Global Spine Journal最新文献

{"title":"Independent Prognostic Factors Associated With Improved Patient-Reported Outcomes in the Prospective Evaluation of Elderly Deformity Surgery (PEEDS) Study.","authors":"Fthimnir M Hassan, Lawrence G Lenke, Sigurd H Berven, Michael P Kelly, Justin S Smith, Christopher I Shaffrey, Benny T Dahl, Marinus de Kleuver, Maarten Spruit, Ferran Pellise, Kenneth M C Cheung, Ahmet Alanay, David W Polly, Jonathan Sembrano, Yukihiro Matsuyama, Yong Qiu, Stephen J Lewis","doi":"10.1177/21925682231174182","DOIUrl":"10.1177/21925682231174182","url":null,"abstract":"<p><strong>Study design: </strong>Prospective, multicenter, international, observational study.</p><p><strong>Objective: </strong>Identify independent prognostic factors associated with achieving the minimal clinically important difference (MCID) in patient reported outcome measures (PROMs) among adult spinal deformity (ASD) patients ≥60 years of age undergoing primary reconstructive surgery.</p><p><strong>Methods: </strong>Patients ≥60 years undergoing primary spinal deformity surgery having ≥5 levels fused were recruited for this study. Three approaches were used to assess MCID: (1) absolute change:0.5 point increase in the SRS-22r sub-total score/0.18 point increase in the EQ-5D index; (2) relative change: 15% increase in the SRS-22r sub-total/EQ-5D index; (3) relative change with a cut-off in the outcome at baseline: similar to the relative change with an imposed baseline score of ≤3.2/0.7 for the SRS-22r/EQ-5D, respectively.</p><p><strong>Results: </strong>171 patients completed the SRS-22r and 170 patients completed the EQ-5D at baseline and at 2 years postoperative. Patients who reached MCID in the SRS-22r self-reported more pain and worse health at baseline in both approaches (1) and (2). Lower baseline PROMs ((1) - OR: .01 [.00-.12]; (2)- OR: .00 [.00-.07]) and number of severe adverse events (AEs) ((1) - OR: .48 [.28-.82]; (2)- OR: .39 [.23-.69]) were the only identified risk factors. Patients who reached MCID in the EQ-5D demonstrated similar characteristics regarding pain and health at baseline as the SRS-22r using approaches (1) and (2). Higher baseline ODI ((1) - OR: 1.05 [1.02-1.07]) and number of severe AEs (OR: .58 [.38-.89]) were identified as predictive variables. Patients who reached MCID in the SRS22r experienced worse health at baseline using approach (3). The number of AEs (OR: .44 [.25-.77]) and baseline PROMs (OR: .01 [.00-.22] were the only identified predictive factors. Patients who reached MCID in the EQ-5D experienced less AEs and a lower number of actions taken due to the occurrence of AEs using approach (3). The number of actions taken due to AEs (OR: .50 [.35-.73]) was found to be the only predictive variable factor. No surgical, clinical, or radiographic variables were identified as risk factors using either of the aforementioned approaches.</p><p><strong>Conclusion: </strong>In this large multicenter prospective cohort of elderly patients undergoing primary reconstructive surgery for ASD, baseline health status, AEs, and severity of AEs were predictive of reaching MCID. No clinical, radiological, or surgical parameters were identified as factors that can be prognostic for reaching MCID.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9432261","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":"International Spinal Cord Injury Community Survey: Socioeconomic and Healthcare Satisfaction in Spain.","authors":"Miguel Angel González-Viejo, Merce Avellanet, Anna Boada-Pladellorens, Lluïsa Montesinos-Magraner, María Luisa Jaúregui-Abrisqueta, Enrique Bárbara-Bataller, Bosco Méndez-Ferrer, Judith Sánchez-Raya, Nora Cívicos, José Luis Méndez-Suarez, Juana María Barrera-Chacón","doi":"10.1177/21925682231183972","DOIUrl":"10.1177/21925682231183972","url":null,"abstract":"<p><strong>Study design: </strong>Survey study.</p><p><strong>Objectives: </strong>People living with spinal cord injury (SCI) are major healthcare and rehabilitation services consumers and have unmet healthcare needs. This study aimed to describe the socioeconomic characteristics of people living with SCI in Spain and to determine the level of use and satisfaction with the public healthcare system.</p><p><strong>Methods: </strong>We conducted a survey (the Spanish version of the International Spinal Cord Injury Community Survey) consisting of 134 questions. We analyzed the age, sex, neurological classification of the injury on the American Spinal Injury Association Impairment Scale, time of injury, socio-occupational and socioeconomic status, and level of use and satisfaction with the public health system.