European Spine Journal最新文献

{"title":"Protection of the ligamentum flavum reduces epidural fibrosis formation in endoscopic lumbar discectomy.","authors":"Abdullah Merter, Orhun Eray Bozkurt, Ilyas Dolas, Elif Peker, Sena Unal, Duran Sahin, Ebru Dumlupinar","doi":"10.1007/s00586-025-08960-4","DOIUrl":"https://doi.org/10.1007/s00586-025-08960-4","url":null,"abstract":"<p><strong>Purpose: </strong>Lumbar disc herniation is a prevalent condition that leads to lower back pain, weakness, and claudication. While microdiscectomy has long been the gold standard for surgical treatment, advances in technology have introduced endoscopic techniques, such as Unilateral Biportal Endoscopic spine surgery. Despite these advances, epidural fibrosis remains a common complication that, potentially hinders recovery and complicating revision surgeries. This study aimed to compare the extent of epidural fibrosis between microdiscectomy and UBE surgery with preserved flavum and flavectomy.</p><p><strong>Methods: </strong>This retrospective study included 47 patients diagnosed with lumbar disc herniation who underwent surgery between August 2020 and July 2022 at two tertiary university hospitals. The patients underwent endoscopic surgery with flavum preservation (n = 16), flavum excision (n = 16), lumbar microdiscectomy with flavectomy (n = 15). Preoperative and postoperative imaging, including X-rays, computed tomography, and magnetic resonance imaging were performed. Functional scores (Visual Analog Scale, Japanese Orthopedic Association score, and Oswestry Disability Index were assessed. Postoperative magnetic resonance imaging was conducted at three months to evaluate epidural fibrosis.</p><p><strong>Results: </strong>The rate of epidural fibrosis was significantly lower in the flavum sparing UBE (0.18 ± 0.17) compared to the flavum non-sparring UBE (0.38 ± 0.19) and the flavum non-sparring microdiscectomy (0.47 ± 0.18) (p < 0.001). Functional scores significantly improved postoperatively in all groups, with significant differences noted in JOA, Oswestry, and VAS scores (p < 0.01). Early functional score differences between the groups were found to be significant in favor of UBE, particularly in the flavum-sparing group.</p><p><strong>Conclusion: </strong>The preservation of flavum during UBE surgery leads to significantly less epidural fibrosis compared to both flavum non-sparring UBE and microdiscectomy. Functional improvements were similar across groups, but flavum sparring UBE surgery demonstrated better early postoperative outcomes. The results suggest that preserving flavum during endoscopic spine surgery may reduce epidural fibrosis formation and promote better recovery, supporting the benefits of minimally invasive techniques in lumbar disc herniation surgery.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157452","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 nomogram for predicting fracture of the sandwich vertebrae after percutaneous vertebral augmentation: a multicenter study with 1-year follow-up.","authors":"Si Chen, Hanming Li, Wenjie Wu, Li Huo, Boxin Wang, Chuanqi Zou, Junxiong Cao","doi":"10.1007/s00586-025-08896-9","DOIUrl":"https://doi.org/10.1007/s00586-025-08896-9","url":null,"abstract":"<p><strong>Purpose: </strong>This work aimed to investigate the risk factors for fractures in sandwich vertebrae (SDV; an unfractured vertebra located between 2 cemented vertebrae) formed after percutaneous vertebral augmentation (PVA) and to construct a predictive model from this.</p><p><strong>Methods: </strong>This study retrospectively analyzed patients who underwent PVA with the formation of SDV from July 2018 to July 2023 at Affiliated Banan Hospital of Chongqing Medical University. Patients were divided into a fracture group and a control group according to the presence or absence of fracture of the SDV during the 1-year postoperative follow-up period. Independent predictors were confirmed using the least absolute shrinkage and selection operator (LASSO) method, and the nomogram was constructed and transformed into an online calculator. The discrimination, calibration, and clinical applicability of the model were assessed by Area under the receiver operating characteristic curve (AUC), calibration curve analysis, and Decision curve analysis (DCA). Finally, the model was externally validated using data from another centre and internally validated using Bootstrap.