{"title":"Risk factors for adjacent vertebral fracture after kyphoplasty or percutaneous vertebroplasty in osteoporotic vertebral systematic review and meta-analysis compression fractures.","authors":"Lei He, Wei Li, Xingpeng Zhai, Zhiwei Li","doi":"10.1007/s00586-025-09111-5","DOIUrl":"https://doi.org/10.1007/s00586-025-09111-5","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the risk factors of adjacent vertebral re-fracture after percutaneous vertebroplasty and percutaneous kyphoplasty for osteoporotic vertebral compression fractures.</p><p><strong>Methods: </strong>PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang, VIP, CBM and other databases were searched by computer to collect case-control studies on adjacent vertebral re-fracture after vertebroplasty for osteoporotic vertebral compression fractures. The retrieval time was from the establishment of the database to July 17,2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed using Stata 17.0 software.</p><p><strong>Results: </strong>A total of 26 articles were included, including 7604 patients. The results of Meta-analysis showed that postoperative bone cement leakage, excessive recovery rate of vertebral height, too little or too much bone cement injection, low bone mineral density, high recovery rate of anterior vertebral height, no anti-osteoporosis treatment after operation, too many injured vertebrae, previous history of fracture, older age and female patients were risk factors for AVCF. High level of bone cement distribution index, physical exercise after operation and low BMI index are protective factors for AVCF.</p><p><strong>Conclusion: </strong>There are many risk factors for adjacent vertebral re-fracture after vertebroplasty for osteoporotic vertebral compression fractures. Medical staff should make comprehensive assessment, prevention and intervention.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625778","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}
Bernhard Heimkes, Nina Berger, Vincent Frimberger, Bronek Boszczyk, Miguel Pishnamaz, Heide Delbrück
{"title":"Normative values of the sagittal lumbopelvic alignment in children during the first decade of life : A retrospective observational study from a German paediatric orthopaedic hospital.","authors":"Bernhard Heimkes, Nina Berger, Vincent Frimberger, Bronek Boszczyk, Miguel Pishnamaz, Heide Delbrück","doi":"10.1007/s00586-025-09107-1","DOIUrl":"https://doi.org/10.1007/s00586-025-09107-1","url":null,"abstract":"<p><strong>Purpose: </strong>Normal values for lumbopelvic sagittal alignment in prepubertal non-Asian children have rarely been reported. However, they are becoming increasingly important for treating of hip and spinal disorders in this age group.</p><p><strong>Methods: </strong>Standing lateral radiographs of the lumbar spine and pelvis of children aged 3-10 years from 2016 to 2024 from a German paediatric orthopaedic hospital with defined inclusion criteria were evaluated in terms of pelvic incidence (PI), lumbar lordosis (LL), pelvic tilt (PT), and sacral slope (SS). The results were compared with those of comparable studies. Parametric and non-parametric statistical tests, as well as linear correlation and regression analyses, were performed according to the characteristics of the variables.</p><p><strong>Results: </strong>X-rays of 54 children aged 7.8 ± 1.9 years (30 boys, 24 girls, 44 children aged 7-10 years) were included. The mean [± standard deviation (SD)] of LL, PI, PT, and SS were 47.7°±11.2°, 35.8°±7.1°, 5.6°±7.1°, and 30.2°±8.3°, respectively. There were no significant differences between the genders and no age dependencies in our sample. The following significant correlations were observed: PI vs. LL (r = 0.393), PI vs. SS (r = 0.580), PI vs. PT (r = 0.307), SS vs. LL (r = 0.755), SS vs. PT (r=-0.586), and LL vs. PT (r=-0.534). The linear regression analysis yields the following equations: LL = 0.6 PI + 26.35 (R<sup>2</sup> = 0.155; p = 0.006), PT = 0.31 PI - 5.41 (R<sup>2</sup> = 0.094; p = 0.024) and SS = 0.68 PI + 5.86 (R<sup>2</sup> = 0.337; p < 0.001). The measured parameters were not significantly different from those of the Chinese studies, whereas the PI, LL, and SS of the only comparable non-Asian study were significantly higher.