Clinical Spine Surgery最新文献

{"title":"Are Expandable Cages the Ideal Implant for Use During Transforaminal Lumbar Interbody Fusion?","authors":"Blake Salfer, Madelyn Anderson, Alec Thingvold, Thomas Kroymann, Cale Hendricks, Lauren M Boden, William Sheppard, Matthew Davies, Taylor Paziuk","doi":"10.1097/BSD.0000000000002171","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002171","url":null,"abstract":"","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016121","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":"Association Between Preoperative Prognostic Nutritional Index and Delirium After Spine Surgery in the Elderly: A Retrospective Analysis.","authors":"Hyongmin Oh, Hoo Seung Lee, Suk Hyung Choe, Ji-Yoon Jung, Kyung Won Shin, Hyung-Chul Lee, Hee-Pyoung Park, Youn Joung Cho","doi":"10.1097/BSD.0000000000002168","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002168","url":null,"abstract":"<p><strong>Study design: </strong>This is a retrospective case-control study.</p><p><strong>Objective: </strong>This study hypothesized that a low preoperative prognostic nutritional index (PNI) would increase the risk of postoperative delirium in such patients and aimed to prove it.</p><p><strong>Summary of background data: </strong>Postoperative delirium in elderly patients results in prolonged hospitalization and an increased burden of medical costs. Preoperative PNI is associated with perioperative adverse outcomes following major surgery. However, its independent association with postoperative delirium remains underexplored in elderly patients undergoing spine surgery.</p><p><strong>Methods: </strong>Perioperative data of 711 patients (age 65 y or older) who underwent spine surgery were retrospectively analyzed. Based on the optimal cutoff value (47.8) of preoperative PNI, patients were classified into the high (n=512) and the low (n=199) PNI groups. To balance baseline characteristics between the 2 groups, stabilized inverse probability weighting (SIPW) was applied, and logistic regression analysis was performed to evaluate the relationships between preoperative PNI and postoperative delirium.</p><p><strong>Results: </strong>Postoperative delirium developed in 40/711 (5.6%) patients. The incidence of postoperative delirium was markedly higher in the low PNI group than in the high PNI group both before [25 (12.6%) vs. 15 (2.9%), P<0.001] and after [20 (10.1%) vs. 15 (2.9%), P<0.001] SIPW. In logistic regression analysis after SIPW, preoperative PNI <47.8 was associated with increased risk of postoperative delirium [adjusted odds ratio: 3.57 (95% CI: 1.80-7.09), P<0.001].</p><p><strong>Conclusions: </strong>A low preoperative PNI is an independent predictor of postoperative delirium in elderly patients undergoing spine surgery.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023907","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":"Neoplasms of the Cervical Spine: Diagnostic Workup and Clinical Decision-making Algorithms.","authors":"Justin K Zhang, Andrew Coxon, Camilo Molina, Matthew F Glasser, Sama Noroozi Gilandehi, Jacob K Greenberg","doi":"10.1097/BSD.0000000000002172","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002172","url":null,"abstract":"<p><strong>Study design: </strong>Narrative review.</p><p><strong>Objective: </strong>To synthesize current evidence on diagnostics and clinical decision-making for patients with cervical spine neoplasms.</p><p><strong>Background: </strong>Although the cervical spine is disproportionately affected by primary spinal tumors and is the predominant site for intramedullary spinal cord tumors, there remains a relative paucity of reviews focused specifically on cervical spine neoplasms.</p><p><strong>Methods: </strong>PubMed and Scopus were searched using a combination of terms related to cervical spine neoplasms, classification schemas, diagnostic evaluation, staging, and clinical decision-making. Supplemental targeted searches evaluated spinal oncology staging and treatment frameworks. Reference lists of articles and major reviews were screened for additional studies.</p><p><strong>Results: </strong>Cervical spinal tumors are classified by anatomic compartment as intramedullary, intradural extramedullary, or extradural, with pathologic diagnosis described by the 2021 World Health Organization (WHO) Classification of Tumors of the Central Nervous System and the 2020 WHO Classification of Soft Tissue and Bone Tumors. Diagnosis integrates clinical symptoms with a multimodal imaging approach that incorporates magnetic resonance imaging, computed tomography, positron emission tomography/computed tomography, vascular imaging, and adjunctive modalities such as diffusion tensor imaging tractography. Tissue biopsy remains central to diagnosis, with indications, contraindications, and technique selection guided by lesion characteristics and compartment. Liquid biopsy through cerebrospinal fluid-based circulating tumor DNA analysis has also emerged as a promising minimally invasive alternative for intramedullary lesions. Clinical decision-making frameworks have evolved considerably, from early anatomic staging systems through neurological and instability assessments to modern comprehensive treatment algorithms. Multidisciplinary tumor boards are essential for integrating medical, surgical, and radiation oncology expertise and individualizing care for these patients.