European Spine Journal最新文献

{"title":"Answer to the letter to the editor of J. Yao, et al. concerning \"magnetic resonance imaging ultrasonography fusion-guided transforaminal epidural steroid injection: a retrospective cohort\" by Ahmet Sumen, et al. (Eur spine J [2025]: doi.org/10.1007/s00586-025-08705-3).","authors":"Ahmet Sumen, Kubra Neslihan Kurt Oktay","doi":"10.1007/s00586-025-08766-4","DOIUrl":"https://doi.org/10.1007/s00586-025-08766-4","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656604","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":"Do all symptomatic adjacent segment diseases (ASD) require surgery? a prognostic classification and predictors of surgical treatment of lumbar ASD.","authors":"Rishi M Kanna, Gnana Prakash, Ajoy Prasad Shetty, Rajasekaran Shanmuganathan","doi":"10.1007/s00586-025-08797-x","DOIUrl":"https://doi.org/10.1007/s00586-025-08797-x","url":null,"abstract":"<p><strong>Introduction: </strong>Symptomatic Adjacent segment disease presents in myriad ways with varying clinic-radiological presentation but the optimal management and the factors that predict need for revision surgery are unclear.</p><p><strong>Methodology: </strong>Consecutive patients (n = 132) who experienced significant back or leg pain after an asymptomatic period (minimum 1 year) following a lumbar fusion were evaluated with dynamic radiographs and MRI. ASD was classified anatomically as proximal (86.3%), distal (12.1%, or combined (1.5%) and, sub-classified pathologically into six sub-types: Type 1: Disc prolapse (17.4%), Type 2: Disc degeneration with intra-discal instability (15.1%), Type 3: Anterolisthesis and facet instability (6.8%), Type 4: Retrolisthesis (25%), Type 5: Stenosis (21.9%) and Type 6: Combined types (13.6%).</p><p><strong>Results: </strong>The mean duration between the index surgery and ASD was 5.9 ± 4.1 years. Surgery was required in 40.9% (54/132). Six factors were highly predictive of surgical treatment for ASD, viz., Diabetes mellitus (OR-4.3, p = 0.007), ASD- disc prolapse (OR 6.3, p = 0.018), ASD intra-discal instability (OR-16.8206, p = 0.003), ASD - anterolisthesis (OR - 8.2998, p = 0.043), Facet angle > 75° (OR 37.6, p = 0.02) and radiculopathy (OR 48.0, p = 0.002). Retrolisthesis was the most benign type as 84.8% patients were managed conservatively (p = 0.016). Among proximal ASD, retrolisthesis was the most common subtype (28.9%) while disc prolapse was the most common subtype in distal ASD 37.5% (p = 0.032).</p><p><strong>Conclusion: </strong>The study classifies the versatile clinic-radiological presentation of ASD, and identifies factors that predicted the development of the different sub-types of ASD. Knowledge about the six clinic-radiological factors that predict the need for surgical treatment in ASD is beneficial.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656607","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":"Evaluation of the degenerative lumbar spondylolisthesis instability classification (DSIC) system as a guide to surgical technique selection.","authors":"Kathleen A Leinweber, Steven P Baltic, Keith W Lyons, Francine Mariaux, Anne F Mannion, Paul M Werth, Tamas Fekete, Francois Porchet, Kevin J McGuire, Jon D Lurie, Adam M Pearson","doi":"10.1007/s00586-025-08770-8","DOIUrl":"https://doi.org/10.1007/s00586-025-08770-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Degenerative spondylolisthesis (DS) is addressed with a wide range of surgical techniques, though controversy exists regarding surgical technique selection. Given the lack of high-quality evidence to guide surgical technique selection in DS, appropriateness criteria and classification systems have been developed based on expert opinion. The DSIC System uses imaging and patient characteristics to predict stability. The purpose of this study was to evaluate the DSIC system as a guide for technique selection by determining if patients within each DSIC Type have different outcomes when treated with various surgical techniques.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients undergoing surgery for symptomatic DS were prospectively enrolled at two centers. All patients were classified by DSIC Type and surgical technique. Due to small numbers in some subgroups, decompression alone and decompression with uninstrumented fusion were combined as uninstrumented group and decompression with instrumented and circumferential fusion were combined as instrumented group. The primary outcome was the 12-month change on the Core Outcome Measures Index (COMI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 508 patients enrolled, 459 patients could be classified according to DSIC criteria. 