European Spine Journal最新文献

{"title":"Perioperative recognition and management of rare irrigation-related complications in unilateral biportal endoscopy under general anesthesia: two case reports.","authors":"Wenwen Jiang, Yuhui Zhao, Yankun Du, Kai Cui, Chunhe Yang, Zhanzhi Zhao","doi":"10.1007/s00586-025-09077-4","DOIUrl":"https://doi.org/10.1007/s00586-025-09077-4","url":null,"abstract":"<p><strong>Background: </strong>Unilateral biportal endoscopy (UBE) is a widely used minimally invasive technique for treating lumbar disc herniation, employing continuous fluid infusion to maintain a clear surgical field. However, complications related to fluid infusion can occur rarely during or after the procedure, presenting significant challenges in perioperative management.</p><p><strong>Case presentations: </strong>Here, we report two cases of postoperative irrigation-related complications. The first patient developed autonomic dysregulation, which rapidly progressed to a seizure. The second patient experienced acute respiratory failure, which posed an immediate life threat. Both patients were conservatively managed with sedation, analgesia, and respiratory support. The key therapeutic intervention was prompt dehydration to reduce spinal cord pressure. Both patients had a favorable recovery with no long-term sequelae.</p><p><strong>Conclusions: </strong>UBE is a highly effective, minimally invasive treatment, but irrigation-related complications can be life-threatening. This report highlights the need for anesthesiologists to promptly identify and manage such complications, offering valuable insights for clinical care in similar high-risk situations.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552808","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 clinical impact of MRI-based vertebral bone quality score for assessment of bone quality.","authors":"Xingxiao Pu, Tian Tian, Xuejun Dai, Daxing Wang, Weiping Xiao, Shao Gu, Chengwei Liu, Bailian Liu, Pengde Kang, Haifeng Li","doi":"10.1007/s00586-025-09096-1","DOIUrl":"https://doi.org/10.1007/s00586-025-09096-1","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this search was to evaluate the clinical significance of the MRI-based vertebral bone quality (VBQ) score for assessment of bone quality.</p><p><strong>Methods: </strong>We searched all published articles regarding the clinical impact of VBQ score in Embase, Cochrane library, and PubMed before June 1st, 2023.</p><p><strong>Results: </strong>The calculational method of VBQ has gradually been standardized. The association between the VBQ score and bone mineral density (BMD) is well established, and the VBQ score is verified to assess the bone condition. The quantitative computed tomography (QCT) BMD as the gold standard to determine the diagnostic threshold of the VBQ score is recommended. Moreover, the VBQ score is a good predictor for some osteoporosis-related postoperative complications. However, there are still some influential factors for the VBQ score that have not fully understood.</p><p><strong>Conclusion: </strong>VBQ score is a simple and reproducible method to assess bone quality that can be achieved on the lumbar MRI. Preoperative VBQ score can predict some osteoporosis-related postoperative complications precisely. However, the diagnostic threshold value VBQ score and the effect of influential factors on the VBQ score may need to be further explored in the future.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539709","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 H. Wang, et al. concerning \"Comparison of the immobilizing effect of soft, semi-rigid and rigid neck orthoses\" by M. Schulz et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-08854-5).","authors":"Dina W Wiersbicki, Maxi Schulz, Martin Heilemann, Toni Wendler, Christoph-Eckhard Heyde, Stefan Schleifenbaum, Georg Osterhoff","doi":"10.1007/s00586-025-09042-1","DOIUrl":"https://doi.org/10.1007/s00586-025-09042-1","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539673","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":"Risk factors associated with distal junctional kyphosis and failure after surgical management of adult cervical deformity: a systematic review.","authors":"Davin C Gong, Anthony N Baumann, Zhaorui Wang, Omkar S Anaspure, Muhammad Waheed, Evan J Beck, Rakesh D Patel, Ilyas S Aleem","doi":"10.1007/s00586-025-09104-4","DOIUrl":"https://doi.org/10.1007/s00586-025-09104-4","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539708","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":"Comparison of a progressive bone drilling system and a visualized reaming system in percutaneous transforaminal endoscopic discectomy: a comparative study.","authors":"Yang Yu, Meng Li, Kuilin Zhang, Qiang Shi","doi":"10.1007/s00586-025-09061-y","DOIUrl":"https://doi.org/10.1007/s00586-025-09061-y","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous transforaminal endoscopic discectomy (PTED) is an alternative, minimally invasive procedure for the treatment of symptomatic lumbar disc herniation (LDH). Two foraminoplasty techniques exist, however, insufficient literature exists highlighting the differences between these procedures.</p><p><strong>Methods: </strong>A multicentre retrospective study was conducted in consecutive patients diagnosed with symptomatic LDH who received PTED at spine centres from March 2015 to June 2019. A total of 798 patients were recruited, of whom 432 underwent progressive bone drilling system (PBDS) for foraminoplasty and 366 received a visualized reaming system (VRS).