1.Robotic-Assisted Spine Surgery: Role in Training the Next Generation of Spine Surgeons
Jun Seok LEE ; Dong Wuk SON ; Su Hun LEE ; Jong Hyeok LEE ; Young Ha KIM ; Sang Weon LEE ; Bu Kwang OH ; Soon Ki SUNG ; Geun Sung SONG ; Seong YI
Neurospine 2024;21(1):116-127
		                        		
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
2.Robotic-Assisted Spine Surgery: Role in Training the Next Generation of Spine Surgeons
Jun Seok LEE ; Dong Wuk SON ; Su Hun LEE ; Jong Hyeok LEE ; Young Ha KIM ; Sang Weon LEE ; Bu Kwang OH ; Soon Ki SUNG ; Geun Sung SONG ; Seong YI
Neurospine 2024;21(1):116-127
		                        		
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
3.Robotic-Assisted Spine Surgery: Role in Training the Next Generation of Spine Surgeons
Jun Seok LEE ; Dong Wuk SON ; Su Hun LEE ; Jong Hyeok LEE ; Young Ha KIM ; Sang Weon LEE ; Bu Kwang OH ; Soon Ki SUNG ; Geun Sung SONG ; Seong YI
Neurospine 2024;21(1):116-127
		                        		
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
4.Robotic-Assisted Spine Surgery: Role in Training the Next Generation of Spine Surgeons
Jun Seok LEE ; Dong Wuk SON ; Su Hun LEE ; Jong Hyeok LEE ; Young Ha KIM ; Sang Weon LEE ; Bu Kwang OH ; Soon Ki SUNG ; Geun Sung SONG ; Seong YI
Neurospine 2024;21(1):116-127
		                        		
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
5.Robotic-Assisted Spine Surgery: Role in Training the Next Generation of Spine Surgeons
Jun Seok LEE ; Dong Wuk SON ; Su Hun LEE ; Jong Hyeok LEE ; Young Ha KIM ; Sang Weon LEE ; Bu Kwang OH ; Soon Ki SUNG ; Geun Sung SONG ; Seong YI
Neurospine 2024;21(1):116-127
		                        		
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
6.A Single-Center Experience of Robotic-Assisted Spine Surgery in Korea : Analysis of Screw Accuracy, Potential Risk Factor of Screw Malposition and Learning Curve
Bu Kwang OH ; Dong Wuk SON ; Jun Seok LEE ; Su Hun LEE ; Young Ha KIM ; Soon Ki SUNG ; Sang Weon LEE ; Geun Sung SONG ; Seong YI
Journal of Korean Neurosurgical Society 2024;67(1):60-72
		                        		
		                        			 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. 
		                        		
		                        		
		                        		
		                        	
7.Comparative Analysis of Clinical Outcomes after Placement of Enhanced Monofocal, Monofocal, and Trifocal Intraocular Lenses
Journal of the Korean Ophthalmological Society 2023;64(1):25-34
		                        		
		                        			 Purpose:
		                        			To compare the clinical outcomes of patients given an enhanced monofocal intraocular lens (IOL) (Isopure; PhysIOL, Liege, Belgium), and monofocal, and trifocal IOLs. 
		                        		
		                        			Methods:
		                        			Patients who underwent cataract surgery with bilateral implantation of monofocal Vivinex IOLs, enhanced monofocal Isopure IOLs, and trifocal Panoptix IOLs were included. Three months postoperatively, the uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA), and near visual acuity (UNVA), as well as the spherical equivalent (SE) were determined. Photic symptoms were explored via a questionnaire. 
		                        		
		                        			Results:
		                        			The postoperative SE and UDVA did not differ significantly among the three groups (p = 0.100 and 0.204 respectively). The mean UIVAs (logMAR) were 0.61 ± 0.14, 0.3 ± 0.1, and 0.14 ± 0.11 in the Vivinex, Isopure, and Panoptix groups respectively. The Isopure group exhibited a significantly better UIVA than the Vivinex group (p < 0.001) and the Panoptix group exhibited a significantly better UIVA than either the Vivinex or Isopure group (p = 0.002 and < 0.001 respectively). The mean UNVAs (logMAR) were 0.68 ± 0.16, 0.57 ± 0.19, and 0.17 ± 0.12 for the Vivinex, Isopure, and Panoptix groups respectively. There was no significant UNVA difference between the Vivinex and Isopure groups (p = 0.185) but the UNVA of the Panoptix group was significantly better than the UNVAs of the Vivinex and Isopure groups (both p < 0.001). There was no significant difference in photic symptoms between the Vivinex and Isopure groups (p = 0.980); however, the Panoptix group evidenced significantly more severe symptoms than did the other two groups (p = 0.021 and 0.042 respectively). 
		                        		
