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The application area of biportal endoscopic spine surgery (BESS) is gradually expanding. Compared with conventional fusion surgery, transforaminal interbody fusion (TLIF) using BESS (BESS-TLIF) has the advantages of less bleeding, minimal postoperative pain, and faster recovery. This technical note highlights its application in managing complex conditions such as scar tissue adhesion, altered anatomy, and implant removal, common in reoperations. The method focuses on precise dissection, endoscopic visualization, and careful tissue handling to ensure effective decompression and stabilization. Three representative cases, including reoperations for recurrent disc herniation, adjacent segment disease (ASD) following prior fusion, and ASD with nonunion of the prior fusion site requiring fusion extension, were described. All three cases exhibited clinical improvement following surgery. BESS is an effective and safe method for spinal revision surgery not only in simple decompression surgery but also in cases that required fusion surgery. As BESS is advancing, its role in complex spinal surgeries is expected to expand, potentially setting new standards in minimally invasive spine surgery.
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http://dx.doi.org/10.31616/asj.2024.0532 | DOI Listing |
Spine Deform
September 2025
Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Purpose: A subset of adult spinal deformity (ASD) patients undergoing corrective surgery receive a disproportionate level of medical resources and incur greater costs. We examined the characteristics of such super-utilizers of health care resources among ASD patients.
Methods: This prospective, multicenter study analyzed data from ASD patients with > 4 levels of spinal fusion and a minimum 2-year follow-up.
Shoulder Elbow
September 2025
Getting it Right First Time Programme, NHS England, London, UK.
Background: Total elbow arthroplasty (TEA) is a low-volume, high-complexity procedure and clinical guidelines recommend moving to a centralised network model. The aim of the study was to assess the effect of surgeon and unit volume on patient and service level clinical outcomes.
Methods: Analysis the Hospital Episodes Statistics database (HES) for elective and emergency primary TEA surgery between January 2014 and December 2023 was performed.
Spine (Phila Pa 1976)
September 2025
Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Study Design: Retrospective analysis of prospective data.
Objective: Evaluate the impact of radiographic and morphologic configuration of the uppermost instrumented vertebrae (UIV) region on proximal junctional kyphosis (PJK) rates.
Background: Literature is limited on evaluation of the preoperative landing zone (UIV-1 to UIV +2 levels) and its impact on development of PJK.
J Orthop Surg Res
August 2025
Upper Limb Unit, Wrightington Hospital, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wrightington, Wigan, UK.
Background: Total elbow replacement (TER) is an established treatment for the painful arthritic elbow; however, TER has higher failure rates than other joint replacements, such as hip and knee replacement. Understanding the prognostic factors associated with failure of TER is essential for informed decision-making between patients and clinicians, patient selection, and service planning. The aim of this study is to explore the views of patients and healthcare professionals on which potential prognostic factors should be investigated in relation to TER failure.
View Article and Find Full Text PDFSpine (Phila Pa 1976)
August 2025
Department of Orthopedics, Lenox Hill Hospital, New York, NY, USA.
Study Design: Retrospective Multi-Center Study.
Objective: To investigate how advances in spine realignment have impacted lumbar segmental alignment.
Summary Of Background Data: The understanding of spine alignment and Adult Spinal Deformity (ASD) management continues to advance.