Global Spine Journal最新文献

{"title":"Adjacent Segment Motion of Stand-Alone ALIF Versus TLIF in the Degenerative Spine: A Biomechanical Study.","authors":"Alina Jacob, Daniel Haschtmann, Tamás F Fekete, Ivan Zderic, Jan Caspar, Peter Varga, Maximilian Heumann, Christian Rainer Wirtz, Nicolas Ion, R Geoff Richards, Boyko Gueorguiev, Markus Loibl","doi":"10.1177/21925682251341823","DOIUrl":"https://doi.org/10.1177/21925682251341823","url":null,"abstract":"<p><p>Study DesignBiomechanical human cadaveric study.ObjectivesTransforaminal lumbar interbody fusion (TLIF) is a well-established procedure for treating degenerative lumbar spine pathologies. However, posterior fixation has been reported to accelerate adjacent segment degeneration (ASD). Posterior fixation can be omitted in screw-anchored stand-alone anterior lumbar interbody fusion (ALIF). The present study aimed to compare the cranial adjacent segment motion of ALIF vs TLIF in specimens with reduced bone mineral density (BMD).MethodsSixteen fresh-frozen lumbosacral spines with reduced BMD (donors' age 71 ± 13years, BMD 95.7 ± 34.5 mg HA/cm³) were used. Range of motion (ROM) and Neutral Zone (NZ) of the cranial adjacent segment were analyzed in flexion-extension, lateral bending, and axial rotation in native state and after TLIF or stand-alone screwed ALIF instrumentation.ResultsNo significant differences between TLIF and stand-alone screwed ALIF were observed for both absolute ROM and NZ of the cranial adjacent segment in instrumented state across all tested motion directions (<i>P</i>  ≥ .267). Decreased relative ROM of the fused segment - normalized to the corresponding segmental ROM in native state - resulted in compensatory increased relative ROM of the cranial adjacent segment after instrumentation. However, the relative adjacent segment ROM did not differ significantly between TLIF and stand-alone screwed ALIF (<i>P</i> ≥ .172).ConclusionsThis study found no clinically significant difference in adjacent segment motion when comparing TLIF with stand-alone screwed ALIF. Hence, both techniques appear to have a negligible impact on adjacent segment motion in poor bone quality. This suggests that neither TLIF nor stand-alone screwed ALIF increase the risk of ASD due to compensatory motion resulting from an operated adjacent segment.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251341823"},"PeriodicalIF":2.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975534","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":"Analysis of the Predictive Efficiency of Lumbar Vertebral Body Quantification (VBQ) and CT Hounsfield Units (HUs) for Bone Density: Age and Gender Differences.","authors":"Xianghe Wang, Minghang Chen, Chenjie Shan, Xiang Fang, Chaohui Ding, Zongjie Yuan, Honglin Teng","doi":"10.1177/21925682251334985","DOIUrl":"https://doi.org/10.1177/21925682251334985","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectiveThis study examines the consistency of Vertebral Bone Quality (VBQ) and Computed Tomography Hounsfield Units (CT HUs) with Dual-energy X-ray absorptiometry (DXA) as a reference standard, evaluating the diagnostic performance of these 2 imaging techniques across different age groups and genders. Particular attention is given to the applicability of VBQ in different age and gender cohorts.MethodsWe included 972 eligible patients, from which 569 patients were randomly selected and included in the analysis according to the inclusion criteria. These patients underwent lumbar Magnetic Resonance Imaging (MRI), lumbar CT, and DXA within 3 months of hospital admission. The study assessed the correlation and diagnostic efficacy of these techniques in measuring lumbar and femoral neck bone mineral density (BMD).ResultsIt showed good correlation between VBQ and CT HUs with DXA in individuals under 70 years of age. However, in the population over 70 years, the correlation of VBQ with DXA significantly decreased (lumbar BMD pr = -.145 <i>P</i> > .05; femoral neck BMD r = -.097 <i>P</i> > .05), whereas CT HUs maintained high diagnostic performance. The ROC curve analysis indicated that the AUC for differentiating osteoporosis (based on lumbar spine BMD) by VBQ was .545 in males over 70 and .487 in females over 70. However, CT HUs demonstrated diagnostic performance across all groups.ConclusionVBQ is effective in assessing osteoporosis in patients under 70 but shows decreased efficacy in those over 70. When using VBQ to predict osteoporosis in patients on opportunistic grounds, it is still necessary to incorporate additional reference indicators, such as CT HUs.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251334985"},"PeriodicalIF":2.