Global Spine Journal最新文献

{"title":"The Use of Percutaneous Stent-Kyphoplasty (SpineJack®) in Osteoporotic and Non-Osteoporotic Vertebral Fractures: A Retrospective Analysis of 310 Implants From a Level-1 Trauma Center in Switzerland.","authors":"Magdalena Karner, Georg Osterhoff, Kai Sprengel, Hans-Christoph Pape, Julian Scherer","doi":"10.1177/21925682251347225","DOIUrl":"https://doi.org/10.1177/21925682251347225","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesThe SpineJack®-system represents a new generation of kyphoplasty for the treatment of traumatic and osteoporotic fractures. The aim of this study was to analyze the usage, safety and efficacy of the SpineJack®-system, in both osteoporotic and non-osteoporotic fractures.Methods310 patients with vertebral fractures treated with the SpineJack®-system between November 2014 and December 2022 were analyzed. Demographics, intraoperative parameters and outcomes were assessed. A subgroup analysis was performed for traumatic vertebral fractures (tVCFs) and osteoporotic vertebral fractures (oVCFs).ResultsSpineJack®-kyphoplasty was performed for 157 (47.4%) oVCFs and 153 (46.2%) tVCFs. Stand-alone SpineJack®-kyphoplasty was performed in 128 patients, while 182 patients underwent combined procedures. The mean pain reduction from admission to discharge was 3.8 (range 3-10, SD 2.7). Opioids were administered for an average of 4.6 days (range 0-72 days, SD 7.2 days). The overall mean hospital length of stay was 6.1 days, significantly shorter for patients undergoing stand-alone SpineJack® procedures at 4.8 days (SD 6.9 days). The most common complication observed was cement extravasation in 29 patients (8.8%), followed by neurological symptoms in 8 patients (2.4%) and surgical site infections in 4 patients (1.2%). Notably, no surgical site infections were recorded in the stand-alone SpineJack®-group.ConclusionPercutaneous stent-kyphoplasty (SpineJack®-system) appears to be a safe and effective therapeutic option, whether used as a stand-alone procedure or in combination with other interventions, for osteoporotic and non-osteoporotic vertebral fractures.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251347225"},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173391","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":"Identifying Distinct Risk Factors for Early-Onset and Late-Onset PJK in ASD: A Comparative Analysis Across Non-PJK, Early-Onset PJK, and Late-Onset PJK Groups.","authors":"Donghua Huang, Han Jo Kim, Zhan Wang, Mihir Dekhne, Robert Uzzo, Atahan Durbas, Gabrielle Dykhouse, Tejas Subramanian, Andrea Pezzi, Luis Felipe Colon, Stephane Owusu-Sarpong, Francis Lovecchio","doi":"10.1177/21925682251345755","DOIUrl":"https://doi.org/10.1177/21925682251345755","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesThe risk factors for proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) are well established, but their association with onset timing remains unclear. This study aims to identify distinct risk factors for early-onset and late-onset PJK.MethodsThis study included 96 ASD patients who underwent corrective surgery (fusion ≥5 levels, UIV: T1-L1, LIV: L5/S1) with ≥2 years of follow-up. Patients were categorized into Non-PJK, Early-Onset PJK (≤6 months), and Late-Onset PJK (>6 months) groups. Clinical characteristics were compared to identify potential risk factors (<i>P</i> < .10). Multinomial logistic regression was used to evaluate the independent effects of these variables on early-onset and late-onset PJK.ResultsAmong 96 patients, 44 (45.8%) developed PJK (31 early-onset, 13 late-onset), and 7 (7.3%) developed PJF, including 6 cases in the Early-Onset group (19.4%, <i>P</i> = .005). After initial screening and addressing multicollinearity, preoperative PI, UIV location, and postoperative PI-LL and L1PA were finally included in regression analysis. Lower thoracic UIV (T7-L1) increased the risk of Early-Onset PJK (OR = 5.27, <i>P</i> = .015). Higher preoperative PI was associated with Late-Onset PJK, with a 9% increased risk per degree (OR = 1.09, <i>P</i> = .027).ConclusionsMost PJK cases occur within 6 months and have a higher risk of PJF. Lower thoracic UIV increases Early-Onset PJK risk, while higher preoperative PI predisposes to Late-Onset PJK. Strategies should focus on preventing Early-Onset PJK in lower thoracic UIV cases and long-term monitoring for Late-Onset PJK in high-PI patients.