</p><p><strong>Conclusions: </strong>Cervical spine neoplasms are a diagnostically and therapeutically challenging subset of spinal tumors, encompassing a heterogeneous spectrum of primary and metastatic lesions. A multimodal, multidisciplinary approach is essential to optimize diagnostic accuracy, clinical decision-making, and individualized patient care.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024044","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":"Surgical Techniques for Subaxial Cervical Spine Tumors (C3-C7): Anterior, Posterior, Lateral, Circumferential, and Minimally Invasive Approaches.","authors":"Tyler M Compton, Malik Scott, Willa R Schmahl, Andre C Ferreira, Matthew W Colman","doi":"10.1097/BSD.0000000000002177","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002177","url":null,"abstract":"<p><strong>Study design: </strong>Narrative review.</p><p><strong>Objective: </strong>To provide an evidence-based review of surgical approaches to subaxial cervical spine tumors (C3-C7) emphasizing patient selection, technical pearls, and reported outcomes.</p><p><strong>Summary of background data: </strong>Cervical tumors encompass under 10% of spinal metastases yet carry disproportionate clinical significance due to highly mobile biomechanics and the surrounding structures. Primary tumors of the subaxial cervical spine present unique operative challenges that often require complex resection and reconstruction.</p><p><strong>Methods: </strong>Current peer-reviewed literature regarding anterior, posterior, posterolateral, direct lateral, circumferential, and minimally invasive surgical approaches to subaxial cervical tumors was synthesized with recommendations for preoperative planning, tumor management, and reconstruction strategies.</p><p><strong>Results and conclusions: </strong>The Smith-Robinson interval is the gold standard for direct access anterior procedures, including biopsy, en bloc resection, corpectomy, and anterior reconstruction. Posterior approaches address posterior-based tumors, intradural tumors, and resections requiring posterior release, with lateral mass and pedicle screw fixation tailored to individual anatomic features. The direct lateral approach addresses vertebra-adjacent and perineural lesions involving the transverse and neural foramina. En bloc spondylectomy is the standard for margin-negative resection of primary malignant cervical tumors. Advances in radio-chemotherapeutics, 3D-printed implants, robotic instrumentation, and minimally invasive surgery are expanding the treatment options within cervical spine oncology.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024058","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":"The Efficacy of Locoregional Anesthesia on Postoperative Pain After Spine Surgery: A Systematic Review and Meta-Analysis.","authors":"Giuseppe Francesco Papalia, Fabrizio Russo, Giuseppe Pascarella, Alessandro Ruggiero, Sabrina Migliorelli, Marta Di Folco, Alessandro Strumia, Massimiliano Carassiti, Gianluca Vadalà, Rocco Papalia, Vincenzo Denaro","doi":"10.1097/BSD.0000000000002132","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002132","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Summary of background data: </strong>Postoperative pain management in spine surgery remains a significant challenge, often involving general anesthesia (GA) and associated complications. Locoregional anesthesia (LRA) has gained attention for its potential benefits in this context.</p><p><strong>Objective: </strong>The aim of this study was to analyze the effectiveness of LRA techniques on postoperative pain in patients undergoing spine surgery.</p><p><strong>Methods: </strong>A systematic literature search was conducted across PubMed, Scopus, and Cochrane Library, adhering to PRISMA guidelines. Inclusion criteria were randomized controlled trials (RCTs) comparing LRA techniques to GA or combined anesthesia methods in adult patients undergoing spine surgery. Studies were evaluated for procedures, interventional techniques, the Visual Analog Scale for low back pain and leg pain, the Oswestry Disability Index, cumulative analgesic dose, adverse events, and complications. Finally, 2 reviewers assessed the risk of bias of the included studies.