</p><p><strong>Conclusion: </strong>This study adds normal values for lumbopelvic alignment parameters in children aged 3-10 years. Differences and similarities in the parameters and their possible influencing variables between the studies published to date call for further studies, especially with the most likely influencing variables of bone age, percentile curves, body composition, and X-ray technique.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636652","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":"Endplate Hounsfield units outperform lumbar HU and VBQ in predicting cage subsidence after posterior lumbar interbody fusion: a retrospective cohort study.","authors":"Sheyang Xu, Xingling Liu, Xianglong Meng","doi":"10.1007/s00586-025-09062-x","DOIUrl":"https://doi.org/10.1007/s00586-025-09062-x","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625774","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}
Anthony N Baumann, Robert J Trager, Omkar Anaspure, Maria LaMontagne, Gordon Preston, Keegan T Conry, Jacob C Hoffmann
{"title":"Answer to Letter to the Editor of L. Dai, et al. concerning \"The association between postoperative physical therapy and opioid prescription after posterior lumbar interbody fusion: a retrospective cohort study of United States academic health centers\" by Baumann AN, et al. (Eur Spine J [2025]: doi: 10.1007/s00586-025-08824-x).","authors":"Anthony N Baumann, Robert J Trager, Omkar Anaspure, Maria LaMontagne, Gordon Preston, Keegan T Conry, Jacob C Hoffmann","doi":"10.1007/s00586-025-09145-9","DOIUrl":"https://doi.org/10.1007/s00586-025-09145-9","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636647","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}
Giovanni Viroli, Alberto Ruffilli, Matteo Traversari, Mohammadreza Chehrassan, Javad Moeini, Marco Manzetti, Marco Ialuna, Cesare Faldini
{"title":"What factors predict cervical sagittal alignment restoration after correction of thoracic adolescent idiopathic scoliosis with severe thoracic hypokyphosis? A multicenter retrospective study of 57 patients.","authors":"Giovanni Viroli, Alberto Ruffilli, Matteo Traversari, Mohammadreza Chehrassan, Javad Moeini, Marco Manzetti, Marco Ialuna, Cesare Faldini","doi":"10.1007/s00586-025-09131-1","DOIUrl":"https://doi.org/10.1007/s00586-025-09131-1","url":null,"abstract":"<p><strong>Purpose: </strong>to evaluate changes in cervical sagittal alignment after correction of AIS with severe thoracic hypokyphosis (< 10°); to assess radiographical parameters predicting postoperative cervical sagittal alignment through multivariate regression analysis.</p><p><strong>Methods: </strong>A multicenter retrospective study included AIS patients with severe thoracic hypokyphosis. Treatment involved posterior spinal fusion with pedicle screws, Ponte osteotomies, differential rod contouring and DVR. Radiographic analysis was conducted preoperatively and at a minimum 2-year follow-up.</p><p><strong>Results: </strong>Among 57 patients, a significant improvement in T5-T12 thoracic kyphosis was noted at the last follow-up. Cervical Lordosis (CL) also significantly increased, with a remaining mismatch between ideal and actual postoperative CL. Correlation analyses revealed associations between thoracic kyphosis and postoperative CL. In patients with preoperative neutral or kyphotic CL, additional factors, such as TK apex-SVA, C5-T2° Change, and TK apex-scoliosis apex distance, correlated with CL changes.</p><p><strong>Conclusion: </strong>Posterior correction of hypokyphotic AIS demonstrated significant CL improvement, yet a mismatch between ideal and achieved alignment persisted. The degree of thoracic and cervicothoracic alignment restoration correlated with spontaneous CL improvement. Overall, the study highlights the complexities of sagittal alignment in AIS.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636653","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 \"the CASINO trial: surgical versus Conservative management in patients with cervical radiculopathy due to intervertebral disc herniation: a prospective cohort study\" by Gül A, et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-09045-y.","authors":"Yang Zhang, Anqi Sun, Xiujuan Qian","doi":"10.1007/s00586-025-09121-3","DOIUrl":"https://doi.org/10.1007/s00586-025-09121-3","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625775","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}
