Global Spine Journal最新文献

{"title":"Ten-Year Clinical Outcomes After Decompression Surgery for Lumbar Spinal Stenosis: The Impact of Preoperative Modic Changes.","authors":"Kota Watanabe, Takeshi Fujii, Takehiro Michikawa, Takahito Iga, Toshiki Okubo, Kazuki Takeda, Satoshi Suzuki, Masahiro Ozaki, Osahiko Tsuji, Narihiro Nagoshi, Morio Matsumoto, Masaya Nakamura","doi":"10.1177/21925682251361034","DOIUrl":"10.1177/21925682251361034","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectiveModic changes (MCs) have been associated with low back pain; however, their prognostic value in surgical outcomes-particularly in patients with lumbar spinal stenosis (LSS) treated with decompression alone-remains unclear. Few studies have investigated the progression and long-term clinical impact of MCs. This study aimed to evaluate the 10-year progression of MCs and their association with clinical outcomes following posterior decompression surgery for LSS.MethodsThis study included 62 patients who underwent posterior decompression for LSS and completed a 10-year follow-up with MRI and clinical assessments. MCs and disc degeneration were evaluated using standardized MRI criteria. Japanese Orthopaedic Association (JOA) scores and recovery rates were assessed preoperatively and at follow-up. Outcomes were compared between Modic-negative patients and those with preoperative Modic Type 1 or Type 2 changes. Analysis of covariance adjusted for confounding variables.ResultsThe prevalence of MCs increased from 37.1% preoperatively to 74.2% at 10 years. Type 1 changes were dynamic, often progressing to Type 2 or 3. Type 2 changes were more stable and associated with significantly lower postoperative JOA scores and recovery rates compared to Modic-negative or Type 1 patients (<i>P</i> < 0.05), after adjustment for age, sex, sagittal alignment parameters, and disc degeneration. Type 2 MCs were also linked with minimal improvement in back pain.ConclusionModic changes, particularly Type 2, are associated with inferior long-term outcomes. These findings suggest that Modic Type 2 may serve as a prognostic marker of advanced degeneration and may be associated with reduced recovery following decompression surgery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251361034"},"PeriodicalIF":2.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Cost Augmented Reality System in Endoscopic Spine Surgery: Analysis of Surgeon Ergonomics, Perceived Workload and A Step-by-Step Guide for Implementation.","authors":"Facundo Van Isseldyk, Piya Chavalparit, Julio Bassani, Lisandro Rodriguez Sattler, Marcus Serra, Jefferson Leal, Cristian Correa Valencia, Alberto Gotfryd, Jeronimo Milano, Alfredo Guiroy, Jin Sung Kim","doi":"10.1177/21925682251359298","DOIUrl":"10.1177/21925682251359298","url":null,"abstract":"<p><p>Study DesignProspective controlled study.ObjectivesTo evaluate the impact of an augmented reality (AR) visualization system on surgeon workload and ergonomics during endoscopic spine surgery, compared to conventional display monitors.MethodsTen experienced endoscopic spine surgeons (five neurosurgeons and five orthopedic surgeons; mean age 54 years) each performed 20 surgeries: the first 10 using traditional displays and the following 10 with a novel AR system. A step-by-step guide for AR system setup and utilization is provided. Workload was assessed using the NASA Task Load Index (NASA-TLX), and ergonomics were evaluated using the Rapid Upper Limb Assessment (RULA) score after each procedure. Paired t-tests or Wilcoxon signed-rank tests were used to compare traditional and AR systems, with normality assessed via the Shapiro-Wilk test.ResultsUse of the AR system resulted in significantly lower NASA-TLX scores, particularly in physical demand, effort, and performance domains (<i>P</i> < 0.001). RULA scores improved substantially, decreasing from a mean of 6.0 with traditional displays to 3.0 with AR (<i>P</i> < 0.001), indicating improved ergonomic posture. All surgeons demonstrated consistent reductions in perceived workload and ergonomic risk when utilizing the AR system.ConclusionsIntegration of an AR visualization system in endoscopic spine surgery significantly reduces cognitive workload and improves ergonomic posture compared to traditional displays. These findings suggest that AR technology may enhance surgical efficiency, promote surgeon well-being, and support the long-term sustainability of minimally invasive spinal procedures.