European Spine Journal最新文献

{"title":"Posterior spinal fusion with pedicle screw-based constructs in osteogenesis imperfecta: a systematic review of surgical and radiographic outcomes.","authors":"Paolo Brigato, Camilla Ravaioli, Leonardo Oggiano, Sergio De Salvatore, Davide Palombi, Pier Francesco Costici, Lisbet Haglund, Neil Saran, Jean Albert Ouellet","doi":"10.1007/s00586-026-09861-w","DOIUrl":"10.1007/s00586-026-09861-w","url":null,"abstract":"<p><strong>Background: </strong>Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by bone fragility and severe spinal deformities, with scoliosis affecting up to 80% of patients and often progressing despite bracing. Surgical management is challenging due to poor bone quality and high complication risk. Advances in pedicle screw-based constructs and multimodal strategies, including traction and bisphosphonates, have improved outcomes and enabled the successful correction of deformities. This review analyzes radiographic and surgical results of modern posterior spinal fusion (PSF) in OI-associated spinal deformity.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, Embase, Cochrane Library, and Google Scholar (inception to May 2025) was performed using search terms such as \"osteogenesis imperfecta\", \"brittle bone disease\", \"posterior spinal fusion\", \"spinal arthrodesis\", \"scoliosis\" and \"spinal deformity\". Extracted data covered demographics, OI type, traction techniques, instrumentation, radiographic and surgical outcomes, complications, and patient-reported outcome measures (PROMs). The risk of bias was assessed using the MINORS tool, and reporting followed PRISMA guidelines.</p><p><strong>Results: </strong>The initial search identified 264 articles, of which 8 met the inclusion criteria, including 149 patients with OI (mean age 15.5 years). All studies were retrospective case series (level IV evidence). Cement augmentation was used in 31.5% of cases and apical osteotomies in 37.5%. Preoperative main curves ranged from 75.5° to 96°, with a mean correction rate of 49.5% after PSF. Both coronal and sagittal radiographic parameters improved postoperatively. The mean operative time was 410.6 minutes, blood loss averaged 1,375 mL, and hospital stay was 7.9 days. The overall complication rate was 27.5%, with 10.7% requiring unplanned reoperation.</p><p><strong>Conclusion: </strong>Modern pedicle screw-based constructs appear to provide more consistent radiographic correction in OI-associated scoliosis compared to earlier in situ fusion techniques. Although these procedures still entail significant blood loss and long operative times, their complication rates remain acceptable given patient complexity. Future multicenter high-quality studies should focus on optimizing implant density, screw augmentation, rod material, osteotomies, and integrating navigation and new biomaterials to standardize treatment strategies.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"5869-5883"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485390","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":"Using ultrasound to assess connective tissue quality in spine surgery: cutoffs and predictive value for adjacent segment disease.","authors":"Erika Chiapparelli, Ali E Guven, Jiaqi Zhu, Marco D Burkhard, Krizia Amoroso, Bruno Verna, Anna-Maria Mielke, Jennifer Shue, Frank P Cammisa, Federico P Girardi, Andrew A Sama, Alexander P Hughes","doi":"10.1007/s00586-025-09730-y","DOIUrl":"10.1007/s00586-025-09730-y","url":null,"abstract":"<p><strong>Purpose: </strong>Collagen integrity is essential for connective tissue maintenance, and its deterioration may contribute to postoperative complications. Dermal ultrasound (US) echogenicity has been associated with collagen quality, with changes in echogenicity reflecting alterations in collagen composition. These changes may indicate increased susceptibility to revision surgery in lumbar fusion patients, particularly due to adjacent segment disease (ASD). However, no study has established a specific cutoff value for skin US echogenicity to predict the need for ASD-related revision surgery. This single-center prospective cohort study aimed to evaluate the association between dermal echogenicity and ASD revision, and to determine echogenicity cutoff values that could help identify patients at higher risk of requiring revision surgery.</p><p><strong>Methods: </strong>Patients undergoing posterior lumbar fusion from 2014 to 2023 were included. US measurements were conducted at two standardized locations on the lumbar back. Echogenicity values for the average dermal (AD), upper dermal (UD), and lower dermal (LD) layers were calculated using our institution's PACS imaging software. Statistical significance set at p < 0.05.