Clinical Spine Surgery最新文献

{"title":"Static Versus Expandable Cages in Minimally Invasive Lateral Lumbar Interbody Fusion: A Systematic Review and Meta-Analysis.","authors":"Ryan S Beyer, Tara Shooshani, Bianca Batista, Genevieve M Fraipont, Omead Pooladzandi, Nolan J Brown, Zach Pennington, Martin H Pham","doi":"10.1097/BSD.0000000000001737","DOIUrl":"10.1097/BSD.0000000000001737","url":null,"abstract":"<p><strong>Study design: </strong>A meta-analysis approach to a systematic review.</p><p><strong>Objective: </strong>Perform a systematic review to identify all reports directly comparing outcomes of lateral lumbar interbody fusion (LLIF) using static versus expandable interbody cages. Specifically focusing on periprocedural complications, intraoperative morbidity, and fusion outcomes.</p><p><strong>Summary of background data: </strong>Minimally invasive surgical techniques, particularly LLIF, have gained popularity for their potential to reduce muscle and soft tissue dissection, leading to faster postoperative recovery. LLIF has been associated with fewer complications compared with open posterior approaches. The introduction of expandable lumbar interbody devices aims to further reduce surgical difficulty and potential complications. However, concerns include a small graft window due to the expansion mechanism and higher costs.</p><p><strong>Methods: </strong>The Web of Science, Scopus, and PubMed databases were systematically queried in accordance with PRISMA guidelines to identify articles comparing outcomes following LLIF using static and expandable interbodies. The Newcastle-Ottawa Scale (NOS) was employed to assess the risk of bias (ROB) in the selected studies. Extracted data underwent effect-size meta-analysis with the PyMARE library, using P <0.05 to define statistical significance.</p><p><strong>Results: </strong>Of the 77 identified articles, 4 studies comprising 283 patients (mean age: 67.1 y, 55.8% female) met the inclusion and exclusion criteria. A total of 150 patients (53%) were treated with static interbodies compared with 133 (47%) receiving expandable interbodies. The groups did not differ significantly with respect to operative time ( P =0.59), blood loss ( P =0.89), length of stay ( P =0.78), subsidence ( P =0.49), 24-month mean disc height ( P =0.11), 24-month mean ODI ( P =0.58), or 24-month mean visual analog scale (VAS) back pain ( P =0.81). The expandable group saw a trend toward improved fusion rates (97% vs. 92%, P =0.06).</p><p><strong>Conclusions: </strong>The present meta-analysis suggests the use of expandable (vs. static) interbodies in LLIF surgery may result in similar surgical morbidity, subsidence, and decompression. Further prospective comparative studies are merited to validate these results.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"326-332"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945914","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":"Influence of Preoperative Physical Function Scores on Outcomes After Single-level Cervical Disc Replacement.","authors":"Timothy J Hartman, James W Nie, Eileen Zheng, Keith R MacGregor, Omolabake O Oyetayo, Kern Singh","doi":"10.1097/BSD.0000000000001746","DOIUrl":"10.1097/BSD.0000000000001746","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>We aim to determine the influence of preoperative Patient-Reported Outcome Measurement Information System Physical Function (PROMIS-PF) scores on perioperative and postoperative outcomes, the latter determined through patient-reported outcome measures (PROMs) and the degree of achievement rates of minimum clinically important difference (MCID) following single-level cervical disc replacement (CDR).</p><p><strong>Background: </strong>Several studies have examined the relationship between preoperative PROMIS-PF as a prognostic factor for postoperative outcomes. Few studies have examined this relationship as it applies to CDR.</p><p><strong>Methods: </strong>Patients undergoing single-level CDR with preoperative PROMIS-PF scores were identified retrospectively using a single-surgeon database. Patients undergoing surgery for infection/fracture/malignancy were excluded. Patients were divided by mean preoperative PROMIS-PF score: lower-functioning (PROMIS-PF <40) and higher-functioning (PROMIS-PF ≥40). Patient-Reported Outcomes Measurement Information System (PROMIS-PF), 12-item Short Form Physical Component Score (SF-12 PCS), Visual Acuity Scale (VAS) scores for neck and arm, and Neck Disability Index scores, collected at preoperative, 6-week, 12-week, 6-month, and 1-year time points.