1.A Propensity Score-Matched Cohort Study Comparing 3 Different Spine Pedicle Screw Fixation Methods: Freehand, Fluoroscopy-Guided, and Robot-Assisted Techniques
Yoon Ha HWANG ; Byeong-Jin HA ; Hyung Cheol KIM ; Byung Ho LEE ; Jeong-Yoon PARK ; Dong-Kyu CHIN ; Seong YI
Neurospine 2024;21(1):83-94
Objective:
This study aimed to compare the accuracy of robotic spine surgery and conventional pedicle screw fixation in lumbar degenerative disease. We evaluated clinical and radiological outcomes to demonstrate the noninferiority of robotic surgery.
Methods:
This study employed propensity score matching and included 3 groups: robot-assisted mini-open posterior lumbar interbody fusion (PLIF) (robotic surgery, RS), c-arm guided minimally invasive surgery transforaminal lumbar interbody fusion (C-arm guidance, CG), and freehand open PLIF (free of guidance, FG) (54 patients each). The mean follow-up period was 2.2 years. The preoperative spine condition was considered. Accuracy was evaluated using the Gertzbein-Robbins scale (GRS score) and Babu classification (Babu score). Radiological outcomes included adjacent segmental disease (ASD) and mechanical failure. Clinical outcomes were assessed based on the visual analogue scale, Oswestry Disability Index, 36-item Short Form health survey, and clinical ASD rate.
Results:
Accuracy was higher in the RS group (p < 0.01) than in other groups. The GRS score was lower in the CG group, whereas the Babu score was lower in the FG group compared with the RS group. No significant differences were observed in radiological and clinical outcomes among the 3 groups. Regression analysis identified preoperative facet degeneration, GRS and Babu scores as significant variables for radiological and clinical ASD. Mechanical failure was influenced by the GRS score and patients’ age.
Conclusion
This study showed the superior accuracy of robotic spine surgery compared with conventional techniques. When combined with minimally invasive surgery, robotic surgery is advantageous with reduced ligament and muscle damage associated with traditional open procedures.
2.A Propensity Score-Matched Cohort Study Comparing 3 Different Spine Pedicle Screw Fixation Methods: Freehand, Fluoroscopy-Guided, and Robot-Assisted Techniques
Yoon Ha HWANG ; Byeong-Jin HA ; Hyung Cheol KIM ; Byung Ho LEE ; Jeong-Yoon PARK ; Dong-Kyu CHIN ; Seong YI
Neurospine 2024;21(1):83-94
Objective:
This study aimed to compare the accuracy of robotic spine surgery and conventional pedicle screw fixation in lumbar degenerative disease. We evaluated clinical and radiological outcomes to demonstrate the noninferiority of robotic surgery.
Methods:
This study employed propensity score matching and included 3 groups: robot-assisted mini-open posterior lumbar interbody fusion (PLIF) (robotic surgery, RS), c-arm guided minimally invasive surgery transforaminal lumbar interbody fusion (C-arm guidance, CG), and freehand open PLIF (free of guidance, FG) (54 patients each). The mean follow-up period was 2.2 years. The preoperative spine condition was considered. Accuracy was evaluated using the Gertzbein-Robbins scale (GRS score) and Babu classification (Babu score). Radiological outcomes included adjacent segmental disease (ASD) and mechanical failure. Clinical outcomes were assessed based on the visual analogue scale, Oswestry Disability Index, 36-item Short Form health survey, and clinical ASD rate.
Results:
Accuracy was higher in the RS group (p < 0.01) than in other groups. The GRS score was lower in the CG group, whereas the Babu score was lower in the FG group compared with the RS group. No significant differences were observed in radiological and clinical outcomes among the 3 groups. Regression analysis identified preoperative facet degeneration, GRS and Babu scores as significant variables for radiological and clinical ASD. Mechanical failure was influenced by the GRS score and patients’ age.
Conclusion
This study showed the superior accuracy of robotic spine surgery compared with conventional techniques. When combined with minimally invasive surgery, robotic surgery is advantageous with reduced ligament and muscle damage associated with traditional open procedures.
3.A Propensity Score-Matched Cohort Study Comparing 3 Different Spine Pedicle Screw Fixation Methods: Freehand, Fluoroscopy-Guided, and Robot-Assisted Techniques
Yoon Ha HWANG ; Byeong-Jin HA ; Hyung Cheol KIM ; Byung Ho LEE ; Jeong-Yoon PARK ; Dong-Kyu CHIN ; Seong YI
Neurospine 2024;21(1):83-94
Objective:
This study aimed to compare the accuracy of robotic spine surgery and conventional pedicle screw fixation in lumbar degenerative disease. We evaluated clinical and radiological outcomes to demonstrate the noninferiority of robotic surgery.
