Global Spine Journal最新文献

{"title":"The Influence of Multilevel Spinal Deformity Surgery on the EuroQol 5 Dimensions' (EQ-5D) Questionnaire and Residential Status in the Elderly: A Prospective, Observational, Multicenter Study.","authors":"Thorsten Jentzsch, Stephen J Lewis, Colby Oitment, Anna Rienmüller, Allan R Martin, Christopher J Nielsen, Hananel Shear-Yashuv, Marinus de Kleuver, Yong Qiu, Yukihiro Matsuyama, Lawrence G Lenke, Ahmet Alanay, Ferran Pellisé-Urquiza, Kenneth M C Cheung, Maarten Spruit, David W Polly, Jonathan N Sembrano, Christopher I Shaffrey, Justin S Smith, Michael P Kelly, Benny Dahl, Sigurd H Berven","doi":"10.1177/21925682231162574","DOIUrl":"10.1177/21925682231162574","url":null,"abstract":"<p><strong>Study design: </strong>Multicenter, international prospective study.</p><p><strong>Objective: </strong>This study investigated the clinical outcome up to 2 years after multi-level spinal deformity surgery in the elderly by reporting the minimal clinically important difference (MCID) of EuroQol 5-dimensions (EQ-5D), EQ-VAS, and residential status.</p><p><strong>Methods: </strong>As an ancillary study of 219 patients ≥60 years with spinal deformity undergoing primary instrumented fusion surgery of ≥5 levels, this study focuses on EQ-5D (3-L) as the primary outcome and EQ-VAS and residential status as secondary outcomes. Data on EQ-5D were compared between pre-operatively and postoperatively at 10 weeks, 12 months, and 24 months. An anchor-based approach was used to calculate the MCID.</p><p><strong>Results: </strong>The EQ-5D index and EQ-VAS, respectively, improved significantly at each time point compared to pre-operatively (from .53 (SD .21) and 55.6 (SD 23.0) pre-operatively to .64 (SD .18) and 65.8 (SD 18.7) at 10 weeks, .74 (SD .18) and 72.7 (SD 18.1) at 12 months, and .73 (SD .20) and 70.4 (SD 20.4) at 24 months). 217 (99.1%) patients lived at home pre-operatively, while 186 (88.6%), 184 (98.4%), and 172 (100%) did so at 10 weeks, 12 months, and 24 months, respectively. Our calculated MCID for the EQ-5D index at 1 year was .22 (95% CI .15-.29).</p><p><strong>Conclusions: </strong>The EQ-5D index significantly increased at each time point over 24 months after ≥5 level spinal deformity surgery in elderly patients. The MCID of the EQ-5D-3 L was .22. Patients living at home pre-operatively can expect to be able to live at home 2 years postoperatively.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9146820","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":"The Lumbosacral Fractional Curve vs Maximum Coronal Cobb Angle in Adult Spinal Deformity Patients with Coronal Malalignment: Which Matters More?","authors":"Scott L Zuckerman, Hani Chanbour, Fthimnir M Hassan, Christopher S Lai, Yong Shen, Mena G Kerolus, Alex Ha, Ian Buchanan, Nathan J Lee, Eric Leung, Meghan Cerpa, Ronald A Lehman, Lawrence G Lenke","doi":"10.1177/21925682231161564","DOIUrl":"10.1177/21925682231161564","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Retrospective cohort study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;In patients undergoing adult spinal deformity (ASD) surgery we sought to: 1) report preoperative and postoperative lumbosacral fractional (LSF) curve and maximum coronal Cobb angles and 2) determine their impact on radiographic, clinical, and patient-reported outcomes (PROs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single-institution cohort study was undertaken. The LSF curve was the cobb angle between the sacrum and most tilted lower lumbar vertebra. Coronal/sagittal vertical axis (CVA/SVA) were collected. Patients were compared between 4 groups: 1) Neutral Alignment (NA); 2) coronal malalignment only (CM); 3) Sagittal malalignment only (SM); and 4) Combined-Coronal-Sagittal-Malalignment (CCSM). Outcomes including postoperative CM, postoperative coronal vertical axis, complications, readmissions, reoperation, and PROs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 243 patients underwent ASD surgery with mean total instrumented levels of 13.5. Mean LSF curve was 12.1±9.9°(0.2-62.3) and mean max Cobb angle was 43.0±26.5° (0.0-134.3). The largest mean LSF curves were seen in patients with CM (14.6°) and CCSM (13.1°) compared to NA (12.1°) and