Clinical Spine Surgery最新文献

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Osteotomies for the Correction of Cervical Deformity: When, How, and Why? 截骨术矫正颈椎畸形:何时、如何、为何?
IF 1.7 4区 医学
Clinical Spine Surgery Pub Date : 2025-08-20 DOI: 10.1097/BSD.0000000000001895
Antonio Lobao, Samuel Rice, Sang Lee, Ryan Schiedo, Michael Stauff
{"title":"Osteotomies for the Correction of Cervical Deformity: When, How, and Why?","authors":"Antonio Lobao, Samuel Rice, Sang Lee, Ryan Schiedo, Michael Stauff","doi":"10.1097/BSD.0000000000001895","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001895","url":null,"abstract":"<p><strong>Study design: </strong>CSRS - Deformity Issue.</p><p><strong>Objective: </strong>This review focuses on the current understanding of osteotomy techniques for cervical deformity correction, with an emphasis on indications, decision-making, and surgical technique.</p><p><strong>Background: </strong>Cervical deformity is a challenging condition that often leads to significant functional impairment, including issues related to posture, pain, neurological status, and psychosocial problems. Surgical correction of these deformities, particularly through osteotomy, is a crucial part of the treatment paradigm, and osteotomy is required for significant fixed deformity.</p><p><strong>Methods: </strong>A review of the literature on osteotomy techniques, including posterior column osteotomy (PCO), pedicle subtraction osteotomy (PSO), and anterior osteotomy was conducted. Current indications, complications, and outcomes of these procedures were analyzed.</p><p><strong>Results: </strong>Cervical deformity osteotomies have evolved significantly, with techniques like PCO and PSO being central in realigning the cervical spine. The choice of technique depends on deformity characteristics, including rigidity and location, and requires a tailored approach. The cervicothoracic junction has emerged as a key region for correction.</p><p><strong>Conclusion: </strong>Osteotomy remains a powerful tool in the correction of cervical deformities, offering improvements in alignment, function, and quality of life. Future innovations in surgical planning, minimally invasive techniques, and robotics hold promise for improving outcomes and reducing complications.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945417","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}
引用次数: 0
Open Door Posterior Cervical Laminoplasty: A Step-by-Step Surgical Technique Guide by the Cervical Spine Research Society. 开放门后颈椎椎板成形术:一步一步的手术技术指南由颈椎研究学会。
IF 1.7 4区 医学
Clinical Spine Surgery Pub Date : 2025-08-18 DOI: 10.1097/BSD.0000000000001896
Rafael Garcia de Oliveira, Takeshi Fujii, Michael D Daubs, Brian W Su, Philip K Louie
{"title":"Open Door Posterior Cervical Laminoplasty: A Step-by-Step Surgical Technique Guide by the Cervical Spine Research Society.","authors":"Rafael Garcia de Oliveira, Takeshi Fujii, Michael D Daubs, Brian W Su, Philip K Louie","doi":"10.1097/BSD.0000000000001896","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001896","url":null,"abstract":"<p><strong>Study design: </strong>Surgical technique video alongside a detailed technical report.</p><p><strong>Objective: </strong>To present an open door posterior cervical laminoplasty step-by-step surgical technique guide.</p><p><strong>Summary of background data: </strong>Cervical laminoplasty is a motion-sparing surgical technique that addresses cervical myelopathy resulting from spinal cord compression, largely in a degenerative setting. This procedure decompresses the spinal cord while maintaining the integrity of posterior stabilizing structures, minimizing postoperative kyphosis, and eliminating pseudoarthrosis risk. Laminoplasty has also demonstrated superior improvement in neck disability compared with fusion, while achieving comparable long-term outcomes for functional status, pain, quality of life, and satisfaction.</p><p><strong>Materials and methods: </strong>We present an open door posterior cervical laminoplasty step-by-step guide, both video and written format, illustrating clinical scenarios where this technique may be applicable, complications, pearls and pitfalls. The full video of the surgical technique can be found at: https://www.youtube.com/watch?v=q2WVlSFcjjA.</p><p><strong>Results: </strong>Laminoplasty can be performed for cervical myelopathy secondary to cervical spondylosis, multilevel disc herniation, congenital stenosis, and ossification of the posterior longitudinal ligament. Careful preoperative evaluation of the cervical alignment is essential. The surgical technique involves a posterior midline approach, C3 laminectomy, C7 dome laminectomy, and preparation of opening and hinge troughs. Laminoplasty opening is performed, and plate reconstruction is recommended for stability. Complications reported include: C5 palsy, axial neck pain (minimized by preserving Semispinalis cervicis insertions), loss of cervical motion, and dural tear.