		                        			Conclusions
		                        			Enhanced monofocal Isopure IOL showed superior intermediate vision compared to Vivinex monofocal IOL, and inferior intermediate and near visual acuity compared Panoptix trifocal IOL, but with fewer photic symptoms. 
		                        		
		                        		
		                        		
		                        	
8.Treatment Efficacy of Various Maneuvers for Lateral Canal Benign Paroxysmal Positional Vertigo With Apogeotropic Nystagmus: A Randomized Controlled Trial
Hyun Jin LEE ; Eun-Ju JEON ; Sungil NAM ; Seog-Kyun MUN ; Shin-Young YOO ; Seong Hyun BU ; Jin Woong CHOI ; Jae Ho CHUNG ; Seok Min HONG ; Seung-Hwan LEE ; Min-Beom KIM ; Ja-Won KOO ; Hyun Ji KIM ; Jae-Hyun SEO ; Seong-Ki AHN ; Shi Nae PARK ; Minbum KIM ; Won-Ho CHUNG
Clinical and Experimental Otorhinolaryngology 2023;16(3):251-258
		                        		
		                        			 Objectives:
		                        			The aim of this study was to determine the most effective treatment approach by comparing the impacts of various otolith reduction techniques in patients with apogeotropic lateral semicircular canal benign paroxysmal positional vertigo (LC-BPPV). 
		                        		
		                        			Methods:
		                        			We performed a multicenter randomized prospective study from January to December 2015, involving 72 consecutive patients with apogeotropic LC-BPPV. The patients were divided into three treatment groups: therapeutic head-shaking (group A), the Gufoni-Appiani maneuver (group B), and the cupulolith repositioning maneuver (CuRM; group C). Each group underwent evaluation and treatment up to the fourth week. Treatment success was defined as the disappearance of positional vertigo and nystagmus. 
		                        		
		                        			Results:
		                        			This study included 72 patients (49 male and 23 female), with a mean (±standard deviation) age of 55.4±13.5 years. The mean duration of vertigo experienced prior to treatment was 3.9±4.4 days. The mean latency and duration of nystagmus were 2.7±3.0 seconds and 47.9±15.8 seconds, respectively. The overall treatment frequency was 2.0±0.9. The number of treatments differed significantly among the three groups (P<0.05). After 4 weeks, the success rates for groups A, B, and C were 90.5%, 92.3%, and 100%, respectively. No significant difference was observed in the success rate across treatment methods and periods (P>0.05). However, CuRM was the only method with a 100% treatment success rate. 
		                        		
		                        			Conclusion
		                        			While no clear difference was observed among the three treatments for LC-BPPV, CuRM was found to be superior to the other approaches in the long term. 
		                        		
		                        		
		                        		
		                        	
9.Does the COVID-19 Screening Test Affect the Postoperative Prognosis of Patients Who Undergo Emergency Surgery for Cerebral Hemorrhage?
Chang Ho LEE ; Young Ha KIM ; Bu Kwang OH ; Chi Hyung LEE ; Chang Hyeun KIM ; Soon Ki SUNG ; Sang Weon LEE ; Geun Sung SONG
Korean Journal of Neurotrauma 2022;18(2):198-207
		                        		
		                        			 Objective:
		                        			The coronavirus disease 2019 (COVID-19) pandemic has affected all medical fields, including neurosurgery. Particularly, performing preoperative screening tests has become mandatory, potentially extending the time from admission to the emergency room and operating room, thus possibly affecting patients’ prognosis. This study aimed to determine the influence of COVID-19 screening time on patients’ postoperative prognosis. 
		                        		
		                        			Methods:
		                        			From September 10, 2020, to May 31, 2021, we retrospectively evaluated 54 patients with cerebral hemorrhage who underwent emergency surgery in the emergency room after the screening test. The control group included 89 patients with cerebral hemorrhage who underwent emergency surgery between January 2019 and March 2020, i.e., the period before the COVID-19 pandemic. Prognosis was measured using the Glasgow Coma Scale scores, which were obtained preoperatively, postoperatively, and at discharge, and the modified Rankin Scale (mRS). Additionally, unfavorable outcomes (mRS score 3–6) and in-hospital mortality rates were investigated for postoperative prognostic assessments. 
		                        		
		                        			Results:
		                        			No remarkable differences were observed in the time to surgical intervention and prognostic evaluation scores between patients with cerebral hemorrhage who underwent COVID-19 screening tests and subjects in the control group. 
		                        		
		                        			Conclusion
		                        			This study confirmed that patient treatment and prognosis were not significantly affected by additional preoperative screening testing times during the pandemic. We believe that our results are informative for the evaluation and performance of emergency neurosurgery during the pandemic. 
		                        		
		                        		
		                        		
		                        	
            
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