</p><p><strong>Results: </strong>Twelve RCTs comprising 890 patients (457 in the intervention group and 433 in the comparison group) met the inclusion criteria. LRA techniques were associated with significantly reduced postoperative pain at 24 hours (MD=-0.45, 95% CI: -0.82 to -0.07; P=0.02). In addition, LRA was associated with lower analgesic consumption (OR=0.18, 95% CI: 0.11-0.31; P<0.00001) and fewer complications, such as nausea and vomiting (OR=0.41, 95% CI: 0.18-0.95; P=0.04). However, significant heterogeneity among studies was noted.</p><p><strong>Conclusion: </strong>LRA offers several advantages, including modest but statistically significant differences in pain levels, lower analgesic consumption, and a decreased incidence of complications such as nausea and vomiting compared with GA.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016074","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":"Twenty-Year Retrospective Analysis of Bone Morphogenetic Protein (BMP) Use in Anterior Cervical Fusion: Incidence of Severe Dysphagia and Airway Complications in a Single-Surgeon Study.","authors":"Brianna N Hebeka, Jennifer A Reilly, Amaya J Jones, Charles C Edwards","doi":"10.1097/BSD.0000000000002175","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002175","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective, nonrandomized.</p><p><strong>Objective: </strong>The objective of this study is to assess the incidence of severe swallowing and airway complications in patients who underwent anterior cervical discectomy and fusion (ACDF) with low-dose bone morphogenetic protein (BMP) by a single surgeon.</p><p><strong>Summary of background data: </strong>The FDA released a black box warning against the use of BMP in ACDF surgeries in 2008, but few studies have reported the incidence of complications cited in the warning. Further, few studies have longitudinally tracked the use of low-dose BMP in the cervical spine and reported complication rates. This study aims to fill a gap in the literature by providing a 20-year longitudinal review of the use of low-dose BMP by a single surgeon.</p><p><strong>Methods: </strong>The retrospective analysis assessed patients who underwent ACDF surgeries from 2003 to 2023 by a single surgeon. Patient demographics and surgical characteristics were identified. Complications, as defined by the FDA Black Box Warning, were prospectively recorded. Statistical analysis included binary logistic regressions to predict complications.</p><p><strong>Results: </strong>One thousand ten patients were included in this study. 2.2% of the patients developed a Black Box Complication. In response to these complications, 1.5% of patients received intravenous steroids, 0.2% of patients were reintubated, 0.2% of patients underwent second surgeries to drain the surgical site, and 2.1% of patients were readmitted for swallowing or airway complications. No patients required a tracheostomy.</p><p><strong>Conclusions: </strong>The complication rates of the current study are comparable to the published rates of ACDF procedures without BMP. Given the current study and the growing body of evidence supporting the safety and efficacy of low-dose BMP, categorical cautions against the use of BMP in the cervical spine should be reconsidered.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988293","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":"Cervical Chondrosarcoma: Management Strategies, Technical Considerations, and Long-Term Outcomes.","authors":"Tianyi Niu, Ziya Gokaslan","doi":"10.1097/BSD.0000000000002176","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002176","url":null,"abstract":"<p><strong>Study design: </strong>Illustrative cases with review of the literature.</p><p><strong>Objective: </strong>In this manuscript, we aim to review the current available literature on cervical spine chondrosarcoma management and present two recent illustrative cases with long-term follow-ups to highlight management strategies and surgical technical considerations.</p><p><strong>Summary of background data: </strong>Chondrosarcoma of the mobile cervical spine is exceedingly rare. Management strategies are largely based on retrospective studies and case reports. As with other malignant primary spine column tumors, en bloc resection when feasible, remains the oncologic gold standard and leads to lower local recurrence rates and better disease-free survival rates. Given the complexity of the surrounding anatomic structures, multidisciplinary and individualized approaches are often necessary when planning and executing the en bloc resections for cervical chondrosarcomas.</p><p><strong>Methods: </strong>Literature review and case reports/illustrations.