European Spine Journal最新文献

{"title":"Impact of caudal segment bone fusion on rod load at the cranial segment in a two-level spinal interbody fusion construct- a biomechanical study.","authors":"Maximilian Heumann, Chencheng Feng, Boyko Gueorguiev, Jan Buschbaum, Christian Mazel, Maarten Spruit, R Geoff Richards, Manuela Ernst","doi":"10.1007/s00586-025-08929-3","DOIUrl":"https://doi.org/10.1007/s00586-025-08929-3","url":null,"abstract":"<p><strong>Purpose: </strong>One-dimensional implant load measurement has been validated as a method for assessing spinal fusion progression in preclinical and in vitro studies. However, multilevel fusion procedures, which are more susceptible to non-union and implant failure than single-level fusions, pose additional challenges. Specifically, the need for implantable sensors at each segment is questioned, especially in space-constrained regions such as L5-S1, where non-union and implant failure are more common. This study explores whether a single sensor at the cranial level can effectively monitor fusion progression of a caudal segment in a two-segment posterior instrumentation following TLIF surgery. It is hypothesized that adjacent level fusion has no influence on the rod load above the separating pedicle screw.</p><p><strong>Methods: </strong>Seven human cadaveric spines (L3-S1), stabilized with posterior instrumentation following TLIF surgery at levels L4-L5 and L5-S1 were used. Bone fusion at level L4-L5 was simulated during the instrumentation. Flexibility testing and implant load measurements were conducted to compare segmental range of motion (ROM) and rod strain measured at L4-L5 between 2 states- without and with simulated bone fusion at level L5-S1. For strain measurement, an implantable sensor was used as well as one strain gauge (SG) aligned with the rod axis and one SG aligned at a 45° angle to the rod axis.</p><p><strong>Results: </strong>Axial strain measurements taken by the implantable sensor and the axial SG at L4-L5 during flexion-extension (FE), lateral bending (LB), and axial rotation (AR) were unaffected by L5-S1 fusion (p ≥ 0.172). However, torsional strain at L4-L5 decreased during AR following L5-S1 fusion (p = 0.018). A strong correlation was found between the relative decrease in ROM and torsional strain during AR motion (r = 0.828, p = 0.022).</p><p><strong>Conclusion: </strong>In this biomechanical study the rod load measurements taken by an implantable strain sensors were unaffected by adjacent level fusion. This implies that the decrease in implant load measured by this sensor, only reflects biomechanical changes at the segment containing the sensor. The strong correlation between the reduction in AR-ROM and AR-torsional strain demonstrated the potential of an alternative assessment method of multilevel fusion. However, the interpretation of the sensor signal would be challenging, as it cannot be differentiated between the contributions of each segment to the implant load changes. Consequently, this precludes the assessment of potential different fusion stages of the individual segments.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186917","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":"Radiological evaluation of posterior cervical misalignment by ligamentum flavum angle in patients with degenerative cervical myelopathy.","authors":"Junhua Ye, Ramzi Roshani, Qinguo Huang, Dongying Zheng, Qiang Zhou, Hong Li, Lin Peng, Songtao Qi, Yuntao Lu","doi":"10.1007/s00586-025-08898-7","DOIUrl":"https://doi.org/10.1007/s00586-025-08898-7","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior cervical misalignment is commonly observed in patients with degenerative cervical myelopathy (DCM), yet its clinical significance remains unclear. This study takes aim to investigate the radiological value of ligamentum flavum angle (LFA) to evaluate the implications of posterior cervical misalignment in DCM.</p><p><strong>Methods: </strong>Baseline LFA was determined in 76 adults with normal cervical alignment. LFA was then analyzed in 155 DCM patients and categorized into enlarging (eLFA), normal (nLFA), and decreasing LFA (dLFA) groups. Cervical spine parameters and MRI findings were compared, and multiple linear regression identified factors associated with LFA changes. Static LFA on MRI and dynamic LFA (ΔLFA) on X-ray were evaluated for detecting cervical instability.