European Spine Journal最新文献

{"title":"Letter to the editor concerning \"Epidemiological trends and predictive factors of adolescent scoliosis in qingdao: insights from a Large-scale screening program (2022-2024)\" by du X, et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-09245-6).","authors":"Yujing Chen, Xiaowei Yuan","doi":"10.1007/s00586-025-09426-3","DOIUrl":"https://doi.org/10.1007/s00586-025-09426-3","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212093","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 blood flow restriction combined with routine rehabilitation in incomplete thoracic and lumbar spinal cord injury after decompression: a retrospective study.","authors":"Guihua Xiao, Yonggang Zhu, Zhou Yang, Minxing Wang, Yegai Feng, Xueliang Xu, Yongxue Li","doi":"10.1007/s00586-025-09412-9","DOIUrl":"https://doi.org/10.1007/s00586-025-09412-9","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) is a disabling condition. While conventional rehabilitation provides benefits, its effects are often limited. This study aimed to evaluate the efficacy and safety of blood flow restriction (BFR) training combined with routine rehabilitation in SCI patients after decompression surgery.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 80 patients with SCI who underwent decompression surgery and received rehabilitation treatment at our hospital between January 2023 and January 2024. Based on treatment records, patients were categorized into a control group (routine rehabilitation only) and a combination group (BFR plus routine rehabilitation). Treatment lasted for 12 weeks. Outcomes assessed included muscle strength, Lower Extremity Motor scores (LEMS), Activity of daily living (ADL), lower limb muscle circumference, hemodynamic parameters, and adverse events.</p><p><strong>Results: </strong>At 3-month follow-up, patients in the combination group exhibited greater improvements in hip, knee, and ankle muscle strength, LEMS scores, ADL scores, and lower limb muscle circumference compared to both baseline and the control group (P < 0.05). No significant intergroup differences were observed at baseline or at 1-month follow-up. Heart rate, blood pressure, and adverse event incidence remained similar between the two groups throughout the observation period (P > 0.05).</p><p><strong>Conclusion: </strong>BFR training combined with routine rehabilitation may enhance motor function, gait performance, and daily living abilities in SCI patients after decompression surgery without increasing adverse events. These findings support its clinical feasibility, but further prospective studies are warranted to confirm the results.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212112","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 \"Diagnostic accuracy of the compression overload test versus straight leg Raise test in detecting lumbar disc herniation: an MRI-Validated Cross-Sectional study\" by M. Madhesh, et al. (Eur spine J [2025]; doi: 10.1007/s00586-025-09164-6).","authors":"Vishal Kumar, Pawan Kumar, Ankit Dadra","doi":"10.1007/s00586-025-09394-8","DOIUrl":"https://doi.org/10.1007/s00586-025-09394-8","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212132","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":"Characterization of abnormal asymmetrical lifting mechanics in surgery-candidate patients with lumbar radiculopathy.","authors":"Ram Haddas, Haseeb Goheer, Ye Shu, Paul Rubery, Ashley Rogerson, Varun Puvanesarajah","doi":"10.1007/s00586-025-09344-4","DOIUrl":"https://doi.org/10.1007/s00586-025-09344-4","url":null,"abstract":"<p><strong>Study design/setting: </strong>Case-Control Study.</p><p><strong>Purpose: </strong>To quantify and evaluate kinematic parameters and range of motion during asymmetric lifting in patients with symptomatic lumbar degeneration with unilateral radiculopathy (LR) on the symptomatic and asymptomatic side, and to provide insight into the compensatory mechanisms used by patients, aiming to improve diagnostic accuracy and enhance therapeutic strategies.</p><p><strong>Methods: </strong>Thirty one LR surgical candidates and 26 healthy controls were enrolled consecutively at a single institution. Participants were fitted with a full-body external reflective marker set for three-dimensional motion capture. Participants performed six standardized functional lifting tasks using a box weighted up to 10% of their body mass, lifting to a target surface positioned 1 m high. Kinematic parameters and range of motion during asymmetrical lifting were compared between groups using linear mixed-effects regression models.