</p><p><strong>Conclusions: </strong>Cervical laminoplasty provides effective spinal cord decompression for cervical myelopathy, yielding outstanding outcomes when performed with meticulous surgical technique. Preservation of posterior structures avoids postoperative immobilization and graft-related complications. Careful attention to each surgical step is essential for maximizing patient benefit and minimizing potential complications.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871792","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}
引用次数: 0
Early Emergency Department Visits are a Predictor of Increased Health Care Utilization Within 1 Year After Elective Spine Surgery for Degenerative Pathologies. 早期急诊科就诊是退行性脊柱手术后1年内医疗保健使用率增加的预测因子。
IF 1.7 4区 医学
Clinical Spine Surgery Pub Date : 2025-08-12 DOI: 10.1097/BSD.0000000000001870
Mark A Plantz, Jacob R Staub, Erik B Gerlach, Srikanth N Divi, Wellington K Hsu, Alpesh A Patel
{"title":"Early Emergency Department Visits are a Predictor of Increased Health Care Utilization Within 1 Year After Elective Spine Surgery for Degenerative Pathologies.","authors":"Mark A Plantz, Jacob R Staub, Erik B Gerlach, Srikanth N Divi, Wellington K Hsu, Alpesh A Patel","doi":"10.1097/BSD.0000000000001870","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001870","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objectives: </strong>The purpose of this study is to determine the incidence of and risk factors for emergency department (ED) utilization following elective spine surgery and to quantify health care utilization in this subpopulation of patients.</p><p><strong>Summary of background data: </strong>The Centers for Medicare and Medicaid Services (CMS) imposes financial penalties for unplanned 30-day hospital readmissions following the surgery. Determining predictive factors of hospital readmission and further health care utilization is a concern aligned with the values of both payers and providers to better improve patient outcomes.</p><p><strong>Methods: </strong>A total of 618 patients who underwent elective spine surgery between 2013 and 2018 at a single academic institution were identified. Demographic and surgical variables were compared between patients with and without 90-day ED visits. After propensity score matching, univariate analysis and binary logistic regression were used to identify risk factors for 90-day ED visits and compare health care utilization between groups.</p><p><strong>Results: </strong>Of the 618 included patients, 44 (7.1%) had a 90-day ED visit. Patients with ED visits were more likely to have class II obesity (P=0.043), diabetes (P=0.013), congestive heart failure (P=0.006), and a history of myocardial infarction (P=0.027). Independent risk factors were obesity, diabetes, congestive heart failure, history of myocardial infarction, and preoperative opioid use. Patients with a 90-day ED visit had increased health care utilization within 1 year postoperatively, including: more MRI studies (P=0.044), repeat ED visits (P=0.033), more urgent care visits (P=0.007), and opioid prescriptions (P=0.043).</p><p><strong>Conclusions: </strong>While only ∼7% of patients visit the ED within 90 days of spine surgery, various patient-specific factors were predictive of this. As these patients are more likely to be high health care utilizers, attention should be garnered toward preoperative patient optimization.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820708","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}
引用次数: 0
Failure to Reach Early MCID in ACDF Patients. ACDF患者未能达到早期MCID。
IF 1.7 4区 医学
Clinical Spine Surgery Pub Date : 2025-08-06 DOI: 10.1097/BSD.0000000000001824
Andrea M Roca, Fatima N Anwar, Ishan Khosla, Srinath S Medakkar, Alexandra C Loya, Arash J Sayari, Gregory D Lopez, Kern Singh
