Global Spine Journal最新文献

{"title":"K-Line Tilt May Influence the Short-Term Surgical Outcomes After Laminoplasty in Patients With Degenerative Cervical Myelopathy.","authors":"Qifei Duan, Jianxiong Zhuang, Shuaihao Huang, Xiaoqing Zheng, Xiaoping Wang, Yunbing Chang","doi":"10.1177/21925682241288202","DOIUrl":"https://doi.org/10.1177/21925682241288202","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objectives: </strong>To explore the relationship between K-line tilt and short-term surgical outcomes following laminoplasty in patients with multilevel degenerative cervical myelopathy (DCM), and to evaluate the potential of K-line tilt as a reliable preoperative predictor.</p><p><strong>Methods: </strong>A retrospective analysis was performed for 125 consecutive patients who underwent laminoplasty for multilevel DCM. The radiographic parameters utilized in this study encompassed T1 slope (T1S), C2-C7 lordosis (CL), C2-C7 sagittal vertical axis (cSVA), T1 slope minus C2-C7 lordosis (T1S-CL), C2-C7 range of motion (ROM), and K-line tilt. The neurological recovery was evaluated using the Japanese Orthopaedic Association (JOA) score. Pearson correlation coefficients were calculated to assess the relationship between K-line tilt and other classical cervical parameters. Logistic regression analysis was employed to examine the association between K-line tilt and surgical outcomes.</p><p><strong>Results: </strong>Of the 125 patients, 89 were men. The mean age of the patients was 61.74 ± 11.31 years. The results indicated a correlation between the K-line tilt and the cSVA (<i>r</i> = 0.628, <i>P</i> < 0.001), T1S (<i>r</i> = 0.259, <i>P</i> = 0.004), and T1S-CL (<i>r</i> = 0.307, <i>P</i> < 0.001). The K-line tilt showed an association with the failure of the JOA recovery rate (RR) to reach the minimal clinically important difference (MCID) and the occurrence of postoperative kyphotic deformity. We identified cutoff values for the K-line tilt which predict the failure of the JOA RR to reach the MCID and postoperative kyphotic deformity as 10.13° and 9.93°, respectively.</p><p><strong>Conclusions: </strong>The K-line tilt is an independent preoperative risk factor associated with both the failure of the JOA RR to reach the MCID and the occurrence of postoperative kyphotic deformity in patients with multilevel DCM after laminoplasty.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Factors for Outcome of Fusion Surgery in Patients With Chronic Low Back Pain - A Systematic Review.","authors":"Rinse J Meester, Wilco C H Jacobs, Maarten Spruit, Robert Jan Kroeze, Miranda L van Hooff","doi":"10.1177/21925682241286031","DOIUrl":"https://doi.org/10.1177/21925682241286031","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review.</p><p><strong>Objective: </strong>This systematic review aims to identify prognostic factors, encompassing biomedical and psychosocial variables, linked to outcome of fusion surgery for chronic low back pain (CLBP) in single or two-level lumbar degenerative spinal disorders. Identifying these factors is crucial for decision making and therefore long-term treatment outcome.</p><p><strong>Methods: </strong>A systematic search (PROSPERO ID: CRD4202018927) from January 2010 to October 2022 was conducted, utilizing Medline, Embase, and the Cochrane Database of Systematic Reviews (CDSR, CENTRAL). Prognostic factors associated with various outcomes, including functional status, back and leg pain, health-related quality of life, complications, return to work, and analgesic use, were assessed. Risk of bias was determined using QUIPS, and the quality of evidence was evaluated using GRADE approach.</p><p><strong>Results: </strong>Of the 9852 initially screened studies, eleven studies (n = 16,482) were included in the analysis. In total, 161 associations were identified, with 67 prognostic factors showing statistical significance (<i>P</i> < 0.05). Thirty associations were supported by two or more studies, and only eight associations were eligible for meta-analyses: female gender remained statistically significant associated with decreased postoperative back pain, but negatively associated with complication rates and functional status, and smoking with increased postoperative back pain.