Global Spine Journal最新文献

{"title":"Spinopelvic-Hip Harmony [PFA-(PI-LL)] as a Radiographic Indicator of Hip Extension Compensatory Reserve in Kyphotic Adult Spinal Deformity: A Multicenter Study.","authors":"Keisuke Ishikawa, Kohei Takahashi, Ko Hashimoto, Kenichiro Yahata, Kazuyoshi Baba, Takahiro Onoki, Ryo Fujita, Junya Kusakabe, Tomonori Kawaharada, Michiyoshi Sato, Takeshi Nakamura, Ryo Sugawara, Kyoichi Handa, Haruo Kanno, Hiroshi Ozawa, Yasuhisa Tanaka, Toshimi Aizawa","doi":"10.1177/21925682261438473","DOIUrl":"10.1177/21925682261438473","url":null,"abstract":"<p><p>Study DesignRetrospective multicenter observational study.ObjectivesIn kyphotic adult spinal deformity (ASD), hip extension, assessed by pelvic femoral angle (PFA), compensates for sagittal malalignment, but no radiographic measure quantifies residual \"hip extension reserve.\" When hip compensation fails, knee flexion, assessed by femoral inclination (FI), is recruited and forward trunk inclination, assessed by sagittal vertical axis (SVA), worsens. We aimed to identify which sagittal radiographic parameter best explains FI, SVA, and health-related quality of life (HRQOL), and to evaluate whether spinopelvic-hip harmony, defined as PFA minus spinopelvic mismatch [PFA-(PI-LL)], reflects hip extension reserve.MethodsWe included 115 kyphotic ASD patients from three spine centers. Spinopelvic parameters, PFA, and FI were measured; PI-LL and PFA-(PI-LL) were calculated. HRQOL was assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). We performed Spearman correlations and hierarchical linear regression (baseline: age, sex, and body mass index), adding each radiographic parameter individually and comparing ΔR² and the corrected Akaike information criterion (AICc) (complexity-penalized fit).ResultsPFA-(PI-LL) correlated with FI (ρ = -0.71) and SVA (ρ = -0.73). After adjustment, PFA-(PI-LL) yielded the greatest incremental explanatory power for FI (ΔR² = 0.43) and SVA (ΔR² = 0.56), with ΔAICc >10 vs the others. PFA-(PI-LL) was also associated with JOABPEQ lumbar function and walking ability. ROC analyses showed PFA-(PI-LL) cutoffs for FI >10° and SVA >95 mm were around 160°.ConclusionsIn kyphotic ASD, PFA-(PI-LL) best explained both knee flexion recruitment and forward trunk inclination and may indicate hip extension reserve.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"3469-3481"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511615","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":"Enhanced Recovery After Lumbar Fusion Surgery: An International Survey on Current Practice.","authors":"Hein R Jonkman, Floris R van Tol, Tim M Govers, Silje A C A Debets, Thomas W Wainwright, Bertrand Debono, Michael M H Yang, Hans D de Boer, Maroeska M Rovers, Jorrit-Jan Verlaan","doi":"10.1177/21925682261434216","DOIUrl":"10.1177/21925682261434216","url":null,"abstract":"<p><p>Study DesignCross-sectional, web-based international survey study.ObjectivesTo assess spine surgeons' perspectives on the importance of Enhanced Recovery After Surgery (ERAS) components and barriers to implementing ERAS programs in degenerative lumbar fusion.MethodsIn May 2024, a web-based survey was distributed to AOSpine members. The survey covered eight ERAS components derived from the 2021 consensus statement for perioperative care in lumbar fusion. Respondents selected up to three components with the biggest perceived impact on recovery and up to three with the greatest room for improvement. Responses were summarized in a priority matrix. Demographics, perceived barriers, and implementation support needs were analyzed using descriptive statistics.ResultsThe survey was accessed by 400 individuals, yielding 322 responses (80.5%) and a 76.7% completion rate. Respondents represented academic (50.6%), private (28.9%), and local/community hospitals (20.5%) worldwide. ERAS components perceived to have the biggest impact on recovery were multimodal opioid-sparing analgesia (73.3%), early mobilization (63.8%), and preoperative education & counselling (58.6%), which were also identified as having the greatest room for improvement (39.4%, 41.4%, and 62.6%, respectively). Key barriers were the absence of clear protocols and guidelines (56.2%), staff shortages (53.8%), and difficulties coordinating implementation and adherence (43.0%).ConclusionMultimodal opioid-sparing analgesia, early mobilization, and preoperative education & counselling were identified as ERAS components with the biggest perceived impact on patient recovery and the greatest room for improvement. Targeted efforts in these domains may represent an important opportunity to enhance perioperative care and support the implementation of ERAS programs in lumbar spinal fusion.