried stx genes. The Shiga toxin genes were detected in 177 isolates (51.3%) and the number of strains that carried stx1, stx2 and stx1/stx2 were 46, 73 and 58, respectively. Among 177 Shiga toxin-producing E. coli isolates, 89 carried the ehxA gene and 87 possessed the saa gene. Further characterization of the stx subtypes showed that among 104 stx1-positive isolates, 58 were the stx1c variant and 46 were the stx1 variant. Of the 131 stx2-positive strains, 48 were stx2, 48 were stx2c, 11 were stx2d, 17 were stx2g, and seven were stx2c/stx2g subtypes. The serogroups most prevalent among the 345 isolates were O15, O20, O103 and O157.
Animals ; Cattle ; Cattle Diseases/epidemiology/*microbiology ; DNA, Bacterial/chemistry/genetics ; Diarrhea/epidemiology/microbiology/*veterinary ; Escherichia coli/genetics/*isolation & purification/pathogenicity ; Escherichia coli Infections/epidemiology/microbiology/*veterinary ; Feces/microbiology ; Fimbriae, Bacterial/genetics ; Polymerase Chain Reaction/veterinary ; Polymorphism, Restriction Fragment Length ; Vietnam/epidemiology ; Virulence Factors/*genetics