SM (9.5°) (p=0.100). A higher LSF curve was seen in patients with fusion to the sacrum and instrumentation to the pelvis (p=0.009), and a higher LSF curve was associated with more TLIFs (p=0.031). Postoperatively, more TLIFs were associated with greater amount of LSF curve correction (p&lt;0.001). Comparing the LSF and the max Cob angle among Qiu types, the highest mean max Cobb angle was in Qiu Type B patients (p=0.025), whereas the highest mean LSF curve was in Qiu Type C patients (p=0.037). Moreover, 82.7% of patients had a LSF curve opposite the max Cobb angle. The LSF curve was larger than the max Cobb angle in 22/243 (9.1%) patients, and most of these 22 patients were Qiu Type A (59.1%). Regarding correction, the max Cobb angle achieved more correction than the LSF curve, judged by the percent improved from preop (54.5% Cobb vs. 46.5% LSF, p=0.025) in patients with max cobb&gt;20° and LSF curve &gt;5°. The LSF curve underwent greater correction in Qiu Type C patients (9.2°) compared to Type A (5.7°) and Type B (5.1°) (p=0.023); however, the max Cobb angle was similarly corrected among Qiu Types: Type A 21.8°, Type B 24.6°, and Type C 25.4° (p=0.602). Minimal differences were seen comparing the preop/postop/change in LSF curve and max Cobb angle regarding postop CM, postop CVA, complications, readmissions, reoperation, and PROs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The LSF curve was highest in patients with CM, CCSM, and Qiu Type C curves. Most patients had a LSF curve opposite the max Cobb angle. The max Cobb angle was more often corrected than the LSF curve. The LSF curve underwent greater correction among Qiu Type C patients, whereas the max Cobb angle was similarly corrected among all Qiu Types. No clear trend was seen regar","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9567980","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":"Biomechanical Analysis of Lumbar Interbody Fusion Cages With Various Elastic Moduli in Osteoporotic and Non-osteoporotic Lumbar Spine: A Finite Element Analysis.","authors":"Da Zou, Lihao Yue, Zheyu Fan, Yi Zhao, Huijie Leng, Zhuoran Sun, Weishi Li","doi":"10.1177/21925682231166612","DOIUrl":"10.1177/21925682231166612","url":null,"abstract":"<p><strong>Study design: </strong>Finite element analysis (FEA).</p><p><strong>Objective: </strong>This study aimed to explore the effects of cage elastic modulus (Cage-E) on the endplate stress in different bone conditions: osteoporosis (OP) and non-osteoporosis (non-OP). We also explored the correlation between endplate thickness and endplate stress.</p><p><strong>Methods: </strong>The FEA models of L4-L5 with lumbar interbody fusion were designed to access the effects of Cage-E on the endplate stress in different bone conditions. Two groups of the Young's moduli of bony structure were assigned to simulate the conditions of OP and non-OP, and the bony endplates were analyzed in 2 kinds of thicknesses: .5 mm and 1.0 mm, with the insertion of cages with different Young's moduli including .5, 1.5, 3, 5, 10, and 20 GPa. After model validation, an axial compressive load of 400 N and a flexion/extension moment of 7.5Nm was performed on the superior surface of L4 vertebral body in order to analyze the distribution of stress.</p><p><strong>Results: </strong>The maximum Von Mises stress in the endplates increased by up to 100% in the OP model compared with non-OP model under the same condition of cage-E and endplate thickness. In both OP and non-OP models, the maximum endplate stress decreased as the cage-E decreased, but the maximum stress in the lumbar posterior fixation increased as the cage-E decreased. Thinner endplate thickness was associated with increased endplate stress.</p><p><strong>Conclusion: </strong>The endplate stress is higher in osteoporotic bone than non-osteoporotic bone, which explains part of the mechanism of OP-related cage subsidence. It is reasonable to reduce the endplate stress by reducing the cage-E, but we should balance the risk of fixation failure. Endplate thickness is also important when evaluating the cage subsidence risk.