</p><p><strong>Results: </strong>Fifty-seven patients were included with 33 considered higher functioning. Operative times were increased in the higher-functioning group ( P = 0.003). The lower-functioning cohort saw improvement in all 6-week/12-week/6-month PROMs. The higher-functioning cohort saw improvement in all PROMs except SF-12 PCS. Between groups, the higher-functioning cohort reported greater postoperative PROMIS-PF at multiple time points, preoperative SF-12 PCS, 12-week/preoperative VAS-neck, and preoperative VAS-arm ( P ≤ 0.036, all). The lower-functioning group had greater preoperative/6-week Neck Disability Index ( P ≤ 0.027, all) and had greater MCID achievement at 6-month SF-12 PCS/12-week VAS arm ( P ≤ 0.026, all).</p><p><strong>Conclusion: </strong>Independent of preoperative function, both groups reported improvement in all outcomes except for SF-12 PCS in the higher-functioning cohort. Between groups, the higher-functioning cohort had significantly better outcomes; however, this significance was not seen past 12 weeks for any PROM. MCID achievement rates were significantly greater in the lower-functioning group in the SF-12 PCS and VAS arm. Patients with lower preoperative PROMIS-PF scores may experience greater rates of clinically noticeable improvements in function/arm pain postoperatively.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E376-E382"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969564","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":"Refracture and Morphologic Classification in Osteoporotic Vertebral Compression Fractures After Percutaneous Kyphoplasty: A Retrospective Observational Study.","authors":"Wenxiang Tang, Haifu Sun, Weiqiao Tu, Yanping Niu, Yuye Zhang, Tao Liu, Fanguo Lin","doi":"10.1097/BSD.0000000000001893","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001893","url":null,"abstract":"<p><strong>Study design: </strong>This study is a clinical retrospective case-control study.</p><p><strong>Summary of background data: </strong>Percutaneous kyphoplasty (PKP) is a common treatment for osteoporotic vertebral compression fractures (OVCF). It is effective in relieving pain and restoring vertebral height, but it can also lead to new compression fractures in other vertebrae.</p><p><strong>Objective: </strong>To investigate whether the type of OVCF affects the risk of refracture after PKP and to identify other risk factors for refracture.</p><p><strong>Methods: </strong>The study included 3676 patients with OVCF who had undergone PKP. They were divided into 2 groups: those who experienced refractures and those who did not. Fractures were classified into 4 types based on magnetic resonance imaging (MRI) signals. The study used univariate and multivariate logistic regression analyses to assess factors such as fracture type, gender, age, bone cement leakage, and Hounsfield-unit (HU) value.</p><p><strong>Results: </strong>There were 157 patients in the refracture group (type I, 51 cases; type II, 23 cases; type III, 44 cases; type IV, 39 cases). And 3,519 patients in the nonrefracture group (type I, 1464 cases; type II, 637 cases; type III, 1063 cases; type IV, 355 cases). Intra-group analysis showed that the distribution of type I and type IV fractures between the 2 groups was statistically different. The results of the multivariate analysis showed that the morphologic classification of fractures, age, gender, bone cement leakage, and HU values were independent risk factors for refracture after PKP.</p><p><strong>Conclusion: </strong>The risk of refracture after PKP in patients with OVCF is influenced by the fracture type. Among the different types, type IV has the highest risk of refracture after PKP.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752617","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":"Sagittal Angle of Pedicle Screws as a Influencing Factor for Postoperative Collapse of Thoracolumbar Fractures: A Case-control Study.","authors":"Xinyuan Lin, Bolai Chen, Yong Li, Jinxin Zhang, Yao Lu","doi":"10.1097/BSD.0000000000001892","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001892","url":null,"abstract":"<p><strong>Study design: </strong>This study is a retrospective case analysis.</p><p><strong>Objective: </strong>This study evaluates the impact of varying pedicle screw angles on postoperative vertebral body collapse in patients with single-segment thoracolumbar fractures managed with short-segment pedicle screw fixation.</p><p><strong>Summary of background data: </strong>Thoracolumbar fractures are prevalent in spinal trauma. Posterior pedicle screw fixation treat for single-segment fractures often encounters the challenge of postoperative vertebral collapse. While the causes are multifactorial, the impact of the pedicle screw's sagittal angle on collapse remains understudied.</p><p><strong>Methods: </strong>We retrospectively analyzed 38 patients, grouped by pedicle screw angle in the sagittal plane, comparing postoperative and final follow-up height of the injured vertebrae.