Clinical Spine Surgery最新文献

{"title":"How Does Inflammatory Bowel Disease Impact Outcomes and Costs of Care Following Primary 1- to 2-level Lumbar Fusion for Degenerative Lumbar Disease?","authors":"Faisal Elali, Patrick Nian, Ariel N Rodriguez, Charles A Conway, Ahmed Saleh, Afshin E Razi","doi":"10.1097/BSD.0000000000001688","DOIUrl":"10.1097/BSD.0000000000001688","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>The purpose of this study was to determine whether IBD in patients with degenerative lumbar changes undergoing primary 1-2LF is associated with higher rates of (1) in-hospital length of stay, (2) medical complications, (3) readmissions, and (4) costs of care.</p><p><strong>Summary of background data: </strong>In the United States, the prevalence of inflammatory bowel disease (IBD) has increased concurrently with an aging population with degenerative disk changes. In these patients, primary 1- to 2-lumbar fusion (1-2LF) is a common procedure to resolve serious complications of the spine. Studies comparing these patient demographics to hospital lengths of stay, postoperative complications, readmission rates, and costs of care are limited in the literature.</p><p><strong>Methods: </strong>The inclusion criteria consisted of patients with IBD who underwent 1-2LF, using a 90-day surveillance period, postoperatively. This 90-day surveillance period was used to measure the length of hospital stay, rates of medical complications, rates of readmissions, and overall costs of care. The IBD cohort was matched against a case-matched cohort group.</p><p><strong>Results: </strong>Patients in the study group had significantly longer in-hospital lengths of stay. In addition, patients in the study group had significantly higher incidence and odds of developing postoperative medical complications within 90 days. Also, study group patients had significantly higher readmission rates. Finally, patients in the study group had significantly higher costs of care than their case-matched cohort.</p><p><strong>Conclusions: </strong>This study demonstrated that patients with IBD and degenerative lumbar disease are burdened with longer in-hospital lengths of stay, rates of postoperative medical complications, rates of readmission, and costs of care after undergoing primary 1-2LF.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"148-153"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Postoperative Neck Pain and Kyphotic Change After Laminoplasty Affected by Degree of Facet Joint Degeneration?","authors":"Gumin Jeong, Sehan Park, San Kim, Chang Ju Hwang, Jae Hwan Cho, Dong-Ho Lee","doi":"10.1097/BSD.0000000000001760","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001760","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Objective: </strong>To date, the association between postlaminoplasty neck pain or kyphosis and facet joint degeneration (FJD) remains unknown. Therefore, this study aimed to determine whether FJD affects postlaminoplasty neck pain or kyphosis.</p><p><strong>Summary of background data: </strong>FJD can cause medial branch irritation leading to postlaminoplasty neck pain. Cervical lordosis is a prerequisite for laminoplasty as it achieves cord decompression through posterior shifting.</p><p><strong>Methods: </strong>This study included 126 consecutive patients who underwent laminoplasty and were followed up for a minimum of 2 years. The radiographic cervical sagittal parameters, neck pain visual analog scale (VAS), arm pain VAS, neck disability index (NDI), and Japanese Orthopedic Association score were evaluated. A comparison was made between patients with moderate-to-severe neck pain (neck pain VAS ≥4; severe neck pain group) and those with mild or no neck pain (neck pain VAS <4; mild neck pain group) at the 2-year follow-up. Furthermore, patients who experienced postlaminoplasty kyphosis of C2-C7 (kyphotic group) were compared with those who did not develop kyphosis (nonkyphotic group).</p><p><strong>Results: </strong>The mild and severe neck pain groups included 99 (78.6%) and 27 (21.4%) patients, respectively. The preoperative degree of FJD was significantly higher in the severe neck pain group (P=0.040). The cervical sagittal parameters and demographics did not exhibit significant intergroup differences. Multivariate logistic regression analysis revealed that higher preoperative FJD grade was associated with postoperative severe neck pain (P=0.046). In addition, lesser preoperative C2-C7 extension capacity was identified as a factor influencing postoperative kyphosis (P=0.027).