Global Spine Journal最新文献

{"title":"Comments on \"Interlaminar Contralateral Endoscopic Foraminotomy Reduces Postoperative Dysesthesia in Patients With Degenerative Lumbar Deformity: A Multicenter Comparative Cohort Study\".","authors":"Fatih Kaplan, Bilge Kurnaz Kaplan","doi":"10.1177/21925682261499693","DOIUrl":"10.1177/21925682261499693","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261499693"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192836","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":"Dual-Eligible Patient Burden Is Independently Associated With Lower Standardized Reimbursement Among Lumbar Laminectomy Surgeons: A National Medicare Analysis.","authors":"Alexander Kucherina, Steven Govinda Persaud, Paul Mastrokostas, Charla Fischer","doi":"10.1177/21925682261498031","DOIUrl":"10.1177/21925682261498031","url":null,"abstract":"<p><p>Study DesignRetrospective cross-sectional analysis of a national Medicare administrative dataset (2023).ObjectivesDual eligibility for Medicare and Medicaid is an established marker of socioeconomic vulnerability, but its association with surgeon reimbursement is uncharacterized in the lumbar laminectomy market. We evaluated whether surgeon-level dual-eligibility proportion is associated with laminectomy volume and standardized reimbursement.MethodsSingle-level lumbar laminectomy surgeons were identified by CPT code 63047 in the 2023 Centers for Medicare and Medicaid Services (CMS) Physician and Other Practitioners file. Dual-eligibility proportion, the share of dual-eligible beneficiaries in each surgeon's Medicare panel, was categorized into quartiles. Outcomes were laminectomy volume and mean standardized reimbursement per procedure; panel comorbidity, minority composition, behavioral health diagnoses, and rurality were also assessed. Quartile and multivariable analyses were restricted to the 3,075 surgeons (73.7%) with complete panel data.ResultsWe identified 4,170 surgeons performing 102,006 procedures. Higher dual-eligibility proportion was associated with lower standardized reimbursement (Q1, $672.81 vs. Q4, $502.53), greater beneficiary risk (Hierarchical Condition Category score, 1.11 vs. 1.38), higher minority panel composition, and more anxiety (28.88% vs. 34.21%) and depression (26.00% vs. 32.30%); all P < 0.001. Each 1-percentage-point increase in dual-eligibility proportion was independently associated with $5.68 lower standardized reimbursement (β = -5.676; 95% CI, -7.75 to -3.60; P < 0.001).ConclusionsSurgeons who disproportionately serve dual-eligible beneficiaries receive lower standardized reimbursement despite treating more medically and psychosocially complex patients. Because analyses required complete CMS panel data, estimates may not generalize to lower-volume or rural providers.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261498031"},"PeriodicalIF":3.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192843","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":"Practical Application of the AO Spine Primary Infection Classification System: Clarifying Definitions, Borderline Cases and Common Misinterpretations.","authors":"Barry Ting Sheen Kweh, Alexander R Vaccaro, Gregory Schroeder, Mohamed Aly, Mohammad El-Sharkawi, Charlotte Dandurand, Jonathan Neuhoff, Brian Karamian, Grace Xiong, Harvinder Singh Chhabra, Richard Bransford, Andrei Fernandes Joaquim, Jin Wee Tee","doi":"10.1177/21925682261498682","DOIUrl":"10.1177/21925682261498682","url":null,"abstract":"<p><p>Study DesignNarrative review.ObjectiveTo clarify nuances when applying the AO Spine Primary Infection Classification.MethodsThe international validation of the AO Spine Primary Infection Classification System was successful but recurring themes caused confusion. This included the exact definition and reasons for infections to transition between categories, definition of canal involvement or neural compression and whether an epidural infection superimposed on degenerative disease escalates infection severity. There was uncertainty regarding handling of multi-level or junctional infection and clinicians encountered difficulty applying the modifiers.ResultsThe difference between a Type 0 and Type 1 infection is reasonably distinct given the former is purely extraspinal whilst the latter involves spondylodiscitis or osteomyelitis without canal involvement. Type 2 infections include those with any canal involvement, regardless of whether CSF effacement occurs, in the absence of neural compression. The spinal canal is defined as the compartment dorsal to the posterior longitudinal ligament and excludes infections that are ventral to this ligament but bow into the canal. Any neural compression of the thecal sac centrally or within the foramen escalates categorization to a Type 3 infection.ConclusionsPrimary spinal infections have the potential to rapidly progress and cause devastating neurological deficits. The introduction of the AO Spine Primary Infection Classification establishes a universal language to communicate disease severity. We clarify common nuances encountered during international validation of this system including definition of canal involvement and relevance of CSF effacement, whether foraminal involvement constitutes neural compression and the nomenclature concerning multi-level or junctional disease.