</p><p><strong>Result: </strong>Analysis of the injured vertebrae height postoperatively and at final follow-up revealed the following: (1) with PTH in the upper vertebral body, vertebra height decreased. PTT reduced anterior edge height (P<0.05), with no effect on the middle or rear edges height. (2) No height changes occurred with PTH in the lower vertebral body. Instead, PTT reduced anterior edge height (P<0.05), with stable middle and rear edge heights. (3) No height changes with dorsal opening angles between upper and lower pedicle screws. Instead, ventral opening reduced anterior edge height (P<0.05), with stable middle and rear edge height.</p><p><strong>Conclusions: </strong>To preserve postoperative vertebral height in single-segment thoracolumbar fractures, optimal pedicle screw placement involves directing the upper screw tip towards the tail (PTT) and the lower towards the head (PTH). Form a dorsal opening angle between the upper and lower screws after rod connection.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728437","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":"Differing Definitions of \"Outpatient\" Surgery Can Influence Study Outcomes Related to Lumbar Fusion.","authors":"Junho Song, Ryan Hoang, Timothy Hoang, Jennifer Yu, Justin Tiao, Alexander Yu, Avanish Yendluri, Auston R Locke, Niklas H Koehne, Nikan K Namiri, John J Corvi, Brian H Cho, Samuel K Cho, Saad Chaudhary, Andrew C Hecht","doi":"10.1097/BSD.0000000000001894","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001894","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To evaluate whether different methods of defining \"outpatient\" surgery influence postoperative outcomes following lumbar fusion.</p><p><strong>Summary of background data: </strong>Lumbar spinal fusion is increasingly performed in outpatient settings due to advancements in techniques and patient selection. However, inconsistencies in the definition of \"outpatient\" surgery can complicate outcome comparisons with patients categorized as outpatient by the hospital may unexpectedly require inpatient admission postoperatively.</p><p><strong>Methods: </strong>ACS-NSQIP was queried for patients undergoing primary elective lumbar fusion from 2012 to 2022. Those with revision surgeries, infection, malignancy, and nonelective cases were excluded. Two definitions of \"outpatient\" surgery were evaluated: hospital-defined outpatient (HDO) and same-day discharge (SDD). Propensity score matching was used to compare HDO and SDD cohorts to their respective inpatient counterparts. Primary outcomes analyzed included 30-day readmission, reoperation, and postoperative complications. Univariate analyses were performed to compare the risks of complications for HDO and SDD cohorts compared with their inpatient counterparts.</p><p><strong>Results: </strong>Of the 131,113 patients included, 9623 (7.3%) were HDO and 2019 (1.5%) were SDD. In propensity matched cohorts, inpatient lumbar fusion was associated with greater risk of 30-day readmission [odds ratio (OR) 1.148, P<0.001], reoperation (OR: 1.243, P<0.001), mortality (OR: 2.339, P<0.001), pulmonary embolism (OR: 1.790, P=0.002), urinary tract infection (OR: 1.359, P<0.001), and myocardial infarction (OR: 1.773, P=0.003). Compared with the propensity matched SDD cohort, inpatient lumbar fusion was significantly associated with greater rates of readmission (OR: 1.279, P=0.005), reoperation (OR: 1.429, P=0.006), and urinary tract infection (OR: 2.520, P<0.001).</p><p><strong>Conclusion: </strong>Discrepancies in outcomes between inpatient and outpatient lumbar fusion were more pronounced with the hospital-defined outpatient definition compared with in the same-day discharge cohort.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728436","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":"Upper-Level Instrumentation at C2 Versus C3 Does Not Influence Radiographic or Clinical Outcomes After Posterior Cervical Fusion.","authors":"Mark A Plantz, Jeremy Marx, Tyler Compton, Joseph Weiner, David M Hiltzik, Erik B Gerlach, Peter R Swiatek, Srikanth N Divi, Alpesh A Patel, Wellington K Hsu","doi":"10.1097/BSD.0000000000001889","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001889","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To assess clinical and radiographic outcomes after posterior cervical decompression and fusion (PCDF) with upper instrumented vertebra (UIV) at C2 versus C3.</p><p><strong>Summary of background data: </strong>PCDF is a common procedure for treatment of multilevel cervical spondylotic myelopathy. The evidence is sparse as to whether C2 versus C3 is the optimal UIV.</p><p><strong>Methods: </strong>Adult patients undergoing PCDF for cervical myelopathy from 2014 to 2019 at a single center were identified. Patients with UIV at C2 or C3 and LIV at or above T2 were included. Exclusion criteria included pediatric patients, revision procedures, staged procedures, and intervention for infectious, oncologic, or traumatic indications. Patients with incomplete follow-up (eg, <2 y postoperatively) were excluded from the final analysis. Demographic data, surgical characteristics, clinical outcomes, and radiographic outcomes were compared.