Publications by authors named "Seung-Woo Suh"

Over the past two decades, interest in minimally invasive scoliosis surgery (MISS) for adolescent idiopathic scoliosis (AIS) has grown substantially, driven by advancements in growth-based surgical techniques. Given the substantial advancements in MISS for AIS, investigating the bibliometric data of the scientific literature is crucial to understanding the current research trend and providing valuable insights into its future directions. However, limited information on MISS for AIS exists in the literature.

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: Surgical treatment is generally recommended for adolescent idiopathic scoliosis (AIS) when the Cobb angle exceeds 50 degrees even after skeletal maturity or 40 degrees with remaining growth potential. However, limited evidence exists regarding the natural history of curves between 40 and 50 degrees during the late stage of skeletal growth. This study aimed to evaluate the curve progression in AIS patients with a curve between 40 and 50 degrees at Risser stage IV or V.

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: Previous studies have reported satisfactory outcomes and low rates of instrumentation-related complications (IRCs) following nonfusion posterior fixation in patients with metastatic spinal tumors (MSTs). However, to adequately assess the longevity and durability of nonfusion instrumentation in patients with longer life expectancy, an extended follow-up period is essential. This study aims to evaluate the incidence of and risk factors for IRCs in patients with MSTs who underwent nonfusion posterior fixation and had radiographic follow-up data available for at least one year postoperatively.

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Background: Pelvic tilt (PT) is an important sagittal parameter to be restored to the normal range in corrective surgery for spinopelvic malalignment. However, the normal value of PT varies among patients. With the introduction of the pelvic inclination angle (PIA), which is the angle subtended by the vertical axis and the line connecting the anterior pubic tubercle and the anterior superior iliac spine, we aimed to determine whether the PIA could reflect the symptom severity and whether normal PIA values exist.

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Background: To evaluate the clinical impact of intraoperative tranexamic acid administration in minimizing intraoperative blood loss and transfusion requirements during minimally invasive scoliosis surgery (MISS).

Methods: Consecutive data were collected from 97 patients with adolescent idiopathic scoliosis who underwent MISS between 2021 and 2023. Tranexamic acid was first introduced in June 2022.

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Backgroud: Menarche has a significant impact on the progression of adolescent idiopathic scoliosis (AIS); however, studies in this area are insufficient. This study used large-scale school screening data to investigate the relationship between menarcheal age and AIS, especially the severity of scoliosis.

Methods: Of 2,326,577 students who participated in school screening for scoliosis (SSS) in South Korea from 2001 to 2021, 38,879 girls with AIS, who experienced menarche, were included.

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Article Synopsis
  • The study evaluates the effectiveness of AI models ChatGPT and Bard in generating structured abstracts for spine surgery, comparing them to human-written ones.
  • The methodology involved analyzing 174 abstracts (60 human-written, 60 by ChatGPT, and 54 by Bard), focusing on compliance with journal guidelines, formatting, and content consistency.
  • Results indicated ChatGPT performed better in meeting formatting guidelines, while Bard had higher adherence to word count requirements and showed greater similarity in content, suggesting differences in AI capabilities and implications for academic writing.
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: Although several biomechanical studies have been reported, few clinical studies have compared the efficacy of monoaxial and polyaxial pedicle screws in the surgical treatment of adolescent idiopathic scoliosis (AIS). This study aims to compare the radiological and clinical outcomes of mono- and polyaxial pedicle screws in the surgical treatment of AIS. : A total of 46 AIS patients who underwent surgery to treat scoliosis using pedicle screw instrumentation (PSI) and rod derotation (RD) were divided into two groups according to the use of pedicle screws: the monoaxial group ( = 23) and polyaxial group ( = 23).

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(1) The amount of blood loss during oblique lumber interbody fusion (OLIF) surgery is often underestimated and may contribute to adverse postoperative outcomes. This study aims to evaluate hidden blood loss (HBL) in patients who underwent OLIF for degenerative lumbar spine disease and to analyze its risk factors. (2) The medical records of 179 patients who underwent OLIF surgery from 2015 to 2022 were reviewed.

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Article Synopsis
  • Despite efforts to address forward head posture (FHP), effective screening and diagnostic methods are still lacking; this study introduces a new noninvasive approach using body angle measurements alongside radiological assessments.
  • A total of 145 adolescents were screened, measuring the forward neck tilt angle (FNTA) with a device called the POM-Checker and analyzing various sagittal alignment parameters through standing lateral radiographs.
  • The preliminary diagnostic model developed showed a high agreement rate (95.35%) and was 100% effective in identifying participants needing further radiographic evaluation, indicating that FNTA is a crucial factor in diagnosing FHP.
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Background: The lumbosacral (LS) junction has a higher nonunion rate than other lumbar segments, especially in long-level fusion. Nonunion at L5-S1 would result in low back pain, spinal imbalance, and poor surgical outcomes. Although anterior column support at L5-S1 has been recommended to prevent nonunion in long-level LS fusion, fusion length requiring additional spinopelvic fixation (SPF) in LS fusion with anterior column support at L5-S1 has not been evaluated thoroughly.

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Study Design: A retrospective cohort study.

Objective: To evaluate long-term rotational changes in the vertebrae of patients with adolescent idiopathic scoliosis (AIS) who underwent direct vertebral rotation (DVR).

