European Spine Journal最新文献

{"title":"Effect of thoracoplasty on patient-reported outcomes in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion: a systematic review and meta-analysis.","authors":"Paolo Brigato, Jean Albert Ouellet, Neil Saran, Sergio De Salvatore, Leonardo Oggiano, Davide Palombi, Gian Mario Sangiovanni, Federico Cardahi, Gianluca Vadalà, Pier Francesco Costici, Rocco Papalia, Vincenzo Denaro","doi":"10.1007/s00586-025-09418-3","DOIUrl":"https://doi.org/10.1007/s00586-025-09418-3","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent idiopathic scoliosis (AIS) is commonly associated with rib hump (RH) deformity, which poses a significant cosmetic concern for patients. Traditionally, thoracoplasty (TH) has been the preferred treatment to address this issue. This systematic review and meta-analysis evaluates the impact of combining TH with posterior spinal fusion (PSF) compared to PSF alone in AIS surgery. It focuses on patient-reported outcome measures (PROMs), particularly self-image scores, to assess the true cosmetic benefit of incorporating TH into PSF procedures.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic review was conducted from inception to March 2025 using Medline, Scopus, Embase, and Cochrane Library. Search terms included \"thoracoplasty\", \"scoliosis\", \"rib hump\", \"Scoliosis Research Society Score\" and \"self-image scores\". Outcomes assessed included surgical and radiological metrics, functional outcomes and complications. A meta-analysis was conducted to compare PROMs between patients treated with TH + PSF and those treated with PSF alone. The risk of bias was assessed using the MINORS score.</p><p><strong>Results: </strong>The 5 included studies had a level of evidence of either 2 or 3, with a total of 599 patients analyzed. Patients who underwent TH + PSF (n = 270) did not exhibit statistically significant differences in functional outcomes, including SRS questionnaire scores for pain, function, mental health, satisfaction, self-image, and overall score, compared to those who underwent PSF alone (n = 329) (p > 0.05). Additionally, the TH + PSF groups experienced an higher rate of postoperative complications compared to the PSF alone groups.</p><p><strong>Conclusion: </strong>The current meta-analysis indicates that TH did not result in significant improvements across any PROMs domains when added to PSF in AIS patients. Further well-conducted randomized controlled trials are needed to refine clinical decision-making by identifying the degree of deformity that may benefit from the addition of TH.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250685","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 \"Age-based prediction of non-routine discharge after anterior cervical discectomy and fusion using machine learning\" by G. Mastrokostas, et al. (Eur Spine J [2025]: doi: 10.1007/s00586-025-09303-z).","authors":"Tiantaixi Tu, Lu Wang","doi":"10.1007/s00586-025-09446-z","DOIUrl":"https://doi.org/10.1007/s00586-025-09446-z","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238407","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: Answer to the Letter to the Editor of P. Aphale, et al. concerning \"Comparison of saline consumption between microdiscectomy, uniportal, and biportal endoscopic lumbar disc surgery: a multicenter observational study\" by X. Castel, et al. (Eur Spine J [2025]; doi: 10.1007/s00586-025-09256-3).","authors":"Xavier Castel, Henri d'Astorg, Marc Szadkowski, Martin Dupuy","doi":"10.1007/s00586-025-09439-y","DOIUrl":"https://doi.org/10.1007/s00586-025-09439-y","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238368","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":"Lateral lumbar interbody fusion with lateral plating: techniques, feasibility and efficacy.","authors":"Timothy L Siu, Rachel Park, Prashant Kaushal, Kainu Lin, Behzad Eftekhar","doi":"10.1007/s00586-025-09411-w","DOIUrl":"https://doi.org/10.1007/s00586-025-09411-w","url":null,"abstract":"<p><strong>Purpose: </strong>Standalone lateral lumbar interbody fusion (LLIF) enables single-position surgery and avoids the complications of posterior instrumentation though the lack of fixation may risk non-union and cage subsidence. Performing lateral plating following cage insertion may avert these untoward outcomes though the feasibility and efficacy of this approach, particularly with a four-hole plate, has been scarcely examined. The aim of this study is to review the techniques and appraise the performance of LLIF with lateral plating through analyzing a comprehensive set of clinical and radiographic case series data.