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Article: Bench to Bed (B2B) Project; Intervertebral Disc Degeneration in Collaboration With Biospine.

Kim, Joo Han

2020 Volume 17, Issue 1, Page(s) 1–2

Language	English
Publishing date	2020-03-31
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3031654-6
ISSN	2586-6591 ; 2586-6583
ISSN (online)	2586-6591
ISSN	2586-6583
DOI	10.14245/ns.2040110.055
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Article ; Online: Lumbar fusion surgery in the era of an aging society: analysis of a nationwide population cohort with minimum 8-year follow-up.

Kwon, Woo-Keun / Theologis, Alekos A / Kim, Joo Han / Moon, Hong Joo

The spine journal : official journal of the North American Spine Society

2024

Abstract: Background context: Fusions for lumbar spine diseases are widely performed and have a growing incidence, especially in elderly population.: Purpose: The goal of this study was to assess national trends of lumbar spinal fusions and examine the risk ... ...

Abstract	Background context: Fusions for lumbar spine diseases are widely performed and have a growing incidence, especially in elderly population. Purpose: The goal of this study was to assess national trends of lumbar spinal fusions and examine the risk for re-operations after a lumbar fusion with a focus on 'epidemiologic transition' relating to age. Study design/setting: The prospectively collected Korean Health Insurance Review and Assessment Service (HIRA) nationwide cohort database was retrospectively reviewed. Patient sample: The total 278,815 patients who underwent lumbar spinal fusions for degenerative spine diseases between 2010 and 2018 were reviewed and used to assess trends in operative incidence. The 37,050 patients who underwent lumbar fusions between 1/2010 and 12/2011 were enrolled to determine 8-year reoperation rates. Outcome measures: The overall number of lumbar spinal fusions were analyzed for the national annual trend. Demographic data, reoperation rates, and confounding clinical factors were evaluated. Methods: The overall number of lumbar spinal fusions was analyzed to determine the national annual trend of operative incidence. For the reoperation rate analysis, the primary outcome measured was the cumulative incidence of revision operations within a minimum 8-year follow-up period. Additional outcomes included comparative analyses of the reoperation rate with respect to age, sex, or other underlying comorbidities. Results: Over time, elderly patients comprised a larger portion of the cohort (2010:24.2%; 2018:37.6%), while operations in younger patients decreased over time (2010:40.3%; 2018:27.0%). In the cohort of patients with a minimum 8-year follow-up (n=37,050), rates of reoperation peaked in patients aged 60-69 years (17.6 per 1000 person-years [HR 2.20 compared to <40years]) and decreased for more elderly patients (14.3 per 1000 person-years [HR 1.80 compared to <40years]). Age was the most significant risk factor for reoperation. Osteoporosis was also a risk factor for reoperation in post-menopausal females. Conclusions: Increasing incidence of lumbar fusions in elderly patients was seen however the risk of reoperation decreased in patients aged 70 or more. Lumbar fusion for elderly patients should not be hesitated in the decision-making process because of concerns about reoperation.
Language	English
Publishing date	2024-03-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2024.03.003
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Article ; Online: Full endoscopic surgery for calcium pyrophosphate deposition disease (CPPD) in the cervical ligamentum flavum: report of two cervical myelopathy cases.

Choi, Seung Jin / Kang, Dong Wan D / Ham, Chang Hwa / Kim, Joo Han / Kwon, Woo-Keun

Acta neurochirurgica

2024 Volume 166, Issue 1, Page(s) 185

Abstract: Calcium pyrophosphate deposition disease (CPPD), known as pseudogout, is characterized by the accumulation of calcium pyrophosphate crystals in musculoskeletal structures, primarily joints. While CPPD commonly affects various joints, involvement in the ... ...