Akhil Xavier Joseph, Alia Vidyadhara, Anjana Kashyap, Abhishek Soni, Balamurugan Thirugnanam, Madhava Pai, Vidyadhara S
{"title":"\"Beyond the incision\": A case-control study on IV and epidural pre-emptive analgesia in lumbar spine surgery.","authors":"Akhil Xavier Joseph, Alia Vidyadhara, Anjana Kashyap, Abhishek Soni, Balamurugan Thirugnanam, Madhava Pai, Vidyadhara S","doi":"10.1007/s00586-025-09143-x","DOIUrl":"https://doi.org/10.1007/s00586-025-09143-x","url":null,"abstract":"<p><strong>Introduction: </strong>Effective pain management in lumbar spine surgery is critical to enhancing postoperative recovery and minimizing complications. Preemptive analgesia, administered either intravenously or epidurally, has shown promise in controlling pain; however, limited data exist comparing the two routes directly to determine the optimal approach for lumbar procedures.</p><p><strong>Purpose: </strong>To evaluate and compare pain control efficacy, recovery outcomes, and postoperative complications between IV and epidural preemptive analgesia routes in lumbar spine surgeries.</p><p><strong>Methods: </strong>A prospective, double blinded study comparing the efficacy of intravenous (IV) and epidural preemptive analgesia in patients undergoing lumbar spine surgery. Patients undergoing lumbar spine surgery were divided into three groups based on the analgesia route: Epidural, IV and Control respectively. Pain scores, analgesic consumption, and recovery profiles were assessed postoperatively. Statistical analyses, including ANOVA and Chi-square tests, were used to evaluate differences in pain control and recovery outcomes between groups.</p><p><strong>Results: </strong>VAS scores at 4, 8, 12, and 24 h postoperatively were significantly different among groups (p < 0.0001). Group 1 (epidural) reported scores of 5.13 ± 0.86, 4.97 ± 0.93, 3.23 ± 0.94, and 3.17 ± 0.91; Group 2 (IV): 6.79 ± 1.29, 5.07 ± 0.92, 3.79 ± 1.18, and 3.21 ± 0.94; Group 3 (control): 8.92 ± 0.84, 6.96 ± 0.84, 5.82 ± 0.81, and 5.55 ± 0.50. Time to first analgesic was 26.00 ± 9.77 min (G1), 25.00 ± 9.82 min (G2), and 10.41 ± 3.51 min (G3) (p < 0.0001). Total 24-hour consumption: fentanyl- G1: 32.20 ± 4.99 mcg, G2: 30.90 ± 8.78, G3: 62.55 ± 12.34; paracetamol- 1.00 ± 0.00, 1.03 ± 0.19, 2.00 ± 0.00 g; ketorolac- 50.00 ± 0.00, 51.72 ± 9.28, 100.00 ± 0.00 mg; tramadol- 45.00 ± 15.26, 49.66 ± 16.58, 73.47 ± 15.08 mg (all p < 0.0001).</p><p><strong>Conclusion: </strong>This study fills a critical gap by directly comparing IV and epidural pre-emptive analgesia in lumbar spine surgery, providing insights for clinical decision-making. Findings suggest IV analgesia offers comparable pain control to epidural, presenting a safer alternative with fewer procedural risks. Results hold valuable implications for optimizing perioperative care.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636646","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":"Comparative analysis of the correlation between paraspinal muscles fat infiltration and vertebral bone quality in patients with lumbar degenerative diseases.","authors":"Siyi Wang, Yongdi Wang, Zhe Wang, Youwei Ai, Qian Chen, Yize Zhao, Ruibang Wu, Yong Huang, Ce Zhu, Limin Liu, Ganjun Feng","doi":"10.1007/s00586-025-09142-y","DOIUrl":"https://doi.org/10.1007/s00586-025-09142-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to comprehensively evaluate the association between paraspinal muscle fat infiltration (FI) and three MRI-based vertebral bone quality indicators-Vertebral Bone Quality (VBQ), Modified VBQ (MVBQ), and Endplate Bone Quality (EBQ)-in patients with lumbar degenerative diseases (LDD), and to compare their diagnostic and prognostic implications.