• Title/Summary/Keyword: Fusion Index

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Comparison between Instrumented Mini-TLIF and Instrumented Circumferential Fusion in Adult Low-Grade Lytic Spondylolisthesis : Can Mini-TLIF with PPF Replace Circumferential Fusion?

  • Kim, Jin-Sung;Kim, Dong-Hyun;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.45 no.2
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    • pp.74-80
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    • 2009
  • Objective : To evaluate clinical and radiological results of two different fusion techniques in adult low-grade isthmic spondylolisthesis. Methods : Between November 2003 and December 2004, 46 consecutive patients underwent instrumented mini-transforaminal lumbar interbody fusion (mini-TLIF) (group I) at Wooridul Spine Hospital, Seoul, Korea. Between February 2003 and October 2006, 32 consecutive patients underwent instrumented circumferential fusion (group II) at Leon Wiltse Memorial Hospital, Suwon, Korea. The mean follow-up periods were 29.7 and 26.1 months, respectively. Results : Mean visual analog scale (VAS) scores for back and leg pain decreased, respectively, from 6.98 and 6.33 to 2.3 and 2.2 in group I and from 7.38 and 6.00 to 1.7 and 1.0 in group II. Mean Oswestry disability index (ODI) improved from 51.85% to 14.4% in group I and from 60% to 9.1% in group II. In both groups, VAS and ODI scores significantly changed from pre- to postoperatively (p<0.001), but postoperative outcome between groups was statistically not significant. Radiologic evidence of fusion was noted in 95.7% and 100% of the patients in group I and II, respectively. In both groups, changes in disc height, segmental lordosis, degree of listhesis, and whole lumbar lordosis between the pre- and postoperative periods were significant except whole lumbar lordosis in both groups. Conclusion : Clinical and functional outcomes demonstrate no significant differences between groups in treating back and leg pain of adult patients with low-grade isthmic spondylolisthesis. However, in terms of operative data (i.e. operation time and hospital stay), instrumented mini-TLIF demonstrated better results.

Usefulness of Oblique Lateral Interbody Fusion at L5-S1 Level Compared to Transforaminal Lumbar Interbody Fusion

  • Mun, Hah Yong;Ko, Myeong Jin;Kim, Young Baeg;Park, Seung Won
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.723-729
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    • 2020
  • Objective : The use of oblique lateral interbody fusion at the L5-S1 level (OLIF51) is increasing, but no study has directly compared OLIF51 and transforaminal lumbar interbody fusion (TLIF) at the L5-S1 level. We evaluated the usefulness of OLIF51 by comparing clinical and radiologic outcomes with those of TLIF at the same L5-S1 level. Methods : We retrospectively reviewed and compared 74 patients who underwent OLIF51 (OLIF51 group) and 74 who underwent TLIF at the L5-S1 level (TLIF51 group). Clinical outcomes were assessed with the visual analogue scale for back pain and leg pain and the Oswestry Disability Index. Mean disc height (MDH), foraminal height (FH), disc angle (DA), fusion rate, and subsidence rate were measured for radiologic outcomes. Results : The OLIF51 group used significantly higher, wider, and larger-angled cages than the TLIF51 group (p<0.001). The postoperative MDH and FH were significantly greater in the OLIF51 group than in the TLIF51 group (p<0.001). The postoperative DA was significantly larger in the OLIF51 group than in the TLIF51 group by more than 10º (p<0.001). The fusion rate was 81.1% and 87.8% at postoperative 6 months in the OLIF51 and TLIF51 groups, respectively, and the TLIF51 group showed a higher fusion rate (p<0.05). The subsidence rate was 16.2% and 25.3% in the OLIF51 and TLIF51 groups, respectively, and the OLIF51 group showed a lower subsidence rate (p<0.05). Conclusion : OLIF51 was more effective for the indirect decompression of foraminal stenosis, providing strong mechanical support with a larger cage, and making a greater lordotic angle with a high-angle cage than with TLIF.

