European Spine Journal最新文献

{"title":"Artificial intelligence in predicting postoperative heterotopic ossification following anterior cervical disc replacement.","authors":"Rui Zong, Can Guo, Jun-Bo He, Ting-Kui Wu, Hao Liu","doi":"10.1007/s00586-024-08396-2","DOIUrl":"10.1007/s00586-024-08396-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop and validate a machine learning (ML) model to predict high-grade heterotopic ossification (HO) following Anterior cervical disc replacement (ACDR).</p><p><strong>Methods: </strong>Retrospective review of prospectively collected data of patients undergoing ACDR or hybrid surgery (HS) at a quaternary referral medical center was performed. Patients diagnosed as C3-7 single- or multi-level cervical disc degeneration disease with > 2 years of follow-up and complete pre- and postoperative radiological imaging were included. An ML-based algorithm was developed to predict high grade HO based on perioperative demographic, clinical, and radiographic parameters. Furthermore, model performance was evaluated according to discrimination and overall performance.</p><p><strong>Results: </strong>In total, 339 ACDR segments were included (61.65% female, mean age 45.65 ± 8.03 years). Over 45.65 ± 8.03 months of follow-up, 48 (14.16%) segments developed high grade HO. The model demonstrated good discrimination and overall performance according to precision (High grade HO: 0.71 ± 0.01, none-low grade HO: 0.85 ± 0.02), recall (High grade HO: 0.68 ± 0.03, none-low grade HO: 0.87 ± 0.01), F1-score (High grade HO: 0.69 ± 0.02, none-low grade HO: 0.86 ± 0.01), and AUC (0.78 ± 0.08), with lower prosthesis‑endplate depth ratio, higher height change, male, and lower postoperative-shell ROM identified as the most important predictive features.</p><p><strong>Conclusion: </strong>Through an ML approach, the model identified risk factors and predicted development of high grade HO following ACDR with good discrimination and overall performance. By addressing the shortcomings of traditional statistics and adopting a new logical approach, ML techniques can support discovery, clinical decision-making, and intraoperative techniques better.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4082-4091"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787679","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 deep neural network for MRI spinal inflammation in axial spondyloarthritis.","authors":"Yingying Lin, Shirley Chiu Wai Chan, Ho Yin Chung, Kam Ho Lee, Peng Cao","doi":"10.1007/s00586-023-08099-0","DOIUrl":"10.1007/s00586-023-08099-0","url":null,"abstract":"<p><strong>Objective: </strong>To develop a deep neural network for the detection of inflammatory spine in short tau inversion recovery (STIR) sequence of magnetic resonance imaging (MRI) on patients with axial spondyloarthritis (axSpA).</p><p><strong>Methods: </strong>A total 330 patients with axSpA were recruited. STIR MRI of the whole spine and clinical data were obtained. Regions of interests (ROIs) were drawn outlining the active inflammatory lesion consisting of bone marrow edema (BME). Spinal inflammation was defined by the presence of an active inflammatory lesion on the STIR sequence. The 'fake-color' images were constructed. Images from 270 and 60 patients were randomly separated into the training/validation and testing sets, respectively. Deep neural network was developed using attention UNet. The neural network performance was compared to the image interpretation by a radiologist blinded to the ground truth.</p><p><strong>Results: </strong>Active inflammatory lesions were identified in 2891 MR images and were absent in 14,590 MR images. The sensitivity and specificity of the derived deep neural network were 0.80 ± 0.03 and 0.88 ± 0.02, respectively. The Dice coefficient of the true positive lesions was 0.55 ± 0.02. The area under the curve of the receiver operating characteristic (AUC-ROC) curve of the deep neural network was 0.87 ± 0.02. The performance of the developed deep neural network was comparable to the interpretation of a radiologist with similar sensitivity and specificity.</p><p><strong>Conclusion: </strong>The developed deep neural network showed similar sensitivity and specificity to a radiologist with four years of experience. The results indicated that the network can provide a reliable and straightforward way of interpreting spinal MRI. The use of this deep neural network has the potential to expand the use of spinal MRI in managing axSpA.