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.Parvimonas micra-Induced Paraspinal Abscess and Pyogenic Spondylitis Following Dental Extraction: A Case Report with a Brief Literature Review
Jae Wook YU ; Bu Kwang OH ; Dong Wuk SON ; Jun Seok LEE ; Su Hun LEE ; Soon Ki SUNG ; Sang Weon LEE ; Geun Sung SONG
The Nerve 2024;10(1):39-44
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.
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.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.
7.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.
8.A Comprehensive Analysis of Potential Complications after Oblique Lumbar Interbody Fusion : A Review of Postoperative Magnetic Resonance Scans in Over 400 Cases
Kang-Hoon LEE ; Su-Hun LEE ; Jun-Seok LEE ; Young-Ha KIM ; Soon-Ki SUNG ; Dong-Wuk SON ; Sang-Weon LEE ; Geun-Sung SONG
Journal of Korean Neurosurgical Society 2024;67(5):550-559
Objective:
: This study focuses on identifying potential complications following oblique lumbar interbody fusion (OLIF) through routine magnetic resonance (MR) scans.
Methods:
: From 650 patients who underwent OLIF from April 2018 to April 2022, this study included those with MR scans taken 1-week post-operatively, and only for indirect decompression patients. The analysis evaluated postoperative MR images for hematoma, cage insertion angles, and indirect decompression efficiency. Patient demographics, post-operatively symptoms, and complications were also evaluated.
Results:
: Out of 401 patients enrolled, most underwent 1- or 2-level OLIF. Common findings included approach site hematoma (65.3%) and contralateral psoas hematoma (19%). The caudal level OLIF was related with less orthogonality and deep insertion of cage. Incomplete indirect decompression occurred in 4.66% of cases but did not require additional surgery. Rare but symptomatic complications included remnant disc rupture (four cases, 1%) and synovial cyst rupture (four cases, 1%).
Conclusion
: This study has identified potential complications associated with OLIF, including approach site hematoma, contralateral psoas hematoma, cage malposition risk at caudal levels, and radiologically insufficient indirect decompression. Additionally, it highlights rare, yet symptomatic complications such as remnant disc rupture and synovial cyst rupture. These findings contribute insights into the relatively under-explored area of OLIF complications.
10.Radiological Changes in Adjacent and Index Levels after Cervical Disc Arthroplasty
Jun Jae SHIN ; Kwang-Ryeol KIM ; Dong Wuk SON ; Dong Ah SHIN ; Seong YI ; Keung-Nyun KIM ; Do-Heum YOON ; Yoon HA
Yonsei Medical Journal 2022;63(1):72-81
Purpose:
The purpose of this retrospective study was to evaluate radiological and clinical outcomes in patients undergoing cervical disc arthroplasty (CDA) for cervical degenerative disc disease. The results may assist in surgical decision-making and enable more effective and safer implementation of cervical arthroplasty.
Materials and Methods:
A total of 125 patients who were treated with CDA between 2006 and 2019 were assessed. Radiological measurements and clinical outcomes included the visual analogue scale (VAS), the Neck Disability Index (NDI), and the Japanese Orthopaedic Association (JOA) myelopathy score assessment preoperatively and at ≥2 years of follow-up.
Results:
The mean follow-up period was 38 months (range, 25–114 months). Radiographic data demonstrated mobility at both the index and adjacent levels, with no signs of hypermobility at an adjacent level. There was a non-significant loss of cervical global motion and range of motion (ROM) of the functional spinal unit at the operated level, as well as the upper and lower adjacent disc levels, compared to preoperative status. The cervical global and segmental angle significantly increased. Postoperative neck VAS, NDI, and JOA scores showed meaningful improvements after one- and two-level CDA. We experienced a 29.60% incidence of heterotrophic ossification and a 3.20% reoperation rate due to cervical instability, implant subsidence, or osteolysis.
Conclusion
CDA is an effective surgical technique for optimizing clinical outcomes and radiological results. In particular, the preservation of cervical ROM with an artificial prosthesis at adjacent and index levels and improvement in cervical global alignment could reduce revision rates due to adjacent segment degeneration.

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