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"3369-3378"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432403","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":"Global Consensus on the Management of Spinal Infections: Recommendations From International Consensus Meeting 2025.","authors":"Shanmuganathan Rajasekaran, Javad Parvizi","doi":"10.1177/21925682261427448","DOIUrl":"10.1177/21925682261427448","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"16 3_suppl","pages":"5S-6S"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864576","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":"Relationship of Adult Cervical Spinous Processes to Vertebral Midline for Cervical Disc Replacement.","authors":"Kevin G Liu, Jacob T Wechsler, Daniel Rusu, Aidan Lindgren, Marc A Abdou, Jeffrey C Wang, Raymond J Hah, Ram K Alluri","doi":"10.1177/21925682261486413","DOIUrl":"10.1177/21925682261486413","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort.ObjectivesAccurate, midline artificial disc placement is crucial when performing cervical disc replacement (CDR). Although cervical spinous processes (SPs) are considered midline structures, clinical experience has often shown noticeable deviation at times. This study aims to quantitatively characterize this known observation to better understand the utility of SPs as midline indicators during CDR.MethodsPatients who underwent anterior cervical discectomy and fusion with preoperative cervical spine computerized tomography (CT) scans were retrospectively identified, excluding those with previously surgically altered spines. Angular and lateral SP deviations from C3-C7 were collected from these CTs. Statistical analysis was conducted using one-way ANOVA with post-hoc testing using Tukey's test.ResultsThe average angular SP deviations at C3-C7 were 2.94 ± 2.06 degrees, 3.52 ± 2.19 degrees, 3.50 ± 2.13 degrees, 4.31 ± 2.15 degrees, and 3.53 ± 2.86 degrees, respectively. The average lateral SP deviations at C3-C7 relative to vertebral body widths were 5.43%, 6.10%, 6.14%, 8.17%, and 7.52%, respectively. Angular deviation at C6 was greater than C3 (p = 0.009). Relative lateral deviation at C6 was greater than at C3 (p = 0.027). Neither angular nor lateral deviation differed by sex at any level (p > 0.05 for all).ConclusionsGiven significant variation in cervical SP deviation between patients and by level, surgeons should hesitate to solely rely on them for determining vertebral midline during CDR. The C6 and C7 SPs especially should be used cautiously as they show relatively higher magnitudes and variations of deviation. However, the C3-C5 SPs may be of use if viewed in conjunction with other radiographic landmarks, such as the uncinate processes or medial borders of the pedicles.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261486413"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864631","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":"Perioperative GLP-1 Receptor Agonist Use is Associated With Reduced Revisions and Complications Following ACDF: A Propensity-Matched Analysis.","authors":"Matthew T Kim, Seungjun Lee, Graham S Goh, K Daniel Riew","doi":"10.1177/21925682261419753","DOIUrl":"10.1177/21925682261419753","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesGlucagon-like peptide-1 receptor agonists (GLP-1RAs) are prescribed for obesity and type 2 diabetes mellitus (T2DM) and exhibit anti-inflammatory and osteogenic effects which may influence fusion outcomes. This study evaluated