Abstract	Calcium pyrophosphate deposition disease (CPPD), known as pseudogout, is characterized by the accumulation of calcium pyrophosphate crystals in musculoskeletal structures, primarily joints. While CPPD commonly affects various joints, involvement in the cervical spine leading to myelopathy is rare. Surgical intervention becomes necessary when conservative measures fail, but reports on full endoscopic surgeries are extremely rare. We present two successful cases where full endoscopic systems were used for CPPD removal in the cervical spine. The surgical technique involved a full endoscopic approach, adapting the previously reported technique for unilateral laminotomy bilateral decompression. Full-endoscopic removal of cervical CPPD inducing myelopathy were successfully removed with good clinical and radiologic outcomes. The scarcity of endoscopic cases for cervical ligamentum flavum CPPD is attributed to the condition's rarity. However, our successful cases advocate for endoscopic surgery as a potential primary treatment option for CPPD-induced cervical myelopathy, especially in elderly patients or those with previous cervical operation histories. This experience encourages the consideration of endoscopic surgery for managing cervical ligamentum flavum CPPD as a viable alternative.
MeSH term(s)	Humans ; Aged ; Chondrocalcinosis/diagnostic imaging ; Chondrocalcinosis/surgery ; Ligamentum Flavum/diagnostic imaging ; Ligamentum Flavum/surgery ; Spinal Cord Diseases/diagnostic imaging ; Spinal Cord Diseases/surgery ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Neck
Language	English
Publishing date	2024-04-19
Publishing country	Austria
Document type	Journal Article
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-024-06080-4
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Article ; Online: Current Knowledge and Future Therapeutic Prospects in Symptomatic Intervertebral Disc Degeneration.

Kim, Joo Han / Ham, Chang Hwa / Kwon, Woo-Keun

Yonsei medical journal

2022 Volume 63, Issue 3, Page(s) 199–210

Abstract: Intervertebral disc (IVD) degeneration is the main source of intractable lower back pain, and symptomatic IVD degeneration could be due to different degeneration mechanisms. In this article, we describe the molecular basis of symptomatic IVD degenerative ...

Abstract	Intervertebral disc (IVD) degeneration is the main source of intractable lower back pain, and symptomatic IVD degeneration could be due to different degeneration mechanisms. In this article, we describe the molecular basis of symptomatic IVD degenerative disc diseases (DDDs), emphasizing the role of degeneration, inflammation, angiogenesis, and extracellular matrix (ECM) regulation during this process. In symptomatic DDD, pro-inflammatory mediators modulate catabolic reactions, resulting in changes in ECM homeostasis and, finally, neural/vascular ingrowth-related chronic intractable discogenic pain. In ECM homeostasis, anabolic protein-regulating genes show reduced expression and changes in ECM production, while matrix metalloproteinase gene expression increases and results in aggressive ECM degradation. The resultant loss of normal IVD viscoelasticity and a concomitant change in ECM composition are key mechanisms in DDDs. During inflammation, a macrophage-related cascade is represented by the secretion of high levels of pro-inflammatory cytokines, which induce inflammation. Aberrant angiogenesis is considered a key initiative pathologic step in symptomatic DDD. In reflection of angiogenesis, vascular endothelial growth factor expression is regulated by hypoxia-inducible factor-1 in the hypoxic conditions of IVDs. Furthermore, IVD cells undergoing degeneration potentially enhance neovascularization by secreting large amounts of angiogenic cytokines, which penetrate the IVD from the outer annulus fibrosus, extending deep into the outer part of the nucleus pulposus. Based on current knowledge, a multi-disciplinary approach is needed in all aspects of spinal research, starting from basic research to clinical applications, as this will provide information regarding treatments for DDDs and discogenic pain.
MeSH term(s)	Annulus Fibrosus/metabolism ; Annulus Fibrosus/pathology ; Extracellular Matrix/metabolism ; Humans ; Intervertebral Disc ; Intervertebral Disc Degeneration/metabolism ; Intervertebral Disc Degeneration/therapy ; Nucleus Pulposus/metabolism ; Nucleus Pulposus/pathology ; Vascular Endothelial Growth Factor A/metabolism
Chemical Substances	Vascular Endothelial Growth Factor A
Language	English
Publishing date	2022-02-20
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	303740-x
ISSN	1976-2437 ; 0513-5796
ISSN (online)	1976-2437
ISSN	0513-5796
DOI	10.3349/ymj.2022.63.3.199
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Article ; Online: A quantitative analysis of surgical smoke-derived particulate matter and formaldehyde exposure during spine surgery: a possible occupational hazard.

Choi, Seung Jin / Seo, Dongmin / Ham, Chang Hwa / Kim, Joo Han / Kwon, Woo-Keun

Journal of neurosurgery. Spine

2023 Volume 40, Issue 3, Page(s) 395–402

Abstract: Objective: Since its introduction, electrocautery has served as a valuable surgical tool, enabling precise tissue cutting and effective hemostasis in spine surgery. While there have been numerous efforts to elucidate the possible hazardous effects of ... ...

