Global Spine Journal最新文献

{"title":"Development and Validation of a Computer-Assisted Screw Trajectory Planning Model Based on Iterative Closest Point Registration and Weighted K-Nearest Neighbors Algorithms for Cortical Bone and Pedicle Screw Techniques.","authors":"Abudusalamu Tuoheti, Gufuding, Musitapa Mijiti, Jitao Yang, Hali Habulihan, Awuzhaer Abuliken, Yilixiati Mamuti, Paerhati Rexiti","doi":"10.1177/21925682261485860","DOIUrl":"https://doi.org/10.1177/21925682261485860","url":null,"abstract":"<p><p>Study DesignRetrospective study.ObjectivesTo develop and validate a computer-assisted model for planning screw trajectories to support modified cortical bone trajectory (MCBT), cortical bone trajectory (CBT), and pedicle screw (PS) techniques, based on iterative closest point (ICP) registration and weighted k-nearest neighbors (kNN) algorithms.MethodsCT data from 110 patients undergoing lumbar surgery were analyzed, comprising an internal set of 50 younger patients with normal bone density and an external set of 60 patients including younger and older individuals with or without bone loss. L4-L5 segments were reconstructed using Mimics 21.0. Two surgeons manually planned MCBT, CBT, and PS trajectories bilaterally in the internal set to serve as reference standards. A personalized computer-assisted screw planning model was developed using ICP registration and weighted kNN, where the template library consisted of manually generated screw plans. Accuracy was evaluated by comparing algorithm-generated screw trajectories against expert manually planned trajectories to calculate deviations in sagittal inclination (α), axial inclination (β), screw head, pedicle entry point, pedicle crossing point, and screw tip. Hounsfield unit (HU) values along screw trajectories were also measured.ResultsIn the external set (total of 720 screws: 240 PS, 240 CBT, 240 MCBT), deviations for CBT weresagittal inclination (α) 4.117 (2.028, 7.251)°, axial inclination (β) 3.714 (1.901, 6.316)°, screw head 3.382 (2.514, 4.803) mm, pedicle entry point 3.0 (1.999, 4.149) mm, pedicle crossing point 1.511 (1.008, 2.443) mm, screw tip 3.586 (2.465, 4.542) mm. Those for MCBT were 4.865 (2.126, 7.547)°, 3.801 (1.658, 6.147)°, 4.153 (3.14, 5.658) mm, 3.818 (2.43, 6.209) mm, 1.545 (1.061, 2.222) mm, 3.777 (2.768, 5.241) mm, respectively. Computational acceptance rates for PS were 97.06% (HU: 238.4±67.71) in younger normal bone group, 92.71% (173.6±53.83) in older normal bone group, and 97.37% (113.3±58.68) in older bone loss group. For CBT, rates were 100% (477.2±168.6 HU), 100% (338.5±125.8 HU), and 100% (178.1±99.75 HU), respectively. For MCBT, rates were 100% (475.8±131 HU), 98.96% (376.8±104.9 HU), and 97.37% (213.4±106 HU), respectively. MCBT and CBT achieved significantly higher HU values than PS (P < 0.05).ConclusionThe ICP registration and weighted kNN-based planning model demonstrates high computational acceptance rates and excels in planning cortical bone screw trajectories with low breach rates and high HU values.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261485860"},"PeriodicalIF":3.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887174","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":"Testosterone Replacement Therapy is Associated With Increased Risk of Pseudarthrosis After Single-Level Anterior Cervical Discectomy and Fusion: A Propensity Matched Analysis.","authors":"William Han, Kyle Stump, Karim Gubara, Prabhat Gottipati, Stephan Aynaszyan, Theresa Pazionis","doi":"10.1177/21925682261487188","DOIUrl":"10.1177/21925682261487188","url":null,"abstract":"<p><p>ObjectiveTo evaluate whether preoperative testosterone replacement therapy (TRT) use is associated with increased risks of pseudarthrosis and reoperation following single-level anterior cervical discectomy and fusion (ACDF).MethodsThe TriNetX Research Network was queried to identify adult males aged 18 to 89 years who underwent single-level ACDF. Patients were separated into a TRT exposure group within 1 year before initial ACDF procedure as well as comparator cohort without TRT exposure that was matched 1:1 using propensity score matching based on age, race, and relevant medical comorbidities. Patients were followed longitudinally for 2 years from the index procedure to assess postoperative outcomes. The primary outcomes were pseudarthrosis and reoperation. Risk ratios and time-to-event hazard ratios were calculated along with 95% confidence intervals.ResultsAfter propensity score matching, 494 matched pairs reached balance across all baseline characteristics. Patients receiving TRT demonstrated a 70% increased risk of pseudarthrosis (RR 1.70, CI 1.20-2.39; HR 1.71 CI 1.19 - 2.46) compared to the non-TRT cohort. TRT use was not associated with an increased risk of reoperation (RR 0.92 CI 0.59-1.43; HR 0.87, CI 0.55-1.38) following ACDF.ConclusionsPreoperative testosterone replacement therapy was associated with increased risk of pseudarthrosis, but not reoperation following ACDF. These findings suggest that TRT may represent an important patient-specific risk marker in patients undergoing ACDF. Given the observational design and potential for residual confounding, these findings should not be interpreted as evidence of a causal effect.