</p><p><strong>Results: </strong>The average radiation exposure and operative time in the PBDS group were significantly greater than those in the VRS group (P < 0.05). Compared with those before the operation, the postoperative VAS and ODI scores in both groups were significantly improved (P < 0.05). Additionally, the VAS score for leg pain and the JOA/ODI score in the PBDS group were significantly lower than those in the VRS group at both the 1-week and 1-month follow-up (P < 0.05). The good-to-excellent rates of the PBDS group and VRS group were 90.97% and 81.14%, whereas the complication occurrence rates were 11.80% and 15.30% in the PBDS group and VRS group, respectively.</p><p><strong>Conclusion: </strong>PBDS and VRS have acceptable efficacy at a midterm follow-up of 2 years in treating LDH with PTED. Although PBDS is associated with longer intraoperative fluoroscopy and operative times, it should still be considered superior to VRS considering the benefits of fewer complications, quicker pain relief, and functional recovery.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539674","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":"Reversible intraoperative neuromonitoring changes in thoracic ossification of the posterior longitudinal ligament and/or ossification of the ligamentum flavum surgery.","authors":"Tun Liu, Wentao Wang, Huaguang Qi, Jia Li, Bin Guo, Songchuan Zhao, Jin Wang, Kuo Jiang, Gang Wu, Gang Wang","doi":"10.1007/s00586-025-09100-8","DOIUrl":"https://doi.org/10.1007/s00586-025-09100-8","url":null,"abstract":"<p><strong>Objective: </strong>We aim to determine the surgical outcomes in patients with thoracic ossification of the posterior longitudinal ligament (OPLL) and/or ossification of the ligamentum flavum (OLF) who experienced intraoperative somatosensory- and/or motor-evoked potential (SSEP and/or MEP) changes.</p><p><strong>Methods: </strong>Patients who diagnosed with OPLL and/or OLF were identified. SSEP/MEP signals were acquired at two time-points: (1) during the maximal signal change and (2) 20 min after the change. Manual muscle testing (MMT) and the modified Japanese Orthopedic Association Scoring System (mJOA) were obtained to assess perioperative spinal neurological function.</p><p><strong>Results: </strong>Of the 165 eligible patients, 104 experienced SSEP/MEP changes. These patients were stratified into two subgroups: 22 patients exhibited persistent signal changes, while 82 patients showed partial or complete signal recovery within 20 min after the maximum change. Patients with reversible SSEP/MEP changes had comparable surgical outcomes to those in the no-change group, including estimated blood loss ( 463 ±145  ml vs.  486±162  ml, p = 0.47) and operative time (205 ± 28 min vs. 213 ± 27 min, p = 0.81). Furthermore, postoperative spinal neurological function in patients with reversible change was similar to those of the no-change group in terms of short-term postoperative motor deficit (PMD) cases (reversible group: n = 4; no-change group: n = 2; p = 0.64 ) and long-term mJOA recovery ratio (RR) (reversible change group: 29.19% ± 9.76%; no-change group: 31.22% ± 13.91%; p = 0.21).</p><p><strong>Conclusions: </strong>Reversible signals provide surgeons with confidence to complete the surgery safely, with surgical outcomes comparable to those of patients who do not experience SSEP/MEP changes.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539707","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":"Development and validation of a prognostic prediction model for lumbar-disc herniation based on machine learning and fusion of clinical text data and radiomic features.","authors":"Zhipeng Wang, Hongwei Zhang, Yuanzhen Li, Xiaogang Zhang, Jianjun Liu, Zhen Ren, Daping Qin, Xiyun Zhao","doi":"10.1007/s00586-025-09102-6","DOIUrl":"https://doi.org/10.1007/s00586-025-09102-6","url":null,"abstract":"<p><strong>Objective: </strong>Based on preoperative clinical text data and lumbar magnetic resonance imaging (MRI), we applied machine learning (ML) algorithms to construct a model that would predict early recurrence in lumbar-disc herniation (LDH) patients who underwent percutaneous endoscopic lumbar discectomy (PELD). We then explored the clinical performance of this prognostic prediction model via multimodal-data fusion.</p><p><strong>Methods: </strong>Clinical text data and radiological images of LDH patients who underwent PELD at the Intervertebral Disc Center of the Affiliated Hospital of Gansu University of Traditional Chinese Medicine (AHGUTCM; Lanzhou, China) were retrospectively collected. Two radiologists with clinical-image reading experience independently outlined regions of interest (ROI) on the MRI images and extracted radiomic features using 3D Slicer software. We then randomly separated the samples into a training set and a test set at a 7:3 ratio, used eight ML algorithms to construct predictive radiomic-feature models, evaluated model performance by the area under the curve (AUC), and selected the optimal model for screening radiomic features and calculating radiomic scores (Rad-scores). Finally, after using logistic regression to construct a nomogram for predicting the early-recurrence rate, we evaluated the nomogram's clinical applicability using a clinical-decision curve.</p><p><strong>Results: </strong>We initially extracted 851 radiomic features. After constructing our models, we determined based on AUC values that the optimal ML algorithm was least absolute shrinkage and selection operator (LASSO) regression, which had an AUC of 0.76 and an accuracy rate of 91%. After screening features using the LASSO model, we predicted Rad-score for each sample of recurrent LDH using nine radiomic features. Next, we fused three of these clinical features -age, diabetes, and heavy manual labor-to construct a nomogram with an AUC of 0.86 (95% confidence interval [CI], 0.79-0.94). Analysis of the clinical-decision and impact curves showed that the prognostic prediction model with multimodal-data fusion had good clinical validity and applicability.