European Spine Journal最新文献

{"title":"Reply to the Letter to the Editor of M. Zhang, et al. concerning \"Surgical strategies and outcomes in degenerative myelopathy at the cervico-thoracic junction: a multicenter retrospective analysis\" by Umana GE, et al. (Eur Spine J [2025]: doi:10.1007/s00586-025-09139-7).","authors":"Giuseppe Emmanuele Umana, Gianluca Scalia, Luca Ricciardi, Giorgio Lofrese, Lorenzo Mongardi, Nicola Montemurro, Francesco Acerbi, Lidia Strigari, Miguel Ruiz Cardozo, Gabriele Capo, Ali Baram, Maurizio Fornari, Camilo Molina","doi":"10.1007/s00586-025-09351-5","DOIUrl":"10.1007/s00586-025-09351-5","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4768-4769"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991932","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":"Application of extracorporeal collagenase chemonucleolysis and combined intradiscal and extracorporeal collagenase chemonucleolysis via FLEX electrode in patients with lumbar disc herniation: a retrospective study.","authors":"Chao Ma, Peng Song, Qiqi Chen, Yan Xu, Shengdeng Fan, Yongjun Zhang, Yan Yuan","doi":"10.1007/s00586-025-09067-6","DOIUrl":"10.1007/s00586-025-09067-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate and compare the short-term and long-term clinical outcomes of extracorporeal collagenase chemonucleolysis(ECCNL) and intradiscal-extracorporeal collagenase chemonucleolysis(IECCNL) via FLEX electrode in patients with lumbar disc herniation (LDH).</p><p><strong>Method: </strong>A retrospective analysis was performed on 65 patients diagnosed with LDH who met the inclusion criteria between April 2021 and April 2022. Patients were divided into two groups: 30 received ECCNL via FLEX electrodes (Group A) and 35 received IECCNL via FLEX electrode (Group B). Clinical outcomes were evaluated using the modified MacNab criteria, Numerical Rating Scale (NRS), and Japanese Orthopaedic Association (JOA) scores to assess the excellent/good rate, excellent rate, pain severity, and neurological function at specified intervals (3, 6, 12, and 24 months for clinical outcomes; 3 days, 1, 3, 6, 12, and 24 months for pain/neurological status). Perioperative complications, recurrence rates, and reoperation rates were systematically documented.</p><p><strong>Results: </strong>A total of 58 patients were included. At 1 month postoperatively, Group A showed significantly lower NRS scores compared to Group B (P < 0.05) and a higher pain relief rate (P < 0.05). Although Group A had higher JOA scores than Group B at 3 days postoperatively (P < 0.05), Group B showed higher JOA scores than Group A at 24 months postoperatively (P < 0.05). The excellent-good rate between the two groups at any postoperative time point, Group B demonstrated a significantly higher excellent rate than Group A at both 3 months and 24 months postoperatively (P < 0.05). In Group A, there was 1 case of recurrence and 2 reoperations, with a recurrence rate of 3.45% [95% CI: 0.09%, 17.7%] and reoperation rate of 6.90% [95% CI: 0.84%, 22.8%]. Group B showed no recurrences or reoperations [95% CI: 0%, 9.7%] for both outcomes. No statistically significant differences were observed between the two groups. During the 24-month follow-up period, no severe complications were observed in Group A. However, one case of nerve root injury occurred in Group B.</p><p><strong>Conclusion: </strong>FLEX electrode application in conjunction with two collagenase injection strategies enhances therapeutic outcomes. Short-term results favor ECCNL alone, whereas long-term benefits are more pronounced with the intradiscal-extracorporeal therapy.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4369-4376"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368743","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 \"Incidence, clinical features, and risk factors for acute pancreatitis following posterior instrumented fusion surgery for lumbar degenerative disease: a single‑center, retrospective analysis of 20,929 patients\" by Y. Hu et al. (Eur spine J [2023]: doi:10.1007/s00586-023-07845-8).","authors":"Jun Ma, Hui Kang, Feng Xu","doi":"10.1007/s00586-025-09183-3","DOIUrl":"10.1007/s00586-025-09183-3","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4853-4854"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759593","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 \"the safety and accuracy of radiation-free spinal navigation using a short, scoliosis-specific BoneMRI-protocol, compared to CT\" by P.P.G. Lafranca, et al. (Eur spine J [2025]; doi: 10.1007/s00586-025-09151-x).","authors":"Elham Mohebi, Ehsan Alimohammadi","doi":"10.1007/s00586-025-09300-2","DOIUrl":"10.1007/s00586-025-09300-2","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4848-4849"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948319","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 \"Transforaminal lumbar interbody fusion using banana-shaped and straight cages: meta-analysis of clinical and radiological outcomes\" by A. Sebaaly et al. (Eur Spine J [2023]: doi: 10.1007/s00586-023-07797-z).","authors":"Guang-Xun Lin, Chien-Min Chen","doi":"10.1007/s00586-025-09186-0","DOIUrl":"10.1007/s00586-025-09186-0","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4859-4860"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948333","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 outcomes, safety, and cost considerations of rhBMP-2 in the surgical management of pyogenic spinal infections: a focused review.","authors":"Hassan Mahfouz, Hamza Mahfouz, Humaid Al Farii","doi":"10.1007/s00586-025-08993-9","DOIUrl":"10.1007/s00586-025-08993-9","url":null,"abstract":"<p><strong>Background: </strong>Pyogenic spondylodiscitis and vertebral osteomyelitis remain challenging clinical entities, particularly when surgical intervention is required. While recombinant human bone morphogenetic protein-2 (rhBMP-2) is well established in degenerative spinal fusion, its role in the context of active or previously treated spinal infection remains controversial. This focused review evaluates the clinical outcomes, safety profile, and cost considerations of rhBMP-2 in the surgical management of pyogenic spondylodiscitis and vertebral osteomyelitis.</p><p><strong>Methods: </strong>A focused literature review was conducted to identify studies reporting on the use of rhBMP-2 in patients undergoing spinal fusion for pyogenic spondylodiscitis and vertebral osteomyelitis. Data were extracted on patient demographics, rhBMP-2 dose, fusion rates, complication profiles, infection recurrence, neurological outcomes, and cost-related metrics.</p><p><strong>Results: </strong>Six retrospective studies encompassing 346 patients treated with rhBMP-2 were included. Fusion rates ranged from 95 to 100%, with a weighted average of 97.84% across reported studies. Infection recurrence was low at 1.54%, and no study attributed reinfection to rhBMP-2 use. The complication rate averaged 18.49%, with only one transient rhBMP-2 related event (radiculitis) reported. Neurological improvement was observed in 68.0% of patients. Cost data, though limited, suggest reduced long-term healthcare utilisation in rhBMP-2 treated patients, potentially offsetting initial implant costs.</p><p><strong>Conclusion: </strong>Based on currently available retrospective data, rhBMP-2 appears to be a potentially safe adjunct in the surgical management of pyogenic spondylodiscitis and vertebral osteomyelitis. When used selectively, it has been associated with high fusion rates and an acceptable safety profile. These findings support the need for prospective, controlled trials to further define its optimal role, dosing strategies, and cost-effectiveness in the surgical management of pyogenic spondylodiscitis and vertebral osteomyelitis.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4631-4637"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274596","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 Patients´ quality of life and outcome after surgical treatment for primary spinal infection.","authors":"Ryo Fujita, Kajsa Ytterberg, Paul Gerdhem, Anna MacDowall","doi":"10.1007/s00586-025-09037-y","DOIUrl":"10.1007/s00586-025-09037-y","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical intervention can be an option in the treatment of primary spinal infection as a means to control infection, improve severe paralysis and save lives. However, there is a knowledge gap regarding how the patients fare after restitution, in terms of patient-reported outcomes (PROMs). This study aims to assess the outcomes 1 year after surgical treatment for primary spinal infection using PROMs by analyzing data with available cases from the national Swedish spine registry (Swespine).</p><p><strong>Methods: </strong>This retrospective case-control cohort study included 907 patients who underwent surgery for primary spinal infection, registered in Swespine between 2006 and 2023. Among them, 82 patients had complete baseline and one-year follow-up data. Variables included age, sex, BMI, mortality rate, reoperation rate, and preoperative and one-year postoperative scores for the EQ-5D index, EQ-visual analogue scale (VAS), and Numerical Rating Scale (NRS) for back/neck and leg/arm pain. Patient status at one year post-surgery were calculated using ANCOVA analysis and compared with a cohort of healthy controls (n = 273) and with the I year follow-up of patients surgically treated for degenerative lumbar spine disease (n = 89,478). Patients' return to work 1 year after the surgery were also assessed via postal questionnaires.