</p><p><strong>Results: </strong>Among 383 patients (51% female, median age 63), those undergoing ASD revision were significantly older (median age 66.8 vs. 62 years, p = 0.012). Higher echogenicity in the LD (OR = 1.03, p = 0.008), UD (OR = 1.03, p = 0.027), and AD (OR = 1.03, p = 0.005) layers was associated with increased ASD risk. The optimal LD echogenicity cutoff was 124.3 (AUC = 0.654, sensitivity = 0.6, specificity = 0.69).</p><p><strong>Conclusion: </strong>We identify echogenicity cutoff values that correlate with an increased risk of revision surgery for ASD. Higher dermal US echogenicity may reflect alterations in collagen, contributing to poorer tissue quality. These findings support the use of dermal US parameters as a potential biomarker for high-risk lumbar fusion patients.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"6423-6429"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029016","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":"Quantifying gait and mobility in severe idiopathic scoliosis with inertial measurement technology.","authors":"Pablo Ulldemolins, Jorge Mario Morales, Pedro Rubio, Silvia Pérez, Miquel Bovea, Jose Luis Bas, Paloma Bas, Teresa Bas, Javier Martínez-Gramage","doi":"10.1007/s00586-026-09890-5","DOIUrl":"10.1007/s00586-026-09890-5","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"5974-5983"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622225","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":"Can curve characteristics predict severe progression in night-time bracing in adolescent idiopathic scoliosis?","authors":"Jamie Gross, Lærke Ragborg, Martin Heegaard, Rosemarie Høi-Hansen, Benny Dahl, Martin Gehrchen, Søren Ohrt-Nissen","doi":"10.1007/s00586-026-09884-3","DOIUrl":"10.1007/s00586-026-09884-3","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"5965-5973"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510867","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":"Evolution of surgical strategy for superior kyphosis restoration in patients with Lenke 1 & 2 adolescent idiopathic scoliosis.","authors":"Lorena V Floccari, Trinity A Kronk, Matthew B Holloway, Trey W Moberly, Richard P Steiner, Alexandria Mallinos, Miraides F Brown, Todd F Ritzman","doi":"10.1007/s00586-026-09853-w","DOIUrl":"10.1007/s00586-026-09853-w","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the outcomes of three sequential surgical techniques used over time for posterior spinal fusion (PSF) in adolescent idiopathic scoliosis (AIS) patients with Lenke 1 & 2 curves.</p><p><strong>Methods: </strong>Three sequential cohorts of Lenke 1 & 2 AIS patients who underwent PSF between 2008 and 2021 were retrospectively identified. Surgical technique, including concave rod derotation (T1), concave en bloc reduction (T2), or convex-first differential rod contouring technique (T3), was recorded. Preoperative, intraoperative, and minimum 2-year postoperative variables were compared.</p><p><strong>Results: </strong>Ninety-three Lenke 1 & 2 AIS patients were evaluated: 30 T1, 25 T2, and 38 T3. No significant differences were noted in demographics or preoperative radiographic measurements. The T3 group utilized higher implant density and more posterior column osteotomies (PCOs). Postoperatively, there was equivalent coronal correction index in all three cohorts. T3 resulted in significantly improved sagittal plane parameters, including final T5-T12 kyphosis (16.8° vs. 13.3° vs. 20.8° p = 0.011), final T2-T12 kyphosis (19.9° vs. 18.8°, 27.0° p = 0.033), delta T2-T12 kyphosis (-1.0° vs. -6.7° vs.1.5° p = 0.005), and delta 3D kyphosis (14.1° vs. 10.5° vs. 15.8° p = 0.034). Significant covariates of postoperative T5-T12 kyphosis included preoperative 3D kyphosis (p = < 0.001) and number of PCOs (p = 0.002). There were no differences in complications, readmissions, or unplanned reoperations.</p><p><strong>Conclusion: </strong>Practice evolution using a recent technique, specifically the convex-first differential rod reduction technique (T3), results in superior restoration of thoracic kyphosis compared to older concave rod derotation (T1) or concave en bloc reduction (T2) techniques for Lenke 1 & 2 AIS patients.