</p><p><strong>Results: </strong>A total of 259 patients were enrolled in this study, and 36 patients had fractures of SDV within one year. Multifactorial analyses showed that low bone mineral density (BMD) (OR = 4.264, 95% CI: 2.245-8.098, P < 0.001), number of PVA > 3 (OR = 3.703, 95% CI: 1.399-9.801, P = 0.008), lack of anti-osteoporosis (OR = 4.051, 95% CI: 1.573-10.430, P = 0.004), postoperative kyphosis angle of sandwich fracture segments (PKASFS) > 10° (OR = 8.273, 95% CI: 2.991-22.881, P < 0.001), and lumbar lordosis minus thoracic kyphosis (LL-TK) < 0° (OR = 3.701, 95% CI: 1.523-8.994, P = 0.004) were screened as independent risk factors. The AUC of the model constructed based on this was 0.881 (95% CI: 0.829-0.933). The calibration curves and DCA verified that the model had satisfactory practical consistency and clinical applicability. The externally validated AUC was 0.859 (95% CI: 0.788-0.930), validating the stability of the model.</p><p><strong>Conclusions: </strong>BMD, number of PVA, anti-osteoporosis, PKASFS, and LL-TK are independent influencing factors for fractures in SDV within one year, and a model based on this had excellent predictive efficacy.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149790","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":"Geriatric nutrition risk index is useful to assess the risk of postoperative urinary retention in elderly patient undergoing lumber interbody fusion.","authors":"Yize Zhao, Yong Huang, Zhe Wang, Yueming Song, Qian Chen, Ganjun Feng","doi":"10.1007/s00586-025-08957-z","DOIUrl":"https://doi.org/10.1007/s00586-025-08957-z","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether the Geriatric Nutrition Risk Index (GNRI) can serve as an independent predictor of postoperative urinary retention (PUR) in elderly patients undergoing transforaminal lumbar interbody fusion (TLIF).</p><p><strong>Methods: </strong>This retrospective study reviewed elderly patients who underwent TLIF at a single institution between 2016 and 2021. Patients diagnosed with PUR during hospitalization were identified. GNRI was calculated based on body weight and preoperative serum albumin levels. Multivariate logistic regression analysis was used to determine the association between preoperative GNRI and PUR. Receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal GNRI cutoff value for predicting PUR.</p><p><strong>Results: </strong>A total of 294 patients met the inclusion criteria. PUR occurred in 47 patients (15.9%). The GNRI was significantly lower in the PUR group compared to the non-PUR group (93.3 ± 7.49 vs. 101.6 ± 6.59, P < 0.001). Multivariate logistic regression analysis confirmed that a lower GNRI independently predicted PUR (OR: 0.763; 95% CI: 0.699-0.834, p < 0.001). ROC analysis identified a GNRI cutoff value of 94.7, with an area under the curve (AUC) of 0.799 ± 0.037.</p><p><strong>Conclusion: </strong>Lower GNRI is significantly associated with increased risk of PUR following TLIF. GNRI may serve as a useful, independent predictor of PUR risk.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149801","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":"Feasibility and intra-operative accuracy of robotic-guided stacked S1AI and S2AI screw placement.","authors":"Gregory Fasani-Feldberg, Stanley Kisinde, Isador H Lieberman","doi":"10.1007/s00586-025-08951-5","DOIUrl":"https://doi.org/10.1007/s00586-025-08951-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pelvic fixation with S1 and S2 sacral alar-iliac screws (S1 & S2 AIs) in a stacked configuration can help to offset the exceedingly large forces across the lumbosacral junction in long spinal fusion constructs extending to the sacrum. Traditionally, these modalities of pelvic fixation have been heavily reliant on fluoroscopy and other intraoperative imaging for safe insertion through the sacral alar, the sacroiliac joint and into the narrow corridor of the wing of the ilium. However, recently, computer-assisted robotic guidance and its intraoperative re-registration function has allowed for safe and accurate placement, and intraoperative accuracy assessment of S1 & S2 AIs while minimizing additional radiation associated with fluoroscopic-guidance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To review and report our experience with, and assess the intraoperative accuracy and feasibility of, robotic-guided S1AI and S2AI screws inserted in a stacked bedrock configuration as part of instrumented constructs aimed to achieve spinopelvic fusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design / setting: &lt;/strong&gt;Retrospective Cohort study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;We evaluated the number of sacral spinopelvic fixation screws successfully implanted under robotic guidance and the deviation of the achieved screw trajectories from the pre-operatively planned trajectories. The presence and orientation of sacral alar-iliac cortical screw breaches and other intra- or postoperative