</p><p><strong>Methods: </strong>A retrospective analysis included 261 patients undergoing transforaminal lumbar interbody fusion (TLIF) for LDD. Paraspinal muscle parameters-total cross-sectional area (TCSA), functional CSA (FCSA), relative FCSA (rFCSA), and fat infiltration rate (FIR)-were obtained from preoperative MRI. VBQ, MVBQ, and EBQ scores were also calculated. Patients were stratified into high and low FI groups based on FIR quartiles. Correlation and multivariable regression analyses were performed, and diagnostic performance was assessed using Receiver Operating Characteristic (ROC) curves, Clinical outcomes (Oswestry Disability Index (ODI), Visual Analogue Scale (VAS)) were followed up for 2 years.</p><p><strong>Results: </strong>Patients with high FI exhibited significantly elevated VBQ (3.41 vs. 3.01, p < 0.001), MVBQ (3.47 vs. 2.91, p < 0.001), and EBQ (3.31 vs. 2.97, p = 0.001) scores compared to the normal FI group. FIR correlated positively with all bone quality indices, with the strongest association for MVBQ (r = 0.432, p < 0.001). MVBQ demonstrated superior diagnostic performance (AUC = 0.70) compared to VBQ (AUC = 0.64) and EBQ (AUC = 0.53). At 2-year follow-up, high FI patients had worse ODI scores (11.61 vs. 10.57, p = 0.031), though no differences in VAS were observed.</p><p><strong>Conclusion: </strong>Our study established a significant association between paraspinal muscles FI and the bone quality of various regions of the vertebrae, as well as prognosis undergoing surgery for LDD patients. MVBQ may serve as a reliable and practical preoperative marker for musculoskeletal degeneration in patients with LDD, guiding individualized risk stratification and rehabilitation planning.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636648","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":"Natural course of moderate adolescent idiopathic scoliosis: a mean 25-year follow-up study.","authors":"Masayuki Ohashi, Kei Watanabe, Toru Hirano, Kazuhiro Hasegawa, Hideki Tashi, Keitaro Minato, Yohei Shibuya, Masayuki Sato, Mio Kubota, Hiroyuki Sekimoto, Hiroyuki Kawashima","doi":"10.1007/s00586-025-09135-x","DOIUrl":"https://doi.org/10.1007/s00586-025-09135-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the natural course of moderate adolescent idiopathic scoliosis (AIS) in terms of curve progression and health-related quality of life (HRQOL).</p><p><strong>Methods: </strong>The inclusion criteria were nonoperatively treated patients with AIS who had a major curve between 30° and 40° at skeletal maturity (Risser ≥ 4) and age ≥ 30 years at the survey. Fifty-eight patients (55 women) were included (follow-up rate, 37.4%). The mean age was 14.2 years at skeletal maturity and 39.9 years at the survey, with a mean 25.7-year follow-up. The HRQOL scores were compared with age- and sex-matched healthy volunteers (n = 112).</p><p><strong>Results: </strong>The median magnitude of the major curve was 36.5° at skeletal maturity (n = 58), 40° at the age of 18 years (n = 30), and 45.5° at the survey (n = 47) with a progression rate of 0.5°/year. The major curve at the survey was over 50° in 46.7% of patients, 82.4% of whom had already had major curves ≥ 40° at the age of 18 years. Despite their curve progression, patients demonstrated comparable HRQOL scores with control participants, except for the SRS-22 self-image score (AIS 2.8 vs. Control 3.4, p < 0.001).</p><p><strong>Conclusion: </strong>Moderate AIS progressed slowly but significantly throughout adulthood. Over 40% of the curves were > 50° during the mean 25-year follow-up period. Although the HRQOL scores of adult patients with moderate AIS at skeletal maturity were comparable with those of the controls, their cosmetic concerns could not be disregarded. Therefore, moderate curves, especially those ≥ 40° at the age approximately 18 years, warrant long-term follow-up.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636651","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":"Reply to the Letter to the Editor concerning \"The CASINO trial: surgical versus conservative management in patients with cervical radiculopathy due to intervertebral disc herniation: a prospective cohort study\" by Gül A, et al. (Eur Spine J [2025]: doi: 10.1007/s00586-025-09045-y).","authors":"Azra Gül, Carmen Vleggeert-Lankamp","doi":"10.1007/s00586-025-09123-1","DOIUrl":"https://doi.org/10.1007/s00586-025-09123-1","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625776","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}