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"5939-5948"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of the clinical efficacy between AUSS-TLIF combined with tianJi ROBOT-assisted PPSF and conventional TLIF in the treatment of Single-Stage lumbar spondylolisthesis.","authors":"Rui Li, Haiwei Cheng, Zhiqiang Wang, Yanhu Li, Wenxiang Shen, Zhixuan Nian, En Song, Peng Cheng","doi":"10.1007/s00586-026-09751-1","DOIUrl":"10.1007/s00586-026-09751-1","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"6056-6070"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249819","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":"Large language models with image processing in automated Cobb angle.","authors":"Jonathan Gibson, Sanika Kharwadkar, Chuck Lam, William Harland, Morgan Jones, Rajesh Botchu","doi":"10.1007/s00586-026-09803-6","DOIUrl":"10.1007/s00586-026-09803-6","url":null,"abstract":"<p><strong>Background: </strong>The degree of scoliosis is assessed through the Cobb angle, which quantifies severity and is measured by clinicians on radiographs. With the increasing adoption of artificial intelligence (AI) in clinical workflows, there is uncertainty as to whether large language models (LLMs) with image processing capabilities can streamline and improve spinal deformity classification. This study aims to assess the diagnostic capabilities of 4 leading LLMs: ChatGPT, Gemini, Perplexity and Grok in calculating Cobb angles from radiographs.</p><p><strong>Methods: </strong>A cross-sectional analysis of 122 scoliosis patients was undertaken. Cobb angles were independently calculated using Horos software by a fellowship-trained radiologist, serving as the reference standard. All 122 radiographs were further uploaded to each of the 4 AI models to identify the type of scoliosis, generate a Cobb angle overlay and calculate the Cobb angle. Qualitative usability was assessed through pre-defined questions ranked on a Likert scale. Statistical tests included mean difference, paired t-tests and intraclass correlation coefficients.</p><p><strong>Results: </strong>Gemini produced no calculated Cobb angles. ChatGPT failed to produce Cobb angles in 90 radiographs, and, even when Cobb angles were calculated, there were large errors (MAE 58.6° ± 45.9°). Both Perplexity and Grok generated estimates for all thoracolumbar cases, with mean differences of 18.8° (± 13.3°) and 24.2° (± 18.3°), respectively. None of the AI models successfully identified the S-shaped scoliosis cases. All AI models demonstrated a difference greater than the clinically accepted difference (≤ 10%).</p><p><strong>Conclusion: </strong>This study concludes that current commercially available LLMs show limited accuracy in Cobb angle measurement. Whilst out of the 4 AI models assessed, Perplexity and Grok displayed the highest performance, no model displayed an acceptable clinical ability. These findings highlight the need for a dedicated and rigorous development of a spinal deformity AI tool before clinical integration of Cobb angle determination.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"6484-6493"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257844","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":"Abdominal aortic calcification and functional recovery in patients undergoing posterior lumbar interbody fusion: a retrospective cohort study.","authors":"Shangshu Wei, Sizheng Zhan, Yanjun Huang, Danning Lu, Chenxu Liu, Haoning Ma, Ping Yi, Xiangsheng Tang","doi":"10.1007/s00586-026-09778-4","DOIUrl":"10.1007/s00586-026-09778-4","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"6099-6108"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141581","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":"Early postoperative hypophosphatemia is an independent predictor of ileus after transforaminal lumbar interbody fusion: a multicenter retrospective cohort study.","authors":"Juehan Wang, Zichuan Wu, Dongfeng Zhang, Shuliang Li","doi":"10.1007/s00586-026-09864-7","DOIUrl":"10.1007/s00586-026-09864-7","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"6031-6042"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456546","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":"Wearable sensor-based spinal motion assessments for identifying phenotypic clusters in chronic low back pain.","authors":"Prasath Mageswaran, Jonathan Dufour, Alexander Aurand, Ryan Gifford, Guy Brock, Yousef Alish, Gregory Knapik, Hamed Hani, Lindsay Hanes, Samantha Krening, Francesco Sammartino, Dukagjin Blakaj, Ehud Mendel, Melissa Tornero-Bold, Andrew Grossbach, Kristen Noon, Joanna Peng, Adam Farris, Varun Singh, Venkat Kavuri, Christina McGhee, Anthony Nguyen, Jaime Patterson, Whitney Luke, Nasir Hussain, Jayesh Vallabh, Tristan Weaver, William Marras","doi":"10.1007/s00586-026-09781-9","DOIUrl":"10.1007/s00586-026-09781-9","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"6439-6452"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}