</p><p><strong>Conclusions: </strong>This study demonstrates that patients with higher preoperative FJD are more likely to experience postoperative severe neck pain. However, it did not find an association between FJD and postlaminoplasty kyphosis, indicating that FJD does not influence cervical alignment aggravation.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different Concepts in Short Segment Reconstruction of Moderate to Severe PI-LL Mismatch Deformity with ALIF, Mini-PSO, and TLIF: A Video Case Series.","authors":"William Sheppard, Landon Reading, Arpan A Patel, Jacob Greenberg, Alexander Spiessberger","doi":"10.1097/BSD.0000000000001796","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001796","url":null,"abstract":"<p><p>Sagittal plane deformities of the thoracolumbar spine, in which there is a significant mismatch between pelvic incidence (PI) and lumbar lordosis (LL) can negatively impact quality of life. Reconstructive surgery frequently involves long-segment spinal fusion. This video case series presents 3 patients with moderate to severe PI-LL mismatch spinal deformities, who underwent short construct corrections using varying strategies. Case 1 utilizes a combination of posterior column osteotomy (PCO) and anterior lumbar interbody fusion (ALIF) to achieve correction. Case 2 describes a combined transforaminal lumbar interbody fusion (TLIF) with a partial pedicle subtraction osteotomy (PSO). Lastly, case 3 details deformity correction with a multilevel TLIF, using extra-large footprint static banana cages, combined with posterior column osteotomy. The aim of this video case series is to outline these 3 techniques and illustrate that in select cases, a short-segment fusion limited to the lumbar spine can achieve significant deformity correction.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Atlantoaxial Level Overlooked in the Radiologic Interpretation of Cervical Magnetic Resonance Imaging?","authors":"Tyler W Henry, Taylor Paziuk, Jessa Tunacao, Alec Giakas, Aditya S Mazmudar, William Conaway, Khoa S Tran, Saewon Chun, Jeffrey A Belair, Jeffrey A Rihn","doi":"10.1097/BSD.0000000000001805","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001805","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective analysis.</p><p><strong>Objective: </strong>The purpose of this study is to quantify the rate at which the atlantoaxial level is omitted from official cervical magnetic resonance imaging (MRI) radiologic reports and to identify potential missed pathology, emphasizing the need for improved standardization of evaluation.</p><p><strong>Summary of background data: </strong>MRI is a readily utilized modality for evaluating the axial skeleton. In our experience, the atlantoaxial level of the cervical spine is often overlooked on MRI radiologic reports in the absence of trauma or obvious pathology.</p><p><strong>Methods: </strong>The preoperative MRIs and associated radiologic reports of 219 patients undergoing cervical decompression and fusion in a single year were collected. The inclusion or omission of distinct evaluation at the atlantoaxial level within each radiologic report was recorded. All imaging was then reviewed. The atlantoaxial level was specifically evaluated, and any pathology was noted and compared with the official radiologic reports. The rates of atlantoaxial evaluation omission from the radiologic reports and missed pathology at this level were primarily and secondarily reported.</p><p><strong>Results: </strong>MRI studies were performed at 101 different institutions, with reports issued by 126 individual radiologists. Specific documentation of atlantoaxial evaluation was noted in 32 (14.6%) radiology reports, with the remaining 187 cases (85.4%) including no mention of this level. Upon independent re-review of the imaging, pathology was noted at the atlantoaxial level in 18 patients (8.2%), totaling 19 abnormal findings. Such findings were absent from the official reports in 13 of these cases (5.9% of the total study population).</p><p><strong>Conclusions: </strong>In our study, formal documentation was omitted from 85% of reports resulting in missed pathology in nearly 6% of cases. This study underscores the importance of thorough imaging interpretation and clinical correlation with patient symptoms. In addition, it highlights the need for standardized reporting of these studies to prevent potential morbidity associated with a missed diagnosis.