Global Spine Journal最新文献

{"title":"Comparable Outcomes Under Supervision Do Not Establish Equivalence in Anterior Cervical Discectomy and Fusion.","authors":"Takumi Kajitani, Yuma Hiratsuka, Eriko Samura","doi":"10.1177/21925682261501964","DOIUrl":"https://doi.org/10.1177/21925682261501964","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261501964"},"PeriodicalIF":3.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227591","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":"Response to the Letter to the Editor Regarding \"Does Surgeon Experience Influence Surgical Safety and Patient Satisfaction After Anterior Cervical Discectomy and Fusion? A Prospective Multicenter Comparison Study Between Non-Board-Certified and Board-Certified Spine Surgeons\".","authors":"Toshiki Okubo, Narihito Nagoshi, Junichi Yamane, Norihiro Isogai, Reo Shibata, Takahiro Kitagawa, Kentaro Ago, Takeshi Fujii, Yosuke Horiuchi, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1177/21925682261501968","DOIUrl":"https://doi.org/10.1177/21925682261501968","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261501968"},"PeriodicalIF":3.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227623","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":"Combined Anterior-Posterior vs. Posterior-Only Fusion in Adult Spinal Deformity Radiographic, Clinical, and Mechanical Outcomes With Longitudinal Mixed-Effects Analysis.","authors":"Nuri Demirci, Mohamed A Zaazoue, Caglar Yilgor, Yasemin Yavuz, Tugba Akkaya Hocagil, R Adams Cowley, Nicholas Pallotta, Munish C Gupta","doi":"10.1177/21925682261499343","DOIUrl":"https://doi.org/10.1177/21925682261499343","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesTo compare radiographic, clinical, and mechanical outcomes of posterior-only versus combined anterior-posterior fusion in adult spinal deformity (ASD) patients undergoing long-segment thoracolumbar fusion with pelvic fixation.MethodsConsecutive ASD patients undergoing instrumented fusion ≥7 levels with pelvic fixation at a single center (2016-2023) were stratified by surgical approach. Longitudinal radiographic changes were analyzed using linear mixed-effects models with difference-in-differences (DiD) estimation. Mechanical complications were evaluated with Kaplan-Meier survival and Cox proportional hazards analysis.Results207 patients were included (posterior-only, n=115; combined, n=92). Mean age was 62.1 ± 11.1 years (77.8% female), with mean follow-up of 46.2 ± 21.2 months. The combined approach demonstrated significantly greater DiD estimates for lumbar lordosis (-7.8° to -9.2°, all p<0.001), relative pelvic version mismatch (+3.4° to +4.2°, all p<0.001), and GAP score (-1.8 to -2.1, all p<0.001) at all postoperative timepoints. DiD estimates were stable across three covariate specifications. Rod fractures occurred in 14.8% of posterior-only versus 3.3% of combined patients (p=0.008), with superior rod fracture-free survival in the combined cohort (log-rank p=0.019). In the primary Cox model, the combined approach showed a non-significant trend toward lower rod fracture hazard (HR 0.35, 95% CI 0.10-1.24, p=0.10). Patient-reported outcomes improved comparably in both groups.ConclusionsIn long-segment ASD fusion with pelvic fixation, the combined anterior-posterior approach was associated with greater sustained sagittal correction and lower rod fracture rates, while both approaches provided comparable clinical improvement.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261499343"},"PeriodicalIF":3.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227599","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":"Heart Failure With Reduced Ejection Fraction Is Associated With Greater Cardiovascular Risk Following Lumbar Interbody Fusion.","authors":"Shankar S Thiru, Haseeb E Goheer, Calvin J Harris, Abdulrahman Nazif, Mina Botros, Jonathan J Carmouche","doi":"10.1177/21925682261501004","DOIUrl":"https://doi.org/10.1177/21925682261501004","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectiveTo compare perioperative cardiovascular outcomes between patients with heart failure with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF) following transforaminal or posterior lumbar interbody fusion (TLIF/PLIF).MethodsThe TriNetX Research Network was used to identify patients undergoing elective TLIF or PLIF between 2011 and 2025. Cohorts were defined by heart failure phenotype and propensity score-matched (PSM) 1:1 for baseline demographics and comorbidities. Outcomes included postoperative atrial fibrillation or flutter (AF/AFL), myocardial