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251359298"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Radiological Assessment of Lumbar Fusion Status: Which Imaging Modality is Best Assessing Non-union in Lumbar Spine Pseudarthrosis?\"","authors":"","doi":"10.1177/21925682251361009","DOIUrl":"10.1177/21925682251361009","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251361009"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Reliability and Validity of the German Version of the AO Spine Patient Reported Outcome Spine Trauma Questionnaire\".","authors":"","doi":"10.1177/21925682251361027","DOIUrl":"10.1177/21925682251361027","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251361027"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All Cause 5-Year Revision Rates of Patients with Surgically Treated Lumbar Stenosis with and Without Instrumented Arthrodesis.","authors":"Wesley M Durand, Yesha Parekh, Andrew H Kim, Hamid Hassanzadeh, Amit Jain","doi":"10.1177/21925682251360656","DOIUrl":"10.1177/21925682251360656","url":null,"abstract":"<p><p>Study DesignRetrospective study using the MarketScan database.ObjectiveThis study sought to investigate: (1) real-world surgical management, and (2) 5-year all-cause reoperation rates after index surgical treatment.MethodsPatients 18 - 65 years old with 2-year minimum follow-up undergoing single-level lumbar decompression were included. Patients were stratified based on the presence of spondylolisthesis (+LISTH) and arthrodesis (+FUSION) during the index procedure. Those undergoing multi-level, endoscopic, revision, corpectomy/transpedicular, and thoracic/cervical decompression were excluded, as were those with infectious, traumatic, or neoplastic etiologies. The time elapsed between primary and any revision surgery was determined. Follow-up was terminated at 5 years post-operatively.ResultsIn total, 86 708 adult patients undergoing single-level lumbar decompression were included. Spondylolisthesis was observed in 10.8%. Of + LISTH, 90.7% underwent additional arthrodesis. Of -LISTH, 89.8% underwent decompression alone. Among + LISTH, at 5-year post-operatively, 15.2% vs 20.3% of patients with +FUSION vs -FUSION had undergone surgical revision involving the lumbar spine (aHR 0.76, <i>P</i> = 0.009). Conversely, among those without spondylolisthesis (-LISTH), 17.6% vs 17.6% of those with +FUSION vs -FUSION had undergone revision at 5-year (aHR 0.94, <i>P</i> = 0.116). In the -LISTH group, patients demonstrated higher occurrence of revision over 2 - 5 years (aHR 1.43, <i>P</i> < 0.0001) among patients treated with additional arthrodesis.ConclusionsIn this retrospective cohort study of patients undergoing surgical treatment for single-level lumbar stenosis, patients with spondylolisthesis who underwent arthrodesis with decompression had lower revision rates at 5-year follow-up.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251360656"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AO Spine Clinical Practice Recommendations: Evaluation, Implications and Management of Osteoporosis in Adult Spinal Deformity.","authors":"So Kato, Brett Rocos, Go Yoshida, Zeeshan Sardar, Kristen E Jones, Shin Oe, Charles Fisher, Stephen J Lewis, Ao Spine Knowledge Forum Deformity","doi":"10.1177/21925682251357200","DOIUrl":"10.1177/21925682251357200","url":null,"abstract":"<p><p>Study designLiterature review with clinical recommendation.ObjectivesTo provide the readers with a concise curation of the relevant spine literature regarding the identification and management of osteoporosis in patients with adult spinal deformity (ASD) and set out recommendations for how the practicing clinician should interpret and make use of this evidence.MethodsKey articles from the published literature surrounding osteoporosis in patients being treated for ASD were