European Spine Journal最新文献

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Assessing the impact of metabolic syndrome on the accuracy of vertebral bone quality in determining bone mineral density in patients undergoing lumbar fusion surgery. 评估代谢综合征对腰椎融合术患者测定骨密度时椎体骨质量准确性的影响。
IF 2.6 3区 医学
European Spine Journal Pub Date : 2025-05-30 DOI: 10.1007/s00586-025-08934-6
Xuan Zhao, Wei Wang, Xiaolong Chen, Shibao Lu
{"title":"Assessing the impact of metabolic syndrome on the accuracy of vertebral bone quality in determining bone mineral density in patients undergoing lumbar fusion surgery.","authors":"Xuan Zhao, Wei Wang, Xiaolong Chen, Shibao Lu","doi":"10.1007/s00586-025-08934-6","DOIUrl":"https://doi.org/10.1007/s00586-025-08934-6","url":null,"abstract":"<p><strong>Objective: </strong>Existing evidence indicates that MRI-based vertebral bone quality (VBQ) provides a tool for primary screening of bone density. However, the diagnostic accuracy of this tool is not well understood. The study aims to investigate whether metabolic symptom (MetS) affects the accuracy of VBQ in determining bone mineral density (BMD) in patients undergoing lumbar fusion surgery.</p><p><strong>Methods: </strong>In this retrospective study, patients with preoperative non-contrast T1-weighted MRI were included. Patients' demographics and medical profiles were identified and analyzed. Patients were separated into two groups according the presence of MetS. Pearson correlation analysis and linear regression were used to analyze the correlation between VBQ and the BMD in different groups. Receiver operating characteristic (ROC) analysis to calculate the area under the curve (AUC) was used to assess diagnostic efficacy.</p><p><strong>Results: </strong>A total of 536 patients (241 female and 295 male patients) with a mean age of 66.5 ± 5.1 years were included in the final analysis. Sufficient intra- and interobserver reliability were determined for VBQ measures (≥ 0.8). Patients with MetS have higher lumbar BMD T-score and MetS increases the MRI-based VBQ score in patients with normal BMD. However, patients with MetS present higher proportion of history of fragility fracture. The correlation coefficient between VBQ and the lumbar BMD was - 0.42 for patients with MetS and - 0.54 for patients without MetS. VBQ demonstrated statistically significant differences among patients across the two subgroups (p < 0.001). The ROC analysis revealed indicated that there was significant better diagnostic accuracy in determining osteoporosis based on VBQ in patients without MetS than patients with MetS (AUC 0.84 vs. 0.63, p = 0.011).</p><p><strong>Conclusions: </strong>In the study, we found better performance among patients without MetS and the correlation between VBQ and BMD was stronger in patients without MetS. Interestingly, although higher lumbar T-score, there was significant more patients with a history of fragility fracture in patients with MetS.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186900","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}
引用次数: 0
Support or constraint? A comprehensive analysis of postoperative cervical bracing practices: insights from the Italian society of neurosurgery (SINch) survey and a systematic review of the literature. 支持还是约束?术后颈椎支具实践的综合分析:来自意大利神经外科学会(SINch)调查和文献系统综述的见解。
IF 2.6 3区 医学
European Spine Journal Pub Date : 2025-05-30 DOI: 10.1007/s00586-025-08913-x
Claudio Bernucci, Giorgio Cracchiolo, Luca Raspagliesi, Filippo Rambelli, Matteo Borrotti, Caterina Liberati, Angela Dele Rampini, Giorgio Cane, Carlo Brembilla, Andrea Fanti
{"title":"Support or constraint? A comprehensive analysis of postoperative cervical bracing practices: insights from the Italian society of neurosurgery (SINch) survey and a systematic review of the literature.","authors":"Claudio Bernucci, Giorgio Cracchiolo, Luca Raspagliesi, Filippo Rambelli, Matteo Borrotti, Caterina Liberati, Angela Dele Rampini, Giorgio Cane, Carlo Brembilla, Andrea Fanti","doi":"10.1007/s00586-025-08913-x","DOIUrl":"https://doi.org/10.1007/s00586-025-08913-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to capture current bracing practices for cervical spine surgery among members of the Spine Section of the Italian Society of Neurosurgery (SINch). It explores the rationale behind these practices and compares them with available evidence in the literature. A systematic review was conducted to evaluate whether patients undergoing single- or double-level anterior cervical discectomy and fusion (ACDF) without plating experience better clinical or radiological outcomes with or without postoperative cervical bracing.