Global Spine Journal最新文献

{"title":"Combined Epidural Stimulation and Virtual Reality Rehabilitation for Comprehensive Neuromotor Recovery Following Spinal Cord Injury: A Single Arm Study.","authors":"Surbhi Kaura, Shahiduz Zafar, Pritam Majumdar","doi":"10.1177/21925682251389598","DOIUrl":"10.1177/21925682251389598","url":null,"abstract":"<p><p>Study DesignProspective pre-post interventional study.ObjectivesTo evaluate the effects of epidural spinal cord stimulation (ESCS) combined with task-specific rehabilitation on mobility, sitting balance, bladder control, lower limb strength, and postural stability in individuals with spinal cord injury.MethodsFifteen participants with chronic thoracic SCI received daily ESCS sessions combined with physiotherapy and Tyromotion-based robotic balance training for 8 weeks. Outcome measures included: Timed Up and Go (TUG) test for mobility, Walking Index for Spinal Cord Injury II for ambulatory function, Neurogenic Bladder Symptom Score for bladder control, Manual Muscle Testing for knee extension strength, and anterior-posterior displacement for postural stability and Modified Ashworth Scale (MAS) for spasticity from<b>.</b>ResultsAll participants successfully completed the study. The Timed Up and Go (TUG) test time significantly improved from 430.25 ± 265.2 seconds to 141.9 ± 92.6 seconds (<i>P</i> < 0.001). The Walking Index for Spinal Cord Injury II (WISCI II) score increased markedly from 0.07 ± 0.26 to 6.07 ± 1.03 (<i>P</i> < 0.001). Antero-posterior (AP) displacement during standing balance decreased from 18.2 ± 3.5 mm to 11.4 ± 2.9 mm (<i>P</i> < 0.001), indicating enhanced static postural control. The Neurogenic Bladder Symptom Score (NBSS) improved significantly, reducing from 24.05 ± 6.91 to 7.4 ± 5.08 (<i>P</i> < 0.001). Manual Muscle Testing (MMT) of knee extension increased from 0.25 ± 0.44 to 3.85 ± 0.37 (<i>P</i> < 0.001). Finally, the Modified Ashworth Scale (MAS) scores were significantly reduced from <b>3.6</b> ± <b>0.257</b> to <b>1.26</b> ± <b>0.</b> (<i>P</i> < 0.001), reflecting decreased lower limb spasticity.ConclusionsESCS with Tyromotion significantly improves motor strength, trunk balance, gait function, and bladder control in thoracic SCI. These findings support task-specific therapies in SCI recovery programs.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1854-1868"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470895","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":"Normal Global Sagittal Alignment Radiographic Parameters in Patients Without Spinal Deformity.","authors":"Akiro H Duey, Timothy Hoang, Yash S Lahoti, Mark Kurapatti, Alexander Yu, Kareem S Mohamed, Ryan Hoang, Junho Song, Ula N Isleem, Samuel Q Li, Jun S Kim, Samuel K Cho","doi":"10.1177/21925682251386853","DOIUrl":"10.1177/21925682251386853","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesThe purpose of this study was to report reference ranges for global sagittal alignment parameters stratified by age and sex in patients without spinal deformity.MethodsThis retrospective cohort study included consecutive patients undergoing biplanar full-body spine x-rays at a single institution, excluding those with spinal deformity or prior spine surgery. Global sagittal alignment parameters included cranial sagittal vertical axis to the sacrum (CrSVA-S), hip (CrSVA-H), knee (CrSVA-K), and ankle (CrSVA-A) as well as the cranium-hip-sacrum (CrHS), cranium-knee-sacrum (CrKS), and cranium-ankle-sacrum (CrAS) angles. Patients were stratified by age and sex, and ANOVA and multivariable logistic regression were used to compare groups, with age and sex as predictors of each radiographic parameter. Multivariable logistic regression models were created using age and sex as predictors, and each radiographic parameter as the outcome. In these models, age was treated as a continuous variable.ResultsA total of 518 patients were included, 253 (48.8%) male and 265 (51.2%) female, with ages ranging from 12 to 91 years old. In multivariable linear regression models, each 10-year increase in age was associated with a 0.6 cm increase in CrSVA-S (<i>P</i> < .001) and a 0.3 cm increase in CrSVA-H (<i>P</i> < .001). Conversely, age was associated with a 0.3 cm decrease in CrSVA-K per decade (<i>P</i> = .002), with no significant association observed between age and CrSVA-A. Male sex was associated with greater CrSVA-S (1.3 cm; <i>P</i> < .001), CrSVA-H (1.2 cm; <i>P</i> < .001), and CrSVA-A (1.2 cm; <i>P</i> < .001) compared to females. CrSVA-K did not differ significantly by sex.ConclusionThis study establishes reference values for normal global sagittal alignment to support operative planning and improve understanding of global sagittal alignment in spinal deformity.