Clinical Spine Surgery最新文献

{"title":"An Introduction to Machine Learning for the Practicing Spine Surgeon.","authors":"Ryan T Lin, Jonathan Dalton, Matthew H Meade, Mark Miller, Ruchir Nanavati, Jarod Olson, Joydeep Baidya, Robert J Oris, Barrett I Woods, Gregory D Schroeder, Alexander R Vaccaro","doi":"10.1097/BSD.0000000000002026","DOIUrl":"10.1097/BSD.0000000000002026","url":null,"abstract":"<p><p>The applications of new and emerging technologies in spine surgery are constantly expanding. Specifically, machine learning algorithms have seen a rise in utilization in clinical research, allowing for interpretation of large datasets that have the capability of experiential learning. The goal of this work is to present a guide for surgeons to better understand model design, key takeaways, and common pitfalls related to machine learning to ensure accurate and appropriate interpretation of analytical findings in their practice.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"345-348"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988310","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 Approach to Vertebral Artery Exposure: A Step-By-Step Surgical Technique Guide By the Cervical Spine Research Society.","authors":"Iyan Younus, Kento Yamanouchi, John M Rhee, Brain W Su, Philip K Louie","doi":"10.1097/BSD.0000000000002042","DOIUrl":"10.1097/BSD.0000000000002042","url":null,"abstract":"<p><strong>Introduction: </strong>This guide reviews vertebral artery (VA) anatomy and anomalies, highlights key considerations for VA injury (VAI) prevention, and provides a step-by-step technique guide for VA exposure in the event of an intraoperative VAI.</p><p><strong>Surgical technique: </strong>VA exposure begins with packing to obtain hemostatic control. If direct repair is necessary and feasible, dissection is carried out laterally beyond the uncus to expose the transverse process (TP) using a Kerrison rongeur at both the superior and inferior levels. The anterior portion of the TP is removed with a Kerrison to unroof the transverse foramen. Temporary clips can be applied proximal and distal to the injured segment of the VA. Primary repair of the injured VA can be attempted using 7-0 or 8-0 prolene sutures. It is critical to not use hemostatic agents that are flowable, expandable, or contain thrombin as they may pose a risk of embolism and subsequent stroke or neurological injury. Postoperatively, the artery is evaluated with angiography.</p><p><strong>Conclusion: </strong>While iatrogenic VAI is rare, it can lead to severe complications. Here, we present an overview of preoperative and postoperative considerations and a step-by-step technique guide for VA exposure from an anterior approach to the cervical spine.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"319-325"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970970","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":"Clinical Efficacy of Percutaneous Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation in Patients Over 70 Years Old.","authors":"Ying Chen, Zong Yang, Fan Zhang, Jie Liang, Weifei Wu","doi":"10.1097/BSD.0000000000001862","DOIUrl":"10.1097/BSD.0000000000001862","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objective: </strong>To study the efficacy of percutaneous endoscopic discectomy (PED) for treating LDH patients over 70 years old.</p><p><strong>Summary of background data: </strong>PED is considered an effective surgical method for treating LDH, but few studies have focused on the clinical efficacy of PED in elderly patients with LDH.</p><p><strong>Materials and methods: </strong>LDH patients over 70 years old with radicular pain or signs of radiculopathy were included. All patients underwent PED under local/general anesthesia. Operative time, length of hospital stay, complications, visual analogue score (VAS) and the Oswestry Disability Index (ODI) were assessed preoperatively, 3 days postoperatively, 3 months postoperatively, 6 months postoperatively, and 12 months postoperatively. A paired-sample t test was performed to compare differences in the ODI and VAS scores between the preoperative, postoperative and follow-up periods.</p><p><strong>Results: </strong>A total of 132 patients over 70 years old with LDH were included. The average age was 75.31 years. No related complications occurred, and there was no recurrence of LDH within 12 months after surgery. The differences in the VAS scores and the ODI scores before and after surgery were statistically significant ( P <0.0001). Differences in the ODI scores at 3 months, 6 months, and 12 months after surgery were statistically significant ( P <0.0001). There were significant differences in the VAS scores at 3 days, 3 months, and 6 months after surgery ( P <0.0001). However, the differences in VAS scores between 6 months after surgery and 12 months after surgery were not statistically significant ( P =0.083).</p><p><strong>Conclusions: </strong>Our results demonstrated that PED is a safe and effective technique for elderly patients with LDH and that it yields significant improvements in pain and functional outcomes.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E335-E341"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332558","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}