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251345755"},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173291","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":"Outcomes of Cefazolin Administration in a Propensity Matched Cohort of Penicillin Allergic Patients Compared to Non-penicillin Allergic Patients.","authors":"Rajkishen Narayanan, Michael Carter, Gregory Toci, Rachel Huang, Jonathan Dalton, Amit Syal, Andrew Kim, Andrew Vanichkachorn, Asad Pasha, Matthew Sabitsky, Shiraz Mumtaz, Mark Kurd, Ian David Kaye, Jose Canseco, Alan Hilibrand, Alexander Vaccaro, Christopher Kepler, Gregory Schroeder","doi":"10.1177/21925682251344907","DOIUrl":"https://doi.org/10.1177/21925682251344907","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectiveTo investigate whether cefazolin can be given to penicillin-allergic patients undergoing spine surgery without significantly increasing rates of allergic reactions. Additionally, we sought to determine if patients receiving cefazolin would be at increased risk of surgical site infection due to allergy-associated skin or wound reactions.MethodsPatients with a documented penicillin allergy who underwent lumbar fusion from 2017-2022 and received cefazolin for surgical prophylaxis were matched to a cohort of non-penicillin allergic patients. Length of surgery and in-hospital complications related to infections were recorded for each patient. Allergic reactions were recorded, in addition to all-cause mortality, hospital length of stay (LOS), 30 and 90 day readmissions due to infectious etiologies and need for irrigation and debridement (I&D) surgery.Results254 penicillin-allergic patients were matched to 762 non-allergic patients. Penicillin- allergic patients had a comparable LOS when compared to non-allergic patients and had comparable incidences of respiratory complaints, sepsis, cellulitis, wound infections and all-cause mortality. While one penicillin-allergic patient was diagnosed with a mild drug-induced skin reaction, overall, cefazolin did not increase rates of allergic reactions compared to the non-allergic cohort. Cefazolin administration to penicillin allergic patients also did not significantly increase 90 day readmissions due to surgical site infections or need for subsequent I&D.ConclusionOur findings suggest that cefazolin can be safely administered to penicillin-allergic patients undergoing lumbar spine surgery without risk of cross-reactivity. Additionally, we found that cefazolin did not increase rates of non-surgical site infections or postoperative wound complications.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251344907"},"PeriodicalIF":2.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173320","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":"Impact of Hypothyroidism on Short-Term and Long-Term Outcomes After Lumbar Fusion: A Nationwide Propensity-Matched Cohort Study.","authors":"Muhammad Waheed, Abdul-Lateef Shafau, Abdelrahman Diab, Abdurrahman Ehsan, Sazid Hasan, Omar Diab, Bilal Butt, Ilyas Aleem","doi":"10.1177/21925682251346114","DOIUrl":"https://doi.org/10.1177/21925682251346114","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesHypothyroidism is associated with increased perioperative risks across various surgical specialties and has recently been linked to hematologic and short-term complications following spinal fusion. However, its impact on long-term mechanical complications remains unclear. This study aims to evaluate short-term (45-day) and long-term (2-year) medical and mechanical complications in hypothyroid patients undergoing primary lumbar fusion.MethodsA retrospective analysis was conducted using the TriNetX database to identify patients who underwent lumbar fusion between 2002 and 2022 with at least 2 years of follow-up. Patients with preoperative hypothyroidism (n = 3,348, identified via ICD-10-CM code E03.9) were propensity score-matched 1:1 to euthyroid controls based on demographic and clinical risk factors.ResultsAfter matching (n = 2850 per cohort), hypothyroid patients had higher rates of sepsis at 45 days (2.1% vs 1.3%; <i>P</i> = 0.019; RR: 1.62, 95% CI [1.08-2.44]). At 2 years, they had increased risks of chronic device-related infection (0.7% vs 0.3%; <i>P</i> = 0.019; RR: 2.27, 95% CI [1.12-4.61]), wound disruption (3.6% vs 2.7%; <i>P</i> = 0.031; OR: 1.35, 95% CI [1.03-1.75]), and proximal junctional kyphosis (3.2% vs 2.3%; <i>P</i> = 0.017; RR: 1.42, 95% CI [1.06-1.90]). No significant differences were observed in readmissions, revision surgery, or pseudoarthrosis rates.ConclusionsHypothyroidism is a risk factor for early and late postoperative complications in patients undergoing primary lumbar fusion. Appropriate preoperative optimization with thyroid hormone supplementation to achieve euthyroid status could potentially minimize the incidence of developing notable postoperative medical and mechanical complications.