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1736-1744"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225263","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":"Could Spinal Cord-Canal Mismatch Compromise Clinical Success of Cervical Disc Replacement in Cervical Myelopathy?","authors":"Zhan Wang, Donghua Huang, Eric R Zhao, Tomoyuki Asada, Sereen Halayqeh, Andrea Pezzi, Adrian Th Lui, Olivia C Tuma, Atahan Durbas, James Farmer, Russel C Huang, Francis C Lovecchio, Todd J Albert, Han Jo Kim, Sheeraz A Qureshi, Sravisht Iyer","doi":"10.1177/21925682251386759","DOIUrl":"10.1177/21925682251386759","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectiveTo evaluate whether spinal cord-canal mismatch (SCCM) affects clinical outcomes following cervical disc replacement (CDR) in patients with cervical myelopathy, using patient-reported outcome measures (PROMs), global rating of change (GRC), and minimal clinically important differences (MCIDs).MethodsA retrospective review of a prospectively maintained database identified patients who underwent 1- or 2-level CDR at a single institution from 2016 to 2024. SCCM is measured by the spinal cord occupation ratio (SCOR). Patients were categorized into SCCM (SCOR ≥ 0.7) and no-SCCM (SCOR < 0.7) groups. PROMs, including the Neck Disability Index (NDI), Visual Analog Scale for Neck (VAS-Neck), Arm Pain (VAS-Arm), and GRC, were assessed preoperatively and postoperatively. MCID achievement was analyzed at early (6-12 weeks) and late (6 months-2 years) follow-ups. Statistical tests and logistic regression identified predictors of MCID failure.ResultsNinety-eight patients (55 SCCM, 43 no-SCCM) were included. Both groups demonstrated significant postoperative improvements in PROMs. Early postoperative MCID rates for NDI, VAS-Neck, and VAS-Arm were 61.4%, 61.4%, and 56.8%, respectively, with no significant differences between groups. Similarly, late postoperative MCID rates and GRC outcomes showed no significant differences. SCCM was not a significant predictor of MCID failure, though male sex was associated with higher odds of MCID failure in NDI (<i>P</i> = .032).ConclusionOur findings suggest that SCCM may not adversely affect short-to mid-term clinical outcomes after CDR, although further validation is needed.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1727-1735"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12571791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145400539","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":"Predictive Factors for Failure of Closed Reduction in Traumatic Cervical Facet Dislocations: A Systematic Review of 631 Patients.","authors":"Jorge Tabilo, Andrei F Joaquim","doi":"10.1177/21925682251407637","DOIUrl":"10.1177/21925682251407637","url":null,"abstract":"<p><p>Study DesignSystematic review of clinical studies.ObjectiveTo identify neurological, anatomical, and technical predictors of failure in closed cranial traction (CCT) for traumatic cervical facet dislocations (CFD) in adults, and to synthesize evidence to guide early surgical decision-making.MethodsA systematic search was conducted across five databases: PubMed, PubMed Central (PMC), SciELO, Scopus, and Web of Science, for studies published from January 2000 to May 2025. Eligible studies included patients ≥16 years with traumatic CFD managed initially with CCT, reporting both success/failure rates and predictive variables. Data extraction focused on demographics, injury patterns, reduction techniques, and outcomes.ResultsEight studies met the inclusion criteria, encompassing 631 patients. Overall, the success rate of closed reduction was 73.3% (463/631), ranging from 56% to 92%. Consistently reported predictors of failure included complete neurological deficit (ASIA A-B; four studies), absence of a contralateral perched facet, involvement of the C7-T1 level, inferior endplate fracture, and attempts without general anesthesia. When open reduction was required after failed CCT, posterior approaches achieved higher success rates than anterior approaches (100% vs 45%).ConclusionsIn adults with traumatic cervical facet dislocations, CCT is more likely to fail with complete neurological deficits (ASIA A-B), C7-T1 involvement, absence of a contralateral perched facet, and awake traction protocols; GA-first strategies showed higher success in available cohorts. Unlike prior technique-focused overviews, this review consolidates predictors of CCT failure and proposes a practical algorithm to triage patients for early open reduction.