{"title":"Examining the Postoperative Outcomes After Minimally Invasive Versus Open Fixation of Thoracolumbar Fractures in Patients With Ankylosing Spondylitis: A Systematic Review and Meta-analysis.","authors":"Omkar S Anaspure, Shiv Patel, Andrew Newsom, Anthony N Baumann, Aryan S Anaspure, Susan M Goodman, Bella Mehta, Sravisht Iyer","doi":"10.1097/BSD.0000000000001925","DOIUrl":"10.1097/BSD.0000000000001925","url":null,"abstract":"<p><strong>Study design: </strong>Systematic Review and Meta-Analysis.</p><p><strong>Objective: </strong>This review aims to evaluate medical complications, patient-reported outcomes, and bony healing, operative time, and blood loss after MIS versus open fixation for TL fractures in patients with AS.</p><p><strong>Summary of background data: </strong>Ankylosing spondylitis (AS) causes spinal rigidity and increases the risk of vertebral fractures, especially in the thoracolumbar (TL) region. While pedicle screw fixation via percutaneous or open approaches is commonly used, evidence on the safety and bony healing outcomes specifically in AS patients is limited. This study evaluates medical complications, patient-reported outcomes, and bony healing after minimally invasive (MIS) versus open fixation in AS patients with TL fractures.</p><p><strong>Methods: </strong>This systematic review and meta-analysis evaluated postoperative complications and clinical outcomes in patients with AS undergoing MIS or open fixation of TL fractures by querying PubMed, SCOPUS, CINAHL, and Web of Science, up to August 26, 2024.</p><p><strong>Results: </strong>Nine comparative and 4 noncomparative studies (n=443; 77.16% male; mean age 70.74 ± 9.21 y; mean follow-up 24.27 ± 15.10 mo) were included. Bony healing was achieved in 98% (n=111) and 97.14% (n=35) of MIS and open fixation patients, respectively, which was not significantly different (P=0.978). However, MIS had a significantly shorter mean operative time (150.97 ± 50.96 vs. 251.43 ± 84.36 min; P<0.001), less blood loss (275.73 ± 100 vs. 856.44 ± 294.91 mL; P=0.016) and shorter hospital stay (17.68 ± 10.93 d vs. 32.44 ± 13.58 d; P<0.001) compared with open fixation, respectively. Revision surgery was necessitated in 1.39% (n=1) of MIS patients and in 8% (n=4) of open fixation patients, which was not found to be significantly different (P=0.135).</p><p><strong>Conclusions: </strong>Percutaneous MIS instrumented fixation for TL fractures in patients with AS is viable, affording comparable bony healing, reduced blood loss, operative time, and hospital stay compared to traditional open fixation.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":"39 7","pages":"326-341"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583531","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":"Comparing Three and Four-Rod Constructs in Adult Spinal Deformity Patients With Long Fusions to the Pelvis: Is There a Difference in Rod Fractures and Revision Rates at Minimum 2-Year Follow-up?","authors":"Fthimnir M Hassan, Sarthak Mohanty, Erik Lewerenz, Christopher Mikhail, Stephen R Stephan, Andrew Platt, Joshua Bakhsheshian, Nathan J Lee, Justin L Reyes, Gabriella Greisberg, Joseph M Lombardi, Zeeshan M Sardar, Ronald A Lehman, Lawrence G Lenke","doi":"10.1097/BSD.0000000000001868","DOIUrl":"10.1097/BSD.0000000000001868","url":null,"abstract":"<p><strong>Study design: </strong>Single-center retrospective cohort study.</p><p><strong>Objective: </strong>To determine if the 4-rod construct (4RC) is protective against the occurrence of rod fractures when compared with the 3-rod construct (3RC) in adult spinal deformity (ASD) patients with long fusions to the sacrum.</p><p><strong>Summary of background data: </strong>Past studies have explored the different outcomes in subjects with dual-rod versus multirod constructs. There is a lack of literature distinguishing the ramifications of 3RC versus 4RC, particularly in the prevalence of rod fractures and rod fractures requiring subsequent revision surgery as a result of pseudarthrosis.