complications directly related to placement of the stacked S1AI or S2AI implants were also evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We included all patients that underwent posterior instrumented spinal fusion up to the pelvis under computer-assisted robotic guidance with open bilateral sacroiliac joint fixation and fusion using S1 & S2 AIs from June 2022 to December 2024. Patients were excluded if the pelvic fixation was not applied in a stacked bedrock configuration. Patient demographics, intra-operative technical errors, complications and other surgical parameters, and any post-operative complications were reviewed and recorded. The data was collected from clinical charts in the electronic medical records system, radiologic images from PACS, and surgical details from operative notes. We also obtained intraoperative secondary registration images for assessment of accuracy, interpreted as the deviation (mm) of the achieved trajectories from the preoperatively planned trajectories in the coronal and sagittal planes, from the robotic planning software system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;51 patients (32 F & 19 M), mean age 66 (34-80) years, underwent placement of S1AI and S2AI screws under computer-assisted robotic guidance in a stacked bedrock configuration. The most common primary indication for instrumented spinopelvic fusion in these cases was scoliosis (degenerative scoliosis = 26, idiopathic scoliosis = 8), followed in descending order by degenerative spondy","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149791","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":"The resisted levator scapulae test: a clinical test for C4 radiculopathy.","authors":"William Roger Peters, James Thomas Ernest Smith, Mario Giuseppe Zotti","doi":"10.1007/s00586-025-08903-z","DOIUrl":"https://doi.org/10.1007/s00586-025-08903-z","url":null,"abstract":"<p><strong>Purpose: </strong>Cervical radiculopathy results from compression of a nerve root in the cervical spine creating upper limb or shoulder girdle sensorimotor dysfunction which commonly affects the C5-8 roots. Isolated C4 radiculopathy is rare and lacks typical clinical radiculopathy features and, as a result is underreported and poorly diagnosed. Nerve blocks can be used on the basis of pain distribution and clinical suspicion, however, no bedside tests exist to identify and test C4 radiculopathy in isolation. The objective of our study was to assess the clinical utility of using the Resisted Levator Scapulae test in identifying patients with C4 radiculopathy on physical exam.</p><p><strong>Methods: </strong>Participants were recruited on the basis of clinical suspicion of C4 radiculopathy. Participants were separated into test and pragmatic control based on radiographic evidence of C3/4 foraminal stenosis. Test group patients received the reference standard CT guided nerve root injection, pragmatic control patients were classed based on imaging. The reference standard was performed after review with a spinal surgeon where the RLS test result was recorded. Data was collected with primary and expanded analyses providing data for for predictive values using a contingency table.</p><p><strong>Results: </strong>Twenty-five participants (12 male, 13 female) with a median age of 69 completed the study in the test group, with 298 participants (192 male, 106 female) completing the study in the pragmatic control group. Nine test group participants (2.8%) showed isolated C4 radiculopathy with response to the diagnostic CT guided C4 nerve block, while 15 (4.6%) had multilevel involvement including C4. Primary analysis revealed sensitivity of 90% and specificity of 20% with an odds ratio of 2.25 (confidence interval: 0.2-25.4). Expanded analysis strengthened specificity (93%) and NPV (99.6%).</p><p><strong>Conclusion: </strong>The resisted levator scapulae test is a novel bedside physical diagnostic test for C4 radiculopathy used to complement a neurological examination and raise suspicion when positive.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149802","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 \"Do all symptomatic adjacent segment diseases (ASD) require surgery? A prognostic classification and predictors of surgical treatment of lumbar ASD\" by RM Kanna, et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-08797-x).","authors":"Dazhi Li, Li Liu","doi":"10.1007/s00586-025-08937-3","DOIUrl":"https://doi.org/10.1007/s00586-025-08937-3","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141879","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":"Radiographic and patient reported outcomes in adult spinal deformity revision surgery.","authors":"Mehmet Erkilinc, Laviel Fernandez, Deniz Kara, Julio Jauregui, Tomas Ries, Munish Gupta","doi":"10.1007/s00586-025-08952-4","DOIUrl":"https://doi.org/10.1007/s00586-025-08952-4","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the differences in radiographic and health-related quality of life outcomes of patients who were either younger or older than 65 years of age and underwent a revision adult spinal deformity surgery.