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1999-2011"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12698454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742198","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":"Comparative Efficacy and Safety of Minimally Invasive, Full-Endoscopic, and Biportal Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Diseases: A Network Meta-Analysis.","authors":"Hsiao-Yi Cheng, Chun-Wei Liang, Yuan-Fu Liu, Chao-Jui Chang, Wei-Lun Chang, Ting-An Cheng, Hao-Chun Chuang, Yu-Chia Hsu, Cheng-Li Lin","doi":"10.1177/21925682251408367","DOIUrl":"10.1177/21925682251408367","url":null,"abstract":"<p><p>Study DesignNetwork Meta-analysis.ObjectiveTo evaluate the clinical efficacy and safety of minimally invasive (MIS-), full endoscopic (FE-), and biportal endoscopic (BE-) transforaminal lumbar interbody fusion (TLIF).MethodsPubMed, Embase, Cochrane Library, and ClinicalTrials.gov registry were searched up to August 2025. Randomized controlled trials and nonrandomized studies of intervention comparing MIS-TLIF, FE-TLIF, and BE-TLIF for lumbar degenerative diseases were included. Network meta-analysis was conducted using the frequentist framework, with meta-regressions assessing effect modifiers.Results49 studies (4188 patients) were included. FE-TLIF and BE-TLIF significantly reduced back pain vs MIS-TLIF from 1 month postoperatively through final follow-up. However, leg pain showed no significant differences among the three approaches. FE-TLIF and BE-TLIF demonstrated superior short- and mid-term functional outcomes, with FE-TLIF achieving the shortest hospital stay. Both endoscopic techniques reduced blood loss compared to MIS-TLIF. Long-term functional improvement, fusion rates, and complication rates were comparable, though FE-TLIF and BE-TLIF required longer operative times. Meta-regression suggested greater back pain relief in older patients following FE-TLIF.ConclusionBE-TLIF and FE-TLIF are safe techniques offering advantages over MIS-TLIF, including greater back pain reduction, improved short-term function, shorter hospital stays, and reduced blood loss. However, both require longer operative times. Meta-regression analysis suggested a promising signal that FE-TLIF may provide greater back pain relief in older patients. MIS-TLIF remains viable for those with higher anesthesia risk or significant cardiopulmonary comorbidities. Further high-quality randomized controlled trials are needed to validate these findings and refine patient selection criteria.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2040-2049"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12718175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793976","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":"Scoliosis School Screening Using Electronic Devices in Henan Province, China: An Exploratory Study.","authors":"Weiwei Xia, Hongzhen Li, Shuaiqi Zhu, Chong Zhao, Bing Hou, Zhijie Zhu, Yongping Zheng, De Yang, Yanhui Dong, Haiying Liu, Shuai Xu","doi":"10.1177/21925682251411255","DOIUrl":"10.1177/21925682251411255","url":null,"abstract":"<p><p>Study DesignAn Exploratory Study.ObjectivesTo estimate the prevalence of scoliosis and associated factors among adolescents, and to evaluate the clinical utility of an electronic scoliometer in school screening.MethodsThe scoliosis school screening was conducted in Xinyang City, Henan Province, in 2024. Students' study habits and daily routines were collected via questionnaires. Manual and electronic scoliometers were used for primary screening and compared using receiver operating characteristic (ROC) curves and agreement statistics. Three-dimensional ultrasound provided a provisional diagnosis. Multivariable logistic regression identified factors associated with scoliosis.ResultsA total of 1874 students were enrolled in this study. The positive screening rates using manual and electronic scoliometers were 4.97% and 2.87%, respectively. Among these cases, 102 students were referred for 3D ultrasound examination, with 74 students showing an ultrasound Cobb angle ≥10°. The prevalence of scoliosis was 4.55% in seventh-grade students and 4.04% in eighth-grade students. The prevalence of scoliosis was 2.99% in males and 5.96% in females. In the paired sample (n = 39), the electronic device had an AUC of 0.844 (95% CI 0.718-0.971) vs 0.751 (95% CI 0.596-0.907) for the manual device (ΔAUC = 0.093, <i>P</i> = 0.033). Agreement for continuous ATR showed moderate absolute agreement (ICC(3,1) = 0.614; 95% CI 0.373-0.777). Multinomial regression identified sitting with crossed legs and lack of sports participation as potential risk factors.ConclusionsThe prevalence of scoliosis among seventh and eighth-grade students in Xinyang City, Henan Province, was 4.33%. We recommend ATR ≥5°be triaged with 3D ultrasound before radiography; cases with UCA <20°should be rechecked at 3 months. Schools/parents should promote correct seated posture and more physical activity.