{"title":"Failure to Reach Early MCID in ACDF Patients.","authors":"Andrea M Roca, Fatima N Anwar, Ishan Khosla, Srinath S Medakkar, Alexandra C Loya, Arash J Sayari, Gregory D Lopez, Kern Singh","doi":"10.1097/BSD.0000000000001824","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001824","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The objective of this study is to identify factors of early minimal clinically important difference (MCID) failure after anterior cervical discectomy and fusion (ACDF).</p><p><strong>Summary of background data: </strong>Research on predictors of MCID failure after ACDF is limited.</p><p><strong>Methods: </strong>Patients undergoing primary, elective ACDF were selected from a single spine surgeon database. Demographics, perioperative characteristics, and Visual Analog Scale Neck (VAS-N), VAS-Arm (VAS-A), Neck Disability Index (NDI), patient-reported outcome measurement information system-physical function (PROMIS-PF), 12-item Short Form (SF-12) Mental Component Score (MCS), SF-12 Physical Component Score (SF-12 PCS), and 9-item Patient Health Questionnaire (PHQ-9) scores were collected. A 2-step multivariable logistic regression was performed to determine predictors of MCID failure.</p><p><strong>Results: </strong>A total of 240 patients were included. Preoperative VAS-N and diagnosis of foraminal stenosis were significant positive predictors of failure. Workers' compensation (WC) was a negative predictor, whereas smoker status and preoperative VAS-A were positive predictors. Preoperative PROMIS-PF, preoperative SF-12 PCS/MCS, and postoperative day 0 narcotic consumption were negative predictors, and length of stay was a positive predictor.</p><p><strong>Conclusion: </strong>The variations in follow-up compliance among spine surgery patients highlight the importance of identifying predictors of early MCID failure rates to avoid less than favorable patient experiences. In our study, we identified data to suggest that positive predictors of early failure may be associated with higher preoperative neck pain, smoker status, and longer length of stay. In comparison, negative predictors are related to WC insurance, better preoperative physical function and mental health, or postoperative narcotic consumption.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788427","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}
引用次数: 0
Immediate Procedure Reimbursement, 30-Day and 90-Day Episode Payments are Lower in Ambulatory Surgery Centers Versus Hospital Outpatient Departments for Lumbar Laminectomy. 对于腰椎椎板切除术,门诊手术中心的即时手术报销、30天和90天的治疗费用低于医院门诊。
IF 1.7 4区 医学
Clinical Spine Surgery Pub Date : 2025-08-04 DOI: 10.1097/BSD.0000000000001890
Justin Tiao, Mayuri Jain, Ryan Hoang, Alexander Yu, Jonathan J Huang, Andrew C Hecht, Brocha Z Stern, Saad Chaudhary
{"title":"Immediate Procedure Reimbursement, 30-Day and 90-Day Episode Payments are Lower in Ambulatory Surgery Centers Versus Hospital Outpatient Departments for Lumbar Laminectomy.","authors":"Justin Tiao, Mayuri Jain, Ryan Hoang, Alexander Yu, Jonathan J Huang, Andrew C Hecht, Brocha Z Stern, Saad Chaudhary","doi":"10.1097/BSD.0000000000001890","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001890","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The primary objective was to compare the immediate procedure reimbursement between ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs) for single-level and multilevel lumbar laminectomies in commercially insured patients. The secondary objectives were to compare (1) patient out-of-pocket expenditures and surgeon-specific reimbursement and (2) 30-day and 90-day episode payments between the surgery settings.</p><p><strong>Summary of background data: </strong>Lumbar laminectomy is a common treatment for lumbar spine pathology, with cases increasing annually in outpatient settings. However, there is no clear consensus on financial savings related to ASCs versus HOPDs for these procedures.</p><p><strong>Methods: </strong>The Merative MarketScan Commercial Claims and Encounters Database identified lumbar laminectomies performed at an ASC or HOPD in patients aged 18-64. Immediate procedure reimbursement, surgeon reimbursement, and 30-day and 90-day payments were constructed from gross payments; corresponding patient out-of-pocket expenditures were extracted. Multivariable regression models estimated adjusted between-setting mean differences and 95% confidence intervals.</p><p><strong>Results: </strong>After matching, the single-level cohort included 699 patients (36.9% ASCs), and the multilevel cohort included 694 patients (36.0% ASCs). In multivariable models, the adjusted mean of immediate procedure reimbursement was lower for ASCs (single-level: -$2492, P=0.001; multilevel: -$5629, P<0.001). Surgeon reimbursement was higher for single-level procedures in ASCs ($911, P<0.001). Payments were lower for ASCs in the 30-day period (single-level: -$4354, P<0.001; multilevel: -$7781, P<0.001) and 90-day period (single-level: -$3757, P<0.001; multilevel: -$8465, P<0.001).</p><p><strong>Conclusions: </strong>Immediate procedure reimbursement, 30-day and 90-day payments were lower for ASCs versus HOPDs. Surgeon reimbursement was higher in ASCs for single-level while no difference was observed for multilevel procedures. These findings highlight the potential for savings from performing lumbar laminectomies in ASCs versus HOPDs for commercially insured patients.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783659","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}