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4125-4134"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377439","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":"Fusion versus decompression alone for lumbar degenerative spondylolisthesis and spinal stenosis: a target trial emulation with index trial benchmarking.","authors":"Ines Unterfrauner, Javier Muñoz Laguna, Miquel Serra-Burriel, Jakob M Burgstaller, Ilker Uçkay, Mazda Farshad, Cesar A Hincapié","doi":"10.1007/s00586-024-08495-0","DOIUrl":"10.1007/s00586-024-08495-0","url":null,"abstract":"<p><strong>Purpose: </strong>The value of adding fusion to decompression surgery for lumbar degenerative spondylolisthesis and spinal canal stenosis remains debated. Therefore, the comparative effectiveness and selected healthcare resource utilization of patients undergoing decompression with or without fusion surgery at 3 years follow-up was assessed.</p><p><strong>Methods: </strong>Using observational data from the Lumbar Stenosis Outcome Study and a target trial emulation with index trial benchmarking approach, our study assessed the comparative effectiveness of the two main surgical interventions for lumbar degenerative spondylolisthesis-fusion and decompression alone in patients with lumbar degenerative spondylolisthesis and spinal canal stenosis. The primary outcome-measure was change in health-related quality of life (EuroQol Health Related Quality of Life 5-Dimension 3-Level questionnaire [EQ-5D-3L]); secondary outcome measures were change in back/leg pain intensity (Numeric Rating Scale), change in satisfaction (Spinal Stenosis Measure satisfaction subscale), physical therapy and oral analgesic use (healthcare utilization).</p><p><strong>Results: </strong>153 patients underwent decompression alone and 62 had decompression plus fusion. After inverse probability weighting, 137 patients were included in the decompression alone group (mean age, 73.9 [7.5] years; 77 female [56%]) and 36 in the decompression plus fusion group (mean age, 70.1 [6.7] years; 18 female [50%]). Our findings were compatible with no standardized mean differences in EQ-5D-3L summary index change score at 3 years (EQ-5D-3L German: 0.07 [95% confidence interval (CI), - 0.25 to 0.39]; EQ-5D-3L French: 0.18 [95% CI, - 0.14 to 0.50]). No between-group differences in change in back/leg pain intensity or satisfaction were found. Decompression plus fusion was associated with greater physical therapy utilization at 3 years follow-up.</p><p><strong>Conclusion: </strong>Decompression alone should be considered the primary option for patients with lumbar degenerative spondylolisthesis and spinal stenosis.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4281-4291"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282787","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 deep learning approach for cervical cord injury severity determination through axial and sagittal magnetic resonance imaging segmentation and classification.","authors":"I Gusti Lanang Ngurah Agung Artha Wiguna, Yosi Kristian, Maria Florencia Deslivia, Rudi Limantara, David Cahyadi, Ivan Alexander Liando, Hendra Aryudi Hamzah, Kevin Kusuman, Dominicus Dimitri, Maria Anastasia, I Ketut Suyasa","doi":"10.1007/s00586-024-08464-7","DOIUrl":"10.1007/s00586-024-08464-7","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional Database Study.</p><p><strong>Objective: </strong>While the American Spinal Injury Association (ASIA) Impairment Scale is the standard for assessing spinal cord injuries (SCI), it has limitations due to subjectivity and impracticality. Advances in machine learning (ML) and image recognition have spurred research into their use for outcome prediction. This study aims to analyze deep learning techniques for identifying and classifying cervical SCI severity from MRI scans.</p><p><strong>Methods: </strong>The study included patients with traumatic and nontraumatic cervical SCI admitted from 2019 to 2022. MRI images were labeled by two senior resident physicians. A deep convolutional neural network was trained using axial and sagittal cervical MRI images from the dataset. Model performance was assessed using Dice Score and IoU to measure segmentation accuracy by comparing predicted and ground truth masks. Classification accuracy was evaluated with the F1 Score, balancing false positives and negatives.