</p><p><strong>Results: </strong>En bloc resection significantly decreases local recurrence and mortality for cervical chondrosarcoma when feasible. En bloc resection remains the gold standard for the treatment of spinal chondrosarcoma. Perioperative complication rates are high for cervical en bloc spondylectomies due to the complex surrounding anatomic structures. Multidisciplinary and individualized approaches are standard. Multistaged procedures are common. Lastly, modern technological advancements can be helpful in surgical planning and execution.</p><p><strong>Conclusions: </strong>Cervical chondrosarcoma is a rare disease that remains challenging. Treatment requires multidisciplinary and individualized planning and approach. Durable local control and long-term survival can be achieved with careful planning. When feasible, en bloc resection remains the gold standard.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988328","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":"Peri-Plate Gas Detected on Cervical CT as an Exploratory Imaging Indicator of Esophageal Perforation After Anterior Cervical Spine Surgery: A Single-Center Observational Study.","authors":"Seiichi Odate, Jitsuhiko Shikata, Bungo Otsuki, Kazuaki Morizane","doi":"10.1097/BSD.0000000000002170","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002170","url":null,"abstract":"<p><strong>Study design: </strong>Exploratory, single-center retrospective observational study.</p><p><strong>Objective: </strong>To evaluate candidate imaging markers associated with esophageal perforation in patients undergoing reoperative anterior cervical exploration more than 1 month after anterior cervical spine surgery (ACSS) with anterior cervical plate fixation, with particular attention to peri-plate gas on preoperative noncontrast computed tomography (CT).</p><p><strong>Summary of background data: </strong>Esophageal perforation after ACSS is a rare but potentially life-threatening complication. Preoperative recognition is important for planning multidisciplinary revision surgery, but diagnosis remains challenging in delayed revision settings because of adhesions, infection, or hardware-related changes. Although case reports have suggested that prevertebral or peri-implant gas may indicate occult esophageal communication, cohort-level evidence remains limited.</p><p><strong>Methods: </strong>We reviewed ACSS procedures with anterior cervical plate fixation performed at a single institution between April 2002 and March 2025. Patients who underwent repeat anterior cervical exploration more than 1 month after the index surgery were included in the analysis. The primary outcome was esophageal perforation confirmed preoperatively, intraoperatively, or within 48 hours after revision surgery. Candidate markers were summarized using cross-tabulated diagnostic-performance estimates, and delayed infection was defined without gas-related imaging criteria.</p><p><strong>Results: </strong>Among 1593 ACSS procedures with anterior cervical plate fixation, 39 underwent repeat anterior exploration, and 35 delayed revision cases were analyzed. Esophageal perforation was confirmed in 8 patients in the delayed-infection group. Peri-plate gas was observed in 7 patients, 6 of whom had esophageal perforation; among the 28 patients without peri-plate gas, 2 had esophageal perforation. This 2 × 2 distribution yielded 75.0% sensitivity, 96.3% specificity, 85.7% positive predictive value, 92.9% negative predictive value, and an area under the curve (AUC) of 0.856 (95% CI: 0.680-1.000).</p><p><strong>Conclusions: </strong>In this enriched cohort of delayed revision cases, peri-plate gas on noncontrast CT was a highly specific red-flag imaging finding associated with esophageal perforation. Despite limited events and cohort selection, peri-plate gas assessment may help select patients for targeted esophagography or endoscopy and early multidisciplinary preparation.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988295","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":"Anterior Cervical Approaches for 2-Level Radiculopathy: An International Survey on Surgeon Preferences Regarding Anterior Cervical Discectomy Fusion, Cervical Disc Arthroplasty, and Cervical Hybrid Constructs.","authors":"Philip K Louie, Patricia Lipson, Aiyush Bansal, K D Riew, S T Yoon, Andreas Demetriades, Sathish Muthu, Amit Jain","doi":"10.1097/BSD.0000000000002173","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002173","url":null,"abstract":"<p><strong>Study design: </strong>Anonymous, survey-based study.</p><p><strong>Objective: </strong>The primary objective of this study is to understand and assess the factors influencing the choice of cervical fusion, disc arthroplasty, and hybrid procedures for radiculopathy in the setting of 2-level cervical degenerative pathology.</p><p><strong>Summary of background data: </strong>Anterior cervical discectomy and fusion (ACDF) has long been the gold standard for treating cervical degenerative pathologies. Cervical disc arthroplasty (CDA) usage has rapidly increased over the past decade, but hybrid constructs (a combination of ACDF and an adjacent disc arthroplasty) are rarely performed.