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic Acid Reduces Perioperative Blood Loss in Pediatric Spinal Deformity Surgery​​​: A Retrospective Analysis in Nonidiopathic Scoliosis Patients.","authors":"Anna Bichmann, Ali E Guven, Edda Klotz, Matthias Pumberger, Friederike Schömig","doi":"10.1097/BSD.0000000000001806","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001806","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To assess the efficacy of tranexamic acid (TXA) on reducing perioperative blood loss and blood transfusion requirements in nonidiopathic scoliosis patients undergoing primary posterior spinal fusion.</p><p><strong>Summary of background data: </strong>Posterior spinal fusion for correcting scoliosis in pediatric patients is associated with substantial volumes of perioperative blood loss and high transfusion requirements. Patients with nonidiopathic scoliosis typically experience greater blood loss than those with idiopathic scoliosis.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent primary posterior fusion for nonidiopathic scoliosis between November 2014 and December 2020. Patients were assigned to the TXA or no-TXA group depending on intraoperative administration of TXA.</p><p><strong>Results: </strong>Despite longer surgical duration (P=0.009) and more spinal levels fused (P=0.014), perioperative blood loss [2602 (810-9262) mL in the TXA group vs. 2058 (1019-4170) mL in the no-TXA group, P=0.554] and allogenic red blood cell transfusion rates (63% in the TXA group vs. 55% in the no-TXA group, P=0.508) were similar in the TXA and the no-TXA groups. After adjustments, TXA administration was found to have a significant negative effect on estimated blood loss (Est=-513.73, 95% CI=-925.41 to 125.3, P=0.045).</p><p><strong>Conclusions: </strong>Significant perioperative blood loss and high transfusion rates remain a challenge in the surgical treatment of nonidiopathic scoliosis patients. Given the demonstrated negative effect of TXA on estimated blood loss, its routine application may be considered in the perioperative blood management of pediatric nonidiopathic scoliosis patients.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complication, Readmission, Intensive Care Unit Admission, and Revision Incidence Following Anterior Cervical Discectomy and Fusion Surgery in End-stage Renal Disease and Renal Transplant Patients.","authors":"Spencer Smith, Mackenzie Kelly, Won Hyung A Ryu, Jonathan Kark, Josiah Orina, Travis Philipp, Jung Yoo","doi":"10.1097/BSD.0000000000001785","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001785","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cross-sectional study aimed to investigate the postoperative outcomes following anterior cervical discectomy and fusion (ACDF) surgery in patients with end-stage renal disease (ESRD) and renal transplant recipients, using data from a large national database. Three patient groups were analyzed: control group, ESRD group, and renal transplant group.</p><p><strong>Objective: </strong>To investigate the postoperative outcomes following ACDF surgery in patients with ESRD and renal transplant recipients, utilizing data from a large national database.</p><p><strong>Background: </strong>Patients with ESRD and renal transplant recipients face unique health challenges, and there is a paucity of comprehensive research examining their postoperative surgical experiences, especially in the context of spine surgery.</p><p><strong>Materials and methods: </strong>Data from 158,101 ACDF procedures performed between 2016 and 2019 were analyzed. Patients were stratified into 3 groups: control, end-stage renal failure, and renal transplant. The primary outcomes included 30-day medical complications, 30-day intensive care unit admissions, 90-day readmissions, and 1-year revision surgery. Multivariable logistic regression was employed for analysis.</p><p><strong>Results: </strong>Patients with ESRD had significantly higher rates of 30-day medical complications (56%) and 90-day readmissions (38%) compared with the control patients (3% and 3%, respectively). Renal transplant patients also showed elevated rates of medical complications and readmissions, 12% and 10%, respectively, but lower than patients with ESRD. Patients with ESRD had significantly higher odds of intensive care unit admission. There were no significant differences in revision rates among the groups.</p><p><strong>Conclusions: </strong>Patients with ESRD and renal transplant recipients undergoing ACDF surgery face increased risks of medical complications and readmissions, with patients with ESRD showing surprisingly high rates. Tailored care strategies and close monitoring are crucial for these patient cohorts, emphasizing the need for specialized postoperative care. The study's findings highlight the multifaceted nature of surgical outcomes in medically complex populations and the importance of holistic assessment.