Global Spine Journal最新文献

{"title":"Comparison of Hybrid Surgery and Two-Level ACDF in Treating Consecutive Cervical Degenerative Disc Disease: A Systematic Review and Meta-Analysis.","authors":"Yihan Yang, Weishi Liang, Duan Sun, Bo Han, Zhangfu Li, Yeqiu Xu, Peng Yin, Xianjun Qu, Yong Hai","doi":"10.1177/21925682251343524","DOIUrl":"10.1177/21925682251343524","url":null,"abstract":"<p><p>Study DesignSystematic review and meta-analysis.ObjectiveThis meta-analysis aimed to compare hybrid surgery (HS) and two-level anterior cervical discectomy and fusion (ACDF) in the treatment of consecutive two-level cervical degenerative disc disease (CDDD).MethodsComprehensive searches were conducted in PubMed, Embase, and Web of Science. Extracted data from the selected studies included operative time, intra-operative blood loss, C2-C7 range of motion (C2-C7 ROM), superior adjacent segment range of motion (SAS ROM), inferior adjacent segment range of motion (IAS ROM), complication incidence, neck disability index (NDI) score, Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS) score. Meta-analysis was conducted using RevMan 5.3.ResultsA total of 626 patients from 11 studies who underwent either HS or two-level ACDF for CDDD were analyzed. Compared to ACDF in the non-ROI-C cage group, HS better preserved post-operative and final follow-up C2-C7 ROM (post-operation: MD 10.08, 95% CI 6.58 to 13.58, <i>P <</i> 0.01; final follow-up: MD 7.62, 95% CI 5.83 to 9.42, <i>P <</i> 0.01). HS significantly reduced post-operative and final follow-up SAS ROM and IAS ROM at the final follow-up. Additionally, HS resulted in less intraoperative blood loss than ACDF when blood loss reached 90 mL or more. Analysis of functional scores (NDI, JOA, and VAS), operative time, and complication rates showed no significant differences between HS and ACDF.ConclusionHS achieved better radiographic outcomes compared to two-level ACDF, with comparable clinical outcomes, reduced intraoperative blood loss, and a similar complication rate. However, further high-quality randomized controlled trials are needed.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251343524"},"PeriodicalIF":2.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110428","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":"Artificial Intelligence vs Human Authorship in Spine Surgery Fellowship Personal Statements: Can ChatGPT Outperform Applicants?","authors":"William J Karakash, Henry Avetisian, Jonathan M Ragheb, Jeffrey C Wang, Raymond J Hah, Ram K Alluri","doi":"10.1177/21925682251344248","DOIUrl":"10.1177/21925682251344248","url":null,"abstract":"<p><p>Study DesignA comparative analysis of AI-generated vs human-authored personal statements for spine surgery fellowship applications.ObjectiveTo assess whether evaluators could differentiate between ChatGPT- and human-authored personal statements and determine if AI-generated statements could outperform human-authored ones in quality metrics.Summary of Background DataPersonal statements are key in fellowship admissions, but the rise of AI tools like ChatGPT raises concerns about their use. While previous studies have examined AI-generated residency statements, their role in spine fellowship applications remains unexplored.MethodsNine personal statements (4 ChatGPT-generated, 5 human-authored) were evaluated by 8 blinded reviewers (6 attending spine surgeons and 2 fellows). ChatGPT-4o was prompted to create statements focused on 4 unique experiences. Evaluators rated each for readability, originality, quality, and authenticity (0-100 scale), determined AI authorship, and indicated interview recommendations.ResultsChatGPT-authored statements scored higher in readability (65.69 vs 56.40, <i>P</i> = 0.016) and quality (63.00 vs 51.80, <i>P</i> = 0.004) but showed no differences in originality (<i>P</i> = 0.339) or authenticity (<i>P</i> = 0.256). Reviewers could not reliably distinguish AI from human authorship (<i>P</i> = 1.000). Interview recommendations favored ChatGPT-generated statements (84.4% vs 62.5%, OR: 3.24 [1.08-11.17], <i>P</i> = 0.045).ConclusionChatGPT can produce high quality, indistinguishable spine fellowship personal statements that increase interview likelihood. These findings highlight the need for nuanced guidelines regarding AI use in application processes, particularly considering its potential role in expanding access to high-quality writing assistance and editing.