10 patients were classified as DSIC Type I (stable), 366 as DSIC Type II (potentially unstable), and 83 as DSIC Type III (unstable). Surgical technique varied significantly across DSIC Type, with decompression alone performed most commonly in DSIC I and decompression and fusion performed more commonly in DSIC II and III. There were no significant differences in COMI scores between the DSIC groups at baseline, 3 or 12 months post-operatively. At 12 months, the DSIC I uninstrumented group improved by 3.48 points on the COMI compared to 1.75 points in the DSIC I instrumented group (p &gt; 0.05). The DSIC III uninstrumented group improved by 2.94 points at 12 months compared to the DSIC III instrumented group that improved by 4.06 points (p &gt; 0.05). DSIC II patients showed similar COMI score improvement between the surgical technique groups. All DSIC groups improved significantly from baseline with greater than 75% of patients meeting minimal clinically important difference. Patients in DSIC I trended toward greater improvement with decompression alone, and patients in DSIC III trended toward greater improvement with decompression and instrumented fusion. There were no significant differences in reoperation rates between surgical technique cohorts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study found no significant differences in COMI scores between the surgical technique cohorts within each DSIC Type. There were non-significant trends suggesting that DSIC III patients with unstable slips may benefit from instrumented fusion, whereas DSIC I patients with stable slips may improve more with decompression alone or with an uninstrumented fusion. This study does not support the use ","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647876","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":"Prediction models for adjacent vertebral fractures after vertebral augmentation: a systematic review and meta-analysis.","authors":"Dan Sun, Yuhang Wen, Qiongge Yu, Yu Long, Yuyan Liu, Yue Zhou, Yufeng Yu","doi":"10.1007/s00586-025-08785-1","DOIUrl":"https://doi.org/10.1007/s00586-025-08785-1","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review published studies on risk prediction models for adjacent vertebral fractures (AVF) after vertebral augmentation (VA), thereby providing a reference for constructing and improving such models.</p><p><strong>Methods: </strong>PubMed, Web of Science, The Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Database, and SinoMed were searched from their inception to July 13, 2024. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess the risk of bias and applicability of the prediction model studies; STATA 15.0 software was used to perform a meta-analysis on the area under the curve (AUC) values of the model validation and the common predictors used in model construction.</p><p><strong>Results: </strong>A total of 13 studies were included, establishing 13 risk prediction models, with a total sample size of 3,083 patients. The AUC values of the included models ranged from 0.72 to 0.988. Of the included studies, 11 conducted internal validation, while two performed external validation. According to the PROBAST evaluation, all 13 studies exhibited a high risk of bias, yet demonstrated good applicability. The results of meta-analysis showed that the combined AUC value for the 5 validation models was 0.86 (95% CI: 0.76, 0.97). Notably, bone cement leakage (OR = 5.75, 95% CI: 3.43 ~ 9.60), age (OR = 1.20, 95% CI: 1.05 ~ 1.36), and a history of vertebral fractures (OR = 2.60, 95% CI: 1.64 ~ 4.13) were identified as significant high-risk factors for AVF after VA.</p><p><strong>Conclusion: </strong>The risk prediction models for AVF after VA performed well, but exhibited a high risk of bias. It is recommended that future studies should consider selecting more appropriate machine learning algorithms and conducting large-sample, multicenter studies. Meanwhile, healthcare providers should focus on patients with bone cement leakage, advanced age, and a previous history of vertebral fractures, remaining vigilant for the potential occurrence of AVF.