• Asian Spine Journal
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• v.12 no.6
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• pp.1017-1027
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• 2018

Study Design: This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015. Purpose: This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach. Literature Review: AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described. Methods: We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds' outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required. Results: The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds' outcome analysis score at the latest follow-up revealed goodto-excellent outcomes in all patients. Conclusions: ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.290-294
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• 2023

Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.

• Korean Journal of Head & Neck Oncology
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• v.22 no.2
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• pp.155-158
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• 2006

Intrathoracic goiters can be classified anterior and posterior mediastinal goiter with its locations. Most intrathoracic goiters are retrosternally situated in the anterior mediastinal compartment. Posterior mediastinal goiters are rare, but might present a difficult diagnostic and surgical problem. Although thyroid goiters are nearly always amenable to a cervical approach, posterior mediastinal goiters may require a combined cervicothoracic approach with sternotomy or thoracothomy. We herein describe a case of posterior mediastinal goiter which was excised only by cervical approach. The relevant literature is briefly reviewed.

• Clinics in Shoulder and Elbow
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• v.8 no.1
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• pp.49-56
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• 2005

Purpose: To review the surgical results of stiff elbow using the posterior extensile approach which provides a wide surgical view with a single posterior skin incision. Materials and Methods: From February 1999 to May 2002, we performed 6 surgical correction of stiff elbow using posterior extensile approach and followed the patients more than 1 year. In order to get better result, we performed cadaver study (four elbows of two fresh cadavers). Average duration of follow up was 15.7 months $(14{\sim}21)$. Functional results was analyzed using Brobery and Morrey analysis scale. Results: The approach through the plane between the extensor carpi radialis longus and the extensor carpi radialis brevis was ideal, because it preserves normal anatomy and provides a wide surgical view of the anterior joint. The posterior joint could be approached directly between the medial head of the triceps brachii and brachialis medially, the lateral head of triceps brachii and brachioradialis laterally. In all patients, an improved ROM was obtained with intra and extra-articular adhesiolysis: an average $61.7^{\circ}$ improvement $(50{\sim}75)$. Functional results were as follows: five excellent, one good. In addition, the patients' satisfaction was high since the scar from the operation was only a single line at the posterior surface of the elbow. Conclusion: In the treatment of stiff elbow, posterior extensile approach is thought to be useful because this method provides wide anterior and posterior surgical view.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.963-967
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• 2000

The aneurysm arising from the posterior cerebral artery is relatively uncommon, and has been reported in 0.7- 2.2% of whole cerebral aneurysm. Moreover, only a few cases of the giant aneurysm over 2.5cm in diameter arising from the distal portion of the posterior cerebral artery have been reported. Neurologic complications may occur after surgical treatment of this aneurysm due to difficult surgical approach and neurovascular complexity around the brain stem. Authors experienced a case of the thrombosed giant aneurysm with approximately 2.7cm in diameter arising from the P2 segment of the left posterior cerebral artery. Complete removal of the thrombus in the aneurysmal sac and direct neck clipping was performed via left subtemporal approach.

• Journal of Korean Neurosurgical Society
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• v.40 no.3
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• pp.206-209
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• 2006

Objective : Traditionally, standard access to the posterior fossa was a suboccipital craniectomy. After introducing the technique and benefit of posterior fossa craniotomy, several surgeons have used this procedure to manage various pathologies in posterior fossa in children. Though this approach offers several advantages over conventional suboccipital craniectomy, the elevation of bone flap is not easy in adult because of the irregular contour of inner bone surface and tight adhesion of dura to the skull. The aim of this article is to describe the technical aspects of this approach and to delineate the important landmarks for a safe and quick performance in adult. Methods : We report on our series of twenty-five adult patients who underwent craniotomy for posterior fossa pathologies between 2002 and 2005. The maximal follow-up period was 4 years. Results : None of the patients complained of persistent headache and no CSF leaks have occurred postoperatively. We have encountered only two cases of transient subcutaneous CSF retention after craniotomy. Three-dimensional reconstruction of the CT scan confirmed the well-fitted suboccipital bone contour after craniotomy. And patients were satisfied with the cosmetic results. Conclusion : This method is safer and simpler. It restores normal anatomical planes and improves protection of the contents of the posterior fossa. The authors recommend craniotomy as an alternative method of access to the posterior fossa in all age groups.