</p><p><strong>Conclusion: </strong>We developed and analyzed a prognostic prediction model for LDH with multimodal-data fusion. Our model demonstrated good performance in predicting early postoperative recurrence in LDH patients; therefore, it has good prospects for clinical application and can provide clinicians with objective, accurate information to help them decide on presurgical treatment plans. However, external-validation studies are still needed to further validate the model's comprehensive performance and improve its generalization and extrapolation.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527117","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 \"Percutaneous pedicle screw placement with a mini-open decompression versus open surgery in the treatment of lumbar spondylolisthesis: one-year results of a randomised controlled trial\" by A. Broekema, et al. (Eur spine J [2025]: doi:10.1007/s00586-025-08855-4).","authors":"Neda Khaledian, Ehsan Alimohammadi","doi":"10.1007/s00586-025-09092-5","DOIUrl":"https://doi.org/10.1007/s00586-025-09092-5","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527118","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":"Comparable long-term pain and disability outcomes following decompression alone versus decompression with fusion in lumbar spinal stenosis patients with high-signal facet joints.","authors":"Guy John-Malcolm Cameron, Jade Maree Garrett, Anthea Sapphire Azzi, William Colby Matthews, Akash Rae Singh, Richard Ferch","doi":"10.1007/s00586-025-09065-8","DOIUrl":"https://doi.org/10.1007/s00586-025-09065-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the long-term outcomes of decompressive surgery with or without fusion in patients with lumbar spinal stenosis (LSS) exhibiting high-signal facet joints, a radiological marker of potential instability.</p><p><strong>Methods: </strong>A retrospective cohort study analysed surgeries performed by a single surgeon between January 2016 and June 2023. Eligible participants (n = 100) were adults with LSS who underwent decompression with or without fusion and were followed up using validated questionnaires to assess pain (VAS back, VAS leg) and disability (ODI, RMDQ). Statistical analyses included t-tests, ANOVA, and logistic regression to evaluate clinical outcomes.</p><p><strong>Results: </strong>Fifty-seven patients underwent decompressive surgery (SD), and 43 underwent decompression with fusion (DF). DF patients were younger (67.67 vs. 73.07 years, p = 0.0008) and more likely to exhibit radiological markers of instability, including L5-S1 involvement (p = 0.0315) and Grade 1 spondylolisthesis (p = 0.0118). Both groups showed significant improvements in pain and disability scores (p < 0.0001), with no significant differences between groups at follow-up. DF was associated with longer hospital stays (3.07 vs. 1.70 days, p < 0.0001) but fewer revision surgeries (2.33% vs. 15.79%, p = 0.0402). Higher BMI reduced odds of ODI improvement in the SD group (p = 0.0252), while older age decreased the odds of RMDQ improvement in the DF group (p = 0.0102).</p><p><strong>Conclusion: </strong>Both surgical approaches yielded significant improvements in pain and disability for patients with LSS. The findings suggest fusion may not be necessary for patients with high-signal facet joints absent additional instability markers, supporting a tailored approach to surgical decision-making.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527116","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 spine metastases from lung cancer with incomplete paralysis treated by endoscopic spinal surgery: a case report.","authors":"Ningdao Li, Runhan Zhao, Jun Zhang, Xiaoji Luo, Xifeng Zhang","doi":"10.1007/s00586-025-09078-3","DOIUrl":"10.1007/s00586-025-09078-3","url":null,"abstract":"<p><strong>Study design: </strong>A case report.</p><p><strong>Objective: </strong>Presentation of transpedicular approach for endoscopic spine surgery (ESS) in a patient with thoracic spine metastases from lung cancer with incomplete paralysis.</p><p><strong>Background: </strong>The spine is the most colonized site for tumor bone metastases, and approximately 5-10% of patients develop symptoms of nerve and spinal cord compression. Traditional open surgery is the best management strategy to address patients' neurological symptoms, but its demanding physical status and low clinical benefit in end-stage patients limit its application in spinal metastases. With the accumulation of experience and technological breakthroughs in ESS, this technology has become an ideal choice for palliative treatment of patients with end-stage spinal metastases.</p><p><strong>Method: </strong>A patient with thoracic spine metastasis from lung cancer with incomplete paralysis was treated with ESS using a transpedicular approach.</p><p><strong>Results: </strong>A patient with lung cancer thoracic spine metastasis with incomplete paralysis was unable to tolerate traditional open surgery due to her physical condition, so our team used the strategy of spinal endoscopic decompression with tumor resection via transpedicular approach to treat him. After the operation, the patient's pain and neurological symptoms were significantly relieved, and he regained the ability to walk on himself within two months. Moreover, the technique prolonged his survival while safeguarding his quality of life.</p><p><strong>Conclusion: </strong>ESS is ideal for patients with end-stage spinal metastases.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505311","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}