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251344248"},"PeriodicalIF":2.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110477","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":"Do Three-Dimensional Printed Porous Titanium Relative to Polyetheretherketone Interbody Cages Reduce Complications and Revisions after Transforaminal Lumbar Interbody Fusion?","authors":"Hannah A Levy, Abdelrahman M Hamouda, Christopher A Magera, Jayanth Kumar, Cassandra Willson, Brian C Goh, James T Bernatz, Benjamin D Elder, Brett A Freedman, Arjun S Sebastian","doi":"10.1177/21925682251339998","DOIUrl":"10.1177/21925682251339998","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectivesTo determine if 3D printed porous titanium (Ti) cages compared to non-porous polyetheretherketone (PEEK) cages predicted improved fusion rate or clinical outcomes after transforaminal lumbar interbody fusion (TLIF).MethodsAll adult patients who underwent one- and two-level TLIF for degenerative conditions by a single surgeon at an academic center between 2017-2021 were retrospectively identified. Patients were dichotomized into porous Ti and non-porous PEEK interbody cage groups. Fusion status was assessed by at 6-months and 1-year postoperatively by CT Bridwell scale and flexion/extension X-Rays. Postoperative complications (CT-based subsidence, adjacent segment disease, reoperation rates) and interval changes in lumbar radiographic alignment at short- and long-term follow-up were determined. Univariate and multivariate analysis compared patient and surgical factors, fusion rates, alignment, and complications across interbody groups.ResultsA total of 136 patients with 169 unique fusion levels (125 Ti cages, 44 PEEK cages) met the inclusion/exclusion criteria. Ti relative to PEEK interbodies had significantly decreased surface area and increased height and lordosis. Ti cage use was associated with greater subsidence (<i>P</i> < 0.001) but did not independently predict maximum subsidence on regression (<i>P</i> = 0.109). In the overall cohort, there were no significant differences in fusion rates or lumbopelvic alignment between interbody groups. Reoperation (Ti: 10.9% vs PEEK: 28.6%, <i>P</i> = 0.026) and reoperation for pseudoarthrosis (Ti: 2.0% vs PEEK: 11.4%, <i>P</i> = 0.038) was significantly more likely in the PEEK relative to the Ti group.ConclusionsUse of 3D printed porous Ti cages relative to non-porous PEEK cages may mitigate pseudoarthrosis related reoperation after TLIF.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251339998"},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092938","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":"Analysis of Screw/Pedicle-Width Ratio and Accuracy in Navigated Versus 3D-Controlled Fluoroscopy-Guided Pedicle Screw Placement.","authors":"Jula Gierse, Felix Zimmermann, Paul A Grützner, Jan Stallkamp, Sven Y Vetter, Eric Mandelka","doi":"10.1177/21925682251343523","DOIUrl":"10.1177/21925682251343523","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesDue to the close anatomic relationship between the pedicle and neurovascular structures, avoiding pedicle perforations is crucial in pedicle screw placement. Still, the use of larger screws has biomechanical advantages. Intraoperative 2D and 3D imaging, and navigation guidance can be used to combine both goals. The aim of this study was to compare the screw diameter/pedicle width ratio (SPR) and the screw placement accuracy for 3D controlled fluoroscopy-guided pedicle screw placement vs computer navigated transpedicular screw placement in the thoracic and lumbar spine.Methods200 cases of thoracic and lumbar pedicle screw placement, of which 100 cases were performed using intraoperative computer navigation and 100 cases were performed using fluoroscopy-guidance were retrospectively registered. In the fluoroscopy group, intraoperative 3D scans were performed to confirm implant position and allow for potential intraoperative revision. In addition to accuracy and SPR, demographics, dose reports, and procedure times were analyzed.ResultsOverall, 716 fluoroscopy-guided screws were compared with 740 screws placed using navigation. Screw accuracy (83.2% vs 