</p><p><strong>Result: </strong>In the axial spinal cord segmentation, we achieved a Dice score of 0.94 for and IoU score of 0.89. In the sagittal spinal cord segmentation, we obtained Dice score up to 0.9201 and IoU scores up to 0.8541. The model for axial image score classification gave a satisfactory result with an F1 score of 0.72 and AUC of 0.79.</p><p><strong>Conclusion: </strong>Our models successfully identified cervical SCI on T2-weighted MR images with satisfactory performance. Further research is needed to develop more advanced models for predicting patient outcomes in SCI cases.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4204-4213"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092589","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 mechanical properties measurement could be affected by forceps: a technical note on sampling human annulus fibrosus.","authors":"Tianchi Zhou, Bowei Xiao, Juying Huang, Tianhua Rong, Bingxuan Wu, Baoge Liu","doi":"10.1007/s00586-024-08438-9","DOIUrl":"10.1007/s00586-024-08438-9","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the mechanical properties of human annulus fibrosus obtained by forceps versus bistoury and observe whether the measurement could be affected by forceps sampling method.</p><p><strong>Methods: </strong>In this study, the mechanical properties of the the extracellular matrix (ECM) of human annulus fibrosus, including elastic modulus and stiffness, were investigated using atomic force microscope (AFM). Tissue was obtained from patients during operation using a bistoury or nucleus pulposus forceps. Tissues obtained with the nucleus pulposus forceps were considered as the forceps group and those obtained with a bistoury were considered as the bistoury group.</p><p><strong>Results: </strong>There was no significant difference observed between the forceps and bistoury group according to histological staining. The elastic modulus of the forceps group was 0.41 ± 0.08 MPa, and that of bistoury group was 0.53 ± 0.13 MPa, and the difference between the two groups was statistically significant (p < 0.05). The stiffness of the forceps group was 0.024 ± 0.003 N/m, and that of the bistoury group was 0.037 ± 0.003 N/m, and the difference between the two groups was statistically significant (p < 0.05).</p><p><strong>Conclusion: </strong>The results indicate that the forceps sampling method has a substantial negative effect on the micromechanical properties of the ECM of the annulus fibrosus. Bistoury sampling method is recommended as the experimental subject for exploring the micromechanics mechanisms of cervical degenerative disease.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4038-4048"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139707","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 Association between prior arthroplasty and Paraspinal Muscle Degeneration in patients undergoing elective lumbar surgery.","authors":"Jan Hambrecht, Paul Köhli, Erika Chiapparelli, Jiaqi Zhu, Ali E Guven, Gisberto Evangelisti, Marco D Burkhard, Koki Tsuchiya, Roland Duculan, Jennifer Shue, Andrew A Sama, Frank P Cammisa, Federico P Girardi, Carol A Mancuso, Alexander P Hughes","doi":"10.1007/s00586-024-08432-1","DOIUrl":"10.1007/s00586-024-08432-1","url":null,"abstract":"<p><strong>Purpose: </strong>Spinal and lower extremity degeneration often causes pain and disability. Lower extremity osteoarthritis, eventually leading to total knee- (TKA) and -hip arthroplasty (THA), can alter posture through compensatory mechanisms, potentially causing spinal misalignment and paraspinal muscle (PM) atrophy. This study aims to evaluate the association between prior THA or TKA and PM-degeneration in patients undergoing elective lumbar surgery for degenerative conditions.</p><p><strong>Methods: </strong>A retrospective analysis of patients undergoing lumbar surgery for degenerative conditions was conducted. Patients were categorized based on prior THA, TKA, or both. Quantitative analysis of functional cross-sectional area (fCSA) and fat infiltration (FI) of psoas, multifidus (MF), and erector spinae (ES) muscles at L4-level was performed using T2-weighted MRI images. The association between the FI and fCSA of the PM and prior arthroplasty was investigated. Differences were assessed using ANOVA and multivariable linear regression.