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963798","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":"Role of Neck Pain in Defining Clinical Trajectories of Outcomes in Patients With Degenerative Cervical Myelopathy: Results of a Novel Machine Learning Algorithm.","authors":"Raymond Wong, Mohammed Ali Alvi, Ayesha I Quddusi, Michael G Fehlings","doi":"10.1177/21925682251341263","DOIUrl":"https://doi.org/10.1177/21925682251341263","url":null,"abstract":"<p><p>Study DesignRetrospective analysis of prospective data.ObjectivesNeck pain represents a crucial factor underscoring a patient's decision to receive surgical intervention for degenerative cervical myelopathy (DCM). However, postoperative pain trajectories are poorly defined. This study aimed to employ machine learning-based trajectory modeling to identify patient subpopulations with distinct pain trajectories after surgery.MethodsWe pooled subjects from three major clinical studies on DCM. Group-based multivariate trajectory (GBMT) modeling was used to classify patients into distinct trajectories based on their neck pain score over one year. Outcome differences were examined with univariate analyses. Predictors of group membership were revealed with multinomial logistic regression.ResultsThree distinct trajectories of neck pain were identified from a total of 968 patients with DCM: \"slow pain improvement\" (n = 239; 25%), \"no pain improvement\" (n = 537; 55%), and \"fast pain improvement\" (n = 192; 20%) groups. Each trajectory exhibited a unique baseline pain profile. The \"fast pain improvement\" group, comprised of patients experiencing profound neck pain, had the best overall outcomes for pain, NDI, SF-36 PCS, and SF-36 MSC postoperatively. On the other hand, the \"no pain improvement\" group, consisting of patients with pain and multimodal impairment of moderate severity, had residual pain that remained constant and was least likely to experience functional outcome and quality of life improvement after one year.ConclusionsUnsupervised learning on neck pain identified unique pain recovery trajectories that consist of distinct patient phenotypes. Trajectory grouping offers an important framework to both identify novel DCM subpopulations and predict patterns of pain over time.Clinical Trials Included(1) Assessment of Surgical Techniques for Treating Cervical Spondylotic Myelopathy (CSM); https://clinicaltrials.gov/study/NCT00285337; ClinicalTrials.gov ID NCT00285337. (2) Surgical Treatment of Cervical Spondylotic Myelopathy; https://clinicaltrials.gov/study/NCT00565734; ClinicalTrals.gov ID NCT00565734. (3) Efficacy of Riluzole in Surgical Treatment for Cervical Spondylotic Myelopathy (CSM-Protect) (CSM-Protect); https://clinicaltrials.gov/study/NCT01257828; ClinicalTrials.gov ID NCT01257828.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251341263"},"PeriodicalIF":2.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983789","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":"Utilization of the Fragility Index to Assess Randomized Controlled Trials Comparing Cervical Total Disc Arthroplasty to Anterior Cervical Discectomy and Fusion.","authors":"Sarah L Lucas, Austin H Carroll, Zachary K Backstrom, Kory B Dylan Pasko, Addisu Mesfin","doi":"10.1177/21925682251341812","DOIUrl":"https://doi.org/10.1177/21925682251341812","url":null,"abstract":"<p><p>Study designSystematic Review.ObjectivesCervical total disc arthroplasty (CTDA) remains an alternative to anterior cervical discectomy and fusion (ACDF) in select patients with cervical radiculopathy or myelopathy secondary to degenerative disc disease. Studies comparing CTDA to ACDF often have conflicting conclusions and varying quality. The purpose of this study was to utilize the fragility index (FI) to assess the robustness of randomized controlled trials (RCT) comparing CTDA to ACDF.MethodsA systematic review was performed by searching PubMed, Ovid MEDLINE, Web of Science, and Embase for RCTs with 2 parallel study arms and 1:1 allocation of subjects investigating CTDA vs ACDF with at least 1 statistically significant, dichotomous outcome. The FI was calculated by individually shifting 1 patient from the event group to the non-event group with re-calculation of Fisher's Exact test until the reported <i>P</i> value was no longer statistically significant (<i>P</i> > 0.05).ResultsThe search identified 934 abstracts with 19 RCTs meeting inclusion criteria. The mean patient sample size was 276.4 (median 209, range 30-541). The number of patients lost to follow-up ranged from 0-229 (mean 69.7, median 45). The mean FI was 4.6 (range 0-30, median 2) with 3 (13.6%) of the studies having an associated FI of 0. Loss to follow up exceeded the fragility index in all but 2 studies.ConclusionRCTs comparing ACDF to CTDA are often fragile with only 1-2 patients experiencing an alternative outcome or lost to follow-up to change the studied outcome.