Abstract	Objective: Since its introduction, electrocautery has served as a valuable surgical tool, enabling precise tissue cutting and effective hemostasis in spine surgery. While there have been numerous efforts to elucidate the possible hazardous effects of surgical smoke in various surgical fields, there has been very little discussion in the context of spine surgery. The objective of this study was to measure and conduct a quantitative analysis of the particulate matter (PM) of different sizes and of formaldehyde (HCHO) generated by smoke during spine surgeries. Methods: This study included a consecutive series of patients who underwent 1- or 2-level lumbar spinal fusion surgery between June and November 2021. Particle counts were measured using a particle counter, specifically focusing on six different sizes of PM (0.3, 0.5, 1, 2.5, 5, and 10 µm). Additionally, measurements were taken for HCHO in parts per million (ppm). Monopolar cautery was used in the surgical setting. Systematic measurements were conducted at specific time points during the surgical procedures to assess the levels of PM and HCHO. Furthermore, the efficacy of surgical smoke suction was evaluated by comparing the PM levels with and without adjacent placement of suction. Results: This study involved 35 patients, with measurements of both PM and HCHO taken in 27 cases. The remaining 8 cases had measurements only for PM. In this study, statistically significant quantitative changes in various PM sizes were observed when electrocautery was used during spine surgery (12.3 ± 1.7 vs 1975.7 ± 422.8, 3.4 ± 0.5 vs 250.1 ± 45.7, and 1.9 ± 0.2 vs 78.1 ± 13.3, respectively, for 2.5-, 5-, and 10-µm PM; p < 0.05). The level of HCHO was also significantly higher (0.085 ± 0.006 vs 0.131 ± 0.014 ppm, p < 0.05) with electrocautery use. Utilization of adjacent suction of surgical smoke during electrocautery demonstrated a statistically significant reduction in PM levels. Conclusions: The findings of this study highlight the potential surgical smoke-related hazards that spine surgeons may be exposed to in the operating room. Implementing simple interventions, such as utilizing nearby suction, can effectively minimize the amount of toxic surgical smoke and mitigate these risks.
MeSH term(s)	Humans ; Particulate Matter/adverse effects ; Formaldehyde/adverse effects ; Lumbosacral Region ; Spinal Fusion ; Respiratory Hypersensitivity
Chemical Substances	Particulate Matter ; Formaldehyde (1HG84L3525)
Language	English
Publishing date	2023-12-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2158643-3
ISSN	1547-5646 ; 1547-5654
ISSN (online)	1547-5646
ISSN	1547-5654
DOI	10.3171/2023.10.SPINE23806
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Article ; Online: Radiologic risk factors associated with development of myelopathy in patients with ossification of the posterior longitudinal ligament of the cervical spine.

Kwon, Woo-Keun / Ham, Chang Hwa / Moon, Hong Joo / Kim, Joo Han / Park, Youn-Kwan

Clinical neurology and neurosurgery

2023 Volume 227, Page(s) 107668

Abstract: Study design: Retrospective Cohort Study OBJECTIVE: Myelopathy following ossification of the posterior longitudinal ligament (OPLL) is one of the devastating clinical features in these patients, while we still know little about which factors are ... ...

Abstract	Study design: Retrospective Cohort Study OBJECTIVE: Myelopathy following ossification of the posterior longitudinal ligament (OPLL) is one of the devastating clinical features in these patients, while we still know little about which factors are associated with development of myelopathy. We evaluated the difference of radiologic measurements between OPLL patients with or without myelopathy and searched for the clinical significance with emphasis on the impact of dynamic motion. Methods: 305 patients diagnosed of OPLL were enrolled for retrospective review. They were divided into two groups according to the coexistence of radiographic evidence of myelopathy. Demographic data as well as radiologic measures including the presence of disc degeneration (DD), anterior-posterior diameter (APD) of central canal, canal compromise (CC) ratio, global and segmental range of motion (gROM and sROM), OPLL type (morphologic classification) and K-line were collected. Results: APD (odds ratio (OR); 0.411), CC ratio (OR; 1.100) and sROM (OR; 1.371) were significantly associated with the presence of myelopathy in the multivariate analysis. While the statistically significant factors were same in OPLLs with CC larger than 50%, presence of DD (OR; 4.509) and sROM (OR; 1.295) were significantly associated with myelopathy but not the CC itself in OPLLs with CC smaller than 50%. Conclusions: We discovered that the APD, CC ratio and sROM had significant association with development of myelopathy in OPLLs. And the presence of dynamic factors had significant association with myelopathy in OPLLs with smaller CC ratios. This observation and its clinical significance on development of myelopathy might enhance our understanding of OPLL.
MeSH term(s)	Humans ; Longitudinal Ligaments ; Retrospective Studies ; Osteogenesis ; Treatment Outcome ; Spinal Cord Diseases/etiology ; Spinal Cord Diseases/complications ; Ossification of Posterior Longitudinal Ligament/complications ; Ossification of Posterior Longitudinal Ligament/diagnostic imaging ; Risk Factors ; Cervical Vertebrae/diagnostic imaging
Language	English
Publishing date	2023-03-09
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2023.107668
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Article ; Online: Adipokine human Resistin promotes obesity-associated inflammatory intervertebral disc degeneration via pro-inflammatory cytokine cascade activation.