</p><p><strong>Methods: </strong>A retrospective study was conducted on a series of 55 lateral plating LLIF patients with lumbar degenerative disease. Patients with significant deformity (Cobb angle > 20° and grade 2 spondylolisthesis) were excluded. Clinical outcomes were rated by patient reported outcome measures (PROMs). Non-union and cage subsidence were evaluated by computed tomography (CT) scans performed at 12 months post-surgery or beyond.</p><p><strong>Results: </strong>A four-hole plate was successfully implanted in 65 out of 77 operative levels. The remainder had a two-hole plate inserted. Postoperative psoas weakness occurred in eight patients (15%) and thigh or groin numbness in 10 (18%). All had complete or near complete resolution at the last follow-up. Of 68 operative levels with postoperative CT available, non-union was noted in eight (12%) and cage subsidence in 14 (21%), all low grade. Significant improvement in mean PROMs scores were demonstrated in patients with non-union or cage subsidence and none required reoperation. Multivariable logistic regression analyses revealed smoking (p = 0.002) and a lack of bicortical screw purchase (p = 0.038) were significant predictors for cage subsidence.</p><p><strong>Conclusion: </strong>A four-screw plating construct is a safe and feasible fixation technique for LLIF. The treatment paradigm is associated with significant improvement in PROMs and a favorable fusion rate. Low grade cage subsidence is a potential caveat though this may not translate into poorer clinical outcomes. Fixation with bicortical screws may help reduce the odds of cage subsidence.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238400","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":"Is surgery for multiple myeloma-related spinal involvement associated with higher blood loss compared to spinal metastases?","authors":"Jens P Te Velde, Hester Zijlstra, Robertus J B Pierik, Ganesh M Shankar, Barend J van Royen, Diederik H R Kempen, Joseph H Schwab, Daniel G Tobert","doi":"10.1007/s00586-025-09294-x","DOIUrl":"https://doi.org/10.1007/s00586-025-09294-x","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple myeloma (MM) is a hematologic malignancy often presenting with diffuse osteolysis of bone in the vertebral column. So far, little is known about the risk of perioperative blood loss in spinal surgery, as MM-related spinal lesions are often grouped with spinal metastases (SPMs). A more definitive understanding of bleeding risks for myeloma specifically will improve surgical planning and treatment. This study aims to assess the bleeding index (BI) and visually estimated blood loss (EBL) in MM patients versus SPM patients undergoing oncological spine surgery.</p><p><strong>Methods: </strong>In this retrospective propensity-score-matched case-control study, we included 119 patients with MM and 119 patients with spinal metastases (SPM) who underwent oncological spine surgery between January 2002 and December 2022. A Wilcoxon signed-rank test was used to compare intraoperative bleeding values in MM and SPM patients, presented as BI and EBL.</p><p><strong>Results: </strong>MM patients had significantly higher bleeding scores (BI 5.6) compared to SPM patients (BI 3.9) (p = 0.02). The visual EBL was significantly higher in MM patients (850 ml) compared to SPM patients (600 ml) as well (p = 0.039). The BI of MM patients was comparable to hormone-dependent breast cancer (BI 5.1) and renal cell carcinoma (BI 4.95) primary tumor types. No significant differences were found when the bleeding risk was subdivided per surgical procedure in MM (p = 0.647) or SPM patients (p = 0.403).</p><p><strong>Conclusion: </strong>This study demonstrated that the BI and EBL are significantly higher in MM compared to SPMs. MM lesions have an intraoperative bleeding risk comparable to SPMs traditionally regarded as hypervascular.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238359","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":"The relative contribution of discs and vertebral bodies to thoracic kyphosis in healthy volunteers.","authors":"Mikael Finoco, Renaud Lafage, Claudio Vergari, Wafa Skalli, Jonathan Elysée, Ayman Assi, Pierre Guigui, Emmanuelle Ferrero, Virginie Lafage, Marc Khalife","doi":"10.1007/s00586-025-09392-w","DOIUrl":"https://doi.org/10.1007/s00586-025-09392-w","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding the normal anatomy of thoracic kyphosis (TK) in healthy subjects is essential for evaluating sagittal malalignment and planning the surgery accordingly. The aim of this study was to identify the proportion of thoracic kyphosis originating from disc versus vertebral body shape and to describe its variation according to age and thoracic kyphosis magnitude.