Global Spine Journal最新文献

{"title":"Are Randomized Trials Better? Comparison of Baseline Covariate Balance of a Propensity Score-Balanced Lumbar Spine IDE Trial and Comparable RCTs.","authors":"Greg Maislin, Brendan T Keenan, Todd F Alamin, Louis C Fielding, Ashley Scherman, Robert Hachadoorian, Clifford Pierre, Rick C Sasso, William F Lavelle, Jens Chapman","doi":"10.1177/21925682251316287","DOIUrl":"10.1177/21925682251316287","url":null,"abstract":"<p><strong>Study design: </strong>Prospective Observational Propensity Score.</p><p><strong>Objectives: </strong>Randomization may lead to bias when the treatment is unblinded and there is a strong patient preference for treatment arms (such as in spinal device trials). This report describes the rationale and methods utilized to develop a propensity score (PS) model for an investigational device exemption (IDE) trial (NCT03115983) to evaluate decompression and stabilization with an investigational dynamic sagittal tether (DST) vs decompression and Transforaminal Lumbar Interbody Fusion (TLIF) for patients with symptomatic grade I lumbar degenerative spondylolisthesis with spinal stenosis.</p><p><strong>Methods: </strong>Twenty-five baseline covariates were selected for their expected relationship to patient outcomes or enrollment bias. Subclassification by PS quintiles was used to design a sample of investigational DST patients and TLIF controls with excellent covariate balance in which to estimate causal treatment effects. Additionally, balance in PS covariates was compared to available matching covariates from seven randomized spine IDE trials.</p><p><strong>Results: </strong>The PS subclassification design resulted in excellent balance across baseline covariates, as evidenced by small standardized mean differences and no significant between group differences after accounting for the PS design (all <i>P</i> ≥ 0.768). Differences in SMDs among covariates of randomized spine IDE trials were not significant (<i>P</i> = 0.396).</p><p><strong>Conclusion: </strong>The PS subclassification design achieved excellent covariate balance between DST investigational and TLIF control participants. This PS designed sample shows covariate balance similar to that observed in published studies in which patients were randomized to investigational or control arms.Clinical trial registered with https://www.clinicaltrials.gov (NCT03115983).</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251316287"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046266","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":"Frontline Voice: AO Spine Member Survey Regarding Spine Oncology Knowledge Generation and Translation Needs.","authors":"Matthew L Goodwin, Janneke I Loomans, Ori Barzilai, Nicolas Dea, Alessandro Gasbarrini, Aron Lazáry, Cordula Netzer, Jeremy Reynolds, Laurence Rhines, Arjun Sahgal, Jorrit-Jan Verlaan, Charles G Fisher, Ilya Laufer, On Behalf Of Ao Spine Knowledge Forum Tumor","doi":"10.1177/21925682251314497","DOIUrl":"10.1177/21925682251314497","url":null,"abstract":"<p><strong>Study design: </strong>cross-sectional survey.</p><p><strong>Objectives: </strong>To evaluate AO Spine members' practices and comfort in managing metastatic and primary spine tumors, explore the use of decision-support and patient assessment tools, and identify knowledge gaps and future needs in spine oncology.</p><p><strong>Methods: </strong>An online survey was distributed to AO Spine members to query comfort levels with key decisions in spinal oncology management, utilization of decision frameworks and spine oncology-specific instruments, and educational material preferences.</p><p><strong>Results: </strong>Responses were obtained from 381 members across 82 countries. Most respondents were orthopedic spine surgeons (62%) or neurosurgeons (36%), with 42% performing 100-200 spine surgeries per year. Extradural primary and metastatic tumors were managed by 84% and 95% of respondents, respectively, with survival and frailty assessment tools used for both. While most surgeons felt comfortable determining when emergency surgery was needed (81% for primary and 82% for metastatic tumors), nuanced decisions about surgical timing were more challenging. Surgeons also noted challenges in tailoring the oncologic surgical plan to what the patient could safely tolerate. There was a strong desire for guidelines on tumor-related spinal pain (85%), treatment timing (85%), stabilization (85%), and glucocorticoid use for symptomatic extradural metastatic tumors (77%). Interest was high for classification systems for spine tumor pain (65%) and stabilization decisions (80%).