European Spine Journal最新文献

{"title":"Three-dimensional spatial distribution of lumbar paraspinal intramuscular fat revealed by spatial parametric mapping.","authors":"K A Weber, E O Wesselink, J Gutierrez, C S W Law, S Mackey, J Ratliff, S Hu, A S Chaudhari, A Pool-Goudzwaard, M W Coppieters, J M Elliott, M Hancock, B De Leener","doi":"10.1007/s00586-024-08559-1","DOIUrl":"https://doi.org/10.1007/s00586-024-08559-1","url":null,"abstract":"<p><strong>Purpose: </strong>Lumbar paraspinal intramuscular fat (IMF) has emerged as a biological factor in low back pain (LBP). Traditional assessments measure IMF across the entire muscle or at specific levels and may miss key information on the role of IMF in LBP. Despite known variations across the lumbar spine, the three-dimensional (3D) distribution of IMF has not been characterized across people. Here we develop a template-based spatial parametric mapping approach to explore the 3D spatial distribution of lumbar paraspinal IMF.</p><p><strong>Methods: </strong>To generate a lumbar spine template, we used T2-weighted magnetic resonance imaging from 76 people who recently recovered from LBP. We spatially normalized fat probability maps from Gaussian mixture modeling to the template and then calculated group-level spatial parametric maps of IMF and the associations between IMF and age, BMI, and sex.</p><p><strong>Results: </strong>The template had clear delineation of the neural, vertebral, and muscular structures. We observed muscle-specific and spatially varying 3D patterns of IMF across the lumbar spine along with age-, BMI-, and sex-related associations. For the lumbar multifidus and erector spinae, IMF increased inferiorly and was greatest at the anterior-medial muscle borders, while psoas major IMF was more evenly distributed. The associations between IMF and age, BMI, and sex varied spatially with both positive and negative associations present within an individual muscle.</p><p><strong>Conclusion: </strong>The developed 3D spatial parametric mapping approach provides a comprehensive assessment of lumbar paraspinal IMF, potentially enhancing our understanding of lumbar spine function and pathology, treatment mechanisms, and the modifiable factors promoting recovery from LBP.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647274","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":"Target trial emulation: complementing findings from randomised trials with observational studies.","authors":"Joanna Diong, Manuela Ferreira","doi":"10.1007/s00586-024-08555-5","DOIUrl":"https://doi.org/10.1007/s00586-024-08555-5","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643512","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 W. Nagata, et al. concerning \"Abdominal aortic calcification is independently associated with lumbar endplate degeneration\" by L. Schönnagel et al. (Eur Spine J [2023]; doi:10.1007/s00586-023-07871-6).","authors":"Alexander P Hughes","doi":"10.1007/s00586-024-08549-3","DOIUrl":"https://doi.org/10.1007/s00586-024-08549-3","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638474","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 to: Modified pedicle subtraction osteotomy for osteoporotic vertebral compression fractures: a retrospective study of 104 patients.","authors":"Junyu Li, Jiahao Zhang, Siming Xian, Wenbin Bai, Yihao Liu, Zhuoran Sun, Yongqiang Wang, Miao Yu, Weishi Li, Yan Zeng, Yun Tian","doi":"10.1007/s00586-024-08548-4","DOIUrl":"https://doi.org/10.1007/s00586-024-08548-4","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638399","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":"\"Elucidating the immunomodulatory role of endocannabinoids in intervertebral disc degeneration\".","authors":"Gowdaman Vasudevan, Karthik Ramachandran, Chitraa Tangavel, Sharon Miracle Nayagam, Chellappa Gopalakrishnan, Raveendran Muthurajan, K S Sri Vijay Anand, Shanmuganathan Rajasekaran","doi":"10.1007/s00586-024-08550-w","DOIUrl":"10.1007/s00586-024-08550-w","url":null,"abstract":"<p><strong>Purpose: </strong>The endocannabinoid system (ECS) has been well-established to play a crucial role in the regulation of several physiological processes as well as many inflammatory disease conditions. However, its role in intervertebral disc degeneration has been least explored. We aim to investigate the immunomodulatory role of endocannabinoids in regulating IVD health.</p><p><strong>Methods: </strong>The study population included 20 healthy volunteers (controls) and 40 patients with disc degeneration (disease group) (20 Modic and 20 Non Modic). 16S metagenome sequencing of the V3-V4 region was performed for the DNA extracted from NP tissue samples of both control and disease groups. Sequencing was carried out using the Novaseq 6000 platform using 250 bp paired-end chemistry. A global metabolic profile was obtained using the uHPLC system coupled with Q Exactive Plus Hybrid Quadrupole-Orbitrap mass spectrometer.