Global Spine Journal最新文献

{"title":"Opioid Use Prior to Adult Spine Deformity Correction Surgery is Associated With Worse Pre- and Postoperative Back Pain and Prolonged Opioid Demands.","authors":"Juan P Sardi, Justin S Smith, Jeffrey L Gum, Brett Rocos, Anastasios Charalampidis, Lawrence G Lenke, Christopher I Shaffrey, Kenneth M C Cheung, Yong Qiu, Yukihiro Matsuyama, Ferran Pellisé, David W Polly, Jonathan N Sembrano, Benny T Dahl, Michael P Kelly, Marinus de Kleuver, Maarten Spruit, Ahmet Alanay, Sigurd H Berven, Stephen J Lewis","doi":"10.1177/21925682241261662","DOIUrl":"10.1177/21925682241261662","url":null,"abstract":"<p><p>Study DesignProspective multicenter database post-hoc analysis.ObjectivesOpioids are frequently prescribed for painful spinal conditions to provide pain relief and to allow for functional improvement, both before and after spine surgery. Amidst a current opioid epidemic, it is important for providers to understand the impact of opioid use and its relationship with patient-reported outcomes. The purpose of this study was to evaluate pre-/postoperative opioid consumption surrounding ASD and assess patient-reported pain outcomes in older patients undergoing surgery for spinal deformity.MethodsPatients ≥60 years of age from 12 international centers undergoing spinal fusion of at least 5 levels and a minimum 2-year follow-up were included. Patient-reported outcome scores were collected using the Numeric Rating Scale for back and leg pain (NRS-B; NRS-L) at baseline and at 2 years following surgery. Opioid use, defined based on a specific question on case report forms and question 11 from the SRS-22r questionnaire, was assessed at baseline and at 2-year follow-up.ResultOf the 219 patients who met inclusion criteria, 179 (81.7%) had 2-year data on opioid use. The percentages of patients reporting opioid use at baseline (n = 75, 34.2%) and 2 years after surgery (n = 55, 30.7%) were similar (<i>P</i> = .23). However, at last follow-up 39% of baseline opioid users (Opi) were no longer taking opioids, while 14% of initial non-users (No-Opi) reported opioid use. Regional pre- and postoperative opioid use was 5.8% and 7.7% in the Asian population, 58.3% and 53.1% in the European, and 50.5% and 40.2% in North American patients, respectively. Baseline opioid users reported more preoperative back pain than the No-Opi group (7.0 vs 5.7, <i>P</i> = .001), while NRS-Leg pain scores were comparable (4.8 vs 4, <i>P</i> = .159). Similarly, at last follow-up, patients in the Opi group had greater NRS-B scores than Non-Opi patients (3.2 vs 2.3, <i>P</i> = .012), but no differences in NRS-Leg pain scores (2.2 vs 2.4, <i>P</i> = .632) were observed.ConclusionsIn this study, almost one-third of surgical ASD patients were consuming opioids both pre- and postoperatively world-wide. There were marked international variations, with patients from Asia having a much lower usage rate, suggesting a cultural influence. Despite both opioid users and nonusers benefitting from surgery, preoperative opioid use was strongly associated with significantly more back pain at baseline that persisted at 2-year follow up, as well as persistent postoperative opioid needs.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1749-1759"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237425","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":"Posterolateral Fusion Versus Posterior Lumbar Interbody Fusion for Adult Low-Grade Isthmic Spondylolisthesis: Analysis of Sagittal Radiographic Parameters - A Randomized Controlled Trial.","authors":"Mahmoud Fouad Ibrahim, Fady Samy Saeed, Essam Mohammed El-Morshidy, Khaled Mohammed Hassan, Mohamed Gamal Hassan, Mohammad El-Sharkawi, Belal Elnady","doi":"10.1177/21925682241254317","DOIUrl":"10.1177/21925682241254317","url":null,"abstract":"<p><p>Study DesignRandomized controlled trial.ObjectivesTo compare the effect of posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF) on sagittal radiographic parameters in patients with low-grade isthmic spondylolisthesis. Additionally, to explore the correlation between changes in these parameters and clinical outcomes.MethodsForty-six consecutive patients with single-level low-grade isthmic spondylolisthesis were initially enrolled. They were randomly assigned to undergo either PLF or PLIF. Patients were followed up for at least 24 months. Radiographic outcomes included pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, sagittal vertical axis, T1 pelvic angle, slip angle, slip degree and disc height. Clinical outcomes were assessed by the Oswestry Disability Index (ODI) and visual analogue scale (VAS).ResultsFour participants were lost to follow-up. Of the remaining 42 patients, 29 were female. The mean age was 40.23 ± 10.25 years