Background
Endoscopic spinal surgery for lumbar foraminal lesions comes to be more popular recently. Bleedings around the foramen during extraforaminal endoscopic approach could make surgical filed turbid and more difficult to perform procedures safely. There were, however, few reports and insufficient information about vascular geometry around the foramen. Purpose: To report lumbar foraminal vascular geometry to help endoscopic spinal surgery underwent well and decrease technical complications by control of bleeding.
Materials and Methods
We reviewed operating record movie clips of extraforaminal approach using biportal endoscopic spine surgery (BESS). Several bleeding foci were matched with previously reported vascular anatomy and vascular geometry was modified to adapt to endoscopic view.
Results
There were four main arterial branches coming out from the lumbar segmental artery. Inferior articular artery, superior articular artery, inter-articular artery and radicular artery could be faced in order during extraforaminal approach using BESS. To escape heavy bleeding from the inferior articular artery and superior articular artery, the dorso-distal surface of transverse process (TP) should be exposed to make a working space without scratching the proximal area of the TP and dorsal surface of the facet. Inter-articular artery was hidden and covered under the capsule overlying superior articular process. Radicular artery was running along the midline of the root under the foraminal ligamentum flavum.
Conclusion
The information of the geometric location of the four arterial branches could help to escape heavy bleeding on extra-foraminal approach and control the bleeding foci to prevent postoperative hematoma.

Background
Context: There are few reports of changes in global sagittal alignment and corresponding factors like hand grip strength (HGS) and muscle performance tests to detect changes in global sagittal alignment after surgery for lumbar spinal stenosis (LSS). Purpose: The purpose of the study was to determine whether HGS can be a useful predictive marker of global sagittal alignment changes after decompression with fusion surgery for LSS. Study Design: This is a retrospective observational study. Patient Sample: Patients who underwent spine surgery for LSS were included in the present study. Outcome Measures: Radiological spinopelvic parameters including sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), global tilt (GT), and T1 pelvic angle (T1PA) were assessed. Clinical outcomes parameters like Oswestry Disability Index (ODI), Euro-QOL (EQ-5D), visual analog scale (VAS) scores for back or leg pain were assessed. To assess muscle performance, three functional mobility tests (6-meter walk test, timed up and go test, sit-to-stand test) and HGS were checked.
Materials and Methods
A total 91 consecutive patients who underwent spine fusion surgery for LSS were included. 1 year after posterior decompression and fusion surgery, the patients were further classified into four groups according to preoperative and postoperative SVA. We analyzed radiological parameters like SVA, LL, PT, PI, GT, and T1PA. The ODI, the EQ-5D and VAS scores for back or leg pain were recorded as clinical outcomes assessment. To assess muscle performance, SMT, TUGT, STS, and HGS were checked.
Results
HGS was significantly correlated with age, postoperative SVA, ODI, EQ-5D and muscle performance test. HGS was related with change of preoperative sagittal alignment 1yr after surgery. Using a receiver operating characteristic (ROC) curve to determine the cutoff values of HGS as predictors of postoperative balanced sagittal alignment according to SVA, cutoff value of HGS demonstrated 19.5 kg with a sensitivity of 82.1% and specificity of 66.7%.
Conclusion
Patients with non-balanced sagittal alignment in LSS demonstrated decreased muscle function and muscle strength. If the muscle strength was weak in the group in which the sagittal balance was maintained preoperatively, it could be converted to non-balanced sagittal alignment. Thus, preoperative HGS may be a good predictor of postoperative SVA change.

Purpose
of Study: Purpose of this study is to summarize the technique of UBE surgery in lumbar interbody fusion and review the clinical outcomes and complications of UBE surgery in lumbar interbody fusion.
Materials and Methods
Medical databases were searched for the key words of unilateral biportal endoscopic surgery and lumbar spinal stenosis using PubMed from 2005 to the present.
Conclusion
UBE spinal surgery is a new technique that can be a feasible alternative and an effective treatment modality for spinal degenerative diseases and can achieve the necessary surgical skills for experienced microscopic surgeons, which is still expanding the indications for lumbar spinal surgery.

Spinal cord injury is a devastating condition that leaves permeant disability. Surgical decompression and stabilization with various pharmacological treatments have been tried to prevent secondary injury, however, their results have been disappointing. Therefore, novel therapeutic options are required enthusiastically. Cell transplantation that has the potential of neuroregenerative and neuroprotective ability is regarded as a promising remedy. We would like to describe about the micro-anatomy and the mechanism of injury of spinal cord injury. We also delineate transplanted cells; embryonic stem cell, induced pluripotent stem cell, mesenchymal stem cell as stem cells and Schwan cell, olfactory ensheathing cell as supporting cells with brief reviews of their experimental results.

Interspinous process devices for spinal surgery are designed to keep the spine in a flexed position, to achieve indirect decompression of the mobile segment. Such devices have been fabricated using numerous materials and designs. In this study, the fundamental knowledge required for choosing an appropriate interspinous process device for spinal surgery was reviewed.