</p><p><strong>Results: </strong>The mean LFA in normal subjects (C2/3 to C6/7) was 76.3 ± 7.2°, varying by segment and age. The LFA was significantly reduced in DCM patients (70.7 ± 11.6°). The spinal cord diameter of the adjacent vertebrae and the increased signal intensity were significant difference among eLFA, nLFA and dLFA groups. LFA correlated with vertebral body movement (β = - 3.361, P < 0.001) and cervical disc angle (β = - 0.774, P < 0.001). The static LFA cutoff for posterior slippage was 67.6°, and △LFA for instability was 12.3°.</p><p><strong>Conclusions: </strong>Posterior cervical spine misalignment in DCM is closely linked to both horizontal and angular vertebral displacements, potentially exacerbating spinal cord injury. Static and dynamic LFA measurements provide valuable supplementary parameters for the accurate assessment of cervical instability.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186918","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":"Thoracic and pelvic compensation during lumbar degeneration: a retrospective study of 625 asymptomatic adults.","authors":"Xiangyu Li, Dongfan Wang, Xiaolong Chen, Zheng Wang, Yu Wang, Weiguo Zhu, Wei Wang, Chao Kong, Shibao Lu","doi":"10.1007/s00586-025-08941-7","DOIUrl":"https://doi.org/10.1007/s00586-025-08941-7","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186920","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":"Radiographical changes and clinical prognosis after cervical laminectomy with posterior instrumented fusion for degenerative cervical myelopathy.","authors":"Yuhao Zheng, Qiyuan Yang, Bing Tan, Xiaobin Wang, Jing Li","doi":"10.1007/s00586-025-08965-z","DOIUrl":"https://doi.org/10.1007/s00586-025-08965-z","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Objective: </strong>The aim of the study is to investigate the radiographic changes of the spinal canal, intervertebral foramina, and spinal cord after cervical laminectomy with posterior instrumented fusion (LF), and to determine the correlation with the length of decompression levels, clinical symptoms, and C5 palsy (C5P). LF is an effective procedure for the treatment of cervical stenosis caused by various reasons. However, the radiographic changes of the spinal canal, intervertebral foramina and spinal cord after the surgery have been poorly reported, and the relationship with clinical prognosis is controversial.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive cases that underwent cervical LF with at least 1-year follow-up. The radiographic measurements included the spinal canal, intervertebral foramina, and spinal cord use image parameters. The clinical results were evaluated using the Japanese Orthopedic Association (JOA) score. The patients were divided into two groups according to length of decompression levels, the recovery rate of the JOA score, or the C5P complication. The correlation between changes in image parameters and these three factors was analyzed.</p><p><strong>Results: </strong>A total of 125 patients met the inclusion criteria (M: F = 74:51, mean age 57.8 year, mean follow-up 18.76 months). C5P observed in 21 patients (16.8%). Statistical analyses revealed that there was a statistical difference in the postoperative cervical lordosis angle between the long and short segment groups. In terms of neurological improvement, patient satisfaction was positively correlated with postoperative spinal cord cross-sectional area (SAS) and pre- and postoperative ratio of spinal cord expansion (SCE), but not with other spinal cord and spinal canal morphology parameters. C5P was negatively correlated with preoperative superior articular process projection (SAP), and the smaller the SAP, the greater the likelihood of C5P. No significant correlation was found with other morphologies of the foramen magnum, vertebral canal, and spinal cord.</p><p><strong>Conclusion: </strong>In LF, long-segment and short-segment decompression did not produce significant differences in intervertebral foraminal, spinal canal, or spinal cord morphology pre- and postoperative. Neurological improvement was correlated with the postoperative SAS and SCE, but not with other spinal cord, intervertebral foraminal, or spinal canal morphologies. The incidence of postoperative C5P was significantly correlated with preoperative SAP in the spinal canal morphology, making it a potential predictive factor for C5P.