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261487188"},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887110","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 of Patients Achieving Clinically Meaningful Improvement in Neuropathic Pain After Surgery for Degenerative Cervical Myelopathy.","authors":"Narihito Nagoshi, Junichi Yamane, Toshiki Okubo, Hitoshi Kono, Kentaro Fukuda, Takeshi Fujii, Yosuke Horiuchi, Yasuhiro Kamata, Norihiro Isogai, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1177/21925682261488031","DOIUrl":"10.1177/21925682261488031","url":null,"abstract":"<p><p>Study DesignRetrospective analysis of a prospectively maintained multicenter cohort.ObjectivesTo identify clinical characteristics associated with clinically meaningful improvement in neuropathic pain and to evaluate its relationship with postoperative functional outcomes in patients with degenerative cervical myelopathy (DCM).MethodsAmong 816 patients with complete Neuropathic Pain Symptom Inventory (NPSI) data, 597 with baseline total NPSI scores ≥7 were included in the primary analysis because they were eligible to achieve the predefined minimal clinically important difference (MCID) of a 7-point reduction. Patients were classified as responders or non-responders according to MCID achievement at 2 years postoperatively. Clinical outcomes included the cervical Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS), Short Form-36 (SF-36), and JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ).ResultsOf the 597 patients, 323 (54.1%) achieved the NPSI MCID. Responders had significantly higher preoperative total NPSI scores than non-responders, whereas no significant differences were observed in baseline JOA, VAS, or SF-36 scores. Responders demonstrated greater improvement in upper-extremity pain and numbness and in the SF-36 mental component summary score. They also showed significantly higher effectiveness rates in the upper-extremity, lower-extremity, bladder, and quality-of-life domains of the JOACMEQ.ConclusionsClinically meaningful improvement in neuropathic pain after surgery for DCM was associated with broader postoperative recovery across pain-related, functional, mental health, and quality-of-life outcomes. Assessment of neuropathic pain may provide clinically relevant information complementary to conventional measures of neurological function.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261488031"},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880137","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: Surgical Timing and Neurological Outcomes in Traumatic Central Cord Syndrome: A Single-Center Retrospective Cohort Study.","authors":"Zitong Wang","doi":"10.1177/21925682261484602","DOIUrl":"10.1177/21925682261484602","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261484602"},"PeriodicalIF":3.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873933","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":"Recommendations of the International Consensus Meeting (ICM) 2025 on Spinal Infections: Part B Tubercular Spondylodiscitis.","authors":"Shanmuganathan Rajasekaran, Gnanaprakash Gurusamy, Sathish Muthu, Javad Parvizi","doi":"10.1177/21925682261454366","DOIUrl":"10.1177/21925682261454366","url":null,"abstract":"<p><p>Study DesignSystematic review with guidelines.ObjectiveTo develop evidence-based, globally applicable recommendations for diagnosis and management of Tubercular spondylodiscitis (TBSD) as a part of the International Consensus Meeting (ICM) 2025 on Spinal Infection.MethodsThis article represents a structured, multi-phase international consensus process conducted under the auspices of ICM 2025. Systematic literature reviews were performed using PubMed, Scopus, Web of Science, and ClinicalTrials.gov in accordance with Cochrane methodology. Evidence synthesis was integrated with structured expert deliberation. Consensus statements were developed across 7 domains: screening and initial evaluation, imaging, microbiological diagnosis, anti-tubercular therapy, response monitoring and conservative management, surgical indications, and surgical techniques. Recommendations were finalised through structured voting, with levels of evidence assigned to each statement.ResultsThe consensus emphasises early recognition, routine HIV screening, lesion-specific tissue diagnosis with drug-susceptibility testing, and a multimodal diagnostic strategy. MRI remains the primary imaging modality but lacks specificity for etiological differentiation. Six months of rifampicin-based chemotherapy is sufficient in clinically responding patients, irrespective of surgery. Surgery is indicated for neurological deficit associated with instability or deformity, progressive deterioration, or failure of conservative management. Posterior-only approaches are appropriate in most thoracic and lumbar cases, with anterior surgery reserved for selected indications.ConclusionThe ICM 2025 recommendations provide a comprehensive, evidence-informed framework for the diagnosis and management of TBSD and aim to standardise care while guiding future research priorities worldwide.