</p><p><strong>Results: </strong>472 people responded to the survey [68.9% male; mean age 51.2 years (standard deviation: 13.9 years); 61.7% with paraplegia and 38.3% with tetraplegia]. 89.2% of those surveyed were unemployed and 77.1% received a disability pension. The number of medical visits was 2.3/year, and 19.8% of the patients required at least 1 hospital admission during the previous year. 94.7% of the people with SCI considered the health care received as good or very good.</p><p><strong>Conclusions: </strong>Respondents with SCI in Spain considered they had good access to primary and specialized care and were satisfied with the healthcare system. Notably, we observed a high average of annual visits to medical professionals but a low rate of hospitalizations. Technical aids and state services related to disability should be the most important elements to be improved.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9637158","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":"We Need RI and Not Just AI! Thoughts on the Implementation of Artificial Intelligence in Medicine and Spine Surgery Specifically.","authors":"Jens R Chapman, Jeffrey C Wang, Karsten Wiechert","doi":"10.1177/21925682241272348","DOIUrl":"10.1177/21925682241272348","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557762","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 Central Sensitization Influence Outcomes of Lumbar Discectomy Surgery in Patients With Lumbar Disc Herniation? A Multicenter Prospective Study.","authors":"Junichi Yamada, Koji Akeda, Norihiko Takegami, Tatsuhiko Fujiwara, Koichiro Murata, Toshibumi Kono, Takao Sudo, Takao Imanishi, Tatsuya Kurata, Eiji Kawakita, Toshihiko Sakakibara, Tetsushi Kondo, Kenji Takegami, Masayoshi Sato, Akihiro Sudo","doi":"10.1177/21925682231182333","DOIUrl":"10.1177/21925682231182333","url":null,"abstract":"<p><strong>Study design: </strong>Multicenter prospective study.</p><p><strong>Objective: </strong>Patients with central sensitization (CS) are reported to be at high risk of poor outcomes after spinal surgery. However, the influence of CS on surgical outcomes for lumbar disc herniation (LDH) remains unknown. This study aimed to examine the association between preoperative CS and surgical outcomes in LDH patients.</p><p><strong>Methods: </strong>A total of 100 consecutive patients with LDH (mean age 51.2) who underwent lumbar surgery were included in this study. The extent of CS was evaluated using the central sensitization inventory (CSI), a screening tool for CS-related symptoms. The patients completed the following CSI and clinical outcome assessments (COAs) preoperatively and 12 months postoperatively: the Japanese Orthopaedic Association (JOA) score for back pain, JOA back pain evaluation questionnaire (JOABPEQ), and Oswestry Disability Index (ODI). The association between preoperative CSI scores, and preoperative and postoperative COAs was analyzed, and the postoperative changes were statistically evaluated.</p><p><strong>Results: </strong>The preoperative CSI score significantly decreased 12 months postoperatively. Preoperative CSI scores showed a significant correlation with most COAs; however, a significant correlation was only identified in the social function and mental health domains of JOABPEC postoperatively. Higher preoperative CSI showed worse preoperative COAs; however, all COAs significantly improved regardless of CSI severity. There were no significant differences in any COAs among the CSI severity groups 12 months postoperatively.</p><p><strong>Conclusions: </strong>The results of this study showed that lumbar surgeries significantly improved the COAs regardless of preoperative severity of CS in patients with LDH.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9595081","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":"Impact of Individual Spinopelvic Anatomy on the Localization and Severity of Symptomatic Isthmic Spondylolisthesis.","authors":"Kirsten Labbus, Justus Bürger, Jannis Löchel, Frederik Maximilian Schäfer, Michael Putzier, Robert Karl Zahn","doi":"10.1177/21925682231178206","DOIUrl":"10.1177/21925682231178206","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective analysis of prospectively collected data.