Clinical Spine Surgery最新文献

{"title":"Can a Simple Smartphone Be a Cornerstone in School Health Screening Program for Detecting Scoliosis in Resource-Poor Developing Countries? Revisiting the \"Scoliometer\".","authors":"Saptarshi Barman, Nikhil Goyal, Shivam Bansal, Anil Regmi, Bishwa B Niraula, Aman Verma, Vishal Verma, Vivek Singh, Pankaj Kandwal","doi":"10.1097/BSD.0000000000002166","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002166","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional observational analytical study.</p><p><strong>Objective: </strong>A scoliometer is an inclinometer that quantifies rib hump. It is now possible to use various apps which can methodically function same as a scoliometer. In our study, we revisit the reliability, validity of scoliometer; its correlation with various app-based digital inclinometers and try to extrapolate the role of digital inclinometers in the overall diagnostic accuracy of scoliosis.</p><p><strong>Summary of background data: </strong>Scoliometer is a well-tested instrument for screening of scoliosis for decades. But whether various digital applications can be used for the same is not very clear.</p><p><strong>Methods: </strong>An observational study was conducted on patients with Juvenile and Adolescent Idiopathic Scoliosis. Two independent observers noted 3 scoliometer values separately. Cobbs angle, apical vertebral rotation (Nash-Moe grading and CT), and SRS-22r questionnaire were also noted. The accuracy and reliability of app-based digital inclinometers were also analysed. All the values were compared statistically.</p><p><strong>Results: </strong>The interobserver agreement for scoliometer instrument and app-based digital inclinometers were found strong to substantial, respectively. A strong positive correlation exists between the scoliometer and digital inclinometers from the same patients. Except for the SRS-22r score, which has a substantial negative correlation, all radiologic parameters have a substantial to strong positive correlation. A mathematical formula was also derived between scoliometer values and Cobb angle. On the basis of that a suitable referral criterion of 7-degree of digital/manual scoliometer value to a higher center was suggested.</p><p><strong>Conclusion: </strong>Scoliometer and app-based digital inclinometers have a strong predictive power to measure the degree of deformity in scoliosis. If incorporated into the latest School Health Screening Programs, these instruments have the potential to decrease the overall burden of scoliosis in society.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988341","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":"Biomechanical Analysis of Expandable Interbody Cage Stiffness, Force Exertion, and Subsidence in the Setting of Spondylolisthesis.","authors":"Junho Song, Austen D Katz, Samuel K Cho, Andrew C Hecht, Sheeraz A Qureshi, Sohrab Virk","doi":"10.1097/BSD.0000000000002165","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002165","url":null,"abstract":"<p><strong>Study design: </strong>Biomechanical laboratory study.</p><p><strong>Objective: </strong>To determine how simulated spondylolisthesis grade affects expansion stiffness, force generation, and subsidence of an expandable transforaminal lumbar interbody fusion (TLIF) cage in a vertebral body surrogate model.</p><p><strong>Summary of background data: </strong>Expandable TLIF cages allow low-profile insertion with in situ height restoration. However, concerns regarding endplate violation and subsidence remain. The effect of intervertebral translation on expansion mechanics is unknown.</p><p><strong>Methods: </strong>An expandable TLIF cage was tested between paired cortical shell blocks of polyurethane foam. The superior block was positioned at 0%, 35%, or 50% anterior translation relative to the inferior block. Five independent trials were performed per condition using new cages and block surfaces. Cage expansion was performed using the manufacturer's inserter, connected to a digital torque gauge and an electrodynamic test frame that recorded axial force. Outcomes included expansion stiffness (force-displacement slope from 100-200 N), force-to-torque ratio (force-torque slope), and subsidence depth (block displacement adjusted for cage height change). Outcomes were compared using one-way analysis of variance with post hoc testing.