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"16 3_suppl","pages":"71S-107S"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864579","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":"Global Consensus on the Management of Spinal Infections: Recommendations From International Consensus Meeting 2025.","authors":"Shanmuganathan Rajasekaran, Javad Parvizi","doi":"10.1177/21925682261427448","DOIUrl":"10.1177/21925682261427448","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"16 3_suppl","pages":"5S-6S"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864576","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":"Relationship of Adult Cervical Spinous Processes to Vertebral Midline for Cervical Disc Replacement.","authors":"Kevin G Liu, Jacob T Wechsler, Daniel Rusu, Aidan Lindgren, Marc A Abdou, Jeffrey C Wang, Raymond J Hah, Ram K Alluri","doi":"10.1177/21925682261486413","DOIUrl":"10.1177/21925682261486413","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort.ObjectivesAccurate, midline artificial disc placement is crucial when performing cervical disc replacement (CDR). Although cervical spinous processes (SPs) are considered midline structures, clinical experience has often shown noticeable deviation at times. This study aims to quantitatively characterize this known observation to better understand the utility of SPs as midline indicators during CDR.MethodsPatients who underwent anterior cervical discectomy and fusion with preoperative cervical spine computerized tomography (CT) scans were retrospectively identified, excluding those with previously surgically altered spines. Angular and lateral SP deviations from C3-C7 were collected from these CTs. Statistical analysis was conducted using one-way ANOVA with post-hoc testing using Tukey's test.ResultsThe average angular SP deviations at C3-C7 were 2.94 ± 2.06 degrees, 3.52 ± 2.19 degrees, 3.50 ± 2.13 degrees, 4.31 ± 2.15 degrees, and 3.53 ± 2.86 degrees, respectively. The average lateral SP deviations at C3-C7 relative to vertebral body widths were 5.43%, 6.10%, 6.14%, 8.17%, and 7.52%, respectively. Angular deviation at C6 was greater than C3 (p = 0.009). Relative lateral deviation at C6 was greater than at C3 (p = 0.027). Neither angular nor lateral deviation differed by sex at any level (p > 0.05 for all).ConclusionsGiven significant variation in cervical SP deviation between patients and by level, surgeons should hesitate to solely rely on them for determining vertebral midline during CDR. The C6 and C7 SPs especially should be used cautiously as they show relatively higher magnitudes and variations of deviation. However, the C3-C5 SPs may be of use if viewed in conjunction with other radiographic landmarks, such as the uncinate processes or medial borders of the pedicles.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261486413"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864631","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":"ICM 2025 (Spine Section).","authors":"","doi":"10.1177/21925682261477400","DOIUrl":"10.1177/21925682261477400","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"16 3_suppl","pages":"7S-13S"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864568","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":"Recommendations of the International Consensus Meeting (ICM) 2025 on Spinal Infections: Part A Pyogenic Spondylodiscitis.","authors":"Shanmuganathan Rajasekaran, Sathish Muthu, Gnanaprakash Gurusamy, Javad Parvizi","doi":"10.1177/21925682261454361","DOIUrl":"10.1177/21925682261454361","url":null,"abstract":"<p><p>Study DesignSystematic review with guidelines.ObjectiveTo develop evidence-based, globally applicable recommendations for diagnosis and management of pyogenic spondylodiscitis (PSI) as a part of the International Consensus Meeting (ICM) 2025 on Spinal Infection.MethodsA multi-phase consensus process combined systematic evidence appraisal (PubMed, Scopus, Web of Science, Clinicaltrials.org) with structured expert deliberation. Seven domains were explored: diagnosis, microbiological workup, antibiotic management, response assessment, morphology-based planning, surgical techniques, and adjunctive measures.ResultsExpert consensus established that serum albumin (<3.5 g/dL) is a critical prognostic marker, while ESR and CRP remain the most reliable diagnostic tests. The assembly strongly rejected initiating empirical treatment without tissue diagnosis, even in early-stage infection. Surgical fixation is recommended for instability, deformity, or neurological deficit, with instrumentation levels tailored to bone destruction and patient-specific factors like osteoporosis. While MRI is the gold standard for initial diagnosis, its role in monitoring is limited, as radiological progression in clinically stable patients does not necessitate surgery. Advanced adjuncts, including Next-Generation Sequencing (NGS) and Vacuum-Assisted Closure (VAC), show promise in enhancing pathogen detection and wound healing, respectively.ConclusionEffective PSI management requires integrating clinical, laboratory, and morphological data. Meticulous debridement and targeted antimicrobial therapy remain the cornerstones of treatment. This consensus provides a practical guide for clinicians while highlighting the need for prospective, multicenter research to validate emerging technologies and standardize global surgical protocols.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"16 3_suppl","pages":"27S-70S"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864598","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":"Response to the Letter to the Editor Regarding \"Fusion Construct Length Is Associated with Increased Risk of Delayed Reoperation Following Cervical and Lumbar Fusion\".","authors":"Roman Rahmani, Evan R Simpson, Zachary T Mills, Hunter Hitchens, Jon I White, Casey Slattery, Vance Gardner, Jeremy Smith","doi":"10.1177/21925682261487438","DOIUrl":"10.1177/21925682261487438","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261487438"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864633","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}