</p><p><strong>Objectives: </strong>Isthmic spondylolisthesis (iSPL) occurs most commonly in L5/S1 and L4/5. This study investigates the association between spinopelvic anatomy and the pathogenesis of iSPL.</p><p><strong>Methods: </strong>Spinopelvic parameters as well as severity of slip grade were measured in sagittal spine radiographs of symptomatic patients with iSPL in segments L4/5 and L5/S1. Means were calculated and differences between both groups were analyzed. A correlation between the analyzed parameters and degree of slippage was performed.</p><p><strong>Results: </strong>We included 73 subjects in this study; 11 in L4/5 group and 62 in L5/S1 group. Pelvic anatomy significantly differed between L4/5 and L5/S1 iSPL (Pelvic Incidence (PI) 54.8° vs 66.3°, <i>P</i> value = .006; Pelvic Radius (PR) 124.4 mm vs 137.4 mm; <i>P</i> value = .005 and Sacral Table Angle (STA) 101.0° vs 92.2°, <i>P</i> value < .001). The relative degree of slippage was significantly higher in the L5/S1 group (L4/5 29.1% vs L5/S1 40.1%, <i>P</i> value .022). We also observed a significant correlation between pelvic anatomy and the severity of the slip in iSPL at the L5/S1 level.</p><p><strong>Conclusions: </strong>Pelvic parameters PI and STA play an important role concerning the level of occurrence and severity of iSPL. Spinopelvic anatomy determines the pathogenesis of iSPL.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9640019","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 Optimizing Management and Minimizing Risk of Osteoporotic Vertebral Fractures - Perspectives of the AO Spine KF Trauma and Infection Group Key Opinion Leaders.","authors":"Andrei F Joaquim, Sebastian F Bigdon, Richard Bransford, Harvinder Singh Chhabra, Ratko Yurac, Vishal Kumar, Mohammad El-Sharkawi, Lorin M Benneker, Brian A Karamian, Jose A Canseco, Julian Scherer, Ahmed Abdelazim Hassan, Gregory D Schroeder, Cumhur F Öner, Shanmuganathan Rajasekaran, Emiliano Vialle, Rishi M Kanna, Alexander R Vaccaro, Jin Tee, Gaston Camino-Willhuber, Charles G Fisher, Marcel F Dvorak, Klaus J Schnake","doi":"10.1177/21925682241278953","DOIUrl":"10.1177/21925682241278953","url":null,"abstract":"<p><strong>Study design: </strong>Literature review with clinical recommendations.</p><p><strong>Objective: </strong>To highlight important studies about osteoporotic spinal fractures (OF) that may be integrated into clinical practice based on the assessment of the AO Spine KF Trauma and Infection group key opinion leaders.</p><p><strong>Methods: </strong>4 important studies about OF that may affect current clinical practice of spinal surgeons were selected and reviewed with the aim of providing clinical recommendations to streamline the journey of research into clinical practice. Recommendations were graded as strong or conditional following the GRADE methodology.</p><p><strong>Results: </strong>4 studies were selected. Article 1: a validation of the Osteoporotic Fracture (OF)-score to treat OF fractures. <b>Conditional</b> recommendation to incorporate the OF score in the management of fractures to improve clinical results. Article 2: a randomized multicenter study comparing romosozumab/alendronate vs alendronate to decrease the incidence of new vertebral fractures. <b>Strong</b> recommendation that the group receiving romosozumab/alendronate had a decreased risk of new OF when compared with the alendronate only group only. Article 3: a systematic literature review of spinal orthoses in the management of. <b>Conditional</b> recommendation to prescribe a spinal orthosis to decrease pain and improve quality of life. Article 4: post-traumatic deformity after OF. A <b>conditional</b> recommendation that middle column injury and pre-injury use of steroids may lead to high risk of post-traumatic deformity after OF.</p><p><strong>Conclusions: </strong>Management of patients with OF is still complex and challenging. This review provides some recommendations that may help surgeons to better manage these patients and improve their clinical practice.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046564","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":"Development and Validation of a Predictive Nomogram for Patients With Myxopapillary Ependymoma: A Surveillance, Epidemiology, and End Results (SEER) Retrospective Cohort Analysis.","authors":"Abhishek S Bhutada, Srijan Adhikari, Joshua A Cuoco, Austin R Hoggarth, Vaibhav M Patel, Adeolu L Olasunkanmi","doi":"10.1177/21925682241270101","DOIUrl":"10.1177/21925682241270101","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Study.