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647878","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 sagittal alignment after spinal reconstruction following en bloc tumor resection impact revision rate? A preliminary long-term retrospective study.","authors":"Riccardo Cecchinato, Domenico Compagnone, Jorrit-Jan Verlaan, Nicolas Dea, Tianyi Niu, Andrea Pezzi, Francesco Langella, Stefano Boriani","doi":"10.1007/s00586-025-08789-x","DOIUrl":"https://doi.org/10.1007/s00586-025-08789-x","url":null,"abstract":"<p><strong>Objective: </strong>To investigate if postoperative sagittal alignment in long spinal fusions after lumbar enbloc resections can affect mechanical failure rates in a long-term follow-up study.</p><p><strong>Methods: </strong>Retrospective study. All patients with more than 2-years follow-up, with complete demographic and oncological data, and with a set of standing x-rays that allowed the measure of sagittal spinopelvic parameters, the difference between the ideal and actual postoperative lumbar lordosis (LLM) and the Pelvic Incidence - Lumbar Lordosis mismatch (PI-LL) were included. Data on complications, revision surgery and causes of revision were analyzed.</p><p><strong>Results: </strong>A total of 31 patients were included. Mechanical failure was observed in 10 patients (31%), and of these, 7 (22.6%) received revision surgery. Higher postoperative LLM (21.7° vs. 10.8°, p < 0.05) and higher PI-LL (15.3° vs. 2.8°, p < 0.05) values were found in the group that suffered for implant failure or adjacent disease. Moreover, patients who had undergone surgical revision showed higher LLM (23.7° vs. 11.6, p < 0.05), and PI-LL (19.9° vs. 3°, p < 0.05).</p><p><strong>Conclusions: </strong>The oncological effectiveness of en bloc resections should be combined with a long-term effectiveness and stability of spinal implants, in order to avoid reduction of quality of life due to implant failure and re-hospitalizations for revision surgery. Our study found that for all included patients mechanical failures were strictly correlated with a mismatch between PI and LL. This suggests that the sagittal balance of the spine affects the endurance of surgical implants also in en bloc resection cases.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633813","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":"Would Roussouly classification affect the diagnostic efficiency of vertebral bone quality score for assessing osteopenia or osteoporosis in lumbar degenerative disease?","authors":"Tong Su, Tong Meng, Kangcheng Zhao, Dianwen Song, Weibo Huang, Huabin Yin","doi":"10.1007/s00586-025-08760-w","DOIUrl":"https://doi.org/10.1007/s00586-025-08760-w","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to estimate the diagnostic efficiency of VBQ score for assessing osteopenia and osteoporosis in different Roussouly types in lumbar degenerative disease.</p><p><strong>Methods: </strong>We reviewed the preoperative data of 501 patients with lumbar degenerative diseases who underwent lumbar spine surgery between July 2019 and December 2022 with available T1-weighted magnetic resonance imaging and dual-energy X-ray absorptiometry. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic performance of VBQ score in different Roussouly classifications. For each Roussouly type, one-way ANOVA was applied to compare VBQ score across different lumbar segments. Statistical significance was set at P < 0.05.</p><p><strong>Results: </strong>No statistical difference was found between the VBQ score of L1, L2, L3 and L4. Lumbar lordosis and sacral slope were not independently associated with VBQ score. According to the ROC curve, Roussouly type 1 to 4 showed AUC of 0.738, 0.799, 0.764 and 0.817, respectively, in diagnosing osteopenia. Roussouly type 1 to 4 showed AUC of 0.690, 0.703, 0.851 and 0.643, respectively, in diagnosing osteoporosis.</p><p><strong>Conclusions: </strong>Different Roussouly types would not affect the diagnosis efficiency of VBQ score in diagnosing osteopenia. However, VBQ score showed better performance in diagnosing osteoporosis for Roussouly type 3. When VBQ score was applied as opportunistic screening method for osteoporosis, choosing appropriate patients was important to improve the diagnostic accuracy.