</p><p><strong>Methods: </strong>An anonymous 45-item survey was distributed to SINch Spine Section Members to collect data on bracing protocols following various cervical spine procedures, including degenerative and traumatic conditions, and fusion and non-fusion procedures. Additionally, a systematic review adhering to PICO standards and PRISMA guidelines, was performed to evaluate the evidence on bracing after ACDF without plating. Eligible studies included prospective data on the Neck Disability Index (NDI) and fusion rates following single- or multiple-level ACDF without plating for cervical spondylosis. Methodological quality was evaluated using the Jadad Scale for randomized controlled trials and the GRADE framework for overall evidence assessment.</p><p><strong>Results: </strong>The survey (61 respondents, 15% response rate) revealed that 85.2% of surgeons prescribed cervical collars for 2-level ACDF without plating. The main reasons cited were pain reduction and early mobilization, often based on personal experience and colleague recommendations, rather than literature evidence (14%). The systematic review identified two prospective studies, both showing no statistically significant impact of bracing on fusion rates. One study reported minor short-term improvements in neck pain (p0.05) with bracing, but no long-term differences in NDI were found.</p><p><strong>Conclusions: </strong>Cervical bracing following single- or double-level ACDF without plating remains controversial, with no significant difference in fusion rates, kyphosis progression, or cage migration between braced and non-braced patients. The routine use of postoperative bracing appears driven by tradition rather than strong evidence, suggesting that a more selective and evidence-based approach is warranted. Further high-quality research is needed to establish standardized guidelines.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186919","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}
引用次数: 0
Impact of caudal segment bone fusion on rod load at the cranial segment in a two-level spinal interbody fusion construct- a biomechanical study. 在两节段脊柱椎体间融合结构中,尾节骨融合对颅骨节段棒载荷的影响-一项生物力学研究。
IF 2.6 3区 医学
European Spine Journal Pub Date : 2025-05-30 DOI: 10.1007/s00586-025-08929-3
Maximilian Heumann, Chencheng Feng, Boyko Gueorguiev, Jan Buschbaum, Christian Mazel, Maarten Spruit, R Geoff Richards, Manuela Ernst
{"title":"Impact of caudal segment bone fusion on rod load at the cranial segment in a two-level spinal interbody fusion construct- a biomechanical study.","authors":"Maximilian Heumann, Chencheng Feng, Boyko Gueorguiev, Jan Buschbaum, Christian Mazel, Maarten Spruit, R Geoff Richards, Manuela Ernst","doi":"10.1007/s00586-025-08929-3","DOIUrl":"https://doi.org/10.1007/s00586-025-08929-3","url":null,"abstract":"<p><strong>Purpose: </strong>One-dimensional implant load measurement has been validated as a method for assessing spinal fusion progression in preclinical and in vitro studies. However, multilevel fusion procedures, which are more susceptible to non-union and implant failure than single-level fusions, pose additional challenges. Specifically, the need for implantable sensors at each segment is questioned, especially in space-constrained regions such as L5-S1, where non-union and implant failure are more common. This study explores whether a single sensor at the cranial level can effectively monitor fusion progression of a caudal segment in a two-segment posterior instrumentation following TLIF surgery. It is hypothesized that adjacent level fusion has no influence on the rod load above the separating pedicle screw.</p><p><strong>Methods: </strong>Seven human cadaveric spines (L3-S1), stabilized with posterior instrumentation following TLIF surgery at levels L4-L5 and L5-S1 were used. Bone fusion at level L4-L5 was simulated during the instrumentation. Flexibility testing and implant load measurements were conducted to compare segmental range of motion (ROM) and rod strain measured at L4-L5 between 2 states- without and with simulated bone fusion at level L5-S1. For strain measurement, an implantable sensor was used as well as one strain gauge (SG) aligned with the rod axis and one SG aligned at a 45° angle to the rod axis.</p><p><strong>Results: </strong>Axial strain measurements taken by the implantable sensor and the axial SG at L4-L5 during flexion-extension (FE), lateral bending (LB), and axial rotation (AR) were unaffected by L5-S1 fusion (p ≥ 0.172). However, torsional strain at L4-L5 decreased during AR following L5-S1 fusion (p = 0.018). A strong correlation was found between the relative decrease in ROM and torsional strain during AR motion (r = 0.828, p = 0.022).