Methods:
This study employed propensity score matching and included 3 groups: robot-assisted mini-open posterior lumbar interbody fusion (PLIF) (robotic surgery, RS), c-arm guided minimally invasive surgery transforaminal lumbar interbody fusion (C-arm guidance, CG), and freehand open PLIF (free of guidance, FG) (54 patients each). The mean follow-up period was 2.2 years. The preoperative spine condition was considered. Accuracy was evaluated using the Gertzbein-Robbins scale (GRS score) and Babu classification (Babu score). Radiological outcomes included adjacent segmental disease (ASD) and mechanical failure. Clinical outcomes were assessed based on the visual analogue scale, Oswestry Disability Index, 36-item Short Form health survey, and clinical ASD rate.
Results:
Accuracy was higher in the RS group (p < 0.01) than in other groups. The GRS score was lower in the CG group, whereas the Babu score was lower in the FG group compared with the RS group. No significant differences were observed in radiological and clinical outcomes among the 3 groups. Regression analysis identified preoperative facet degeneration, GRS and Babu scores as significant variables for radiological and clinical ASD. Mechanical failure was influenced by the GRS score and patients’ age.
Conclusion
This study showed the superior accuracy of robotic spine surgery compared with conventional techniques. When combined with minimally invasive surgery, robotic surgery is advantageous with reduced ligament and muscle damage associated with traditional open procedures.
4.Correction: 2023 Korean Society of Echocardiography position paper for diagnosis and management of valvular heart disease, part I: aortic valve disease
Sun Hwa LEE ; Se Jung YOON ; Byung Joo SUN ; Hyue Mee KIM ; Hyung Yoon KIM ; Sahmin LEE ; Chi Young SHIM ; Eun Kyoung KIM ; Dong Hyuk CHO ; Jun Bean PARK ; Jeong Sook SEO ; Jung Woo SON ; In Cheol KIM ; Sang Hyun LEE ; Ran HEO ; Hyun Jung LEE ; Jae Hyeong PARK ; Jong Min SONG ; Sang Chol LEE ; Hyungseop KIM ; Duk Hyun KANG ; Jong Won HA ; Kye Hun KIM ;
Journal of Cardiovascular Imaging 2024;32(1):34-
5.Contemporary diagnosis and treatment of valvular heart disease in Korea: a nationwide hospital‑based registry study
Hyung Yoon KIM ; Hee Jeong LEE ; In‑Cheol KIM ; Jung‑Woo SON ; Jun‑Bean PARK ; Sahmin LEE ; Eun Kyoung KIM ; Seong‑Mi PARK ; Woo‑Baek CHUNG ; Jung Sun CHO ; Jin‑Sun PARK ; Jeong‑Sook SEO ; Sun Hwa LEE ; Byung Joo SUN ; Chi Young SHIM ; Hyungseop KIM ; Kye Hun KIM ; Duk‑Hyun KANG ; Jong‑Won HA ;
Journal of Cardiovascular Imaging 2024;32(1):37-
Background:
This study was designed to determine the current status of diagnosis and treatment of valvular heart disease (VHD) in Korea.
Methods:
A nationwide registry study was conducted in 45 hospitals in Korea involving adult patients with at least moderate VHD as determined by echocardiography carried out between September and October of 2019. Of a total of 4,094 patients with at least moderate VHD, 1,482 had severe VHD (age, 71.3 ± 13.5 years; 49.1% male). Echocar‑ diographic data used for the diagnosis of each case of VHD were analyzed. Experts from each center determined the diagnosis and treatment strategy for VHD based on current guidelines and institutional policy. The clinical out‑ come was in-hospital mortality.
Results:
Each valve underwent surgical or transcatheter intervention in 19.3% cases of severe mitral stenosis, 31.4% cases of severe primary mitral regurgitation (MR), 7.5% cases of severe secondary MR, 43.7% cases of severe aortic stenosis, 27.5% cases of severe aortic regurgitation, and 7.2% cases of severe tricuspid regurgitation. The overall inhospital mortality rate for patients with severe VHD was 5.4%, and for secondary severe MR and severe tricuspid regur‑ gitation, the rates were 9.0% and 7.5%, respectively, indicating a poor prognosis. In-hospital mortality occurred in 73 of the 1,244 patients (5.9%) who received conservative treatment and in 18 of the 455 patients (4.0%) who received a surgical or transcatheter intervention, which was significantly lower in the intervention group (P = 0.037).