infarction (MI), and secondary complications within 90 days. Odds ratios with 95% confidence intervals were calculated. Significance was defined as p < 0.05.ResultsOf 46,431 patients, 1,253 (2.7%) had HFrEF, 1,920 (4.1%) had HFpEF, and 43,258 (93.2%) had no heart failure. After PSM, both phenotypes carried elevated risk relative to non-HF controls across measured complications, including acute respiratory failure, pneumonia, AF/AFL, acute kidney injury, venous thromboembolism, and 90-day emergency department visits (all p<0.05). In the direct phenotype comparison (1,217 matched pairs), acute MI occurred more frequently in HFrEF than HFpEF patients (14.4% vs. 8.7%, p<0.001). HFrEF was associated with greater odds of acute MI (OR 1.760 [95% CI: 1.363, 2.273], p<0.001) and AF/AFL (OR 1.278 [95% CI: 1.079, 1.513], p=0.005) compared with HFpEF.ConclusionAmong patients with heart failure undergoing TLIF or PLIF, those with HFrEF are at increased risk of postoperative AF/AFL and MI compared with HFpEF patients. These findings highlight the importance of distinguishing heart failure phenotype during preoperative risk stratification and may support enhanced perioperative precautions.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261501004"},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224028","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":"Vertebral Rotation Discrepancy for Distal Add-on when Selecting the Touched Vertebra as the Lowest Instrumented Vertebra in Thoracic Curves of Adolescent Idiopathic Scoliosis.","authors":"Hong Jin Kim, Subin Lim, Hyung Rae Lee, Jae Hyuk Yang, Seung Woo Suh","doi":"10.1177/21925682261498680","DOIUrl":"https://doi.org/10.1177/21925682261498680","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesTo assess the influencing factors of the distal add-on when selecting the touched vertebra (TV) as the lowest instrumented vertebra (LIV) in thoracic idiopathic scoliosis (IS).MethodsA total of 96 thoracic IS patients who underwent deformity correction with LIV = TV were retrospectively analyzed to evaluate the distal add-on. Patients were divided into the DA group and the non-DA group. Radiological variables included coronal (Cobb's angle, coronal balance, sacral slanting angle, and L4 vertebral tilt), sagittal (sagittal vertical axis, thoracic kyphosis, and lumbar lordosis), and axial parameters (vertebral rotation angle).ResultsWhen selecting the TV as the LIV, the occurrence rate of distal add-on was 20.8% (20 of 96) at a mean follow-up of 3 years. The mean number of remnant motion segments was significantly higher in the DA group (4.7) compared to the non-DA group (3.8) (<i>P</i> < 0.001). The difference in the vertebral rotation angle between the lumbar apex and the TV level was significantly higher in the DA group (6.6°) than in the non-DA group (1.3°) (<i>P</i> < 0.001). Multivariate logistic regression analysis demonstrated that the distal add-on was significantly associated with remnant motion segments (OR = 3.69, 95% CI: 1.03-13.18) and the vertebral rotation discrepancy (OR = 4.09, 95% CI: 1.98-8.43).ConclusionsGreater vertebral rotation discrepancy between the LIV and lumbar apex was consistently associated with distal add-on when the TV was selected as the LIV, suggesting that three-dimensional rotational mismatch may contribute to residual distal add-on risk.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261498680"},"PeriodicalIF":3.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224000","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 Facet Joint Morphology and Degenerative Lumbar Spondylolisthesis: A Systematic Review and Meta-Analysis.","authors":"Alberto Suarez, Justin Gumbs, Michelle Schmidt, Zeena Shather, Hanna Neustadter, Dominic Lafalce, Marissa Middleton, Jaden Wise, Isabella Merem, Maohua Lin, Frank D Vrionis","doi":"10.1177/21925682261499356","DOIUrl":"10.1177/21925682261499356","url":null,"abstract":"<p><p>Study DesignSystematic review and meta-analysis.ObjectivesTo evaluate the associations between lumbar facet orientation, facet tropism, and degenerative lumbar spondylolisthesis (DLS), while assessing sex-specific differences in facet morphology.MethodsA PRISMA-compliant systematic review and meta-analysis was prospectively registered in PROSPERO (CRD420261417450). PubMed/MEDLINE, Embase, Scopus, Cochrane CENTRAL, and Web of Science were searched through June 2026. Studies evaluating lumbar facet morphology in adults with DLS were included. Random-effects meta-analyses using restricted maximum likelihood estimation and Hartung-Knapp