</p><p><strong>Results: </strong>Increasing translation altered cage mechanics. Expansion stiffness increased with slip grade, whereas force-to-torque ratio decreased, indicating that greater torque was required to generate additional axial force in higher-slip conditions. Subsidence depth at matched torque decreased nearly linearly with increasing spondylolisthesis, with the 50% condition demonstrating less endplate penetration than the 0% condition.</p><p><strong>Conclusions: </strong>In this benchtop model, intervertebral translation influenced the mechanics of the expandable TLIF cage. Higher-slip conditions exhibited greater expansion stiffness, lower force-generation efficiency, and less subsidence at a given torque. Slip severity should be considered along with bone quality and cage design when interpreting tactile feedback and assessing endplate risk during cage expansion.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988344","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":"Predictors of Non-home Discharge in Elderly Patients Undergoing Multilevel Anterior Cervical Discectomy and Fusion Procedures.","authors":"Haseeb E Goheer, Brian J Bao, Richard X Feng, Taral K Jella, Scott D Semelsberger, Kevin Z Black, Jonathan J Carmouche","doi":"10.1097/BSD.0000000000002160","DOIUrl":"10.1097/BSD.0000000000002160","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The study aimed to identify perioperative variables associated with non-home discharge in elderly patients undergoing anterior cervical discectomy and fusion.</p><p><strong>Summary of background data: </strong>Anterior cervical discectomy and fusion (ACDF) is the most common cervical spine surgery in the United States, with procedures projected to increase, particularly among elderly patients. Discharge disposition after surgery impacts outcomes and cost, but predictors of non-home discharge in elderly patients undergoing multilevel ACDF remain underexplored.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was retrospectively queried to identify elderly patients undergoing multilevel ACDF procedures between 2011 and 2023. Multivariable logistic regression was used to identify independent predictors of non-home discharge. Restricted cubic spline models assessed nonlinear associations for continuous variables.</p><p><strong>Results: </strong>Among 10,565 elderly patients undergoing multilevel ACDF procedures, 800 patients (7.6%) were discharged to non-home facilities. Older age (OR=1.103 per year, 95% CI: 1.087-1.119, P <0.001), female sex (OR=1.310, 95% CI: 1.119-1.534, P <0.001), Black race (OR=2.186, 95% CI: 1.743-2.727, P <0.001), operative time (OR=1.045 per 10 min, 95% CI: 1.034-1.056, P <0.001), inpatient admission (OR=5.189, 95% CI: 4.016-6.816, P <0.001), diabetes (non-insulin-dependent OR=1.291, 95% CI: 1.057-1.572, P =0.012; insulin-dependent OR=1.682, 95% CI: 1.313-2.141, P <0.001), and functional dependence (partially dependent OR=6.232, 95% CI: 4.629-8.368; totally dependent OR=7.147, 95% CI: 2.642-19.85; P <0.001) were independent predictors of non-home discharge. Spline models revealed nonlinear associations for age ( P =0.034) and BMI ( P <0.001), with elevated risk at both BMI extremes, but no nonlinearity for operative time ( P =0.835).</p><p><strong>Conclusion: </strong>Older age, female sex, Black race, longer operative time, inpatient admission, diabetes, and functional dependence were identified as independent predictors of non-home discharge in elderly patients undergoing multilevel ACDF. These findings can be used to improve risk stratification and informed consent for elderly patients undergoing multilevel ACDF procedures.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988300","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":"Medial Pedicle Wall Referencing Extra-pedicular (EP) Screw Insertion Technique in Narrow Dysplastic Pedicles During Posterior Spinal Fusion (PSF) in Adolescent Idiopathic Scoliosis (AIS) Patients.","authors":"Saturveithan Chandirasegaran, Chris Yin Wei Chan, Chee Kidd Chiu, Mun Keong Kwan","doi":"10.1097/BSD.0000000000002161","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002161","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objectives: </strong>To describe technique of medial pedicle wall referencing extra-pedicular (EP) screw insertion method. To compare the EP chord length of this technique with the conventional technique in adolescent idiopathic scoliosis (AIS) patients and report the accuracy of this technique based on computed tomography (CT) assessment.