in the PLF group and 35.81 ± 10.58 years in the PLIF group. There was a statistically significant greater correction of all radiographic parameters in the PLIF group. The ODI and VAS improved significantly in both groups, with no significant differences between the two groups. Changes in the ODI and VAS were significantly correlated with changes in disc height, slip angle and lumbar lordosis.ConclusionsIn patients with low-grade isthmic spondylolisthesis, PLIF demonstrates superior efficacy compared to PLF in correcting sagittal radiographic parameters. Nevertheless, this distinction does not seem to influence short-term clinical results. Restoring disc height, correcting the slip angle, and reestablishing normal lumbar lordosis are crucial steps in the surgical management of isthmic spondylolisthesis.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1614-1624"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903611","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":"Remineralization Rate of Lytic Lesions of the Spine in Multiple Myeloma Patients Undergoing Radiation Therapy.","authors":"Hester Zijlstra, Jens P Te Velde, Brendan M Striano, Olivier Q Groot, Tom M de Groot, Noopur Raje, Chirayu Patel, Jad Husseini, Diyar Delawi, Diederik H R Kempen, Jorrit-Jan Verlaan, Joseph H Schwab","doi":"10.1177/21925682241260651","DOIUrl":"10.1177/21925682241260651","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectiveIn general, Multiple Myeloma (MM) patients are treated with systemic therapy including chemotherapy. Radiation therapy can have an important supportive role in the palliative management of MM-related osteolytic lesions. Our study aims to investigate the degree of radiation-induced remineralization in MM patients to gain a better understanding of its potential impact on bone mineral density and, consequently, fracture prevention. Our primary outcome measure was percent change in bone mineral density measured in Hounsfield Units (Δ% HU) between pre- and post-radiation measurements, compared to non-targeted vertebrae.MethodsWe included 119 patients with MM who underwent radiotherapy of the spine between January 2010 and June 2021 and who had a CT scan of the spine at baseline and between 3-24 months after radiation. A linear mixed effect model tested any differences in remineralization rate per month (β_difference) between targeted and non-targeted vertebrae.ResultsAnalyses of CT scans yielded 565 unique vertebrae (366 targeted and 199 non-targeted vertebrae). In both targeted and non-targeted vertebrae, there was an increase in bone density per month (β_overall = .04; <i>P</i> = .002) with the largest effect being between 9-18 months post-radiation. Radiation did not cause a greater increase in bone density per month compared to non-targeted vertebrae (β_difference = .67; <i>P</i> = .118).ConclusionOur results demonstrate that following radiation, bone density increased over time for both targeted and non-targeted vertebrae. However, no conclusive evidence was found that targeted vertebrae have a higher remineralization rate than non-targeted vertebrae in patients with MM.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1712-1724"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295912","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":"Representation and Race in Adolescent Idiopathic Scoliosis Research: Disparities in Curve Magnitude and Follow-Up.","authors":"Julia E Todderud, Bharadwaj Jilakara, Michael P Kelly, Michelle C Marks, Nicholas D Fletcher, Joshua M Pahys, Jaysson T Brooks, Peter O Newton, A Noelle Larson","doi":"10.1177/21925682241266787","DOIUrl":"10.1177/21925682241266787","url":null,"abstract":"<p><p>Study DesignProspective Cohort Study.ObjectiveThe present study aims to determine if the racial representation of patients enrolled in a large prospective scoliosis registry is reflective of the general United States population. Further, we studied whether there was an association between race, pre-operative parameters, outcomes and loss to follow-up.MethodsProspectively collected data for patients who underwent spinal fusion for adolescent idiopathic scoliosis (AIS) was reviewed, including self-reported race/ethnicity. The U.S. pediatric population and U.S. patients enrolled in the prospective registry were compared. The data obtained was analyzed for variations between races, for pre-operative variables and follow-up.ResultsOf the 2210 included patients in the registry 66% of patients reported as White, while 52% of the 2018 U.S. pediatric population reported as White. 