</p><p><strong>Conclusion: </strong>In this biomechanical study the rod load measurements taken by an implantable strain sensors were unaffected by adjacent level fusion. This implies that the decrease in implant load measured by this sensor, only reflects biomechanical changes at the segment containing the sensor. The strong correlation between the reduction in AR-ROM and AR-torsional strain demonstrated the potential of an alternative assessment method of multilevel fusion. However, the interpretation of the sensor signal would be challenging, as it cannot be differentiated between the contributions of each segment to the implant load changes. Consequently, this precludes the assessment of potential different fusion stages of the individual segments.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186917","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}
引用次数: 0
Radiological evaluation of posterior cervical misalignment by ligamentum flavum angle in patients with degenerative cervical myelopathy. 退行性脊髓型颈椎病患者后颈椎黄韧带角错位的影像学评价。
IF 2.6 3区 医学
European Spine Journal Pub Date : 2025-05-30 DOI: 10.1007/s00586-025-08898-7
Junhua Ye, Ramzi Roshani, Qinguo Huang, Dongying Zheng, Qiang Zhou, Hong Li, Lin Peng, Songtao Qi, Yuntao Lu
{"title":"Radiological evaluation of posterior cervical misalignment by ligamentum flavum angle in patients with degenerative cervical myelopathy.","authors":"Junhua Ye, Ramzi Roshani, Qinguo Huang, Dongying Zheng, Qiang Zhou, Hong Li, Lin Peng, Songtao Qi, Yuntao Lu","doi":"10.1007/s00586-025-08898-7","DOIUrl":"https://doi.org/10.1007/s00586-025-08898-7","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior cervical misalignment is commonly observed in patients with degenerative cervical myelopathy (DCM), yet its clinical significance remains unclear. This study takes aim to investigate the radiological value of ligamentum flavum angle (LFA) to evaluate the implications of posterior cervical misalignment in DCM.</p><p><strong>Methods: </strong>Baseline LFA was determined in 76 adults with normal cervical alignment. LFA was then analyzed in 155 DCM patients and categorized into enlarging (eLFA), normal (nLFA), and decreasing LFA (dLFA) groups. Cervical spine parameters and MRI findings were compared, and multiple linear regression identified factors associated with LFA changes. Static LFA on MRI and dynamic LFA (ΔLFA) on X-ray were evaluated for detecting cervical instability.</p><p><strong>Results: </strong>The mean LFA in normal subjects (C2/3 to C6/7) was 76.3 ± 7.2°, varying by segment and age. The LFA was significantly reduced in DCM patients (70.7 ± 11.6°). The spinal cord diameter of the adjacent vertebrae and the increased signal intensity were significant difference among eLFA, nLFA and dLFA groups. LFA correlated with vertebral body movement (β = - 3.361, P < 0.001) and cervical disc angle (β = - 0.774, P < 0.001). The static LFA cutoff for posterior slippage was 67.6°, and △LFA for instability was 12.3°.</p><p><strong>Conclusions: </strong>Posterior cervical spine misalignment in DCM is closely linked to both horizontal and angular vertebral displacements, potentially exacerbating spinal cord injury. Static and dynamic LFA measurements provide valuable supplementary parameters for the accurate assessment of cervical instability.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186918","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}
引用次数: 0
Thoracic and pelvic compensation during lumbar degeneration: a retrospective study of 625 asymptomatic adults. 腰椎退变期间的胸椎和骨盆代偿:625名无症状成人的回顾性研究。
IF 2.6 3区 医学
European Spine Journal Pub Date : 2025-05-30 DOI: 10.1007/s00586-025-08941-7
Xiangyu Li, Dongfan Wang, Xiaolong Chen, Zheng Wang, Yu Wang, Weiguo Zhu, Wei Wang, Chao Kong, Shibao Lu
{"title":"Thoracic and pelvic compensation during lumbar degeneration: a retrospective study of 625 asymptomatic adults.","authors":"Xiangyu Li, Dongfan Wang, Xiaolong Chen, Zheng Wang, Yu Wang, Weiguo Zhu, Wei Wang, Chao Kong, Shibao Lu","doi":"10.1007/s00586-025-08941-7","DOIUrl":"https://doi.org/10.1007/s00586-025-08941-7","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186920","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}
引用次数: 0
Radiographical changes and clinical prognosis after cervical laminectomy with posterior instrumented fusion for degenerative cervical myelopathy. 颈椎椎板切除术后路固定融合术治疗退行性颈椎病后影像学改变及临床预后。
IF 2.6 3区 医学
