Global Spine Journal最新文献

{"title":"Predictors of In-Hospital Mortality After Operative Cervical Spinal Cord Injury: A National Trauma Data Bank Analysis From 2021 to 2023.","authors":"Mitchell K Ng, Leonidas E Mastrokostas, Paul G Mastrokostas, Alejandro J Friedman, Sean Inzerillo, Pemla Jagtiani, Jesse M Galina, Arie Monas, Jorden Xavier, Khaled Elmenawi, Anthony E Seddio, Arya Varthi, Jad Bou Monsef, Afshin E Razi, Andrew P Alvarez, Mark F Kurd, Ian David Kaye, Barrett Woods, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler, Thomas D Cha","doi":"10.1177/21925682261468269","DOIUrl":"10.1177/21925682261468269","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesTo evaluate patient, injury, and hospital-level predictors of in-hospital mortality following operative management of cervical spinal cord injury (cSCI) using a national trauma registry.MethodsA retrospective cohort study was performed using the National Trauma Data Bank (NTDB) from 2021 to 2023. Adult patients with cSCI were identified using ICD-10-CM diagnosis codes and included if they underwent operative treatment at the cervical spine level. Patient and injury characteristics were assessed using the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). Hypotension and Glasgow Coma Scale (GCS) were used to characterize arrival physiology. Multivariable logistic regression identified independent predictors of in-hospital mortality, with significance set at the <i>P <</i> 0.05 level.ResultsAmong 18,401 operatively managed cSCI patients, 1,222 (7.1%) died in-hospital, with no variation across years (<i>P</i> = 0.827). Compared with survivors, decedents were older, more often male, and more frequently injured by falls (all <i>P</i> ≤ 0.007). Polytrauma and hypotension were more common among in-hospital deaths (both <i>P</i> < 0.001), and decedents demonstrated higher injury severity and worse presenting neurologic status (both <i>P</i> < 0.001). In adjusted analyses, mortality was independently associated with older age, higher ISS, worse GCS, hypotension, critical spine AIS severity, and polytrauma. Key comorbidity predictors included advanced directives limiting care, functional dependence, congestive heart failure, chronic renal failure, cirrhosis, diabetes mellitus, and anticoagulant therapy.ConclusionsIn-hospital mortality after operative cSCI was 7.1% and was driven by initial physiology, neurologic status, injury severity, and comorbidity burden.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261468269"},"PeriodicalIF":3.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420424","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":"Surgical Outcomes of Degenerative Cervical Myelopathy in Patients with Parkinson Disease: A Systematic Review.","authors":"Shota Takenaka, Hiroyuki Ishiguro, Toshitaka Yoshii, Kentaro Yamada, Eiji Takasawa, Satoshi Nori, So Kato, Kazuya Kitamura, Takeo Furuya, Hiroaki Nakashima, Norimitsu Wakao, Kazuyoshi Nakanishi, Yasushi Fujiwara, Masahiro Yoshida, Masahiko Watanabe, Hirotaka Chikuda","doi":"10.1177/21925682261468270","DOIUrl":"10.1177/21925682261468270","url":null,"abstract":"<p><p>Study DesignSystematic review.ObjectivesTo synthesize outcomes, complications, and healthcare utilization after surgery for degenerative cervical myelopathy (DCM) in patients with Parkinson disease (PD).MethodsPubMed/MEDLINE, EMBASE, and the Cochrane Library were searched from inception to March 2026. Eligible studies evaluated adults with PD undergoing cervical decompression with or without fusion for DCM; studies not specifically defining myelopathy but reporting cervical outcomes within broader PD spine cohorts were retained as indirect supportive evidence. Two reviewers independently screened studies, extracted data, and appraised quality using standard checklists. Because of marked heterogeneity, findings were synthesized narratively, with greater weight given to myelopathy-defined cohorts.ResultsEleven studies were included: 5 myelopathy-defined cohorts and 6 supportive studies. In myelopathy-defined cohorts, PD patients improved after surgery, but some studies showed smaller gains in modified Japanese Orthopaedic Association (mJOA) or Nurick scores, lower odds of clinically important mJOA improvement, and less EQ-5D improvement compared with non-PD controls. Database studies showed higher complication rates, longer hospital stays, non-home discharge, and a dysphagia/aspiration signal. Supportive studies suggested similar increases in hospitalization and medical complications and raised concern for long-term mechanical failure or reoperation.ConclusionsThe most direct evidence suggests that patients with PD undergoing surgery for cervical myelopathy may improve neurologically, although functional recovery may be smaller or less clinically meaningful in some cohorts. Perioperative risk and healthcare utilization also appear higher. Indirect supportive evidence further suggests that dysphagia or aspiration-related events and long-term mechanical failure or reoperation are important concerns in this population.