</p><p><strong>Results: </strong>A total of 135 consecutive patients were included, of whom 47 (34.8%) had UIV at C2 and 88 (65.2%) had UIV at C3. There was no difference in 90-day readmission (14.9% vs. 20.5%, P=0.491) or 2-year reoperation between the groups (17.0% vs. 14.0%, P=0.628). The mean difference from baseline to final follow-up in cSVA, T1 slope, CL, TS-CL, and C0-C2 were similar between groups (P=0.753, 0.181, 0.797, 0.910, 0.959, respectively). Multivariate analysis did not reveal any correlation between UIV and radiographic outcomes (P>0.05).</p><p><strong>Conclusions: </strong>There was no significant difference in clinical and radiographic outcomes in C2 versus C3 UIV groups. The added complexity of C2 instrumentation does not seem to be critical for successful radiographic and clinical outcomes after posterior cervical decompression and fusion for cervical myelopathy.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682160","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":"Indirect Posterior Decompression With a Plate Gliding Technique During an Anterior Cervical Discectomy and Fusion for Treatment of Cervical Myelopathy Accompanied by Ligamentum Flavum Pathologies: A Technical Note and Case Series.","authors":"Gun Woo Lee, Sang Yun Seok, Jin Sup Yeom, Dong-Ho Lee, Hyung Rae Lee, Sehan Park","doi":"10.1097/BSD.0000000000001887","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001887","url":null,"abstract":"<p><strong>Study design: </strong>Technical note and case series.</p><p><strong>Objectives: </strong>We describe an indirect posterior decompression technique using plate gliding during anterior cervical discectomy and fusion (ACDF) in cervical myelopathy patients with an accompanying posterior pathology.</p><p><strong>Summary of background data: </strong>ACDF can effectively address an anterior pathology, that is, directly causing cord compression. However, a concurrent posterior pathology, such as hypertrophy or buckling of the ligamentum flavum, is challenging to resolve. Furthermore, occasional worsening of cord compression after ACDF due to aggravation via a posterior pathology may occur.</p><p><strong>Materials and methods: </strong>We reviewed 6 patients with cervical myelopathy who underwent the plate gliding technique during ACDF in 2023. We assessed radiologic factors, including cord compression from the ligamentum flavum (CCLF) grade and segmental lordosis, before and after surgery. In addition, we evaluated the Japanese Orthopedic Association (JOA) scores preoperatively and 3 months postoperatively.</p><p><strong>Results: </strong>A postoperative improvement in CCLF grade was observed in all patients alongside a decrease in segmental lordosis. The average recovery rate indicated by the JOA scores at 3 months postoperatively was 65.3%.</p><p><strong>Conclusions: </strong>An indirect decompression technique using plate gliding during ACDF is beneficial for cervical myelopathy patients accompanied by posterior pathologies such as ligamentum flavum hypertrophy or buckling.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682159","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":"Narrative Review of Perioperative Glucagon-like Peptide-1 (GLP-1) Agonists in Spine Surgery.","authors":"James W Connelly, Rajkishen Narayanan, Teeto Ezeonu, Parth Kothari, Nicholas Spina, William Ryan Spiker, Brandon Lawrence, Darrel S Brodke, Gregory D Schroeder, Brian A Karamian","doi":"10.1097/BSD.0000000000001888","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001888","url":null,"abstract":"<p><p>Spine surgeons are increasingly likely to encounter patients taking glucagon-like peptide-1 (GLP-1) receptor agonists for glycemic control and/or weight loss. GLP-1 receptor agonists present an attractive option for helping patients meet hemoglobin A1C and body mass index goals before elective surgeries and have already been implemented for these purposes. It is imperative for spine surgeons to understand the potential risks and benefits of these drugs during the perioperative period and their influence on patient outcomes. This review provides an overview of the history of GLP-1 receptor agonists, their mechanism of action and efficacy as a diabetic and weight loss treatment, as well as the clinical relevance to the field of spine surgery. Further studies are required to truly understand the impact of these medications on spine surgery and in the management of these patients in the perioperative period.