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9769004","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.","authors":"Charles G Fisher, Janneke I Loomans, Olesja Hazenbiller","doi":"10.1177/21925682241254810","DOIUrl":"10.1177/21925682241254810","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943380","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":"Does Spinal Cord Type Predict Intraoperative Neuro-Monitoring Alerts in Scoliosis Correction Surgery? A Systematic Review and Meta-Analysis of Operative and Radiologic Predictors.","authors":"Abdulrahman O Al-Naseem, Abdulaziz O Al-Naseem, Derek T Cawley, Ahmed Aoude, Anthony A Catanzano, Muhammad M Abd-El-Barr, Aman Sharma, Roozbeh Shafafy","doi":"10.1177/21925682241237475","DOIUrl":"10.1177/21925682241237475","url":null,"abstract":"<p><strong>Study design: </strong>Systematic literature review and meta-analysis.</p><p><strong>Objectives: </strong>Predicting patient risk of intraoperative neuromonitoring (IONM) alerts preoperatively can aid patient counselling and surgical planning. Sielatycki et al established an axial-MRI-based spinal cord classification system to predict risk of IONM alerts in scoliosis correction surgery. We aim to systematically review the literature on operative and radiologic factors associated with IONM alerts, including a novel spinal cord classification.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines. A literature search identifying all observational studies comparing patients with and without IONM alerts was conducted. Suitable studies were included. Patient demographics, radiological measures and operative factors were collected.</p><p><strong>Results: </strong>11 studies were included including 3040 patients. Relative to type 3 cords, type 1 (OR = .03, CI = .01-.08, <i>P</i> < .00001), type 2 (OR = .08, CI = .03, <i>P</i> <.00001) and all non-type 3 cords (OR = .05, CI = .02-.16, <i>P</i> < .00001) were associated with significantly lower odds of IONM alerts. Significant radiographic measures for IONM alerts included coronal Cobb angle (MD = 10.66, CI = 5.77-15.56, <i>P</i> < .00001), sagittal Cobb angle (MD = 9.27, CI = 3.28-14.73, <i>P</i> = .0009), sagittal deformity angle ratio (SDAR) (MD = 2.76, CI = 1.57-3.96, <i>P</i> < .00001) and total deformity angle ratio (TDAR) (MD = 3.44, CI = 2.27-4.462, <i>P</i> < .00001). Clinically, estimated blood loss (MD = 274.13, CI = -240.03-788.28, <i>P</i> = .30), operation duration (MD = 50.79, CI = 20.58-81.00, <i>P</i> = .0010), number of levels fused (MD = .92, CI = .43-1.41, <i>P</i> = .0002) and number of vertebral levels resected (MD = .43, CI = .01-.84, <i>P</i> = .05) were significantly greater in IONM alert patients.</p><p><strong>Conclusions: </strong>This study highlights the relationship of operative and radiologic factors with IONM alerts.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140012558","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":"Improving How Orthopaedic Journals Report Research Outcomes Based on Sex and Gender.","authors":"Seth S Leopold, Robert N Hensinger, Andrew J Schoenfeld, Marc Swiontkowski, Michael J Rossi, Kimberly J Templeton","doi":"10.1177/21925682241258917","DOIUrl":"10.1177/21925682241258917","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440408","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":"Intravoxel Incoherent Motion Factors Affecting Collapse and Nonunion of Osteoporotic Vertebral Fracture.","authors":"Izaya Ogon, Tsuneo Takebayashi, Hiroyuki Takashima, Yasuhisa Abe, Hiroshi Oguma, Rui Imamura, Yoshihiro Akatsuka, Tomonori Morita, Atsushi Teramoto","doi":"10.1177/21925682231167788","DOIUrl":"10.1177/21925682231167788","url":null,"abstract":"<p><strong>Study design: </strong>Longitudinal study.</p><p><strong>Objectives: </strong>Intravoxel incoherent motion (IVIM), a magnetic resonance imaging (MRI) scanning technique that applies diffusion-weighted imaging (DWI), is effective for the quantitative assessment of malignant tumors of the vertebral bone. We hypothesized that IVIM parameters of vertebral bodies are associated with the prognosis of osteoporotic vertebral fracture (OVF). We aimed to explore the relationships between IVIM parameters for vertebral collapse and non-union after OVF and calculate the cut-off values of these parameters for vertebral collapse and non-union.