</p><p><strong>Results: </strong>Patients with LR exhibited significantly reduced bilateral hip flexion during the initiation of asymmetrical lifting tasks, irrespective of the direction of the lift. When lifting toward the symptomatic side, hip flexion was reduced on both the symptomatic (89.4° vs. 97.2°, p = 0.027) and asymptomatic (89.1° vs. 97.2°, p = 0.036) limbs compared to healthy controls. Similarly, during lifts toward the asymptomatic side, reductions were observed on both the symptomatic (87.7° vs. 97.2°, p = 0.001) and asymptomatic (88.6° vs. 97.2°, p = 0.022) sides. Additionally, LR patients had significantly reduced hip flexion in the lower extremity on the same side as the asymmetric lift (symptomatic: 66.7° vs. 80.2°, p < 0.001 and asymptomatic: 65.4° vs. 80.2°, p < 0.001). LR patients also experienced altered pelvic rotation during both the lift on the symptomatic side (45.3° vs. 50.7°, p = 0.046) and the asymptomatic side (44.9° vs. 50.7°, p = 0.028) compared to controls.</p><p><strong>Conclusion: </strong>Patients with LR demonstrated significantly less hip and pelvis motion when lifting to both the symptomatic and asymptomatic side. This study quantitatively assessed clinically measurable kinematic parameters and range of motion during asymmetric lifting activities in patients with LR. These findings may provide further insight into disease-specific effects and compensatory mechanisms associated with symptomatic lumbar degeneration with unilateral radiculopathy.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212150","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":"Return to Golf after corrective surgery in adult spinal deformity patients with long fusion constructs: A retrospective case series.","authors":"Kurt Holuba, Justin L Reyes, Brendan Schwartz, Roy Miller, Alexandra C Dionne, Gabriella Greisberg, Josephine R Coury, Varun Arvind, Ronald A Lehman, Zeeshan M Sardar, Lawrence G Lenke, Joseph M Lombardi","doi":"10.1007/s00586-025-09370-2","DOIUrl":"https://doi.org/10.1007/s00586-025-09370-2","url":null,"abstract":"<p><strong>Purpose: </strong>Golf is a popular sport that requires truncal strength and spinal flexibility. Spinal fusion surgery limits range of motion which may impact a golfer's ability to return to golf (RTG). The purpose of this study is to report clinical outcomes and return to golf following long-construct spinal fusion surgery.</p><p><strong>Methods: </strong>Patients fused from the pelvis to T10 or higher were screened for golfing participation between November 2023 - April 2024. Inclusion criteria included: ≥18 years old, >2 year minimum follow-up, active golfers. Visual analogue scale (VAS) back pain level, self-perceived golf ability, golf handicap score, average days golfing per year, pain while golfing, preoperative and postoperative physical rehabilitation information, and associated regret of undergoing surgery was collected. Predictive factors for ability to RTG were evaluated.</p><p><strong>Results: </strong>12 golfers from 2015-2023 were included (age 61.1±10.0 years, BMI 23.4±4.0 kg/m², female composition 66.7%, follow-up 5.8±1.9 years). 75.0% (n=9) patients RTG at an average of 1.4±0.6 years after surgery. Patients who RTG maintained or improved their performance in the following metrics: 88.9% (n=8) in self-assessed golf ability, 40.0% (n=2) in golf handicap score, 66.7% (n=6) in average number of days golfing per year, and 100.0% (n=9) in pain while golfing. Pain scores improved from baseline to FFU: VAS (7.8±2.2 vs 1.3±1.4; p<0.01), SRS-22r (68.0±12.8 vs 92.0±15.0; p<0.01), ODI (35.3±18.1 vs 8.0±7.9; p<0.01).</p><p><strong>Conclusion: </strong>This was the largest and most in-depth case series pertaining to return to golf following corrective spinal deformity surgery. 75% of golfers returned to golf after long-construct fusion to pelvis, and the majority reported similar or improved performance. Mean pain and quality of life scores improved significantly for the whole group. Adult spinal deformity patients that play golf can expect equal or improved performance following corrective spine surgery.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212128","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":"Multimodal imaging fusion and machine learning model development: differential diagnosis of spinal inflammatory lesions using combined CT hounsfield units and MRI features.","authors":"Yuchao Wang, Xuepeng Bai, Ting Li, Sen Yuan, Shuli Zong, Yungang Chen, Hao Wang, Zhen Song, Hongchao Wang, Yanke Hao, Yiwei Qu, Junhui Liu, Qiang Zhang, Guoyan Liu","doi":"10.1007/s00586-025-09341-7","DOIUrl":"https://doi.org/10.1007/s00586-025-09341-7","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to develop a differential diagnosis model for tuberculous spondylitis (TS) and pyogenic spondylitis (PS) by integrating MRI morphological features and computed tomography (CT) density parameters (Hounsfield Units, HU). This study aims to leverage multimodal data complementarity to achieve fusion of qualitative and quantitative information, thereby providing clinicians with a rapid and objective decision support tool for spinal inflammatory lesion characterization.