</p><p><strong>Conclusion: </strong>Only female gender and smoking were consistently associated with outcome of fusion for CLBP. Most of the included studies exhibited low to moderate methodological quality, which may explain the relatively weak associations identified for the assessed prognostic factors.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What if You Could Treat the Same Patient Again, Would You do the Exact Same Spine Surgery? A Multi-Surgeon Survey of Their Own Revisions","authors":"Connor Sheehan, Ayman Mohamed, Frank Schwab, Douglas Burton, David Okonkwo, Robert Eastlack, Han J. Kim, Eric Klineberg, KoJo Hamilton, Shay Bess, Renaud Lafage, Virginie Lafage","doi":"10.1177/21925682241286445","DOIUrl":"https://doi.org/10.1177/21925682241286445","url":null,"abstract":"Study DesignCase-based survey.ObjectivesThis study aims to investigate what a group of surgeons learned from their own revisions, and what they would do differently today.MethodsA multi-center database of ASD surgical patients was queried to identify those with at least 2 surgical procedures performed by the same surgeon between 2009 and 2019. A clinical vignette was created for each case including demographics, a timeline of events, radiographs/measurements, patient-reported outcomes, complications, and surgical strategies used for the index and revision surgeries. The operative surgeon was then asked to fill out a five-question survey aimed at determining factors that contribute to operative decision-making and planning.Results86 patients were operated on by 6 participating surgeons for both index and revision ASD surgery. The revised patients had similar follow-up compared to the non-revised group ( P = 0.73), with the most common complications indicating a need for revision surgery being proximal junctional failure (42%) and pseudoarthrosis (28%). Surgeons reported that they would not change their surgical strategy in 52.3% of the cases. The leading cause for revision was hardware/instrumentation issues (24.4%). Learning points included rod-related choice (23.3%), level selection (19.8), PJF prophylactic strategy (15.1%), and sagittal alignment objective (11.6%).ConclusionsSurgeons saw opportunity in nearly half of the cases to improve outcomes by changing something in the original surgery. While 40% of the failures remained unexplained from the surgeons’ perspective, this study highlights the capacity for adopting changes in adult spinal deformity surgery and illuminates the reasoning behind certain surgical decisions.","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waterpipe Smoking and Lumbar Intervertebral Disc Degeneration: A Pilot Study","authors":"Hala Ishak, Tarek P. Sunna, Sara A. Assaf, Hanin Banna, Riad A. Khouzami, Zhi Wang, Ghazi Zaatari, Diana Rahme, Carine J. Sakr","doi":"10.1177/21925682241286451","DOIUrl":"https://doi.org/10.1177/21925682241286451","url":null,"abstract":"Study DesignRetrospective study.ObjectiveThe objective of this study is to investigate the association of waterpipe smoking with lumbar intervertebral disc degeneration (IVDD).MethodsThis is a retrospective chart review study. A total of 286 adults who underwent a lumbar magnetic resonance imaging (MRI) at a tertiary medical center were included and divided into three groups. Group 1 (n = 125) included non-smokers, group 2 (n = 80) smoked cigarettes only, and group 3 (n = 81) smoked waterpipe only. The intervertebral discs were graded using the Pfirmann disc degeneration grading system.ResultsThe study showed higher lumbar disc degeneration scores for waterpipe and cigarette smokers compared to non-smokers at all spinal levels. Specifically, post hoc analysis showed that there was a significant difference at L1-L2 between cigarette smokers and non-smokers ( P = 0.007) and between waterpipe smokers and non-smokers ( P = 0.013), and a significant difference at L3-L4 and L4-L5 between non-smokers and cigarettes smokers ( P &lt; .001 and P = .029 respectively).ConclusionWaterpipe smoking is associated with lumbar intervertebral disc degeneration.","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Sacroiliac Joint Fusion after Instrumented Spinal Fusion.","authors":"Peter Z Du, Gurmit Singh, Spencer Smith, Travis Philipp, Jonathan Kark, Clifford Lin, Jung U Yoo","doi":"10.1177/21925682241286458","DOIUrl":"https://doi.org/10.1177/21925682241286458","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort Study.