</p><p><strong>Results: </strong>One year post-surgery, spinal infection patients showed significant improvements in the EQ-5D index, EQ-VAS, and NRS scores (p-values: <0.001, < 0.001, 0.002, 0.001). The EQ-5D index improvement exceeded the minimum clinically important difference (MCID) of 0.24, but NRS improvements fell below the MCID threshold of 2.5. Despite improvements, the postoperative EQ-5D index remained significantly lower in the spinal infection group than in population-based controls (control: 0.93, infection: 0.49; p < 0.001). Additionally, EQ-5D and EQ-VAS improvements were less pronounced compared to degenerative disease patients (infection: 0.51, 57.3; degenerative: 0.65, 67.2; p < 0.001). The reoperation rate was 18.2%, and half of the working patients (20/40) had not resumed work within a year.</p><p><strong>Conclusion: </strong>Surgical treatment for spinal infection improves life quality and pain. However, pain relief remains suboptimal, as the improvements do not reach the MCID. One year postoperatively, PROMs in spinal infection patients remain worse than those in population-based controls and degenerative disease patients, suggesting persistent symptoms despite healing and restitution of the spinal infection.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4749-4757"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293623","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 \"assessing lumbar vertebral bone quality: a methodological evaluation of CT and MRI as alternatives to traditional DEXA\" by courtois, E.C., et al. (Eur spine J [2023]: doi: 10.1007/s00586-023-07855-6).","authors":"Youwei Ai, Dun Luo, Qian Chen, Limin Liu","doi":"10.1007/s00586-025-09184-2","DOIUrl":"10.1007/s00586-025-09184-2","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4855-4856"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717841","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":"Exploring upstream and downstream causality of inflammatory cytokines in intervertebral disc degeneration: a bidirectional, two-sample Mendelian randomization study.","authors":"Pan Huang, Yi He, Na Zhi, Wenqi Yi, Caixia Guo, ZeFei Jiang, Hong Zhang","doi":"10.1007/s00586-025-09005-6","DOIUrl":"10.1007/s00586-025-09005-6","url":null,"abstract":"<p><strong>Background and purpose: </strong>Growing evidence indicates that inflammatory cytokines may influence intervertebral disc degeneration both upstream and downstream. To further explore the upstream and downstream direct causality of inflammatory cytokines in intervertebral disc degeneration, we performed a bidirectional, two-sample Mendelian randomization (MR) study.</p><p><strong>Methods and results: </strong>Five MR analysis techniques were used to explore the causal relationship, with a sensitivity analysis validating the results. We examined 91 inflammatory cytokines to assess their impact on intervertebral disc degeneration and identify upstream modulators. Three key regulators were identified: cystatin D(OR, 0.88; CI [0.78-1.00]; P = 0.04), IL-15 receptor subunit alpha (OR, 1.17; CI [1.02-1.34]; P = 0.02), and TNF-related apoptosis-inducing ligand (OR, 0.85; CI [0.75-0.98]; P = 0.02). Additionally, we examined the effects of disc degeneration on inflammatory cytokines to identify downstream effectors influencing disc degeneration. We identified four downstream effectors associated with disc degeneration: IL-13(OR 1.05, CI 1.01-1.10, P = 0.01), IL-2 (OR 0.95, CI 0.91-0.99, P = 0.02), IL-20 receptor subunit alpha (OR, 1.05; CI [1.01-1.09]; P = 0.03), and Thymic stromal lymphopoietin(OR, 1.05; CI [1.00-1.10]; P = 0.02).</p><p><strong>Conclusion: </strong>This research identified a causal link between inflammatory cytokines and intervertebral disc degeneration, highlighting Cystatin D, IL-15 receptor subunit alpha, and TNF-related apoptosis-inducing ligand as key regulators, with IL-15 receptor subunit alpha possibly being the primary factor. Our hypothesis proposes that after disc degeneration, increased IL-13 and decreased IL-2 levels might slow disc degeneration and provide a protective response. Conversely, higher levels of IL-20 receptor subunit alpha and thymic stromal lymphopoietin could exacerbate inflammation and accelerate disc degeneration.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4558-4580"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247239","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 \"assessing the association between degenerative disc disease and spinal mobility\" by Schönnagel L, et al. (Eur spine J [2025]: doi: 10.1007/s00586-025-08919-5).","authors":"Chao Yang, Xingyu Huang, Wiraphong Sucharit","doi":"10.1007/s00586-025-09201-4","DOIUrl":"10.1007/s00586-025-09201-4","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4809-4810"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948326","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}