</p><p><strong>Methods: </strong>Imaging data were extracted from MRI and CT scans of patients with TS and PS, then compared and summarized. Receiver operating characteristic (ROC) curves were used to determine optimal HU value thresholds. The least absolute shrinkage and selection operator (Lasso) regression was applied to identify the most predictive features for model construction. A logistic regression-based predictive model was developed and visualized as a nomogram. Model validation was performed using bootstrap resampling, ROC analysis, and decision curve analysis (DCA).</p><p><strong>Results: </strong>A total of 171 patients with TS (n = 91) or PS (n = 80) were included. Statistically significant differences in MRI features were observed between the two groups (P < 0.05). Additionally, significant HU value differences were found in diseased vertebral endplates, small cavitary abscesses, large cavitary abscesses, and intravertebral abscesses between TS and PS patients (P < 0.05). The predictive model incorporated seven independent predictors. Calibration curves, ROC analysis, and DCA all demonstrated excellent model performance.</p><p><strong>Conclusion: </strong>Combined MRI and CT HU value analysis effectively differentiates TS from PS. The predictive model integrating imaging features and quantitative parameters demonstrates high accuracy and clinical utility, offering a novel approach to optimize diagnostic and treatment strategies for spinal infectious diseases.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212083","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 V. Kumar, et al. concerning \"Diagnostic accuracy of the compression overload test versus straight leg Raise test in detecting lumbar disc herniation: an MRI-validated cross-sectional study\" by M. Madhesh, et al. (Eur Spine J [2025]; doi:10.1007/s00586-025-09164-6).","authors":"Malini Madhesh, Charu Eapen, Parthasarathy Eappakkam Kumaraswamy, Vijayakumar Palaniswamy","doi":"10.1007/s00586-025-09397-5","DOIUrl":"https://doi.org/10.1007/s00586-025-09397-5","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212117","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":"CT vs. MRI-based synthetic CT: accuracy of thoracic and lumbar pedicle screw placement using 3D-printed guides.","authors":"Jules Cool, Peter P G Lafranca, Joëll Magré, Johannes G G Dobbe, Moyo C Kruyt, Geert J Streekstra, Tom P C Schlösser, Barend J van Royen","doi":"10.1007/s00586-025-09367-x","DOIUrl":"https://doi.org/10.1007/s00586-025-09367-x","url":null,"abstract":"<p><strong>Purpose: </strong>3D-printed patient-specific guides enable accurate pedicle screw placement in the treatment of paediatric spinal deformities. MRI-based synthetic CT (sCT) eliminates the radiation exposure associated with the preoperative planning CT, while still providing detailed bony morphology. It may therefore offer a radiation-free method for pedicle screw navigation. Thus, the aim of this study was to compare the accuracy of thoracic and lumbar pedicle screw placement using 3D-printed guides based on conventional CT versus sCT.</p><p><strong>Methods: </strong>Full-spine MRI and CT images of four human cadaveric spines were obtained, followed by AI-generation of sCTs, the digital planning of pedicle screws and 3D-printed guide manufacturing. A total of 62 K-wires were inserted, 30 sCT-based and 32 CT-based. Accuracy was evaluated by superimpose analysis of planned and achieved trajectories, and by the postoperative grading of the cortical breach rate using the Gertzbein-Robbins classification, based on projected screws along the K-wires.</p><p><strong>Results: </strong>Median translational entry-point deviations were 1.0 mm vertically and 0.5 mm horizontally for both sCT-based guides and CT-based guides. Angular deviations in the axial plane were 1.0˚ for sCT and 0.9˚ for CT. In the sagittal plane these were 1.8˚ and 2.1˚, respectively. No significant differences were observed between sCT and CT. Grading of pedicle's cortical breach showed no severe malposition for both sCT- and CT-based guides.</p><p><strong>Conclusion: </strong>sCT matched the accuracy of conventional CT in providing source data for personalized 3D-printed guides for thoracic and lumbar pedicle screw placement in terms of translational- and angular deviations, and cortical breach rates in this cadaveric study.