</p><p><strong>Objective: </strong>Myxopapillary ependymomas (MPEs) are a unique subgroup of spinal ependymomas originating from the filum terminale's ependymal glia. The 2021 WHO classification reclassified all MPEs as grade 2, recognizing their higher recurrence risk. Due to their rarity, our objective with this study is to understand MPEs' clinical course and optimal management through a large retrospective cohort analysis.</p><p><strong>Methods: </strong>From the years 2000 to 2020, patients with MPEs were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariable Cox proportional hazard models were run to identify variables that had a significant impact on the primary endpoint of overall survival (OS). A predictive nomogram was built to predict 5-year and 10-year survival probability.</p><p><strong>Results: </strong>This retrospective cohort includes 1373 patients. Patients 65 years or older at diagnosis had a poorer OS (<i>P</i> < 0.001). Most patients received subtotal resection. Only 320 patients (23%) received gross total resection (GTR). Patients that received GTR had the best OS when compared against all other modalities of treatment (<i>P</i> < 0.05). Receiving radiotherapy did not affect OS in patients with MPE (<i>P</i> = 0.2). Nomogram includes patient age and treatment modalities, demonstrating acceptable accuracy in estimating the survival probability at 5-year and 10-year intervals, with a C-index of 0.80 (95% CI of 0.71 to 0.90).</p><p><strong>Conclusion: </strong>This study highlights the survival benefit of GTR in the treatment of patients with MPE. The role of adjuvant radiotherapy remains unclear as it did not seem to improve OS. The nomogram stratifies the risk of survival in patients with MPE based on age and treatment modality.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562715","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":"Global Research Trends on Gait Rehabilitation in Individuals With Spinal Cord Injury- A Bibliometric Analysis.","authors":"Vandana Phadke, Ridhi Sharma, Navita Sharma, Shambhovi Mitra","doi":"10.1177/21925682241243074","DOIUrl":"10.1177/21925682241243074","url":null,"abstract":"<p><strong>Study design: </strong>Bibliometric analysis.</p><p><strong>Objective: </strong>The study aims to comprehensively assess the literature related to gait rehabilitation for individuals with spinal cord injury (SCI) to identify significant contributors, and to explore the collaborations and emerging themes in the field.</p><p><strong>Methods: </strong>Original and review articles in English using relevant keywords were searched in the Clarivate Web of Science database. The data from the selected articles were imported into R software. Bibliometric indicators were assessed to determine author contributions, country affiliations, journal sources, and thematic trends.</p><p><strong>Results: </strong>A total of 1313 relevant articles were identified. The USA, followed by Canada and Switzerland were the most prolific countries contributing to gait rehabilitation research in SCI. The most relevant journals were Spinal Cord, Archives of Physical Medicine and Rehabilitation, Journal of Spinal Cord Medicine, Journal of NeuroEngineering, and Journal of Neurotrauma. The highest contributions came from Northwestern University, the University of Miami, and the University of Alberta. The analysis revealed an increase in research interest in gait rehabilitation after 2000, with a focus on interdisciplinary approaches and emerging technologies like robotics, exoskeletons, and neuromodulation.</p><p><strong>Conclusion: </strong>The analysis demonstrates the importance of collaborative and interdisciplinary research in gait rehabilitation. The results indicate a shift in research focus from traditional methods to the integration of technology. The impact of publications from the USA and Europe is a notable finding. The study highlights the growth of articles related to technology-driven approaches and understanding neuroplasticity in gait rehabilitation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318118","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 Effect of COVID-19 on Spine Surgery.","authors":"Emily S Mills, Kevin Mertz, Ethan Faye, Andy Ton, Jeffrey C Wang, Raymond J Hah, Ram K Alluri","doi":"10.1177/21925682231173368","DOIUrl":"10.1177/21925682231173368","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort analysis.