European Spine Journal最新文献

{"title":"The relationship between muscle mass and low back pain: a cross-sectional study.","authors":"Rudong Chen, Congwen Yang, Xiaofu Tang, Shijie Han, Mingjie Kuang, Xiaoming Li","doi":"10.1007/s00586-025-09026-1","DOIUrl":"https://doi.org/10.1007/s00586-025-09026-1","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between ASM/BMI (Appendicular Skeletal Muscle Mass/ body mass index) and low back pain.</p><p><strong>Methods: </strong>Participants from the National Health and Nutrition Examination Survey (NHANES 1999 ~ 2004) were included. Multiple logistic regression modeling was used to explore the relationship between ASM/BMI and low back pain.</p><p><strong>Result: </strong>A total of 11,738 participants were included in this study, and there were significant differences between the pain group and non-pain group in terms of sex, race, poverty-to-income ratio, and educational attainment. We analyzed ASM/BMI by quartiles into Q1, Q2, Q3, and Q4 into four groups, and the results showed that participants in Q4 had a significantly lower risk of low back pain compared to those in Q1 (p = 0.003); No significant difference in low back pain risk was observed between Q2, Q3, and Q1. Subgroup analyses suggest that the role of elevated ASM/BMI in reducing the risk of low back pain may be more pronounced in women and in individuals aged 40-59 years.</p><p><strong>Conclusion: </strong>This study demonstrated that there is a negative correlation between ASM/BMI and low back pain, and that the negative correlation between ASM/BMI and low back pain is more significant in women and in individuals aged 40-59 years. This suggests that incorporating ASM/BMI assessment into clinical evaluations could improve risk stratification for low back pain, particularly in women and middle-aged populations (40-59 years).</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247246","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 for facet joint violation in minimally invasive and open lumbar interbody fusion: a systematic review and meta-analysis.","authors":"Natalia Anna Koc, Piotr Oleksy, Maciej Szyduczyński, Michał Krakowiak, Tomasz Szmuda, Piotr Zieliński, Grzegorz Miękisiak","doi":"10.1007/s00586-025-09015-4","DOIUrl":"https://doi.org/10.1007/s00586-025-09015-4","url":null,"abstract":"<p><strong>Purpose: </strong>Facet joint violation (FJV) is an underreported consequence of screw placement in spine surgery, significantly impacting load-bearing capability of the level. Rates of FJV range from 6.3 to 100% due to variability in surgical techniques, navigation methods, and FJV definitions. This study identifies FJV predictors during lumbar fusion in minimally invasive spine surgery (MISS) and open procedures.</p><p><strong>Methods: </strong>Literature review was performed according to PRISMA guidelines. PubMed, Web of Science and Scopus were searched using keywords \"MIS\", \"minimally invasive\", \"percutaneous\", \"endoscopic\", \"open\", \"conventional\", \"traditional\", \"lumbar fusion\", \"spine fusion\", \"FJV\", \"facet joint violation\". The quality of studies was evaluated using the Newcastle-Ottawa Scale (NOS). Odds ratio (OR) for dichotomous values and mean difference (MD) for continuous values were calculated. Patients were divided into minimally invasive spine surgery (MISS) and open subgroups.</p><p><strong>Results: </strong>Seven retrospective studies reporting 1155 patients and 2309 screws were identified, among which 412 violated the facet joint. Body Mass Index (BMI) ≥ 30 predicted FJV, particularly in the MISS subgroup (OR = 3.73, p < 0.0001). Screw placement at L4 level was associated with lower risk (OR = 0.64, p = 0.0003), while L5 level increased the risk of FJV (OR = 1.85, p < 0.0003). Lower pedicle screw angle (PSA) was another FJV predictor (MD= -5.82, p = 0.0002). In the MIS subgroup, 3D navigation decreased the FJV risk (OR = 0.39, p = 0.001).</p><p><strong>Conclusion: </strong>BMI ≥ 30, screw placement at L5, and a lower PSA increase the risk of FJV during lumbar interbody fusion. Screw placement at L4 and the use of 3D navigation in MISS are associated with a decreased FJV risk. These findings provide valuable insights for optimizing surgical techniques and reducing FJV incidence in lumbar spine instrumentation.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247244","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":"https://doi.org/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":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","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 \"A multimodal machine learning model integrating clinical and MRI data for predicting neurological outcomes following surgical treatment for cervical spinal cord injury\" by T.Shimizu, et al. (Eur Spine J [2025]: doi: 10.1007/s00586-025-08873-2).","authors":"Weijie Yu, Yujing Chen","doi":"10.1007/s00586-025-09017-2","DOIUrl":"https://doi.org/10.1007/s00586-025-09017-2","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247240","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":"Novel CT-based vertebral three-dimensional Hounsfield unit for assessment of bone mineral density.","authors":"Rongkun Chang, Yang You, Lijun Cai, Feng Chang, Jinxin Gu, Jing Song, Jizhe Zhang, Zebin Wang, Qiujiang Li, Lei Liang","doi":"10.1007/s00586-025-09010-9","DOIUrl":"https://doi.org/10.1007/s00586-025-09010-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to establish a novel index, three-dimensional Hounsfield unit (3D-HU), to assess bone density, and evaluated its correlation with dual-energy X-ray absorptiometry (DXA) scores.