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212167","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":"Challenges and limitations of the existing scoring systems for postoperative outcomes in thoracolumbar pyogenic spondylitis: a multicenter retrospective cohort study.","authors":"Hisanori Gamada, Toru Funayama, Yosuke Ogata, Yusuke Setojima, Takane Nakagawa, Takahiro Sunami, Kotaro Sakashita, Shun Okuwaki, Kaishi Ogawa, Yosuke Shibao, Hiroshi Kumagai, Katsuya Nagashima, Kengo Fujii, Yosuke Takeuchi, Masaki Tatsumura, Itsuo Shiina, Masafumi Uesugi, Masao Koda","doi":"10.1007/s00586-025-08933-7","DOIUrl":"10.1007/s00586-025-08933-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the predictive ability of existing scoring systems for postoperative outcomes in patients with thoracolumbar pyogenic spondylitis treated with minimally invasive posterior fixation.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study of 90 patients with thoracolumbar pyogenic spondylitis treated with minimally invasive posterior fixation between January 2014 and June 2024. We assessed the Brighton spondylodiscitis score (BSDS), spinal instability spondylodiscitis score (SISS), and spinal infection treatment evaluation (SITE) score. Patients were divided into success and failure groups based on infection control or implant failure. The predictive ability of each scoring system for treatment failure was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC).</p><p><strong>Results: </strong>The success and failure groups consisted of 78 (87%) and 12 patients (13%), respectively, with the failure group including seven and five patients due to infection control or implant failure. The failure group had higher BSDS, SISS, and SITE scores, but the ROC analysis showed low predictive accuracy (AUC: BSDS = 0.65, SISS = 0.64, SITE score = 0.56). Grading the BSDS into three categories revealed no failure in the low-risk patients, whereas 22% of the high-risk patients required unplanned additional surgeries for infection control or implant failure.</p><p><strong>Conclusions: </strong>Existing scoring systems showed limited ability to predict postoperative outcomes in patients with thoracolumbar pyogenic spondylitis treated with minimally invasive posterior fixation. BSDS grading demonstrated some utility, with 22% of high-risk patients experiencing postoperative infection control failure and implant failure, highlighting the need for careful treatment planning.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4717-4727"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar disc herniation modelling: a review of ex-vivo mechanical models and a comparison with clinical data.","authors":"Thomas David Slater, Hans-Joachim Wilke, Gnanaprakash Gurusamy, Shanmuganathan Rajasekaran, Nicolas Newell","doi":"10.1007/s00586-025-09054-x","DOIUrl":"10.1007/s00586-025-09054-x","url":null,"abstract":"<p><strong>Purpose: </strong>Ex-vivo herniation models are essential for studying lumbar disc herniation mechanisms, but their morphological accuracy remains unclear due to limited validation against patient-derived clinical data. This review collates clinical lumbar disc herniation characteristics and evaluates whether existing models replicate real-world pathology. By identifying the most morphologically relevant models, this study provides a stronger foundation for improving mechanistic herniation models.</p><p><strong>Methods: </strong>A systematic review following PRISMA guidelines identified clinical studies detailing herniation characteristics and experimental models of ex-vivo lumbar disc failure. Models were categorised by loading conditions (complex ultimate compression; cyclic; and intradiscal pressurisation), then compared to clinical data to assess their validity.</p><p><strong>Results: </strong>In patients, extrusions (50%) and protrusions (34%) are the most common lumbar disc herniation types, with paracentral herniations (61%) predominantly occurring at L4-L5 (49%) and L5-S1 (42%). Structural failure patterns varied, with annulus fibrosus failure reported in 35-81% of cases and endplate junction failure in 19-68%. Among 25 analysed models, all loading types induced herniations, but often with different damage patterns. Complex ultimate compression caused abrupt failures and fractures, while cyclic led to progressive annular damage. Intradiscal pressurisation highlighted nucleus pulposus migration pathways. Within a single herniation model, the damage mechanisms seen were similar between discs.</p><p><strong>Conclusions: </strong>Clinical herniation patterns show significant variability, while ex-vivo models yield more repeatable outcomes. Cyclic, complex ultimate compression, and intradiscal pressurisation models provide valuable mechanistic insights but differ in physiological relevance. Researchers must consider the physiological relevance of the applied load and the differences between animal and human discs when selecting a model. Future research should focus on understanding herniation progression and identifying initiating factors to improve prevention strategies.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4353-4368"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}