</p><p><strong>Objective: </strong>To characterize the impact of COVID-19 on utilization of the ten most common spine procedures and percentages of outpatient procedures.</p><p><strong>Methods: </strong>The PearlDiver national database was queried from January 2010 to April 2021 for short (<6 segments) and long segment posterior instrumented fusion <b>(≥6 segments),</b> posterior cervical fusion, anterior cervical decompression and fusion (ACDF), cervical laminectomy, laminoplasty, and disc arthroplasty, lumbar laminectomy, microdiscectomy, and interbody fusion. Annual procedure utilization between January 2010 through April 2021 was recorded and compared. Monthly trends were compared to January 2020. Outpatient trends were compared between 2010-2019 and 2019-2021 using segmented linear regression.</p><p><strong>Results: </strong>Overall, all ten procedures decreased 4.3% in 2020 compared to 2019 and increased 6.3% in 2021 compared to 2019. March and April of 2020 had the largest decreases, with March 2020 decreasing 18.2% and April 2020 decreasing 51.6% compared to January 2020. Despite increasing COVID cases in January 2021, overall procedure utilization decreased only 1.8% compared to January 2020, and increased later in 2021 with April 2021 case volumes increasing by 138% compared to January 2020. Outpatient utilization of short segment posterior lumbar fusion and lumbar interbody fusion significantly increased during this time (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>The greatest impact on spine surgery volume from the COVID-19 pandemic occurred in March and April 2020. Spine procedure utilization was otherwise similar or increased compared to January 2020. Additionally, the volume of outpatient short segment posterior fusion and lumbar interbody fusions increased during this time period.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/48/10.1177_21925682231173368.PMC10155052.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9403255","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":"Correlation Study Between Spinal Cord Function, Spinal Cord Morphology and Cervical Spine Alignments in Patients With Hirayama Disease.","authors":"Yuan Gao, Chi Sun, Shuyi Zhou, Fan Zhang, Jianyuan Jiang, Jun Zhang, Hongli Wang","doi":"10.1177/21925682231181871","DOIUrl":"10.1177/21925682231181871","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the relationship between diffusion tensor imaging (DTI) parameters, cervical spine alignments, and spinal cord morphological parameters in patients with Hirayama disease (HD).</p><p><strong>Methods: </strong>In this retrospective cohort study, 41 HD patients were recruited from the Huashan hospital from July 2017 to November 2021. Patients received X-rays, conventional magnetic resonance (MR), and DTI scans in flexion and neutral positions. The DTI parameters assessed were calculated using the region of interest (ROI) method. Paired t-tests were performed on the DTI parameters of neck flexion and neutral position. Cervical spine alignments, including flexion and neutral Cobb angles, were measured, and range of motion (ROM) was calculated. Spinal cord morphological parameters were measured, including spinal cord atrophy (SCA) and loss of attachment (LOA). Spearman's correlation analysis between DTI parameters, cervical spine alignments, and spinal cord morphological parameters was performed.</p><p><strong>Results: </strong>In comparing DTI parameters, segments of the C3/4, C4/5, C6/7, and lower cervical spine were significantly different, while segments of C5/6 were not significantly different. In Spearman's correlation analysis, the flexion Cobb angle was significantly correlated with the fractional anisotropy (FA) value (<i>R</i>² = .111, P = .033) and apparent diffusion coefficient (ADC) value (<i>R</i>² = .119, <i>P</i> = .027). Flexion FA values were correlated with SCA in C4/5 (<i>R</i>² = .211, P = .003), C5/6 (<i>R</i>² = .454, P < .001), and C6/7 (<i>R</i>² = .383, <i>P</i> < .001) while flexion ADC values were correlated with SCA in the C4/5 (<i>R</i>² = .178, <i>P</i> = .006), C5/6 (<i>R</i>² = .388, P < .001) and C6/7 segments (<i>R</i>² = .187, P = .005).</p><p><strong>Conclusion: </strong>The DTI parameters were correlated with the flexion Cobb angle and the SCA. These data support the dynamic cervical flexion compression hypothesis and indicate that the degree of SCA may be used to assess the condition of HD patients quantitatively.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9586267","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}