European Spine Journal最新文献

{"title":"A novel classification of congenital cervicothoracic scoliosis: identification of coronal subtypes and their prognostic significance.","authors":"Kai Sun, Xu Sun, Zezhang Zhu, Yong Qiu, Song Li, Jie Zhou, Yitong Zhu, Yanyu Ma, Saihu Mao","doi":"10.1007/s00586-024-08527-9","DOIUrl":"https://doi.org/10.1007/s00586-024-08527-9","url":null,"abstract":"<p><strong>Objective: </strong>To propose a novel classification system for stratifying coronal curve patterns in congenital cervicothoracic scoliosis with hemivertebrae (CTS-HV).</p><p><strong>Methods: </strong>Type A: regional cervicothoracic deformity only disturbing the balance of head-neck-shoulder complex; Type B: cervicothoracic deformity with significant trunk tilt to the convex side; Type C: cervicothoracic deformity with a significant compensatory thoracic curve. The reliability and reproducibility were assessed via the Kappa test. The differences among different subtypes in deformity parameters and bony structures were compared to identify the causative factors predisposing to different subtypes.</p><p><strong>Results: </strong>98 patients were classified into Type A (47 cases), Type B (31 cases), and Type C (20 cases). The Kappa test showed excellent reliability (Kappa value = 0.847) and reproducibility (Kappa value = 0.881). The proportions of Klippel-Feil syndrome in Types B (71.0%) and C (85.0%) were significantly higher than in Type A (46.8%; all P < 0.05). Type A (66.0%) and Type B (71.0%) predominantly had their hemivertebra (HV) at T3 or T4, while Type C (75%) mostly had HV at T1 or T2. Type B exhibited the most severe trunk tilt, head shift, neck tilt, head tilt, and coronal balance distance (all P < 0.05). Type C had the lowest T1 tilt and first rib angle despite the greatest cervicothoracic Cobb angle (all P < 0.05).</p><p><strong>Conclusions: </strong>This novel reliable classification allows a better understanding of structural diversity and different coronal compensatory mechanisms for the natural progression of CTS-HV. It can contribute to determining the individualized treatment strategy and standardizing academic communication for this rare clinical entity.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497798","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 randomized trial on three different minimally invasive decompression techniques for lumbar spinal stenosis. Five years follow-up from the NORDSTEN-SST.","authors":"Erland Hermansen, Kari Indrekvam, Eric Franssen, Tor Åge Myklebust, Ivar Magne Austevoll, Christian Hellum, Kjersti Storheim, Ingrid Fjeldheim Bånerud, Eira Kathleen Ebbs, Jørn Aaen, Hasan Banitalebi, Jens Ivar Brox, Clemens Weber, Tore Solberg, Arild Hjulstad, Helena Brisby","doi":"10.1007/s00586-024-08514-0","DOIUrl":"https://doi.org/10.1007/s00586-024-08514-0","url":null,"abstract":"<p><strong>Purpose: </strong>The short-term clinical outcome for midline-preserving posterior decompression techniques was comparable. The aim of this study was to evaluate long-term clinical results after three different midline-preserving posterior decompression techniques.</p><p><strong>Material: </strong>In the NORDSTEN spinal stenosis trial (NORDSTEN-SST) 437 patients were randomized to three different midline-retaining posterior decompression techniques: Unilateral laminotomy with crossover (UL), bilateral laminotomy (BL) and spinous process osteotomy (SPO). Primary outcome was the mean change in Oswestry disability index (ODI) score at five-years follow-up. Secondary outcomes were the proportion of patients classified as success, mean change in EQ-5D, ZCQ-score, NRS-score for leg and low back pain, a seven-point Global Perceived Effect (GPE) Scale and proportion of subsequential spinal surgery.</p><p><strong>Results: </strong>The number of patients that completed follow-up data after five years was 358 (82%): In the UL, BL and SPO group the numbers were 122, 119 and 117, respectively. Mean age at baseline was 66.7 (SD 8.2) years, mean BMI was 27.8 (SD 4.1), and 172/358 (48%) were female. In the UL group the mean change was  -18.2 (95% CI  -21.0  -5.4), in the BL group it was  -19.0 (95% CI -21.9-16.1) and in the SPO it was  -18.6 (95% CI  -21.6-15.7) (p = 0.917). No significant differences in the secondary outcomes between the three surgical groups were found, also the subsequent spinal surgery rates were similar.</p><p><strong>Conclusion: </strong>There were no significant differences in patient reported outcomes and subsequent spinal surgery rates after the three different decompression techniques at five-year follow-up.