</p><p><strong>Summary of background data: </strong>Conventional EP screw technique has a high medial convergence angle, which increases the difficulty of entry into vertebral body, increasing the risk of anterior perforations. Lateral entry point requires more extensive dissection. A lateral starting point leads to malalignment of the screw heads when placed next to intra-pedicular screws.</p><p><strong>Methods: </strong>A total of 103 AIS patients who had undergone posterior spinal fusion (PSF) from 2018 to 2023 were recruited. A total of 2472 thoracic pedicles were analyzed on preoperative CT scans and the pedicle morphometry were classified based on the Chiu et al classification. The EP chord length of both techniques was measured for narrow dysplastic pedicles (grade C and D). Postoperative CT scans were used to assess for medial perforations (Gertzbein and Robbins classification modified by Rao et al) and anterior perforations (Hansen-Algenstaedt et al grading) .</p><p><strong>Results: </strong>The longest chord length in conventional technique was in left T8 (53.7±3.5 mm) and T9 (53.7±3.7 mm) versus medial pedicle referencing technique which recorded 38.6±3.2 mm and 38.3±3.2 mm, respectively (P<0.001). A total of 434 EP screws were inserted using this technique in narrow dysplastic pedicles. The prevalence of grade 1 medial perforations were 11.3% and for grade 1 anterior perforations were 4.1%. There were only 0.7% grade 2 (critical) perforations [medial: 0.2%, anterior: 0.5%]. None of the perforations were symptomatic and no grade 3 perforations were observed.</p><p><strong>Conclusion: </strong>The medial pedicle wall referencing EP screw technique is a safe alternative method, especially in narrow dysplastic pedicles. This technique has a shorter chord length and a less convergent trajectory with an acceptable critical perforation rate (0.7%).</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891105","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":"Biomechanical Comparison of Skip Laminectomy and Laminoplasty in the Lower Cervical Spine: An Experimental Study Using a Sheep Model.","authors":"Mert Arslan, Can Şensöğüt, Taner Arslan, Buğra Hüsemoğlu, Ceren Kizmazoglu, Ahmet Karakaşlı, Murat Yılmaz","doi":"10.1097/BSD.0000000000002159","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002159","url":null,"abstract":"<p><strong>Study design: </strong>Controlled experimental biomechanical study using a sheep cervical spine model.</p><p><strong>Objective: </strong>To biomechanically evaluate and compare skip laminectomy and laminoplasty in the lower cervical spine, focusing on their influence on spinal stability.</p><p><strong>Summary of background data: </strong>Skip laminectomy and laminoplasty are 2 posterior cervical surgical techniques widely used for spinal canal decompression. Although their clinical outcomes have been compared, no previous study has biomechanically analyzed and compared these techniques in the cervical region.</p><p><strong>Methods: </strong>Twenty-eight C2-T1 cervical spine specimens obtained from merino sheep were used in this study. Seven specimens underwent preliminary fracture testing to establish nondestructive loading parameters. The remaining specimens were assigned to 3 groups: intact control, laminoplasty, and skip laminectomy (n=7 per group). Bone mineral density (BMD) was measured to ensure baseline equivalence across specimens. Biomechanical testing was performed using an electromechanical actuator to evaluate displacement during flexion, extension, lateral bending, and axial rotation under standardized loading conditions. Statistical analysis was conducted to compare biomechanical behavior among the groups.</p><p><strong>Results: </strong>No statistically significant differences were observed among the control, laminoplasty, and skip laminectomy groups with respect to displacement during flexion (P=0.755), extension (P=0.546), right lateral bending (P=0.359), left lateral bending (P=0.415), or axial rotation (P=0.690). Both surgical techniques demonstrated biomechanical behavior comparable to that of intact cervical spine specimens under the tested loading conditions.