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261498682"},"PeriodicalIF":3.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181146","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 Impact of Hip Osteoarthritis on Patient Reported Outcomes Following Lumbar Fusion.","authors":"Ali Farooqi, Joshua Mathew, Mitchell Ng, Roy Miloh, Emily Berthiaume, Yulia Lee, Gregorio Baek, William Green, Morgan Hitchner, Yasmine Eichbaum, Steven Banko, Manav Dasondi, Alan Mathew, Matthew Silva, Darshan Patel, Dipti Venkatesh, Andrew Vanichkachorn, Brandon Martinazzi, Alec Giakas, Bradley Hammoor, Jonathan Dalton, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder","doi":"10.1177/21925682261496527","DOIUrl":"10.1177/21925682261496527","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectivesWith an aging population, the burden of concomitant joint disease continues to rise. The effects of hip OA on lumbar fusion outcomes are underexplored. Therefore, this study aimed to: (1) describe demographic differences between Osteoarthritis (OA) patients and those without OA; (2) assess perioperative differences; and (3) compare patient-reported outcome measures (PROMs).MethodsA retrospective review of a single academic tertiary center was performed (2016-2025). Patients undergoing lumbar fusion with isolated hip OA or no diagnosis of OA, and 12-month ODI scores were included. Patients with prior arthroplasty were excluded. Kellgren-Lawrence scores were collected through chart review or graded on x-ray when missing. Patients were stratified based on the presence of Hip OA. Bivariate comparison was performed as appropriate. Multivariable regressions were performed to identify independent predictors of PROMs.ResultsA total of 271 patients were included (No OA: 229; OA: 42). There were significant differences between groups regarding age (71.8 versus 60.2 years, <i>P</i><0.001), ethnicity (<i>P</i>=0.025), and smoking status (<i>P</i><0.001). Most patients with OA had moderate OA based on KL grading, with grade 3 being most common (35.7%). On bivariate analysis, there were no differences in PROMs or improvement at any timepoint except Δ6month VASback (P=0.024). Multivariable regression analysis showed that the presence of hip OA was not an independent predictor of PROMs or improvement from baseline (all P>0.05).ConclusionsThese findings suggest that concomitant hip OA <b>may</b> not independently impact postoperative recovery and should not be considered a contraindication to lumbar fusion.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261496527"},"PeriodicalIF":3.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181212","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":"Fracture and Vertebral Augmentation Utilization Following Androgen Deprivation Therapy in Men With Prostate Cancer: A Propensity Score-matched Cohort Study.","authors":"Taha Taka, Carson Cummings, Sarah Meng, Andrew Miner, Graydon Dietrich, David Shin, Trupti Trivedi, Rory Goodwin, William Richardson, Olumide Danisa","doi":"10.1177/21925682261496842","DOIUrl":"10.1177/21925682261496842","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectiveTo investigate the association between androgen deprivation therapy (ADT), vertebral compression fracture (VCF) incidence, and subsequent vertebral augmentation (vertebroplasty/kyphoplasty) utilization in adult men with prostate cancer.MethodsAdult men with prostate cancer were stratified by ADT exposure and matched 1:1 to non-ADT controls on demographics, comorbidities, and bone health. Primary outcomes were VCF incidence at 3 months, 1 year, 3 years, and 5 years and vertebral augmentation utilization. Secondary outcomes included posterior spinal instrumentation, dependency, fracture burden, and bisphosphonate/denosumab use. Risks were compared using Kaplan-Meier and Cox proportional hazards models, with chi-square tests for categorical outcomes.ResultsAfter matching, 122,511 patients were included per cohort. ADT was associated with higher 5-year VCF incidence (1.95% vs 1.29%; HR, 1.49; p < 0.001), representing a 54% relative increase (NNH = 143), with consistent findings at earlier time points (all p < 0.05). Among 2,926 matched pairs with VCFs, vertebral augmentation utilization was higher with ADT (7.4% vs 5.1%; p < 0.001), representing a 45% relative increase. Posterior instrumentation (2.1% vs 2.0%) and dependency (7.5% vs 7.7%) were similar, while fracture burden did not differ (p = 0.07).ConclusionsADT is associated with increased VCF incidence and vertebral augmentation utilization without differences in posterior instrumentation. This pattern is consistent with osteoporotic insufficiency fractures and supports bone health screening and preventive therapy at ADT initiation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261496842"},"PeriodicalIF":3.