ObjectiveHelicopter ambulance transport (HAT) is a highly resource-intensive facility that is a well-established part of the trauma transport system in many developed countries. Here, we review the benefit of HAT for neurosurgical patients in Korea.MethodsThis retrospective study followed neurotrauma patients who were transferred by HAT to a single emergency trauma center over a period of 2 years. The clinical benefits of HAT were measured according to the necessity of emergency surgical intervention and the differences in the time taken to transport patients by ground ambulance transport (GAT) and HAT.ResultsNinety-nine patients were transferred to a single university hospital using HAT, of whom 32 were taken to the neurosurgery department. Of these 32 patients, 10 (31.3%) needed neurosurgical intervention, 14 (43.8%) needed non-neurosurgical intervention, 3 (9.4%) required both, and 11 (34.4%) did not require any intervention. The transfer time was faster using HAT than the estimated time needed for GAT, although for a relatively close distance (<50 km) without ground obstacles (mountain or sea) HAT did not improve transfer time. The cost comparison showed that HAT was more expensive than GAT (3,292,000 vs. 84,000 KRW, p<0.001).ConclusionIn this Korean-based study, we found that HAT has a clinical benefit for neurotrauma cases involving a transfer from a distant site or an isolated area. A more precise triage for using HAT should be considered to prevent overuse of this expensive transport method.

The main purpose of this study was to evaluate radiologic outcomes and Finite element method (FEM) results of anterior cervical discectomy and fusion (ACDF) using H-beam shaped allospacer, in comparison with rim-shaped allospacer. Methods: From March 2011 to February 2014, 95 patients underwent ACDF using allospacers (H-beam shaped and rim shaped). Sixty-two patients were divided into 2 groups: H-beam shaped allospacer in group A (n=31); rim shaped allospacer in group B (n=31). We retrospectively estimated clinical outcomes, such as, neck and arm pain, radiographic fusion rate and adverse effects. In the FEM study, we compared the performance of 3 different shaped allospacer; i.e., H-beam shaped, H-hole shaped, rim-shaped. We tested the effectiveness of stress distribution from the 3 types of allospacer, using the evaluation criteria of (a) compression; (b) shear; and (c) torsion, under the same load. Results: Neck and arm pain was reduced similarly by 63% to 73% in 2 groups. Fusion rates after 1 year in group A and B were 100% and 98% retrospectively. The complication rates of breakage and displacement in Group B were 16% and 3%. Group A show no adverse effects. From the FEM study, in the cases of the (a), (b), (c), we found that H-beam shaped allospacer resulted in effectiveness stress distribution and diversification regarding compression, shear and torsion compared with rim shaped allospacer. Conclusion: In ACDF using allospacer, H-beam shaped allospacer shows more stable fusion rates with low incidence of complication compared with rim shaped allospacer.