</p><p><strong>Methods: </strong>This study reviewed the electronic medical records of patients who underwent lumbar spine computed tomography (CT) and DXA at our hospital within one week. Patients were divided into osteoporotic and non-osteoporotic groups according to T-score. Demographics information and radiological parameters were compared. Using preoperative CT scanning of the lumbar spine, the novel 3D-HU was measured for each patient. DXA scores were obtained and were compared to 3D-HU using multivariate logistic regression analyses and Pearson correlation.</p><p><strong>Results: </strong>This study involved 612 vertebrae from 191 patients. Among them, 134 were found to have a T-score ≤ -2.5. Multivariate analysis showed that lower 3D-HU and body mass index (BMI) were independent predictors for osteoporosis. Correlation analysis revealed that 3D-HU was highly correlated with bone mineral density (BMD) measured by DXA, and this correlation was consistently stronger than that of traditional HU. Receiver operating characteristic curve (ROC) analysis showed that 3D-HU has high accuracy, excellent sensitivity, and specificity in the diagnosis of osteoporosis.</p><p><strong>Conclusions: </strong>This is the first study to directly correlate the novel 3D-HU with the diagnosis of osteoporosis. We identified this novel index as a significant predictor of osteoporosis, and established a strong correlation between 3D-HU and the BMD of the lumbar spine.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247243","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 effect of symptom duration on the outcomes of lumbar discectomy for radicular pain secondary to lumbar disc herniation: a systematic review and meta-analysis.","authors":"Wen Xian Low, Arjan Sehmbi, Farzad Shabani, Nitin Shetty, Saeed Mohammad, Hasan Raza Mohammad","doi":"10.1007/s00586-025-08912-y","DOIUrl":"https://doi.org/10.1007/s00586-025-08912-y","url":null,"abstract":"<p><strong>Background: </strong>Low back pain, often resulting from degenerative disc disease, affects up to 80% of the population at some point in their lives. The impact of preoperative radicular pain duration on discectomy outcomes remains inconclusive. We aim to compare the outcomes of lumbar discectomy for patients with different symptom durations to determine the optimal timing of surgery.</p><p><strong>Methods: </strong>Medline, Embase, and Central databases were searched for studies comparing the outcomes of discectomy in patients with different durations of radicular pain secondary to lumbar disc herniation. Cutoffs at three months (very early), six months (early), and after 12 months (delayed) were selected based on pilot searches for symptom durations comparisons. Mean differences (MD) and standardised mean differerences (SMD) were calculated using the inverse-variance method, and risk ratios (RR) were calculated using the Mantel-Haenszel method.</p><p><strong>Results: </strong>29 studies with a total of 23,550 patients were included in this study. No statistically significant differences were found in the postoperative improvement in back pain, Oswestry Disability Index (ODI) or one-year reoperation rate for all of the cutoffs used (three months, six months, and 12 months). Sensitivity analyses found significant improvement in leg pain for symptom durations of < 12 months compared to > 12 months (SMD = 0.26, 95%CI: 0.11; 0.41, p = 0.02), which equates to a score of 1 point on the Visual Analogue Scale (VAS). Existing studies suffer from high risk of bias, inconsistent outcome measures, and varied timepoint assessment postoperatively.</p><p><strong>Conclusions: </strong>There is low quality evidence suggesting that discectomy within 12 months of symptom onset can improve postoperative leg pain. There was no significant effect of symptom duration on postoperative back pain, disability, quality of life and reoperation risk. As a precaution, we recommend surgeons to operate within 12 months of symptom onset after a trial of nonoperative management has failed. We recommend the collection of discectomy outcomes in national registry programmes for detailed assessment of factors affecting postoperative outcomes.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247245","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 the role of Serpins as a potential molecular target in intervertebral disc degeneration.","authors":"Sri Vijay Anand K S, Sharon Miracle Nayagam, Karthik Ramachandran, Narmatha Devi, Chitraa Tangavel, Shanmuganathan Rajasekaran","doi":"10.1007/s00586-025-09035-0","DOIUrl":"https://doi.org/10.1007/s00586-025-09035-0","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247238","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":"Ultrasound and MRI-based evaluation of relationships between morphological and mechanical properties of the lower lumbar multifidus muscle in chronic low back pain.","authors":"Neda Naghdi, Sara Masi, Cleo Bertrand, Brent Rosenstein, Julien Cohen-Adad, Hassan Rivaz, Mathieu Roy, Maryse Fortin","doi":"10.1007/s00586-025-09012-7","DOIUrl":"https://doi.org/10.1007/s00586-025-09012-7","url":null,"abstract":"<p><strong>Purposes: </strong>While lumbar multifidus (MF) muscle alterations are linked to low back pain (LBP), the structure-function relationship is not fully understood. This study aims to evaluate the relationship between fatty degeneration of the lumbar MF muscle and its function in individuals with and without LBP.