Shin, Jae Hee / Park, SeongHyun / Cho, Hansang / Kim, Joo Han / Choi, Hyuk

Scientific reports

2022 Volume 12, Issue 1, Page(s) 8936

Abstract: Adipokine human Resistin (hResistin), is known to be associated with insulin resistance and secrete low-grade pro-inflammatory cytokines in obesity. Although studies on low-grade inflammation of adipokine hResistin are known, studies on the effects and ... ...

Abstract	Adipokine human Resistin (hResistin), is known to be associated with insulin resistance and secrete low-grade pro-inflammatory cytokines in obesity. Although studies on low-grade inflammation of adipokine hResistin are known, studies on the effects and mechanisms of intervertebral disc degeneration (IVDD) are still lacking. Thus, we investigated the adipokine hResistin with or without pro-inflammatory cytokine IL-1β in intervertebral disc (IVD) cells such as human annulus fibrosus (hAF) and nucleus pulposus (hNP). The protein expression changes in IL-1β, IL-6, IL-8, MMP-1, MMP-3, and MMP-13, induced by the combined-hResistin and IL-1β stimulation on hAF cells, was significantly greater than that of the same induced by mono-IL-1β stimulation. Similarly, in the case of the protein expression change of inflammatory mediators induced by the combined-hResistin and IL-1β stimulation on hNP cells was also significantly greater than that of the same induced by mono-IL-1β stimulation. These results improve understanding of hResistin on inflammatory IVDD but also with other obesity-related inflammatory diseases.
MeSH term(s)	Adipokines ; Cytokines ; Humans ; Intervertebral Disc Degeneration/metabolism ; Obesity/complications ; Resistin/metabolism
Chemical Substances	Adipokines ; Cytokines ; Resistin
Language	English
Publishing date	2022-05-27
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-12793-2
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Article ; Online: Intervertebral disc organ-on-a-chip: an innovative model to study monocyte extravasation during nucleus pulposus degeneration.

Son, Hyeong-Guk / Hwang, Min-Ho / Lee, Sumin / Kim, An-Gi / Kim, Tae-Won / Kim, Joo-Han / Choi, Hyuk / Jeong, Sehoon

Lab on a chip

2023 Volume 23, Issue 12, Page(s) 2819–2828

Abstract: Degenerative cascades of the intervertebral disc (IVD) are characterized by the presence of immune cells like monocytes, macrophages, and leukocytes, which contribute to inflammation. ... ...

Abstract	Degenerative cascades of the intervertebral disc (IVD) are characterized by the presence of immune cells like monocytes, macrophages, and leukocytes, which contribute to inflammation. Previous
MeSH term(s)	Humans ; Nucleus Pulposus/metabolism ; Monocytes ; Intervertebral Disc Degeneration/metabolism ; Microphysiological Systems ; Intervertebral Disc/metabolism
Language	English
Publishing date	2023-06-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2056646-3
ISSN	1473-0189 ; 1473-0197
ISSN (online)	1473-0189
ISSN	1473-0197
DOI	10.1039/d3lc00032j
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Article ; Online: Use of prophylactic perioperative antibiotics for lumbar spinal fusions: A nationwide population-based cohort study.

Ham, Chang Hwa / Kwon, Woo-Keun / Moon, Hong Joo / Kim, Joo Han / Park, Youn-Kwan / Hofstetter, Christoph P

Journal of infection and public health

2023 Volume 16, Issue 3, Page(s) 354–360

Abstract: Background: Perioperative prophylactic antibiotic (PPA) use in spine surgery is known to reduce the rate of surgical site infections. In the past decade, several evidence-based guidelines have been published and surveillance systems to monitor the ... ...