</p><p><strong>Results: </strong>Our study revealed a higher prevalence of gram-negative bacteria, particularly opportunistic pathogens like Pseudomonas, in diseased discs (71-81%) compared to healthy controls (54%). Further investigation using metabolomics identified significant changes in the lipid profiles of diseased discs. We found that the signalling molecules of the ECS, 2-arachidonylglycerol (2-AG) and N-arachidonoylethanolamine (AEA), were significantly lower in diseased discs compared to controls (Log2FC -2.62 for 2-AG and  -3.15 for AEA). Conversely, pro-inflammatory metabolites like LTA4, HPETE, HETE, and Prostaglandin G2 were elevated in diseased discs, with a Log2 fold increase greater than 2.5.</p><p><strong>Conclusion: </strong>The study reveals that the endocannabinoid metabolites (2-AG and AEA) of the ECS could be a significant molecule influencing susceptibility to infection and inflammation within the intervertebral discs, which could be a potential target for improving disc health.</p><p><strong>Level of evidence: </strong>Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617859","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":"Life-threatening postoperative hemorrhage caused by lumbar artery injury in asymmetrical pedicle subtraction osteotomy for severe spinal deformity: two case reports.","authors":"Dongyue Li, Zongshan Hu, Zezhang Zhu, Yong Qiu, Zhen Liu","doi":"10.1007/s00586-024-08530-0","DOIUrl":"https://doi.org/10.1007/s00586-024-08530-0","url":null,"abstract":"<p><strong>Purpose: </strong>To present two cases of life-threatening hemorrhage related to lumbar artery injury in adult spinal deformity (ASD) patients following S2‑alar‑iliac (S2AI) fixation and asymmetrical pedicle subtraction osteotomy (PSO), and discuss the possible reasons for postoperative hemorrhage in these patients.</p><p><strong>Methods: </strong>Patient A was a 52-year-old female with degenerative lumbar scoliosis who underwent posterior spinal fusion from T₈-S₂ and one-level PSO at L₂. Patient B was a 24-year-old male with severe kyphoscoliosis due to non-ambulatory cerebral palsy, who underwent posterior spinal fusion from T₃-S₂ and one-level PSO at L₁. Both patients underwent asymmetric PSO, where a larger wedge was resected from the convex side of the vertebral body rather than the concave side.</p><p><strong>Results: </strong>Both patients occurred a sudden increase in drainage within 3 h postoperatively, who were under anesthesia in AICU. Digital subtraction angiography (DSA) was emergently performed and revealed that the bleeding sites were from the lumbar artery, which was adherent to the convex side of the osteotomized vertebra in both cases. Then successful bleeding control was achieved through vascular embolization. Postoperative CT revealed spike formation at the anterior edges of the open wedge at the PSO level due to sagittal translation (ST), with noticeable derotation of the osteotomized vertebra.</p><p><strong>Conclusion: </strong>For patients with severe kyphoscoliosis, asymmetrical PSO increases the risk of lumbar artery injury on the convex side, and postoperative ST may further contribute to this risk. In cases where a sudden increase in drainage is observed postoperatively, it is crucial to consider the possibility of lumbar artery injury, particularly on the convex side of the osteotomized vertebra.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615532","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":"Impact of cervical kyphosis on segmental motion and symptomatic adjacent segment degeneration: a long-term follow-up data of more than 5 years.","authors":"Bingxuan Wu, Bowei Xiao, Tianhua Rong, Duo Zhang, Shuo Duan, Baoge Liu","doi":"10.1007/s00586-024-08542-w","DOIUrl":"https://doi.org/10.1007/s00586-024-08542-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study was performed to assess the impact of cervical kyphosis on the locations of average center of rotation (COR) of each level preoperatively and to investigate whether uncorrected cervical kyphosis increases the incidence of symptomatic adjacent segment degeneration (ASD) after anterior cervical decompression and fusion (ACDF).</p><p><strong>Methods: </strong>We retrospectively analyzed all patients surgically treated for cervical myelopathy, radiculopathy, or deformity at a single institution from 2012 to 2018. They were divided into cervical kyphosis and cervical lordosis cohorts. Propensity score matching was performed. Preoperative cervical segmental and postoperative adjacent segment CORs were measured. Development of symptomatic ASD in all patients was assessed after > 5 years of follow-up.</p><p><strong>Results: </strong>Among 412 patients with cervical lordosis and 47 patients with S-type cervical kyphosis, we established 37 matched pairs before and after surgery. In total, 368 COR locations were measured. Uncorrected kyphosis was identified in seven patients. The CORs of the cervical spine were located farther forward and upward in the cervical kyphosis group than in the control group (p < 0.05). At 1-year visit after ACDF, the locations of the adjacent COR showed no significant differences between the cervical postoperative lordosis group and control group. The incidence of symptomatic ASD was significantly higher in the uncorrected kyphosis group than in the corrected kyphosis group (42.9% vs. 2.5%, p = 0.001) and lordosis group (42.9% vs. 1.9%, p < 0.001).