the association between preoperative GLP-1RA use and perioperative complications, resource utilization, and revision rates after anterior cervical discectomy and fusion (ACDF) in patients with T2DM.MethodsThe TriNetX Global Network was queried for patients with T2DM undergoing single-level or multi-level ACDF. GLP-1RA users were defined by prescriptions within 6 months before and after surgery. Propensity score matching controlled for demographics, comorbidities, and socioeconomic factors. Outcomes included medical and surgical complications, revision rates, and healthcare utilization at 90 days, 6 months, and 1 year.Results608 single-level and 639 multi-level GLP-1RA users were compared with matched nonusers. GLP-1RA use was associated with lower revision rates after single-level ACDF at 90 days (OR:0.445, <i>P</i> = 0.032) and 6 months (OR:0.489, <i>P</i> = 0.034). Pseudarthrosis risk was reduced across all timepoints for both single-level and multi-level ACDF (OR:0.296-0.608, all <i>P</i> ≤ 0.008). GLP-1RA users also had lower dysphagia risk following single-level ACDF across all timepoints (OR:0.506-0.661, all <i>P</i> ≤ 0.030). Resource utilization was decreased, with fewer readmissions (single-level: OR:0.401-0.634; multi-level: OR:0.418-0.593, all <i>P</i> ≤ 0.003) and ED visits (single-level: OR:0.563-0.697, all <i>P</i> ≤ 0.007) across all timepoints. On multivariate Cox regression, GLP-1RA use independently predicted reduced pseudarthrosis at 1 year (HR:0.665, 95% CI:0.570-0.775, <i>P</i> = 0.005).ConclusionPerioperative GLP-1RA therapy was associated with reduced rates of pseudarthrosis, revision, dysphagia, and healthcare utilization following ACDF without increased adverse events.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2975-2984"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096975","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":"In-Hospital Mortality After Lumbar Fusion is Rare But Occurs Early: A Nationwide Analysis of Risk Factors, 2016-2022.","authors":"Mitchell K Ng, Leonidas E Mastrokostas, Paul G Mastrokostas, Anton J Cristofoli, Matthew W Xie, Gregorio Baek, Sean Inzerillo, Luke B Schwartz, Rajendra Singh, Mohamed Said, Matthew Meade, Afshin E Razi, Andrew P Alvarez, Jeffrey A Rihn, Mark F Kurd, Ian David Kaye, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler, Thomas D Cha","doi":"10.1177/21925682261423475","DOIUrl":"10.1177/21925682261423475","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesTo update national estimates of in-hospital mortality after lumbar fusion, characterize when deaths occur during hospitalization, and identify independent predictors of mortality.MethodsAdult (≥18 years) lumbar fusion hospitalizations in the National Inpatient Sample (NIS) from 2016 to 2022 were analyzed. The primary outcome was in-hospital mortality. Secondary outcomes included hospital-day timing of death and survivor-decedent comparisons of comorbidity and perioperative complication profiles. Multivariable logistic regression identified independent predictors (<i>P</i> < 0.05).ResultsAmong 1,181,465 weighted admissions, mortality was 0.11% (1290 deaths) and occurred early (approximately 50% within 7 days; >90% by ∼ 30 days). Decedents more often underwent multilevel fusion (67.8% vs 38.8%, <i>P</i> < 0.001), were aged ≥75 years (41.5% vs 16.5%, <i>P</i> < 0.001), and had higher comorbidity burden (mean Elixhauser count 3.92 vs 2.15, <i>P</i> < 0.001). Independent predictors included age ≥75 years (OR 4.49, <i>P</i> = 0.003), multilevel fusion (OR 2.09, <i>P</i> < 0.001), congestive heart failure (OR 4.46, <i>P</i> < 0.001), coagulopathy (OR 3.44, <i>P</i> < 0.001), neurologic disorders (OR 9.27, <i>P</i> < 0.001), peripheral vascular disease (OR 1.61, <i>P</i> = 0.031), and higher comorbidity count (per-point OR 1.16, <i>P</i> = 0.010). Female sex (OR 0.72, <i>P</i> = 0.022) and highest income quartile (OR 0.58, <i>P</i> = 0.009) were protective.ConclusionsIn-hospital mortality after lumbar fusion is uncommon but concentrates early and disproportionately affects older, medically complex patients undergoing multilevel procedures, supporting preoperative counseling, front-loaded perioperative risk stratification, and heightened early postoperative vigilance.