引用次数: 0
Comparison of Anterior Surgery Versus Posterior Surgery for the Treatment of Multilevel Cervical Spondylotic Myelopathy: A Meta-Analysis. 前路手术与后路手术治疗多节段脊髓型颈椎病的比较:荟萃分析。
IF 1.6 4区 医学
Clinical Spine Surgery Pub Date : 2025-08-01 Epub Date: 2025-03-13 DOI: 10.1097/BSD.0000000000001778
Xiaoming Bao, Kun Ren, Weidong Guo, Xiaoping Zhang, Xin Dong, Kang Yan, Huanhuan Qiao, Haien Zhao, Bo Liao
{"title":"Comparison of Anterior Surgery Versus Posterior Surgery for the Treatment of Multilevel Cervical Spondylotic Myelopathy: A Meta-Analysis.","authors":"Xiaoming Bao, Kun Ren, Weidong Guo, Xiaoping Zhang, Xin Dong, Kang Yan, Huanhuan Qiao, Haien Zhao, Bo Liao","doi":"10.1097/BSD.0000000000001778","DOIUrl":"10.1097/BSD.0000000000001778","url":null,"abstract":"<p><strong>Study design: </strong>A meta-analysis.</p><p><strong>Objective: </strong>To evaluate the impact of anterior versus posterior surgical approaches on outcomes in MCSM.</p><p><strong>Background: </strong>Multilevel cervical spondylotic myelopathy (MCSM) is the most common cause of spinal cord dysfunction, and the clinical effectiveness of anterior versus posterior surgical approaches remains elusive.</p><p><strong>Methods: </strong>A comprehensive search was conducted across electronic databases, including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, to evaluate the effects of anterior surgery versus posterior surgery on outcomes, such as Japanese Orthopedic Association (JOA) score, neck disability index (NDI) score, neck visual analog scale (VAS), blood loss, operation time, length of stay, cervical range of motion, cervical Cobb angle, and complications. The baseline characteristics of the included studies were assessed using the Newcastle-Ottawa Scale score to measure the risk of bias.</p><p><strong>Results: </strong>In this meta-analysis, 14 retrospective and 6 prospective cohort studies, involving 2712 patients, were included. The analysis indicated no significant difference between the 2 groups in preoperative JOA score, postoperative JOA score, JOA recovery rate, postoperative neck VAS score, operation time, preoperative range of motion (ROM), or SF-36 score ( P =0.95, 0.15, 0.20, 0.31, 0.94, 0.33, and 0.43, respectively). However, the NDI score and blood loss were significantly lower in the anterior surgery group compared with the posterior surgery group ( P <0.04, P =0.0003). The anterior surgery group was also associated with shorter length of stay ( P <0.00001), while had higher rates of complications ( P =0.04). C2-7 Cobb angle and postoperative ROM were significantly lower in the anterior surgery group than those in the posterior surgery group ( P =0.0002 and 0.01, respectively).</p><p><strong>Conclusion: </strong>This meta-analysis found no clear advantage of 1 surgical approach over the other for MCSM in terms of neurological function recovery, as measured by JOA scores. The anterior approach was associated with improved NDI scores, lower blood loss, shorter length of stay, and better recovery of cervical lordosis, accompanied by limited postoperative mobility. Careful consideration should be given to potential complications, including dysphagia with the anterior surgery, axial pain, and C5 palsy with the posterior surgery.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"333-344"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Single Incision Posteromedial to Ventrolateral (PML) Surgical Technique for Minimally Invasive Sacroiliac Joint Fusion. 微创骶髂关节融合术的单切口后内侧至腹外侧(PML)手术技术。
IF 1.6 4区 医学
Clinical Spine Surgery Pub Date : 2025-08-01 Epub Date: 2025-06-20 DOI: 10.1097/BSD.0000000000001867
Babajide Ogunseinde