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261468270"},"PeriodicalIF":3.1,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420551","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":"Surgical Timing and Neurological Outcomes in Traumatic Central Cord Syndrome: A Single-Center Retrospective Cohort Study.","authors":"Rachel Crasta, Saeed Abdollahifard, Tyler Barnes, Mehrdad Behboodi, Fahimeh Golabi, Erfan Sanaei, Ali Razmkon, Rouzbeh Motiei-Langroudi","doi":"10.1177/21925682261466959","DOIUrl":"10.1177/21925682261466959","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort.ObjectiveTo investigate whether the timing of surgery, defined by admission-to-surgery intervals, influences short-term in-hospital outcomes and motor recovery in adult patients with Central Cord Syndrome (CCS). This single-center study aimed to investigate the optimal timing for surgery in patients with CCS by using a new categorization of surgical timing.MethodsThis study includes adult patients with clinically and radiologically confirmed traumatic CCS who received surgical care at a tertiary academic center between March 2012 and July 2022 (n = 70). Patients were classified by time of surgery as ultra-early (<24 h, n = 11), early (24-48 h, n = 33), late (48 h-14 days, n = 22), or ultra-late (>14 days, n = 4). The studied outcomes were in-hospital mortality, mechanical ventilation requirement, ventilation duration, intensive care unit (ICU) length of stay, ambulatory status at last follow-up, and changes in motor score in each group. Chi-square and Kruskal-Wallis tests were used to compare groups. The correlation between surgical timing and motor improvement was identified using correlation analysis.ResultsThe four timing subgroups showed no significant differences in in-hospital mortality, ambulatory status, need for mechanical ventilation, ventilation duration, or ICU length of stay (p = 0.7, 0.4, 0.6, 0.8, and 0.3, respectively). Moreover, although there was a notable postoperative improvement in the total (four limbs), bilateral upper extremity (BUE), and bilateral lower extremity (BLE) motor scores, these improvements were not significantly different across subgroups (p = 0.7, 0.7, and 0.6, respectively). There was no significant correlation between surgery time and motor improvement (p = 0.63).ConclusionsIn this single-center study, the timing of surgery after admission did not appear to influence short-term in-hospital outcomes or early motor recovery in adult patients with CCS. Key limitations of this study include the retrospective design, the small sample sizes in some surgical timing subgroups, and the reliance on admission-to-surgery timing rather than injury-to-surgery intervals. Furthermore, long-term follow-up data were not consistently available.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261466959"},"PeriodicalIF":3.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411513","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 \"Asymptomatic,\" Radiographic Foraminal Stenosis on Lumbar Spine Surgery Outcomes: A Systematic Review.","authors":"Rebecca L Boyle, Tim Xu, Zora C Hahn, Tomoyuki Asada, Ted Shi, John E Lama, Arsen M Omurzakov, Evan D Sheha, Sheeraz A Qureshi, Sravisht Iyer","doi":"10.1177/21925682261464611","DOIUrl":"10.1177/21925682261464611","url":null,"abstract":"<p><p>Study DesignSystematic Review.ObjectivesLumbar foraminal stenosis (LFS) is a common finding on spine imaging. While surgery is indicated for symptomatic LFS, the clinical impact of incidentally found asymptomatic LFS (aLFS) on surgical outcomes remains unclear. This study aims to evaluate the influence of aLFS on reoperation rates and functional outcomes following lumbar spine surgery.MethodsA systematic search of PubMed, Embase, MEDLINE, and the Cochrane Library was conducted. Eight of 795 records met inclusion criteria and encompassed 1,744 adult patients undergoing lumbar spinal surgery, of whom 468 (26.8%) had aLFS. Due to heterogeneity in LFS classification, surgical procedures, follow-up duration, and patient-reported outcome measures (PROMs), quantitative pooling was not feasible and a structured narrative synthesis was performed. Study characteristics, patient demographics, surgical details, LFS classification methods, PROMs, and reoperation events were assessed.ResultsaLFS was associated in some studies with less postoperative improvement in Oswestry Disability Index and greater residual back and leg pain. Several studies suggested that preoperative aLFS at the surgical level was associated with increased index-level reoperations following decompression (low-moderate certainty). However, no association was found at adjacent levels or with fusion procedures.ConclusionsEvidence regarding the prognostic significance of incidental aLFS remains limited, heterogeneous, and low certainty. Association between index-level aLFS and later reoperation should be interpreted cautiously because instability-related factors may be stronger drivers of failure than stenosis severity alone. Current evidence does not support prophylactic treatment of radiographically asymptomatic foraminal stenosis, particularly at adjacent levels in the absence of instability or symptom correlation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261464611"},"PeriodicalIF":3.