</p><p><strong>Methods: </strong>This study was a retrospective review of a prospective multicenter database of healthy volunteers aged 18 years or older. Vertebral body and disc sagittal Cobb angles were measured at each level and summed within each of the 3 TK regions (Upper, Middle and Lower TK). Relative contributions of discs and vertebral bodies to Upper, Middle, Lower, and total TK were assessed in the whole cohort, and according to age and TK groups, after stratification. Finally, a multivariate analysis including age and TK magnitude was conducted.</p><p><strong>Results: </strong>Among these 645 subjects, the mean age was 37.6 ± 16.3 years with 51% of females. Intervertebral discs were kyphotic in Upper and Middle TK with respective discs contribution to total TK of 4.2% and 9.6%, for a total of 13.8% of total kyphosis. Lower TK discs were lordotic, with a participation of -13.2% of total TK, leading to an overall discs contribution to TK of 0.6%. Vertebral bodies were all kyphotic with a contribution of 99.4% of total kyphosis. Vertebral bodies kyphosis increased across age groups for Middle TK (p = 0.004), Lower TK (p < 0.001), and Total TK (p < 0.001). Discs contributions to total TK increased significantly with increasing TK (-13.8% for Low TK, -1.5% for Average-Low TK, 5.7% for Average-High TK and 9.1% for High TK), (p < 0.001). Finally, discs contribution was significantly greater in males than in females, with respective values of 2.6% and -1.8% (p = 0.01).</p><p><strong>Conclusion: </strong>This study highlights the predominant role of vertebral bodies contribution to thoracic kyphosis, 99.4% on average. The contribution of disc to thoracic kyphosis (values ranging from -13.8% to 9.1%) increases significantly with increasing thoracic kyphosis magnitude. The association of age with thoracic kyphosis was greater for vertebral bodies than discs, particularly in Middle and Lower TK.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231881","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":"Bone tunnel approach for cervical spondylotic radiculopathy with uncovertebral osteophytes.","authors":"Xin Wang, Tao Hu, Bo Lei, Chaofan Qin, Xiang Tan, Changjun Pi, Mingxin Chen, Qingshuai Yu, Si Cheng, Zhengjian Yan","doi":"10.1007/s00586-025-09400-z","DOIUrl":"https://doi.org/10.1007/s00586-025-09400-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the clinical efficacy of posterior endoscopic surgery using a bone tunnel approach in treating cervical spondylotic radiculopathy (CSR) secondary to uncovertebral osteophytes.</p><p><strong>Methods: </strong>From January 2022 to July 2023, 68 patients diagnosed with cervical osseous foraminal stenosis due to uncovertebral osteophytes and treated with posterior endoscopic surgery through the bone tunnel approach were retrospectively enrolled in this study, with a minimum follow-up period of 1 year. Clinical outcomes were evaluated using the Visual Analogue Scale (VAS) for neck and arm pain, Neck Disability Index (NDI), and success rate according to Odom's criteria. Radiological outcomes were assessed by measuring the C2-7 sagittal Cobb angle (SCA), segmental angle (SA), and cervical curvature angle (CA) on the lateral, hyperflexion and hyperextension radiographs.</p><p><strong>Results: </strong>All the patients successfully underwent the procedure without severe complications. The mean operative duration was 84.1 ± 24.6 min, with an average hospital stay of 4.4 ± 2.2 days and a mean follow-up time of 14.7 ± 3.1 months. Significant improvements in the NDI and VAS scores were observed postoperatively (p < 0.05). At the final follow-up, the clinical success rate, defined as excellent or good outcomes, was 100% (43 excellent and 25 good outcomes). On lateral radiographs, no statistically significant differences were detected in SCA, CA, and SA measurements at various time points. On hyperextension radiographs, all measurements at the final follow-up were significantly larger than those taken pre- and postoperatively (p < 0.05). On hyperflexion radiographs, all postoperative measurements were significantly smaller than those taken preoperatively and at the final follow-up (p < 0.05).</p><p><strong>Conclusion: </strong>Posterior endoscopic surgery through the bone tunnel approach is a safe and effective route for achieving direct neuroventral bony decompression, demonstrating favorable clinical and radiological outcomes in the treatment of CSR with uncovertebral osteophytes.