Notes, case reports, technical observations, and perspective essays on neurosurgery and minimally invasive spine practice.
We often stare at MRI images searching for answers. Yet the image reveals only anatomy. It shows the shape of bones, ligaments, and nerves, but not necessarily how they function.
At night, after all consultations and surgeries have ended, only the cool black-and-white cross-sections remain on the clinic monitor. In this hour, cleared of the day’s bustle, I face the anatomical structures within the images in absolute solitude.
A practical framework for applying Enhanced Recovery After Surgery (ERAS) principles to unilateral biportal endoscopic spine surgery — the three-phase ERAS triad (preoperative, intraoperative, postoperative), core elements adapted to the UBE surgical profile, and the common pitfalls of real-world implementation.
A reflection on the asymmetry between short- and long-term outcomes in minimally invasive spine surgery, the lessons fusion has taught the field, the role of the learning curve, the moving target paradox of evaluating surgical innovation, and the discipline required to navigate speed and direction in an era of accelerating technical change.
A practical strategy for hemostasis in unilateral biportal endoscopic spine surgery — classification of bleeder sources, principles of RF coagulation, source-specific management, and prevention of postoperative epidural hematoma.
A hands-on guide to fluid dynamics and irrigation control in unilateral biportal endoscopic spine surgery — hydrodynamic principles, optimal pressure settings, and prevention of irrigation-related complications.
A hands-on guide to the foundational portal placement geometry in unilateral biportal endoscopic spine surgery.
First technical description of fully endoscopic lumbar interbody fusion using a unilateral biportal approach.
A fellow's first lead case taught a lesson no textbook had. On technique, timing, and what surgery cannot undo.
A patient's first question on the day after surgery is rarely about the angled instrument that reached behind the lamina, or the precise plane of dissection that spared the descending nerve root.
The population presenting to spine clinics in Korea has changed during my career, and the change is not subtle.
This note is written for the trainee—the early resident, the visiting observer, the fellow in transition—whose first impressions of spinal anatomy were shaped, as mine were, by textbook diagrams rather than by the operative field.