Se‐Jun Park
성균관대학교 의과대학 · 의학
Se-Jun Park 교수의 연구실은 척추 정렬 및 생체역학을 중심으로 한 척추외과 임상 연구를 전문으로 합니다. 특히 척추 후방유합술 후 발생하는 PJK(Pelvic Obliquity and Junctional Kyphosis)와 PJF(Pelvic Incidence-related Junctional Failure)의 발생 기전과 위험 인자를 규명하며, 정확한 체중 중심 및 체계적 정렬 조절의 중요성을 강조하고 있습니다. 또한 척추 전방유합술에서 고정된 고정 위치와 고정 높이가 척추 정렬 복원과 신경간접 해부학적 복원에 미치는 영향을 분석하여 최적의 수술 전략을 모색하고 있습니다. 특히 연령, 체질량지수, 체형 특성에 맞춘 개인화된 정렬 목표 설정의 필요성을 제기하고 있습니다.
표시된 성과는 수집된 데이터 기준으로 산출되며, 일부 차이가 있을 수 있습니다.
PJK developed at a median of 17 months and PJF at a median of 3 months. A high body mass index was an independent risk factor for PJK, whereas older age, osteoporosis, uppermost instrumented vertebra level at the thoracolumbar junction, and greater preoperative sagittal vertical axis were risk factors for PJF.
The cage position within the anterior 1/3 of disk space is better for achieving the restoration of the SA without compromising the indirect neural decompression, if the height of cage is large enough.
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Overcorrection relative to age-adjusted sagittal alignment increases the risk of PJF development and is associated with poor clinical outcomes. Older patients and those with small PI are likely to be overcorrected in terms of the age-adjusted PI-LL target. Therefore, the age-adjusted alignment should be considered more strictly in these patients.
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SPFF develops in different patterns with different risk factors. Above-S1 SPFF was associated with nonunion at L5-S1, while below-S1 SPFF was associated with mechanical stress.
Bony failure with PJA of greater than 22° increased the likelihood for revision surgery. Therefore, early surgical intervention should be considered in these patients.Level of Evidence: 4.
Even if PJK was asymptomatic at initial development, it progressed radiographically with time and eventually gave a negative impact on the clinical outcomes in long-term follow-up.Level of Evidence: 3.
The current study reported successful outcomes with very low complication rates after nonfusion surgery for patients with spinal metastases, even among those who survived for more than 6 months. More than half of the instrumentation-related complications were asymptomatic and did not require revision. The results suggest that nonfusion surgery might be sufficient for a majority of patients with spinal metastases.
In patients younger than 70 years, a greater change in LL was associated with PJF development regardless of PI-related values. However, in older patients, overcorrection of PI-LL relative to the age-adjusted PI-LL target was a significant risk factor of PJF.
The present study indicates that osteoporosis should be well corrected preoperatively and extending the fusion above T10 should be considered for severe imbalance in old patients. However, the amount of correction was not associated with PJF development.
De novo scoliosis developed in 3.7% and scoliosis progressed in 16.4% of the patients during rhGH treatment. However, scoliosis development or progression was not affected by the types or duration of rhGH treatment in patients with ISS.