</p><p><strong>Methods: </strong>A total of 150 patients with acute OVF (150 women; mean age: 79.1 ± 7.4 years) were included and treated conservatively with bracing. MRI was performed at the time of injury. IVIM parameters, such as apparent diffusion coefficient (ADC), molecular diffusion coefficient (D), and perfusion-related diffusion (D*) were recorded. The patients were classified into 3 groups: low-collapse (height loss of ≤50%), high-collapse (height loss of >50%), and non-union. We compared ADC, D, and D* among the low-collapse, high-collapse, and non-union groups and performed a receiver operating characteristic (ROC) curve analysis to determine the boundary values of the high-collapse and non-union groups.</p><p><strong>Results: </strong>The low-collapse, high-collapse, and non-union groups had no significant differences in ADC and D. However, D* differed significantly among the 3 groups. ROC analysis revealed cut-off values of 19.0 × 10^-3 mm²/s and 12.3 × 10^-3 mm²/s for the high-collapse and non-union groups, respectively.</p><p><strong>Conclusions: </strong>D* is a significant prognostic indicator for high-collapse and non-union groups with OVF. This suggests that D* should be considered when assessing OVF.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9224707","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":"Association Between Industry Sponsorship of Spine-Related Clinical Trials, Publication Status, and Research Outcomes.","authors":"Maria A Munsch, Stephen R Chen, Jonathan Dalton, Robert Tisherman, Jeremy D Shaw, Joon Y Lee","doi":"10.1177/21925682231166379","DOIUrl":"10.1177/21925682231166379","url":null,"abstract":"<p><strong>Study design: </strong>Observational Database Study.</p><p><strong>Objectives: </strong>Prospective clinical trials in spinal surgery are expensive to conduct, especially when randomized, appropriately powered, and/or multicentered. Industry collaborations generate symbiotic relationships promoting technological advancement; however, they also allow for bias. To the authors' knowledge, there is no known analysis of correlations between industry sponsorship and publication rates of spine-related clinical trials. This observational work evaluates such potential associations.</p><p><strong>Methods: </strong>The ClinicalTrials.gov database was queried with terms <i>spine</i>, <i>spinal</i>, <i>spondylosis</i>, <i>spondylolysis</i>, <i>cervical</i>, <i>lumbar</i>, and <i>compression fracture</i> over an 11-year period. Design characteristics and outcomes were recorded from 822 spine surgery-related trials. Trials were stratified based on funding source and intervention class. Groups were compared via two-tailed chi-square test of independence or Fisher's exact test (α = .05), based on completion status and publication rates of positive vs negative results.</p><p><strong>Results: </strong>Industry-sponsored spine-related clinical trials were more likely to be terminated than their non-industry-sponsored counterparts (P < .001). Of the trials achieving publication, industry-sponsored trials reported positive results at a higher rate than did trials without industry funding (P = .037). Clinical trials examining devices were more likely to be terminated than those studying other intervention classes (P = .001).</p><p><strong>Conclusions: </strong>High termination rates and positive result publication rates among industry-sponsored clinical trials in spinal surgery likely reflect industry's influence on the research community. Such partnership alleviates financial burden and provides accessibility to cutting-edge innovation. It is essential that all parties remain mindful of the significant bias that funding source may impart on study outcome.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9395298","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":"Can a Novel Natural Language Processing Model and Artificial Intelligence Automatically Generate Billing Codes From Spine Surgical Operative Notes?","authors":"Bashar Zaidat, Justin Tang, Varun Arvind, Eric A Geng, Brian Cho, Akiro H Duey, Calista Dominy, Kiehyun D Riew, Samuel K Cho, Jun S Kim","doi":"10.1177/21925682231164935","DOIUrl":"10.1177/21925682231164935","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>Billing and coding-related administrative tasks are a major source of healthcare expenditure in the United States. We aim to show that a second-iteration Natural Language Processing (NLP) machine learning algorithm, XLNet, can automate the generation of CPT codes from operative notes in ACDF, PCDF, and CDA procedures.