European Spine Journal最新文献

{"title":"MR-based evaluation of osseous cervical neural foraminal stenosis (OCNFS) using fast-field-echo resembling CT using restricted echo-spacing (FRACTURE).","authors":"Dejun She, Dongmei Jiang, Junhuan Hong, Yuwei Pan, Xiang Lin, Weilin Huang, Xiaojun Lin, Peiying You, Xiance Zhao, Ruiquan Chen, Dairong Cao","doi":"10.1007/s00586-025-09112-4","DOIUrl":"https://doi.org/10.1007/s00586-025-09112-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the feasibility of fast-field-echo resembling CT using restricted echo-spacing (FRACTURE) for evaluating osseous cervical neural foraminal stenosis (OCNFS).</p><p><strong>Methods: </strong>A total of 280 cervical foramina from 28 patients with cervical radiculopathy (CR) were analyzed on oblique sagittal CT, FRACTURE, T1WI, and T2WI from bilateral C2/3 to C6/7 segments by three readers. CT served as the reference standard to identify OCNFS. Detection rate and grade of OCNFS were assessed. OCNFS severity was classified into four grades according to Park's system: Grade 0 (no stenosis), Grade 1 (mild stenosis), Grade 2 (moderate stenosis), and Grade 3 (severe stenosis). Inter-modality agreements of OCNFS grade were evaluated using linear weighted Cohen's kappa (κ). Sensitivity and specificity were calculated to compare diagnostic performance between FRACTURE and conventional MRI for the diagnosis of OCNFS.</p><p><strong>Results: </strong>The inter-modality agreement of OCNFS grade was substantial between CT and FRACTURE (κ = 0.689-0.715), and moderate between CT and T1WI (κ = 0.427-0.594) or T2WI (κ = 0.462-0.604). Among the 280 cervical neural foramina, 104 were diagnosed as OCNFS using CT. Detection rate of OCNFS was 96.15% (100/104) for FRACTURE, 76.92% (80/104) for T1WI, and 95.19% (99/104) for T2WI. FRACTURE achieved a sensitivity of 96.2% and a specificity of 97.2% for detecting OCNFS. T1WI demonstrated a sensitivity of 76.9% and a specificity of 85.2%, while T2WI exhibited a sensitivity of 95.2% and a specificity of 73.9% for detecting OCNFS.</p><p><strong>Conclusion: </strong>FRACTURE can provide a reliable alternative to CT for evaluating OCNFS.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical strategies and outcomes in degenerative myelopathy at the cervico-thoracic junction: a multicenter retrospective analysis.","authors":"Giuseppe Emmanuele Umana, Gianluca Scalia, Luca Ricciardi, Giorgio Lofrese, Lorenzo Mongardi, Nicola Montemurro, Francesco Acerbi, Lidia Strigari, Miguel Ruiz Cardozo, Gabriele Capo, Ali Baram, Maurizio Formari, Camilo Molina","doi":"10.1007/s00586-025-09139-7","DOIUrl":"https://doi.org/10.1007/s00586-025-09139-7","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the clinical characteristics, treatment strategies, and outcomes of patients with cervico-thoracic junction degenerative myelopathy.</p><p><strong>Methods: </strong>A multicenter retrospective study was conducted, involving 51 adult patients with spondylotic myelopathy crossing the cervico-thoracic junction. Data on demographics, comorbidities, surgical procedures, complications, and short-term outcomes were collected. Univariate and multivariate logistic regression models were used to assess associations with postoperative outcomes, ensuring statistical rigor (e.g., multicollinearity and event-per-variable thresholds). T1-slope values were measured before and after surgery. A change within ± 2° was defined as \"stable\".</p><p><strong>Results: </strong>Patients underwent anterior-only (n = 13), posterior-only (n = 25), or combined anterior-posterior (n = 13) approaches. The mean preoperative T1-slope was 24.5° ± 7.6°, and the postoperative T1-slope was 28.2° ± 8.1° (p = 0.04). Posterior-only approaches were associated with greater early increases in T1-slope and higher complication rates. Higher ASA scores (> 2) were significantly correlated with postoperative complications. Surprisingly, general comorbidities were not independently associated with worse outcomes. Multilevel myelopathy involving C7-T1 correlated with more frequent complications and T1-slope changes.</p><p><strong>Conclusions: </strong>Surgical strategy and ASA classification emerged as key factors in short-term outcomes for CTJ myelopathy. While posterior-only approaches showed worse early radiographic and clinical results, causality cannot be inferred due to the retrospective design. Early changes in sagittal alignment (T1-slope) may reflect the quality of postoperative alignment correction, but their long-term clinical significance requires prospective evaluation. Tailored, risk-adapted surgical planning may help optimize outcomes in this complex anatomical region.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of thoracic mobilization on acmio-humeral distance, thoracic kyphosis angle, pain and shoulder function in patients with subacromial impingement syndrome: A randomized controlled trial.","authors":"Mahmut Calik, Dilara Kara, Mustafa Mert Terzi, Ugur Bezirgan, Sercan Misirli, Defne Kaya Utlu, Irem Duzgun","doi":"10.1007/s00586-025-09144-w","DOIUrl":"https://doi.org/10.1007/s00586-025-09144-w","url":null,"abstract":"<p><strong>Purpose: </strong>Thoracic hyperkyphosis, an extrinsic cause of subacromial impingement syndrome (SIS), can contribute to a decrease in the acromio-humeral distance (AHD). Thoracic mobility is necessary to reduce pain and maintain function during shoulder elevation. The aim of this study was to investigate the effect of thoracic mobilization on AHD, thoracic kyphosis angle, pain, and shoulder function in patients with SIS.