reviewed and clinical recommendations were formulated by consensus. The recommendations are dichotomously graded into strong and conditional after integrating an assessment of methodological quality and expert opinion. This opinion considers experience and practical issues such as risks, burdens, costs, patient values, and circumstances.Results6 articles were selected by practicing spinal deformity surgeons and each evaluated for the strength of methodology and scientific evidence.ConclusionsThe current evidence suggests that preoperative evaluation of osteoporosis before ASD surgery should be routine. Additionally, there is clinical benefit in using anabolic agents for at least 3 months to improve bone stock and prevent mechanical complications. While high quality, strong evidence is still yet to be reported, all healthcare providers managing patients with ASD should be aware of the importance of bone health for optimizing post-operative outcomes and minimising complications.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251357200"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Risk of Lumbar Fusion Following Sacroiliac Joint Fusion in Patients With Lumbar Degenerative Disease: A Nationwide Cohort Analysis.","authors":"William J Karakash, Ali Issani, Henry Avetisian, Dil Patel, Raymond J Hah, Ram K Alluri, John C Liu, Jeffrey C Wang","doi":"10.1177/21925682251358728","DOIUrl":"10.1177/21925682251358728","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectivesTo evaluate the risk of subsequent lumbar fusion following sacroiliac (SI) joint fusion in patients with lumbar degenerative disease (LDD) and identify associated risk factors.MethodsPatients with undergoing SI joint fusion with concurrent diagnosis of LDD between 2010-2022 were identified in the PearlDiver Mariner Database. Those with prior lumbar fusion were excluded. A 1:10 propensity-matched control group of LDD patients without SI joint fusion was created. Logistic regression assessed the odds of subsequent lumbar fusion. Risk factors were analyzed using multivariable regression. Kaplan-Meier analysis evaluated time to lumbar fusion over 5 years.ResultsAmong 22 957 patients with LDD undergoing SI joint fusion, 4.5% required subsequent lumbar fusion. SI joint fusion was associated with significantly higher odds of subsequent lumbar fusion compared to controls (OR: 2.97 [2.77-3.19], <i>P</i> < 0.001). Risk factors included open SI joint fusion (aOR: 2.78), bilateral fusion (aOR: 1.97), Elixhauser Comorbidity Index ≤ 4 (aOR: 1.91), preoperative opioid use (aOR: 1.53), osteoarthritis (aOR: 1.45), fibromyalgia (aOR: 1.26), and age ≥ 70 (aOR: 1.15). Minimally invasive and unilateral SI joint fusion were associated with reduced risk. Kaplan-Meier analysis showed increased lumbar fusion risk beyond 1250 days post-SI joint fusion.ConclusionsSI joint fusion significantly increases the risk of subsequent lumbar fusion in patients with LDD, particularly following open or bilateral procedures. These findings emphasize the need for thorough preoperative risk assessment and patient counseling regarding potential long-term lumbar effects. Future research should investigate clinical outcomes and biomechanical mechanisms underlying stress redistribution after SI joint fusion.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251358728"},"PeriodicalIF":2.6,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Accuracy and Readability of ChatGPT in Addressing Patient Queries on Adult Spinal Deformity Surgery.","authors":"Fergui Hernandez, Rafael Guizar, Henry Avetisian, Marc A Abdou, William J Karakash, Andy Ton, Matthew C Gallo, Jacob R Ball, Jeffrey C Wang, Ram K Alluri, Raymond J Hah, Michael Safaee","doi":"10.1177/21925682251360655","DOIUrl":"10.1177/21925682251360655","url":null,"abstract":"<p><p>Study DesignCross-Sectional.ObjectivesAdult spinal deformity (ASD) affects 68% of the elderly, with surgical intervention carrying complication rates of up to 50%. Effective patient education is essential for managing expectations, yet high patient volumes can limit preoperative counseling. Language learning models (LLMs), such as ChatGPT, may supplement