</p><p><strong>Results: </strong>Overall, 584 patients (60% female, 64 ± 12 years) were included. 66 patients (11%) had prior TKA, 36 patients (6%) THA, and 15 patients (3%) both TKA and THA. Patients with arthroplasty were mostly female (57%) and notably older (p < 0.001). The FI of the MF and the ES was significantly higher in the arthroplasty-group (both p < 0.001). Patients with prior TKA showed significantly higher FI (Est = 4.3%, p = 0.013) and lower fCSA (Est=-0.9 cm², p = 0.012) in the MF compared to the non-arthroplasty-group.</p><p><strong>Conclusion: </strong>This study demonstrates a significant lower fCSA and higher FI in the MF among individuals with prior TKA. This highlights the complex knee-spine relationship and how these structures interact with each other.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4029-4037"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016881","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 Regarding 'Causal relationship between basal metabolic rate and intervertebral disc degeneration: a Mendelian randomization study' by Liu Z, et al. (Eur Spine J. 2024 Jun 24. Doi: 10.1007/s00586-024-08367-7).","authors":"Ji Tu, Wentian Li","doi":"10.1007/s00586-024-08399-z","DOIUrl":"10.1007/s00586-024-08399-z","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4410-4411"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344425","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":"Responsiveness of the Oswestry Disability Index and Zurich Claudication Questionnaire in patients with lumbar spinal stenosis: evaluation of surgically treated patients from the NORDSTEN study.","authors":"Kari Indrekvam, Tor Åge Myklebust, Ivar Magne Austevoll, Erland Hermansen, Hasan Banitalebi, Ingrid Fjeldheim Bånerud, Clemens Weber, Helena Brisby, Jens Ivar Brox, Christian Hellum, Kjersti Storheim","doi":"10.1007/s00586-024-08440-1","DOIUrl":"10.1007/s00586-024-08440-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the responsiveness of the original low back pain specific Oswestry Disability Index (ODI) and the spinal stenosis specific Zürich Claudication Questionnaire (ZCQ), and to investigate cut-off values for clinical \"success\" for ODI and ZCQ in surgically treated patients with lumbar spinal stenosis (LSS).</p><p><strong>Methods: </strong>We included 601 LSS patients (218 with, 383 without degenerative spondylolisthesis) from the NORDSTEN trials. Outcome measures included ODI and ZCQ (symptom severity and physical function scales) with three alternative response parameters: scores at follow-up, absolute and relative changes from baseline to two-year follow-up. Effect size and standardised response mean evaluated internal responsiveness. External responsiveness was assessed by the Spearman rank correlation between patient-reported global perceived effect scale (GPE) and ODI and ZCQ, and receiver operating characteristics (ROC). We evaluated which cut-off values could maximise the percentage of correctly classified patients according to the GPE-anchor \"completely recovered\" / \"much improved\" for each parameter.</p><p><strong>Results: </strong>Internal and external responsiveness were high for all three indices with effect sizes, standardized response means, ROC and corresponding area under the curve > 0.8. Correlations with GPE responses were moderate (> 0.50) for absolute change and strong (> 0.67) for relative change and follow-up scores. The 30% ODI relative change cut-off correctly classified 81% of patients to \"success\", within a range of accurate cut-offs according to the GPE-anchor.</p><p><strong>Conclusion: </strong>ODI and ZCQ demonstrate comparable responsiveness in evaluating outcomes for surgically treated LSS patients. The 30% ODI threshold was consistent with treatment \"success\" in NORDSTEN trials.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov; NCT02007083 10/12/2013, NCT02051374 31/01/2014 and NCT03562936 20/06/2018.