European Spine Journal最新文献

{"title":"Responsiveness of the Japanese version of the lumbar stiffness disability index.","authors":"Hidetaka Furuya, Kenji Hirohata, Sho Mitomo, Masahiro Hoshino, Tomoko Sakai, Tetsuya Jinno, Robert A Hart","doi":"10.1007/s00586-025-09120-4","DOIUrl":"https://doi.org/10.1007/s00586-025-09120-4","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate the psychometric characteristics of the Japanese version of the Lumbar Stiffness Disability Index (J-LSDI) in patients undergoing lumbar spinal surgery, with a focus on its responsiveness and minimal clinically important differences (MCID).</p><p><strong>Methods: </strong>This prospective, single-institution cohort study enrolled adult individuals diagnosed with degenerative spinal pathologies who underwent surgical intervention approximately 1 year prior inclusion in the study. Participants were stratified into three groups according to the number of lumbar segments included in the arthrodesis construct: Group 1 (no fusion or single-level fusion); Group 2 (fusion across two to four levels); and Group 3 (fusion involving five or more levels). Within the distribution-based framework, responsiveness was quantified using effect size (ES) and standardized response mean (SRM). Areas under the receiver operating characteristic curves (AUCs) and MCID were determined for participants who reported either \"minimal\" or \"moderate\" improvement.</p><p><strong>Results: </strong>A total of 488 participants completed the J-LSDI at baseline and 1 year. In Group 1, the LSDI scores improved from preoperatively to postoperatively, with moderate ES and SRM values (ES = 0.78; SRM = 0.59). In Group 2, the preoperative and postoperative LSDI scores did not differ, with low ES and SRM values (ES = 0.13; SRM = 0.12). In Group 3, the LSDI scores worsened from preoperatively to postoperatively, with high ES and SRM values (ES = 1.20; SRM = 0.90). The optimal cutoff points for the MCID in Groups 1, 2, and 3 were - 8.0, 0.2, and 17.1, respectively. The AUCs for the MCID in Groups 1, 2, and 3 were 0.72, 0.73, and 0.76, respectively, indicating moderate accuracy. Between-group analysis of variance revealed no significant differences in preoperative LSDI scores (p = 0.40), while significant differences were observed in postoperative scores at 1 year (p < 0.01).</p><p><strong>Conclusion: </strong>This study underscores the clinical relevance and measurement reliability of the J-LSDI as an effective tool for evaluating the functional impact of spinal stiffness on activities of daily living among Japanese patients, in both the preoperative and postoperative phases of spinal surgery.</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":"144625777","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 novel dura splitting technique for surgical resection of anterior spinal meningioma: a case series and systematic review of the literature.","authors":"Abdurrahim Elashaal, Abdalhaleem Ibdah, Atef Hulliel, Asem Almomani","doi":"10.1007/s00586-025-09079-2","DOIUrl":"https://doi.org/10.1007/s00586-025-09079-2","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607897","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 novel artificial Intelligence-Based model for automated Lenke classification in adolescent idiopathic scoliosis.","authors":"Kunjie Xie, Suping Zhu, Jincong Lin, Yi Li, Jinghui Huang, Wei Lei, Yabo Yan","doi":"10.1007/s00586-025-09106-2","DOIUrl":"https://doi.org/10.1007/s00586-025-09106-2","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an artificial intelligence (AI)-driven model for automatic Lenke classification of adolescent idiopathic scoliosis (AIS) and assess its performance.</p><p><strong>Methods: </strong>This retrospective study utilized 860 spinal radiographs from 215 AIS patients with four views, including 161 training sets and 54 testing sets. Additionally, 1220 spinal radiographs from 610 patients with only anterior-posterior (AP) and lateral (LAT) views were collected for training. The model was designed to perform keypoint detection, pedicle segmentation, and AIS classification based on a custom classification strategy. Its performance was evaluated against the gold standard using metrics such as mean absolute difference (MAD), intraclass correlation coefficient (ICC), Bland-Altman plots, Cohen's Kappa, and the confusion matrix.</p><p><strong>Results: </strong>In comparison to the gold standard, the MAD for all predicted angles was 2.29°, with an excellent ICC. Bland-Altman analysis revealed minimal differences between the methods. For Lenke classification, the model exhibited exceptional consistency in curve type, lumbar modifier, and thoracic sagittal profile, with average Kappa values of 0.866, 0.845, and 0.827, respectively, and corresponding accuracy rates of 87.07%, 92.59%, and 92.59%. Subgroup analysis further confirmed the model's high consistency, with Kappa values ranging from 0.635 to 0.930, 0.672 to 0.926, and 0.815 to 0.847, and accuracy rates between 90.7 and 98.1%, 92.6-98.3%, and 92.6-98.1%, respectively.