</p><p><strong>Methods: </strong>A multidimensional survey (designed using a modified Delphi approach) was distributed worldwide to surgeons in the AO Spine membership. Questions were focused on surgical preferences, challenges, and barriers with various anterior cervical techniques. Imaging studies of several patients presenting with radiculopathy and 2-level cervical degenerative pathology were presented to assess surgical recommendations.</p><p><strong>Results: </strong>A total of 267 surgeons participated in this survey, representing 5 regions worldwide. The majority of participants practice in Europe and Southern Africa (31.5%), followed by Asia Pacific (27.3%), North America (16.5%), Latin America (15.7%), and the Middle East and Northern Africa (8.9%). When presented with 2-level degenerative conditions, ACDF represents the most frequently selected individual surgical option (45.75% among the 4 clinical cases). However, substantial variability exists, with many surgeons favoring motion-preserving or hybrid approaches depending on clinical context. Preservation of motion at the index level (71.7%) and the absence of adjacent segment disease (71.7%) were considered advantages of a hybrid construct compared with a 2-level ACDF. Respondents considered that the more advantageous location of CDA would be based on the clinical scenario, with CDA preferred above the ACDF level.</p><p><strong>Conclusion: </strong>When considering anterior cervical approaches to address radiculopathy, cervical fusions remain far more commonly performed globally, compared with CDA for 2-level degenerative cervical pathology. Despite their potential advantages in preserving motion and reducing adjacent-segment degeneration, hybrid procedures are less frequently performed, and fewer surgeons consider themselves experts in this technique.</p><p><strong>Level of evidence: </strong>Level V.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988289","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":"Unilateral Biportal Endoscopic Cervical Foraminotomy: Initial Clinical Experience and Outcomes.","authors":"Ryan W Turlip, Julia Kincaid, Gnanesh Patel, Asim Handy, Richard J Chung, Richelle J Kim, Mert M Dagli, Hasan S Ahmad, Ben J Gu, Yohannes Ghenbot, Jang W Yoon","doi":"10.1097/BSD.0000000000002164","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002164","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>This study presents an initial case series evaluating the safety, feasibility, and early recovery outcomes of biportal endoscopic posterior cervical foraminotomy (UBE-PCF) for single-level decompression.</p><p><strong>Summary of background data: </strong>While endoscopic approaches have gained traction in the lumbar spine, their application in the cervical spine remains limited. Biportal endoscopic cervical decompression may improve visualization and maneuverability while minimizing tissue disruption.</p><p><strong>Methods: </strong>A retrospective review was performed of the first 17 patients who underwent one-level UBE-PCF at a single academic institution (CPT 63045 or 63020, 2023-2025). Data included demographics, comorbidities, operative details, discharge disposition, and patient-reported outcome measures (PROMs: EQ. 5D, VAS, PROMIS Physical Function, PROMIS Pain Interference, PROMIS Depression). PROMs were compared pre-postoperatively and postoperatively using paired t tests and Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>The cohort had a mean age of 50.3 years and a mean BMI of 28.5 (64.7% female). Most patients had a mild comorbidity burden (Charlson Comorbidity Index 0-2 in 76.5%; ASA II in 64.7%). Median operative time was 74 minutes (IQR: 66-83), and median length of stay was 0.46 days (IQR: 0.38-1.29), with most patients discharged the same day. Mean follow-up was 0.57 years. Postoperative PROMs showed improvement across all domains. PROMIS Pain Interference significantly decreased (pre-op 69.6±8.9 vs. post-op 60.2±9.3, P=0.041). Improvements were observed in PROMIS Physical Function (+4.1), EQ. 5D (+7.5), NDI (-13.4) and VAS pain (-0.55), though not statistically significant. PROMIS Depression trended downward (pre-op median 56.0 vs. post-op 52.0, P=0.17).</p><p><strong>Conclusion: </strong>This retrospective case series provides preliminary evidence supporting the feasibility of UBE-PCF for single-level cervical decompression. Patients experienced short operative times, minimal hospitalization, and encouraging early improvements in PROMs. These findings contribute early clinical data on UBE-PCF and support larger prospective comparative studies with longer follow-up to better define its role.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988357","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}