</p><p><strong>Conclusion: </strong>This study represents, to our knowledge, the first direct biomechanical comparison of skip laminectomy and laminoplasty in the cervical spine. Both procedures preserved immediate postoperative mechanical stability in this experimental ovine model, with no significant biomechanical differences identified between the techniques. Further biomechanical and long-term clinical studies are needed to determine the clinical relevance of these findings.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886386","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":"Assessing Global Upper Extremity Function Before and After Decompressive Surgery in Patients With Degenerative Cervical Myelopathy (DCM).","authors":"Angie Zhang Lung, John Hong, Vicky Chan, Maya N Hatch, Jay J Han, Yu-Po Lee, Nitin N Bhatia, Michael Oh","doi":"10.1097/BSD.0000000000002151","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002151","url":null,"abstract":"<p><strong>Study design: </strong>A total of 20 patients with degenerative cervical myelopathy (DCM) and a plan for surgical decompression were recruited in this pilot study to assess a new outcome measure. Patients were evaluated preoperatively and 3 months, 6 months, and 1 year postoperatively using a 3-dimensional motion-tracking application (reachable workspace) to calculate an upper extremity (UE) relative surface area (RSA) and standard measurements [modified Japanese Orthopedic Association (mJOA), 12-Item Short Form Health Survey (SF-12), and visual analog pain (VAP) score]. Baseline demographic data were collected.</p><p><strong>Objective: </strong>To assess the validity and comparativeness of a new measurement tool in DCM.</p><p><strong>Summary of background data: </strong>Currently, no universally accepted outcome measure exists for DCM. Traditionally used assessment scales are subjective and lack sensitivity. The reachable workspace, a graphical representation of UE spatial surface area using motion-sensor technology, can be used as an objective adjuvant assessment tool in DCM.</p><p><strong>Methods: </strong>The Welch t test was performed to assess UE RSA differences between DCM patients and healthy controls (HC). Concurrent validity and effect size of the RSA were compared to the standard measurements. A P=0.05 was accepted as statistically significant.</p><p><strong>Results: </strong>DCM patients had significantly reduced RSA of all quadrants compared to controls, with the largest reductions in the upper quadrants (P<0.0001). Total RSA was significantly associated with total mJOA score (ρ=0.48, P<0.0001), upper extremity mJOA score (ρ=0.44, P<0.0002), VAP score during movement (ρ=-0.40, P<0.0007), and the SF-12 mental component (ρ=0.34, P<0.005). Patients with symptoms <1 year before surgery showed improved function via significant increases in total RSA and mJOA score. A stronger effect size was seen with RSA.</p><p><strong>Conclusion: </strong>The reachable workspace shows potential to track DCM UE function with accuracy, reliability, and sensitivity to change. Given the promise of this pilot study, a larger study to increase power and substantiate our results will be performed in the future.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886475","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":"Comparative Study of Sagittal Spinopelvic Parameters and Clinical Outcomes After Minimally Invasive Versus Open Fusion in Mild Isthmic Lumbar Spondylolisthesis.","authors":"Zhongzheng Sun, Qiquan Hao, Kai Sun, Janlei Hou","doi":"10.1097/BSD.0000000000002162","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002162","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective comparative study.</p><p><strong>Objective: </strong>This study evaluated the radiologic and clinical outcomes of minimally invasive versus open fusion surgery using a computer-assisted image analysis tool.</p><p><strong>Background: </strong>Lumbar spondylolisthesis, isthmic in nature, tends to interfere with sagittal balance and results in chronic back pain and disability. Operationally, the primary aim is to correct sagittal imbalance and restore functional stability.</p><p><strong>Methods: </strong>Patients with single-level mild isthmic lumbar spondylolisthesis who underwent treatment with minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) or open posterior lumbar fusion were evaluated retrospectively. Sagittal spinopelvic parameters, such as pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), disc height (DH), and spondylolisthesis degree (SD), were measured preoperatively and postoperatively at 3 months with quantitative image-processing software. Functional outcomes were assessed using the Oswestry Disability Index (ODI), and the connection between radiographic and clinical changes was analyzed.