</p><p><strong>Conclusion: </strong>This novel AI system facilitates the rapid and accurate automatic Lenke classification, offering potential assistance to spinal surgeons.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607896","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":"No long term benefit of decompression of a borderline lumbar spinal stenosis level adjacent to a more stenotic index level.","authors":"Erland Hermansen, Eric Franssen, Tor Åge Myklebust, Kari Indrekvam, Ivar Magne Austevoll, Christian Hellum, Sara Tronstad, Kjersti Storheim, Jørn Aaen, Hasan Banitalebi, Jens Ivar Brox, Trond Ottar, Tore K Solberg, Helena Brisby","doi":"10.1007/s00586-025-09113-3","DOIUrl":"https://doi.org/10.1007/s00586-025-09113-3","url":null,"abstract":"<p><strong>Purpose: </strong>Lumbar spinal stenosis (LSS) frequently involves multiple levels of the spine. Whether to perform single-level decompression (SLD) or multi-level decompression (MLD) in patients with at least one borderline stenotic level adjacent to the primary (index) level, remains debated. Short-term follow-up studies show comparable outcomes for both strategies. This study aimed to assess five-year outcomes in patients with adjacent borderline stenosis.</p><p><strong>Material: </strong>All participants were recruited from the NORDSTEN-SST. Patients with a preoperative adjacent borderline stenosis, defined as Schizas grade B or C, in addition to the index level, were included in the study. The cohort was divided into two groups based on the type of surgical intervention: SLD or MLD. Baseline characteristics and clinical outcomes were recorded for both groups, with follow-up conducted five years postoperatively. Subgroup analysis based on the Schizas grade in the adjacent level were also performed.</p><p><strong>Results: </strong>Out of 437 patients in the NORDSTEN-SST, the 222 with borderline adjacent stenosis were included. Among these, 114 underwent SLD, while 108 underwent MLD. Baseline characteristics were comparable between groups. Mean change in ODI-score was - 16.0 (95% CI -18.9-12.9) for the SLD group and - 18.6 (95% CI -22.1-15.1) for the MLD group, p = 0.26. Subgroup analyses revealed no significant differences between groups in clinical outcomes or need for subsequent spinal surgeries.</p><p><strong>Conclusion: </strong>In this observational study, five-year clinical outcomes in patients operated for lumbar spinal stenosis with a significant stenotic index level were not influenced by additional decompression of preoperative adjacent borderline stenotic levels.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599875","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":"Research on a deep learning-based model for measurement of X-ray imaging parameters of atlantoaxial joint.","authors":"Yuhua Wu, Yuwen Zheng, Jinping Zhu, Xiaofei Chen, Fuwen Dong, Linyang He, Jinyang Zhu, Guohua Cheng, Ping Wang, Sheng Zhou","doi":"10.1007/s00586-025-09075-6","DOIUrl":"https://doi.org/10.1007/s00586-025-09075-6","url":null,"abstract":"<p><strong>Purpose: </strong>To construct a deep learning-based SCNet model, in order to automatically measure X-ray imaging parameters related to atlantoaxial subluxation (AAS) in cervical open-mouth view radiographs, and the accuracy and reliability of the model were evaluated.</p><p><strong>Methods: </strong>A total of 1973 cervical open-mouth view radiographs were collected from picture archiving and communication system (PACS) of two hospitals(Hospitals A and B). Among them, 365 images of Hospital A were randomly selected as the internal test dataset for evaluating the model's performance, and the remaining 1364 images of Hospital A were used as the training dataset and validation dataset for constructing the model and tuning the model hyperparameters, respectively. The 244 images of Hospital B were used as an external test dataset to evaluate the robustness and generalizability of our model. The model identified and marked landmarks in the images for the parameters of the lateral atlanto-dental space (LADS), atlas lateral mass inclination (ALI), lateral mass width (LW), axis spinous process deviation distance (ASDD). The measured results of landmarks on the internal test dataset and external test dataset were compared with the mean values of manual measurement by three radiologists as the reference standard. Percentage of correct key-points (PCK), intra-class correlation coefficient (ICC), mean absolute error (MAE), Pearson correlation coefficient (r), mean square error (MSE), root mean square error (RMSE) and Bland-Altman plot were used to evaluate the performance of the SCNet model.