Conclusions
This study provides important information about the current status of VHD diagnosis and treatment through a nationwide registry in Korea and helps to define future changes.
6.Correction: 2023 Korean Society of Echocardiography position paper for diagnosis and management of valvular heart disease, part I: aortic valve disease
Sun Hwa LEE ; Se Jung YOON ; Byung Joo SUN ; Hyue Mee KIM ; Hyung Yoon KIM ; Sahmin LEE ; Chi Young SHIM ; Eun Kyoung KIM ; Dong Hyuk CHO ; Jun Bean PARK ; Jeong Sook SEO ; Jung Woo SON ; In Cheol KIM ; Sang Hyun LEE ; Ran HEO ; Hyun Jung LEE ; Jae Hyeong PARK ; Jong Min SONG ; Sang Chol LEE ; Hyungseop KIM ; Duk Hyun KANG ; Jong Won HA ; Kye Hun KIM ;
Journal of Cardiovascular Imaging 2024;32(1):34-
7.Contemporary diagnosis and treatment of valvular heart disease in Korea: a nationwide hospital‑based registry study
Hyung Yoon KIM ; Hee Jeong LEE ; In‑Cheol KIM ; Jung‑Woo SON ; Jun‑Bean PARK ; Sahmin LEE ; Eun Kyoung KIM ; Seong‑Mi PARK ; Woo‑Baek CHUNG ; Jung Sun CHO ; Jin‑Sun PARK ; Jeong‑Sook SEO ; Sun Hwa LEE ; Byung Joo SUN ; Chi Young SHIM ; Hyungseop KIM ; Kye Hun KIM ; Duk‑Hyun KANG ; Jong‑Won HA ;
Journal of Cardiovascular Imaging 2024;32(1):37-
Background:
This study was designed to determine the current status of diagnosis and treatment of valvular heart disease (VHD) in Korea.
Methods:
A nationwide registry study was conducted in 45 hospitals in Korea involving adult patients with at least moderate VHD as determined by echocardiography carried out between September and October of 2019. Of a total of 4,094 patients with at least moderate VHD, 1,482 had severe VHD (age, 71.3 ± 13.5 years; 49.1% male). Echocar‑ diographic data used for the diagnosis of each case of VHD were analyzed. Experts from each center determined the diagnosis and treatment strategy for VHD based on current guidelines and institutional policy. The clinical out‑ come was in-hospital mortality.
Results:
Each valve underwent surgical or transcatheter intervention in 19.3% cases of severe mitral stenosis, 31.4% cases of severe primary mitral regurgitation (MR), 7.5% cases of severe secondary MR, 43.7% cases of severe aortic stenosis, 27.5% cases of severe aortic regurgitation, and 7.2% cases of severe tricuspid regurgitation. The overall inhospital mortality rate for patients with severe VHD was 5.4%, and for secondary severe MR and severe tricuspid regur‑ gitation, the rates were 9.0% and 7.5%, respectively, indicating a poor prognosis. In-hospital mortality occurred in 73 of the 1,244 patients (5.9%) who received conservative treatment and in 18 of the 455 patients (4.0%) who received a surgical or transcatheter intervention, which was significantly lower in the intervention group (P = 0.037).
Conclusions
This study provides important information about the current status of VHD diagnosis and treatment through a nationwide registry in Korea and helps to define future changes.
8.A Propensity Score-Matched Cohort Study Comparing 3 Different Spine Pedicle Screw Fixation Methods: Freehand, Fluoroscopy-Guided, and Robot-Assisted Techniques
Yoon Ha HWANG ; Byeong-Jin HA ; Hyung Cheol KIM ; Byung Ho LEE ; Jeong-Yoon PARK ; Dong-Kyu CHIN ; Seong YI
Neurospine 2024;21(1):83-94
Objective:
This study aimed to compare the accuracy of robotic spine surgery and conventional pedicle screw fixation in lumbar degenerative disease. We evaluated clinical and radiological outcomes to demonstrate the noninferiority of robotic surgery.