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497799","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":"Association between acute pain trajectory and patient-reported outcomes at 6-months following lumbar surgery for patients with lumbar degenerative disease.","authors":"Keita Sato, Masumi Iwabuchi, Tatsuya Endo, Takuya Miura, Toshikazu Ito, Osamu Shirado","doi":"10.1007/s00586-024-08534-w","DOIUrl":"https://doi.org/10.1007/s00586-024-08534-w","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between acute pain trajectory over one week and patient-reported outcomes (PRO) at 6-months following lumbar surgery in patients with lumbar degenerative disease (LDD).</p><p><strong>Methods: </strong>Two hundred and fifty-five subjects with LDD who received surgical treatment at our hospital between April 2019 and March 2022. Acute pain trajectory was measured using a pain trajectory calculator to determine an approximate line using the linear least squares method based on pain intensity on postoperative days 1, 3, 5, and 7. The pain trajectory-slope, which represents the change in postoperative pain intensity of the calculated approximation line, was evaluated as the main exposure for the present study. The PRO was assessed using the Oswestry Disability Index (ODI) measured at 6 ± 1 months postoperatively. Poor PRO scores in this study were defined using a threshold of an ODI of 22% or greater, which represents the patient acceptable symptomatic state after lumbar spine surgery. Multivariable logistic regression analysis including covariates was performed to investigate the association between pain trajectory-slope and PRO at 6-months following lumbar surgery.</p><p><strong>Results: </strong>In this study, 101 (39.6%) had poor PRO scores. Multivariable logistic regression analysis adjusted for covariates showed that pain trajectory-slope was associated with the poor PRO scores (odd ratios; 1.203, 95% confidence intervals; 1.130-1.288).</p><p><strong>Conclusions: </strong>The results of this study show that acute pain trajectory is significantly associated with poor PRO scores 6-months after lumbar surgery. Patients with slower pain relief or worsening pain were associated with poor PRO scores.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497800","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":"Defining modern iatrogenic flatback syndrome: examination of segmental lordosis in short lumbar fusion patients undergoing thoracolumbar deformity correction.","authors":"Bassel G Diebo, Manjot Singh, Mariah Balmaceno-Criss, Mohammad Daher, Lawrence G Lenke, Christopher P Ames, Douglas C Burton, Stephen M Lewis, Eric O Klineberg, Renaud Lafage, Robert K Eastlack, Munish C Gupta, Gregory M Mundis, Jeffrey L Gum, Kojo D Hamilton, Richard Hostin, Peter G Passias, Themistocles S Protopsaltis, Khaled M Kebaish, Han Jo Kim, Christopher I Shaffrey, Breton G Line, Praveen V Mummaneni, Pierce D Nunley, Justin S Smith, Jay Turner, Frank J Schwab, Juan S Uribe, Shay Bess, Virginie Lafage, Alan H Daniels","doi":"10.1007/s00586-024-08531-z","DOIUrl":"https://doi.org/10.1007/s00586-024-08531-z","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding the mechanism and extent of preoperative deformity in revision procedures may provide data to prevent future failures in lumbar spinal fusion patients.</p><p><strong>Methods: </strong>ASD patients without prior spine surgery (PRIMARY) and with prior short (SHORT) and long (LONG) fusions were included. SHORT patients were stratified into modes of failure: implant, junctional, malalignment, and neurologic. Baseline demographics, spinopelvic alignment, offset from alignment targets, and patient-reported outcome measures (PROMs) were compared across PRIMARY and SHORT cohorts. Segmental lordosis analyses, assessing under-, match, or over-correction to segmental and global lordosis targets, were performed by SRS-Schwab coronal curve type and construct length.</p><p><strong>Results: </strong>Among 785 patients, 430 (55%) were PRIMARY and 355 (45%) were revisions. Revision procedures included 181 (23%) LONG and 174 (22%) SHORT corrections. SHORT modes of failure included 27% implant, 40% junctional, 73% malalignment, and/or 28% neurologic. SHORT patients were older, frailer, and had worse baseline deformity (PT, PI-LL, SVA) and PROMs (NRS, ODI, VR-12, SRS-22) compared to primary patients (p < 0.001). Segmental lordosis analysis identified 93%, 88%, and 62% undercorrected patients at LL, L1-L4, and L4-S1, respectively. SHORT patients more often underwent 3-column osteotomies (30% vs. 12%, p < 0.001) and had higher ISSG Surgical Invasiveness Score (87.8 vs. 78.3, p = 0.006).</p><p><strong>Conclusions: </strong>Nearly half of adult spinal deformity surgeries were revision fusions. Revision short fusions were associated with sagittal malalignment, often due to undercorrection of segmental lordosis goals, and frequently required more invasive procedures. Further initiatives to optimize alignment in lumbar fusions are needed to avoid costly and invasive deformity corrections.