{"title":"Single Incision Posteromedial to Ventrolateral (PML) Surgical Technique for Minimally Invasive Sacroiliac Joint Fusion.","authors":"Babajide Ogunseinde","doi":"10.1097/BSD.0000000000001867","DOIUrl":"10.1097/BSD.0000000000001867","url":null,"abstract":"<p><strong>Summary of background data: </strong>Sacroiliac joint fusion transfixing procedures place implants across 3 bone cortices. The most studied trajectory is lateral to medial. While the safety and effectiveness of this trajectory have been well documented, concerns of vascular injury involving the branches of the SGA over the lateral ilium have been raised. In heavier patients, a straight lateral-to-medial trajectory frequently requires traversing through a significant amount of soft tissue. While the posterolateral transfixing trajectory decreases the amount of soft tissue dissection, concerns of inferior patient outcomes and biomechanical stability have been published. Herein, we describe a new transfixing procedure for SIJ fusion with implants starting on the dorsal sacrum with a posteromedial to ventrolateral (sacro-alar iliac) implant trajectory.</p><p><strong>Methods: </strong>A case video of posteriomedial to ventrolateral SIJ fusion demonstrates the operative technique and is accompanied by a step-by-step description of this technique. Four cases are presented.</p><p><strong>Conclusions: </strong>The posteromedial to ventrolateral operative trajectory allows for minimally invasive bilateral SIJ fusion through a single incision with minimal tissue disruption and avoids branches of the superior gluteal artery.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"319-325"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Prospective Study on Gait Impairment in Patients With Symptomatic Lumbar Canal Stenosis and Impact of Surgical Intervention on Gait Function. 症状性腰椎管狭窄症患者步态障碍及手术干预对步态功能影响的前瞻性研究
IF 1.6 4区 医学
Clinical Spine Surgery Pub Date : 2025-08-01 Epub Date: 2024-11-27 DOI: 10.1097/BSD.0000000000001752
Aman Verma, Pankaj Kandwal, Aditya K S Gowda, Rajkumar Yadav
{"title":"A Prospective Study on Gait Impairment in Patients With Symptomatic Lumbar Canal Stenosis and Impact of Surgical Intervention on Gait Function.","authors":"Aman Verma, Pankaj Kandwal, Aditya K S Gowda, Rajkumar Yadav","doi":"10.1097/BSD.0000000000001752","DOIUrl":"10.1097/BSD.0000000000001752","url":null,"abstract":"<p><strong>Study design: </strong>Prospective observational cohort study.</p><p><strong>Objective: </strong>To analyze the effect of decompression surgery on gait characteristics in patients with stenosis. Also, to test the hypothesis that patient-reported functional outcomes and gait parameters (spatiotemporal, kinetic, and kinematic measures) will improve postoperatively and achieve normal values when compared with matched healthy controls.</p><p><strong>Summary of background data: </strong>Lumbar spinal stenosis is one of the leading causes of disability among elderly population. Gait impairment is one of the primary symptoms of degenerative conditions involving lumbar spine. Research suggests that decompressive surgery can positively influence gait parameters in patients with spinal stenosis. Studies have shown improvements in walking speed, stride length, and balance post-surgery.</p><p><strong>Methods: </strong>Thirty-two patients with single-level lumbar stenosis and 32 healthy volunteers were prospectively recruited. All patients underwent gait analysis preoperatively and 6 months postoperatively as per standard protocol. Spatiotemporal, kinematic, and kinetic parameters were analyzed. Stepwise linear regression models were used to detect significant relationships between changes in functional score (Visual Analogue Scale/Oswestry Disability Index) and gait parameters.</p><p><strong>Results: </strong>Significant improvement was noted in functional scores( P <0.05) 6 months post-surgery. Spatiotemporal (swing phase, mean velocity, cadence, stride length, step length, and step width) and kinetic parameters (hip, knee, and ankle power) were significantly better after surgery, reaching normal levels. Kinematic parameters significantly improved after surgery but did not reach normal levels when compared with controls. A significant correlation was found between changes in functional scores with changes in certain kinematic parameters (knee-power, ankle plantarflexion, swing time, peak ankle dorsiflexion in swing, peak-hip, and knee flexor moment).</p><p><strong>Conclusion: </strong>Decompression surgery in lumbar stenosis produces improvement in gait parameters, pain scores, and functional outcomes that significantly improve gait posture and speed.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E404-E411"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726449","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}
引用次数: 0
The Risk of Intravenous Cement Leakage and Short-term Outcomes of Selective Cement-augmented Pedicle Screws: A Multicenter Retrospective Study. 选择性骨水泥增强椎弓根螺钉静脉内骨水泥渗漏的风险和短期疗效:一项多中心回顾性研究。
IF 1.6 4区 医学
Clinical Spine Surgery Pub Date : 2025-08-01 Epub Date: 2024-12-30 DOI: 10.1097/BSD.0000000000001757