</p><p><strong>Conclusions: </strong>Cervical kyphosis can impact the locations of COR and increase the incidence of symptomatic ASD. Kyphosis correction is needed during ACDF in patients with cervical kyphosis.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603887","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 snake-eye appearance affect the clinical outcome of ACDF in treating cervical myelopathy.","authors":"Baifeng Sun, Aochen Xu, Cheng Cui, Zichuan Wu, Wenchao Zhou, Min Qi, Yang Liu","doi":"10.1007/s00586-024-08451-y","DOIUrl":"https://doi.org/10.1007/s00586-024-08451-y","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the impact of the snake-eye appearance (SEA) on the efficacy of anterior cervical discectomy and fusion (ACDF) in treating Degenerative Cervical Myelopathy (DCM).</p><p><strong>Methods: </strong>A total of 316 Patients were divided into three groups, those with SEA were in the SEA group, and those with the absence of SEA were in the non-SEA group. Meanwhile, in the non-SEA group, patients with grade 1 or 2 increased signal intensity (ISI) on T2-weighted MRI were in the ISI group, and the remaining patients without ISI were in the non-ISI group. The modified Japanese Orthopaedic Association scale (mJOA) and the neurologic functional improvement rate (IR) were measured. The number of patients who achieved upper-limb motor weakness improvement was recorded and compared. Propensity score matching (PSM) was used among the three groups.</p><p><strong>Results: </strong>The postoperative JOA and IR were similar in the SEA and non-SEA group; however, they were significantly lower than in the non-ISI group after PSM(P < 0.05). Besides, only 32.1% of patients in the SEA obtained an improvement of upper-limb motor weakness, which was the lowest in three groups after PSM (60.7% in the non-SEA group and 78.6% in the non-ISI group, P < 0.05).</p><p><strong>Conclusions: </strong>We suggested that patients with SEA tend to achieve an inadequate neurological recovery after ACDF. Besides, a SEA may be an unfavorable prognostic factor for upper extremity motor function recovery.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617860","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":"Announcements.","authors":"","doi":"10.1007/s00586-024-08554-6","DOIUrl":"https://doi.org/10.1007/s00586-024-08554-6","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603886","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":"A safe, novel and ingenious method for autogenous bone graft storage in spine surgery with constrained resources - operative site as the bone bank.","authors":"Ravi S Bains, Si Jian Hui, Veushj Sharma, Niten Kumar, Laranya Kumar, Nirmal Singh, Amarjit Singh Rai, Naresh Kumar","doi":"10.1007/s00586-024-08525-x","DOIUrl":"https://doi.org/10.1007/s00586-024-08525-x","url":null,"abstract":"<p><strong>Background: </strong>The aim of our study is to establish whether the bone graft harvested and stored in the surgical wound by our novel technique is safe, reproducible and preserves the viability of the graft. In doing so, it promises successful bony fusion in spine and orthopaedic surgeries.</p><p><strong>Methods: </strong>A prospective clinical case series was conducted for autogenous bone graft storage in complex spine surgeries requiring staged procedures, in resource constrained settings. The bone graft harvested was morselized, wrapped in moist sterile gauze and stored in the paraspinal gutter within the operative site. Thereafter, the surgical wound was easily closed without tension. During the second stage surgery, the stored bone was retrieved and mixed with more autologous/allogenic bone (if necessary) and appropriately laid at fusion sites. Bacterial samples were sent before implantation.</p><p><strong>Results: </strong>16 complex spinal deformity patients who underwent surgery in a resource constrained hospital over a period of 5 years were included. Duration between both stages was within 2 weeks. All patients showed successful fusion, with mean follow-up of 2.6 years. There were no cases of deep or systemic infection in our series. Surgeons found harvesting, storing and retrieval of graft to be straightforward.</p><p><strong>Conclusion: </strong>The operative site provides an ideal, safe and reproducible location for bone graft storage for staged surgeries conducted in resource constrained situations. The osteogenic potential of the autogenous bone graft is retained. This technique can be extrapolated to other orthopaedic surgeries conducted under resource limited environments like in surgical camps or combat medical facilities.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582089","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}