Summary Of Background Data: DVR using thoracic pedicle screws, a rotational corrective maneuver used in the surgical treatment of AIS, was introduced in 2004.

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Objective: Osteotomies are required for the mobilization of spinal segments in patients with revisional scoliosis surgery with a fusion mass; however, only a few techniques have shown efficacy and safety, and their mid- and long-term outcomes remain unelucidated. This study aimed to analyze long-term outcomes of the posterior multilevel crack osteotomy (PMCO) technique for revisional surgery for scoliosis with a fusion mass.

Methods: Data from 18 patients who underwent revisional scoliosis surgery using PMCO between 2009 and 2015 and had more than 5-year follow-up were retrospectively reviewed.

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Background Context: Adolescent idiopathic scoliosis (AIS) is the most prevalent spinal deformity in adolescents. However, pathophysiology and long-term complications remain unclear. Characteristics of the mechanical work in AIS gait have not been well-studied.

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Article Synopsis
  • Pelvic fixation is used to align the pelvis in patients with neuromuscular scoliosis (NMS) who have a pelvic tilt greater than 15º, but its effectiveness remains debated, especially for those who are immobile.
  • A study involving 77 NMS patients assessed the impact of pelvic fixation on spinal deformity correction and quality of life by comparing three groups based on the fixation point (iliac, S1, L5).
  • Results showed similar rates of scoliosis and pelvic obliquity correction across all groups, with no significant differences in clinical outcomes or complications, indicating that pelvic fixation might not significantly affect patient results.
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Background: Spinopelvic fixation (SPF) has been a challenge for surgeons despite the advancements in instruments and surgical techniques. C-arm fluoroscopy-guided SPF is a widely used safe technique that utilizes the tear drop view. The tear drop view is an image of the corridor from the posterior superior iliac spine to the anterior inferior iliac spine (AIIS) of the pelvis.

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Objective: The safety and clinical usefulness of minimally invasive scoliosis surgery (MISS) has been reported in various studies. However, freehand pedicle screwing in MISS remains technically challenging. The purpose of this study is to evaluate the accuracy and safety of pedicle screw placement using the freehand technique in adolescent idiopathic scoliosis (AIS) patients treated with MISS compared to conventional open scoliosis surgery (COSS).

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  • The study aimed to compare the quality of paraspinal muscles in patients with either single or multiple osteoporotic vertebral fractures (OVFs) and understand their role in these fractures.
  • A total of 262 patients with OVFs were analyzed, revealing that those with multiple fractures had significantly higher fatty degeneration and lower muscle cross-sectional area than those with a single fracture.
  • The findings suggest that the quality of paraspinal muscles is crucial in the development of multiple OVFs, indicating the need for targeted interventions to prevent further fractures.
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  • The study assessed the learning curve for minimally invasive scoliosis surgery (MISS) in adolescents with idiopathic scoliosis (AIS) by analyzing patient data over two time periods.
  • It involved 76 AIS patients, dividing them into early (31 patients) and late (45 patients) groups, focusing on operation time and blood loss as key parameters.
  • Results showed a significant reduction in operative time (from 431 to 360 minutes) and estimated blood loss (from 1164 to 798 mL) in the late group, indicating that surgeons need to perform over 46 MISS cases to reach proficiency.
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Article Synopsis
  • * Methods: Eighty-six AIS patients were split into two groups (COSS and MISS), with the MISS group further categorized based on the type of graft substitute used (allograft, demineralized bone matrix [DBM], or demineralized cancellous bone chips). Fusion rates were assessed using conventional X-rays.
  • * Results: Fusion rates were similar between COSS and MISS, and across different graft substitutes in MISS, indicating
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Owing to rapidly changing global demographics, adult spinal deformity (ASD) now accounts for a significant proportion of the Global Burden of Disease. Sagittal imbalance caused by age-related degenerative changes leads to back pain, neurological deficits, and deformity, which negatively affect the health-related quality of life (HRQoL) of patients. Along with the recognized regional, global, and sagittal spinopelvic parameters, poor paraspinal muscle quality has recently been acknowledged as a key determinant of the clinical outcomes of ASD.

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Despite advancements in instruments and surgical techniques for adolescent idiopathic scoliosis (AIS) surgery, conventional open scoliosis surgery (COSS) is usually required to achieve satisfactory deformity correction using various distinct surgical techniques, such as rod derotation, direct vertebral rotation, facetectomies, osteotomies, and decortication of the laminae. However, COSS is accompanied by significant blood loss and requires a large midline skin incision. Minimally invasive surgery (MIS) has evolved enormously in various fields of spinal surgery, including degenerative spinal diseases.

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Background: A single-stage correction for congenital scoliosis through a posterior-only approach is a commonly used surgical technique. However, there are few studies on the surgical treatment effect of posterior single-stage correction in patients with neglected congenital scoliosis. Methods: Patients who underwent a single-stage posterior correction for congenital scoliosis with a minimum follow-up of 2 years were divided into three groups based on age: Group A (7−11 years), B (12−18 years) and C (>18 years).

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Background: Denosumab (DEN) and zoledronic acid (ZOL) currently represent the most potent antiresorptive agents for the treatment of osteoporosis. Despite similar effects on bone resorption, these agents have distinct mechanisms of action. The objective of this study was to compare the effect of DEN and ZOL after two-year administration on bone mineral density (BMD), trabecular bone score (TBS), bone turnover markers, and persistence.

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