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181907","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 arthrodesis in elderly patients, is it a good option? A retrospective analysis of complications and pain improvement in a geriatric hospital.","authors":"Pedro Miguel González-Vargas, José Luis Thenier-Villa, Antonio Riveiro, Julián Castro, Pilar Varela, Olalla Lista, Martín Raposo, Ana Pastor, Juan Pou","doi":"10.1007/s00586-025-08944-4","DOIUrl":"https://doi.org/10.1007/s00586-025-08944-4","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar arthrodesis is a well-established surgical procedure for degenerative spinal diseases, but its use in patients over 75 remains controversial due to potential complications. This retrospective study evaluates complication rates and postoperative pain control in elderly patients.</p><p><strong>Methods: </strong>A total of 150 patients over 75 years old underwent lumbar arthrodesis with laminectomy between 2015 and 2022 in a hospital in Galicia, Spain. Patients with tumors, infections, scoliosis, trauma, or prior spinal surgeries were excluded. Follow-up lasted three years and included clinical and imaging assessments.</p><p><strong>Results: </strong>- Mean age: 78.9 years; 62% female.- Common comorbidities: hypertension (70.7%), osteoporosis (64.4%).- Postoperative complications: 5.3%, including infection, epidural hematoma, pseudoarthrosis, among others.- Significant pain improvement on the Visual Analog Scale (VAS): from 7.82 preoperatively to 2.41 postoperatively.- No statistically significant associations were found between age, number of surgical levels, or comorbidities and the presence of complications.</p><p><strong>Conclusions: </strong>Lumbar arthrodesis with laminectomy in well-selected elderly patients over 75 may be a safe and effective option for pain relief. Advanced age alone does not imply a higher risk of complications. This study supports its use in geriatric populations under well-defined criteria.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180009","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 MRI-based clinical radiomics model for predicting postoperative anemia in patients with spinal metastases.","authors":"Weili Zhao, Siyuan Qin, Ruixin Yan, Yongye Chen, Qizheng Wang, Ke Liu, Ning Lang","doi":"10.1007/s00586-025-08966-y","DOIUrl":"https://doi.org/10.1007/s00586-025-08966-y","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180970","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":"Evaluating the predictive value of multimodal intraoperative neuromonitoring in anterior cervical discectomy and fusion: a retrospective cohort study on 442 patients.","authors":"Giuseppe Corazzelli, Hernàn Ileyassoff, Sergio Corvino, Elena Furno, Viviana Baiano, Fabio Di Rienzo, Francesco Ricciardi, Nicola Gorgoglione, Paolo Di Russo, Settimio Leonetti, Alessandro D'Elia, Valentina Pizzuti, Marco Santilli, Marco Ciavarro, Sergio Paolini, Vincenzo Esposito, Gualtiero Innocenzi","doi":"10.1007/s00586-025-08985-9","DOIUrl":"https://doi.org/10.1007/s00586-025-08985-9","url":null,"abstract":"<p><strong>Background and objectives: </strong>Anterior cervical discectomy and fusion (ACDF) is a widely regarded surgical technique for the management of cervical disc herniation (CDH) and myelopathy, offering significant therapeutic efficacy. However, the potential for neurological complications persists, underscoring the need for strategies to enhance procedural safety. Multimodal intraoperative neuromonitoring (IONM) has emerged as a promising adjunct, providing real-time assessment of neural integrity to identify and address intraoperative compromise. This study seeks to rigorously assess the diagnostic accuracy of IONM in ACDF, evaluate its predictive utility for postoperative neurological outcomes, and analyze its association with intraoperative neural events.</p><p><strong>Methods: </strong>This monocentric retrospective observational study analyzed CDH patients who underwent ACDF between 2014 and 2023. Neurological status was pre- and postoperatively assessed and compared to IONM data, including somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), and electromyography (EMG) alarms. IONM diagnostic performance was analyzed using confusion matrices and ROC curves on the binary variables. Multivariate logistic regression was implemented to identify predictors of postoperative neurological decline.</p><p><strong>Results: </strong>SSEPs and MEPs demonstrated high diagnostic accuracy, with ROC curve areas improving significantly from preoperative (T0) to postoperative (T1) assessments (SSEP AUC: 0.922 to 1.000; MEP AUC: 0.915 to 0.996, p < 0.01). Among 442 consecutive patients, 38 (9%) intraoperative IONM alerts were recognized, labeled as transient, sustained single-modality, or sustained dual-modality changes. Permanent neurological injuries correlated with alert severity. Intraoperative alarms were the strongest predictor of postoperative motor deficits (OR:14.0, p < 0.01).