15% of the registry reported as Hispanic/Latino compared to 22% of the U.S. pediatric population, 13% Black compared to 14% of the U.S. pediatric population, and 4% Asian compared to 5% of the U.S. pediatric population. Asian and White patients had statistically significant higher 2-year follow-up in all but one of six enrollment sites (<i>P</i> < 0.001). Native American, Other, and Hispanic/Latino patients had the highest BMIs. Native American and Black patients had the highest pre-op thoracic Cobb angles. Pre-op ages of Black, Hispanic, and Native American patients were statistically lower (<i>P</i> < 0.01).ConclusionThis study demonstrates the association between race and patient follow-up and pre-operative factors in patients who underwent surgery for AIS. Black, Native American, and Hispanic populations were underrepresented both at pre-op and follow-up when compared to their relative proportion in the U.S. pediatric population.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1832-1838"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733944","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":"Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Evaluation and Treatment of Pyogenic Spondylodiscitis of the Spine: AO Spine Knowledge Forum Trauma and Infection.","authors":"Sebastian F Bigdon, Emiliano Vialle, Charlotte Dandurand, Julian Scherer, Gaston Camino-Willhuber, Andrei F Joaquim, Harvinder S Chhabra, Mohammad El-Sharkawi, Richard Bransford, Charles G Fisher, Klaus J Schnake, Gregory D Schroeder","doi":"10.1177/21925682251316814","DOIUrl":"10.1177/21925682251316814","url":null,"abstract":"<p><p>Study DesignLiterature Review with clinical recommendations.ObjectiveTo highlight impactful studies on pyogenic spondylodiscitis (PS), identified by the AO Spine Knowledge Forum Trauma and Infection, with recommendations for their integration into clinical practice.MethodsFive influential studies on PS that have the potential to shape current practice in spinal infections were selected and reviewed. Each study was chosen for its contribution to a critical phase in PS management: diagnosis, imaging, surgical vs conservative treatment, and antibiotic duration. Recommendations were graded as strong or conditional following the GRADE methodology.ResultsFive studies were highlighted. Article 1: Pluemer et al introduced the Spinal Infection Treatment Evaluation (SITE) Score, a novel scoring tool for standardizing treatment decision-making. Conditional recommendation to incorporate the SITE Score or SISS Score for improved treatment outcomes. Article 2: Maamari et al conducted a meta-analysis comparing imaging modalities, with conditional recommendation to consider 18F-FDG PET/CT to diagnosis PS as an adjunct to MRI which remains the gold standard. Article 3: Thavarajasingam et al demonstrated the potential survival benefit of early surgery in specific PS cases, leading to a strong recommendation for early intervention in appropriate patients. Article 4: Neuhoff et al compared conservative and surgical treatments in well-resourced settings, concluding a strong recommendation for early surgery in appropriate patients. Article 5: Bernard et al evaluated antibiotic treatment duration, with a conditional recommendation for a 6-week course in confirmed cases, based on comparable efficacy to a 12-week regimen.ConclusionsManagement of PS remains complex and varied. This perspective provides spine surgeons with evidence-based recommendations to enhance standardization and effectiveness in clinical practice.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1490-1497"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033078","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":"Identifying Key Factors Influencing Hospital Stay After Spine Surgery: A Comprehensive Predictive Model.","authors":"Francesco Langella, Francesca Barile, Pablo Bellosta-Lòpez, Federico Fusini, Domenico Compagnone, Daniele Vanni, Marco Damilano, Pedro Berjano","doi":"10.1177/21925682251331451","DOIUrl":"https://doi.org/10.1177/21925682251331451","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectivesTo develop and validate a multivariable predictive model for length of hospital stay (LOS) following spine surgery, incorporating sociodemographic characteristics, medical data, and self-reported patient outcomes.MethodsA retrospective analysis of 4583 patients from a spine surgery registry was conduct-ed. Predictors included age, sex, BMI, ASA score, surgical complexity, and patient-reported outcomes. Binary logistic regression was used to model LOS (<3 days vs ≥3 days).ResultsLower age, active work status, lower ASA scores, and specific surgical procedures were associated with shorter LOS. The model demonstrated good accuracy and dis-criminative ability.ConclusionsSociodemographic, medical, and patient-reported outcomes are valuable predictors of LOS. These findings can help improve preoperative planning and