</p><p><strong>Level of evidence: </strong>IV: Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497801","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":"Characteristics and outcomes of inpatients aged 85 and older with thoracolumbar vertebral fractures: impact on hospital stay and mortality.","authors":"Erik Gräschke, Jan-Sven Jarvers, Christoph-Eckhard Heyde, Ulrich Albert Joseph Spiegl","doi":"10.1007/s00586-024-08520-2","DOIUrl":"https://doi.org/10.1007/s00586-024-08520-2","url":null,"abstract":"<p><strong>Background: </strong>There is a gap in evidence about medical outcomes in oldest-old patients (aged 85 and older) with vertebral fractures (VFs). The aim of this study was to evaluate the impact of patient and fracture characteristics on \"short-term\" hospital outcomes.</p><p><strong>Methods: </strong>All patients aged ≥ 85 presenting an acute or subsequent VF at our single level I spine center between 2019 and 2021 requiring hospital treatment were included. The data collection was conducted retrospectively. The primary parameters of interest were length of stay (LOS) and in-hospital mortality. Further outcome parameters were the occurrence of general (non-operative) complications and Intensive Care Unit (ICU) admission. For statistical analysis, linear and binary logistic regression modeling were performed.</p><p><strong>Results: </strong>A total of 153 patients with an average age of 88.5 (range 85 to 99) met the inclusion criteria. Our patients were mostly female (68.6%) and moderately comorbid according to a Charlson Comorbidity Index (CCI) of 2.9. 58.8% had diagnosed osteoporosis. Fracture morphologies represented as \"Osteoporotic Fracture\" (OF) classification types were of central importance for undergoing operative treatment (OP) (p < 0.001), necessity for intensive care (p = 0.023), LOS (p = 0.014), and mortality (p = 0.018). 38.6% had OP. We recorded a complication rate of 59.5%, which highly influenced (p < 0.001) both primary outcome parameters. Overall, patients stayed 14.6 days with a mortality of 11.1%.</p><p><strong>Conclusion: </strong>VFs are a severe event in oldest-old patients with a crucial risk of poor medical outcomes during hospitalization. The fracture morphologies are of central importance. However, little is known about the hospital stay of oldest-old inpatients with VFs. Considering an aging population, further investigations would be recommended.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461614","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":"Tractography analysis results of the trigeminus nerve, which contains fibers responsible for proprioception sensation and motor control in Adolescent Idiopathic Scoliosis.","authors":"Ahmet Payas, Fatih Çiçek, Yakup Ekinci, Sabri Batın, Şule Göktürk, Yasin Göktürk, Caner Karartı, İlyas Uçar","doi":"10.1007/s00586-024-08524-y","DOIUrl":"https://doi.org/10.1007/s00586-024-08524-y","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional Study.</p><p><strong>Background: </strong>It is not yet clear whether the loss of proprioceptive sensation and muscle weakness seen in adolescent idiopathic scoliosis (AIS) is the result of central nervous system dysfunction or secondary to spinal deformity. In our study, in order to find an answer to this question, we examined the microarchitecture of the nervus trigeminus, which is least affected by spinal deformity and contains both proprioceptive sensory and motor fibers.</p><p><strong>Methods: </strong>In this single-center, cross-sectional cohort study, 40 Lenke Type 3 (27 female, 13 male) AIS patients and 40 (25 female, 15 male) healthy individuals between the ages of 10-18 years. Tractography of the nervus trigenimus was performed using the \"DSI Studio\" program. The volumes of the targeted musculus pterygoideus lateralis and musculus pterygoideus medialis were measured using the Insight Segmentation and Registration Tool Kit (ITK -SNAP) program. The data were evaluated using the Statistical Package for the Social Sciences 22.0 program for Windows.</p><p><strong>Results: </strong>There was no significant difference between the two groups in terms of baseline characteristics (p˃0.05). Left nervus trigeminus fiber number and fiber ratio were significantly higher in the control group compared to the scoliosis group p < 0.05. Right and left lateral pterygoid muscle showed lower volume and volume percentage in the scoliosis group compared to the control group (p < 0.05).</p><p><strong>Conclusion: </strong>According to the study data, proprioceptive sensory and motor control dysfunction in AIS is predicted to develop independently of spinal deformity.