Purpose
To evaluate the difference of clinical and radiologic outcomes between Luschka’s joint preservation vs. total uncinatectomy in anterior cervical microforaminotomy.
Materials and Methods
From Dec. 2006 to Feb. 2012, 37 patients suffered unilateral cervical radiculopathy due to cervical foraminal disc herniation or spondylotic cervical stenosis underwent anterior cervical microforaminotomy in our hospital. The mean age of patients was 52.9 (range 35 to 72). 27 were men and 10 were women. 19 patients received total uncinatectomy and the other 18 patients received partial uncinatectomy. There was no difference in statistical significance for demographic factors between two groups. Clinical outcomes have been evaluated based on preoperative and postoperative VAS scores for axial pain and radicular pain described on medical records and classified according to modified Odom’s criteria. Postoperative radiologic evaluation was performed through follow up CT, MRI and plain films. Through this serial studies, postoperative degenerative change was evaluated.
Results
Mean follow up period was 44.6 months (from 12 month to 86 months). 6 of 19 patients from total uncinatectomy group suffered chronic postoperative axial neck pain lasting over 3 months after the surgery. In contrast, only 2 of 18 patients in the partial uncinatectomy group complained chronic neck pain. One patient of the partial uncinatectomy group underwent revision surgery due to incomplete decompression. The revision surgical modality was ACDF. Surgical result was classified according to modified Odom’s criteria. But, there was no statistical differences between outcomes of two groups. During the follow up period, degenerative change was observed in 10 of 19 patients in total uncinatectomy group and 7 of 18 patients in partial uncinatectomy group. But, there was no statistical differences, either (by Kaplan-Meier).
Conclusions
Anterior cervical microforaminotomy for unilateral cervical radiculopathy showed favorable results regardless of pathologic lesions, such as disc herniation or stenosis. Total uncinatectomy group seems to cause postoperative chronic axial neck pain, but there was no statistical significance. Anterior cervical microforaminotomy causes early degenerative changes of involved segment. There was no difference in development of degenerative changes between total uncinatectomy group and partial uncinatectomy group

Purpose
To analyze the serial change of the cervical saggital alignment especially cobb angle from immediately post operation to 3 month of post operation, and evaluate the effect of anatomically designed pillow to restore cervical lordosis.
Materials and Methods
cervical cobb angle (C2-C7) was measured in 38 patients whose radiographs at immediately post op, post op 1mo and post op 3mo were completely equipped. The patient group consisted of 10 patients in the general pillow group, 19 patients in the cervical pillow group, and 9 patients in the Philadelphia orthosis group.
Results
There was no statistically significant difference between the two groups using any pillow and the group using Philadelphia orthosis. Among them, patients who used anatomically designed pillow for 1 month to 3 months postoperatively were more likely to have lordotic change than the other patients, though it was not statistically significant.
Conclusion
The use of a cervical orthosis until the first month after the operation and subsequently anatomically degsined pillow for up to 3 months may be considered as a way to maintain lordotic curvature and prevent kyphotic changes.

The foramen of L5-S1 can develop several degenerative diseases such as extraforaminal lumbar disc herniation, foraminal stenosis with disc height collapse, degenerative or spondylolytic spondylolisthesis, and far-out syndrome. The floating technique in biportal endoscopic spine surgery (BESS) keeps a certain distance between instruments and spinal structures. 1) This key point makes the floating technique different from conventional endoscopic surgery, which uses the Kambin’s safe triangle as a work zone. The floating view can enable the surgeon to see the structures panoramically, under high magnification: consequently, fine discrimination of their margin and safe manipulation of neural structures can be guaranteed. A certain gap between the floating scope and lesion can permit various instruments, generally used in open spine surgery, to be inserted from the sides with fewer limitations. Extraforaminal or foraminal lesions under the lamina can be reached by avoiding the iliac crest, and total facetectomy, which has the potential of iatrogenic instability, is not required to explore the foraminal structures. However, the floating view can be obstructed by small bleeds from laminectomized bone and/or surrounding vessels. This present article describes the technique and provides tips on how to perform BESS with floating technique safely and successfully for various lesions at the L5-S1 foramen.

Many techniques have been introduced and performed, with different strengths and benefits. The lateral lumbar interbody fusion techniques (direct lateral lumbar interbody fusion [DLIF] and oblique lateral interbody fusion [OLIF]) have yielded good results for elderly patients. These are useful options for elderly patients with high risk of complications with traditional approaches.

Purpose
To report a rare case of alveolar soft-part sarcoma in the spine. Alveolar soft-part sarcoma (ASPS) is a rare, distinctive sarcoma typically occurring in young adults. Although it shows a relatively indolent clinical course, the ultimate prognosis is poor and often characterized by late metastases. However, with radical resection, long-term survival is possible. ASPS usually arises in the skeletal muscle and occurs most frequently in the lower limbs.
Materials and Methods
A 17-year-old male patient presented with a palpable mass on the back that enlarged about 1 year before admission. The mass was approximately 4×3 cm, located on the right side of the thoracic midline, and was palpated to be relatively soft and fixed, with no pain. On preoperative magnetic resonance imaging (MRI), a 2.5 ×2.0×4.1-cm lobulating contoured intermuscular mass was located between the spinalis thoracis and logissimus thoracis muscles in the right lumbar area at the T5–6 level. In the T1- and T2-weighted images with enhanced view, the tumor was enhanced with homogeneous intensity.
Results
We considered the possibility of a benign tumor that is frequently found in back muscle, rather than the possibility of a malignant tumor. We performed mass excision and biopsy without prior fine-needle biopsy or incisional biopsy, with the patient under general anesthesia. The tumor was confirmed to be ASPS.
Conclusions
The possibility of malignancy should be considered in the treatment of all tumors, and accurate diagnosis is important before surgery.

A 77-year-old female suffering from severe degenerative scoliosis, spinal stenosis and lumbar disc herniation underwent Direct lateral lumbar interbody fusion (DLIF) at L2-4. On the 3rd postoperative day, she complained of severe back pain without any trauma history. Simple radiograph revealed L3 vertebral fracture and cage subsidence. Pain was subsided after conservative treatment including TLSO and medication. Radiographic union was achieved at fractured vertebra after 3 months. Solid fusion was observed at operated level after 6 months. Patient has visited our clinic without any pain. DLIF is one of novel minimally invasive spine procedures available today. It is designed to maximize benefits and minimize risks of other traditional techniques such as anterior approach and posterior approach. However, there can be some risk of cage subsidence and vertebral fracture after DLIF. Therefore, care should be taken to avoid cage subsidence during the operation.