Henry Bohlman (July 22, 1937– May 27, 2010)

K. Daniel Riew 대한척추신경외과학회 2020 Neurospine Vol.17 No.3

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The Role of Atlantoaxial Instability on Chiari, Ossification of the Posterior Longitudinal Ligament, Spondylosis and Stenosis

K. Daniel Riew 대한척추신경외과학회 2019 Neurospine Vol.16 No.2

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Editorial for Effect of Myelopathy on Outcomes After Cervical Disc Replacement: A Study of a Local Patient Cohort and a Large National Cohort

K. Daniel Riew 대한척추신경외과학회 2019 Neurospine Vol.16 No.3

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Review of Vertebral Body Sliding Osteotomy for Cervical Myelopathy with Rigid Kyphosis

K. Daniel Riew 대한척추신경외과학회 2020 Neurospine Vol.17 No.3

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Double Dome Laminoplasty: Works Well but There Are Exceptions

K. Daniel Riew 대한척추신경외과학회 2021 Neurospine Vol.18 No.4

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Preoperative Narcotic Use, Impaired Ambulation Status, and Increased Intraoperative Blood Loss Are Independent Risk Factors for Complications Following Posterior Cervical Laminectomy and Fusion Surgery

Ryan K. Badiee,Andrew K. Chan,Joshua Rivera,Annette Molinaro,Brianna R. Doherty,K. Daniel Riew,Dean Chou,Praveen V. Mummaneni,Lee A. Tan 대한척추신경외과학회 2019 Neurospine Vol.16 No.3

Objective: This retrospective cohort study seeks to identify risk factors associated with complications following posterior cervical laminectomy and fusion (PCLF) surgery. Methods: Adults undergoing PCLF from 2012 through 2018 at a single center were identified. Demographic and radiographic data, surgical characteristics, and complication rates were compared. Multivariate logistic regression models identified independent predictors of complications following surgery. Results: A total of 196 patients met the inclusion criteria and were included in the study. The medical, surgical, and overall complication rates were 10.2%, 23.0%, and 29.1% respectively. Risk factors associated with medical complications in multivariate analysis included impaired ambulation status (odds ratio [OR], 2.27; p=0.02) and estimated blood loss over 500 mL (OR, 3.67; p=0.02). Multivariate analysis revealed preoperative narcotic use (OR, 2.43; p=0.02) and operative time (OR, 1.005; p=0.03) as risk factors for surgical complication, whereas antidepressant use was a protective factor (OR, 0.21; p=0.01). Overall complication was associated with preoperative narcotic use (OR, 1.97; p=0.04) and higher intraoperative blood loss (OR, 1.0007; p=0.03). Conclusion: Preoperative narcotic use and estimated blood loss predicted the incidence of complications following PCLF for CSM. Ambulation status was a significant predictor of the development of a medical complication specifically. These results may help surgeons in counseling patients who may be at increased risk of complication following surgery.

쥐의 척수손상 후 사이토카인 발현 연구를 통한 세포 사멸을 조절하는 길항제의 연구

양준영(Jun Young Yang),K. Daniel Riew 대한정형외과학회 2007 대한정형외과학회지 Vol.42 No.1

목적: 쥐의 척수 손상 후 발현되는 사이토카인을 분석하여 세포 사멸을 조절하는 길항제에 대하여 알아보고자 하였다. 대상 및 방법: 평균 16주 된 Sprague-Dawley rat, 암컷 60마리를 사용하였으며, 9번 흉추에서 추궁절제 후 신경 손상을 유도한 후 생리식염수를 투여한 대조군 및 aminoguanidine을 투여한 Ⅰ군, GM-CSF를 투여한 Ⅱ군, riluzole을 투여한 Ⅲ군, erythropoietin을 투여한 Ⅳ군, 그리고 methylprednisolone을 투여한 Ⅴ군으로 분류하였다. 운동 측정은 Tarlov 점수를 이용하였고, 술 후 1일, 3일, 5일, 그리고 7일에 각각 쥐를 희생시켜 척수 공동의 크기, e-NOS에 대한 면역조직화학염색 및 XIAP에 대한 RT-PCR을 실시하였다. 결과: 운동 회복 및 척수 공동 증가 억제는 Ⅴ, Ⅰ, Ⅲ군에서 다른 군에 비해 유의한 결과를 보였다(p<0.05). e-NOS 활성도의 발현은 Ⅰ과 Ⅴ, Ⅲ군에서 저명하였으나, 나머지 군에서는 e-NOS 활성도의 발현은 거의 없었다. RT-PCR상 XIAP의 발현은 시간의 경과에 따라 Ⅴ, Ⅰ, Ⅲ군에서 다른 군에 비해 강한 발현을 보였다. 결론: 척수 손상 후 초기에 세포 사멸을 조절하는 인자로 steroid, NOS 억제제, Na 통로 억제제 등이 중요할 것으로 사료되며, 추후 연구는 이들 약물들이 synergic effect를 일으킬 수 있는 약물의 개발에 중점을 두고자 한다. Purpose: To analyze the cytokines that appear after a spinal cord injury in rats and to determine the agonists that regulate apoptosis. Materials and Methods: Sixty female Sprague-Dawley rats were anesthetized, and a laminectomy was performed at the 9th thoracic vertebra. The spinal cord injury was induced by dropping a 10 gm weight at a height of 20 ㎜. The subjects were divided into 5 groups. Group Ⅰ was administered aminoguanidine, group Ⅱ was administered GM-CSF, group Ⅲ was administered riluzole, group Ⅳ was administered erythropoietin, and group Ⅴ was administered methylprednisolone. A control group was administered normal saline. The results were assessed using the Tarlov motor grading method. In 1, 3, 5 and 7 days after the spinal cord injury, the rats were sacrificed and evaluated using the syringomyelic cavity size. Immunohistochemical staining for e-NOS and RT-PCR for XIAP were also performed. Results: Groups Ⅰ, Ⅲ, and Ⅴ showed significantly different results in terms of the motor recovery and inhibition of increase in the syringomyelic cavity compared with the other groups (p 〈 0.05). The e-NOS activity was observed in groups Ⅰ, Ⅲ, and Ⅴ. The other groups showed almost no e-NOS activity. On the RT-PCR, groups Ⅰ, Ⅲ, and Ⅴ showed significantly different results in terms of XIAP expression with time compared with the other groups. Conclusion: Steroids, NOS inhibitors and sodium channel inhibitors appear to be important factors for regulating apoptosis in the early stage of a spinal cord injury. Further study will be needed to develop new pharmaceuticals with synergic effects on spinal cord injuries.