</p><p><strong>Methods: </strong>Thirty-two patients with SIS, aged between 25 and 50 years, were included in the study. The exercise group (EG) performed the home exercises (rotator cuff and scapulothoracic joint-based exercises) for 12 weeks. The thoracic mobilization group (TMG) received thoracic mobilization for the first 6 weeks in addition to the same exercise program. AHD was assessed with ultrasonography, thoracic kyphosis angle with the Goniometer-pro, pain intensity with a visual analog scale (VAS), and shoulder function with American Shoulder and Elbow Surgeons (ASES) at before treatment, and follow-up at 6-week and 12-week.</p><p><strong>Results: </strong>The TMG had a greater increase in AHD at 60º and 90º (at 60º;6th weeks, p = 0.000; 12th weeks, p = 0.000, at 90º;6th weeks, p = 0.048;12th weeks, p = 0.000) and shoulder function (6th weeks, p = 0.000;12th weeks, p = 0.000) and a decrease in thoracic kyphosis angle (6th weeks, p = 0.002;12th weeks, p = 0.000) and pain intensity in night and activity (night pain;6th weeks, p = 0.000;12th weeks, p = 0.042, activity pain;6th weeks, p = 0.000;12th weeks, p = 0.000) than the EG both at 6th and 12th weeks.</p><p><strong>Conclusion: </strong>Thoracic mobilization applied in addition to the rotator cuff and scapulothoracic joint-based exercises was found to be more effective in increasing AHD and shoulder function in patients with SIS and reducing pain intensity and thoracic kyphosis angle.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar Spinal Stenosis Detection from Sagittal and Axial MR Images using Hybrid of Deep Kronecker Network and SpinalNet.","authors":"A Beulah","doi":"10.1007/s00586-025-09073-8","DOIUrl":"https://doi.org/10.1007/s00586-025-09073-8","url":null,"abstract":"<p><strong>Purpose: </strong>The main purpose of this research is to develop an automated and accurate method for detecting Lumbar Spinal Stenosis (LSS) using both sagittal and axial MRI images. The study addresses the challenge of differentiating LSS from similar conditions such as herniated disks, aiming to facilitate quick diagnosis with less dependence on expert interpretation.</p><p><strong>Method: </strong>This research proposes a Hybrid Deep Kronecker Spinal Network (DKN_Spinal) for LSS detection using sagittal and axial Magnetic Resonance Imaging (MRI) images. Here, the input sagittal and axial images are fed for the pre-processing, which is done by bias field correction. Then, the stenosis region segmentation is carried out by Fuzzy Local Information C-Means (FLICM) method. After that, the LSS is detected for both the segmented images by DKN_Spinal, which is the combination of Deep Kronecker Network (DKN) and SpinalNet. Furthermore, the classification of lumbar spine conditions in sagittal and axial images is performed, categorizing them as mild, moderate, or severe. Finally, the majority voting is carried out for both the categorized phases, which is then classified as mild, moderate, or severe based on the training loss.</p><p><strong>Results: </strong>The proposed DKN_Spinal model demonstrated superior performance, achieving an accuracy of 92.1%, True Positive Rate (TPR) of 92.2%, and True Negative Rate (TNR) of 92.9%.</p><p><strong>Conclusion: </strong>The proposed method achieves high diagnostic accuracy and effectively classifies spinal conditions into mild, moderate, or severe, providing detailed insights that support appropriate treatment planning and reduce the need for extensive expert involvement.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transdural rootlet herniation- An exceptional complication of full endoscopic lumbar discectomy: case reports and review of literature.","authors":"Kandarpkumar K Patel, Siravich Suvithayasiri, Yanting Liu, Jin-Sung Kim","doi":"10.1007/s00586-025-09137-9","DOIUrl":"https://doi.org/10.1007/s00586-025-09137-9","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic lumbar spine surgery has been regarded as a safe and minimally invasive procedure over the last decades. The incidence of dural tears in endoscopic spine surgery has been around 1.1%. Transdural nerve root herniation is a rare but severe complication if not treated early. We reviewed the literature related to our cases. A classification is proposed by the authors to categorize the cases into 4 types.</p><p><strong>Case description: </strong>We present 5 cases of transdural nerve root herniations in endoscopic lumbar spine surgery. The five cases have been classified into four different types by their time of detection, neurological status, and associated complications. According to anatomical location, 3 cases were ventral, one was lateral, and one was dorsal. One case was detected intraoperatively, while four were detected after the patient showed symptoms postoperatively. 