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648766","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":"What Cervical MRI Findings Can Tell About ACDF Outcomes and Risks of ASD.","authors":"Olga Leonova, Evgenii Baykov, Aleksandr Krutko","doi":"10.1097/BSD.0000000000001881","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001881","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective analysis of data on patients with cervical degenerative disc disease who underwent single-level anterior cervical discectomy and fusion (ACDF).</p><p><strong>Objective: </strong>To determine the association between preoperative cervical MRI parameters and surgical outcomes, and their role in the adjacent segment disease (ASD).</p><p><strong>Summary of background data: </strong>There is no evidence on what preoperative findings are related to ACDF outcomes, and the progression of postoperative degenerative changes at the adjacent levels has not been found yet.</p><p><strong>Methods: </strong>The patients' demographic data, cervical MRI findings at all cervical levels and clinical data were collected preoperatively and postoperatively. A comparative analysis of MRIs of the levels adjacent and nondjacent to ACDF was performed to find out whether or not they were undergoing accelerated degeneration. A regression analysis was carried out for the identification of predictors of fusion rates and implant subsidence.</p><p><strong>Results: </strong>The study included 121 patients at visit 1 and 83 at visit 2. The median follow-up duration was 26.5 [18.9; 33.1] months. Complete fusions were observed in 85.5% of the patients (71/83), and implant subsidence was observed in 40% of the patients (33/83). Neither failed fusions nor implant subsidence were significant to clinical data (P>0.05). Significant changes in the Modic changes ratio of type 1 to type 2 were observed 1 or 2 segments above ACDF (P>0.05), along with an increase in the endplate damage there (P<0.001). Endplate defects grade are a strong and independent predictor of implant subsidence at the same level (OR=1.3-12.94, P<0.05).</p><p><strong>Conclusions: </strong>At the levels adjacent to and above the ACDF segment, there is a change in the Modic change type-to-type ratio and an increase in the endplate damage. However, these changes in MRI parameters cannot be regarded as evidence for accelerated segment degeneration due to ACDF. Endplate defects revealed on preoperative MRI scans are predictors of implant subsidence at the same level.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There Any Relationship Between Idiopathic Scoliosis and Pineal Gland, Pituitary Gland, and Brain Ventricles?","authors":"Fatma Yasemin Öksüzler, Mahmut Öksüzler, Sema Polat","doi":"10.1097/BSD.0000000000001886","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001886","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>This paper aims to contribute to the determination of the possible factors that may be associated with idiopathic scoliosis (IS) by assessing the dimensions in the pineal and pituitary gland volumes, and brain ventricle morphometry.</p><p><strong>Summary of background data: </strong>The role of hormones in growth and development is known. Growth hormones and melatonin play a role in bone metabolism. Some studies have shown that hormones that play roles in growth and development and the glands that secrete these hormones may affect the formation of scoliosis.</p><p><strong>Methods: </strong>A total of 46 subjects with scoliosis and 52 healthy subjects aged between 18 and 46 years were included in the study. Magnetic resonance imaging was used to measure pineal and pituitary gland volumes and brain ventricles. Also, the Cobb angle was evaluated using X-rays to determine the severity of scoliosis.</p><p><strong>Results: </strong>The average Cobb angle in the IS group was 33.02±17.02 degrees. The mean volumes of the pineal and pituitary glands were 41.53±19.25 mm3, 215.15±82.39 mm3 in IS, and 57.75±31.04 mm3 and 284.90±96.90 mm3 in healthy groups, respectively (P<0.05). Frontal horn widths, fourth ventricle anteroposterior, and transverse diameters were lower in the IS group than in healthy subjects. There was a significant difference in 3 parameters, including the fourth ventricle anteroposterior, transverse diameter, and third ventricle width (P<0.05).</p><p><strong>Conclusion: </strong>The differences in the dimensions of pineal, and pituitary glands may be an underlying cause of scoliosis or support a link with scoliosis. Although the values of the brain ventricles differed in both groups, more studies are needed to determine the relationship between the brain ventricles and scoliosis. Gaining insight into neuroendocrine influences on spine development or a comprehensive understanding of how these factors affect the risk and progression of scoliosis is of clinical importance, as it may lead to innovative preventive strategies.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648765","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}