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"Dong-Ho Kang"

Original Articles

Deformity

Establishing Optimal L1 Pelvic Angle Targets to Minimize Both Proximal Junctional Kyphosis and Pelvic Nonresponse in Adult Spinal Deformity Surgery
Se-Jun Park, Jin-Sung Park, Dong-Ho Kang, Chong-Suh Lee, Hyun-Jun Kim
Neurospine 2025;22(4):987-997.   Published online December 31, 2025
DOI: https://doi.org/10.14245/ns.2550908.454

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Establishing Optimal L1 Pelvic Angle Targets to Minimize Both Proximal Junctional Kyphosis and Pelvic Nonresponse in Adult Spinal Deformity Surgery
Neurospine. 2025;22(4):987-997.   Published online December 31, 2025
DOI: https://doi.org/10.14245/ns.2550908.454
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Establishing Optimal L1 Pelvic Angle Targets to Minimize Both Proximal Junctional Kyphosis and Pelvic Nonresponse in Adult Spinal Deformity Surgery
Neurospine. 2025;22(4):987-997.   Published online December 31, 2025
DOI: https://doi.org/10.14245/ns.2550908.454
Close
Objective
To determine the optimal targets of the L1 pelvic angle (L1PA) that minimize the risk of both proximal junctional kyphosis (PJK) and pelvic nonresponse (PNR) following adult spinal deformity (ASD) surgery.
Methods
A retrospective study was conducted on 323 patients who underwent fusion surgery from the low thoracic spine (T9–12) to the pelvis and were followed up for 2 years. Risk factors for PJK and PNR were evaluated separately using multivariate logistic regression analysis. Receiver operating characteristic (ROC) curve analyses were performed to identify L1PA cutoff values predictive of PJK and PNR across 3 pelvic incidence (PI) categories: <45°, 45°–60°, and ≥60°. L1PA thresholds were defined to delineate “ideal” alignment.
Results
Risk factor analyses revealed that low L1PA was an independent risk factor for PJK (odds ratio [OR], 0.927; p=0.019), while high PI–LL (OR, 1.101; p<0.001) and high L1PA (OR, 1.249; p<0.001) were significant risk factors for PNR. On ROC curve analyses, optimal L1PA ranges were 2.5°–4.5° for PI<45°, 8.7°–12.6° for PI 45°–60°, and 15.1°–17.3° for PI≥60°. Patients within these ideal L1PA ranges had significantly lower rates of both PJK and PNR compared to those exceeding ideal L1PA ranges.
Conclusion
This study demonstrated that optimal correction based on these L1PA targets reduced the risk of both PJK and PNR. Therefore, these L1PA targets can serve as reliable alignment goals to optimize surgical outcomes in ASD surgery.
  • 1,914 View
  • 53 Download

Spinal Deformity

Proximal Junctional Failure Development Despite Achieving Ideal Sagittal Correction According to Age-Adjusted Alignment Target in Patients With Adult Spinal Deformity: Risk Factor Analysis of 196 Cases Undergoing Low Thoracic to Pelvic Fusion
Se-Jun Park, Jin-Sung Park, Dong-Ho Kang, Minwook Kang, Kyunghun Jung, Chong-Suh Lee
Neurospine 2024;21(4):1080-1090.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448734.367