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181119","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":"Predicting the Risk of Distal Junctional Kyphosis After Surgery for Adolescent Idiopathic Scoliosis Using Preoperative Radiographic Indicators and Machine Learning.","authors":"Tao Li, Chaofeng Guo, Emmanuel Alonge, Xiangbin Wang, Yubin Long","doi":"10.1177/21925682261496528","DOIUrl":"10.1177/21925682261496528","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesTo develop and internally validate an interpretable machine learning model using preoperative radiographic indicators to predict distal junctional kyphosis (DJK) after surgery for Lenke type 1 or 2 adolescent idiopathic scoliosis (AIS).MethodsWe included 279 patients with Lenke type 1 or 2 AIS undergoing posterior spinal fusion, including 47 with DJK and 232 without DJK. Thirty-three preoperative variables were evaluated. The cohort was stratified 7:3 into training and internal hold-out validation sets. Feature selection and hyperparameter tuning were restricted to the training set. Boruta and least absolute shrinkage and selection operator regression were used for feature selection, and nine algorithms were compared.ResultsIn the internal hold-out validation set, support vector machine (SVM) had the numerically highest C-index (0.930; 95% CI, 0.867-0.992) versus logistic regression (0.912; 95% CI, 0.838-0.987). A paired DeLong test showed no statistically significant difference (difference, 0.017; 95% CI, -0.015 to 0.050; P = 0.292). SVM sensitivity was 0.857, specificity 0.843, precision 0.522, F1 score 0.649, and Brier score 0.073. Ten-fold nested cross-validation yielded a pooled C-index of 0.891 (95% CI, 0.826-0.948). SHAP identified TLK, LIV-SSV, and TK as dominant contributors.ConclusionsPreoperative sagittal alignment and the LIV-SSV relationship may aid exploratory DJK risk stratification. The three-feature SVM showed promising internal performance, but its numerical advantage over logistic regression does not establish superiority. External validation is required before clinical implementation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261496528"},"PeriodicalIF":3.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165718","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":"Procedural Complications and Implant Cutout of the SpineJack®-System in Thoracolumbar Vertebral Fractures: A Retrospective Analysis of 204 Implants from a Level-1 Trauma Center.","authors":"Julian Scherer, Magdalena Karner, Georg Osterhoff, Kai Sprengel, Hans-Christoph Pape","doi":"10.1177/21925682261497980","DOIUrl":"10.1177/21925682261497980","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesImplant-related complications of SpineJack® stent-kyphoplasty, particularly endplate cutout, remain poorly characterized. This study determined the incidence of procedural complications, with a focus on cutout, and identified associated factors.MethodsAll patients treated with stand-alone SpineJack® stent-kyphoplasty at a level-1 trauma center (November 2014-December 2022) were retrospectively reviewed, excluding malignant fractures. In total, 204 implants were analyzed (129 OVFs, 75 VCFs). Intraoperative complications and postoperative endplate cutout, assessed on imaging after mobilization, were analyzed by fracture type, AO/OF classification, region and vertebral level.ResultsMean age was 64.9 years (SD 17.5); OVF patients were significantly older than VCF patients (74.3 vs 48.8 years, p<0.001). Vascular cement leakage occurred in 2 cases (1.0%); no technical failures or conversions were recorded. Cement leakage occurred in 18 implants (8.8%) and cutout in 16 (7.8%), neither differing by fracture type. Cutout incidence differed significantly across OF grades (p=0.018), though not after excluding the small OF1 subgroup (p=0.211) or in multivariable analysis (OR 1.03, p=0.918), suggesting limited power; cutout was not correlated with cement leakage or vertebral level.ConclusionsStand-alone SpineJack® stent-kyphoplasty is associated with infrequent vascular and cement-related complications. Endplate cutout (7.8%) was numerically more frequent in severely collapsed osteoporotic (OF4) fractures, but this association was not robust to sensitivity or multivariable analysis, consistent with limited power rather than a true absence of effect; no cutout event in this cohort had a demonstrated clinical consequence. Prospective, adequately powered study is needed to confirm this association.