</p><p><strong>Conclusions: </strong>Additional support is needed in decision-making regarding surgical timing, patient selection, and tailoring treatment invasiveness to life expectancy and frailty. Surgeons seek further guidance to prevent neurologic deterioration and optimize recovery. Guidelines and classification systems were highly coveted for daily practice.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251314497"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046283","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":"Risk Factors Preventing Identification of the Microorganism Causing Vertebral Osteomyelitis.","authors":"Yushi Sakamoto, Eijiro Onishi, Sadaki Mitsuzawa, Satoshi Ota, Hisataka Takeuchi, Yoshihiro Tsukamoto, Shinnosuke Yamashita, Atsushi Tanaka, Ryohei Saito, Tadashi Yasuda","doi":"10.1177/21925682251317136","DOIUrl":"10.1177/21925682251317136","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>To elucidate the factors influencing the identification of causative microorganisms in vertebral osteomyelitis (VO) and the effectiveness of different culture methods in increasing the identification rate.</p><p><strong>Methods: </strong>A total of 252 patients diagnosed with and treated for VO at a single hospital were enrolled. The results of various culture methods were reviewed along with the clinical data of the patients retrospectively.</p><p><strong>Results: </strong>Microbiological diagnosis was achieved in 210 out of 252 patients (83.3%). Diagnostic percentages of blood cultures, CT-guided drainage, fluoroscopic disc biopsy, and intraoperative specimens were 73.6%, 73.9%, 27.6%, and 50.8%, respectively. <i>Staphylococcus aureus</i> was the most common pathogen (85 cases, 40.5%). Higher White Blood Cell (WBC) count, lower serum albumin (ALB) level, epidural abscess, and absence of prior antibiotic exposure were significant predictors of positive culture results across all culture methods. Prior antibiotic exposure was the most significant predictor of negative outcomes (OR 0.24). Blood culture results correlated with body temperature, C-reactive protein (CRP), ALB, and prior antibiotic exposure. A shorter duration of antibiotic administration before culture was associated with an increased likelihood of positive blood culture results.</p><p><strong>Conclusions: </strong>This study demonstrated that laboratory findings indicating a high inflammatory response (elevated WBC count, CRP level, and body temperature), lower ALB level, presence of epidural abscess, absence of prior antibiotic exposure, and shorter duration of antibiotics were significant predictors of positive culture results. Blood cultures should be conducted in the presence of high inflammation levels to improve microorganism identification rates.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251317136"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046299","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":"Correlation Between Facet Tropism and Ossification of the Posterior Longitudinal Ligament in the Cervical Spine.","authors":"Hao Zhou, Jianxi Wang, Wenyu Zhang, Chenfei Gao, Bo Hu, Genjiang Zhen, Xingyu Li, Hui Wang, Wen Yuan, Huajiang Chen, Lei Liang","doi":"10.1177/21925682251316835","DOIUrl":"10.1177/21925682251316835","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objectives: </strong>To explore the correlation between Facet Tropism (FT) and OPLL in cervical spine.</p><p><strong>Methods: </strong>One-hundred patients with OPLL of cervical spine and one-hundred normal participants without OPLL or cervical disc herniation were included in this study, the patients were matched to the normal participants respectively based on the same sex and similar age (±5). For patients, the cervical levels with and without OPLL were categorized into \"OPLL group\" and \"patient control group,\" respectively. Bilateral facet joint angles at C2/3-C6/7 were measured on sagittal, coronal, and axial planes on CT.