Methods:
This study employed propensity score matching and included 3 groups: robot-assisted mini-open posterior lumbar interbody fusion (PLIF) (robotic surgery, RS), c-arm guided minimally invasive surgery transforaminal lumbar interbody fusion (C-arm guidance, CG), and freehand open PLIF (free of guidance, FG) (54 patients each). The mean follow-up period was 2.2 years. The preoperative spine condition was considered. Accuracy was evaluated using the Gertzbein-Robbins scale (GRS score) and Babu classification (Babu score). Radiological outcomes included adjacent segmental disease (ASD) and mechanical failure. Clinical outcomes were assessed based on the visual analogue scale, Oswestry Disability Index, 36-item Short Form health survey, and clinical ASD rate.
Results:
Accuracy was higher in the RS group (p < 0.01) than in other groups. The GRS score was lower in the CG group, whereas the Babu score was lower in the FG group compared with the RS group. No significant differences were observed in radiological and clinical outcomes among the 3 groups. Regression analysis identified preoperative facet degeneration, GRS and Babu scores as significant variables for radiological and clinical ASD. Mechanical failure was influenced by the GRS score and patients’ age.
Conclusion
This study showed the superior accuracy of robotic spine surgery compared with conventional techniques. When combined with minimally invasive surgery, robotic surgery is advantageous with reduced ligament and muscle damage associated with traditional open procedures.
9.Correction: 2023 Korean Society of Echocardiography position paper for diagnosis and management of valvular heart disease, part I: aortic valve disease
Sun Hwa LEE ; Se Jung YOON ; Byung Joo SUN ; Hyue Mee KIM ; Hyung Yoon KIM ; Sahmin LEE ; Chi Young SHIM ; Eun Kyoung KIM ; Dong Hyuk CHO ; Jun Bean PARK ; Jeong Sook SEO ; Jung Woo SON ; In Cheol KIM ; Sang Hyun LEE ; Ran HEO ; Hyun Jung LEE ; Jae Hyeong PARK ; Jong Min SONG ; Sang Chol LEE ; Hyungseop KIM ; Duk Hyun KANG ; Jong Won HA ; Kye Hun KIM ;
Journal of Cardiovascular Imaging 2024;32(1):34-
10.Contemporary diagnosis and treatment of valvular heart disease in Korea: a nationwide hospital‑based registry study
Hyung Yoon KIM ; Hee Jeong LEE ; In‑Cheol KIM ; Jung‑Woo SON ; Jun‑Bean PARK ; Sahmin LEE ; Eun Kyoung KIM ; Seong‑Mi PARK ; Woo‑Baek CHUNG ; Jung Sun CHO ; Jin‑Sun PARK ; Jeong‑Sook SEO ; Sun Hwa LEE ; Byung Joo SUN ; Chi Young SHIM ; Hyungseop KIM ; Kye Hun KIM ; Duk‑Hyun KANG ; Jong‑Won HA ;
Journal of Cardiovascular Imaging 2024;32(1):37-
Background:
This study was designed to determine the current status of diagnosis and treatment of valvular heart disease (VHD) in Korea.
Methods:
A nationwide registry study was conducted in 45 hospitals in Korea involving adult patients with at least moderate VHD as determined by echocardiography carried out between September and October of 2019. Of a total of 4,094 patients with at least moderate VHD, 1,482 had severe VHD (age, 71.3 ± 13.5 years; 49.1% male). Echocar‑ diographic data used for the diagnosis of each case of VHD were analyzed. Experts from each center determined the diagnosis and treatment strategy for VHD based on current guidelines and institutional policy. The clinical out‑ come was in-hospital mortality.
Results:
Each valve underwent surgical or transcatheter intervention in 19.3% cases of severe mitral stenosis, 31.4% cases of severe primary mitral regurgitation (MR), 7.5% cases of severe secondary MR, 43.7% cases of severe aortic stenosis, 27.5% cases of severe aortic regurgitation, and 7.2% cases of severe tricuspid regurgitation. The overall inhospital mortality rate for patients with severe VHD was 5.4%, and for secondary severe MR and severe tricuspid regur‑ gitation, the rates were 9.0% and 7.5%, respectively, indicating a poor prognosis. In-hospital mortality occurred in 73 of the 1,244 patients (5.9%) who received conservative treatment and in 18 of the 455 patients (4.0%) who received a surgical or transcatheter intervention, which was significantly lower in the intervention group (P = 0.037).
Conclusions
This study provides important information about the current status of VHD diagnosis and treatment through a nationwide registry in Korea and helps to define future changes.

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