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420641","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":"Testosterone Replacement Therapy in Posterior Lumbar Fusion Patients: A Propensity Score-Matched Analysis of Long-Term Outcomes.","authors":"Mark Miller, Blake Delgadillo, Matthew Meade, Hunter Smith, Omar Sbaih, Ruchir Nanavati, Nithin Gupta, William DiCiurcio, Charles Middleton, Shannon Fehr, Mitch Ng, Gregory Schroeder, Christopher Kepler, Barrett Woods","doi":"10.1177/21925682261467396","DOIUrl":"10.1177/21925682261467396","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort study.ObjectivePosterior lumbar fusion (PLF) carries notable risks of bleeding and implant-related complications. Testosterone replacement therapy (TRT) has been associated with a myriad of medical and postsurgical-related complications in orthopedic procedures, but its impact on PLF outcomes remains unclear.MethodsUsing the TriNetX Research Network, adults undergoing PLF were identified and grouped by perioperative TRT use. After 1:1 propensity score matching demographics, comorbidities, and 3,380 patients remained per cohort. Outcomes included acute postoperative events and long-term surgical sequelae, assessed through 2 years. Risk ratios (RR), 95% confidence intervals (CI), and p-values were calculated; Kaplan-Meier curves assessed long-term event incidence.ResultsThe TRT cohort had lower rates of readmission (2.07% vs. 3.05%; RR 0.69, 95% CI 0.51-0.94; p=0.016) and ED visits (2.66% vs. 4.26%; RR 0.64, 95% CI 0.49-0.83; p=0.001). There were no statistically significant differences between cohorts for DVT intensive care unit admission, PE, wound dehiscence, SSI, or AKI at 90 days. TRT use was associated with increased revision PLF (8.05% vs. 6.15%; RR 1.31, 95% CI 1.10-1.56; p=0.002). No statistically significant differences were observed for implant displacement or pseudoarthrosis.ConclusionsPerioperative TRT exposure is associated with a favorable immediate postoperative recovery timeline, with subsequent increased revision surgery. Recognition of these risks should inform preoperative counselling, postoperative surveillance, and multidisciplinary care planning for patients undergoing PLF.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261467396"},"PeriodicalIF":3.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404542","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":"Forgotten Spine Surgery Score Cervical (FS3-C): A Patient-Reported Outcome Measure for Assessing the Impact of Motion Preservation in Cervical Spine Surgery.","authors":"Arsen M Omurzakov, Chad Z Simon, Cole Kwas, Gregory S Kazarian, Joshua Zhang, Tomoyuki Asada, Sheeraz Qureshi, Sravisht Iyer","doi":"10.1177/21925682261460757","DOIUrl":"10.1177/21925682261460757","url":null,"abstract":"<p><p>Study Design/SettingProspective cohort study.ObjectivesTo test whether the novel Forgotten Spine Surgery Score-Cervical (FS3-C) better differentiates outcomes between motion-preserving cervical disc replacement (CDR) and fusion via anterior cervical discectomy and fusion (ACDF) compared with the NDI.MethodsThe FS3-C was derived from a 20-item pool and reduced to 12 items after pilot testing in 41 CDR patients. Validation cohorts included 127 CDR and 112 ACDF patients who completed FS3-C and NDI. Internal consistency, ceiling/floor effects, and convergent validity were assessed. Group comparisons used appropriate parametric and nonparametric tests. Multivariable linear regression adjusting for age, Charlson Comorbidity Index, sex, and number of operated levels, as well as propensity score matching, were performed to address baseline differences.ResultsA total of 239 patients were included. Cronbach α was 0.95 (FS3-C) and 0.88 (NDI). FS3-C correlated inversely with NDI (r = -0.606, <i>P</i> < 0.001). Mean FS3-C was higher after CDR (59.9 ± 19.6) than ACDF (53.2 ± 22.2; <i>P</i> = 0.012), while NDI did not differ (<i>P</i> = 0.074). In multivariable analysis, CDR remained independently associated with higher FS3-C scores (β = 8.94, <i>P</i> = 0.009), with no association for NDI (<i>P</i> = 0.239). Propensity-matched analysis yielded consistent results (mean difference 9.22, <i>P</i> = 0.008), while NDI remained nonsignificant (<i>P</i> = 0.289).ConclusionsThe FS3-C detected differences between CDR and ACDF not detected by the NDI. Findings were consistent across adjusted and propensity-matched analyses, supporting its strong performance and greater discriminatory capacity as a cervical spine PROM.