</p><p><strong>Results: </strong>On every planes at the level of C2/3-C6/7,the mean difference between left and right facet angles and FT incidence in the most levels of the OPLL group were significantly greater than those in the control groups (<i>P</i> < 0.001). At the most cervical levels, there was no significant difference in mean difference of facet angles and FT incidence between the 2 control groups. On the axial plane, the incidence of FT in segmental type OPLL patients was significantly higher than that in continuous type OPLL patients (<i>P</i> = 0.036). On the coronal plane, the incidence of FT in segmental type OPLL was significantly higher than that in the other OPLL types (<i>P</i> < 0.001), and local type OPLL had a higher incidence of FT compared to mixed type OPLL (<i>P</i> = 0.016). On the sagittal plane, the incidence of FT in segmental type OPLL was higher than that in continuous type OPLL (<i>P</i> = 0.019) and mixed type OPLL (<i>P</i> = 0.036).</p><p><strong>Conclusions: </strong>There is a significant correlation between OPLL of cervical spine and FT. There are significant differences in the incidence of FT among different cervical OPLL types.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251316835"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046278","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 re: \"Are Variable Screw Angle Change and Screw-To-Vertebral Body Ratio Associated with Radiographic Subsidence Following Anterior Cervical Discectomy and Fusion?\"","authors":"Hongyu Chen, Yu Sun, Feifei Zhou","doi":"10.1177/21925682251316544","DOIUrl":"https://doi.org/10.1177/21925682251316544","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251316544"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046295","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":"Anterior Lumbar Interbody Fusion (ALIF) Versus Full-Endoscopic/Percutaneous TLIF With a Large-Footprint Interbody Cage: A Comparative Observational Study.","authors":"Christian Morgenstern, Francisco Nogueras, Geoffrey Delbos, Rudolf Morgenstern","doi":"10.1177/21925682251316280","DOIUrl":"10.1177/21925682251316280","url":null,"abstract":"<p><strong>Study design: </strong>Exploratory prospective observational case-control study.</p><p><strong>Objectives: </strong>Aim of this study was to compare clinical and radiologic outcome, as well as peri-operative complications, of anterior lumbar interbody fusion (ALIF) and full-endoscopic/percutaneous trans-Kambin transforaminal lumbar interbody fusion (pTLIF) with a large-footprint interbody cage.</p><p><strong>Methods: </strong>Patients that underwent elective ALIF and pTLIF with a large-footprint interbody cage were prospectively evaluated. Clinical follow-up was measured pre- and post-operatively with Visual Analogic Scale and Oswestry Disability Index scores. Radiologic outcome was assessed with a computed tomography scan and standing films at 12 months.</p><p><strong>Results: </strong>44 patients underwent ALIF and 43 pTLIF surgery (total 87 cases). Clinical pre- and post-operative scores were comparable between both groups with 33.4 months mean follow-up. Median surgical time was significantly lower for pTLIF (28 minutes) compared to ALIF (72 minutes). Radiologic outcome was favorable for ALIF with a significantly higher increase in segmental lordosis compared to pTLIF. Fusion rates did not significantly differ between both groups. ALIF showed significantly less cage subsidence than pTLIF. Complications included 9 (21%) cases with transitory post-operative radiculitis for ALIF and 12 (28%) for pTLIF; post-operative partial muscle weakness 3(6%) cases for ALIF and 4 (9%) for pTLIF. Two (4%) cases required revision surgery for pTLIF.</p><p><strong>Conclusions: </strong>ALIF and trans-Kambin pTLIF obtained comparable clinical outcome and fusion rates, while segmental lordosis restoration was favorable for ALIF. pTLIF required less surgery time and presented less intra-operative complications, while ALIF reported lower rates of post-operative subsidence, revision surgery and complications during follow-up.