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Proximal Junctional Failure Development Despite Achieving Ideal Sagittal Correction According to Age-Adjusted Alignment Target in Patients With Adult Spinal Deformity: Risk Factor Analysis of 196 Cases Undergoing Low Thoracic to Pelvic Fusion
Neurospine. 2024;21(4):1080-1090.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448734.367
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Proximal Junctional Failure Development Despite Achieving Ideal Sagittal Correction According to Age-Adjusted Alignment Target in Patients With Adult Spinal Deformity: Risk Factor Analysis of 196 Cases Undergoing Low Thoracic to Pelvic Fusion
Neurospine. 2024;21(4):1080-1090.   Published online December 31, 2024
DOI: https://doi.org/10.14245/ns.2448734.367
Close
Objective
To identify the risk factors for proximal junctional failure (PJF) after adult spinal deformity (ASD) surgery despite ideal sagittal correction according to age-adjusted alignment target.
Methods
The study included patients who underwent low thoracic to pelvic fusion for ASD and obtained ideal correction according to age-adjusted pelvic incidence minus lumbar lordosis. PJF was defined either radiographically as a proximal junctional angle (PJA) of >28° plus a difference in PJA of >22° or clinically as revision surgery for proximal junctional complications. Clinical and radiographic variables were assessed to identify the risk factors for PJF.
Results
The final study cohort consisted of 196 patients, of whom 170 were women (86.7%), with an average age of 68.3 years. During mean follow-up duration of 45.9 months, PJF occurred in 43 patients (21.9%). Multivariate logistic regression analysis revealed that old age (odds ratio [OR], 1.063; 95% confidence interval [CI], 1.001–1.129; p=0.046), large preoperative sagittal vertical axis (OR, 1.007; 95% CI, 1.001–1.013; p=0.024), nonuse of a transverse process (TP) hook (OR, 5.556; 95% CI, 1.205–19.621; p=0.028), and high lumbar distribution index (LDI) (OR, 1.136; 95% CI, 1.109–1.164; p<0.001) were significant risk factors for PJF development.
Conclusion
A sizeable proportion of patients (21.9%) developed PJF despite achieving ideal sagittal correction. Using TP hooks with avoiding excessive LDI can be helpful to further mitigate the risk of PJF development in this patient group.

Citations

Citations to this article as recorded by  Crossref logo
  • Association between lumbar lordosis and proximal junctional failure following adult spinal deformity surgery: a systematic review and meta-analysis
    Abdullah M. Alharran, AbdulMuhsen AlQallaf, Mohammad Mohammad, Mohammad Salem Alajmi, Mohammad Alkaak, Salem Y. Alenezi, Fahad Mohammad, Ahmad Al Ahmad, Nizar Algarni, Yousef Marwan
    Spine Deformity.2026; 14(4): 1051.     CrossRef
  • Does Preoperative Spinal Alignment Influence Surgical Outcomes When Postoperative Alignment and Fixation Strategies Are Matched in ASD Correction?
    Donghua Huang, Zhan Wang, Michael Jian-Wen Chen, Annika Bay, Robert N. Uzzo, Gabrielle Dykhouse, Atahan Durbas, Andrea Pezzi, Stephane Owusu-Sarpong, Luis Felipe Colon, Kasra Araghi, Quante Singleton, Farah Musharbash, Sereen Halayqeh, Matthew E. Cunningh
    Spine.2026; 51(11): 761.     CrossRef
  • Proximal Junctional Kyphosis Prevention in Adult Spinal Deformity Surgery: A Technical Review of Tethering and Adjunctive Strategies
    Paritash Tahmasebpour, Pawel P. Jankowski, Jason Liang, Joshua Lin, Kyriakos D. Chatzis, Peter S. Tretiakov, Spencer Matthews, Louis Boissiere, John F. Burke, Christopher I. Shaffrey, Aaron Hockley, Peter Passias
    Operative Neurosurgery.2026;[Epub]     CrossRef
  • Machine Learning–Based Identification of Distinct Risk Factors for Moderate vs Severe Proximal Junctional Kyphosis After Adult Spinal Deformity Surgery
    Dong-Ho Kang, Jin-Sung Park, Chong-Suh Lee, Se-Jun Park
    The Spine Journal.2026;[Epub]     CrossRef
  • The use of hooks in upper instrumented vertebra to prevent proximal junctional complications: a systematic review and meta-analysis
    Hifza Babar, Dong Li, Jie Li, Zhen Liu, Zezhang Zhu, Yong Qiu
    BMC Surgery.2026;[Epub]     CrossRef
  • Utility of Enabling Technologies in Spinal Deformity Surgery: Optimizing Surgical Planning and Intraoperative Execution to Maximize Patient Outcomes
    Nora C. Kim, Eli Johnson, Christopher DeWald, Nathan Lee, Timothy Y. Wang
    Journal of Clinical Medicine.2025; 14(15): 5377.     CrossRef
  • Postoperative L1 Tilt as a Predictor of Proximal Junctional Kyphosis Following Lower Thoracic Spine-to-Pelvis Fusion for Adult Spinal Deformity
    Se-Jun Park, Jin-Sung Park, Dong-Ho Kang, Kyunghun Jung, Minwook Kang, Chong-Suh Lee
    Spine.2025; 50(24): 1769.     CrossRef
  • From the Editor-in-Chief: Featured Articles in the December 2024 Issue
    Inbo Han
    Neurospine.2024; 21(4): 1051.     CrossRef
  • Risk Factors, Biomechanics, and Prevention Strategies for Proximal Junctional Failure in Adult Spinal Deformity Surgery – A Commentary on “Proximal Junctional Failure Development Despite Achieving Ideal Sagittal Correction According to Age-Adjusted Alignm
    Lee A. Tan
    Neurospine.2024; 21(4): 1094.     CrossRef
  • New Insights Into Risk Factors for Proximal Junctional Failure in Adult Spinal Deformity Surgery – A Commentary on “Proximal Junctional Failure Development Despite Achieving Ideal Sagittal Correction According to Age-Adjusted Alignment Target in Patients
    Masayuki Miyagi, Gen Inoue, Masashi Takaso
    Neurospine.2024; 21(4): 1091.     CrossRef
  • 7,307 View
  • 292 Download
  • 10 Crossref
Comparison of Surgical Burden, Radiographic and Clinical Outcomes According to the Severity of Baseline Sagittal Imbalance in Adult Spinal Deformity Patients
Se-Jun Park, Jin-Sung Park, Dong-Ho Kang, Hyun-Jun Kim, Yun-Mi Lim, Chong-Suh Lee
Neurospine 2024;21(2):721-731.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2448250.125