</p><p><strong>Results: </strong>(1) Within the 2 mm distance threshold, the PCK of the SCNet model predicted landmarks in internal test dataset images was 98.6-99.7%, and the PCK in the external test dataset images was 98-100%. (2) In the internal test dataset, for the parameters LADS, ALI, LW, and ASDD, there were strong correlation and consistency between the SCNet model predictions and the manual measurements (ICC = 0.80-0.96, r = 0.86-0.96, MAE = 0.47-2.39 mm/°, MSE = 0.38-8.55 mm²/°², RMSE = 0.62-2.92 mm/°). (3) The same four parameters also showed strong correlation and consistency between SCNet and manual measurements in the external test dataset (ICC = 0.81-0.91, r = 0.82-0.91, MAE = 0.46-2.29 mm/°, MSE = 0.29-8.23mm²/°², RMSE = 0.54-2.87 mm/°).</p><p><strong>Conclusion: </strong>The SCNet model constructed based on deep learning algorithm in this study can accurately identify atlantoaxial vertebral landmarks in cervical open-mouth view radiographs and automatically measure the AAS-related imaging parameters. Furthermore, the independent external test set demonstrates that the model exhibits a certain degree of robustness and generalization capability under meet radiographic standards.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599891","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 discal cysts: a systematic literature review of diagnostic features and treatment strategies.","authors":"Edoardo Agosti, Lucio De Maria, Francesco Belotti, Enza Gatti, Marco Bruzzone, Paolo Amaddeo, Gianandrea Bellini, Riccardo Bergomi, Marco Fontanella, Nazzareno Fagoni, Claudio Cornali","doi":"10.1007/s00586-025-09059-6","DOIUrl":"https://doi.org/10.1007/s00586-025-09059-6","url":null,"abstract":"<p><strong>Purpose: </strong>Discal cysts are epidural masses connected to the intervertebral disk, primarily affecting younger individuals. Distinguishing discal cysts from other cystic masses within the epidural space is challenging due to overlapping clinical symptoms and neuroimaging characteristics. This systematic review aims to analyze the diagnostic features and management strategies of lumbar discal cysts.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted following PRISMA guidelines. Relevant studies published between January 1990 and July 2023 were included. Data on diagnostic features, management strategies, and outcomes were extracted. The quality of included studies was assessed using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>This systematic review examined a total of 52 articles and 118 cases of discal cysts, including one institutional case. The median age of the patients was 30 years, with a higher prevalence of males. The median follow-up period was 12 months. The most common symptoms reported were leg pain (87.3%) and low back pain (71.2%). Physical examination findings were positive in 45.5% of patients, including hypoesthesia (23.2%), leg weakness (18.8%), and positive straight leg raise test (19.6%). All patients underwent spinal lumbar MRI, which revealed discal nodularity that appeared hypointense in T1-weighted sequences with cystic wall enhancement and hyperintense in T2-weighted sequences. Contrast-enhanced MRI showed enhancement of the cyst wall in the cases where it was performed. Discal cysts were mainly at the L4-L5 level (44.9%) and L5-S1 level (26.3%), with a ventrolateral (94.9%), ventral (4.2%), or lateral position (0.8%). Various treatment modalities were used, including conservative management (5.9%), microscopic cyst resection and discectomy (32.2%), microscopic cyst resection (28.8%), microendoscopic cyst resection (22.1%), and CT-guided cyst aspiration (11%). The majority of patients experienced progressive improvement of symptoms.</p><p><strong>Conclusion: </strong>Discal cysts generally present with low back and radicular pain and can be diagnosed using MRI. Differential diagnoses must be considered to ensure accurate diagnosis and appropriate management. Conservative treatment is typically the initial approach, while surgical interventions are considered for refractory cases.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590803","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 spinopelvic imbalance after minimally invasive lower lumbar fusion predispose patients to subsequent minimally invasive sacroiliac joint fusions? a case-control study.","authors":"Roxana Beladi, Ammar Alsalahi, Gustavo Anton, Heather Lucke, Clifford Houseman, Chad Claus, Boyd Richards, Doris Tong, Teck Soo","doi":"10.1007/s00586-025-09117-z","DOIUrl":"https://doi.org/10.1007/s00586-025-09117-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Sacroiliac joint (SIJ) dysfunction is a frequently overlooked source of persistent low back pain after lower lumbar surgery. The SIJ is an adjacent joint to the lower lumbar spine and can thus be subject to adjacent segment disease (ASD) after lower lumbar fusion. Spinopelvic imbalance can potentially predispose a patient to ASD in the SIJ, causing SIJ dysfunction. However, the impact of spinopelvic imbalance following minimally invasive (MIS) lower lumbar fusion on SIJ dysfunction and, thus, subsequent fusion remains inconclusive. We sought to determine whether spinopelvic imbalance after lower lumbar fusion predisposes patients to subsequent MIS SIJ fusion (SIJF).