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251346114"},"PeriodicalIF":2.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158007","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":"Anatomical Positional Variations of Retroperitoneal Organs and Lumbar Lordosis Angle Changes During Single-Position Prone Lateral Lumbar Interbody Fusion in Diverse Intraoperative Decubitus.","authors":"Xiaopeng Li, Hanming Bian, Genghao Wang, Chao Chen, Xun Sun, Feng Li, Xinlong Ma, Xinyu Liu, Qiang Yang","doi":"10.1177/21925682251344207","DOIUrl":"https://doi.org/10.1177/21925682251344207","url":null,"abstract":"<p><p>Study DesignRetrospective case series.ObjectiveThe single-position prone lateral lumbar interbody fusion (P-LLIF), which eliminates the need to change patient decubitus during the procedure, represents a modification of the traditional lateral lumbar interbody fusion (LLIF). This pioneering study aims to investigate the positional shifts of retroperitoneal organs and changes in lumbar lordosis angle across different decubitus, providing novel insights into the biomechanics of LLIF.MethodsEighteen patients scheduled for LLIF were included. CT scans were performed in 3 positions: prone, right lateral, and oblique decubitus. Measurements included the anatomical positions of the psoas major, abdominal aorta, left common iliac artery, and left kidney at intervertebral disc levels, as well as changes in lumbar lordosis angle across the 3 positions.ResultsIn the prone decubitus compared to the lateral decubitus: The thickness of the psoas major increased by 4.07 ± 3.41 mm. The abdominal aorta shifted laterally by 2.29 ± 2.79 mm. The left common iliac artery shifted laterally by 1.98 ± 3.54 mm. The kidney moved anteriorly by 6.97 ± 5.84 mm. The lumbar lordosis angle increased by 7.73 ± 3.76°. In the oblique decubitus compared to the lateral decubitus: The thickness of the psoas major increased by 3.14 ± 3.36 mm. The abdominal aorta shifted laterally by 1.59 ± 2.82 mm. The left common iliac artery shifted laterally by 2.45 ± 4.51 mm. The kidney moved anteriorly by 3.92 ± 4.70 mm. The lumbar lordosis angle increased by 3.04 ± 3.55°.ConclusionP-LLIF induces significant positional changes in retroperitoneal organs and increases lumbar lordosis angle compared to traditional LLIF. These findings offer critical insights for preoperative planning and underscore the importance of optimizing safety protocols in P-LLIF procedures.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251344207"},"PeriodicalIF":2.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173185","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":"Towards a Definition of Physiologic Vulnerability in Pediatric Spine Surgery: Identification of Key Risk Factors in a Cohort Study of Children With Neuromuscular Disease Undergoing Spinal Fusion.","authors":"Muhammad S Ghauri, Sujay Rajkumar, Lauren E Stone, Michael P Kelly, Rajiv R Iyer, Jennifer Bauer, Christopher P Ames, Peter O Newton, David D Gonda, Michael L Levy, Vijay M Ravindra","doi":"10.1177/21925682251344928","DOIUrl":"https://doi.org/10.1177/21925682251344928","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesPreoperative risk stratification using frailty is common for adults but difficult to apply to pediatric populations. We aimed to identify risk factors indicating physiologic vulnerability and predict perioperative complications in children with neuromuscular scoliosis (NMS) and to create a prediction model for physiological vulnerability (PV-5).MethodsPatients with NMS were identified from the American College of Surgeons National Surgical Quality Improvement Program Pediatric database. The 9442 patients identified were randomly divided into training and testing cohorts. Univariate and multivariable logistic regression were performed; variables significantly associated with complications were evaluated using the Akaike information