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Comparison of Surgical Burden, Radiographic and Clinical Outcomes According to the Severity of Baseline Sagittal Imbalance in Adult Spinal Deformity Patients
Neurospine. 2024;21(2):721-731.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2448250.125
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Comparison of Surgical Burden, Radiographic and Clinical Outcomes According to the Severity of Baseline Sagittal Imbalance in Adult Spinal Deformity Patients
Neurospine. 2024;21(2):721-731.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2448250.125
Close
Objective
To determine the clinical impact of the baseline sagittal imbalance severity in patients with adult spinal deformity (ASD).
Methods
We retrospectively reviewed patients who underwent ≥ 5-level fusion including the pelvis, for ASD with a ≥ 2-year follow-up. Using the Scoliosis Research Society-Schwab classification system, patients were classified into 3 groups according to the severity of the preoperative sagittal imbalance: mild, moderate, and severe. Postoperative clinical and radiographic results were compared among the 3 groups.
Results
A total of 259 patients were finally included. There were 42, 62, and 155 patients in the mild, moderate, and severe groups, respectively. The perioperative surgical burden was greatest in the severe group. Postoperatively, this group also showed the largest pelvic incidence minus lumbar lordosis mismatch, suggesting a tendency towards undercorrection. No statistically significant differences were observed in proximal junctional kyphosis, proximal junctional failure, or rod fractures among the groups. Visual analogue scale for back pain and Scoliosis Research Society-22 scores were similar across groups. However, severe group’s last follow-up Oswestry Disability Index (ODI) scores significantly lower than those of the severe group.
Conclusion
Patients with severe sagittal imbalance were treated with more invasive surgical methods along with increased the perioperative surgical burden. All patients exhibited significant radiological and clinical improvements after surgery. However, regarding ODI, the severe group demonstrated slightly worse clinical outcomes than the other groups, probably due to relatively higher proportion of undercorrection. Therefore, more rigorous correction is necessary to achieve optimal sagittal alignment specifically in patients with severe baseline sagittal imbalance.