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively reviewed consecutive elective lower lumbar fusion patients (ending levels L5/S1) to select our cases and controls in a 1:1 match. We included patients who underwent MIS lower lumbar fusion from 10/2005 to 05/2021 at a single institution with an ending level including L5 or S1, a starting level at or below T12, and had at least two years of follow-up. We excluded patients with inadequate or absent postoperative X-rays, those who underwent lumbar fusion for trauma or infection, pelvic fixation, revision lumbar surgery, and prior SIJF. We performed a pilot study to determine the sample size as 190 per group. Confounders, including the number of pregnancies, were collected. Consistent with prior literature, we defined spinopelvic imbalance as a PI-LL mismatch of &lt;-10° or &gt; 10° [1-5]. We compared the groups using univariate analysis. The odds of developing SIJF related to PI-LL mismatch were calculated using Chi-Square. We performed multivariable analysis modeling on SIJF to adjust for covariates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We included 488 patients (203 SIJF vs. 285 control). Between groups, the SIJF patients were significantly younger (52.55 ± 12.81 vs. 55.84 ± 14.71; P = 0.005), had a higher proportion of females (67.5% vs. 55.1%; P = 0.006), and increased levels fused (1.78 ± 0.97 vs. 1.38 ± 0.64; P &lt; 0.001). Interestingly, number of pregnancies was not significantly different (P = 0.791). PI-LL mismatch demonstrated a 3.54 increased odds of requiring subsequent SIJF (p &lt; 0.001). Multiple logistic regression adjusting for age at lumbar fusion, female sex, and number of levels demonstrated that PI-LL mismatch (OR 1.10; 95% CI 1.06-1.15; p &lt; 0.001) and operative levels (OR 1.84; 95% CI 1.42-2.39; p &lt; 0.001) were independently associated with significantly increased odds of requiring SIJF, while age (OR 0.98; 95% CI 0.96-0.99; p &lt; 0.001) and female sex (OR 0.54; 95% CI 0.36-0.81; p = 0.003) were associated with significantly decreased odds of requiring SIJF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PI-LL mismatch following MIS lower lumbar fusion was independently associated with significant odds of requiring subsequent SIJF. Optimizing spinopelvic imbalance can decrease the odds of requiring subsequent SIJF aft","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590802","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 complications, costs, mortality, and length of stay in lumbar fusion surgery: robotic-assisted versus navigation-guided approaches.","authors":"David Maman, Amir Abu Elhija, Assil Mahamid, Lior Laver, Eyal Behrbalk","doi":"10.1007/s00586-025-09060-z","DOIUrl":"https://doi.org/10.1007/s00586-025-09060-z","url":null,"abstract":"<p><strong>Introduction: </strong>Navigation and robotic technologies emerge as alternatives to conventional freehand techniques for spine fusion. They aim to enhance perioperative and postoperative outcomes, yet their effectiveness remains limited by small cohort sizes in existing literature. Our study compares navigation and robotic technologies in lumbar fusion surgery across complications, costs, and mortality.</p><p><strong>Methods: </strong>This study employed data from the Nationwide Inpatient Sample. The NIS annually captures approximately 7 million unweighted admissions. The dataset spanned 2016 to 2019, comprising 58,270 patients. Exclusions included non-elective admissions, pre-admission surgeries, and cases reporting $0 hospital costs. Validation of comorbidities and complications was conducted using ICD-10 codes. Analytical techniques, such as trend identification and statistical analyses, were applied with a significance threshold of p  < 0.05. Demographic and clinical characteristics, surgery types, and outcomes were assessed.</p><p><strong>Results: </strong>Navigation-guided surgeries dominated (86.7% in 2016, 77.1% in 2019), while Robotic-assisted surgeries increased steadily. Both showed minimal mortality rates. Navigation-guided surgeries had lower charges, lower risks of blood loss anemia, acute kidney injury, and blood transfusion compared to Robotic-assisted surgeries. Navigation-guided surgeries showed significantly lower risks of complications in one level lumbar fusion of vertebral joint and fusion of lumbosacral joint compared to Robotic-Assisted procedures. Additionally, Robotic-Assisted surgeries present higher risks across blood loss anemia, acute kidney injury, and blood transfusion, with risk ratios ranging from 1.24 to 1.72 times higher.</p><p><strong>Conclusion: </strong>This study highlights shifting trends in lumbar fusion surgeries, underscoring the need for tailored approaches and nuanced clinical considerations to improve patient outcomes.