</p><p><strong>Methods: </strong>This is a single center study that retrospectively evaluated the functional scores and radiographic parameters in patients who underwent a revision adult spinal deformity surgery between January 2015 and June 2020. Radiographic measurements and HRQOLs were measured pre-operatively, post-operatively and at final follow up. A total of 103 patients met inclusion criteria. These were divided into 2 groups, under 65 years (n = 60 patients), and over 65 years of age (n = 43 patients).</p><p><strong>Results: </strong>Analysis of the radiographic parameters at the various time points demonstrated statistically significant differences between preoperative and early postoperative parameters, except for thoracic kyphosis TK(p = 0.018). In both group, there was statistically significant improvement in PI-LL difference and LL. Comparison of the early postoperative follow-up data and last follow-up data showed statistically significant difference for PT (p = 0.013), TK (p = 0.012) and SVA (p = 0.015). When analyzing HRQOLs at the various time points, there was a statistically significant improvement in both groups between preoperative and final follow up scores and there was no significant difference between two groups. Complications in patients over 65 years of age occurred in 10/43(23%). In the under 65 group, complications occurred in 16/60 (27%).</p><p><strong>Conclusion: </strong>This study demonstrated similar improvement in radiographic parameters and functional outcome scores in patients undergoing revision ASD surgery stratified according to age.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141882","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":"Bone SPECT/CT in the diagnosis and treatment decision making of axial pain.","authors":"Marta Romera, Víctor Rodrigo-Paradells, Nicolás Varela, Edgar F Guillén, Marta Navarro-Astiasarán, Pablo Domínguez-Echavarri, Vicky Betech-Antar, Fernando Mínguez, Andrés Basanta, Juan J Rosales, Javier Arbizu","doi":"10.1007/s00586-025-08967-x","DOIUrl":"https://doi.org/10.1007/s00586-025-08967-x","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the usefulness of bone SPECT/CT for providing additional information to Magnetic Resonance Imaging (MRI) in patients with axial pain, and for guiding the site of spinal injections.</p><p><strong>Methods: </strong>We studied 194 patients with axial pain evaluated with SPECT/CT and MRI. Imaging abnormalities were classified according to location and diagnosis of pain generators. Patient outcomes after SPECT/CT guided spinal injection were evaluated during clinical follow-up. Descriptive analyses and kappa coefficient were performed for facet joint arthropathy detection and degenerative disc disease between imaging modalities.</p><p><strong>Results: </strong>MRI showed 44.3% more abnormalities than SPECT/CT (329 vs. 228). However, SPECT/CT detected 17% more patients with facet joint arthropathy compared to MRI (43.3% vs. 26.3% respectively). Imaging agreement for diagnosing degenerative disc disease was moderate (κ: 0.44; 95% CI, 0.32-0.56), but only fair for facet joint arthropathy (κ: 0.35; 95% CI, 0.28-0.42). The response to spinal injections guided by SPECT/CT imaging was assessed in 56 patients with facet joint arthropathy. Among these, 26 /56 had a history of previous spinal injections guided by physical examination. In this group, the response was effective or partially effective in 65.4% of patients and ineffective in 34.6%. After a second injection guided by SPECT/CT, the response rate increased to 88.4%, with only 11.6% remaining ineffective, resulting in an absolute benefit of 23.4%. In 30/56 patients with no prior history of spinal injections, the therapy was effective or partially effective in 93.3%, while 6.7% did not show any improvement in pain after SPECT/CT-guided spinal injections.</p><p><strong>Conclusion: </strong>Bone SPECT/CT imaging complements MRI by providing valuable information to identify pain generators. In facet joint arthropathy, it improves the effectiveness of pain relief when used to guide spinal injections.