Comparative Analysis of Image Fusion Methods According to Spectral Responses of High-Resolution Optical Sensors (고해상 광학센서의 스펙트럼 응답에 따른 영상융합 기법 비교분석)

  • Lee, Ha-Seong;Oh, Kwan-Young;Jung, Hyung-Sup
    • Korean Journal of Remote Sensing
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    • v.30 no.2
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    • pp.227-239
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    • 2014
  • This study aims to evaluate performance of various image fusion methods based on the spectral responses of high-resolution optical satellite sensors such as KOMPSAT-2, QuickBird and WorldView-2. The image fusion methods used in this study are GIHS, GIHSA, GS1 and AIHS. A quality evaluation of each image fusion method was performed with both quantitative and visual analysis. The quantitative analysis was carried out using spectral angle mapper index (SAM), relative global dimensional error (spectral ERGAS) and image quality index (Q4). The results indicates that the GIHSA method is slightly better than other methods for KOMPSAT-2 images. On the other hand, the GS1 method is suitable for Quickbird and WorldView-2 images.

Pansharpening Method for KOMPSAT-2/3 High-Spatial Resolution Satellite Image (아리랑 2/3호 고해상도 위성영상에 적합한 융합기법)

  • Oh, Kwan-Young;Jung, Hyung-Sup;Jeong, Nam-Ki
    • Korean Journal of Remote Sensing
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    • v.31 no.2
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    • pp.161-170
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    • 2015
  • This paper presents an efficient image fusion method to be appropriate for the KOMPSAT-2 and 3 satellites. The proposed method is based on the well-established component substitution (CS) approach. The proposed method is divided into two parts: 1) The first step is to create a intensity image by the weighted-averaging operation of a multi-spectral (MS) image and 2) the second step is to produce an optimal high-frequency image using the statistical properties of the original MS and panchromatic (PAN) images. The performance of the proposed method is evaluated in both quantitative and visual analysis. Quantitative assessments are performed by using the relative global dimensional synthesis error (Spatial and Spectral ERGAS), the image quality index (Q4), and the spectral angle mapper index (SAM). The qualitative and quantitative assessment results show that the fusion performance of the proposed method is improved in both the spectral and spatial qualities when it is compared with previous CS-based fusion methods.

A Multi-center Clinical Study of Posterior Lumbar Interbody Fusion with the Expandable Stand-alone Cage($Tyche^{(R)}$ Cage) for Degenerative Lumbar Spinal Disorders

  • Kim, Jin-Wook;Park, Hyung-Chun;Yoon, Seung-Hwan;Oh, Seong-Hoon;Roh, Sung-Woo;Rim, Dae-Cheol;Kim, Tae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.251-257
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    • 2007
  • Objective : This multi-center clinical study was designed to determine the long-term results of patients who received a one-level posterior lumbar interbody fusion with expandable cage ($Tyche^{(R)}$ cage) for degenerative spinal diseases during the same period in each hospital. Methods : Fifty-seven patients with low back pain who had a one-level posterior lumbar interbody fusion using a newly designed expandable cage were enrolled in this study at five centers from June 2003 to December 2004 and followed up for 24 months. Pain improvement was checked with a Visual Analogue Scale (VAS) and their disability was evaluated with the Oswestry Disability Index. Radiographs were obtained before and after surgery. At the final follow-up, dynamic stability, quality of bone fusion, interveretebral disc height, and lumbar lordosis were assessed. In some cases, a lumbar computed tomography scan was also obtained. Results : The mean VAS score of back pain was improved from 6.44 points preoperatively to 0.44 at the final visit and the score of sciatica was reduced from 4.84 to 0.26. Also, the Oswestry Disability Index was improved from 32.62 points preoperatively to 18.25 at the final visit. The fusion rate was 92.5%. Intervertebral disc height, recorded as $9.94{\pm}2.69\;mm$ before surgery was increased to $12.23{\pm}3.31\;mm$ at postoperative 1 month and was stabilized at $11.43{\pm}2.23\;mm$ on final visit. The segmental angle of lordosis was changed significantly from $3.54{\pm}3.70^{\circ}$ before surgery to $6.37{\pm}3.97^{\circ}$ by 24 months postoperative, and total lumbar lordosis was $20.37{\pm}11.30^{\circ}$ preoperatively and $24.71{\pm}11.70^{\circ}$ at 24 months postoperative. Conclusion : There have been no special complications regarding the expandable cage during the follow-up period and the results of this study demonstrates a high fusion rate and clinical success.