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251341812"},"PeriodicalIF":2.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997021","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":"T2-Weighted MRI-Based Vertebral Bone Quality Score is an Independent Risk Factor of Osteoporotic Vertebral Compression Fracture: An Age- and Sex-Matched Study.","authors":"Xianming Huang, Chenhui Cai, Song Huang, Chao Tang, Xu Zhao, Xuan Wen, Ying Zhang, Tongwei Chu","doi":"10.1177/21925682251339995","DOIUrl":"https://doi.org/10.1177/21925682251339995","url":null,"abstract":"<p><p>Study DesignA case-controlled retrospective study.ObjectiveWe aimed to explore the effectiveness of MRI-based VBQ scores derived by different MRI sequences in assessing risk of an osteoporotic vertebral compression fracture (OVCF) in age- and sex-controlled patients.MethodsThis retrospective study included patients hospitalized for OVCF (fracture group) and degenerative lumbar disease (non-fracture group) from July 2022 to July 2024. Patients in both groups were matched for sex and age in a 1:1 ratio. VBQ scores were acquired from non-contrast lumbosacral MRI T1-weighted, T2-weighted, and short tau inversion recovery (STIR)-weighted sequences. A receiver operating characteristic (ROC) curve and area under the ROC (AUC) were plotted to evaluate the diagnostic accuracy.ResultsA total of 168 patients (n = 84 in each group) were included. VBQ-T1 scores were higher in the fracture group (4.4 vs 4.1, <i>P</i> = 0.001), with an AUC of 0.641 to predict OVCF. VBQ-T2 scores were higher in the fracture group (0.60 vs 0.55, <i>P</i> < 0.001), with an AUC of 0.697. Additionally, VBQ-T2-STIR scores were higher in the fracture group (0.99 vs 0.83, <i>P</i> = 0.004), with an AUC of 0.644. Multivariate logistic regression analysis identified VBQ-T2, rather than VBQ-T1 or VBQ-T2-STIR, as an independent risk factor for OVFC.ConclusionThis study evaluated the MRI-based VBQ scores in assessing risk of OVCF based on age- and sex-matched cases. The VBQ-T2 score appears most promising for evaluating the risk of OVCF in clinical practice.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251339995"},"PeriodicalIF":2.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008172","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 Postoperative Dysphagia on Health Care Resource Utilization Following Single-Level Cervical Disc Arthroplasty.","authors":"Paul G Mastrokostas, Leonidas E Mastrokostas, Ahmed K Emara, Jonathan Dalton, Christopher K Kepler, Ahmed Saleh, Jad Bou Monsef, Afshin E Razi, Mitchell K Ng","doi":"10.1177/21925682251334060","DOIUrl":"https://doi.org/10.1177/21925682251334060","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesThis study seeks to highlight differences in 1) postoperative complications, 2) recovery course, and 3) associated costs between patients with and without postoperative dysphagia who underwent single-level CDA.MethodsThe National Inpatient Sample (NIS) was queried to identify patients who underwent single-level CDA between 2016 and 2020. Patients were divided into dysphagia and control groups based on the presence or absence of postoperative dysphagia. Propensity score-matching (1:5) was performed, accounting for age, sex, race, and comorbidities. Primary outcomes included length of stay (LOS), hospital costs, and discharge disposition. Chi-square and t-tests were used for statistical comparisons. Significance was set at the <i>P <</i> .05 level.ResultsThe final analysis included 640 patients in the dysphagia group and 3,200 controls after matching. Patients in the dysphagia group experienced a significantly higher rate of perioperative complications (7.8% vs 2.8%; <i>P</i> = .006). The mean LOS was longer for the dysphagia group (2.9 ± .3 days vs 1.5 ± .1 days; <i>P</i> < .001), and hospitalization costs were significantly higher ($27,100 vs $21,700; <i>P</i> < .001). Additionally, dysphagia patients were more likely to have a non-routine discharge (15.6% vs 9.2%; <i>P</i> = .030).ConclusionsPostoperative dysphagia following CDA significantly escalates healthcare resource utilization, leading to prolonged hospital stays, increased costs, and a greater risk of non-routine discharge. This underscores the need for targeted interventions to reduce the incidence of dysphagia and improve recovery outcomes, ultimately enhancing patient care and reducing the financial burden on healthcare systems.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251334060"},"PeriodicalIF":2.