patient education. This study evaluates ChatGPT-3.5's accuracy and readability in answering common patient questions regarding ASD surgery.MethodsStructured interviews with ASD surgery patients identified 40 common preoperative questions, of which 19 were selected. Each question was posed to ChatGPT-3.5 in separate chat sessions to ensure independent responses. Three spine surgeons assessed response accuracy using a validated 4-point scale (1 = excellent, 4 = unsatisfactory). Readability was analyzed using the Flesch-Kincaid Grade Level formula.ResultsPatient inquiries fell into four themes: (1) Preoperative preparation, (2) Recovery (pain expectations, physical therapy), (3) Lifestyle modifications, and (4) Postoperative course. Accuracy scores varies: Preoperative responses averaged 1.67, Recovery and lifestyle responses 1.33, and postoperative responses 2.0. 59.7% of responses were excellent (no clarification needed), 26.3% were satisfactory (minimal clarification needed), 12.3% required moderate clarification, and 1.8% were unsatisfactory, with one response (\"Will my pain return or worsen?\") rated inaccurate by all reviewers. Readability analysis showed all 19 responses exceeded the eight-grade reading level by an average of 5.91 grade levels.ConclusionChatGPT-3.5 demonstrates potential as a supplemental patient education tool but provides varying accuracy and complex readability. While it may support patient understanding, the complexity of its responses may limit usefulness for individuals with lower health literacy.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251360655"},"PeriodicalIF":2.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Approach for Bilsky Grade 2 Metastatic Epidural Spinal Cord Compression Based on Radiation Therapy Failure Risk.","authors":"Sehan Park, Dong-Ho Lee, Chang Ju Hwang, Gumin Jeong, Ji Uk Choi, Hyuk-Joon Sohn, San Kim, Yeon Joo Kim, Jae Hwan Cho","doi":"10.1177/21925682251359292","DOIUrl":"10.1177/21925682251359292","url":null,"abstract":"<p><p>Study designRetrospective cohort study.ObjectivesThis study evaluated the outcomes of radiation therapy (RT) as the initial treatment for Bilsky grade 2 metastatic epidural spinal cord compression (MESCC) and identified the risk factors associated with RT failure.MethodsThis retrospective cohort study enrolled 151 patients diagnosed with Bilsky grade 2 MESCC. Patients were divided into 2 groups, viz. those who initially underwent RT (n = 127) and those treated with surgery at presentation (n = 24). The patient demographics, treatment outcomes, and risk factors for RT failure were analyzed. The Spinal Instability Neoplastic Score (SINS) and clinical outcomes such as ambulatory status and neurological function were compared. Logistic regression was performed to identify factors predictive of RT failure.ResultsRT was successful in 85.8% (109/127) of patients, and only 14.2% (18/127) required surgery due to symptom progression. The SINS were significantly higher in the RT-failure group (9.6 ± 3.2) than in the RT-success group (7.4 ± 2.8, <i>P</i> = 0.003). SINS scores >8 were associated with a higher risk of RT failure. Patients the surgery group were younger and presented more frequently with neurological deficits. No significant differences in final ambulatory status or survival were observed between the RT-success and RT-failure subgroups.ConclusionsRT can be a viable initial treatment option for Bilsky grade 2 MESCC in the absence of neurological deficits or severe mechanical pain. However, patients with greater spinal instability (SINS >8) face a higher risk of RT failure and may benefit from surgical intervention at diagnosis.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251359292"},"PeriodicalIF":2.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on AO Spine Knowledge Forums Promote Collaboration and Elevate the Impact of Research: Bibliometric Analysis.","authors":"Maheen Sheraz, Umer Sajid","doi":"10.1177/21925682251360743","DOIUrl":"10.1177/21925682251360743","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251360743"},"PeriodicalIF":2.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}