Development of Neuromonitoring Pedicle Screw - Results of Electrical Resistance and Neurophysiologic Test in Pig Model

방우석,박종후,김경태,조대철,K. Daniel Riew,김두환,한인보,현승재,윤도흠,김영백 대한척추신경외과학회 2021 Neurospine Vol.18 No.1

Objective: To analyze the electrical resistance of a newly developed neuromonitoring pedicle screw (Neuro-PS) and to verify the electrophysiologic properties of the Neuro-PS in a pig model. Methods: We developed 2 types of the Neuro-PS in which a gold lead was located internally (type I) and externally (type II). We measured the electrical resistance of the Neuro-PS and the conventional screw and analyzed the electrical thresholds of triggered EMG (t-EMG) of each screw by intentionally penetrating the medial pedicle wall and contacting the exiting nerve root in a pig model. Results: The electrical resistances of the Neuro-PS were remarkably lower than that of the conventional screw. In electrophysiologic testing, only the type II Neuro-PS under the lead-nerve contact condition showed a significantly lower stimulation threshold as compared to the conventional screw. Conclusion: The Neuro-PS demonstrated lower electrical resistances than the conventional screw. The type II Neuro-PS under the lead-nerve contact condition showed a significantly lower stimulation threshold compared to that of the other screws in the t-EMG test.

The Feasibility of Multiple Fixation Points in C2

Ngoc Quyen Nguyen,Riew K. Daniel,Lee So Min,Park Sang-Min,Kim Ho-Joong,장봉순,Lee Sang-Hun,Lee Jae Chul,Yeom Jin S. 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.5

Study Design: Analysis using three-dimensional simulation software for spinal screw placement and computed tomographic scan images.Purpose: To assess the feasibility of achieving multiple (three or four) screw fixation points in C2 vertebra by using a combination of pedicle and laminar screws.Overview of Literature: Secure C2 fixation using multiple screws is required or beneficial in some unique cases. However, to the best of our knowledge, there have been no reports analyzing the feasibility of multiple screw fixation in C2.Methods: We used 1.0-mm interval computed tomographic scan images of 100 patients (50 men and 50 women) and screw trajectory simulation software. The diameter of all screws was set at 3.5 mm, considering its common usage in real surgery. The anatomical feasibility of placing both pedicle and laminar screws on the same side was evaluated. For all feasible sides, the three-dimensional distance between the screw entry points was measured.Results: In 85% of cases, both pedicle and laminar screws could be placed on both sides, allowing for the insertion of 4 screws. In 11% of cases, 2 screws could be placed on one side, while only 1 screw was feasible on the other side, resulting in the placement of 3 screws. In all 181 sides where both types of screws could be inserted, the distance between their entry points exceeded 16.1 mm, which was sufficient to prevent the collision between the screw heads.Conclusions: C2 vertebra can accommodate three (11%) or four (85%) screws in 96% of cases.

Surgical Anatomy of the Longus Colli Muscle and Uncinate Process in the Cervical Spine

박문수,문성환,김태환,오재근,김형준,박건태,K. Daniel Riew 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.4

Purpose: There have been a few previous reports regarding the distances between the medial borders of the longus colli to expose the disc space. However, to our knowledge, there are no reports concerning longus colli dissection to expose the uncinate processes. This study was undertaken to assess the surgical relationship between the longus colli muscle and the uncinate process in the cervical spine. Materials and Methods: This study included 120 Korean patients randomly selected from 333 who had cervical spine MRIs and CTs from January 2003 to October 2013. They consisted of 60 males and 60 females. Each group was subdivided into six groups by age from 20 to 70 years or more. We measured three parameters on MRIs from C3 to T1: left and right longus colli distance and inter-longus colli distance. We also measured three parameters on CT: left and right uncinate distance and inter-uncinate distance. Results: The longus colli distances, uncinate distances, and inter-uncinate distances increased from C3 to T1. The inter-longus colli distances increased from C3 to C7. There was no difference in longus colli distances and uncinate distances between males and females. There was no difference in the six parameters for the different age groups. Conclusion: Although approximate guidelines, we recommend the longus colli be dissected approximately 5 mm at C3–5, 6 mm at C5–6, 7 mm at C6–7, and 8 mm at C7–T1 to expose the uncinate process to its lateral edge.