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992653","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":"Is Intraoperative Neuromonitoring with SSEPs and EMG Predictable for Postoperative Neurologic Deficit in Posterior Lumbar Fusion Surgery? A Retrospective Cohort Analysis.","authors":"Marco D Burkhard, Gisberto Evangelisti, Franziska C S Altorfer, Philip K Paschal, Chukwuebuka C Achebe, George Gorgy, Michael J Kelly, William D Zelenty, Federico P Girardi, Darren R Lebl, Alexander P Hughes, Frank P Cammisa, Andrew A Sama, Ronald G Emerson, Gbolabo Sokunbi","doi":"10.1177/21925682251341820","DOIUrl":"https://doi.org/10.1177/21925682251341820","url":null,"abstract":"<p><p>Study DesignRetrospective, single-center cohort study.ObjectiveTo evaluate intraoperative neuromonitoring (IONM) with free-run electromyography (EMG) and somatosensory evoked potentials (SSEPs) during primary posterior lumbar interbody fusion (PLIF) for degenerative conditions and associations with postoperative motor deficits (PMD).MethodsPatients undergoing PLIF from 2015 to 2020 were reviewed. Revision fusions, deformity corrections, and procedures in proximity to the conus were excluded. Patient characteristics, comorbidities, surgical details and intraoperative EMG and SSEP recordings were reevaluated. PMDs were defined as any decline of ≥1/5 strength grade compared to preoperative. Test accuracy and predictive value of SSEP and EMG events for PMD were calculated.Results401 patients (48.9% females, mean age 61 years, mean BMI 28.6) were included. One- and two-level fusions accounted for 67.8% and 27.7% of cases, respectively, most commonly involving L4/5 (67.8%) and L5/S1 (51.4%). EMG events occurred in 29.4% (n = 118) and SSEP events in 4.5% (n = 18). SSEP events were significantly associated with PMD (<i>P</i> = 0.043), whereas EMG events were not (<i>P</i> = 0.463). In multivariable regression, SSEP events predicted PMD with odds ratios of 3.85 for any SSEP event and OR 10.41 for persistent SSEP signal loss (both <i>P</i> = 0.002). Test performance of SSEP was limited (sensitivity: 13.6%; positive predictive value 16.7%).ConclusionIn posterior lumbar interbody fusion, SSEP events are associated with postoperative motor deficits, whereas EMG events are not. However, the overall test accuracy of IONM in predicting neurologic deficits remains limited. Instead of routine utilization, IONM should be tailored to the individual case.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251341820"},"PeriodicalIF":2.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003578","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":"Vancomycin Antibiotic Prophylaxis Compared to Cefazolin Increases Risk of Surgical Site Infection Following Spine Surgery.","authors":"Brandon J Herrington, Jennifer C Urquhart, Parham Rasoulinejad, Fawaz Siddiqi, Kevin Gurr, Christopher S Bailey","doi":"10.1177/21925682251341833","DOIUrl":"https://doi.org/10.1177/21925682251341833","url":null,"abstract":"<p><p>Study DesignRetrospective analysis of randomized controlled trial.ObjectivesSurgical site infection (SSI) after spine surgery has severe negative health and financial consequences. Surgical antibiotic prophylaxis (SAP) is a routinely used method to prevent SSIs in the spine patient population. The most commonly used antibiotic is cefazolin, with vancomycin often being substituted in the case of penicillin or cephalosporin allergy. Vancomycin as SAP has been associated with increased SSI in the joint replacement literature, but this is not yet well defined in the spinal surgery population. The purpose of this study was to determine whether vancomycin SAP compared to cefazolin SAP is associated with increased risk of SSI.Methods535 patients, aged 16 years or older, underwent elective multi-level open posterior spinal fusion surgery at the thoracic, thoracolumbar, or lumbar levels. Demographic and operative characteristics as well as post-operative outcomes were compared between the following groups: (1) noninfected-cefazolin, (2) noninfected-vancomycin, (3) infected-cefazolin, and (4) infected-vancomycin. Primary outcomes were superficial and complicated (deep and organ/space) infections.ResultsThe following risk factors for SSI were identified in a logistic regression analysis: vancomycin (OR 2.498, 95% CI, 1.085-5.73, <i>P</i> = 0.031), increasing operating time (OR 1.006, 95% CI, 1.001-1.010 <i>P</i> = 0.010), weight (OR 1.020, 95% CI 1.006-1.034, <i>P</i> = 0.005), revision procedure (OR 2.343, 95% CI 1.283-4.277, <i>P</i> = 0.006), and depression (OR 2.366, 95% CI 1.284-4.360, <i>P</i> = 0.006).ConclusionsIn open posterior approach spinal fusion surgery, vancomycin SAP is associated with increased risk of infection compared to cefazolin SAP.