European Spine Journal最新文献

{"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}

{"title":"Clinical risk factors associated with cage migration after posterior approaches for lumbar interbody fusion: a 10-year systematic review and meta-analysis.","authors":"Haozhong Wang, Changming Xiao, Kaiquan Zhang, Mingzhong Xie, Sen Li","doi":"10.1007/s00586-025-09109-z","DOIUrl":"https://doi.org/10.1007/s00586-025-09109-z","url":null,"abstract":"<p><strong>Objective: </strong>Cage migration (CR) after lumbar interbody fusion may result in intractable complications to patients. This meta-analysis was aimed to figure out risk factors of cage migration after posterior approaches for lumbar interbody fusion.</p><p><strong>Methods: </strong>Literature was searched in the PubMed, Embase, Web of Science and Cochrane Library between Feb 2013 to Feb 2023. PRISMA guidelines were followed in this review. The keywords used in the search included: cage, retropulsion, migration, lumbar interbody fusion, spinal fusion. Odds ratio (OR) and 95% confidence interval (CI) of a potential risk factor was calculated via RevMan5.4.</p><p><strong>Results: </strong>8 studies were finally included in this meta-analysis. 10 risk factors were assessed and the outcome showed that Screw loosening (OR 12.98, 95% CI 4.63 to 36.36, P < 0.01), endplate injury (OR 10.14, 95% CI 5.20 to 19.79, P < 0.01) and pear-shaped disc (OR 4.03, 95% CI 1.41 to 11.55, P < 0.01) were associated with cage migration, and poly-ether-ether-ketone (PEEK) cage (OR 0.51, 95% CI 0.27 to 0.96, P = 0.04) could reduce risk of cage migration.</p><p><strong>Conclusion: </strong>Screw loosening, endplate injury and pear-shaped disc increased risk of CM after posterior approaches for lumbar interbody fusion, and PEEK cage probably reduce risk of postoperative cage migration.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575155","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 M. Ashouri, et al. concerning \"Risk factors for mortality after 3-column osteotomy\" by Carbone J, et al. (Eur spine J [2024]: https://doi.org/10.1007/s00586-024-08616-9).","authors":"Julio J Jauregui, Hershil Patel, Steven C Ludwig","doi":"10.1007/s00586-025-09103-5","DOIUrl":"https://doi.org/10.1007/s00586-025-09103-5","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575153","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 Q. Hao, et al. concerning \"Identifying predictors of brace treatment outcomes for adolescents or adults with idiopathic scoliosis: a systematic review\" by khodaei, et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-08736-w).","authors":"Eric Parent, Mahdieh Khodaei, Edmond Lou","doi":"10.1007/s00586-025-09119-x","DOIUrl":"https://doi.org/10.1007/s00586-025-09119-x","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575154","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 retrieval-augmented generation and large language models in clinical guidelines for degenerative spine conditions.","authors":"Audrey Y Su, Ashley Knebel, Andrew Y Xu, Marco Kaper, Phillip Schmitt, Joseph E Nassar, Manjot Singh, Michael J Farias, Jinho Kim, Bassel G Diebo, Alan H Daniels","doi":"10.1007/s00586-025-08994-8","DOIUrl":"https://doi.org/10.1007/s00586-025-08994-8","url":null,"abstract":"<p><strong>Purpose: </strong>Degenerative spinal diseases often require complex, patient-specific treatment, presenting a compelling challenge for artificial intelligence (AI) integration into clinical practice. While existing literature has focused on ChatGPT-4o performance in individual spine conditions, this study compares ChatGPT-4o, a traditional large language model (LLM), against NotebookLM, a novel retrieval-augmented model (RAG-LLM) supplemented with North American Spine Society (NASS) guidelines, for concordance with all five published NASS guidelines for degenerative spinal diseases.</p><p><strong>Methods: </strong>A total of 118 questions from NASS guidelines regarding five degenerative spinal conditions were presented to ChatGPT-4o and NotebookLM. All responses were scored based on accuracy, evidence-based conclusions, supplementary and complete information.</p><p><strong>Results: </strong>Overall, NotebookLM provided significantly more accurate responses (98.3% vs. 40.7%, p < 0.05), more evidence-based conclusions (99.1% vs. 40.7%, p < 0.05), and more complete information (94.1% vs. 79.7%, p < 0.05), while ChatGPT-4o provided more supplementary information (98.3% vs. 67.8%, p < 0.05). These discrepancies became most prominent in nonsurgical and surgical interventions, wherein ChatGPT often produced recommendations with unsubstantiated certainty.</p><p><strong>Conclusion: </strong>While RAG-LLMs are a promising tool for clinical decision-making assistance and show significant improvement from prior models, physicians should remain cautious when integrating AI into patient care, especially in the context of nuanced medical scenarios.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575157","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":"Announcements.","authors":"","doi":"10.1007/s00586-025-09095-2","DOIUrl":"https://doi.org/10.1007/s00586-025-09095-2","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575152","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 \"Machine learning-based models for outcome prediction in skull base and spinal chordomas: a systematic review and meta-analysis\" by B. Hajikarimloo, et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-09053-y).","authors":"Tiantaixi Tu","doi":"10.1007/s00586-025-09115-1","DOIUrl":"https://doi.org/10.1007/s00586-025-09115-1","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Comparison of two ultrasound methods from Scolioscan® for measuring spinal curvature: spinous processes (SP) versus transverse processes (TP).","authors":"Lea Klara Zimmermann, Christian Hülstrunk, Benjamin Schmitt, Gaby Baron, Rebecca Roth, Axel Hennes, Peter Raab, Omar Zabar","doi":"10.1007/s00586-025-09105-3","DOIUrl":"https://doi.org/10.1007/s00586-025-09105-3","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575156","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}