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of RAPT Score in Predicting Discharge Disposition in Patients Undergoing Spine Surgery Within an Enhanced Recovery After Surgery Program.","authors":"Susanna D Howard, Rachel Pessoa, Lauren Costello, Menekse Silpagar, Diana Gardiner, Ujwala Tambe, Scott Rushanan, Disha Joshi, Jessica Nguyen, Dominick Macaluso, Neil R Malhotra, William Welch, Zarina S Ali","doi":"10.1097/BSD.0000000000001810","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001810","url":null,"abstract":"<p><strong>Study design: </strong>This is a retrospective cohort study.</p><p><strong>Objective: </strong>The primary objective was to determine the accuracy of the Risk Assessment and Prediction Tool (RAPT) score-based discharge disposition prediction among patients undergoing spine surgery within an Enha Recovery After Surgery (ERAS) program. The secondary objective was to determine if using RAPT to initiate preoperative referrals to home services expedited care.</p><p><strong>Summary of background data: </strong>The RAPT score has been applied to spine surgery patients but has not been validated among participants in an ERAS program.</p><p><strong>Methods: </strong>All patients undergoing elective spine surgery within an ERAS program over a 1-year period received a preoperative social work evaluation incorporating the generation of RAPT score. Patients predicted to be discharged home with services received a preoperative referral for home services. The predicted versus actual discharge destination was compared, and the association of preoperative home services referral with the timing of home services initiation was assessed.</p><p><strong>Results: </strong>Four hundred eight patients received a preoperative social work evaluation with RAPT score calculation. Two hundred seven (50.7%) patients had an accurately predicted postoperative discharge disposition based on RAPT score. Among the patients who received home services following discharge, the mean time to receipt of home services was shorter among patients who had a correct discharge disposition prediction compared with patients who had an incorrect prediction, but this difference was not statistically significant [31.3 (SD: 15.6) vs. 42.0 h (SD: 44.2), P=0.24].</p><p><strong>Conclusions: </strong>This study supports the feasibility of integrating RAPT score calculation into a preoperative social work evaluation. However, the traditional tiers of RAPT scores had limited accuracy in predicting discharge disposition in this cohort of patients undergoing spine surgery within an ERAS program.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Far Lateral Tubular Microdiscectomy for Extraforaminal, Foraminal, and Lateral Recess Acute Disc Herniation: Surgical Technique.","authors":"Anthony Minh Tien Chau, Aaron Lerch, Amir Amiri, Jason McMillen","doi":"10.1097/BSD.0000000000001793","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001793","url":null,"abstract":"<p><strong>Study design: </strong>We present a 7-minute stepwise instructional video alongside a detailed technical report defining our surgical approach.</p><p><strong>Objective: </strong>We outline our technique for tubular far lateral microdiscectomy for the treatment of a soft extraforaminal, foraminal, and lateral recess disc herniation, avoiding the need for spinal fusion.</p><p><strong>Summary of background data: </strong>This technique relies on a suitable soft disc consistency.</p><p><strong>Methods: </strong>We demonstrate this with a case of a 50-year-old woman presenting with 1 month of acute onset L3 radiculopathy and weakness that is refractory to a cortisone block. Our step-by-step guide, presented in both video and written format, illustrates a specific situation where this technique may be applicable.</p><p><strong>Results: </strong>The patient presented in this case was discharged home the following day, achieved full symptom resolution, and return of normal power/mobility, with sustained clinical outcome at 6 weeks follow-up.</p><p><strong>Conclusions: </strong>The careful preoperative consideration of patients to select a suitable disc consistency allows the effective implementation of this technique to achieve excellent outcomes and avoid spinal fusion.