4 cases were operated with a transforaminal endoscopic approach, and 1 case was operated with an interlaminar full endoscopic approach. One patient presented late with a neurological deficit, whereas one patient presented with pseudomeningoceole and infection. All root herniation cases were treated with an open microscopic repair. All five patients improved symptomatically postoperatively with no further complications. The classification can help categorize the nerve root herniation type in correlation with clinical outcomes. These five cases are described in detail in the manuscript.</p><p><strong>Conclusion: </strong>In our studies, we have given a classification for transdural nerve root herniation in endoscopic lumbar spine surgery. Clinical judgment and radiological evaluation in the postoperative period are vital in cases of unrecognized nerve root herniation. Early detection, repositioning of the nerve root inside the dura, and repair of the dura tear are the treatment of choice for better outcomes.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: \"Risk factors for early-onset adjacent segment disease at L5-S1 segment after isolated L4-5 lumbar fusion surgery\".","authors":"Toshiyuki Kitaori, Masato Ota, Jiro Tamura, Yoshiyuki Asada, Takahiko Saji, Masayuki Ishibashi, Takahiro Maeda, Hiroshi Iwata, Shuga Sano","doi":"10.1007/s00586-025-09122-2","DOIUrl":"https://doi.org/10.1007/s00586-025-09122-2","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the posterior-only approach provide adequate treatment for cervical spine metastases with severe vertebral body compromise?","authors":"Zhehuang Li, Panhong Zhang, Xiaoying Niu, Po Li, Xu Liu, Weitao Yao, Jing Wen, Suxia Luo, Peng Zhang","doi":"10.1007/s00586-025-09127-x","DOIUrl":"https://doi.org/10.1007/s00586-025-09127-x","url":null,"abstract":"<p><strong>Purpose: </strong>To assess posterior-only surgery for cervical spine metastases with severe vertebral compromise, characterized by severe compression fracture, ventral epidural compression, and extensive osteolytic destruction.</p><p><strong>Methods: </strong>We retrospectively analyzed 31 patients with C1-T1 metastases meeting severe compromise criteria: compression fracture with > 50% height collapse or local kyphosis, severe ventral compression with the epidural spinal cord compression scale > 1b, or extensive osteolytic destruction involving > 50% of the vertebral body. Comprehensive clinical assessments included pain severity (Numeric Rating Scale, NRS), neurological function (Frankel grading system), and performance status (Eastern Cooperative Oncology Group, ECOG). Radiographic evaluation focused on cervical sagittal alignment parameters. Survival analysis was performed using Kaplan-Meier methodology.</p><p><strong>Results: </strong>Significant improvements were observed in pain (NRS: 6.1 ± 2.0 to 2.3 ± 1.2, P < 0.001), neurological function (90% of deficit patients improved ≥ 1 Frankel grade), and performance status (ECOG:3.1 ± 0.8 to 1.7 ± 0.9, P < 0.001). Cervical sagittal alignment was significantly restored in compression fracture cases. The surgical approach exhibited favorable stability with no instances of instrumentation failure during follow-up. Survival analysis indicated median overall survival of 11.0 months, with survival rates of 87.1%, 67.7%, and 48.4% at 3, 6, and 12 months postoperatively, respectively.</p><p><strong>Conclusion: </strong>The posterior-only surgical approach can effectively addresses severe vertebral body compromise in cervical metastases, providing durable pain relief, neurological preservation, and stability with acceptable morbidity. Future studies should develop evidence-based algorithms integrating tumor characteristics and patient factors to guide surgical decisions in metastatic cervical spine disease.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Answer to the letter to the editor of T. Tu concerning \"Machine learning-based models for outcome prediction in skull base and spinal chordomas: a systematic review and meta-analysis\" by B. Hajikarimloo, et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-09053-y).","authors":"Bardia Hajikarimloo, Salem M Tos, Ibrahim Mohammadzadeh, Mohammad Amin Habibi","doi":"10.1007/s00586-025-09118-y","DOIUrl":"https://doi.org/10.1007/s00586-025-09118-y","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Answer to the letter to the editor of K. Zhou et al. concerning \"early functional training is not superior to routine rehabilitation in improving walking distance and multifidus atrophy after lumbar fusion: a randomized controlled trial with 6-month follow-up\" by Lu H, et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-08771-7).","authors":"Hongyuan Lu, Wei Feng","doi":"10.1007/s00586-025-09133-z","DOIUrl":"https://doi.org/10.1007/s00586-025-09133-z","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor concerning \"The association between postoperative physical therapy and opioid prescription after posterior lumbar interbody fusion: a retrospective cohort study of united States academic health centers\" by Baumann AN, et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-08824-x).","authors":"Linjie Dai, Kuangyang Yang","doi":"10.1007/s00586-025-09138-8","DOIUrl":"https://doi.org/10.1007/s00586-025-09138-8","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}