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"3129-3138"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118764","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":"Variations in Managing Acute Spinal Cord Injury in the North American Clinical Trials Network and Partner Institutes.","authors":"Teleale Fikru Gebeyehu, Zachary Sokol, James D Guest, Joseph D Harrington, Ashmal Sami Kabani, Evan Fitchett, Alejandro Lopez, Stavros Matsoukas, Daniel Franco, Jack Jallo, Alexander R Vaccaro, Muhammad Abd-El-Barr, Shekar N Kurpad, Charles H Tator, Michael G Fehlings, James Harrop","doi":"10.1177/21925682261421192","DOIUrl":"10.1177/21925682261421192","url":null,"abstract":"<p><p>Study DesignSurvey based study.ObjectivesTo evaluate current patterns for managing SCI among spine surgeons in North America.MethodsA survey of the North American Clinical Trials Network (NACTN) and other institutions collected institutional demographics and specific practices on acute SCI management. Variables included trauma level designation, annual case volumes (patient number, spine fracture and surgery performed), steroid usage, emergent cervical traction, magnetic resonance imaging (MRI) access, surgical decompression timing, intraoperative ultrasound and neuromonitoring use, mean arterial pressure (MAP) and spinal cord perfusion pressure (SCPP) targets, lumbar drain use, and the influence of American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade on decision-making.ResultsThirty surgeons from 23 institutions responded (93.3% Level 1 trauma centers). Most centers (93.3%) had immediate MRI access; about 70% of physicians did not use steroids. Emergent cervical traction was used by 60%. An aim of surgical decompression within 24 h was reported by 90%, with 20% operating immediately upon arrival. MAP goals were used by 93.3%, most targeting 85-90 mmHg for ≥5 days. Lumbar drains for SCPP optimization were used in 30%, typically targeting intrathecal pressure (ITP) < 15 mmHg and SCPP >60 mmHg. Management varied by AIS grade in 43.4%.ConclusionDespite agreement in the general scope of acute SCI care, significant implementation heterogeneity exists across North American spine centers. Variability was pronounced in steroid use, timing of decompression (90% within 24 h), cervical traction, and lumbar drain utilization. These findings call for evidence-based protocols to guide acute SCI management and reduce inter-institutional practice variation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"3026-3039"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12831661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043953","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":"Global Burden of Vertebral Fractures in Women by Menopausal Status, 1990-2021, With 2050 Projections: An Analysis of Global Burden of Disease 2021.","authors":"Jun Fan, Weijie Liu, Genfeng Li, Kangqi Ji, Lingfei Wang, Xiaoyu Lian, Yigong Wang, Yanpeng Jian","doi":"10.1177/21925682261421189","DOIUrl":"10.1177/21925682261421189","url":null,"abstract":"<p><p>Study DesignEco-epidemiological study.ObjectivesVertebral fractures (VFs) are a major cause of morbidity, disability, and mortality in women, with risk increasing sharply after menopause due to accelerated bone loss. However, global patterns of VF burden by menopausal status and long-term projections remain poorly characterized.MethodsWe analyzed Global Burden of Disease (GBD) 2021 data on VF incidence, prevalence, and years lived with disability (YLDs) for 204 countries from 1990-2021. Women were categorized as premenopausal (15-49 years) or postmenopausal (≥50 years). Age-standardized rates (ASRs) were calculated per 100,000 population. Temporal trends were assessed using estimated annual percentage change and joinpoint regression. Socio-demographic disparities were examined with Slope Index of Inequality and Concentration Index. Decomposition analysis quantified contributions of population growth, aging, and