European Spine Journal Pub Date : 2025-05-29 DOI: 10.1007/s00586-025-08965-z
Yuhao Zheng, Qiyuan Yang, Bing Tan, Xiaobin Wang, Jing Li
{"title":"Radiographical changes and clinical prognosis after cervical laminectomy with posterior instrumented fusion for degenerative cervical myelopathy.","authors":"Yuhao Zheng, Qiyuan Yang, Bing Tan, Xiaobin Wang, Jing Li","doi":"10.1007/s00586-025-08965-z","DOIUrl":"https://doi.org/10.1007/s00586-025-08965-z","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Objective: </strong>The aim of the study is to investigate the radiographic changes of the spinal canal, intervertebral foramina, and spinal cord after cervical laminectomy with posterior instrumented fusion (LF), and to determine the correlation with the length of decompression levels, clinical symptoms, and C5 palsy (C5P). LF is an effective procedure for the treatment of cervical stenosis caused by various reasons. However, the radiographic changes of the spinal canal, intervertebral foramina and spinal cord after the surgery have been poorly reported, and the relationship with clinical prognosis is controversial.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive cases that underwent cervical LF with at least 1-year follow-up. The radiographic measurements included the spinal canal, intervertebral foramina, and spinal cord use image parameters. The clinical results were evaluated using the Japanese Orthopedic Association (JOA) score. The patients were divided into two groups according to length of decompression levels, the recovery rate of the JOA score, or the C5P complication. The correlation between changes in image parameters and these three factors was analyzed.</p><p><strong>Results: </strong>A total of 125 patients met the inclusion criteria (M: F = 74:51, mean age 57.8 year, mean follow-up 18.76 months). C5P observed in 21 patients (16.8%). Statistical analyses revealed that there was a statistical difference in the postoperative cervical lordosis angle between the long and short segment groups. In terms of neurological improvement, patient satisfaction was positively correlated with postoperative spinal cord cross-sectional area (SAS) and pre- and postoperative ratio of spinal cord expansion (SCE), but not with other spinal cord and spinal canal morphology parameters. C5P was negatively correlated with preoperative superior articular process projection (SAP), and the smaller the SAP, the greater the likelihood of C5P. No significant correlation was found with other morphologies of the foramen magnum, vertebral canal, and spinal cord.</p><p><strong>Conclusion: </strong>In LF, long-segment and short-segment decompression did not produce significant differences in intervertebral foraminal, spinal canal, or spinal cord morphology pre- and postoperative. Neurological improvement was correlated with the postoperative SAS and SCE, but not with other spinal cord, intervertebral foraminal, or spinal canal morphologies. The incidence of postoperative C5P was significantly correlated with preoperative SAP in the spinal canal morphology, making it a potential predictive factor for C5P.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181907","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}
引用次数: 0
Lumbar arthrodesis in elderly patients, is it a good option? A retrospective analysis of complications and pain improvement in a geriatric hospital. 腰椎融合术对老年患者是一个好的选择吗?一家老年医院并发症和疼痛改善的回顾性分析。
IF 2.6 3区 医学
European Spine Journal Pub Date : 2025-05-29 DOI: 10.1007/s00586-025-08944-4
Pedro Miguel González-Vargas, José Luis Thenier-Villa, Antonio Riveiro, Julián Castro, Pilar Varela, Olalla Lista, Martín Raposo, Ana Pastor, Juan Pou
{"title":"Lumbar arthrodesis in elderly patients, is it a good option? A retrospective analysis of complications and pain improvement in a geriatric hospital.","authors":"Pedro Miguel González-Vargas, José Luis Thenier-Villa, Antonio Riveiro, Julián Castro, Pilar Varela, Olalla Lista, Martín Raposo, Ana Pastor, Juan Pou","doi":"10.1007/s00586-025-08944-4","DOIUrl":"https://doi.org/10.1007/s00586-025-08944-4","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar arthrodesis is a well-established surgical procedure for degenerative spinal diseases, but its use in patients over 75 remains controversial due to potential complications. This retrospective study evaluates complication rates and postoperative pain control in elderly patients.</p><p><strong>Methods: </strong>A total of 150 patients over 75 years old underwent lumbar arthrodesis with laminectomy between 2015 and 2022 in a hospital in Galicia, Spain. Patients with tumors, infections, scoliosis, trauma, or prior spinal surgeries were excluded. Follow-up lasted three years and included clinical and imaging assessments.