</p><p><strong>Methods: </strong>ASD patients undergoing long instrumented fusions to the sacrum were dichotomized between the 3RC and 4RC cohorts. Outcomes of interest include the occurrence of rod fractures (RFs) and RFs requiring revision (RFR). Two-tailed independent-sample t test with Welch's correction and χ 2 /Fisher exact test were used for continuous and categorical variables, respectively. Multivariable logistic regression analysis was performed to assess whether the 4RC is protective against rod fractures when compared with the 3RC.</p><p><strong>Results: </strong>One hundred forty-five patients with a minimum 2-year follow-up were included (3RC=57, 4RC=88). Four RC had a greater body mass index (BMI) ( P =0.002), longer operating room (OR) time ( P =0.002), greater estimated blood loss (EBL) ( P =0.002), total instrumented levels (TIL) ( P =0.028), and more 3-column osteotomies (3COs) performed ( P =0.028). Four RC had greater baseline coronal vertical axis (CVA) (28.2±24.9 vs. 18.5±16.9 mm, P =0.006) and sagittal vertical axis (SVA) (55.1±64.8 vs. 30.4±41.8 mm, P =0.006). Three RC had a greater rate of RF (28.1% vs. 14.8%, P =0.0506) and RFR (14.9% vs. 10.2%, P =0.486) when compared with 4RC, but these findings were not statistically significant. After controlling for BMI, the use of 3-column osteotomies, total instrumented levels, change in coronal alignment (∆CVA), change in sagittal alignment (∆SVA), use of bone morphogenetic protein, and number of interbody fusions, 3RC was associated with 4.93× greater odds of experiencing RFs ( P =0.0078). However, significance fell short when adjusting for the occurrence of RFR [OR=2.58 (0.60-11.19), P =0.2067].</p><p><strong>Conclusion: </strong>ASD patients having long fusions to the sacrum with 4RC across the lumbosacral junction are shown to be at lesser risk of developing rod fractures but not revision surgery as compared with 3RC at 2-year follow-up.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E358-E366"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332559","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":"Patients on Regular Preoperative Weak Opioid Intake Can Achieve Successful Surgical Outcomes After Posterior Decompression Surgery for Cervical Spondylotic Myelopathy.","authors":"Junya Miyahara, Kosei Nagata, Ryuji Sakamoto, Koji Nakajima, Hiroyasu Kodama, Yudai Kumanomido, Katsuyuki Sasaki, Naohiro Kawamura, Akiro Higashikawa, Yujiro Takeshita, Chiaki Horii, So Kato, Toru Doi, Yuki Taniguchi, Yoshitaka Matsubayashi, Sakae Tanaka, Yasushi Oshima","doi":"10.1097/BSD.0000000000001860","DOIUrl":"10.1097/BSD.0000000000001860","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To investigate the surgical outcomes of patients receiving regular weak opioids preoperatively in posterior decompression surgery for cervical spondylotic myelopathy.</p><p><strong>Summary of background data: </strong>Several studies have reported that regular preoperative opioid intake is a risk factor for poor patient outcomes after spine surgery. However, the effect of preoperative weak opioid intake on the outcomes of patients with cervical spondylotic myelopathy, particularly those undergoing posterior decompression surgery without fusion remains unknown.</p><p><strong>Methods: </strong>We reviewed 211 patients with cervical myelopathy who underwent posterior cervical decompression surgery and divided them into 2 groups based on regular preoperative weak opioid intake. The Numerical Rating Scale (NRS score, 0-10) for neck pain, Neck Disability Index (NDI), and Euro-Quality of Life 5-Dimensions (EQ-5D) scores were compared between the 2 groups. Preoperative oral analgesic intake was also assessed.</p><p><strong>Results: </strong>All twenty patients who had taken opioids regularly were using tramadol. Patients were divided into tramadol (+) or tramadol (-) group based on regular preoperative tramadol intake. The tramadol (+) group was more likely to receive pregabalin/mirogabalin or duloxetine. Tramadol (+) group showed worse neck pain, NDI, and EQ-5D scores preoperatively and worse NDI and EQ-5D 1 year postoperatively than tramadol (-) group. However, after propensity score matching, the improvement rate of the NRS for neck pain, and the minimal clinically important difference achievement for the NDI and EQ-5D were comparable between the 2 groups.</p><p><strong>Conclusion: </strong>Patients receiving regular weak opioids preoperatively can achieve successful surgical outcomes after posterior decompression surgery for cervical spondylotic myelopathy.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E321-E326"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Postoperative Physical Therapy and Opioid Prescription After Anterior Cervical Discectomy and Fusion: A Retrospective Cohort Study of United States Academic Health Centers.","authors":"Anthony N Baumann, Robert J Trager, Omkar S Anaspure, Davin C Gong, William L Johns, Peter R Swiatek, Alexander R Vaccaro","doi":"10.1097/BSD.0000000000001863","DOIUrl":"10.1097/BSD.0000000000001863","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>We investigated whether postoperative physical therapy (PT) significantly reduces the risk and amount of oral opioid prescriptions in the first year after primary anterior cervical discectomy and fusion (ACDF) and the risk of any opioid prescription/administration.