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261497980"},"PeriodicalIF":3.1,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165483","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":"Subsequent Knee Arthroplasty Does Not Influence Patient-Reported Outcomes Following Lumbar Fusion.","authors":"Joshua Mathew, Roy Y Miloh, Mitchell Ng, Emily Berthiaume, Yulia Lee, Gregorio Baek, William Green, Yasmine Eichbaum, Morgan Hitchner, Steven J Banko, Jonathan Dalton, Dipti Venkatesh, Vinay Bijoor, Paul Gunter, Gus Duininck, Andrew Vanichkachorn, Brandon Martinazzi, Ali Farooqi, Alec Giakas, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder","doi":"10.1177/21925682261497267","DOIUrl":"10.1177/21925682261497267","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectivesThe impact of knee arthritis and early total knee arthroplasty (TKA) on lumbar fusion recovery remains underexplored. This study aimed to identify demographic differences between lumbar fusion patients that had subsequent TKA and patients with OA without TKA, assess perioperative differences; and compare patient-reported outcomes (PROMs).MethodsRetrospective review was performed at one tertiary care center (2016-2025). Patients undergoing lumbar fusion with concurrent knee osteoarthritis and had 1-year Oswestry Disability Index (ODI) scores were included. Patients with prior joint arthroplasty or concomitant hip arthritis were excluded. Kellgren-Lawrence grading (KL) was collected via chart review and radiographs. Cohorts were stratified by future arthroplasty status and compared using bivariate analysis, with P set at <0.05.Results148 patients were included (OA-104; TKA-44). Overall, there were no significant demographic differences between groups (Age: 64.9 years; 54.1% female). Perioperatively, patients who eventually underwent TKA had higher KL grading at the time of surgery (Grade 4: 56.8% vs 20.2%; <i>P</i> < 0.001). The average time to TKA from lumbar fusion was 679 days. Preoperative ODI was not significantly different between groups (42.9 vs 46.8; <i>P</i> = 0.174). Likewise, at 12 months, postoperative ODI (21.9 vs 27.2; <i>P</i> = 0.137) and improvement from baseline (-20.96 vs -19.61; <i>P</i> = 0.730) were similar between groups.ConclusionThese findings suggest knee osteoarthritis and future TKA should not be considered a contraindication for lumbar fusion and may aid in counseling and expectation management following lumbar fusion in the presence of knee osteoarthritis.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261497267"},"PeriodicalIF":3.1,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169538","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":"Erratum to \"Utilization of Carbon Fiber Spinal Instrumentation in Primary Spinal Tumors: Outcome Analysis from the AO Spine Primary Tumor Research and Outcomes Network\".","authors":"","doi":"10.1177/21925682261496904","DOIUrl":"10.1177/21925682261496904","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261496904"},"PeriodicalIF":3.1,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165802","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":"Spin and Methodological Quality in Systematic Reviews of Decompression Timing for Central Cord Syndrome.","authors":"Marco Napolitano, Andrew Kwon, Aidan Lindgren, Daniel Rusu, Joshua Davood, Clay Beagles, Rajko Vucicevic, Jeffrey C Wang, Raymond J Hah, Ram K Alluri","doi":"10.1177/21925682261498007","DOIUrl":"10.1177/21925682261498007","url":null,"abstract":"<p><p>Study DesignMeta-research.ObjectivesTo evaluate the prevalence and types of severe spin and the methodological quality of systematic reviews addressing early versus delayed surgical decompression for central cord syndrome (CCS).MethodsPubMed, Web of Science, Scopus, and Embase were searched for systematic reviews evaluating decompression timing in CCS. Two reviewers independently assessed studies for the nine most severe spin types and graded methodological quality using AMSTAR-2. Early decompression was designated as the experimental intervention, while conclusion direction was recorded separately from spin classification.ResultsTen reviews met inclusion criteria. Spin was identified in 40% (4/10) of reviews, and all spin-positive reviews contained type 1 spin (clinical recommendations not supported by the review findings). Types 3 and 9 each occurred in 20% (2/10), while types 5, 7, and 8 were each present in 10% (1/10). Overall, six reviews favored early decompression, three had mixed or subgroup-dependent conclusions, and one reported no timing benefit. Nine reviews (90%) were rated critically low and one (10%) low by AMSTAR-2. Interrater agreement for the presence of any spin was substantial (κ = 0.783).ConclusionSevere spin was present in 40% of reviews, most commonly as clinical recommendations judged to extend beyond the supporting findings. These findings identify potential mismatches between recommendation strength and supporting evidence but do not establish that early decompression is ineffective or that spin explains the direction of the literature. Future reviews should align recommendation strength with risk of bias and certainty of evidence.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261498007"},"PeriodicalIF":3.1,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166951","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}