</p><p><strong>Objective: </strong>To identify risk factors for sacroiliac (SI) joint fusion after instrumented spinal fusion.</p><p><strong>Methods: </strong>Patients were identified from the PearlDiver BiscayneBay database. Patients who underwent 1 level (CPT: 22840), 3-6 vertebral segment (22842), and 7+ vertebral segment spinal fusions (22843 and 22844) were identified. Patients were separated based on whether they received an SI joint fusion (27280 and 27279) after their spinal fusion. A univariate analysis and multivariate logistic regression was performed to evaluate the associations between patient factors and incidence of SI joint fusion.</p><p><strong>Results: </strong>549,625 patients who underwent posterior spinal fusions were identified, 6068 of whom underwent subsequent SI joint fusion (1.1%). Factors associated with future SI joint fusion included female gender, patients with obesity, fibromyalgia, diabetes, tobacco use, increased construct length, and prior SI joint injection. Prior SI joint injection had the highest odds ratio (OR: 8.70; 95% CI: 8.25-9.16; <i>P</i> < 0.001), followed by 7+ vertebral segment (OR: 2.17; 95% CI: 2.03-2.33; <i>P</i> < 0.001) and 3-6 vertebral segment fusion (OR: 1.49; 95% CI: 1.42-1.57; <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>The highest predictor of requiring subsequent SI joint fusion is a prior SI joint injection. We also found that longer fusion constructs are associated with increased risk for future SI joint fusion.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142284334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Characteristics of Spinal Morphology According to the “Current” and “Theoretical” Roussouly Classification Systems in a Diverse, Asymptomatic Cohort: Multi-Ethnic Alignment Normative Study (MEANS)","authors":"Juan Esteban Muñoz Montoya, Praveen R. Iyer, Ajoy Prasad Shetty","doi":"10.1177/21925682241280652","DOIUrl":"https://doi.org/10.1177/21925682241280652","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Hangman’s Fractures: An Institutional Study of 51 Patients With Atypical Traumatic Spondylolisthesis of C2","authors":"Mina Botros, Aman Singh, Hashim Shaikh, Gabriel Ramirez, Robert W. Molinari, Varun Puvanesarajah","doi":"10.1177/21925682241284559","DOIUrl":"https://doi.org/10.1177/21925682241284559","url":null,"abstract":"Study DesignRetrospective cohort study.ObjectivesAtypical hangman’s fractures are associated with increased risk for neurologic injury due to involvement of the posterior cortex of the axis body. We present the largest single-center cohort of atypical hangman’s fractures with the goal of guiding treatment decisions and outcomes based on fracture classification.MethodsWe performed a retrospective analysis of all patients with atypical hangman’s fractures treated at a single Level I trauma center between January 2010 and September 2023. 51 patients met inclusion criteria and demographic, treatment, and radiographic data were recorded and compared across the Type I and II fracture groups.ResultsFinal treatment modalities varied significantly between the groups ( P &lt; 0.01), with hard cervical collar and invasive halo immobilization being the most prevalent treatments for fracture Types I and II respectively. One Type I fracture patient and four Type II fracture patients failed non-operative treatment, requiring surgery. Across both groups, posterior cervical fusion (73%) was the most common surgical approach. Median length of stay varied significantly between the two fracture groups (2.0 (1.0-7.0) vs 5.0 (3.0-8.0) days; P = 0.01). Irrespective of fracture type, longer hospital length of stay was associated with increased patient age (IRR = 1.02; P &lt; 0.01), non-white race (IRR = 2.47; P = 0.01), injury caused by MVC (IRR = 1.93; P &lt; 0.01), and the presence of non-spine orthopedic injuries (IRR = 1.72; P = 0.03).ConclusionsWhile atypical Type I hangman’s fractures may be