</p><p><strong>Summary of background data: </strong>There is a need for nonopioid pain management strategies following ACDF in light of the opioid epidemic.</p><p><strong>Methods: </strong>We utilized deidentified medical records from the TriNetX network to identify opioid-naïve adults undergoing their first ACDF from 2014 to 2023. Patients were divided into cohorts by the presence or absence of postoperative PT (≤2 mo post-ACDF) and propensity matched for variables related to opioid prescription. Primary outcomes were risk ratio (RR) and the mean number of oral opioid prescriptions in the first postoperative year. Secondary outcomes included the cumulative incidence and risk of any opioid prescription/administration.</p><p><strong>Results: </strong>Each cohort had 4864 patients after propensity matching. Patients receiving PT had a significantly lower risk of oral opioid prescription in the first year after primary ACDF compared with patients not receiving PT [RR: 0.739 (0.714, 0.765); 48.8% vs. 66.1%; P <0.0001]. Patients receiving PT had a statistically significant lower risk of any-route opioid prescription in the first year after primary ACDF as compared with patients who did not receive PT [RR: 0.801 (0.782, 0.821); 65.7% vs. 82.0%; P <0.0001]. In addition, the mean instances of prescriptions per patient were lower for oral opioids (1.9 vs. 2.2; P =0.006) and any-route opioids (2.8 vs. 3.1; P =0.004) among patients receiving PT versus patients not receiving PT within 2 months.</p><p><strong>Conclusion: </strong>Postoperative PT is associated with significantly lowered risk and mean opioid prescriptions in the first year after primary ACDF. Further investigation is needed to understand PT's role in reducing opioid use.</p><p><strong>Levels of evidence: </strong>Level II.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E327-E334"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Top 100 Endoscopic Spine Surgery Publications: An Updated Bibliometric Review.","authors":"Leonide Toussaint Iv, Andrew Lewis, Jonathan DeLeon, Connor Carpenter, Sudha Ramakrishnan, Ioannis Avramis, Joseph Chavarria, James Rizkalla","doi":"10.1097/BSD.0000000000002094","DOIUrl":"10.1097/BSD.0000000000002094","url":null,"abstract":"<p><strong>Background: </strong>To identify the current top 100 most-cited publications on endoscopic spine surgery (ESS) and analyze emerging trends from the past 5 years.</p><p><strong>Methods: </strong>A 2-step process was used to identify the top 100 most-cited articles. Eight key phrases commonly used in ESS research were utilized to collect relevant articles from 3 research databases. The list from each database was arranged by number of citations and compared with determine the top 100 most-cited publications in ESS.</p><p><strong>Results: </strong>The top 100 most-cited publications had a minimum of 94 citations and a maximum of 648. Most of the articles were published after 2006, and nearly one-third were published in Spine . South Korea, the United States, and Germany were the biggest contributors.</p><p><strong>Conclusion: </strong>During the past 5 years, research productivity has increased exponentially. The updated list demonstrates emerging trends within the field, including changing levels of engagement from different countries and authors, along with new techniques and pathologies.</p><p><strong>Clinical relevance: </strong>This analysis highlights the most influential research shaping current practices in ESS, offering clinicians insight into evolving surgical techniques, outcomes, and global contributions. Understanding these trends can guide evidence-based decisions and promote the adoption of innovative and minimally invasive approaches.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"309-318"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013971","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":"Percutaneous Endoscopic Lumbar Discectomy for Single-Level Lumbar Disc Herniation With Sciatic Scoliosis in Adults: A Retrospective Study of 76 Patients.","authors":"Jitao Yang, Haopeng Luan, Xuyang Xie, Weibin Sheng, Hailong Guo, Qiang Deng","doi":"10.1097/BSD.0000000000001943","DOIUrl":"10.1097/BSD.0000000000001943","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>To evaluate the clinical and radiologic results of PELD in the treatment of different segments of lumbar disc herniation with sciatic scoliosis in adults.