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630309","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":"Two to five years pulmonary functions after thoracic, thoracolumbar and bilateral vertebral body tethering surgery.","authors":"Altug Yucekul, Nuri Demirci, Burcu Akpunarli, Peri Kindan, Feyzi Kilic, Elif Gizem Carus, Tais Zulemyan, Gokhan Ergene, Sahin Senay, Sule Turgut, Pinar Yalinay Dikmen, Yasemin Yavuz, Caglar Yilgor, Ahmet Alanay","doi":"10.1007/s00586-025-08654-x","DOIUrl":"https://doi.org/10.1007/s00586-025-08654-x","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent Idiopathic Scoliosis negatively impacts chest wall development. Bracing and fusion surgery have shown varied effects on pulmonary outcomes. Vertebral Body Tethering presents a growth-sparing alternative that might mitigate these effects by reducing biomechanical disruptions. Aim was to evaluate changes in pulmonary functions during the course of the follow-up after VBT surgery.</p><p><strong>Methods: </strong>Retrospective cohort study including patients who underwent Thoracic, Thoracolumbar and Bilateral VBT surgery with a minimum 24 months follow-up. Forced Vital Capacity (FVC%), Forced Expiratory Volume in the first second (FEV1%) and FEV1/FVC ratio were evaluated at multiple time points. Four groups were formed using main curve location and surgical technique. Analyses of variance were used to assess changes over time.</p><p><strong>Results: </strong>81 consecutive patients (76F, 5 M; 12.5 ± 1.6 years) with a mean follow-up 53.4 (24-105) months were included. Preoperatively, the median Sanders was 3 (1-7) and the median Risser was 0 (- 1-5). The mean MT curve of 50.8º ± 11.0º was corrected to 26.0º ± 7.3º at 6 weeks, which was modulated to 22.4º ± 13.4º. FVC%, FEV1%, and FEV1/FVC showed significant improvements over time for the entire cohort up to 2-3 years (p < 0.0005) where the curve type and surgical technique influenced improvement patterns. For patients with longer follow-up, values at 4-6 years did not differ from those at 2-3 years (p > 0.05, for all comparisons).</p><p><strong>Conclusions: </strong>Thoracoscopic VBT surgery led to consistent increases in FVC%, FEV1%, and FEV1/FVC values across the entire cohort, which were sustained at longer follow-up in a subset of patients. Surgeries on thoracic curves showed more pronounced improvements compared to thoracolumbar curves.</p><p><strong>Key points: </strong>Pulmonary function test results (FVC%, FEV1% and FEV1/FVC) improved following VBT surgery for AIS patients. Thoracic and thoracolumbar surgery for thoracic curves, and bilateral surgery resulted in more pronounced FVC% and FEV1% improvements. Improvement in FVC% and FEV1% values started earlier after Thoracic VBT. Thoracolumbar surgery for thoracolumbar curves displayed significant improvement only in FEV1/FVC results, as they had better preoperative pulmonary functions. Observed improvements in FVC%, FEV1% and FEV1/FVC were preserved at 4-6 and 7-8 years follow-up in a subset of patients, averaging a mean duration of 48.7 months for the whole cohort.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630294","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":"Beyond the surface: understanding psychiatric disorders in individuals with spinal cord injury- a narrative exploration.","authors":"Carlos Santander González, Ivan Ignacio Mejia, Hector Faustino Noyola Villalobos, Marco Antonio Vargas, Antonio Ibarra","doi":"10.1007/s00586-025-08735-x","DOIUrl":"https://doi.org/10.1007/s00586-025-08735-x","url":null,"abstract":"<p><strong>Purpose: </strong>Spinal Cord Injury (SCI) presents a life-threatening condition that compromises the spinal cord's integrity. Among the complications affecting SCI patients are psychiatric disorders, whose causal mechanisms remain elusive. These disorders are often attributed to multifactorial aspects, encompassing physiological, neurobiological, psychological, and social factors. In the context of SCI patients, we are interested in identifying the specific factors that contribute to the development of psychiatric disorders in this population, emphasizing the critical need for prevention strategies and comprehensive therapeutic management, ultimately aiming to improve the affected patients' quality of life.