AUTOMATIC BUILDING EXTRACTION BASED ON MULTI-SOURCE DATA FUSION

  • Lu, Yi Hui;Trinder, John
    • Proceedings of the KSRS Conference
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    • 2003.11a
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    • pp.248-250
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    • 2003
  • An automatic approach and strategy for extracting building information from aerial images using combined image analysis and interpretation techniques is described in this paper. A dense DSM is obtained by stereo image matching. Multi-band classification, DSM, texture segmentation and Normalised Difference Vegetation Index (NDVI) are used to reveal building interest areas. Then, based on the derived approximate building areas, a shape modelling algorithm based on the level set formulation of curve and surface motion has been used to precisely delineate the building boundaries. Data fusion, based on the Dempster-Shafer technique, is used to interpret simultaneously knowledge from several data sources of the same region, to find the intersection of propositions on extracted information derived from several datasets, together with their associated probabilities. A number of test areas, which include buildings with different sizes, shape and roof colour have been investigated. The tests are encouraging and demonstrate that the system is effective for building extraction, and the determination of more accurate elevations of the terrain surface.

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Anterior Dislodgement of a Fusion Cage after Transforaminal Lumbar Interbody Fusion for the Treatment of Isthmic Spondylolisthesis

  • Oh, Hyeong Seok;Lee, Sang-Ho;Hong, Soon-Woo
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.128-131
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    • 2013
  • Transforaminal lumbar interbody fusion (TLIF) is commonly used procedure for spinal fusion. However, there are no reports describing anterior cage dislodgement after surgery. This report is a rare case of anterior dislodgement of fusion cage after TLIF for the treatment of isthmic spondylolisthesis with lumbosacral transitional vertebra (LSTV). A 51-year-old man underwent TLIF at L4-5 with posterior instrumentation for the treatment of grade 1 isthmic spondylolisthesis with LSTV. At 7 weeks postoperatively, imaging studies demonstrated that banana-shaped cage migrated anteriorly and anterolisthesis recurred at the index level with pseudoarthrosis. The cage was removed and exchanged by new cage through anterior approach, and screws were replaced with larger size ones and cement augmentation was added. At postoperative 2 days of revision surgery, computed tomography (CT) showed fracture on lateral pedicle and body wall of L5 vertebra. He underwent surgery again for paraspinal decompression at L4-5 and extension of instrumentation to S1 vertebra. His back and leg pains improved significantly after final revision surgery and symptom relief was maintained during follow-up period. At 6 months follow-up, CT images showed solid fusion at L4-5 level. Careful cage selection for TLIF must be done for treatment of spondylolisthesis accompanied with deformed LSTV, especially when reduction will be attempted. Banana-shaped cage should be positioned anteriorly, but anterior dislodgement of cage and reduction failure may occur in case of a highly unstable spine. Revision surgery for the treatment of an anteriorly dislodged cage may be effectively performed using an anterior approach.

Posterior Cervical Fixation with a Nitinol Shape Memory Loop for Primary Surgical Stabilization of Atlantoaxial Instability : A Preliminary Report

  • Kim, Duk-Gyu;Eun, Jong-Pil;Park, Jung-Soo
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.21-26
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    • 2012
  • Objective : To evaluate a new posterior atlantoaxial fixation technique using a nitinol shape memory loop as a simple method that avoids the risk of vertebral artery or nerve injury. Methods : We retrospectively evaluated 14 patients with atlantoaxial instability who had undergone posterior C1-2 fusion using a nitinol shape memory loop. The success of fusion was determined clinically and radiologically. We reviewed patients' neurologic outcomes, neck disability index (NDI), solid bone fusion on cervical spine films, changes in posterior atlantodental interval (PADI), and surgical complications. Results : Solid bone fusion was documented radiologically in all cases, and PADI increased after surgery (p<0.05). All patients remained neurologically intact and showed improvement in NDI score (p<0.05). There were no surgical complications such as neural tissue or vertebral artery injury or instrument failure in the follow-up period. Conclusion : Posterior C1-2 fixation with a nitinol shape memory loop is a simple, less technically demanding method compared to the conventional technique and may avoid the instrument-related complications of posterior C1-2 screw and rod fixation. We introduce this technique as one of the treatment options for atlantoaxial instability.