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141876","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":"Hip osteoarthritis is associated with higher revision rates following transforaminal lumbar interbody fusion.","authors":"Michael J Farias, Manjot Singh, Ashley Knebel, Mohammad Daher, Joseph E Nassar, Maxwell Sahhar, Sarah L Criddle, Bassel G Diebo, Alan H Daniels","doi":"10.1007/s00586-025-08943-5","DOIUrl":"https://doi.org/10.1007/s00586-025-08943-5","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with concurrent hip osteoarthritis (OA) and lumbar spinal pathologies often present with more disability and worse baseline measures of pain and function compared to patients with only spinal disease. However, the impact of hip OA on outcomes following specific spinal fusion techniques, such as transforaminal lumbar interbody fusion (TLIF), is not well established.</p><p><strong>Methods: </strong>Patients with and without hip OA who underwent TLIF at a single academic institution were identified. Patients with total hip arthroplasty were excluded. Baseline demographics, one-year postoperative surgical complications, and preoperative to one-year postoperative change in PROMs were compared. Multivariate regression analysis, accounting for age, sex, and CCI, were performed to evaluate outcomes in hip OA patients.</p><p><strong>Results: </strong>Among the 234 included patients, 117 had hip OA and 117 did not. The mean age was 63.7 years, 54.3% were females, the mean CCI was 3.2, and the mean follow-up was 30.6 months. Hip OA patients had a higher revision fusion rate compared to non-hip OA patients (19.7% vs. 6.0%, p = 0.002), with 4.18 times higher odds of revision (95% CI = 1.63-10.70, p = 0.003). At one year postoperatively, patients with hip OA had significantly worse VAS Leg scores (5.04 vs. 3.95, p = 0.005) and demonstrated less improvement in VAS Leg (- 1.61 vs. -2.81, p = 0.008) than non-hip OA patients. Other PROMs did not differ significantly between the two groups.</p><p><strong>Conclusions: </strong>This investigation revealed that patients with hip OA undergoing TLIF have higher revision rates and worse VAS leg pain compared to those without hip OA. This highlights the importance of a comprehensive evaluation and multidisciplinary care of hip and spine disorders in patients undergoing spine surgery, which can guide surgical decision making and patient counselling, with potential to improve postoperative outcomes.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136191","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":"Impact of frailty on short- and long-term outcomes following cervical laminoplasty for ossification of the posterior longitudinal ligament: a retrospective cohort study.","authors":"Xing Cheng, Wenlin Ye, Zhengran Yu, Chong Chen, Tao Yu, Jianxiong Zhuang, Dan Xiao, Yongxiong Huang, Yunbing Chang","doi":"10.1007/s00586-025-08902-0","DOIUrl":"https://doi.org/10.1007/s00586-025-08902-0","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of frailty, as measured by the 5-item modified frailty index (mFI-5), on short- and long-term postoperative outcomes in patients undergoing cervical posterior laminoplasty for ossification of the posterior longitudinal ligament (OPLL).</p><p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Methods: </strong>198 patients who underwent cervical posterior laminoplasty were divided into three groups based on mFI-5 scores: Group A (0 point), Group B (1 point), and Group C (2 or more points). Preoperative and postoperative mJOA, NDI, and VAS scores were assessed at short-term follow-ups (1 and 6 months) and long-term follow-ups (12 and 24 months). The incidence of complications, including superficial surgical site infections (SSI) and deep vein thrombosis (DVT), was recorded. Statistical analyses included ANOVA and Spearman correlation to evaluate the association between mFI-5 scores and clinical outcomes.</p><p><strong>Results: </strong>In the short-term (1 and 6 months), there were no significant differences in mJOA, NDI, and VAS scores among the three groups. However, in the long-term (12 and 24 months), Group C (mFI-5 ≥ 2) exhibited significantly worse mJOA and NDI scores compared to Groups A and B. Additionally, Group C had a higher incidence of complications, such as superficial SSI and DVT.</p><p><strong>Conclusions: </strong>Frailty, as measured by mFI-5, is a significant predictor of long-term postoperative outcomes in patients undergoing cervical posterior laminoplasty for OPLL. Patients with higher mFI-5 scores experienced poorer long-term functional recovery and a higher incidence of complications. These findings emphasize the importance of assessing frailty in preoperative risk stratification and surgical planning.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132358","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}