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461602","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":"Factors prolonging antibiotic duration and impact of early surgery in thoracolumbar pyogenic spondylitis treated with minimally invasive posterior fixation.","authors":"Hisanori Gamada, Toru Funayama, Yosuke Ogata, Takane Nakagawa, Takahiro Sunami, Kotaro Sakashita, Shun Okuwaki, Kaishi Ogawa, Yosuke Shibao, Hiroshi Kumagai, Katsuya Nagashima, Kengo Fujii, Yosuke Takeuchi, Masaki Tatsumura, Itsuo Shiina, Masafumi Uesugi, Masao Koda","doi":"10.1007/s00586-024-08526-w","DOIUrl":"https://doi.org/10.1007/s00586-024-08526-w","url":null,"abstract":"<p><strong>Purpose: </strong>A standard 6-12-week course of antibiotics is recommended for pyogenic spondylitis. Recent evidence supports early minimally invasive posterior fixation surgery; however, its effect on antibiotic treatment duration is unclear. This study aims to identify factors associated with prolonged antibiotic treatment in thoracolumbar pyogenic spondylitis patients resistant to conservative treatment and assess whether early surgery can reduce treatment duration.</p><p><strong>Methods: </strong>We retrospectively reviewed 74 patients with thoracolumbar pyogenic spondylitis undergoing minimally invasive posterior fixation at nine facilities. Patients were grouped based on antibiotic duration (≥ 6 or < 6 weeks) and timing of surgery (≤ 3 weeks or > 3 weeks of starting antibiotics). Univariable and multivariable logistic regression analyses were used to identify factors associated with prolonged antibiotic treatment and study the outcomes of patients undergoing early surgery.</p><p><strong>Results: </strong>Forty-nine patients (66%) required prolonged antibiotic treatment. The presence of an iliopsoas abscess (p = 0.0006) and elevated C-reactive protein (CRP) levels (≥ 10 mg/dL, p = 0.015) were independently associated with prolonged antibiotic treatment. Early surgery significantly reduced total antibiotic duration (5.3 weeks vs. 9.9 weeks, p < 0.0001) without increasing the incidence of postoperative infection recurrences and unplanned additional surgeries. Despite factors associated with prolonged antibiotic treatment, early surgery consistently shortened the treatment duration compared to late surgery.</p><p><strong>Conclusions: </strong>Early surgery (within three weeks) with minimally invasive posterior fixation for thoracolumbar pyogenic spondylitis is associated with reduced antibiotic duration and overall treatment duration regardless of the presence of prolonging factors like iliopsoas abscess and elevated CRP levels.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461616","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":"Cross-cultural adaptation of the Czech version of the core outcome measures index for low back and neck pain.","authors":"Lukas Capek, Václav Bittner, Jan Hradil, Pavel Buchvald","doi":"10.1007/s00586-024-08517-x","DOIUrl":"https://doi.org/10.1007/s00586-024-08517-x","url":null,"abstract":"<p><strong>Purpose: </strong>The Core Outcome Measures Index (COMI) is a short, multidimensional instrument translated into several languages that covers five domains recommended in the assessment of outcome in patients with low-back and neck pain. The purpose of this study was to cross-culturally adapt the COMI from English to Czech language and to test the face and construct validity and reproducibility of its results in patients with low-back and neck pain.</p><p><strong>Methods: </strong>Participants (n = 125) were included from primary and secondary care. The participants reported moderate pain and disability levels. All participants filled in the COMI forms before and after surgery. Descriptive statistics, Wilcoxon paired test, Crombach's alpha, principal component analysis and information entropy calculation were used.</p><p><strong>Results: </strong>The instrument was successfully forward and back-translated. It can be seen that the questionnaire applied as part of our intervention study produces answers with a sufficient degree of variability and with a satisfactory degree of representation of extreme values. It can be also seen that the questionnaire can diagnose an objectively occurring change associated with the surgeon within the intervention procedure. Our other findings support the idea of ​​a possible reduction in the number of questions that measure the same latent variable. Our investigations also showed that it is possible to reduce the range of the point scale of the perception of pain to 5 degrees of intensity and thus unify the range with the other questions.</p><p><strong>Conclusion: </strong>The Czech COMI shows acceptable properties and is thus suitable to use as a short instrument for measuring important domains in patients with low-back and neck pain.