resource allocation in spine surgery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251331451"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763692","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":"Comparison of Postoperative Pain and Surgical Outcomes Between Three Types of Modified Muscle-Sparing Laminoplasty and Conventional Laminoplasty for Multilevel Degenerative Cervical Myelopathy.","authors":"Ben Wang, Ruomu Qu, Zexiang Liu, Nan Zhao, Shengfa Pan, Xin Chen, Yanbin Zhao, Lei Dang, Hua Zhou, Feng Wei, Yu Sun, Feifei Zhou, Liang Jiang","doi":"10.1177/21925682241265625","DOIUrl":"10.1177/21925682241265625","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectiveThis study aimed to compare postoperative pain and surgical outcomes of open-door laminoplasty (LP) and three types of muscle-sparing laminoplasties, namely unilateral muscle-preservation laminoplasty (UL), spinous process splitting double-door laminoplasty (DL) and intermuscular \"raising roof\" laminoplasty (RL) for multilevel degenerative cervical myelopathy (MDCM).MethodsConsecutive MDCM patients underwent LP or modified laminoplasties (UL, DL, RL) in 2022 were enrolled. Patients' preoperative baseline data and surgical characteristics were collected. Postoperative transient pain (TP), the axial pain and Japanese Orthopedic Association (JOA) score and neck disability index (NDI) at 6-month and 12-month follow-up were documented.ResultsA total of 154 MDCM patients were included and a 12-month follow-up was completed for 148 patients (LP: 36, UL:39, DL: 37, RL:36). No significant difference was observed in the baseline data. Four groups presented favorable and comparable surgical outcome. The RL group reported significantly the least severe TP on the first three days following surgery. However, no significant difference was found in the axial pain and axial symptoms at both follow-ups. After regression analysis, RL group exhibited significantly better efficacy in alleviating Day-1 TP (<i>P</i> = 0.047) and 6-month axial pain (<i>P</i> = 0.040). However, this superiority was not observed at 12-month follow-up.ConclusionAll the three muscle-sparing laminoplasty procedures showed similar short-term surgical outcomes compared to LP. The RL procedure demonstrated superiority in alleviating TP and 6-month axial pain compared to LP. The RL and DL groups showed less C5 palsy compared to LP.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1801-1812"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442433","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":"Coronal Deformity is Associated With Uptake on Single Photon Emission Computed Tomography in Patients With Low Back Pain.","authors":"Anand A Dharia, Andrew R Guillotte, Frank A De Stefano, Mia J Birney, Adam G Rouse, Ifije E Ohiorhenuan","doi":"10.1177/21925682241265302","DOIUrl":"10.1177/21925682241265302","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectiveSingle Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) is emerging as a valuable imaging test for identifying pain generators within the lumbar spine. The relationship between radiotracer uptake on SPECT/CT and anatomic biomechanical parameters has not been previously studied.MethodsWe performed a retrospective review of all patients seen at our institution between 2021-2023 who obtained SPECT/CT scans for workup of thoracolumbar back pain. Patient data including demographic, clinical symptoms, and surgical history were collected. Radiology reports were reviewed for evidence of pathologic degeneration and increased bone metabolism on SPECT/CT. Biomechanical parameters were measured from standing scoliosis plain radiographs. Patients were stratified into two cohorts by either presence or absence of asymmetric coronal uptake on SPECT/CT.Results160 patients met inclusion criteria. Patients were primarily male (55%) with average age 55 ± 15 years. 87 (54%) patients demonstrated asymmetric uptake on SPECT/CT. These patients were older (<i>P</i> < 0.001), but with similar gender, prior fusion history, sacroiliitis, adjacent segment degeneration, and pseudoarthrosis (<i>P</i> > 0.05). This cohort had more disc disease, facet arthropathy, and greater degree of coronal scoliosis and coronal imbalance (<i>P</i> < 0.001). There were significantly more sites of uptake in the asymmetric cohort, and uptake was preferentially observed in the concavity of the lumbar curve (<i>P</i> < 0.001). There were no significant differences in sagittal balance or spinopelvic mismatch between cohorts (<i>P</i> > 0.05).ConclusionAsymmetric uptake on SPECT/CT was associated with coronal deformity in patients with low back pain. Further prospective studies are warranted to assess the effect of coronal deformity on pain