</p><p><strong>Methods: </strong>The study included 25 participants with chronic nonspecific LBP and 25 age- and sex-matched healthy controls. Participants underwent MRI assessment for MF fat infiltration, utilizing IDEAL fat-water images. Ultrasound measures evaluated MF function, including shear-wave elastography (SWE) for stiffness/elasticity and thickness ratio from rest to submaximal contraction. All measurements were acquired at L4/L5 and L5/S1 spinal levels, bilaterally. Bivariate and multivariable linear regression models were used to assess the relationship between morphology and function, while age, sex, body max index (BMI), physical activity levels, and LBP status were considered as covariates.</p><p><strong>Results: </strong>Fifty participants (26 females) were included (mean age: 39.22 ± 11.67). Greater % MF fat at L4/L5 was significantly associated with greater MF SWE ratio (p = 0.002). No significant bivariate or multivariable relationships were found between MF fat infiltration and MF thickness ratio. Participants with LBP exhibited lower contraction ratios (p = 0.017) and higher SWE during contraction (p = 0.03) at L4/L5 compared to controls.</p><p><strong>Conclusion: </strong>This study highlights a positive association between MF fat infiltration and SWE-based stiffness measures at L4/L5, suggesting altered muscle composition may impacts MF function. However, no relationship was found between MF fat infiltration and contraction. Participants with LBP demonstrated distinct deficits in muscle activation, supporting the need for targeted rehabilitation strategies addressing these functional impairments.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247247","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-enhanced 3D ultrasound: a non-ionizing alternative for pediatric scoliosis assessment.","authors":"Tamas Ungi, Catherine O Wu, Sarah J D Dance, Charles Lawall, Charles Nagel, Gregg Khodorov, Robert W Ford, Kevin Cleary, Gabor Fichtinger, Matthew E Oetgen, Daniel P Borschneck","doi":"10.1007/s00586-025-08969-9","DOIUrl":"https://doi.org/10.1007/s00586-025-08969-9","url":null,"abstract":"<p><strong>Purpose: </strong>Scoliosis affects up to 5% of the population, and early detection is crucial to prevent progression and surgical intervention. X-ray imaging remains the standard for scoliosis assessment, but repeated exposure to ionizing radiation increases cancer risks, particularly in pediatric patients. This study evaluates bone-enhanced 3D ultrasound (BEUS) as a non-ionizing alternative for scoliosis measurement.</p><p><strong>Methods: </strong>We conducted a comparative analysis of X-ray and BEUS measurements in 34 pediatric patients. Each participant underwent same-day spinal imaging with both modalities. Scoliosis angles were measured independently by two observers using anatomical landmarks visible in both imaging modalities. Statistical tests assessed agreement between X-ray and BEUS, inter-observer variability, and potential biases.</p><p><strong>Results: </strong>Minimal inter-observer variability was found (intraclass correlation coefficient = 0.98). 93% of BEUS measurements fell within a clinically acceptable ± 5° range of X-ray values. Regression analysis identified age and scoliosis severity as significant predictors of measurement differences (p < 0.05). In particular, error increased with scoliosis severity, with curvatures above 40° showing significant deviation.</p><p><strong>Conclusion: </strong>BEUS is a promising alternative for scoliosis assessment, demonstrating strong reliability for mild to moderate cases while eliminating radiation exposure. BEUS holds potential for routine scoliosis monitoring, reducing reliance on X-rays and minimizing radiation risk in pediatric patients.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247234","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":"Unilateral biportal endoscopic in spine surgery: a global bibliometric analysis of research trends and influences.","authors":"Xingyuan Wu, Huilong Pan, Hangchi Wang, Jun Wang, Yile Lin, Elmar Musaev, Ruiyuan Huang, Shu Li, Jin Zhang, Haixiao Wu, Chao Zhang","doi":"10.1007/s00586-025-09002-9","DOIUrl":"https://doi.org/10.1007/s00586-025-09002-9","url":null,"abstract":"<p><strong>Purpose: </strong>Unilateral biportal endoscopic (UBE) technique is increasingly utilized in spine surgery, offering minimally invasive solutions with promising outcomes. This study conducts a comprehensive bibliometric analysis of global research trends and key influences in UBE application.</p><p><strong>Methods: </strong>A systematic search in the Web of Science Core Collection was performed on June 9, 2024, focusing on English publications related to UBE and spine surgery. Bibliographic data were analyzed using R and VOSviewer to visualize trends, collaborations, and citation networks.</p><p><strong>Results: </strong>A total of 231 articles from 59 sources were identified, with World Neurosurgery being the most prolific journal. Publications peaked in 2023, with South Korea and China leading the field through significant collaborations. HEO DH emerged as the most productive and cited author. Key research focuses included \"decompression,\" \"surgery,\" and \"discectomy.\"</p><p><strong>Conclusion: </strong>The analysis highlights increasing research interest in UBE, with key contributors and collaborations shaping advancements. It provides insights into research trends, main areas of focus, and emerging topics, guiding future UBE research and applications.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247248","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}