criterion and area under the curve. Significant variables received weighted scores, and a patient-specific prediction model was generated and evaluated using the Brier score.ResultsPatients with central nervous system abnormality (OR 1.32 [95%CI 1.13-1.53]), hematologic disorder (OR 1.40 [1.06-1.85]), congenital malformation (OR 1.30 [1.1-1.54]), nutritional support (OR 2.21 [1.91-2.57]), and preoperative wound infection (OR 2.3 [1.4-3.76]) were more likely to develop complications after spinal fusion surgery. PV-5 scores were calculated from these risk factors to generate a prediction model. PV-5 scores of 1 (OR: 2.0 [1.27-3.43], <i>P</i> < 0.004), 2 (OR: 2.75 [1.63-4.64], <i>P</i> < 0.001), 3 (OR: 3.67 [2.18-6.19], <i>P</i> < 0.001), 4 (OR: 4.09 [2.39-6.99], <i>P</i> < 0.001), and 5+ (OR: 3.58 [1.35-9.47], <i>P</i> = 0.01) predicted greater complication risk than PV-5 of zero (accuracy = 89.65%, Brier score = 0.09).ConclusionsUsing factors associated with complications in children with NMS undergoing spinal fusion surgery, we created a prediction model to illustrate physiologic vulnerability and morbidity. Our model serves as a foundation for further body system-specific investigation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251344928"},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150264","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":"Lumbar Fusion With Micro- & Nano-Textured, 3D Printed Porous Titanium Versus PEEK Interbody Cages in TLIF: A Single-Blinded, Randomized Controlled Trial.","authors":"Joshua H Weinberg, Nathan Ritchey, Witty Kwok, Shravani Khisti, Bryan Ladd, Stephanus Viljoen, Siri S Khalsa, David S Xu, Andrew J Grossbach","doi":"10.1177/21925682251347528","DOIUrl":"https://doi.org/10.1177/21925682251347528","url":null,"abstract":"<p><p>Study DesignProspective, randomized controlled study.ObjectiveAssess early radiological outcomes in transforaminal lumbar interbody fusion (TLIF) with 3D-printed porous titanium (3DPPT) compared to PEEK.MethodsSingle-blinded prospective, randomized controlled trial comparing 1-2 level TLIF with micro- & nano-textured, 3DPPT vs PEEK cages from 11/2021 to 5/2023. Interbody fusion was assessed on CT at 6 months according to Brantigan and Steffee method, modified to describe the Fraser definition of locked pseudoarthrosis [(BSF) scale]. Primary outcome was radiographic fusion at 6 months. ResultsInitial study protocol included 70 total patients but was ended early given the significance on interim analysis. Amongst 17 patients with 25 interbody levels implanted, 10 3DPPT and 15 PEEK cages were implanted. 3DPPT levels had a significantly higher rate of successful fusion (BSF-3) at 6 months compared with PEEK (100% vs 0.0%, <i>P</i> < 0.001). The posterior probability that 3DPPT increased the odds of fusion versus PEEK was > 99.9%, indicating a near-certain beneficial effect. Using a Bayesian mixed-effects model, the predicted probability of 6-month BSF-3 fusion was 9.0% for PEEK and 91.2% for 3DPPT. There were no significant differences in lumbar pathologies, level of fusion, number of fused levels, cage height, length of hospital stay, surgery duration, postoperative complications, subsidence, or reoperations.ConclusionsThe rate of successful lumbar interbody fusion at 6 months was significantly higher in 3DPPT levels compared to PEEK. 3DPPT may accelerate the rate and quality of bony fusion. Additional studies are needed to further delineate the impact of these radiographical findings on long-term clinical outcomes.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251347528"},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142444","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":"Efficacy of Mesenchymal and Embryonic Stem Cell Therapy for the Treatment of Spinal Cord Injury: A Systematic Review and Meta-Analysis of Human Studies.","authors":"Zachary Troiani, Danielle E Chipman, Thomas J Ryan, Mohammad N Haider, David Kowalski, Bilal Hasanspahic, Maxwell M Scott, Emily K Vallee, Christopher Lucasti","doi":"10.1177/21925682251345450","DOIUrl":"10.1177/21925682251345450","url":null,"abstract":"<p><p>Study DesignSystematic review and meta-analysis.ObjectivesThe objective of this study was to conduct a systematic review and meta-analysis of the literature regarding the therapeutic effect of embryonic and mesenchymal stem cells on the treatment of traumatic spinal cord injury (SCI) in humans. Primary outcome measures were overall American Spinal Injury Association (ASIA) scores, ASIA motor and sensory scores, urinary and bowel function, pain, and adverse events.MethodsStudies with human patients ages 18-80 years receiving embryonic, induced pluripotent, or mesenchymal stem cells for SCI were included. Study quality was assessed using the Cochrane risk of bias 2 tool and the Newcastle Ottawa scale for randomized and non-randomized studies, respectively. Primary outcomes were overall ASIA grade, ASIA motor scores, ASIA sensory scores, bladder and bowel function, pain, and adverse events.ResultsThirty total studies with 656 patients were included, with 43.3% of patients experiencing improvement in ASIA grade, 49.4% in motor function, and 73.6% in sensory function. Qualitative analysis of bladder and bowel outcomes suggests overall improved sensation and control. No serious adverse events were reported. The most common side effects were mild and resolved within hours to weeks without requiring additional medical treatment.ConclusionsStem cell transplantation for SCI appears to offer moderate improvements in overall ASIA grade, motor, sensory, bladder, and bowel function, accompanied by a relatively mild and transient side effect profile. Further research, particularly high-quality, blinded, randomized controlled trials, is essential to optimize treatment protocols and achieve more consistent and improved clinical outcomes.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251345450"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127343","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":"Letter to \"The Effect of Comprehensive Spinal Correction Rehabilitation in Children with Early-Onset Idiopathic Scoliosis: A Clinical Controlled Trial\".","authors":"Xintao Qu, Enshui Zhang, Ke Zhou","doi":"10.1177/21925682251345695","DOIUrl":"10.1177/21925682251345695","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251345695"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119587","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":"Postoperative External Beam Versus Stereotactic Body Radiation Therapy as Adjuvant to Surgically Treated Spinal Metastases.","authors":"Jordan O Gasho, Daniel de Reus, Robert-Jan Pierik, Jantijn Amelink, Joseph H Schwab, Daniel G Tobert","doi":"10.1177/21925682251345753","DOIUrl":"10.1177/21925682251345753","url":null,"abstract":"<p><p>Study DesignRetrospective cohort.ObjectivesWith rising cancer rates and survival, effective palliative treatments are crucial. For decades, conventional external beam RT (cEBRT) has been the standard for palliation but is dose-limited. The efficacy of postoperative radiotherapy for spinal metastases with stereotactic body radiation therapy (SBRT) in direct comparison to cEBRT remains understudied. We aim to compare clinical outcomes after treatment with cEBRT or SBRT for patients with spinal metastases.MethodsEligible patients included those who received palliative RT with cEBRT or SBRT between January 2017 and December 2022 at Massachusetts General Hospital. A matched cohort of 204 patients was created using propensity score matching. Reoperation, overall survival (OS), and postoperative complications were evaluated. Multivariable logistic regression was used to adjust for residual bias after propensity score matching.Results81 patients treated with cEBRT were matched with 123 patients treated with SBRT. Reoperation rate was 13.2%, with no significant difference between the cEBRT and SBRT groups (12.4% vs 13.8%, <i>P</i> = 0.76). Median OS was 15.9 months (IQR, 6.7-40.6 months). Kaplan-Meier analysis revealed no significant association between type of radiotherapy and either reoperation or OS (<i>P</i> = 0.40 and <i>P</i> = 0.56, respectively). When comparing reoperation by radiation modality, multivariable logistic regression analysis showed no significant difference.ConclusionWe observed that SBRT does not reduce rates of reoperation or complications, nor does it improve overall survival. These findings suggest that conventional radiotherapy remains a viable postoperative treatment for spinal metastases, especially when SBRT is not available or feasible, or when cost is a significant concern.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251345753"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119588","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}