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1950-1956"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12743008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833783","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":"Interaction of Preoperative Coagulopathy and Non-Elective Status in Association With Length of Stay for Patients Undergoing Lumbar Spinal Decompression Surgery.","authors":"Vikas N Vattipally, Kathleen R Ran, Kelly Jiang, Patrick Kramer, Carly Weber-Levine, Jacob Jo, Liam P Hughes, Jawad M Khalifeh, Daniel Lubelski, Ali Bydon, Timothy F Witham, Tej D Azad, Nicholas Theodore","doi":"10.1177/21925682251388420","DOIUrl":"10.1177/21925682251388420","url":null,"abstract":"<p><p>Study DesignRetrospective database analysis study.ObjectiveCoagulopathy, often defined as an International Normalized Ratio (INR) > 1.2, is associated with poor postoperative outcomes. We aimed to evaluate interactions between coagulopathy and non-elective surgery status regarding clinical outcomes among patients undergoing single-level lumbar decompression.MethodsData were obtained from the National Surgical Quality Improvement Program (2016-2021). Hierarchical regression models were used to evaluate associations between non-elective surgery and preoperative INR >1.2 with hospital length of stay (LOS) and home discharge. Effect modification of INR > 1.2 by non-elective surgery status and thrombocytopenia (platelet count < 150 k/mcL) was assessed. Random forest modeling simulated outcomes had coagulopathic patients presented with INR ≤ 1.2.ResultsAmong 34 591 patients (median age, 60 years), 8.5% underwent non-elective surgery and 1.8% had INR > 1.2. Non-elective surgery was associated with longer LOS (β = 3.4; <i>P</i> < 0.001) and reduced home discharge (OR, 0.20; <i>P</i> < 0.001). INR > 1.2 was also associated with prolonged LOS (β = 0.97; <i>P</i> < 0.001) and reduced home discharge (OR, 0.65; <i>P</i> < 0.001). Interactions for LOS were observed between INR >1.2 and both non-elective surgery (<i>P</i> < 0.001) and thrombocytopenia (<i>P</i> = 0.001). Simulated normalization of INR among non-elective surgery patients was associated with a reduction in LOS by a median of 2.5 days (IQR, 1.4-5.4 days decrease) and increase in home discharge by 17%.ConclusionsNon-elective surgery and preoperative INR > 1.2 were associated with prolonged LOS and lower odds of home discharge after single-level lumbar decompression. The effect of INR > 1.2 on LOS was more pronounced for non-elective cases and patients with thrombocytopenia.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1833-1842"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299829","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":"Tranexamic Acid Versus no Tranexamic Acid in Spinal Tumor and Metastasis Surgery-Meta-Analysis.","authors":"Anna Łajczak, Paweł Łajczak, Oguz Kagan Sahin, Ayesha Ayesha, Newton Godoy Pimenta, Ramon Guerra Barbosa","doi":"10.1177/21925682251396833","DOIUrl":"10.1177/21925682251396833","url":null,"abstract":"<p><p>Study DesignMeta-analysis.ObjectivesSpinal tumors and metastases remain a challenge for spine surgeons, with a significant risk of perioperative blood loss, which might require blood transfusions and lead to increased complications. Tranexamic acid (TXA) is an antifibrinolytic agent widely used in various surgical procedures; however, its efficacy in spinal oncology surgery remains unclear. This meta-analysis aims to evaluate the clinical effectiveness of TXA on perioperative outcomes, mainly blood loss, among patients with oncological spines undergoing surgery.MethodsPubMed, Scopus, and Web of Science were systematically searched from inception for eligible articles. We included studies assessing TXA vs no TXA or placebo on perioperative outcomes among patients with spinal tumors or metastases.ResultsAfter a comprehensive search, seven studies were included. Blood loss (MD -111.75 mL; 95% CI -217.08 to -6.43; <i>P</i> = 0.04; I² = 83.8%), postoperative drain (MD -90.49 mL; 95% CI -150.17 to -30.81; <i>P</i> < 0.01; I² = 68.1%), hospitalization duration (MD -1.88 days; 95% CI -3.33 to -0.44; <i>P</i> = 0.004; I² = 0%), and overall complication rate (OR 0.54; 95% CI 0.34 to 0.87; <i>P</i> = 0.011; I² = 0.0) were significantly reduced in TXA group. There was no significant difference in operation time, transfusions, or thrombosis events.ConclusionRetrospective data suggest TXA may reduce blood loss in spinal tumor surgery. However, its effect on hospital stay and complications remains uncertain. Despite appearing safe, evidence remains limited by bias and heterogeneity. High-quality RCTs are needed to confirm its efficacy and define clinical guidelines.