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461615","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":"Is ABO blood type a risk factor for adjacent segment degeneration after lumbar spine fusion?","authors":"Samuel S Rudisill, Dustin H Massel, Alexander L Hornung, Cameron Kia, Karan Patel, Khaled Aboushaala, Mbagwu Chukwuemeka, Arnold Y L Wong, J Nicolas Barajas, G Michael Mallow, Sheila J Toro, Harmanjeet Singh, Rahul Gawri, Philip K Louie, Frank M Phillips, Howard S An, Dino Samartzis","doi":"10.1007/s00586-024-08516-y","DOIUrl":"https://doi.org/10.1007/s00586-024-08516-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore associations between ABO blood type and postoperative adjacent segment degeneration/disease (ASD) following lumbar spine fusion, as well as evaluate differences in spinopelvic alignment, perioperative care, postoperative complications, and patient-reported outcome measures (PROMs).</p><p><strong>Methods: </strong>An ambispective study was performed. Patients who underwent posterolateral or posterior lumbar interbody fusion were included. Demographic, perioperative and postoperative, clinical, and blood type information was recorded. Pre- and post-operative radiographic imaging was analyzed for alignment parameters and development of ASD.</p><p><strong>Results: </strong>445 patients were included, representing O+ (36.0%), O- (5.2%), A+ (36.2%), A- (6.3%), B+ (12.1%), B- (1.6%), and AB+ (2.7%) blood types. Most patients were female (59.1%), and had a mean age of 60.3 years and BMI of 31.1 kg/m². Postoperatively, groups did not differ in duration of the hospital (p = 0.732) or intensive care unit (p = 0.830) stay, discharge disposition (p = 0.504), reoperation rate (p = 0.192), or in-hospital complication rate (p = 0.377). Postoperative epidural hematoma was most common amongst A + patients (p = 0.024). Over a mean of 11.0 months of follow-up, all patients exhibited similar improvement in PROMs, with 132 (29.7%) patients developing radiographic evidence of ASD. B + patients were significantly more likely than A + and O + patients to develop spondylolisthesis and ASD (p < 0.05). No significant differences in sagittal alignment parameters and number of levels of fusion were found (p > 0.05).</p><p><strong>Conclusions: </strong>This is the first large-scale study to address and demonstrate proof-of-principle that ABO blood type, a non-modifiable risk factor, is associated with ASD following lumbar spine fusion.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461617","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":"Open vs tubular rate of re-operation for incidental durotomies after lumbar microdiscectomies: a propensity matched analysis.","authors":"Edward McClain, Bhavika Gupta, Lauren Zane, Joel DeFelice, Cody Woodhouse, Jenna Li, Dallas E Kramer, Shahed Elhamdani, Daniel Myers, Chen Xu, Alexander Yu","doi":"10.1007/s00586-024-08503-3","DOIUrl":"https://doi.org/10.1007/s00586-024-08503-3","url":null,"abstract":"<p><strong>Purpose: </strong>Incidental durotomy (ID) is a common complication in spine surgery and can lead to increase in length of stay, decreased satisfaction with surgery and pseudomeningocele formation. Here, we describe a retrospective study comparing ID occurrences and repairs between patients receiving traditional open versus tubular minimally invasive spine (MIS) microdiscectomy.</p><p><strong>Methods: </strong>A retrospective comparative cohort-matched analysis was performed to study ID and its complications in MIS versus open lumbar microdiscectomies. The study included 192 patients in the tubular MIS cohort and 2902 patients in the open microdiscectomy cohort. Propensity scores were estimated by age and Elixhauser comorbidity score. After cohort matching, 156 patients were included in the open cohort. The difference in proportion for incidental durotomies, re-operation for pseudomeningocele, and levels were calculated using a Fisher's exact test.</p><p><strong>Results: </strong>The total incidence of durotomy in our cohort of 348 patients was 3.1% (n = 11), 5 (3.2%) in the open cohort and 6 (3.1%) in the tubular cohort. Various ID repair techniques were used including primary repair and dural sealants. One patient in the open cohort required re-operation for pseudomeningocele formation while none required re-operation in the MIS cohort. This result was not significant (p = 0.45).</p><p><strong>Conclusion: </strong>Pseudomeningocele formation after ID is rare. The rates of ID were similar between cohorts. We found no significant difference between re-operation rate for pseudomeningocele between the two cohorts. Larger, cohort-matched, prospective studies are needed to determine the true difference between rates of re-operation for pseudomeningocele formation after lumbar microdiscectomies.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461618","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}