https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/220 2026-04-04T09:40:59Z 2026-04-04T09:40:59Z Lee, Seung Hoon Kwon, Woo-Keun Ham, Chang Hwa Na, Jung Hyun Kim, Joo Han Park, Youn-Kwan Park, Jung Yul Hur, Junseok W. Moon, Hong Joo https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63802 2024-10-23T08:00:09Z 2024-02-01T00:00:00Z

Title: Postoperative survival after lumbar instrumented surgery for metastatic spinal tumors: a nationwide population-based cohort analysis Authors: Lee, Seung Hoon; Kwon, Woo-Keun; Ham, Chang Hwa; Na, Jung Hyun; Kim, Joo Han; Park, Youn-Kwan; Park, Jung Yul; Hur, Junseok W.; Moon, Hong Joo Abstract: BackgroundIt is difficult to predict the expected survival after lumbar instrumented surgery for metastases owing to the difference among different cancer origins and the relatively short survival after surgery.AimsThe aim of this study is to analyze the postoperative survival period of lumbar spinal metastasis patients who underwent lumbar instrumented surgery.MethodsData were collected from the Korean National Health Insurance Review and Assessment Service database. Patients who underwent lumbar spinal surgery with instrumentation between January 2011 and December 2015 for metastatic lumbar diseases were reviewed. The mean postoperative survival period of patients with metastatic lumbar cancer according to each primary cancer type was evaluated.ResultsA total of 628 patients were enrolled and categorized according to primary cancer type. The overall median survival rate was 1.11 & PLUSMN;1.30 years. The three most prevalent primary cancer groups were lung, hepatobiliary, and colorectal cancers, presenting relatively short postoperative survival rates (0.93 & PLUSMN;1.25, 0.74 & PLUSMN;0.75 and 0.74 & PLUSMN;0.88 years, respectively). The best postoperative survival period was observed in breast cancer (2.23 & PLUSMN;1.83 years), while urinary tract cancer showed the shortest postoperative survival period (0.59 & PLUSMN;0.69 years).ConclusionThe postoperative survival period of patients with lumbar metastatic spinal tumors according to different primary cancers after instrumented fusion was >1 year overall, with differences according to different primary origins. This result may provide information regarding the expected postoperative survival after instrumented surgery for lumbar spinal metastases.

2024-02-01T00:00:00Z Lee, In-Hyoung Ha, Sung-Kon Lim, Dong-Jun Choi, Jong-Il https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64346 2024-09-24T01:30:07Z 2023-12-01T00:00:00Z

Title: Distal placement of balloon guide catheter facilitates stent-retriever mechanical thrombectomy for acute ischemic stroke in the anterior circulation Authors: Lee, In-Hyoung; Ha, Sung-Kon; Lim, Dong-Jun; Choi, Jong-Il Abstract: PurposeAlthough balloon guide catheters (BGCs) have been demonstrated to improve recanalization and functional outcomes by enabling proximal flow control and forced aspiration during mechanical thrombectomy (MT), the significance of the BGC location has been overlooked. We evaluated the impact of BGC location during MT for anterior circulation acute ischemic stroke (AIS).MethodsPatients were divided into the proximal and distal BGC groups according to the BGC tip location relative to the lower margin of the C1 vertebral body. Endovascular and clinical outcomes were compared between the two groups, including subgroup analyses of the two types of extracranial internal carotid artery (ICA) anatomy, categorized based on cerebral angiography.ResultsA total of 124 patients were analyzed, with 62 each in the proximal and distal BGC placement groups. The distal BGC group had higher rates of first-pass recanalization (FPR) (38.7% vs. 17.7%, P = 0.009) and favorable outcomes (64.5% vs. 46.8%, P = 0.047) with shorter procedure time (47.5 min vs. 65 min, P = 0.001) and fewer distal embolization (3.2% vs. 12.9%, P = 0.048) than the proximal BGC group. FPR was also more frequently achieved in the distal BGC group of patients with tortuous ICA (37.0% vs. 12.5%, P = 0.029). Multivariate analysis showed that distal BGC placement was an independent predictor of FPR (odds ratio, 3.092; 95% confidence interval, 1.326-7.210; P = 0.009).ConclusionDistal BGC placement facilitates MT for AIS in the anterior circulation. Therefore, we suggest distal BGC placement to maximize the effect of thrombectomy, even for tortuous extracranial ICA.