</p><p><strong>Conclusion: </strong>Multimodal IONM demonstrated significant predictive value for postoperative neurological outcomes in ACDF, with intraoperative alerts strongly correlating with motor deficits. IONM was associated with postoperative neurological outcomes, suggesting a potential role in selected high-risk patients. Further studies are warranted to assess cost-effectiveness and define standardized indications.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181572","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":"Prevalence of lumbar spondylolisthesis in adults and elderly patients with low back pain in the Jordanian community: radiographic findings.","authors":"Tasneem N Alhosanie, Ahmad F Klaib, Fadi Abdelraheem Al Hadidi, Tareq Kanaan, Khuzama Mohammad, Aya Al-Zurgan, Noor Tareq Yousef, Liyana Oweis, Salah M Hasan, Majed Eftiha, Fatima Abdulsattar Alkubaisi, Maher Ahmad Tarawneh, Abdelrahman Altarazi, Motaz Barakat, Iyas AbuHijlah, Qusai Al-Sabbag, Emad Tarawneh","doi":"10.1007/s00586-025-08963-1","DOIUrl":"https://doi.org/10.1007/s00586-025-08963-1","url":null,"abstract":"<p><strong>Purpose: </strong>Lumbar spondylolisthesis (LS) defined as the displacement of a vertebral body relative to the vertebra below it. Moreover, it typically affects the lower lumbar spine, particularly in women above 50 years of age. Many studies showed that the prevalence of LS increases with age and reported a higher number of cases in women. This study aimed to determine the prevalence of lumbar spondylolisthesis in adults and elderly people in the Jordanian community.</p><p><strong>Methods: </strong>A total of 2000 patients with low back pain, aged 18-94 years, with records of their age, gender, and lumbar spine X-ray from Jordan University Hospital were included in this retrospective cross-sectional study. The anterior-posterior (AP) and lateral lumbosacral X-ray images of every subject under study were read using SYNAPSE Viewer. Finally, the IBM SPSS Statistics program was used for statistical analysis.</p><p><strong>Results: </strong>Among the 1,458 subjects included in the study, 910 (62.4%) were females and 548 (37.6%) were males. Their mean age was (53.2 ± 16.1) years. A total of 385 subjects had lumbar spondylolisthesis, with a total incidence of 26.4%. The percentage of Spondylolisthesis among males was (16.1%) and (32.6%) among females. The rates of spondylolisthesis (P = 0.00) were significantly higher in females. There was no significant difference between prevalence of males and females in patients under 50 years old. But the prevalence of LS in patients who are over 50 years old increased significantly, compared to other age groups. So our results showed that as the age of the patients increased, the prevalence increased in both males and females (P = 0.01). There were 385 cases that had slipped at different level, sorting in prevalence as follows L4-L5 > L5-S1 > L3-L4 > L2-L3 > L1-L2. We noticed that the L4-L5 in females took the largest proportion, but in males L4-L5 and L5-S1 took almost the same proportion. The majority of our patients had LS only at one level, with a percentage of 94.3% among all cases.</p><p><strong>Conclusion: </strong>The total prevalence of LS in adults and the elderly in Jordanian community was 26.4%. The results of our study showed that spondylolisthesis is more common in females and may be more common among older individuals. Finally, spondylolisthesis was most seen at the L4/L5 and L5-S1 levels, and mostly at one level.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181929","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-radiomics nomogram construction from magnetic resonance imaging to diagnose osteoporosis: a preliminary study.","authors":"Ruihong Hou, Wenyun Tan, Chunying Liu, Jiakai Zhang, Shuyan Jing, Li He","doi":"10.1007/s00586-025-08978-8","DOIUrl":"https://doi.org/10.1007/s00586-025-08978-8","url":null,"abstract":"<p><strong>Objective: </strong>To construct a clinical-radiomics nomogram based on T1 weighted imaging (WI) and T2WI of lumbar magnetic resonance imaging (MRI) for predicting osteoporosis.</p><p><strong>Methods: </strong>Sixty-eight participants who underwent both dual-energy X-ray absorptiometry and lumbar MRI were included. Participants were classified as having either normal bone mineral density (BMD) (T > - 1) or osteoporosis (T < - 2.5), with those having osteopenia (T-score between - 2.5 and - 1) being excluded. A total of 396 radiomic features (RFs) were extracted from routine lumbar MRI (T1WI and T2WI). Five RFs highly correlated with osteoporosis were selected via logistic regression. The diagnostic values of osteoporosis using a radiomics model and a combined RFs and clinical factors (e.g. age, sex) model were assessed using the receiver operating characteristic (ROC) method. Diagnostic accuracy, sensitivity and specificity were calculated for the clinical-radiomics nomogram.