</p><p><strong>Methods: </strong>The process of searching and selecting information was performed between August and December of 2023, utilizing PubMed, ResearchGate, and NCBI as the requisite databases for this review. To ensure precise information retrieval, keywords were strategically employed, focusing on publications spanning from 1985 to the present. MeSH terms, including spinal cord injury, acute spinal cord injury, psychiatric disorders, neuropsychiatry, cognitive impairment, and chronic pain, were applied. A total of 127 articles were identified through electronic searches, and 55 of these were chosen for inclusion in this review. The consulted studies encompassed various types, such as meta-analyses, systematic reviews, animal model experiments, and others.</p><p><strong>Results: </strong>Various factors contributing to the onset of psychiatric disorders in patients with SCI were proposed, all grounded in evidence: neurobiological pathology; cognitive impairment; the impact of systemic diseases on psychological well-being; and, lastly, the correlation between chronic pain and diminished daily functionality, experiences widely encountered by SCI patients.</p><p><strong>Conclusion: </strong>The diagnosis of psychiatric disorders remains largely clinical and syndromic, with unclear causal mechanisms. Understanding psychiatric symptoms in SCI patients requires further investigation. Key contributing factors include neurobiological pathology linked to SCI, cognitive impairment, systemic and organ-specific diseases, and chronic pain associated with reduced functionality. We emphasize the importance of therapeutic and rehabilitative measures that address both physical and psychological health to improve overall quality of life.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630292","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 \"Machine learning in predicting cauda equina imaging outcomes- a solution to the problem\" by R. Sun et al. (Eur Spine J [2025]: doi.org/10.1007/s00586-024-08591-1).","authors":"Sayan Biswas, Ved Sarkar, K Joshi George","doi":"10.1007/s00586-025-08781-5","DOIUrl":"10.1007/s00586-025-08781-5","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614110","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":"Nomogram for predicting the postoperative outcomes in cervical spondylotic myelopathy based on apparent diffusion coefficient.","authors":"Jia Li, Xiao-Dan Mu, Yu-Jin Zhang, Bao-Gen Zhao, Ning Wang, Ting Gao, Li Zhang","doi":"10.1007/s00586-025-08776-2","DOIUrl":"https://doi.org/10.1007/s00586-025-08776-2","url":null,"abstract":"<p><strong>Purpose: </strong>To development a nomogram based on clinical features and apparent diffusion coefficient (ADC) of the cervical spinal cord in surgical prognosis in patients with cervical spondylotic myelopathy (CSM).</p><p><strong>Methods: </strong>Patients with CSM who underwent decompression surgery between March and September 2023 were enrolled. Patients underwent conventional cervical spine MRI and sagittal position ZOOM-DWI before surgery. Recovery rate of neurological function was calculated based on the mJOA before and 6 months after surgery. According to recovery rate, patients were divided into good-recovery group (> 50%) and poor-recovery group (< 50%). Clinical- MRI factors model (Model 1) and Clinical-MRI-ADC factors model (Model2) were bulid by multivariate logistic regression to predict. Receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA) were utilized to compare the predictive performance of the two models. A nomogram based on model 2 was constructed to predict poor recovery rate.</p><p><strong>Results: </strong>100 CSM patients were included in this study, including 60 patients in the good-recover group and 40 patients in the poor-recover group. Compared with model 1, the nomogram based on model 2 had a better AUC (0.933vs0.864). The calibration curve of model 2 is closer to the reference line, which indicates that model 2 has better resolution and accuracy. The DCA curve analysis of model 2 also showed better clinical utility. The nomogram based on model 2 performs well in predicting poor recovery rates.</p><p><strong>Conclusion: </strong>The nomogram based on ADC values can effectively predict the outcome of postoperative neurological recovery in CSM patients.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614114","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}