2023-12-01T00:00:00Z Mun, Junho Hyun, Seung-Jae Lee, Jae-Koo An, Sungjae Kim, Ki-Jeong https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64245 2025-09-26T04:31:14Z 2023-09-01T00:00:00Z

Title: Surgical and Clinical Outcomes Associated With the Use of Barbed Sutures and Self-Adhering Mesh System and Polymeric Glue for Wound Closure in Multilevel or Revision Spinal Surgery: A Matched Cohort Comparative Study With Conventional Wound Closure Procedure Authors: Mun, Junho; Hyun, Seung-Jae; Lee, Jae-Koo; An, Sungjae; Kim, Ki-Jeong Abstract: Objective: Multilevel or revisional posterior spinal surgery is prone to infection and delayed wound healing, related with the wound closure time and suture strength. Knotless barbed suture is an innovative self-locking, multianchor suture. This study aims to evaluate the safe-ty and efficacy of the knotless barbed suture and self-adhering mesh with polymeric glue in multilevel or revisional posterior spinal surgery. Methods: This is a single-center retrospective matched cohort study. Patients were divided into 2 groups based on the wound closure method: barbed suture group with novel wound closure, and conventional suture group with conventional wound closure, 1:1 matched by the level of surgery and sex, resulting in 120 subjects each. Total operation time and wound closure time were measured intraoperatively, and perioperative clinical outcome parameters including postoperative wound complication were investigated for the first 3 months postoperatively. The distribution of continuous variables was assessed for normality by Shapiro-Wilk test, then parametric or nonparametric tests were applied accordingly (paired t-test or Wilcoxon signed-rank test). Results: Wound closure time was significantly shorter with the novel barbed suture than with conventional suture in all subgroups divided by the level of spinal surgery: 3-5, 6-9, >= 10 levels (p < 0.001). The 2 groups showed no significant differences in surgical complications (p =1.000). Specially, total operation time and wound-closing time were significantly shorter in revisional subgroup. Conclusion: Absorbable knotless barbed suture and self-adhering mesh with polymeric glue can shorten spinal wound closure time with noninferiority in complications for multilevel or revisional spinal surgery.

2023-09-01T00:00:00Z Lee, Hyun-Seok Cho, Kyung-Rae Park, Kwan Jeon, Chiman https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64047 2023-12-19T05:00:26Z 2023-08-01T00:00:00Z

Title: Management of Cerebrospinal Fluid Leakage after Microvascular Decompression Surgery: Clinical Strategy Authors: Lee, Hyun-Seok; Cho, Kyung-Rae; Park, Kwan; Jeon, Chiman Abstract: (1) Background: Cerebrospinal fluid (CSF) leakage is one of the most common complications of microvascular decompression (MVD) surgery. Before fatal complications, such as intracranial infection, occur, early recognition and prompt treatment are essential. (2) Methods: The clinical data of 475 patients who underwent MVD surgery from September 2020 to March 2023 were retrospectively analyzed. In these patients, if there were any symptoms of CSF leakage, and if CSF leakage was evident, a lumbar drainage catheter was inserted immediately. (3) Results: CSF leakage was suspected in 18 (3.8%) patients. Five of these patients (1.1%) showed signs of CSF leakage during conservative management and subsequently underwent catheter insertion for lumbar drainage. The lumbar drain was removed after an average of 5.2 days, resulting in an average hospitalization of 14.8 days. In all 5 patients, CSF leakage was resolved without reoperation. (4) Conclusions: Our treatment strategy prevented the development of fatal complications. Close observation of the symptoms and postoperative temporal bone computed tomography and audiometry are considered to be good evaluation methods for all patients. If CSF leakage is certain, it is important to perform lumbar drainage immediately.

2023-08-01T00:00:00Z