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Choon-Dae Lee

Bio: Choon-Dae Lee is an academic researcher. The author has contributed to research in topics: Discectomy & Epidural hematoma. The author has an hindex of 2, co-authored 2 publications receiving 28 citations.

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Journal ArticleDOI
TL;DR: Protruding, mixed-type, and C4–5 level were more difficult to remove and required more extensive foraminal unroofing and PCF with or without discectomy is an effective treatment for cervical disk herniation.
Abstract: Study Design:A retrospective review.Objective:To compare the effectiveness of the posterior cervical foraminotomy (PCF) with and without discectomy for the treatment of cervical disk herniation.Summary of Background Data:Although PCF is effective and does not require a fusion procedure, it has certa

25 citations

Journal ArticleDOI
TL;DR: A 79-year-old woman developed neurological deficits 6 weeks after the onset of a thoracic osteoporotic compression fracture and acute decompressive laminectomy and percutaneous vertebroplasty were performed, and follow-up MR imaging showed complete resolution of the hematoma.
Abstract: A 79-year-old woman developed neurological deficits 6 weeks after the onset of a thoracic osteoporotic compression fracture. Magnetic resonance (MR) imaging of the thoracic spine revealed an epidural hematoma at the T10-L2 levels. Acute decompressive laminectomy and percutaneous vertebroplasty were performed. Following the surgery, the patient's neurologic deficits improved and follow-up MR imaging showed complete resolution of the hematoma. Spinal epidural hematomas are rare and associated delayed neurological deficits are extremely rare. Conservative treatment may be effective for epidural hematomas in neurologically intact patients, but epidural hematomas can be a cause of neural compression and symptomatic deterioration resulting in delayed neurological deficits during the follow-up period.

9 citations


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Journal ArticleDOI
TL;DR: For patients with foraminal soft-disk herniation, either MTPF or P-PECD may be regarded as an alternative options to open surgery.
Abstract: The posterior cervical foraminotomy and diskectomy (PCD) is a traditional surgical technique for patients with laterally located soft-disk herniation. Recently, tubular retractor-assisted posterior foraminotomy and diskectomy (MTPF) and posterior percutaneous endoscopic cervical foraminotomy and diskectomy (P-PECD) have been introduced, but a comparative study has not yet been performed. Patients with foraminal soft-disk herniation and a follow-up period of >2 years were retrospectively reviewed; 22 patients underwent a MTPF and 22 patients underwent a P-PECD. The primary end-point was an improvement of arm pain more than 4.3. The clinical parameters (age, sex, disability index, neck and arm pain), radiological parameters (cervical curvature, segmental angle, anterior-/posterior-disk height and amount of facet joint removal) preoperatively and at postoperative month 24 and the surgical methods were considered as co-variates. Successful outcome was achieved in 19/22 (87 %) of the patients after both MTPF and a P-PECD. Preoperative SA showed trend (P = 0.08; OR 1.2; 95 % CI 0.98–1.4) and the cut-off SA was 1.45° (sensitivity 80 %, specificity 73 %). The length of the facet joint’s removal was 0.02–2.49 mm (0.1–15.2 %) with no difference between the MTPF and P-PECD. The surgical method was not a significant factor. For patients with foraminal soft-disk herniation, either MTPF or P-PECD, may be regarded as an alternative options to open surgery. Preoperative kyphotic SA (cut-off value 1.45°) seemed to be associated with poor outcome and this may be considered in selecting surgical methods.

59 citations

Journal ArticleDOI
TL;DR: Cervical curvature does not worsen after posterior PECD, and progressive angulation at the operated segment is a concern, especially for patients with cervical lordosis < 10 degrees.
Abstract: Study Design Case series. Objective Posterior percutaneous endoscopic cervical diskectomy (PECD) can preserve the disk in patients with a foraminal disk herniation. However, progressive angulation at the operated segment is a concern, especially for patients with cervical lordosis Methods Medical records were reviewed of 32 consecutive patients (22 men, 10 women; mean age, 49 ± 12 years) who had single-level foraminal soft disk herniation. The operation levels were as follows: C4–5 in 1 patient, C5–6 in 12, C6–7 in 18, and C7–T1 in 1. All patients were discharged the day after the operation, and neck motion was encouraged. All patients were followed for 30 ± 7 months (range, 24 to 46 months), and 21/32 patients (66%) had radiographs taken at 25 ± 11 months (range, 12 to 45 months). Radiologic parameters were assessed, including cervical curvature (C2–7), segmental Cobb's angle (SA), and anterior and posterior disk height (AH and PH, respectively) at the operative level. Results At the last follow-up, 29/32 patients (91%) had no or minimal pain, and 3/32 patients had occasional pain. SA, AH, and PH were not significantly changed. Cervical lordosis p = 0.01). For patients with cervical lordosis ≥ 10 degrees, cervical curvature changed from −17.5 ± 5.8 to −19.9 ± 5.7 degrees ( p = 0.24). Conclusions Cervical curvature does not worsen after posterior PECD.

55 citations

Journal ArticleDOI
TL;DR: Patients with symptomatic cervical radiculopathy from foraminal stenosis can be effectively managed with either a traditional open or an MIS foraminotomy with no significant difference in the pooled outcomes.

50 citations

Journal ArticleDOI
28 Mar 2018
TL;DR: Two patients in the present series were affected by rheumatologic disorders, confirming the elevated incidence of hematomas in such patients compared to the normal population.
Abstract: Spinal epidural hematoma (SEH) is a rare cause of nerve root or cord compression; its pathogenesis is not always clearly recognizable. The aim of this paper was to investigate possible etiopathological factors in a consecutive series of patients affected by traumatic SEH treated at our institution. Seven patients with neurologic impairment due to traumatic SEH were retrospectively analyzed after diagnosis and surgical treatment. Thoracic localization was found in 5 cases, and lumbar and cervical localization were found in 1 patient each. One patient was affected by ankylosing spondylitis and one by diffuse idiopathic skeletal hyperostosis. SEH was associated with spine fractures in 6 cases. Only 2 cases of traumatic SEH resulted from high-energy trauma. All patients underwent surgical decompression within 24 hours after admittance to the hospital. Three patients recovered completely, 3 remained paraplegic, and 1 remained monoplegic. Several concomitant conditions are suggested to be predisposing factors for the development of SEH, although its inherent mechanism is still unknown. Two patients in the present series were affected by rheumatologic disorders, confirming the elevated incidence of hematomas in such patients compared to the normal population. Three very unusual cases of SEH occurred in senile patients affected by osteoporotic fractures. Early diagnosis and urgent decompression of the hematoma remain mandatory.

35 citations

Journal Article
TL;DR: This paper described the normal and pathological anatomy of the cervical neural foramen as well as their surgical technique, which has been highly effective in cases of cervical discogenic radiculopathy.
Abstract: A POSTERIOR FORAMINOTOMY (hemilaminotomy and medial facetectomy) is indicated for the treatment of nerve root compression secondary to posterolateral disc herniation or spondylotic foraminal stenosis. We describe the normal and pathological anatomy of the cervical neural foramen as well as our surgical technique, which has been highly effective in cases of cervical discogenic radiculopathy.

31 citations