Citations

Citations to this article as recorded by  Crossref logo
  • Radiographic and clinical predictors of surgical outcomes following endoscopic decompression for radiculopathy in adult degenerative scoliosis: A multi-center retrospective study
    Mounica Paturu, Joshua Woo, Kosuke Saguira, David Huie, Christoph Hofstetter, Muhammad M. Abd-el-Barr
    Brain and Spine.2026; 6: 105990.     CrossRef
  • Does Preoperative Spinal Alignment Influence Surgical Outcomes When Postoperative Alignment and Fixation Strategies Are Matched in ASD Correction?
    Donghua Huang, Zhan Wang, Michael Jian-Wen Chen, Annika Bay, Robert N. Uzzo, Gabrielle Dykhouse, Atahan Durbas, Andrea Pezzi, Stephane Owusu-Sarpong, Luis Felipe Colon, Kasra Araghi, Quante Singleton, Farah Musharbash, Sereen Halayqeh, Matthew E. Cunningh
    Spine.2026; 51(11): 761.     CrossRef
  • Balance or Strength? Reconsidering Muscle Metrics in Sagittal Malalignment in Adult Sagittal Deformity Patients
    Donghua Huang, Zhan Wang, Mihir Dekhne, Atahan Durbas, Tejas Subramanian, Gabrielle Dykhouse, Robert N. Uzzo, Luis Felipe Colón, Stephane Owusu-Sarpong, Han Jo Kim, Francis Lovecchio
    Journal of Clinical Medicine.2025; 14(10): 3293.     CrossRef
  • The predictive value of the global alignment and proportion (GAP) score for mechanical complications following adult spinal deformity surgery: A systematic review and meta-analysis
    Vinicius Ricieri Ferraz, Guilherme Santos Piedade, Carlos R. Goulart, Maria Fernanda Ricieri Ferraz Franco de Souza, Marcelo Ochoa Coelho de Souza Furlan, Philippe A. Mercier, Tobias A. Mattei
    North American Spine Society Journal (NASSJ).2025; 24: 100816.     CrossRef
  • 6,886 View
  • 112 Download
  • 5 Web of Science
  • 4 Crossref

Clinical Article

Surgical Treatment of Pyogenic Spondylitis with the Use of Freeze-Dried Structural Allograft
Seung-Soo Kim, Dong-Ho Kang, Jong-Won Yoon, Hyun Park, Chul-Hee Lee, Soo-Hyun Hwang
Korean J Spine 2014;11(3):136-144.   Published online September 30, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.3.136

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Surgical Treatment of Pyogenic Spondylitis with the Use of Freeze-Dried Structural Allograft
Korean J Spine. 2014;11(3):136-144.   Published online September 30, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.3.136
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Surgical Treatment of Pyogenic Spondylitis with the Use of Freeze-Dried Structural Allograft
Korean J Spine. 2014;11(3):136-144.   Published online September 30, 2014
DOI: https://doi.org/10.14245/kjs.2014.11.3.136
Close
Objective

Radical debridement and reconstruction is necessary for surgical treatment of pyogenic spondylitis to control infection and to provide segmental stability. The authors identified 25 patients who underwent surgery for pyogenic spondylitis using freeze-dried structural allograft for reconstruction. This study aimed to evaluate and demonstrate the effectiveness and safety of a freeze-dried structural allograft during the surgical treatment of pyogenic spondylitis.

Methods

From January 2011 to May 2013, we retrospectively reviewed 25 surgically treated patients of pyogenic spondylitis. Surgical techniques used were anterior radical debridement and reconstruction with a freeze-dried structural allograft and instrumentation. In these 25 patients, we retrospectively examined whether the symptoms had improved and the infection was controlled after surgery by evaluating laboratory data, clinical and radiological outcomes. The average follow-up period was 15.7 months (range, 12.2-37.5 months).