</p><p><strong>Results: </strong>- Mean age: 78.9 years; 62% female.- Common comorbidities: hypertension (70.7%), osteoporosis (64.4%).- Postoperative complications: 5.3%, including infection, epidural hematoma, pseudoarthrosis, among others.- Significant pain improvement on the Visual Analog Scale (VAS): from 7.82 preoperatively to 2.41 postoperatively.- No statistically significant associations were found between age, number of surgical levels, or comorbidities and the presence of complications.</p><p><strong>Conclusions: </strong>Lumbar arthrodesis with laminectomy in well-selected elderly patients over 75 may be a safe and effective option for pain relief. Advanced age alone does not imply a higher risk of complications. This study supports its use in geriatric populations under well-defined criteria.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180009","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}
引用次数: 0
Multimodal MRI-based clinical radiomics model for predicting postoperative anemia in patients with spinal metastases. 基于多模态mri的临床放射组学模型预测脊柱转移患者术后贫血。
IF 2.6 3区 医学
European Spine Journal Pub Date : 2025-05-29 DOI: 10.1007/s00586-025-08966-y
Weili Zhao, Siyuan Qin, Ruixin Yan, Yongye Chen, Qizheng Wang, Ke Liu, Ning Lang
{"title":"Multimodal MRI-based clinical radiomics model for predicting postoperative anemia in patients with spinal metastases.","authors":"Weili Zhao, Siyuan Qin, Ruixin Yan, Yongye Chen, Qizheng Wang, Ke Liu, Ning Lang","doi":"10.1007/s00586-025-08966-y","DOIUrl":"https://doi.org/10.1007/s00586-025-08966-y","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180970","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}
引用次数: 0
Evaluating the predictive value of multimodal intraoperative neuromonitoring in anterior cervical discectomy and fusion: a retrospective cohort study on 442 patients. 评价术中多模态神经监测对颈前路椎间盘切除术融合的预测价值:442例患者的回顾性队列研究。
IF 2.6 3区 医学
European Spine Journal Pub Date : 2025-05-29 DOI: 10.1007/s00586-025-08985-9
Giuseppe Corazzelli, Hernàn Ileyassoff, Sergio Corvino, Elena Furno, Viviana Baiano, Fabio Di Rienzo, Francesco Ricciardi, Nicola Gorgoglione, Paolo Di Russo, Settimio Leonetti, Alessandro D'Elia, Valentina Pizzuti, Marco Santilli, Marco Ciavarro, Sergio Paolini, Vincenzo Esposito, Gualtiero Innocenzi
{"title":"Evaluating the predictive value of multimodal intraoperative neuromonitoring in anterior cervical discectomy and fusion: a retrospective cohort study on 442 patients.","authors":"Giuseppe Corazzelli, Hernàn Ileyassoff, Sergio Corvino, Elena Furno, Viviana Baiano, Fabio Di Rienzo, Francesco Ricciardi, Nicola Gorgoglione, Paolo Di Russo, Settimio Leonetti, Alessandro D'Elia, Valentina Pizzuti, Marco Santilli, Marco Ciavarro, Sergio Paolini, Vincenzo Esposito, Gualtiero Innocenzi","doi":"10.1007/s00586-025-08985-9","DOIUrl":"https://doi.org/10.1007/s00586-025-08985-9","url":null,"abstract":"<p><strong>Background and objectives: </strong>Anterior cervical discectomy and fusion (ACDF) is a widely regarded surgical technique for the management of cervical disc herniation (CDH) and myelopathy, offering significant therapeutic efficacy. However, the potential for neurological complications persists, underscoring the need for strategies to enhance procedural safety. Multimodal intraoperative neuromonitoring (IONM) has emerged as a promising adjunct, providing real-time assessment of neural integrity to identify and address intraoperative compromise. This study seeks to rigorously assess the diagnostic accuracy of IONM in ACDF, evaluate its predictive utility for postoperative neurological outcomes, and analyze its association with intraoperative neural events.</p><p><strong>Methods: </strong>This monocentric retrospective observational study analyzed CDH patients who underwent ACDF between 2014 and 2023. Neurological status was pre- and postoperatively assessed and compared to IONM data, including somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), and electromyography (EMG) alarms. IONM diagnostic performance was analyzed using confusion matrices and ROC curves on the binary variables. Multivariate logistic regression was implemented to identify predictors of postoperative neurological decline.