• Journal of Korean Neurosurgical Society
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• v.30 no.12
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• pp.1388-1393
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• 2001

Objective : In the retrospective analyzing 19 consecutive patients with subaxial cervical spine(C3~T1) injury treated by posterior cervical fixation and fusion, clinical manifestation, radiologic finding, operative technique, and postoperative results following 6 months were analyzed. Materials and Methods : Most common fracture level was C4-5, mean age 41, and male to female ratio 13 : 6. The most common cause of injury was motor vehicle accident(17 cases). In 19 cervical procedures, interspinous triple wiring was done in 14 cases, lateral mass plating in 5 cases, and additional anterior fusion in 2 cases. Results : Twelve weeks after operation, all cases were reviewed by plain cervical radiogram. In 17 cases that treated by posterior fusion only, 14 cases(81%) had kyphotic angle change less than $5^{\circ}$, 2 cases(12%) $5-20^{\circ}$, and 1 case(6%) more than $20^{\circ}$. Overall fusion rate was 88%, and there was no significant difference of bone fusion rate between autogenous bone graft and allogenous bone graft. Conclusion : In the case of severe posterior column injury or displacement, posterior approach seems superior to anterior approach, but in the case of combined anterior column injury, anterior approach is considered necessary. In this study, posterior fixation and fusion might be acceptable procedure for subaxial cervical fracture and dislocation, owing to its high fusion rate, low kyphotic angulation and low operation related complication rate.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.242-249
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• 1998

Stiffness of the elbow joint is relatively common after trauma, ectopic ossification, bum, postoperative scar, and etc. Mild flexion deformity can be reduced by use of active or passive motion exercise, dynamic sling, hinged distractor device, or turnbuckle orthosis. But these methods have disadvantages of difficulty in gaining acceptable range of motion only with stretching exercise, re-contracture after conservative managements and poor results that flexion contracture remained. The common described operative exposures for treatment of the stiff elbow are anterior, lateral, posterior, and medial approach. Through Anterior, lateral and medial approach each has not access to all compartments of the elbow. But, posterior approach has benefits that access to posterior, medial and lateral aspects of the elbow and as needed, fenestration to the olecranon fossa that produces a communication between the anterior and posterior compartments of the elbow are possible. From June 1991 through April 1997, 11 patients who had posttraumatic stiff elbow, were treated with debridement arthroplasty through the posterior approach. The purpose of this study are to introduce technique of the debridement arthroplasty and to evaluate final outcomes. With regarding to preoperative pain degree, mild degree matches to 3 cases, moderate to 3 cases, and severe to 2 cases. In preoperative motion, flexion was average 85° and extension was 30°. Postoperatively nine patients had got the complete relief of pain and two patients continued to have mild pain intermittentely. Postoperative flexion improved to 127° and extension to 2°, so that elbow flexion had improved by an average of 42° and elbow extension by 28°. On the objective scale all patients had good or excellent results and they all felt that they were improved by operation. Debridement arthroplasty is one of excellent procedures for the intractable stiff elbow if it is not unstable or it has not incongrous. But it need a meticulous operative technique and a well-programmed rehabilitation.

• Knowledge Management Research
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• v.19 no.2
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• pp.151-162
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• 2018

Response surface methodology (RSM) is one of popular tools to support a systematic improvement of quality of design in the product and process development stages. It consists of statistical modeling and optimization tools. RSM can be viewed as a knowledge management tool in that it systemizes knowledge about a manufacturing process through a big data analysis on products and processes. The conventional RSM aims to optimize the mean of a response, whereas dual-response surface optimization (DRSO), a special case of RSM, considers not only the mean of a response but also its variability or standard deviation for optimization. Recently, a posterior preference articulation approach receives attention in the DRSO literature. The posterior approach first seeks all (or most) of the nondominated solutions with no articulation of a decision maker (DM)'s preference. The DM then selects the best one from the set of nondominated solutions a posteriori. This method has a strength that the DM can understand the trade-off between the mean and standard deviation well by looking around the nondominated solutions. A posterior method has been proposed for DRSO. It employs an interval selection strategy for the selection step. This strategy has a limitation increasing inefficiency and complexity due to too many iterations when handling a great number (e.g., thousands ~ tens of thousands) of nondominated solutions. In this paper, a TOPSIS-based method is proposed to support a simple and efficient selection of the most preferred solution. The proposed method is illustrated through a typical DRSO problem and compared with the existing posterior method.

• Journal of the Korean Statistical Society
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• v.19 no.2
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• pp.145-150
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• 1990

In this article we develop the marginal posterior density of the model parameters in the multiresponse regression models when missing values exist only in one response. The resulting density resolves a couple of problems in the estimation approach proposed by Box, Draper, and Hunter (1970) and provides a general interpretation for relationship between the estimates of the missing values and the parameters.