90.5%; <i>P</i> = .001) and SPR (0.85 ± 0.17 vs 0.88 ± 0.21; <i>P</i> < .001) were significantly higher using navigation compared to fluoroscopic guidance. Furthermore, dose area product (28,545 ± 17,693 vs 20,638 ± 15,856 mGycm²; <i>P</i> < .001), fluoroscopy time (223.6 ± 93.6 vs 92.3 ± 39.7 seconds; <i>P</i> < .001), and procedure time (154.0 ± 81.0 vs 119.7 ± 48.7 min; <i>P</i> = .004) were significantly lower using navigation.ConclusionsIntraoperative navigation does not only increase the accuracy of pedicle screw placement, but also allows for the placement of larger screws relative to the pedicle width, which may have biomechanical advantages. Notably, contrary to other studies, the use of navigation did not increase patient radiation exposure or procedure time compared to fluoroscopic guidance.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251343523"},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092918","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":"Retropharyngeal Hematoma Following Anterior Cervical Discectomy and Fusion: Identifying Risk to Prevent a Life-Threatening Complication.","authors":"Henry Avetisian, William Karakash, Camille Flynn, Atishay Mathur, Mirbahador Athari, Marc A Abdou, Dil Patel, Jeffrey C Wang, Raymond J Hah, Ram K Alluri","doi":"10.1177/21925682251343839","DOIUrl":"10.1177/21925682251343839","url":null,"abstract":"<p><p>Study DesignRetrospective cohort.ObjectivesTo assess the incidence, time to presentation, and independent risk factors for retropharyngeal hematoma causing airway obstruction following anterior cervical discectomy and fusion (ACDF).MethodsThe PearlDiver national database was queried for patients who underwent one- to four-level ACDF. Patients who underwent concomitant posterior fusion or had surgical indications related to malignancy, trauma, or infection were excluded. Patients were stratified based on the development of a retropharyngeal hematoma causing airway obstruction within 7 days. Descriptive statistics assessed differences in patient demographics and comorbidities. Univariable and multivariable regression analyses identified independent predictors.ResultsAmong 430,542 patients, 140 (0.03%) developed postoperative retropharyngeal hematoma leading to acute airway obstruction. A significant proportion of patients presented within 1 day of surgery (45 patients, 32.14%), with 23 (16.43%) on day zero and 22 (15.71%) on day 1. Notably, 40.71% of cases occurred after discharge. Independent predictors included ossified posterior longitudinal ligament (OPLL) (aOR: 8.07, <i>P</i> < 0.001), male gender (aOR: 2.30, <i>P</i> < 0.001), hypertension (aOR: 1.67, <i>P</i> < 0.05), viral hepatitis (aOR: 1.57, <i>P</i> < 0.05), and comorbidity index (aOR: 1.14, <i>P</i> < 0.001).ConclusionThis study identified a 0.03% incidence of retropharyngeal hematoma leading to acute airway obstruction and several independent predictors, including comorbidity index, male gender, hypertension, viral hepatitis, and OPLL. Surgeons should consider overnight admission for observation in patients with these risk factors, as a significant proportion of hematomas present within 1 day of surgery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251343839"},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077527","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":"Accuracy of CT Scan for Detecting Posterior Ligamentous Complex Injury in Traumatic Thoracolumbar Fractures: A Systematic Review and Meta-Analysis.","authors":"Luciano Falcão, Victor Arthur Ohannesian, Philippe Quadros Monteiro, Rafael Andrade Sampaio Silva, Isabelle Rodrigues Menezes, Ricardo Fonseca Oliveira Suruagy Motta, Kenzo Ogasawara Donato, André Nishizima, Andrei Fernandes Joaquim, Danilo Gomes Quadros","doi":"10.1177/21925682251343525","DOIUrl":"10.1177/21925682251343525","url":null,"abstract":"<p><p>Study DesignA systematic review and meta-analysis.ObjectivesThis systematic review and meta-analysis aim to evaluate the diagnostic accuracy of CT in detecting PLC injuries in traumatic thoracolumbar fractures.MethodsA comprehensive search of PubMed/MEDLINE, Embase, and Web of Science was conducted up to January 2025. Studies were included if they examined the diagnostic validity of CT for PLC injuries compared with MRI with predefined outcomes (true/false