Shinji Takahashi, Daisuke Sakai, Shota Ogasawara, Ryo Sasaki, Masato Uematsu, Takahiko Hyakumachi, Akihiko Hiyama, Hiroyuki Katoh, Hidetomi Terai, Akinobu Suzuki, Koji Tamai, Hiroaki Nakamura, Mitsuru Yagi
{"title":"The Risk of Intravenous Cement Leakage and Short-term Outcomes of Selective Cement-augmented Pedicle Screws: A Multicenter Retrospective Study.","authors":"Shinji Takahashi, Daisuke Sakai, Shota Ogasawara, Ryo Sasaki, Masato Uematsu, Takahiko Hyakumachi, Akihiko Hiyama, Hiroyuki Katoh, Hidetomi Terai, Akinobu Suzuki, Koji Tamai, Hiroaki Nakamura, Mitsuru Yagi","doi":"10.1097/BSD.0000000000001757","DOIUrl":"10.1097/BSD.0000000000001757","url":null,"abstract":"<p><strong>Study design: </strong>Multicenter retrospective cohort study.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of using cement-augmented pedicle screw (CAPS) fixation only for the cephalad and caudal vertebral bodies.</p><p><strong>Summary of background data: </strong>Pedicle screw fixation is less effective in patients with low-quality bone. Although CAPS fixation has shown promise in improving stability and reducing screw loosening in such cases, cement leakage can have serious consequences.</p><p><strong>Methods: </strong>This study included 65 patients who underwent spinal surgery using CAPS and were followed up for >3 months. Four CAPSs were used in each patient, and 254 CAPSs were included in the analysis.</p><p><strong>Results: </strong>Of the 65 patients, 36.9% showed intravenous cement leakage, and a low bone mineral density (BMD) was associated with a higher risk of cement leakage. The use of a CAPS on the right side was also potentially associated with a higher risk of leakage. However, the shape and location of the leaked cement remained stable over time. Screw loosening occurred in 3.5% of the CAPSs and was associated with a lower cement volume.</p><p><strong>Conclusion: </strong>Cement leakage was related to lower BMD. Using CAPS exclusively at the lower or upper instrumentation levels might minimize the risk of cement leakage in osteoporotic patients.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E419-E424"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945917","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}
引用次数: 0
A Correlation Among the Most Classic Axis Injuries Classification and the New AO Upper Cervical Spine Classification System. 最经典椎轴损伤分类与新AO上颈椎分类系统的相关性研究。
IF 1.6 4区 医学
Clinical Spine Surgery Pub Date : 2025-08-01 Epub Date: 2025-03-05 DOI: 10.1097/BSD.0000000000001780
Andrei F Joaquim, Rajkishen Narayan, Gregory D Schroeder, Alexander R Vaccaro
{"title":"A Correlation Among the Most Classic Axis Injuries Classification and the New AO Upper Cervical Spine Classification System.","authors":"Andrei F Joaquim, Rajkishen Narayan, Gregory D Schroeder, Alexander R Vaccaro","doi":"10.1097/BSD.0000000000001780","DOIUrl":"10.1097/BSD.0000000000001780","url":null,"abstract":"<p><strong>Study design: </strong>Narrative review.</p><p><strong>Objective: </strong>To establish a correlation among the classic C2 classification systems and the new AO upper cervical spine trauma classification system (UCST).</p><p><strong>Summary of background data: </strong>A multitude of classifications were historically proposed for C2 injuries, none of them with universal acceptation. The new UCST incorporated elements of these prior classifications into this new system to improve their limitations.</p><p><strong>Methods: </strong>Eight classic C2 classification systems-Anderson and D´Alonzo, Roy-Camille, Hadley et al, Grauer et al, Effendi et al, Levine and Edwards, Burke and Harris and Benzel et al were evaluated, and their injury types/subtypes were classified according to the new AO UCST.</p><p><strong>Results and conclusions: </strong>Most of the injuries were classified as type A in accordance with the new UCST, suggesting that most of the detailed descriptions of specific bone injury patterns may not be implied in different treatment strategies, being treated non-surgical. Those with ligamentous injury (type B) were attributed to some injuries with ligamentous/disc disruption without clear dislocations (type C when dislocations were present). This correlation between the classic morphologies and the new AO UCST may improve the understanding of injury patterns and help in the decision of the best treatment.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"309-318"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555964","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}
引用次数: 0
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