Effect of Mixture of Recombinant Human Bone Morphogenic Protein-2 and Demineralized Bone Matrix in Lateral Lumbar Interbody Fusion

  • Jun Ik Son;Young-Seok Lee;Myeong Jin Ko;Seong-Hyun Wui;Seung Won Park
    • Journal of Korean Neurosurgical Society
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    • v.67 no.3
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    • pp.354-363
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    • 2024
  • Objective : This study aims to determine the optimal dose of recombinant-human bone morphogenic protein-2 (rhBMP-2) for successful bone fusion in minimally invasive lateral lumbar interbody fusion (MIS LLIF). Previous studies show that rhBMP is an effective alternative to autologous iliac crest bone graft, but the optimal dose remains uncertain. The study analyzes the fusion rates associated with different rhBMP doses to provide a recommendation for the optimal dose in MIS LLIF. Methods : Ninety-three patients underwent MIS LLIF using demineralized bone matrix (DBM) or a mixture of rhBMP-2 and DBM as fusion material. The group was divided into the following three groups according to the rhBMP-2 usage : group A, only DBM was used (n=27); group B, 1 mg of rhBMP-2 per 5 mL of DBM paste (n=41); and group C, 2 mg of rhBMP-2 per 5 mL of DBM paste (n=25). Demographic data, clinical outcomes, postoperative complication and fusion were assessed. Results : At 12 months post-surgery, the overall fusion rate was 92.3% according to Bridwell fusion grading system. Groups B and C, who received rhBMP-2, had significantly higher fusion rates than group A, who received only DBM. However, there was no significant increase in fusion rate when the rhBMP-2 dosage was increased from group B to group C. The groups B and C showed significant improvement in back pain and Oswestry disability index compared to the group A. The incidence of screw loosening was decreased in groups B and C, but there was no significant difference in the occurrence of other complications. Conclusion : Usage of rhBMP-2 in LLIF surgery leads to early and increased final fusion rates, which can result in faster pain relief and return to daily activities for patients. The benefits of using rhBMP-2 were not significantly different between the groups that received 1 mg/5 mL and 2 mg/5 mL of rhBMP-2. Therefore, it is recommended to use 1 mg of rhBMP-2 with 5 mL of DBM, taking both economic and clinical aspects into consideration.

Predictable Risk Factors for Adjacent Segment Degeneration After Lumbar Fusion

  • Hyun, Seung-Jae;Kim, Young-Baeg;Hong, Hyun-Jong;Kwon, Jeong-Taik;Suk, Jong-Sik;Min, Byung-Kook
    • Journal of Korean Neurosurgical Society
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    • v.41 no.2
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    • pp.88-94
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    • 2007
  • Objective : The aim of this study is to investigate predictable risk factors for radiologic degeneration of adjacent segment after lumbar fusion and preoperative radiologic features of patients who underwent additional surgery with adjacent segment degeneration. Methods : Between January 1995 and December 2002, 201 patients who underwent lumbar fusion for degenerative conditions of lumbar spine were evaluated. We studied radiologic features, the method of operation, the length of fusion, age, sex, osteoporosis, and body mass index. Special attention was focused on, preoperative radiologic features of patients who required additional surgery were studied to detect risk factors for clinical deterioration. Results : Follow-up period ranged from 3 to 11 years. In our study, 61 [30%] patients developed adjacent segment degeneration, and 15 [7%] patients required additional surgery for neurologic deterioration. Age, the postoperative delay, facet volume, motion range, laminar inclination, facet tropism, and preexisting disc degeneration of adjacent segment considered as possible risk factors. Among these, laminar inclination and preexisting disc degeneration of adjacent segment were significantly correlated with clinical deterioration. Conclusion : The radiologic degeneration of adjacent segment after lumbar fusion can be predicted in terms of each preoperative radiologic factor, age and the postoperative delay. Laminar inclination and preexisting disc degeneration of adjacent segment have shown as strong risk factors for neurologic deterioration. Thus, careful consideration is warranted when these risk factors are present.