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251316280"},"PeriodicalIF":2.6,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046261","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":"High Modified 5 Factor Frailty Index is Associated With Worse PROMs and Decreased Return to Activities After 1 or 2 Level MI-TLIF.","authors":"Tejas Subramanian, Pratyush Shahi, Takashi Hirase, Maximilian Korsun, Joshua Zhang, Eric Kim, Cole Kwas, Austin C Kaidi, Venkat Boddapati, Junho Song, Tomoyuki Asada, Eric Mai, Chad Simon, Kasra Araghi, Troy B Amen, Avani Vaishnav, Olivia Tuma, Eric Zhao, Nishtha Singh, Myles Allen, Annika Bay, Evan Sheha, Francis C Lovecchio, James E Dowdell, Sheeraz A Qureshi, Sravisht Iyer","doi":"10.1177/21925682251314380","DOIUrl":"10.1177/21925682251314380","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>Frailty is defined as a state of minimal \"physiologic reserve.\" The modified 5 factor frailty index (mFI-5) is a recently proposed metric for assessing frailty and has been previously studied as a predictor of morbidity and mortality. However, its utility in predicting postoperative patient reported outcomes (PROMs) and return to activities remains understudied.</p><p><strong>Methods: </strong>This is a retrospective cohort study of patients undergoing 1 or 2 level minimally invasive transforaminal lumbar interbody fusion queried from a prospectively maintained multi-surgeon registry. Comorbidities including hypertension, congestive heart failure, diabetes, chronic obstructive pulmonary disease, and functional status were utilized to calculate the mFI-5. Patients were separated into 3 cohorts, \"non-frail,\" \"moderately frail\" or \"severely frail\" based on their mFI-5. Patient outcomes were compared between the cohorts.</p><p><strong>Results: </strong>392 patients were included of which 227 patients were non-frail, 134 were moderately frail, and 31 were severely frail. Frail patients had longer operative time (<i>P</i> = 0.002), greater estimated blood loss (<i>P</i> = 0.038). Despite similar preoperative PROMs, at a longer term follow up, frail patients also had worse PROM scores for ODI (<i>P</i> = 0.009), VAS-back (<i>P</i> = 0.028), and VAS-leg (<i>P</i> = 0.004). Frail patients had worse preoperative (<i>P</i> = 0.017) and postoperative (<i>P</i> < 0.001) SF-12 PCS. At 1-year, frail patients had lower rates of fusion (<i>P</i> = 0.002). Frail patients also demonstrated lower rates of returning to work (<i>P</i> = 0.018), returning to driving (<i>P</i> = 0.027), and discontinuation of narcotics (<i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>Frail patients as measured by the mFI-5 index demonstrated worse postoperative outcomes following 1 or 2 level MI-TLIF. Careful patient selection and preoperative optimization may be especially important in frail patients.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251314380"},"PeriodicalIF":2.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11765304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038048","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":"Influence of Preoperative Depression on Cervical Spine Surgery Outcomes: A Systematic Review and Meta-Analysis.","authors":"Saad Javeed, Salim Yakdan, Braeden Benedict, Samia Saleem, Muhammad Kaleem, Justin K Zhang, Madelyn R Frumkin, Angela Hardi, Brian Neuman, Michael P Kelly, Burel R Goodin, Thomas L Rodebaugh, Wilson Z Ray, Jacob K Greenberg","doi":"10.1177/21925682251316245","DOIUrl":"10.1177/21925682251316245","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and Meta-analysis.</p><p><strong>Objectives: </strong>To quantify the association of preoperative depression on patient reported outcome measures (PROMS) after cervical spine surgery.</p><p><strong>Methods: </strong>We systematically searched PubMed, Cochrane, Embase, Scopus, PsychInfo, Web of Science, and ClinicalTrials.gov until September 14, 2023. Studies including adults undergoing cervical spine surgery and comparing PROMs between depressed and non-depressed patients were included. The primary outcome was the postoperative <i>change</i> in disability, pain, and physical function. Secondary outcomes included absolute disease severity before and after surgery. We conducted random-effects meta-analysis.