adjustment were performed. Risk of bias and evidence certainty were assessed.ResultsThirty-nine studies met the inclusion criteria. Sixteen studies (3,321 participants) were included in the facet orientation meta-analysis. Patients with DLS demonstrated more sagittally oriented facet joints than controls (SMD 1.30, 95% CI 0.78-1.82; p < 0.0001; I² = 97.2%). Nine studies (1,913 participants) showed greater continuous facet tropism in DLS patients (MD 2.72°, 95% CI 2.07°-3.38°; p < 0.0001; I² = 47.2%). Binary facet tropism was not statistically significant (OR 2.20, 95% CI 0.85-5.66; p = 0.0817). Sex-specific, severity, and instability data were insufficient for quantitative synthesis.ConclusionDLS is associated with more sagittally oriented facet joints and greater continuous facet tropism than controls. Limited sex-specific data and heterogeneity highlight the need for standardized measurement techniques and prospective longitudinal studies to clarify causality and sex-related effects.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261499356"},"PeriodicalIF":3.1,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216211","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 Incidental Durotomy on Health Care Resource Utilization Following Posterior Cervical Decompression and Fusion.","authors":"Mitchell K Ng, Leonidas E Mastrokostas, Paul G Mastrokostas, Eli Berglas, Matthew W Xie, Masataka Mizuno, Imran Kyeso, Avi Gupta, Jesse M Galina, Arie Monas, Jorden Xavier, Sarah Brauer, Pemla Jagtiani, Jad Bou Monsef, Afshin E Razi, Daniel R Fassett, Andrew P Alvarez, Nicholas U Ahn, Mark F Kurd, Ian David Kaye, Barrett Woods, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler, Thomas D Cha","doi":"10.1177/21925682261497673","DOIUrl":"10.1177/21925682261497673","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesTo evaluate the national incidence and hospitalization impact of incidental durotomy following elective posterior cervical decompression and fusion (PCDF), with respect to complications, length of stay (LOS), costs, and discharge disposition.MethodsAdults undergoing elective PCDF were identified in the 2016-2022 National Inpatient Sample. Propensity score matching paired durotomy cases with controls at a 1:5 ratio using demographic, comorbidity, hospital, and procedural characteristics. Survey-weighted comparisons and multivariable regression evaluated complications, length of stay (LOS), hospitalization costs, and discharge disposition. Statistical significance was set at <i>P</i> < 0.05.ResultsThe weighted cohort comprised 167,995 encounters, including 2,525 (1.5%) with incidental durotomy. After matching, weighted counts were 12,625 controls and 2,525 durotomy encounters. The durotomy cohort had more complications (41.2% vs 26.5%), longer LOS (7.82 vs 4.34 days), higher hospitalization costs ($65,292 vs $41,196), and more non-routine discharge (59.0% vs 47.7%). Adjusted analyses demonstrated higher odds of complications (OR, 2.03) and non-routine discharge (OR, 1.66), as well as longer LOS (adjusted mean ratio, 1.80) and higher costs (adjusted mean ratio, 1.59; all <i>P</i><0.001).ConclusionsIncidental durotomy was coded in 1.5% of elective PCDF admissions and was associated with greater inpatient morbidity and resource utilization after matching and adjustment. These findings may inform patient counseling, perioperative planning, and anticipation of discharge support needs. Potential coding inaccuracies and residual confounding inherent to administrative data limit causal interpretation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261497673"},"PeriodicalIF":3.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192803","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":"Impact of Preoperative Chronic Opioid Use on Postoperative Outcomes Following Lumbar Fusion: A Nationwide Analysis.","authors":"Atef F Hulliel, Dana Saleh, Ahmad Zayd Alkadri, David J Boughanem, Rafal Chociej, Freddie Rodriguez Beato, Srujan Kopparapu, Patrick Kim, Mohsen Rostami, Puya Alikhani","doi":"10.1177/21925682261492224","DOIUrl":"10.1177/21925682261492224","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesChronic opioid use is common among patients undergoing lumbar fusion, and preoperative use has been linked to worse postoperative outcomes. However, much of this evidence derives from administrative datasets with limited ability to adjust for mental health. We examined associations between chronic preoperative opioid use and a panel of postoperative outcomes, utilizing linked survey data to enhance control of