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261460757"},"PeriodicalIF":3.1,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404463","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":"Radiation-free Assessment of Scoliosis: A Reliability and Validity Study for Ultrasound Angles.","authors":"Shuaiqi Zhu, Yingying Qiu, Chenfei Zhang, Jinying Zhang, Yongping Zheng, Haiying Liu, Shuai Xu","doi":"10.1177/21925682261466587","DOIUrl":"10.1177/21925682261466587","url":null,"abstract":"<p><p>Study designA prospective study.ObjectivesThis study aimed to evaluate the reliability and validity of ultrasound angles, and to explore the impact of body mass index (BMI) and scoliosis status on the accuracy of ultrasound measurements.MethodsA total of 94 subjects were enrolled in this study and subsequently underwent both X-ray and ultrasound examinations. Two orthopedic surgeons independently measured the radiographic Cobb angle and the ultrasound angle to evaluate the intra- and interobserver reliability of ultrasound angles. Based on apical vertebra location, BMI, and scoliosis status, subjects were stratified into clinically relevant subgroups. Linear regression analyses and Bland-Altman plots were employed to assess the accuracy of the ultrasound measurements.ResultsUltrasound angles demonstrated excellent intra- and interobserver reliability (intraclass correlation coefficients, ICCs ranging from 0.939 to 0.99), and manual ultrasound angle showed better correlation with the radiographic Cobb angle than the automatic ultrasound angle. The lowest R² of 0.425 was observed for the automatic ultrasound angle in the overweight group, while manual ultrasound angle maintained comparable correlation with the Cobb angle across different BMI subgroups. Furthermore, a higher correlation was found between ultrasound angles and the Cobb angle in the scoliosis group compared to the non-scoliosis group.ConclusionsThis study showed that ultrasound angles were reliable and valid. Manual measurements showed superior performance and should be prioritized. When using ultrasound angles to assess spinal curvature severity, the influence of BMI and scoliosis status must be considered.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261466587"},"PeriodicalIF":3.1,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390590","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":"Clinical Outcomes Following Three- and Four-Level Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis.","authors":"Tyler M Compton, Ravi A Patel, Mark A Plantz, Rohan M Shah, Theodore A Joaquin, Jacob R Staub, Daniel E Herrera, Cade F Bennett, Anitesh Bajaj, Abhinav R Balu, Matthew W Colman, Wellington K Hsu, Alpesh A Patel, Srikanth N Divi","doi":"10.1177/21925682261466603","DOIUrl":"10.1177/21925682261466603","url":null,"abstract":"<p><p>Study Design/SettingSystematic review and meta-analysis.ObjectivesAnterior cervical discectomy and fusion (ACDF) is a well-established treatment for degenerative cervical pathology. Although outcomes following 1- and 2-level ACDF are favorable, increasing construct length has been associated with worse outcomes. Despite this, 3- and 4-level ACDF are often grouped as \"multilevel\" constructs, though emerging evidence suggests 4-level ACDF may carry greater risk. This study systematically reviewed the literature and performed a meta-analysis comparing outcomes between 3- and 4-level ACDF.MethodsA systematic search of MEDLINE, Embase, and Cochrane databases was performed per PRISMA guidelines. Studies reporting outcomes following three- or four-level ACDF were included. <b>Complex etiology and registry-based studies were excluded. Analysis included patient-reported outcomes, perioperative characteristics, and postoperative fusion and complication rates.</b> Data were synthesized, and random-effects meta-analysis was performed using Cohen's d for continuous outcomes and log odds ratios for dichotomous outcomes.ResultsBoth 3- and 4-level ACDF improved pain, disability, and neurologic function. Meta-analysis showed 4-level ACDF had less improvement in axial neck pain, with similar arm pain improvement. Fusion rates were lower with 4-level ACDF. Perioperative outcomes favored 3-level constructs, with 4-level ACDF associated with longer operative time, greater blood loss, and longer hospital stay. No significant differences were observed in complication or revision rates, though confidence intervals were wide.ConclusionsBoth procedures improved pain and function. However, 4-level ACDF showed less neck pain improvement, lower fusion rates, and greater perioperative morbidity. Meta-analysis reveals clinically meaningful differences that should inform surgical planning and patient counseling.