positives/negatives). Quality assessment was performed using the QUADAS-2 tool, and statistical analysis involved bivariate binomial regression to generate summary receiver operating characteristic (SROC) curves and pooled estimates of sensitivity and specificity.ResultsEight studies involving 1440 patients were included. The pooled sensitivity and specificity of CT for PLC injury detection were 75% (95% CI: 68 to 80, <i>P</i> = 0.00) and 87% (95% CI: 71 to 95, <i>P</i> = 0.00), respectively. The area under the curve (AUC) from the SROC analysis was 0.81 (95% CI: 0.78 to 0.84), indicating fair diagnostic accuracy. Meta-regression analysis revealed that sensitivity and specificity remained consistent across advanced CT techniques, multiplanar reconstruction, and full MRI protocol, but extensive trauma, CT 16-64 or ≥128 slices, and 3.0 T MRI scanner influenced it. No significant publication bias was detected.ConclusionThis meta-analysis demonstrates that CT has fair diagnostic accuracy for detecting PLC injuries in traumatic thoracolumbar fractures, supporting its clinical utility. Future research should explore integrating advanced imaging technologies to enhance CT's diagnostic precision.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251343525"},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086171","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":"Characterizing the Representation of Different Global Regions and National Income-Levels Amongst Invited Speakers and Committee Members at Major International Spine Surgery Conferences.","authors":"Jonathan Dalton, Joydeep Baidya, Rachel Huang, Jarod Olson, Chloe Herczeg, Robert J Oris, Rajkishen Narayanan, Evgeniy V Uvarov, Keyur Patel, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder","doi":"10.1177/21925682251340033","DOIUrl":"10.1177/21925682251340033","url":null,"abstract":"<p><p>Study DesignObservational study.ObjectiveTo evaluate representation of countries and gross national income (GNI) at major international spine conferences.MethodsThe 50 most attended spine conferences were identified via ChatGPT. Conferences were excluded if they (1) reference/are held in a single country, (2) emphasize one technique, (3) emphasize neurosurgery <i>or</i> orthopaedic spine, (4) have <2 years of conference programs available. Programs were reviewed (2022-2024) to identify invited speakers/award recipients, executive board members, and committee members and their country of practice. Countries were assigned GNI/capita from World Bank data.ResultsEurospine, GSC, IMAST, ISASS, NASS, and SRS met inclusion criteria (1462 unique invited speakers/awardees). Other than Eurospine, board members were predominantly from Northern America. Speakers were most commonly from Northern America (56.2%), with no representation from Southern Africa and Central Asia. Speakers were overwhelmingly from high-income countries (89.7%) with none from low-income countries. Speakers at GSC were the most globally representative, with 68.8% from countries diverse from GSC's executive board. GSC and NASS had the greatest representation from lower-middle (9.7%) and upper-middle income countries (30.4%), respectively. USA and Germany had 867 (59.4%) invitees, while all of Africa had four. Committee members followed similar trends compared to invited speakers for region, country, and GNI/capita representation.ConclusionsAmongst major international conferences, a preponderance of invited speakers and committee members were from a small number of regions, particularly Northern America and Western Europe. Most speakers and committee members practice in high-income countries, with no representation from low-income countries.