</p><p><strong>Results: </strong>Both methods significantly restored PT, SS, LL, DH, and SD (all P=0.021-0.038), without changing PI (P=0.412). Greater restoration of LL and DH was associated with improved ODI scores (r=0.64 and 0.59; P=0.001 and 0.003, respectively). Clinical outcomes were comparable between groups (P=0.284); however, the minimally invasive group demonstrated shorter hospital stay and faster early recovery (P=0.018). Quantitative imaging showed high reproducibility (ICC=0.93).</p><p><strong>Conclusion: </strong>Minimally invasive and open fusion methods both restored sagittal spinopelvic parameters and improved functional outcome in mild isthmic spondylolisthesis. Minimally invasive fusion provided similar radiographic correction at decreased perioperative morbidity. Quantitative image-based evaluation offers a consistent method for assessing spinal alignment and improving surgical planning.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886387","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":"Spinal Epidural Lipomatosis: Are Its Prevalence and Severity Increasing.","authors":"Jennifer A Reilly, Charles Edwards, Timothy Edwards, Michael Edwards, Brianna N Hebeka, Charles C Edwards","doi":"10.1097/BSD.0000000000002156","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002156","url":null,"abstract":"<p><strong>Study design: </strong>Nonrandomized, quantitative study.</p><p><strong>Objective: </strong>The goal of this study is to determine whether the prevalence and severity of spinal epidural lipomatosis (SEL) in patients undergoing lumbar spine decompression surgery have increased over the past decade.</p><p><strong>Summary of background data: </strong>There are no reports on whether the incidence of symptomatic spinal stenosis due to epidural lipomatosis has changed over time. This study assesses whether the prevalence and characteristics of spinal epidural lipomatosis have changed over 10 years.</p><p><strong>Methods: </strong>This retrospective cohort study assesses consecutive patients who underwent lumbar decompression surgery (laminotomy/laminectomy, with or without fusion) for treatment of degenerative stenosis in the calendar years of 2013 and 2023 by a single surgeon. Patient demographic factors, surgical details, SEL grade, body mass index, and smoking status were analyzed. Statistical analyses were conducted using the χ2 tests to compare demographic and surgical variables. Binary logistic regressions were used to model the prediction of SEL, adjusting for age, BMI, and smoking status.</p><p><strong>Results: </strong>The prevalence of SEL at multiple levels in the lumbar spine increased significantly from 2013-2023, rising from 47.5%-63% (P=0.028). Elevated Body Mass Index (BMI) was associated with an increased odds of SEL (OR=1.03, P=0.021). Cigarette smoking had a significant association with higher SEL grades, including a 3-fold increase in odds for SEL ≥60%.</p><p><strong>Conclusions: </strong>This study found a significant increase in multilevel SEL involvement from 2013-2023. Smoking and elevated BMI were associated with significantly increased odds of SEL, underscoring their impact as modifiable risk factors. These results support continued efforts to minimize smoking and obesity, while suggesting that additional, unmeasured factors may also be contributing to the increased prevalence of SEL over time.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886561","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 Discectomy and Fusion Versus Posterior Cervical Foraminotomy for Cervical Radiculopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"José O D Tomé, Rafael C de Souza, Wilker H de Oliveira, Bruno V Motter, Guilherme Foizer, André E M César, Luciano M R Rodrigues","doi":"10.1097/BSD.0000000000002136","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002136","url":null,"abstract":"<p><strong>Study design: </strong>Meta-analysis of randomized controlled trials.</p><p><strong>Objectives: </strong>To compare the efficacy and safety of ACDF versus PCF for the treatment of cervical radiculopathy.