</p><p><strong>Results: </strong>In our study of 68 patients (18 men, 50 women), including 33 with osteoporosis and 35 with normal BMD, significant differences were found in age and sex between groups, whereas body mass index was similar. The radiomics model, which analysed 396 features from lumbar MRI, achieved an area under the curve (AUC) of 0.871 (95% CI: 0.768-0.940). Incorporating clinical features into the model improved the AUC to 0.894 (95% CI: 0.796-0.956), with a significant P-value (< 0.0001). Sensitivity increased from 82.86 to 91.43%, whereas specificity decreased from 87.88 to 81.82%. Accuracy rose from 83.8 to 86.8%, and the Akaike information criterion improved from 74.723 to 63.703. Calibration curves indicated good alignment of predicted probabilities with actual outcomes. Decision curve analysis demonstrated enhanced clinical utility for the clinical-radiomics model compared with the radiomics model alone.</p><p><strong>Conclusion: </strong>A radiomics model based on routine lumbar MRI can effectively diagnose osteoporosis. The clinical-radiomics nomogram combining RFs with clinical factors improves diagnostic performance.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180682","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":"One-way self-expanding rods for early onset neuromuscular scoliosis: a two-year follow-up of an international cohort.","authors":"Anne Mareille Post, Mathilde Gaume, Barend Jan van Royen, Esther Janssen, Kris Lundine, Michael Johnson, Petre Neagoe, Moyo Kruyt, Louis Boissiere, Jean-Paul Kaleeta Maalu, Jeroen Renkens, Moritz C Deml, Agnita Stadhouder, Federico Solla, Samuel Schaible, Casper Tabeling, Julia Mielenbrink, Lotfi Miladi","doi":"10.1007/s00586-025-08884-z","DOIUrl":"https://doi.org/10.1007/s00586-025-08884-z","url":null,"abstract":"<p><strong>Introduction: </strong>Fusionless surgical techniques are increasingly used to treat patients with early-onset and juvenile neuromuscular scoliosis (NMS) to correct and stabilize the scoliotic curves while preserving natural growth. This study aimed to evaluate clinical and radiological outcomes two years after minimally invasive surgery using a commercially available CE-certified (Conformité Européenne) one-way self-expanding rod (OWSER) system in a large international cohort of patients with NMS.</p><p><strong>Methods: </strong>Patients who underwent surgical treatment with the OWSER system for NMS correction, with a two-year follow-up were retrospectively included and analyzed for two-year follow-up. The surgery consisted of a bilateral OWSER system from the upper cervico-thoracic spine to the pelvis using a minimally invasive approach. Radiological parameters, including Cobb angle, pelvic obliquity, thoracic kyphosis, lumbar lordosis and spinal length (T1-S1), were assessed preoperatively and at follow-up. Clinical performance was based on complications and unplanned reoperations.</p><p><strong>Results: </strong>Seventy-six patients from ten international centers were included. The mean age at surgery was 9.6 ± 2.5 years. Diagnoses included cerebral palsy (n = 23), spinal muscular atrophy (n = 14), and other neuromuscular syndromes (n = 39). Mean Cobb angle improved from 80 ± 25° preoperative to 39.7 ± 20.9° at 2-years follow-up, mean pelvic obliquity improved from 19 ± 12° to 6.4 ± 6.2° and mean preoperative kyphosis decreased from 44 ± 24° to 32.9 ± 14°. Segment T1-S1 increased 5.9 cm peri-operatively and patients showed a mean growth after instrumentation from 34 ± 5.cm to 35 ± 5.2 cm in two years due to the OWSER system. Procedure related complications occurred in 22 patients (29%): twelve surgical site infections, and 20 mechanical and alignment-related complication, resulting in 27 revision surgeries in 20 patients (26%).</p><p><strong>Conclusion: </strong>The OWSER system provides stable correction of Cobb angle at two-year follow-up while allowing continued spinal growth in juvenile or early-onset NMS. Despite a notable complication rate, this technique offers a reliable treatment for NMS patients. We continue to follow-up these patients as long-term outcomes are necessary to confirm these encouraging results.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181659","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}