</p><p><strong>Summary of background data: </strong>PELD is an effective surgical method for the treatment of adult lumbar disc herniation, but the curative effect of different surgical segments is not clear for patients with sciatic scoliosis.</p><p><strong>Methods: </strong>Adult patients with single-level lumbar disc herniation with sciatic scoliosis who underwent PELD were divided into 3 groups according to the surgical segments: group A(L2-3, L3-4), group B(L4-5), and group C(L5-S1). Lumbar and leg pain was assessed using the Visual Analogue Scale(VAS), functional recovery was assessed using the Oswestry Disability Index(ODI) and the Japanese Orthopaedic Association(JOA), modified Macnab criteria were used to assess clinical outcomes and coronal and sagittal imaging parameters of patients were also measured.</p><p><strong>Results: </strong>A total of 76 patients were included in this study. One month after the operation, the ODI index in group C was higher than that in groups A and B, and the JOA score was lower than that in groups A and B. During the final follow-up, the excellent and good rate of modified Macnab criteria was 94.7% in all patients. The SVA of patients in group C was higher than that of patients in groups A and B. TK and LL were lower than those of patients in groups A and B. Coronal Cobb angle and apical vertebral translation (AVT) changes were directly proportional to postoperative TK and LL improvements in each group.</p><p><strong>Conclusions: </strong>PELD is a safe and effective treatment for single-level lumbar disc herniation with sciatic scoliosis in adults, and the amount of correction of coronal scoliosis and trunk deviation in patients after surgery is significantly correlated with the amount of improvement of compensatory sagittal thoracic lordosis and lumbar kyphosis. The patients with L5-S1 may require a longer recovery time.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E342-E350"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407834","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}

{"title":"Characteristics of Unilateral Cervical Spine Facet Fractures: A Case Series of Adult Trauma Patients.","authors":"Danielle E Chipman, Thomas J Ryan, David Kowalski, Christopher Lucasti, Maxwell M Scott, Emily K Vallee, Alexander Yunke, Dil V Patel, Justin Bird, Lindsey D Clark, Joseph M Kowalski","doi":"10.1097/BSD.0000000000001865","DOIUrl":"10.1097/BSD.0000000000001865","url":null,"abstract":"<p><strong>Study design: </strong>Clinical case series.</p><p><strong>Objective: </strong>The objective of this case series is to describe the demographics, mechanisms of injury, radiologic imaging measurements, and treatment of unilateral cervical facet fractures in adult trauma patients.</p><p><strong>Summary of background data: </strong>Unilateral cervical facet fractures are rare and traumatic injuries of the spine that are frequently misdiagnosed and misclassified. There is a lack of consensus on the appropriate management for various severities of unilateral facet fractures.</p><p><strong>Methods: </strong>All patients over 18 years old who presented at a single center between September 2015 and March 2023 with a unilateral cervical facet fracture were identified. Fracture height and percentage of the lateral mass were measured on computerized tomography (CT). Demographics, treatment course, and intrahospital data were collected.</p><p><strong>Results: </strong>Of the 554 patients identified, 22 met final inclusion and exclusion criteria. The median age was 37.5 (IQR: 36) years, and 68% were male. The most common mechanisms of injury were a motor vehicle crash (55%) or a fall (23%). Seven (32%) patients required surgical intervention, and 15 (68%) patients were treated nonoperatively. The average fracture height for all participants was 1.11 ± 0.4 cm, and the average percentage of the lateral mass was 42.3% ± 18.0%. After 1 year of follow-up, all patients treated nonoperatively had successful outcomes, with no treatment failures or need for surgical intervention.</p><p><strong>Conclusion: </strong>Patients who sustained a unilateral cervical spine facet fracture from a traumatic injury mechanism with fracture fragments >1 cm or >40% of the lateral mass on CT scan can effectively be treated nonoperatively. No patient treated nonoperatively failed treatment and required surgery at 1 year. We recommend considering operative intervention in patients with high-energy mechanisms of injury coupled with the abovementioned radiographic parameters.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E315-E320"},"PeriodicalIF":1.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301251","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}