Results

The infection resolved in all of the patients and there were no cases of recurrent infection. The mean Visual Analog Scale score was 6.92 (range, 5-10) before surgery and 1.90 (range, 0-5) at the time of the last follow-up. Preoperatively, lower extremity motor deficits related to spinal infection were noted in 10 patients, and they improved in 7 patients after surgery. Follow-up computed tomographic scans were obtained from 10 patients, and osseous union between the vertebral body and the structural allograft was achieved in 2 patients.

Conclusion

The freeze-dried structural allograft can be a safe and effective alternative for surgical treatment of pyogenic spondylitis, and another option for vertebral reconstruction instead of using the other materials.

Citations

Citations to this article as recorded by  Crossref logo
  • Use of femoral head allografts in the treatment of nonspecific spondylodiscitis of the thoracic and lumbar spine
    V. K. Shapovalov, I. V. Basankin, A. A. Afaunov, I. V. Gilevich, A. A. Giulzatyan, N. V. Tushkanova
    Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika).2026; 23(1): 72.     CrossRef
  • Risk Factor Analysis of Simple Drainage Followed by Instrumented Fusion in Patients with Pyogenic Spinal Infection
    Jong Tae Ko, Sang Hyub Lee, Tae Yong An, Dong Hwan Kim, Dong Ho Kang
    Journal of Korean Neurosurgical Society.2025; 68(6): 713.     CrossRef
  • An Intravertebral Pseudoaneurysm Formed after Infective Spondylitis
    Sum Kim, Chang Kyung Kang, Hangeul Park, Young Rak Kim, Jun-Hoe Kim, Chang-Hyun Lee, Chun Kee Chung, Chi Heon Kim
    The Nerve.2023; 9(2): 179.     CrossRef
  • Consensus on Implants in Infections After Spine Surgery
    Srikanth N. Divi, Christopher K. Kepler, Barrett S. Boody, Wesley H. Bronson, Glenn S. Russo, Anand H. Segar, Matthew S. Galetta, Dhruv K.C. Goyal, Taolin Fang, Gregory D. Schroeder, Alexander R. Vaccaro
    Clinical Spine Surgery: A Spine Publication.2020; 33(4): 163.     CrossRef
  • Infectious Spondylodiscitis by Uncommon Pathogens: A Pitfall of Empirical Antibiotics
    Seung Han Yu, Dong Hwan Kim, Hwan Soo Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han
    Korean Journal of Spine.2016; 13(3): 97.     CrossRef
  • 9,924 View
  • 75 Download
  • 5 Crossref

Case Report

Tophaceous Gout of the Spine Causing Neural Compression
Jong-Won Yoon, Kyung-Bum Park, Hyun Park, Dong-Ho Kang, Chul-Hee Lee, Soo-Hyun Hwang, Jin-Myung Jung, Jong-Woo Han, In Sung Park
Korean J Spine 2013;10(3):185-188.   Published online September 30, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.3.185

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Tophaceous Gout of the Spine Causing Neural Compression
Korean J Spine. 2013;10(3):185-188.   Published online September 30, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.3.185
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Tophaceous Gout of the Spine Causing Neural Compression
Korean J Spine. 2013;10(3):185-188.   Published online September 30, 2013
DOI: https://doi.org/10.14245/kjs.2013.10.3.185
Close

Gout is a common metabolic disease in which monosodium urate crystals called tophi develop. Spinal involvement in gout resulting in neural compression is unusual. We describe a case of a 64-year-old man with a history of gouty arthritis of the knee. The patient presented with thoracic myelopathy and radiculopathy. Imaging of the spine revealed an extradural mass lesion with bony erosion of the thoracic spine. A decompressive operation was performed, and a chalky white material was found. Histopathological examination confirmed a gouty tophus. The symptoms of spinal gout vary and its radiological features are not sufficiently specific to provide a definite diagnosis. Therefore, in patients with a history of gouty arthritis who present with neural compressive symptoms of the spine, spinal gout should be strongly suspected.

