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Backgrounds : Minimally invasive surgery develops very extensively in past few decades, not only in the scope of decompression but until fusion surgery. Surgeon has been trying to reduce the damage to the normal anatomical structure. In this study we performed unilateral biportal endoscopic lumbar interbody fusion (ULIF) as one of the fusion option which is readily available without sophisticated minimal invasive instrument. The purpose of this study is to introduce unilateral biportal endoscopic surgery and comparing the result with conventional minimal invasive lumbar interbody fusion (MIS-TLIF) Methods : This is a retrospective cohort study of 145 lumbar spondylolisthesis patient underwent conventional MIS-TLIF or ULIF procedure. All patient were followed up until 12 months to evaluate the VAS of back pain and leg pain, ODI, SF-36 and fusion rate. Results : Back pain VAS were a little higher compared with the endoscopic group, but the VAS of leg pain were the same. Both group had improvement in ODI score and SF-36 which shows both of the procedure were quite effective in managing such cases. Conclusion : Full endoscopic fusion offer benefit of minimal invasive surgery with better visualization of decompression and endplate preparation. Long term follow up is still needed to evaluate the result of the procedure.

Background:The development of full endoscopic procedures enables surgeons to visualize the operative field very clearly. Posterior foraminotomy using endoscopy was developed as a minimally invasive procedure to reduce the complication of the anterior cervical approach and to preserve the segmental motion without decreasing the effectiveness of nerve decompression. Our aim is to evaluate the result of full endoscopic posterior cervical foraminotomy in our center. Methods: This is a prospective single-arm study of 65 foraminal disc herniation and foraminal stenosis patients that underwent full endoscopic posterior foraminotomy procedures. All patients were routinely observed for 12-months duration to evaluate Visual Analog Score (VAS) of the neck, arm, and modified Macnab criteria. Results: Arm pain VAS decreased significantly compared with the pre-operation state (p < 0.001, 0.034, 0.001 on immediate post-operative, 6-months follow-up, and 12-months follow-up, respectively) even though 6.15% of patients had hypesthesia on follow-up. There was no neck pain observed during 1 year follow-up, and modified Macnab criteria showed a good outcome following full endoscopic posterior foraminotomy. Conclusion: Full endoscopic posterior foraminotomy provides good nerve decompression with all the benefits of endoscopic spine procedure.

Introduction This case report presents a rare case of vertebral artery and spinal cord injury due to air rifle pellet. Case presentation A previously healthy 19-year-old male was shot on his left neck incidentally during recreational air rifle game. He was taken to the other hospital before being referred to our hospital. Clinical findings and investigations The patient presented with total loss of motoric function on his left side of the body together with sensoric function on the contralateral side from the level of C5 and below. Signs of stroke were also spotted on the patient's face. The cervical plain radiograph and CT scan were carried out preoperatively to depict pellet fragments. Meanwhile, the CT angiography which was commenced postoperatively revealed the left vertebral artery injury. Interventions Surgery comprising of pellet fragments removal, decompression and posterior stabilization of the cervical spine was carried out to retrieve the pellet fragments, which were embedded at the posterior epidural space. Relevance and impact Our findings were consistent with the vertebral artery injury and Brown-Sequard syndrome. Hence, these clinical entities should be considered in the setting of penetrating cervical trauma.

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