</p><p><strong>Methods: </strong>We collected 922 operative notes from patients who underwent ACDF, PCDF, or CDA from 2015 to 2020 and included CPT codes generated by the billing code department. We trained XLNet, a generalized autoregressive pretraining method, on this dataset and tested its performance by calculating AUROC and AUPRC.</p><p><strong>Results: </strong>The performance of the model approached human accuracy. Trial 1 (ACDF) achieved an AUROC of .82 (range: .48-.93), an AUPRC of .81 (range: .45-.97), and class-by-class accuracy of 77% (range: 34%-91%); trial 2 (PCDF) achieved an AUROC of .83 (.44-.94), an AUPRC of .70 (.45-.96), and class-by-class accuracy of 71% (42%-93%); trial 3 (ACDF and CDA) achieved an AUROC of .95 (.68-.99), an AUPRC of .91 (.56-.98), and class-by-class accuracy of 87% (63%-99%); trial 4 (ACDF, PCDF, CDA) achieved an AUROC of .95 (.76-.99), an AUPRC of .84 (.49-.99), and class-by-class accuracy of 88% (70%-99%).</p><p><strong>Conclusions: </strong>We show that the XLNet model can be successfully applied to orthopedic surgeon's operative notes to generate CPT billing codes. As NLP models as a whole continue to improve, billing can be greatly augmented with artificial intelligence assisted generation of CPT billing codes which will help minimize error and promote standardization in the process.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9130079","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":"Radiographic Risk Factors for Adjacent Segment Disease Following Anterior Cervical Discectomy and Fusion (ACDF): A Systematic Review and Meta-Analysis.","authors":"Mohamed Kamal Mesregah, Melissa Baker, Camilla Yoon, Hans-Joerg Meisel, Patrick Hsieh, Jeffrey C Wang, S Tim Yoon, Zorica Buser","doi":"10.1177/21925682241237500","DOIUrl":"10.1177/21925682241237500","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Objectives: </strong>To assess the radiographic risk factors for adjacent segment disease (ASD) following anterior cervical discectomy and fusion (ACDF) for degenerative cervical spine pathologies.</p><p><strong>Methods: </strong>PubMed, Embase and the Cochrane Library databases were searched up to December 2023. The primary inclusion criteria were degenerative spinal conditions treated with ACDF, comparing radiological parameters in patients with and without postoperative ASD. The radiographic parameters included intervertebral disc height, cervical sagittal alignment, sagittal segmental alignment, range of motion, segmental height, T1 slope, sagittal vertical axis (SVA), thoracic inlet angle (TIA), and plate to disc distance (PPD). Risk of bias was assessed for all studies. The Cochrane Review Manager was utilized to perform the meta-analysis.</p><p><strong>Results: </strong>From 7044 articles, 13 retrospective studies were included in the final analysis. Three studies had \"not serious\" bias and the other 10 studies had serious or very serious bias. The total number of patients in the included studies was 1799 patients. Five studies included single-level ACDF, 2 studies included multi-level ACDF, and 6 studies included single or multi-level ACDF. On meta-analysis, the significant risk factors associated with ASD development were reduced postoperative cervical lordosis (mean difference [MD] = 3.35°, <i>P</i> = .002), reduced last-follow-up cervical lordosis (MD = -3.02°, <i>P</i> = .0003), increased preoperative to postoperative cervical sagittal alignment change (MD = -3.68°, <i>P</i> = .03), and the presence of developmental cervical canal stenosis (Odds ratio [OR] = 4.17, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Decreased postoperative cervical lordosis, greater change in cervical sagittal alignment and developmental cervical canal stenosis were associated with an increased risk of ASD following ACDF.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140101430","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}