Citations

Citations to this article as recorded by  Crossref logo
  • Management of Gout: Targeting Pain or Metabolic Control
    G. R. Subbu, Martin M, Milaniya M, Raveendran A
    International Journal of Research and Review.2026; : 155.     CrossRef
  • Tophaceous gout of the spine: Expansile mass with mass effect at L4–5
    May T. Tun, Yemesrach Kerego, Maria Martinez-Baladejo, Anna Ng Pellegrino, Farheen Jaffari
    International Journal of Academic Medicine.2025; 11(1): 31.     CrossRef
  • Endoscopic management of lumbar spinal tophaceous gout: six cases treated with percutaneous transforaminal (PTED) and interlaminar (PIED) discectomy and a literature review
    Han Wang, Xinzhi Li, Bo Li, Qiong Zhang, Xiangyong Que, Wenyao Chen, Chongyu Huang, Qinyue Ai, Mireadeli Abulimiti, Qi Yang, Lunci Zhang
    European Spine Journal.2025; 34(8): 3079.     CrossRef
  • Analysis of the efficacy of UBE in the treatment of tophus deposition within the lumbar spinal canal
    Yingying Qian, Jiang Liu, Mingjie Xiao, Wen Chen, Yonghui Feng, Chunliang Xie, Sineng Zhang, Wenliang Liu, Fengwei Qin
    Medicine.2025; 104(44): e45466.     CrossRef
  • Posterior interosseous nerve compressive neuropathy due to gouty tophi: a case report and literature review
    Wonje Lee, Hyokon Kim, Jinsik Park, Sunghan Ha
    Archives of Hand and Microsurgery.2025; 30(4): 267.     CrossRef
  • Chronic pyogenic spondylitis in patients with spinal gout: a case series and literature review
    Arkadiy A. Vishnevskiy, Denis G. Naumov, Mikhail M. Shchelkunov, Tatiana A. Novitskaya
    Traumatology and Orthopedics of Russia.2024; 30(2): 168.     CrossRef
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    BMC Musculoskeletal Disorders.2024;[Epub]     CrossRef
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    Neurology India.2022; 70(4): 1714.     CrossRef
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    Seminars in Musculoskeletal Radiology.2022; 26(04): 387.     CrossRef
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    Radiology Case Reports.2021; 16(2): 237.     CrossRef
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    Current Rheumatology Reports.2021;[Epub]     CrossRef
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    Frontiers in Medicine.2021;[Epub]     CrossRef
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    Medicine.2020; 99(10): e19348.     CrossRef
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    Taeshin Kim, Bum-Joon Kim, Se-Hoon Kim, Seung-Hwan Lee
    Korean Journal of Spine.2017; 14(2): 50.     CrossRef
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    Michael Toprover, Svetlana Krasnokutsky, Michael H. Pillinger
    Current Rheumatology Reports.2015;[Epub]     CrossRef
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    Z-F Zheng, H-L Shi, Y Xing, D Li, J-Y Jia, S Lin
    Spinal Cord.2015; 53(12): 881.     CrossRef
  • Chronic Tophaceous Gout in Multiple Spines: A Case Report and Literature Review
    Kyoung Hwa Lee, Hyun Sun Woo, Mi Ryoung Seo, Hee Jung Ryu, Hyo Jin Choi, Han Joo Baek
    Journal of Rheumatic Diseases.2015; 22(4): 250.     CrossRef
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    T Liu, H Liu, T Zhu
    Spinal Cord Series and Cases.2015;[Epub]     CrossRef
  • 11,325 View
  • 81 Download
  • 23 Crossref
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