epidemiologic change. Bayesian age-period-cohort models projected trends to 2050.ResultsIn 2021, 1.15 million VFs occurred in premenopausal women and 1.63 million in postmenopausal women, causing 50,060 and 206,652 YLDs, respectively. Absolute VF counts rose substantially since 1990, although ASRs declined in most regions. Postmenopausal women bore the highest burden, with marked geographic heterogeneity and persistent pro-poor inequality. Population growth and aging were the main drivers of increasing burden, and projections indicate that absolute VF cases will continue to rise globally through 2050 despite modest ASR declines.ConclusionsThe global burden of vertebral fractures in women is rising in absolute terms, especially among postmenopausal women. Targeted osteoporosis screening, fall-prevention programs, and equitable treatment access are needed to mitigate the projected growth.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"3010-3025"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092534","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":"Geriatric Nutritional Risk Index as a Predictor of Outcomes After Spinal Deformity Surgery in Elderly Patients.","authors":"Ataollah Shahbandi, Kevin Wojcik, Saman Shabani","doi":"10.1177/21925682261436347","DOIUrl":"10.1177/21925682261436347","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesThe Geriatric Nutritional Risk Index (GNRI) is widely applied to evaluate malnutrition in older adults, yet its relevance in spinal deformity surgery is unclear. This study examined the relationship between nutritional status before surgery, as assessed by GNRI, and postoperative outcomes in geriatric patients undergoing spinal deformity surgery.MethodsThe 2008-2023 ACS-NSQIP database was queried for patients aged ≥65 years who underwent spinal deformity surgery. Patients were stratified by GNRI score: normal (>98), malnourished (92-98), or severely malnourished (<92). The independent association and predictive value of GNRI were assessed in comparison to the 5-item modified Frailty Index (mFI-5) and chronological age for perioperative outcomes, including length of stay, non-home discharge, and 30-day postoperative complications.ResultsA total of 2186 patients were included: 1705 (78%) had normal nutrition, 332 (15.2%) were malnourished, and 149 (6.8%) were severely malnourished. Malnourished status was independently associated with significantly greater odds of wound disruption (OR 3.3, <i>P</i> = .014), prolonged mechanical ventilation (OR 2.2, <i>P</i> = 0.019), postoperative transfusion (OR 1.5, <i>P</i> = .001), increased transfusion volume (coefficient 0.452, <i>P</i> = .044), and non-home discharge (OR 1.6, <i>P</i> < .001) compared to normal patients. In receiver operating characteristic analyses, GNRI demonstrated superior discriminatory ability compared with mFI-5 (<i>P</i> = 0.394, <i>P</i> = .645, <i>P</i> = .179, <i>P</i> = .113, <i>P</i> = .014, <i>P</i> = .233) and age (<i>P</i> = .277, <i>P</i> = .074, <i>P</i> = .039, <i>P</i> = .167, <i>P</i> < .001, <i>P</i> < .001) for predicting wound disruption, superficial surgical site infection, prolonged mechanical ventilation, unplanned intubation, the need for transfusion, and prolonged hospitalization.ConclusionsPreoperative malnutrition, defined by GNRI, is correlated with a greater risk of adverse outcomes following spinal deformity surgery in older adults, highlighting the importance of incorporating nutritional assessment into preoperative evaluation in this population.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"3422-3436"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581045","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":"Letter to \"Could Spinal Cord-Canal Mismatch Compromise Clinical Success of Cervical Disc Replacement in Cervical Myelopathy?\"","authors":"Guoyu Dai, Mingfeng Xue","doi":"10.1177/21925682261416909","DOIUrl":"10.1177/21925682261416909","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"3695-3696"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042062","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}