generation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1783-1791"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426693","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":"Lumbar Total Disc Replacement Leads to Increased Subsequent Facet Injections Compared to Anterolateral Lumbar Interbody Fusions.","authors":"Nakul Narendran, Christopher M Mikhail, Paal K Nilssen, Alexander Tuchman, David L Skaggs","doi":"10.1177/21925682241260733","DOIUrl":"10.1177/21925682241260733","url":null,"abstract":"<p><p>Study DesignRetrospective Matched Cohort.ObjectiveDespite known consequences to the facet joints following lumbar total disc replacement (TDR), there is limited data on facet injection usage for persistent postoperative pain. This study uses real-world data to compare the usage of therapeutic lumbar facet injections as a measure of symptomatic facet arthrosis following single-level, stand-alone TDR vs anterolateral lumbar interbody fusion (ALIF/LLIF).MethodsThe PearlDiver database was queried for patients (2010-2021) with lumbar degenerative disc disease who received either a single-level, stand-alone TDR or ALIF/LLIF. All patients were followed for ≥2 years and excluded if they had a history of facet injections or spinal trauma, fracture, infection, or neoplasm. The two cohorts were matched 1:1 based on age, sex, insurance, year of operation, and medical comorbidities. The primary outcome was the use of therapeutic lumbar facet injections at 1-, 2-, and 5-year follow-up. Secondary outcomes included subsequent lumbar surgeries and surgical complications.ResultsAfter 1:1 matching, each cohort had 1203 patients. Lumbar facet injections occurred significantly more frequently in the TDR group at 1-year (6.07% vs 1.66%, <i>P</i> < .0001), 2-year (8.40% vs 3.74%%, <i>P</i> < .0001), and 5-year (11.47% vs 6.40%, <i>P</i> < .0001) follow-up. 5-year injection-free probability curves demonstrated an 87.1% injection-free rate for TDR vs 92.9% for ALIF/LLIF. There was no clinical difference in the incidence of subsequent lumbar surgeries or complications.ConclusionCompared with ALIF/LLIF, patients who underwent TDR received significantly more facet injections, suggesting a greater progression of symptomatic facet arthrosis. TDR was not protective against reoperations compared to ALIF/LLIF.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1733-1742"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300532","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":"Are Variable Screw Angle Change and Screw-to-Vertebral Body Ratio Associated With Radiographic Subsidence Following Anterior Cervical Discectomy and Fusion?","authors":"Philip K Louie, Rakesh Kumar, Aiyush Bansal, Spencer Raub, Murad Alostaz, Nicole Vivelo, Michelle Gilbert, Jean-Christophe Leveque, Venu Nemani","doi":"10.1177/21925682241252088","DOIUrl":"10.1177/21925682241252088","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort.ObjectiveThis study aims to assess the easily measurable radiographic landmarks of screw-to-vertebral body ratio and changes in screw angle to identify if they are associated with early subsidence following an Anterior cervical discectomy and fusion (ACDF).MethodsA retrospective cohort study was conducted on patients undergoing 1-3 level ACDF with allograft or PEEK cages. Preoperative, immediate postoperative, and 6-month postoperative radiographs were analyzed to measure intradiscal height (or distance between 2 vertebral bodies) as an anterior vertebral distance (AVD), middle (MVD), and posterior (PVD), screw angle, screw-to-vertebral body length ratio, and interscrew distance. Multivariate stepwise regression analyses were performed.Results92 patients were included (42 single-level, 32 two-level, and 18 3-level ACDFs). In single-level ACDFs, a decrease in the caudal screw angle was associated with a decrease in AVD (=.001) and MVD (<i>P</i> = .03). A decrease in the PVD was associated with a decrease in segmental lordosis (<i>P</i> < .001). For two-level ACDFs, a higher caudal screw-to-body ratio was associated with a lower MVD (<i>P</i> = .01).ConclusionSix months following an ACDF for degenerative pathology, a decrease in the caudal screw angle was associated with an increase in radiographic subsidence at the antero-medial aspect of the disc space albeit largely subclinical. This suggests that the caudal screw angle change may serve as a reliable radiographic marker for early radiographic subsidence. Furthermore, a greater screw-to-vertebral body ratio may be protective against radiographic subsidence in two-level ACDF procedures.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1582-1591"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862643","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}