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590801","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":"Quadratus lumborum muscle stiffness in chronic non-specific low back pain: a diagnostic accuracy study.","authors":"Mónica López-Redondo, Davinia Vicente-Campos, Javier Álvarez-González, Alberto Roldán-Ruiz, Sandra Sánchez-Jorge, Jorge Buffet-García, María José Díaz-Arribas, Juan Antonio Valera-Calero","doi":"10.1007/s00586-025-09114-2","DOIUrl":"https://doi.org/10.1007/s00586-025-09114-2","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of muscle tenderness is encouraged in the diagnosis of low back pain (LBP). However, manual palpation is poorly reliable and objective methods to quantify muscle stiffness are needed.</p><p><strong>Objectives: </strong>To investigate quadratus lumborum muscle stiffness differences between individuals with chronic non-specific low back pain (LBP) and pain-free controls, analyze side-to-side stiffness differences, and assess the diagnostic accuracy of shear wave elastography.</p><p><strong>Methods: </strong>A cross-sectional study was conducted recruiting 40 patients with chronic non-specific LBP and 40 asymptomatic controls. Variables assessed included muscle stiffness using shear wave elastography metrics (shear wave speed (SWS) and Young's modulus (YM)), pain chronicity, pain intensity, pain-related disability (using the Oswestry Disability Index) and symptoms associated with central sensitization (using the Central Sensitization Inventory). Diagnostic accuracy was evaluated through sensitivity, specificity, and receiver operating characteristic analysis.</p><p><strong>Results: </strong>No significant side-to-side stiffness differences were observed within either group (both, p > 0.05). Quadratus lumborum muscle stiffness was significantly lower in LBP patients compared to controls (SWS p = 0.010; YM p = 0.008). The receiver operating characteristic analysis for both metrics showed poor discriminatory ability (< 0.7). A modest balance between sensitivity (SWS 70%; YM 75%) and specificity (SWS 97.5%; YM 50%) was found.</p><p><strong>Conclusions: </strong>Although greater stiffness was expected due to the associated prevalence of trigger points in patients with LBP, quadratus lumborum muscle stiffness was significantly lower in patients suffering chronic non-specific LBP compared to controls. Despite significant differences, the diagnostic accuracy of shear wave elastography was poor, requiring further research to improve the diagnostic utility of shear wave elastography.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590804","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":"Assessment of T2-weighted MRI-derived synthetic CT for the detection of suspected lumbar facet arthritis: a comparative analysis with conventional CT.","authors":"Gan Cao, Haiqiao Wang, Shanghuang Xie, Die Cai, Jiandong Guo, Jichao Zhu, Keliang Ye, Yi Wang, Jun Xia","doi":"10.1007/s00586-025-08958-y","DOIUrl":"https://doi.org/10.1007/s00586-025-08958-y","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated sCT generated from T2-weighted imaging (T2WI) using deep learning techniques to detect structural lesions in lumbar facet arthritis, with conventional CT as the reference standard.</p><p><strong>Methods: </strong>This single-center retrospective study included 40 patients who had lumbar MRI and CT with in 1 week (September 2020 to August 2021). A Pix2Pix-GAN framework generated CT images from MRI data, and image quality was assessed using structural similarity index (SSIM), mean absolute error (MAE), peak signal-to-noise ratio (PSNR), nd Dice similarity coefficient (DSC). Two senior radiologists evaluated 15 anatomical landmarks. Sensitivity, specificity, and accuracy for detecting bone erosion, osteosclerosis, and joint space alterations were analyzed for sCT, T2-weighted MRI, and conventional CT.</p><p><strong>Results: </strong>Forty participants (21 men, 19 women) were enrolled, with a mean age of 39 ± 16.9 years. sCT showed strong agreement with conventional CT, with SSIM values of 0.888 for axial and 0.889 for sagittal views. PSNR and MAE values were 24.56 dB and 0.031 for axial and 23.75 dB and 0.038 for sagittal views, respectively. DSC values were 0.935 for axial and 0.876 for sagittal views. sCT showed excellent intra- and inter-reader reliability intraclass correlation coefficients (0.953-0.995 and 0.839-0.983, respectively). sCT had higher sensitivity (57.9% vs. 5.3%), specificity (98.8% vs. 84.6%), and accuracy (93.0% vs. 73.3%) for bone erosion than T2-weighted MRI and outperformed it for osteosclerosis and joint space changes.</p><p><strong>Conclusions: </strong>sCT outperformed conventional T2-weighted MRI in detecting structural lesions indicative of lumbar facet arthritis, with conventional CT as the reference standard.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590800","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}