</p><p><strong>Results: </strong>After screening 3813 articles, 20 studies were included, encompassing 3964 patients (mean age 57, 51% males) with median follow-up duration of 12 months. There was significant heterogeneity in estimates of the primary outcome (<i>I</i>^<i>2</i> = 81%). While patients with depression had a greater magnitude of improvement compared with patients without depression, it was not statistically significant (SMD = 0.04, [95% CI: -0.07, 0.16], <i>I</i>^<i>2</i> = 80%; <i>P</i> = 0.48). However, patients with depression exhibited worse <i>absolute</i> disease severity preoperatively (SMD = -0.31, [-0.44, -0.19], <i>I</i>^<i>2</i> = 84%; <i>P</i> < 0.001) and postoperatively (SMD = -0.31, [-0.48, -0.15], <i>I</i>^<i>2</i> = 89%; <i>P</i> < 0.002). Sensitivity analyses with meta-regression found that older age, sex (male-to-female ratio), percentage of comorbidities, study quality, follow-up duration, number of adjusted factors in the analysis, and surgical approach were significant sources of heterogeneity.</p><p><strong>Conclusions: </strong>Patients with depression experienced similar improvements in disability, pain, and physical function after cervical surgery compared to patients without depression. However, patients with depression exhibited worse disease severity before and after surgery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251316245"},"PeriodicalIF":2.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033023","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":"Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Evaluation and Treatment of Pyogenic Spondylodiscitis of the Spine: AO Spine Knowledge Forum Trauma and Infection.","authors":"Sebastian F Bigdon, Emiliano Vialle, Charlotte Dandurand, Julian Scherer, Gaston Camino-Willhuber, Andrei F Joaquim, Harvinder S Chhabra, Mohammad El-Sharkawi, Richard Bransford, Charles G Fisher, Klaus J Schnake, Gregory D Schroeder","doi":"10.1177/21925682251316814","DOIUrl":"10.1177/21925682251316814","url":null,"abstract":"<p><strong>Study design: </strong>Literature Review with clinical recommendations.</p><p><strong>Objective: </strong>To highlight impactful studies on pyogenic spondylodiscitis (PS), identified by the AO Spine Knowledge Forum Trauma and Infection, with recommendations for their integration into clinical practice.</p><p><strong>Methods: </strong>Five influential studies on PS that have the potential to shape current practice in spinal infections were selected and reviewed. Each study was chosen for its contribution to a critical phase in PS management: diagnosis, imaging, surgical vs conservative treatment, and antibiotic duration. Recommendations were graded as strong or conditional following the GRADE methodology.</p><p><strong>Results: </strong>Five studies were highlighted. Article 1: Pluemer et al introduced the Spinal Infection Treatment Evaluation (SITE) Score, a novel scoring tool for standardizing treatment decision-making. Conditional recommendation to incorporate the SITE Score or SISS Score for improved treatment outcomes. Article 2: Maamari et al conducted a meta-analysis comparing imaging modalities, with conditional recommendation to consider 18F-FDG PET/CT to diagnosis PS as an adjunct to MRI which remains the gold standard. Article 3: Thavarajasingam et al demonstrated the potential survival benefit of early surgery in specific PS cases, leading to a strong recommendation for early intervention in appropriate patients. Article 4: Neuhoff et al compared conservative and surgical treatments in well-resourced settings, concluding a strong recommendation for early surgery in appropriate patients. Article 5: Bernard et al evaluated antibiotic treatment duration, with a conditional recommendation for a 6-week course in confirmed cases, based on comparable efficacy to a 12-week regimen.</p><p><strong>Conclusions: </strong>Management of PS remains complex and varied. This perspective provides spine surgeons with evidence-based recommendations to enhance standardization and effectiveness in clinical practice.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251316814"},"PeriodicalIF":2.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033078","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: \"Comparison of the Accuracy of Pedicle Screw Placement Using a Fluoroscopy-Assisted Free-Hand Technique With Robotic-Assisted Navigation Using an O-Arm or 3D C-Arm in Scoliosis Surgery\" by C. Li et al.","authors":"Ivo Kehayov","doi":"10.1177/21925682251316838","DOIUrl":"10.1177/21925682251316838","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251316838"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028601","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}