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261466603"},"PeriodicalIF":3.1,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390439","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":"Smoking, Alcohol Use, and Low Back Pain: A Large-Scale Study Identifying a Synergistic Lifestyle Risk.","authors":"Sheng-Hao Chang, Szu-Chia Chen, Jiun-Hung Geng","doi":"10.1177/21925682261466184","DOIUrl":"10.1177/21925682261466184","url":null,"abstract":"<p><p>Study DesignAnalytical Cross-sectional Study.ObjectiveTo investigate the association between smoking exposure and the prevalence of low back pain, and to evaluate whether this association varies by alcohol consumption in a large Taiwanese population.MethodsThis cross-sectional study analyzed 22,471 adults aged 30-70 years from the Taiwan Biobank. Smoking exposure, alcohol consumption, and low back pain were ascertained using standardized questionnaires. Multivariable binary logistic regression models were employed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for low back pain, controlling for demographic and comorbidities. Interaction between smoking and alcohol consumption was assessed through stratified analyses.ResultsAfter multivariable adjustment, smoking exposure was independently associated with a higher prevalence of low back pain (OR 1.15; 95% CI 1.06 to1.24). Alcohol consumption alone was not significantly associated with low back pain. A significant interaction between smoking and alcohol use was observed. Smoking was associated with low back pain among participants without alcohol exposure (OR 1.12; 95% CI 1.03 to 1.22), whereas an association was noted among those with alcohol exposure (OR 1.40; 95% CI 1.08 to 1.83).ConclusionsSmoking was associated with low back pain, with a potential interaction with alcohol use. However, the effect size was modest, and the findings should be interpreted with caution.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261466184"},"PeriodicalIF":3.1,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396454","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 First Wave: National Adoption and Economic Shifts of Posterior Cervical Decompression and Fusion in Hospital-Owned Ambulatory Surgery Centers.","authors":"Mitchell K Ng, Leonidas E Mastrokostas, Paul G Mastrokostas, Ilan Podolski, Mohamed Said, Rajendra Singh, Pemla Jagtiani, Alexander Kucherina, Masataka Mizuno, Jad Bou Monsef, Arya Varthi, Daniel R Fassett, Andrew P Alvarez, Thomas D Cha, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler, Afshin E Razi","doi":"10.1177/21925682261466191","DOIUrl":"10.1177/21925682261466191","url":null,"abstract":"<p><p>Study DesignRetrospective cross-sectional study.ObjectiveTo evaluate national trends in utilization and inflation-adjusted charges for single-level posterior cervical decompression and fusion (PCDF) performed in hospital-owned ambulatory surgery centers (ASCs).MethodsThe National Ambulatory Surgery Sample was queried from 2016 to 2022 for adult ASC encounters with CPT 22600, corresponding to single-level posterior cervical fusion. Survey-weighted methods estimated national volumes and modeled adjusted charges using generalized linear models. Statistical significance was set at <i>P</i>< 0.05.ResultsA weighted total of 8,609 single-level PCDF procedures were performed in hospital-owned ASCs from 2016 to 2022 (unweighted n = 6,505). Annual volume increased from 577 cases in 2016 to 3,307 cases in 2021 before declining to 1,586 cases in 2022. Median inflation-adjusted charges rose from $41,697 in 2016 to $69,255 in 2022 (<i>P</i> < 0.001). Adjusted mean charges varied significantly by payer and region, with higher charges for private insurance versus Medicaid ($62,621 vs $50,095, <i>P</i> < 0.001) and for the West versus the Northeast ($93,278 vs $19,847, <i>P</i> < 0.001), based on adequate regional sample sizes (unweighted n = 653 and n = 1,557, respectively). Medicare demonstrated the fastest annual charge growth, higher than Medicaid (+10.35%/year, <i>P</i> = 0.004), private (+12.31%/year, <i>P</i> < 0.001), and Other (+11.87%/year, <i>P</i> < 0.001).ConclusionsOutpatient PCDF adoption in ASCs rose sharply from 2016 to 2021 with persistent, pronounced regional and payer-associated charge variation. These findings suggest that geographic pricing ecosystems and payer dynamics are key drivers of outpatient PCDF economics.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261466191"},"PeriodicalIF":3.1,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396437","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}