Abstract	Background: Perioperative prophylactic antibiotic (PPA) use in spine surgery is known to reduce the rate of surgical site infections. In the past decade, several evidence-based guidelines have been published and surveillance systems to monitor the proper use of antimicrobials had been adapted by many institutes. Objective: To report the trends of PPA prescription in lumbar fusion surgeries nationwide in the Republic of Korea. Methods: This is a nationwide registry study. Using the population-based data from the Republic of Korea provided by the Korean Health Insurance Review and Assessment Service, data of all lumbar spinal fusion surgeries performed between 2010 and 2018 in adult patients (age ≥19 years) were reviewed. Results: The most frequently used antibiotics were first-generation cephalosporins, which accounted for 38.2 % of total PPA prescriptions and were prescribed in 58.96 % of lumbar fusion surgeries. A gradual increase in prescription trends was observed. The second most frequently used PPAs were second-generation cephalosporins, which showed decrease in use from 2016. The frequency of vancomycin prescriptions gradually increased over the observation period and showed an almost four-fold increase in 2018 compared to 2010. First- and second-generation cephalosporins were prescribed less frequently to patients with renal disease. Conclusion: The pattern of PPA use has changed remarkably over the observation period. Furthermore, specific differences in PPA prescriptions were observed among patients with certain co-morbidities.
MeSH term(s)	Adult ; Humans ; Young Adult ; Spinal Fusion/adverse effects ; Cohort Studies ; Anti-Bacterial Agents/therapeutic use ; Vancomycin ; Cephalosporins/therapeutic use ; Retrospective Studies
Chemical Substances	Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU) ; Cephalosporins
Language	English
Publishing date	2023-01-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2467587-8
ISSN	1876-035X ; 1876-0341
ISSN (online)	1876-035X
ISSN	1876-0341
DOI	10.1016/j.jiph.2023.01.005
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Article ; Online: Characteristics of Sagittal Spinopelvic Alignment Changes After Symptom Relief After Simple Lumbar Decompression.

Ham, Chang Hwa / Park, Youn-Kwan / Kim, Joo Han / Kwon, Woo-Keun / Kim, Dong Wook / Moon, Hong Joo

Neurosurgery

2022 Volume 91, Issue 2, Page(s) 331–338

Abstract: Background: Sagittal spinopelvic alignment (SSPA) parameters are essential for the diagnosis of adult spinal deformities (ASDs) and their progression. Certain clinical symptoms that occur in patients with lumbar spinal stenosis (LSS) and herniated ... ...

Abstract	Background: Sagittal spinopelvic alignment (SSPA) parameters are essential for the diagnosis of adult spinal deformities (ASDs) and their progression. Certain clinical symptoms that occur in patients with lumbar spinal stenosis (LSS) and herniated nucleus pulposus (HNP) may distort the SSPA and mimic ASD. Objective: To differentiate SSPA in symptomatic patients from asymptomatic patients within 10 minutes in the standing position. Methods: This retrospective cohort study evaluated changes in SSPA after simple lumbar decompression surgery in patients with LSS and HNP. Relative sagittal alignment (RSA), relative pelvic version, relative lumbar lordosis (RLL), Lordosis Distribution Index (LDI), and global alignment and proportion (GAP) values were calculated using the conventional Schwab classification method. First, the preoperative and postoperative SSPA parameters were compared. Second, patients were subgrouped into symptomatic within 10 minutes of standing (SP group) and other symptoms of LSS and HNP as controls. Changes in SSPA parameters after symptom relief after simple lumbar decompression surgery were compared between the two groups. Results: Overall, all SSPA parameters improved after surgery. However, after subgrouping, patients in the control group did not show significant SSPA alterations, except for LDI, whereas patients in the SP group significantly improved in terms of their RSA, RLL, LDI, and GAP values after symptom relief after surgery. Conclusion: Patients with pain on standing within 10 minutes showed significant correction in RSA, RLL, and GAP values after simple lumbar decompression. Therefore, it is important to observe such clinical symptoms to avoid misdiagnosis of ASD.
MeSH term(s)	Adult ; Decompression ; Humans ; Lordosis/diagnostic imaging ; Lordosis/surgery ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery ; Retrospective Studies ; Spinal Stenosis/surgery
Language	English
Publishing date	2022-05-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002013
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