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Identifying and Resolving the Challenges to the Prognostic Validation of the Classifications for Thoracolumbar Burst Fractures: A Narrative Review.","authors":"Mohamed M Aly, Mohammad El-Sharkawi, Andrei F Joaquim, Javier Pizones, Xavier A Santander Espinoza, Eugen C Popescu, Abdulaziz Bin Shebree N, Paul Gerdhem, Cumhur F Öner","doi":"10.1097/BSD.0000000000001764","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001764","url":null,"abstract":"<p><strong>Objective: </strong>To review the historical thoracolumbar burst fractures (TLBFs) classifications and discuss the probable gaps for their clinical validation.</p><p><strong>Summary of background data: </strong>Despite multiple classification schemes, the treatment decisions for TLBFs in neurologically intact patients remain controversial. There are gaps between the current classifications and their predictive validation.</p><p><strong>Methods: </strong>A narrative literature review.</p><p><strong>Results: </strong>The potential barriers to establishing the predictive value of the current classifications of TLBFs could be connected to validation studies' flaws such as nonvalidated outcome measures and challenges of randomization. It could also be related to limited interobserver reliability in diagnosing A3/A4 fractures. Finally, it might be attributed to the inability to incorporate all prognostic variables, such as computed tomography (CT) parameters, patient-related factors, and traumatic disc injury, may result in failed validation.</p><p><strong>Conclusion: </strong>AOSpine Patient and Clinical Reported Outcome Spine Trauma (PROST) and a recently proposed natural experiment observational study hold promise for mitigating methodological challenges. A structured approach for distinguishing A3/A4 fractures and standardized CT criteria for PLC injury is critical to improving reliability. Finally, a treatment algorithm incorporating all potential prognostic variables, independent of the morphologic classification, may improve the predictive value of the classification. Machine learning techniques could be helpful in this context.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Safety and Efficacy of Unilateral Biportal Endoscopy Combined With Oblique Lumbar Interbody Fusion in the Treatment of Lumbar Infectious Spondylitis.","authors":"Zhiyuan Dai, Haomiao Yang, Yinjia Yan, Shuhe Zhu, Weiqing Qian","doi":"10.1097/BSD.0000000000001802","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001802","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Objective: </strong>To explore the clinical efficacy and safety of unilateral biportal endoscopy (UBE) combined with oblique lumbar interbody fusion (OLIF) in the treatment of lumbar infectious spondylitis (LIS).</p><p><strong>Background: </strong>In recent years, there has been a notable increase in the incidence of LIS. Patients typically present with back pain, tenderness, and stiffness, which may be accompanied by fever, which significantly reduces their quality of life.</p><p><strong>Patients and methods: </strong>This study selected 25 patients with LIS treated by UBE with OLIF from January 2018 to March 2023 in our hospital, including 14 males and 11 females. During the perioperative phase, key indicators such as white blood cell count, erythrocyte sedimentation rate, and C-reactive protein were monitored to evaluate the efficacy of the infection treatment. Surgical-related indicators and the frequency of complications were systematically recorded. Functional and imaging indicators before and after the operation were compared.</p><p><strong>Results: </strong>The surgical intervention was successful in all 25 patients. The average operation time was 155.2 ± 23.5 minutes, the average blood loss was 265.6 ± 46.8 mL, and the average follow-up time was 18.8 ± 6.9 months. Bacterial cultures of 12 patients were positive, and postoperative pathologic examination of all patients showed inflammation. Postoperative patients exhibited significant clinical symptom improvement, characterized by a gradual decrease in erythrocyte sedimentation rate, C-reactive protein, and white blood cell count, ultimately returning to normal levels. The Visual Analog Scale scores, Japanese Orthopedic Association scores, and Oswestry Disability Index were significantly improved after the operation (P < 0.001). In addition, the height of the intervertebral space and the angle of lumbar lordosis were optimally restored. At the last follow-up, the fusion rate of bone graft was 96%.</p><p><strong>Conclusion: </strong>The combined treatment of LIS with UBE and OLIF is effective, thereby establishing itself as an effective, safe, and viable surgical technique.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}