managed effectively non-operatively with a hard cervical collar, atypical Type II fractures managed with a hard cervical collar are at greater risk of requiring subsequent surgical intervention.","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Method for Scoliosis Screening Incorporating Deep Learning With Back Images","authors":"Le Zhang, Baoqing Pei, Shijia Zhang, Da Lu, Yangyang Xu, Xin Huang, Xueqing Wu","doi":"10.1177/21925682241282581","DOIUrl":"https://doi.org/10.1177/21925682241282581","url":null,"abstract":"Study DesignRetrospective observational study.ObjectivesScoliosis is commonly observed in adolescents, with a world0wide prevalence of 0.5%. It is prone to be overlooked by parents during its early stages, as it often lacks overt characteristics. As a result, many individuals are not aware that they may have scoliosis until the symptoms become quite severe, significantly affecting the physical and mental well-being of patients. Traditional screening methods for scoliosis demand significant physician effort and require unnecessary radiography exposure; thus, implementing large-scale screening is challenging. The application of deep learning algorithms has the potential to reduce unnecessary radiation risks as well as the costs of scoliosis screening.MethodsThe data of 247 scoliosis patients observed between 2008 and 2021 were used for training. The dataset included frontal, lateral, and back upright images as well as X-ray images obtained during the same period. We proposed and validated deep learning algorithms for automated scoliosis screening using upright back images. The overall process involved the localization of the back region of interest (ROI), spinal region segmentation, and Cobb angle measurements.ResultsThe results indicated that the accuracy of the Cobb angle measurement was superior to that of the traditional human visual recognition method, providing a concise and convenient scoliosis screening capability without causing any harm to the human body.ConclusionsThe method was automated, accurate, concise, and convenient. It is potentially applicable to a wide range of screening methods for the detection of early scoliosis.","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historical Perspectives on the Evolution of Spino-Pelvic Fixation and its Implications on Clinical Care A Narrative Review.","authors":"Alexander von Glinski,Emre Yilmaz,Periklis Godolias,Lorin Benneker,F C Oner,Frank Kandziora,Gregory Schroeder,Klaus Schnake,Marcel Dvorak,Shanmuganathan Rajasekaran,Mohammad El-Sharkawi,Alexander Vaccaro,Richard Bransford,Thomas A Schildhauer,Jens R Chapman","doi":"10.1177/21925682241283726","DOIUrl":"https://doi.org/10.1177/21925682241283726","url":null,"abstract":"STUDY DESIGNBroad narrative review.OBJECTIVESTo review and summarize the evolution of spinopelvic fixation (SPF) and its implications on clinical care.METHODSA thorough review of peer-reviewed literature was performed on the historical evolution of sacropelvic fixation techniques and their respective advantages and disadvantages.RESULTSThe sacropelvic junction has been a long-standing challenge due to a combination of anatomic idiosyncrasies and very high biomechanical forces. While first approaches of fusion were determinated by many material and surgical technique-related limitations, the modern idea of stabilization of the lumbosacral junction was largely initiated by the inclusion of the ilium into lumbosacral fusion. While there is a wide spectrum of indications for SPF the chosen technique remains is defined by the individual pathology and surgeons' preference.CONCLUSIONBy a constant evolution of both instrumentation hardware and surgical technique better fusion rates paired with improved clinical results could be achieved.","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142224097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Revision Extension of Fusion Surgery in Thoracolumbar Spine Using a Newly Designed Revision Rod - Comparative Matched Cohort Study Versus Implant-Replacement Surgery\".","authors":"","doi":"10.1177/21925682241278202","DOIUrl":"https://doi.org/10.1177/21925682241278202","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}