</p><p><strong>Summary of background data: </strong>ACDF is widely regarded as the standard surgical treatment for cervical radiculopathy, providing reliable symptom relief but carrying risks such as adjacent segment disease, pseudoarthrosis, and implant-related complications. PCF represents a motion-preserving alternative that avoids anterior approach-related morbidity. Despite existing comparative studies, the optimal surgical approach remains controversial.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to PRISMA guidelines. PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to identify randomized controlled trials comparing ACDF and PCF for cervical radiculopathy. The primary outcome was clinical efficacy assessed using the Odom criteria. Secondary outcomes included perioperative complications, revision surgery, and treatment satisfaction. Pooled analyses were performed using random-effects models, and heterogeneity was assessed with the I2 statistic.</p><p><strong>Results: </strong>Five randomized controlled trials involving 568 patients were included, with 284 patients (50%) undergoing ACDF. Mean follow-up ranged from 12 to 50.4 months. There was no significant difference between ACDF and PCF in the proportion of patients achieving excellent or good outcomes according to the Odom criteria (OR: 1.18; 95% CI: 0.48-2.87; P=0.72). Perioperative complication rates (OR: 0.43; 95% CI: 0.10-1.76; P=0.24), revision surgery rates (OR: 1.39; 95% CI: 0.66-2.94; P=0.39), and treatment satisfaction (OR: 0.88; 95% CI: 0.54-1.37; P=0.62) were also comparable between groups.</p><p><strong>Conclusion: </strong>This meta-analysis of randomized controlled trials demonstrates no significant differences between ACDF and PCF in terms of clinical efficacy, safety, revision surgery, or patient satisfaction for cervical radiculopathy. Given its motion-preserving nature and avoidance of anterior approach-related complications, PCF remains a valid surgical alternative in selected patients.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886432","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":"Effects of Adding a Cross-Link During Single-Level Lumbar Interbody Fusion for Degenerative Lumbar Spine Diseases: A Computed Tomography-Based Analysis.","authors":"Koichiro Shima, Bungo Otsuki, Koichi Murata, Takayoshi Shimizu, Takashi Sono, Shintaro Honda, Masaki Sakamoto, Takaki Yoshiyama, Ryohei Saito, Shuichi Matsuda","doi":"10.1097/BSD.0000000000002157","DOIUrl":"https://doi.org/10.1097/BSD.0000000000002157","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objectives: </strong>To evaluate whether adding cross-links during single-level lumbar interbody fusion (LIF) improves fusion rates, segmental alignment, and clinical outcomes.</p><p><strong>Summary of background data: </strong>Biomechanical studies suggest cross-links enhance rotational stability in single-level posterior lumbar interbody fusion, but clinical evidence for their benefit in degenerative lumbar spine diseases remains limited. No previous clinical study has investigated how cross-link addition affects LIF outcomes.</p><p><strong>Methods: </strong>One hundred thirty-one patients underwent single-level LIF for degenerative lumbar spine diseases (2012-2022) and were categorized into cross-link (CL, n=64) and non-cross-link (NCL, n=67) groups. Researchers assessed CT-based fusion parameters (interbody and facet fusion rates), segmental alignment measurements (segmental lordosis, disk height, and coronal tilt), and clinical outcomes (JOA and VAS scores) over a minimum 1-year follow-up. Propensity score matching minimized selection bias.</p><p><strong>Results: </strong>One-year interbody fusion rates were comparable between groups (CL: 72.1% vs. NCL: 69.1%, P=0.839). No significant differences were found in facet fusion rates (CL: 37.7% vs. NCL: 30.9%, P=0.558), pedicle screw loosening (CL: 8.2% vs. NCL: 16.4%, P=0.254), or cage subsidence (CL: 9.8% vs. NCL: 9.1%, P=1.000). Clinical outcomes improved similarly in both groups based on final JOA scores (CL: 26.0±6.8 vs. NCL: 25.3±4.3, P=0.47) and VAS back pain scores (CL: 21.8±20.8 vs. NCL: 22.9±22.7, P=0.79). Propensity score-matched analysis of 32 patients per group confirmed these findings.</p><p><strong>Conclusions: </strong>Routine use of cross-link in single-level LIF does not improve radiographic or clinical outcomes after 1 year. A selective approach could reduce costs while maintaining excellent patient outcomes.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886535","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}