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251340033"},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077508","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":"Laminoplasty vs Laminectomy and Fusion for Cervical Myelopathy: Alarming Rates of Bias.","authors":"Henry Avetisian, Kevin Mathew, Annika Myers, Apurva Prasad, Jordan O Gasho, William Karakash, Jeffrey C Wang, Raymond J Hah, Ram K Alluri","doi":"10.1177/21925682251343833","DOIUrl":"10.1177/21925682251343833","url":null,"abstract":"<p><p>Study DesignCross-sectional.ObjectivesLaminoplasty (LP) and laminectomy with fusion (LF) are surgical approaches for degenerative cervical myelopathy (DCM), but their comparative effectiveness remains controversial. Systematic reviews and meta-analyses are crucial for guiding clinical decision-making; however, spin bias, which distorts results and misleads readers, is prevalent in the orthopaedic literature, and can hinder clinical decision making. We aim to determine the prevalence of spin bias and assess the methodological quality of systematic reviews and meta-analyses comparing LP with LF in the treatment of DCM.MethodsWe systematically searched the PubMed, Web of Science, and Embase databases, identifying systematic reviews and meta-analyses comparing LP and LF for DCM. Spin bias was assessed using the Yavchitz classification system, and methodological quality was graded using the AMSTAR-2 tool.ResultsFourteen studies met the inclusion criteria. Spin bias was identified in 64% of the reviews, with the most common type being Type 9 (inappropriately claiming superiority of treatment despite reporting bias). Spin types 3, 4, and 6 were each present in 14% of studies. AMSTAR-2 quality assessments rated 21% of studies as critically low, 36% as low, and 43% as moderate; none achieved a high-quality rating.ConclusionSpin bias is prevalent in systematic reviews and meta-analyses comparing LP and LF for DCM, and the overall methodological quality remain suboptimal. Addressing spin bias and improving adherence to rigorous reporting standards are essential to enhance the reliability of evidence guiding clinical decision-making.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251343833"},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077520","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":"Decompression-Only for Lumbar Degenerative Spondylolisthesis - What are the Risk for Failure? - A Systematic Review.","authors":"Stipe Corluka, Sathish Muthu, Tim Yoon, Carla Cunha, Matthew Gary, Gianluca Vadala, Giovanni Barbanto Brodano, Annalisa Monetta, Andreas K Demetriades, Stjepan Ivandić, Yabin Wu, Jeffrey Wang, Hans-Jorg Meisel, Zorica Buser","doi":"10.1177/21925682251342230","DOIUrl":"10.1177/21925682251342230","url":null,"abstract":"<p><p>Study DesignSystematic review.ObjectiveThe current literature suggests that decompression-only procedures may be an adequate treatment option for low-grade degenerative spondylolisthesis. It is necessary to understand the causes of the failure to adequately select patients to achieve acceptable results. Our aim is to identify factors associated with failure of decompression-only procedures for degenerative lumbar spondylolisthesis.MethodsAn independent systematic review of scientific databases (PubMed, Scopus, clinicaltrials. gov, Web of Science) was performed to identify relevant articles as per the preferred reporting in systematic reviews and meta-analysis (PRISMA) guidelines. Studies analysing the risk factors for failure following decompression-only procedure for degenerative lumbar spondylolisthesis were included. The pooled analysis was performed using the Stata software.ResultsSix studies were included with the baseline characteristics of the successful group and the failed group. Individual study analysis has found factors like motion at index level, and multi-level decompression to be responsible for failure. However, upon pooled analysis patient-related factors (age, sex, BMI), disease-related factors (Pfirrmann grade, slip distance, disc height, facet angulation, translation, movement at index level, sacral slope), and outcome parameters (VAS, ODI and JOA score) between the two groups did not demonstrate any significant difference.ConclusionHigh-quality evidence analysing the risk factors for failure of decompression-only procedure for degenerative spondylolisthesis is limited. Although factors such as motion at index level, and multi-level decompression were found to be potential risk factors in individual studies, pooled analysis did not find any of them to significantly predict failure of decompression-only procedures for degenerative spondylolisthesis.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251342230"},"PeriodicalIF":2.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077512","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078258/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}