confounding.MethodsRetrospective cohort study within a diverse national research program. Adults undergoing lumbar fusion were classified as chronic opioid users (≥3 opioid prescriptions spanning ≥90 days in the preoperative year) or non-chronic users. Outcomes were persistent postoperative opioid use (prescriptions 90-180 days after surgery), reoperation, readmission, major medical complications, wound complications, pseudarthrosis, and death.ResultsAmong 3424 patients, chronic use was strongly associated with persistent postoperative opioid use ([aOR] 5.40; 95% CI, 4.52-6.46). In contrast, crude associations with surgical outcomes were substantially attenuated after adjustment and were not statistically significant, although confidence intervals for several outcomes did not exclude clinically meaningful effects: reoperation (aOR 0.95; 95% CI, 0.76-1.19), readmission (1.10; 0.92-1.33), major complications (1.03; 0.78-1.34), wound complications (1.36; 0.97-1.88), pseudarthrosis (1.33; 0.86-2.01), and all-cause mortality (1.17; 0.74-1.82).ConclusionChronic preoperative opioid use predicted persistent postoperative use but showed no statistically significant independent association with adverse surgical outcomes after adjustment, though the surgical models were underpowered and though confidence intervals did not exclude clinically meaningful effects for pseudarthrosis and wound complications. The attenuation of crude associations suggests that surgical risks attributed to chronic opioid use may in part reflect confounding by mental health and comorbidity rather than a direct effect.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492224"},"PeriodicalIF":3.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192805","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":"Re: GSJ-26-1985 - Interlaminar Contralateral Endoscopic Foraminotomy Reduces Postoperative Dysesthesia in Patients With Degenerative Lumbar Deformity: A Multicenter Comparative Cohort Study.","authors":"Facundo Van Isseldyk","doi":"10.1177/21925682261499690","DOIUrl":"10.1177/21925682261499690","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261499690"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192789","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":"Blood Transfusion Rates and Predictive Factors in Posterior-Based Minimally Invasive Scoliosis Surgery for Idiopathic Scoliosis: A LASSO-Based Prediction Model.","authors":"Hong Jin Kim, Dong Yun Kim, Subin Lim, Hyung-Rae Lee, Jae Hyuk Yang, Seung Woo Suh","doi":"10.1177/21925682261497372","DOIUrl":"10.1177/21925682261497372","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesTo investigate blood transfusion rates in posterior-based minimally invasive scoliosis surgery (MISS) for idiopathic scoliosis (IS) and to develop a prediction model for perioperative blood transfusion.MethodsWe retrospectively reviewed data of 751 patients with IS who underwent posterior-based MISS between 2015 and 2026. The Least Absolute Shrinkage and Selection Operator (LASSO) regression model was applied to identify predictors of transfusion among demographics, perioperative metrics, radiographic measurements, and transfusion-related profiles. The model was constructed by development cohort March 2015 and February 2024 (development cohort, n = 595) and validated using the temporal data between March 2024 and February 2026 (validation cohort, n = 156).ResultsIn the total cohort, 518 patients (69.0%) required a blood transfusion. Among them, 76 patients received only postoperative transfusions, with the majority administered within 3 days postoperatively. Post-LASSO multivariate regression analysis demonstrated that greater estimated blood loss, lower preoperative hemoglobin (Hb) levels, absence of tranexamic acid use, longer fusion levels, and a larger major preoperative Cobb angle were independently associated with perioperative transfusion. The perioperative model demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.89 in the development cohort and 0.94 in the validation cohort.ConclusionsPostoperative transfusion was uncommon, and transfusion-free surgery may be feasible in selected lower-risk patients undergoing posterior-based MISS for IS. Based on our prediction model, strategies for blood transfusion-free surgery should be individualized, considering patient-specific profiles such as preoperative Hb levels, fusion level, and Cobb angle.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261497372"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192779","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}