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4270-4280"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970978","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":"Estimating lumbar bone mineral density from conventional MRI and radiographs with deep learning in spine patients.","authors":"Fabio Galbusera, Andrea Cina, Dave O'Riordan, Jacopo A Vitale, Markus Loibl, Tamás F Fekete, Frank Kleinstück, Daniel Haschtmann, Anne F Mannion","doi":"10.1007/s00586-024-08463-8","DOIUrl":"10.1007/s00586-024-08463-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop machine learning methods to estimate bone mineral density and detect osteopenia/osteoporosis from conventional lumbar MRI (T1-weighted and T2-weighted images) and planar radiography in combination with clinical data and imaging parameters of the acquisition protocol.</p><p><strong>Methods: </strong>A database of 429 patients subjected to lumbar MRI, radiographs and dual-energy x-ray absorptiometry within 6 months was created from an institutional database. Several machine learning models were trained and tested (373 patients for training, 86 for testing) with the following objectives: (1) direct estimation of the vertebral bone mineral density; (2) classification of T-score lower than - 1 or (3) lower than - 2.5. The models took as inputs either the images or radiomics features derived from them, alone or in combination with metadata (age, sex, body size, vertebral level, parameters of the imaging protocol).</p><p><strong>Results: </strong>The best-performing models achieved mean absolute errors of 0.15-0.16 g/cm² for the direct estimation of bone mineral density, and areas under the receiver operating characteristic curve of 0.82 (MRIs) - 0.80 (radiographs) for the classification of T-scores lower than - 1, and 0.80 (MRIs) - 0.65 (radiographs) for T-scores lower than - 2.5.</p><p><strong>Conclusions: </strong>The models showed good discriminative performances in detecting cases of low bone mineral density, and more limited capabilities for the direct estimation of its value. Being based on routine imaging and readily available data, such models are promising tools to retrospectively analyse existing datasets as well as for the opportunistic investigation of bone disorders.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4092-4103"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105974","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 preemptive retrolaminar block on lumbar spinal decompression surgery.","authors":"Kevser Peker, Gülçin Aydın, Işin Gençay, Ayşe Gizem Saraçoğlu, Ahmet Tuğrul Şahin, Mustafa Öğden, Seydi Ali Peker","doi":"10.1007/s00586-024-08219-4","DOIUrl":"10.1007/s00586-024-08219-4","url":null,"abstract":"<p><strong>Purpose: </strong>Spinal decompression surgery causes severe pain. Retrolaminar block (RLB) is block, which is done by infiltration of local anesthetic to block spinal nerves between the lamina and superior costotransversospinalis muscle. The primary aim of this study is to evaluate the effectiveness of RLB on postoperative analgesia in patients undergoing spinal surgery. Secondary aims are effects on additional anesthetic and analgesic consumption.</p><p><strong>Methods: </strong>The sixty (60) patients who underwent lumbar spinal surgery between May 2020 and May 2021 under general anesthesia with or without applied preemptive RLB for postoperative analgesia were included in this prospective observational study. Group I received ultrasound-guided preemptive RLB. In Group II, no intervention was performed. Postoperative VAS scores were compared in groups as primary outcome, perioperative additional anesthetic and analgesic needs were compared as secondary outcome.</p><p><strong>Results: </strong>There was a significant difference between the groups in favor of the RLB group in terms of postoperative VAS scores at rest [1.33 (0.33-3.509)] and movement [2.40 (1.20-4.00)] (p < 0.001). Perioperative sevoflurane consumption was significantly low in block group (p < 0.001). Postoperative tramadol consumption was lower in Group I compared with Group II [Group 1: 200 (100-300); Group 2: 37.5 (0-200); p < 0.001].</p><p><strong>Conclusion: </strong>Preemptive RLB may be used to reduce patients' pain in lumbar decompression surgery as well as to be part of a multimodal analgesia and anesthesia regimen to reduce anesthetic and analgesic drug consumption. Trial registration numberClinicalTrials.gov (No. NCT04209907).</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4253-4261"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418560","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}