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1980-1988"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12592104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458269","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 Non-Steroidal Anti-inflammatory Drugs on Postoperative Outcomes in Posterior Spinal Surgery: A Systematic Review.","authors":"Rajendra Singh, Ezekiel Kopilak, Rohan Rajan, Jordan Bauer, Afshin E Razi, Mitchell Ng","doi":"10.1177/21925682251407581","DOIUrl":"10.1177/21925682251407581","url":null,"abstract":"<p><p>Study DesignSystematic Review.ObjectiveTo review the effect of NSAID administration on postoperative outcomes following posterior spinal surgery, with specific attention to pain control, opioid reduction, bleeding risk, and fusion outcomes.MethodsPubMed, Google Scholar, Cochrane Library, Embase, Scopus, and Web of Science were queried through September 2025. Studies were included if they included adult patients undergoing posterior spinal procedures, including both fusion and non-fusion surgeries. In addition, studies had to report perioperative NSAID use in posterior spinal surgery with relevant clinical outcomes: Postoperative pain, opioid consumption, blood loss, wound complications, nonunion, and hardware failure. Bias was assessed with MINORS and Newcastle-Ottawa Scales.ResultsEleven studies (396,206 patients) were included. Across posterior fusion and non-fusion procedures, short-term NSAID use consistently reduced postoperative opioid consumption and improved early pain control, with no clinically meaningful increase in bleeding or wound complications. However, prolonged NSAID use was associated with increased risks of nonunion, hardware failure, and wound complications in fusion cohorts. Significant variability in NSAID type, dose, timing, and study design exists.ConclusionsShort-term NSAID use appears safe and effective as an opioid-sparing strategy in non-fusion posterior spinal surgery. Prolonged or high-dose administration may compromise fusion outcomes. Future high-quality studies are needed to definitively define the optimal postoperative NSAID window, dosing, and administration route.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2012-2027"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12714558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Surgeon Experience Influence Surgical Safety and Patient Satisfaction After Anterior Cervical Discectomy and Fusion? A Prospective Multicenter Comparison Study Between Non-Board-Certified and Board-Certified Spine Surgeons.","authors":"Toshiki Okubo, Narihito Nagoshi, Junichi Yamane, Norihiro Isogai, Reo Shibata, Takahiro Kitagawa, Kentaro Ago, Takeshi Fujii, Yosuke Horiuchi, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1177/21925682251392216","DOIUrl":"10.1177/21925682251392216","url":null,"abstract":"<p><p>Study DesignProspective multicenter cohort study.ObjectiveTo evaluate the impact of surgeon experience on surgical safety, radiographic outcomes, and patient-reported outcomes (PROMs) following anterior cervical discectomy and fusion (ACDF) in patients with cervical degenerative disc disease (CDDD).MethodsThis prospective cohort study was conducted at five spine-specialized institutions in Japan. A total of 208 patients with CDDD who underwent ACDF between 2019 and 2022 were enrolled. Procedures were performed by either board-certified spine (BCS) surgeons (n = 150) or non-BCS (NBCS) surgeons (n = 58) under direct BCS supervision. Demographics, surgical variables, radiographic outcomes, and clinical results were compared. Evaluations included surgical duration, estimated blood loss (EBL), complications, cervical alignment and range of motion (ROM), Japanese Orthopaedic Association (JOA) scores, Visual Analog Scale (VAS), JOACMEQ, and SF-36 scores.ResultsSurgical duration was comparable between groups, but EBL was significantly greater in the NBCS group (20.2 ± 35.0 mL vs 12.2 ± 13.7 mL, <i>P</i> = .020). Complication rates were low and similar. No major adverse events occurred in either group. Cervical alignment was maintained, and ROM slightly decreased postoperatively without intergroup differences. Both groups showed significant neurological improvement. Gains in JOA scores, reductions in VAS scores, and improvements in JOACMEQ and SF-36 scores were comparable.ConclusionsACDF performed by NBCS surgeons under BCS supervision achieved clinical outcomes equivalent to those by BCS surgeons. These findings underscore the effectiveness of structured supervision in ensuring surgical safety and fostering competency in spine surgery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1927-1937"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12568534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145388707","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}