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231886","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: Association among clinical severity indicators, psychological health status and elastic properties of neck muscles in patients with chronic mechanical neck pain.","authors":"Juan Antonio Valera-Calero, Umut Varol, Mónica López-Redondo, María José Díaz-Arribas, Marcos José Navarro-Santana, Gustavo Plaza-Manzano","doi":"10.1007/s00586-025-09338-2","DOIUrl":"https://doi.org/10.1007/s00586-025-09338-2","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231899","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":"Clinical efficacy and safety of robot-assisted targeted co-ablation combined with vertebroplasty under local anesthesia for spinal metastases.","authors":"Kang Zheng, Wentao Wang, Zhengpei Liu, Lequn Shan, Dingjun Hao","doi":"10.1007/s00586-025-09326-6","DOIUrl":"https://doi.org/10.1007/s00586-025-09326-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical efficacy and safety of robot-assisted targeted co-ablation (CA) combined with percutaneous vertebroplasty (PVP) under local anesthesia for spinal metastases.</p><p><strong>Methods: </strong>This was a retrospective study of 43 patients with spinal metastases treated in our hospital from October 2022 to October 2023. Among the 43 patients, 18 underwent robot-assisted targeted CA combined with PVP (CA group) and 25 underwent PVP alone (PVP group). The visual analogue scale (VAS), the Oswestry Disability Index (ODI), and the Karnofsky Performance Status (KPS) were used to evaluate the intensity of pain, and the quality of life.</p><p><strong>Results: </strong>There were no significant differences in the baseline data between the two groups (P > 0.05). The time of puncture channel establishment in the CA group was significantly shorter than that in the PVP group (11.33 ± 2.22 vs. 26.72 ± 4.20 min, P < 0.001). There were significantly improvements in VAS, ODI and KPS of two groups at each follow-up visit than before the operation (P > 0.05). However, at the 6 months follow-up, patients of the CA group had significantly lower VAS and ODI scores than the PVP group, and the KPS was higher (P < 0.05). The imaging examination performed at 6 months after the operation revealed that only one patient (5.6%) in CA group experienced local tumor progression (LTP), whereas 9 patients (36%) in PVP group, and the difference was significant (P = 0.03). The incidence of cement leakage in CA group (11.1%) was significantly lower than that in PVP group (44%) (P = 0.02). Multivariate logistic regression analysis of independent risk factors against LTP confirmed that a maximum diameter of spinal metastases ≥ 3.0 cm is an independent risk factor (OR: 7.413, P = 0.022). While, robot-assisted targeted CA combined with PVP is an independent protective factor (OR: 0.095, P = 0.045). For cement leakage, robot-assisted CA combined with PVP was also the independent protective factor (OR: 0.159, P = 0.031).</p><p><strong>Conclusions: </strong>Robot-assisted targeted CA combined with PVP under local anesthesia can provide durable pain relief and improve the quality of life of patients.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231826","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":"Association of paraspinal and psoas muscle morphology with recurrent lumbar disc herniation: a retrospective case-control study.","authors":"Abdurrahim Tekin, Engin Can, Enis Furkan Edehan, Necati Uğur Hazar, Lokman Ayhan, Evren Sönmez, Suna Dilbaz, Akın Öztürk, Nuri Serdar Baş, Serdar Çevik","doi":"10.1007/s00586-025-09424-5","DOIUrl":"https://doi.org/10.1007/s00586-025-09424-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the association between the morphology of paraspinal and psoas muscles and recurrent lumbar disc herniation (rLDH) using quantitative preoperative MRI analysis.​.</p><p><strong>Methods: </strong>​A retrospective analysis was conducted on 43 patients with rLDH and 43 matched controls who had undergone surgery for lumbar disc herniation (LDH). ​ Quantitative measurements of the multifidus (MF), erector spinae (ES), and psoas (PS) muscles were performed, including functional cross-sectional area (FCSA), fat infiltration (FI), and relative FCSA (rFCSA). ​​.</p><p><strong>Results: </strong>The FCSA values of MF and ES muscles were significantly lower in the rLDH group compared to controls, while the PS muscle exhibited higher FCSA values. Multivariate analysis revealed that increased MF FCSA had a protective effect against rLDH (OR = 0.665, p < 0.001), whereas increased PS FCSA was a significant risk factor (OR = 1.15, p < 0.001).</p><p><strong>Conclusion: </strong>Degeneration of the multifidus muscle and hypertrophy of the psoas were significantly associated with recurrence of LDH, whereas erector spinae degeneration did not show a significant independent effect in multivariate analysis.​ These findings emphasize the importance of maintaining paraspinal muscle health to prevent rLDH. ​ Further prospective studies are needed to confirm these results and explore targeted interventions for muscle function improvement.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231833","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}