</p><p><strong>Results: </strong>SSEPs and MEPs demonstrated high diagnostic accuracy, with ROC curve areas improving significantly from preoperative (T0) to postoperative (T1) assessments (SSEP AUC: 0.922 to 1.000; MEP AUC: 0.915 to 0.996, p < 0.01). Among 442 consecutive patients, 38 (9%) intraoperative IONM alerts were recognized, labeled as transient, sustained single-modality, or sustained dual-modality changes. Permanent neurological injuries correlated with alert severity. Intraoperative alarms were the strongest predictor of postoperative motor deficits (OR:14.0, p < 0.01).</p><p><strong>Conclusion: </strong>Multimodal IONM demonstrated significant predictive value for postoperative neurological outcomes in ACDF, with intraoperative alerts strongly correlating with motor deficits. IONM was associated with postoperative neurological outcomes, suggesting a potential role in selected high-risk patients. Further studies are warranted to assess cost-effectiveness and define standardized indications.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181572","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}
引用次数: 0
Prevalence of lumbar spondylolisthesis in adults and elderly patients with low back pain in the Jordanian community: radiographic findings. 约旦社区成人和老年腰痛患者腰椎滑脱的患病率:影像学结果。
IF 2.6 3区 医学
European Spine Journal Pub Date : 2025-05-29 DOI: 10.1007/s00586-025-08963-1
Tasneem N Alhosanie, Ahmad F Klaib, Fadi Abdelraheem Al Hadidi, Tareq Kanaan, Khuzama Mohammad, Aya Al-Zurgan, Noor Tareq Yousef, Liyana Oweis, Salah M Hasan, Majed Eftiha, Fatima Abdulsattar Alkubaisi, Maher Ahmad Tarawneh, Abdelrahman Altarazi, Motaz Barakat, Iyas AbuHijlah, Qusai Al-Sabbag, Emad Tarawneh
{"title":"Prevalence of lumbar spondylolisthesis in adults and elderly patients with low back pain in the Jordanian community: radiographic findings.","authors":"Tasneem N Alhosanie, Ahmad F Klaib, Fadi Abdelraheem Al Hadidi, Tareq Kanaan, Khuzama Mohammad, Aya Al-Zurgan, Noor Tareq Yousef, Liyana Oweis, Salah M Hasan, Majed Eftiha, Fatima Abdulsattar Alkubaisi, Maher Ahmad Tarawneh, Abdelrahman Altarazi, Motaz Barakat, Iyas AbuHijlah, Qusai Al-Sabbag, Emad Tarawneh","doi":"10.1007/s00586-025-08963-1","DOIUrl":"https://doi.org/10.1007/s00586-025-08963-1","url":null,"abstract":"<p><strong>Purpose: </strong>Lumbar spondylolisthesis (LS) defined as the displacement of a vertebral body relative to the vertebra below it. Moreover, it typically affects the lower lumbar spine, particularly in women above 50 years of age. Many studies showed that the prevalence of LS increases with age and reported a higher number of cases in women. This study aimed to determine the prevalence of lumbar spondylolisthesis in adults and elderly people in the Jordanian community.</p><p><strong>Methods: </strong>A total of 2000 patients with low back pain, aged 18-94 years, with records of their age, gender, and lumbar spine X-ray from Jordan University Hospital were included in this retrospective cross-sectional study. The anterior-posterior (AP) and lateral lumbosacral X-ray images of every subject under study were read using SYNAPSE Viewer. Finally, the IBM SPSS Statistics program was used for statistical analysis.</p><p><strong>Results: </strong>Among the 1,458 subjects included in the study, 910 (62.4%) were females and 548 (37.6%) were males. Their mean age was (53.2 ± 16.1) years. A total of 385 subjects had lumbar spondylolisthesis, with a total incidence of 26.4%. The percentage of Spondylolisthesis among males was (16.1%) and (32.6%) among females. The rates of spondylolisthesis (P = 0.00) were significantly higher in females. There was no significant difference between prevalence of males and females in patients under 50 years old. But the prevalence of LS in patients who are over 50 years old increased significantly, compared to other age groups. So our results showed that as the age of the patients increased, the prevalence increased in both males and females (P = 0.01). There were 385 cases that had slipped at different level, sorting in prevalence as follows L4-L5 > L5-S1 > L3-L4 > L2-L3 > L1-L2. We noticed that the L4-L5 in females took the largest proportion, but in males L4-L5 and L5-S1 took almost the same proportion. The majority of our patients had LS only at one level, with a percentage of 94.3% among all cases.</p><p><strong>Conclusion: </strong>The total prevalence of LS in adults and the elderly in Jordanian community was 26.4%. The results of our study showed that spondylolisthesis is more common in females and may be more common among older individuals. Finally, spondylolisthesis was most seen at the L4/L5 and L5-S1 levels, and mostly at one level.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181929","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}
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