Purpose
The biplanar whole body imaging system (EOS) is a new tool for measuring whole body sagittal alignment in a limited space. This tool may affect the sagittal balance of patients compared to conventional whole spine radiography (WSX). This study is to investigate the difference in sagittal alignment between WSX and EOS.
Materials and Methods
We compared spinal and pelvic sagittal parameters in 80 patients who underwent EOS and WSX within one month between July 2018 and September 2019.The patients were divided based on sagittally balanced and imbalanced groups according to pelvic tilt (PT) >20˚, pelvic incidence-lumbar lordosis >10°, C7-sagittal vertical axis (SVA) > 50 mm in WSX.
Results
In sagitally imbalanced group, for WSX versus EOS, the pelvic parameters demonstrated compensation in EOS with smaller PT (27.4±11.6° vs. 24.9±10.9°, p=0.003), greater sacral slope (SS), and patients tended to stand more upright with smaller C7-SVA (58.4±17 mm vs. 48.9±57.3 mm, p=0.003), T1-pelvic angle (TPA), T5-T12, and T2-T12. However, in sagitally balanced group, these differences were less pronounced only with smaller PT (10.8±6.9° vs. 9.4±4.7°, p=0.04), TPA and T2-T12 angle, but SS and C7-SVA were similar (p>0.05).
Conclusions
EOS shows a negative SVA shift and lesser pelvic tilt than WSX especially in patients with sagittal imbalance. When making a surgical plan, surgeon should consider these differences between EOS and WSX.

Spinal cord tumors are uncommon lesions and can lead to significant neurologic morbidity and mortality. The classification of spinal cord tumors is based on their location as intradural intramedullary, intradural extramedullary, and extradural. Ependymomas are more common among intradural intramedullary tumors, and can often be surgically resected, whereas, astrocytomas infiltrate the spinal cord and show unclear marginality between the tumor and spinal cord. Complete surgical resection is obtained rarely. Intradural extramedullary tumors include schwannomas, neurofibromas, and meningiomas. These types are relatively curable with surgical resection than intradural intramedullary tumors. Radiotherapy is applied for malignant variants and recurrent tumors, whereas chemotherapy is usually recommended for recurrent lesions which are not effective with surgery or radiotherapy. Preoperative neurological status, histologic grade of the tumor, and the extent of surgical resection result in different outcomes.

Objective
Peridural fibrosis may cause failed back syndrome and the presence of fibrosis renders reoperations risky. Therefore, preventing the adhesion of scar tissue to the dura and nerve root is one of the issues in spinal surgery. Thus, the purpose of this study is to evaluate and compare the efficacy and the safety between two anti-adhesive agents, BNCH-202 (Korea BNC Inc, Daegu, Korea) and Guardix-SOL (Hanmi, Seoul, Korea).
Methods
Sixty eight patients were enrolled in this study. To evaluate and compare the efficacy in preventing epidural adhesion formation and the safety in human laminotomy models, the two barriers tested were either BNCH-202 or Guardix-SOL (gel/film combination). Clinical evaluation was performed at 0, 6 and 12 weeks to assess pain and functional outcome. The patients were also assessed radiographically with postoperative magnetic resonance imaging (MRI) to evaluate the presence of perinueral scar and adhesion.
Results
There was no statistically significant difference between two biologic barriers in terms of the safety issue, clinical and radiological efficacy. There were no significant differences between the BNCH-202 group and the control group on the preoperative ODI and VAS scores. In general, the ODI and VAS scores decreased in both groups at all the time points. At the 6 week and 12 week time point, the VAS scores for back pain/ leg pain and the ODI scores in both groups were lower than the preoperative score in each group (P<0.01). And at the 12-week time point, the peridural scar scores were assessed in both groups. The mean value of the peridural scar score in BNCH-202 group was not inferior to the mean value of that in Guardix-SOL group.
Conclusion
The results demonstrated that BNCH-202 gel is as effective as Guardix-SOL in reducing posterior dural adhesions in the spine with no apparent safety issues. It can improve patients’ postoperative clinical outcome.