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251341833"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011589","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":"Comparison of Clinical Outcomes Between Anterior Cervical Discectomy and Fusion and Cervical Disc Replacement for Predominant Neck Pain.","authors":"Tomoyuki Asada, Tejas Subramanian, Kasra Araghi, Zora Hahn, Takashi Hirase, Annika Bay, Olivia Tuma, Eric R Zhao, Adin M Ehrlich, Sereen Halayqeh, Harvinder S Sandhu, Todd J Albert, Han Jo Kim, James C Farmer, Russel C Huang, Matthew Cunningham, Francis C Lovecchio, James E Dowdell, Sravisht Iyer, Sheeraz A Qureshi","doi":"10.1177/21925682251338799","DOIUrl":"https://doi.org/10.1177/21925682251338799","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesSevere neck pain has traditionally been considered a relative contraindication for cervical disc replacement (CDR) due to risk of persistent neck pain from the remaining mobile segment. However, recent studies suggest potential for neck pain improvement with CDR. This study aimed to compare postoperative improvements in neck pain and disability between patients undergoing anterior cervical discectomy and fusion (ACDF) and CDR.MethodsPredominant neck pain was defined as neck pain equal to or greater than arm pain preoperatively (visual analog scale [VAS]) and neck disability index (NDI) > 20. Patients with predominant neck pain who underwent 1- or 2-level ACDF or CDR for radiculopathy between 2017 and 2023 were included. Patient-reported outcomes (NDI, VAS) were assessed up to 1 year postoperatively. Inverse probability of treatment weighting (IPTW) was used to control for confounders. Linear mixed-effect models were applied to compare postoperative outcomes.ResultsA total of 179 patients (105 ACDF, 74 CDR) were included. Both groups showed significant improvement in NDI and VAS neck scores from baseline to 1 year (NDI: β = -1.81, <i>P</i> < .001; VAS neck: β = -.26, <i>P</i> < .001). After IPTW, no significant differences were found between ACDF and CDR across all PROMs up to 1 year (NDI: β = -0.44, <i>P</i> = .09; VAS neck: β = -.07, <i>P</i> = .10).ConclusionCDR was associated with postoperative improvements in neck pain and disability comparable to those observed with ACDF in patients with predominant neck pain and radiculopathy. These findings suggest that CDR may be a reasonable treatment option for selected patients.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251338799"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003507","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":"A Study on the Volume Changes of the Posterior Cervical Paravertebral Muscles After Unilateral Exposure Channel-Assisted Laminoplasty.","authors":"Huajian Zhong, Chen Xu, Haoyi Wang, Ruizhe Wang, Leixin Wei, Huiqiao Wu, Xinwei Wang, Yang Liu, Huajiang Chen, Wen Yuan, Xiaolong Shen","doi":"10.1177/21925682251340617","DOIUrl":"https://doi.org/10.1177/21925682251340617","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectiveThe aim of this study was to evaluate the efficacy of our proposed surgical procedure named unilateral exposure channel-assisted (UCA) laminoplasty in treating degenerative cervical myelopathy (DCM), and the postoperative volume changes of cervical paraspinal muscles.MethodsFrom January 2020 to January 2022, 104 patients with DCM underwent unilateral open-door laminoplasty, among which, 63 patients underwent UCA laminoplasty (UCA group) and 41 patients underwent traditional laminoplasty (LP group). The radiological and clinical parameters as well as postoperative complications were recorded and analyzed before operation and during the follow-up.ResultsThe operation was completed successfully for all patients from both groups, who showed significant but comparable improvement in clinical outcome indicators including mJOA score, Neck pain VAS score, NDI score and radiological indicators including spinal canal diameter and area at the final follow-up compared to pre-operation. When conducting the intra-group comparison, less intraoperative time consumption and blood loss, less postoperative drainage and lower incidence of axial symptoms were observed in patients from UCA group than LP group. Furthermore, we found better preservation of C2-7 cobb angle, cervical curvature index (CCI) and cervical paraspinal muscle on the hinge side in patients underwent UCA laminoplasty than traditional laminoplasty.ConclusionThe UCA laminoplasty showed similar efficacy on alleviating clinical symptoms, and priority on maintaining cervical sagittal balance, minimizing intraoperative invasion, speeding up postoperative rehabilitation, reducing paraspinal muscle atrophy and postoperative axial symptoms when compared with traditional unilateral open-door laminoplasty.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251340617"},"PeriodicalIF":2.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013273","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}