Global Spine Journal最新文献

{"title":"Radiographic Alignment Parameters for Lumbosacral Reconstruction in Patients With Altered S1 Morphology.","authors":"Arpan A Patel, Shaarada Srivatsa, Jacob K Greenberg, Dominic W Pelle, Jason W Savage, Michael P Steinmetz, Alexander Spiessberger","doi":"10.1177/21925682241257192","DOIUrl":"10.1177/21925682241257192","url":null,"abstract":"<p><p>Study DesignRetrospective quantitative analysis study.ObjectivesPelvic incidence has been established as central radiographic marker which determines patient-specific correction goals during surgery for adult spinal deformity. In cases with sacral doming or sacral osteotomy where the PI cannot be calculated, reliable radiographic parameters need to be established to determine surgical goals. We aim to determine multiple radiographic parameters and formulas that can be utilized when the S1 superior endplate is obscured.MethodsRetrospective analysis was performed on 68 healthy volunteers without prior spine surgery with full-length radiographs. Pelvic incidence, sacral slope, and pelvic tilt were calculated for each patient. Additional measurements such as L4, L5, and S2 incidence, tilt, and slope were collected. A new radiographic parameter defined as the L4-Sciatic notch angle was measured. Regression analysis was performed on each value to determine its relationship with S1 based incidence, tilt, and slope.ResultsMean values for L5 incidence, L4 incidence, and L4 sciatic notch angle were 21.8° ± 8.9, 4.4° ± 8.1, and 44.4° ± 12, respectively. The linear regression analysis produced the following formulas which can be utilized to determine deformity correction goals when pelvic incidence can be calculated pre-operatively: L5i = .65*S1i-11.4, L4i = .44*S1i-18.6, and L4SNA = -.34*S1i + 66.5. In settings where pelvic incidence cannot be calculated, the following formulas can be utilized: L5i = .66*S2i-32.3 and L4SNA = -.02*S2i² + 1.1*S2i + 63.5. <i>P</i>-values for all regression analyses were <.001.ConclusionThis study provides target radiographic alignment values that can be utilized for patients with either pre-operative altered S1 endplates or in cases with intraoperative alteration of S1 (sacral osteotomy).</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1676-1684"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070781","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":"Hydraulic Polymethylmethacrylate Pressure Delivery System Versus Manual Balloon Tamp System in Balloon Kyphoplasty.","authors":"Raphael Lotan, Itzik Lan, Mojahed Sakhnini, Lev Klatzkin, Oded Hershkovich","doi":"10.1177/21925682241261343","DOIUrl":"10.1177/21925682241261343","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectiveOsteoporotic vertebral compression fractures (VCFs) are prevalent among the elderly population, and Balloon kyphoplasty (BKP) is a minimally invasive solution for these. However, Polymethylmethacrylate (PMMA) leakage is a significant complication with potentially severe consequences. This study compares the safety and efficacy of manual balloon tamp system (MTS) and hydraulic Polymethylmethacrylate pressure delivery system (HPDS) in BKP.MethodsA retrospective study involving 160 patients, comparing MTS (2008-2014) and HPDS (2016-2020) cohorts, assessed PMMA leakage, radiation exposure, and surgery duration.ResultsPMMA leakage occurred in 52.8% of MTS and 62.5% of HPDS cases. Intradiscal leakage was the most common pattern in both groups. Multivariate logistic regression revealed that multilevel BKP and HPDS were associated with higher PMMA leakage rates. Radiation exposure was significantly lower with HPDS, while surgery duration was shorter.DiscussionThis study provides novel insights into PMMA leakage and radiation exposure in BKP. HPDS was associated with a higher PMMA leakage rate. HPDS, however, offers advantages in terms of reduced radiation exposure and shorter surgery duration. Multilevel BKP also increased the risk of leakage. Further investigation is needed to better understand the impact of HPDS on PMMA leakage.ConclusionThis study underscores that while HPDS offers advantages regarding radiation exposure and surgery duration, it is associated with a higher PMMA leakage rate.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1743-1748"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199660","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":"Analyzing the L4-5 Segmental Alignment Change of Two Minimally Invasive Prone-Based Interbody Fusions.","authors":"Michael R McDermott, Michael Rogers, Robert Prior, Joseph Mixa, Jonathon Garrett, Rebecca Michna, Alfredo Guiroy, Jahangir Asghar, Ronjon Paul, Ashish Patel","doi":"10.1177/21925682241266165","DOIUrl":"10.1177/21925682241266165","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectiveRestoration of lumbar lordosis (LL) is a principal objective during spinal fusion procedures, traditionally focusing on achieving an LL within 10° of the pelvic incidence (PI). Recent studies have demonstrated a relatively constant L4-S1 alignment of 35-40° at L4-S1 and at least 15° at L4-5, regardless of PI. Based on these results, this study was created to examine the success rate of achieving a minimum of 15° at L4-5 through two differing prone-based techniques: Prone Lateral (pLLIF) and Trans Foraminal Interbody Fusion (TLIF).MethodsOne hundred patients with a primary single-level L4-5 interbody fusion (50 pLLIF and 50 TLIF) were retrospectively analyzed. Pre and post-operative radiographs were measured to examine the segmental change at each level in the lumbar spine and calculate the success rate for achieving a minimum L4-5 segmental lordosis of 15° at the final follow-up.ResultsThe overall success rate of achieving an L4-5 segmental alignment >15° at the final follow-up was 70%. Prone LLIF was significantly more likely than TLIF to achieve this goal, achieving L4-5 > 15° 84% of the time vs TLIFs 56% (<i>P</i> = 0.002). Prone LLIF demonstrated an average L4-5 increase of 5.6 ± 5.9° which was larger than the mean increase for TLIF 0.4 ± 3.8° (<i>P</i> < 0.001). In both techniques, there was an inverse correlation between pre-operative L4-5 angle and L4-5 angle change.ConclusionProne lateral lumbar interbody fusion demonstrates a high success rate for achieving a post-operative L4-5 angle >15° and achieves this at a higher rate than TLIF.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1823-1831"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727104","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":"More Than a Flesh Wound: Trisomy 21 Patients Undergoing Posterior Spinal Fusion for Scoliosis Have High Odds of Wound Complications.","authors":"Michael Benvenuti, Bryan Ang, Kiertana Kannan, Alexandra Dunham, Alexa Bosco, Danielle Cook, M Timothy Hresko, Craig Birch, Daniel Hedequist, Grant Hogue","doi":"10.1177/21925682241245988","DOIUrl":"10.1177/21925682241245988","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesPatients with trisomy 21 (T21) often have soft tissue differences that lead to greater risk of postoperative wound complications. Our aim was to use a matched cohort of adolescent idiopathic scoliosis (AIS) patients with >2 year outcomes to determine odds of specific wound complications when comparing T21 and AIS patients.Methods14 T21 and 544 AIS patients were available for matching. Propensity score matching was conducted using logistic regression models and yielded a 1:5 match of 14 T21 patients and 70 AIS patients. Bivariate analyses were conducted across both patient groups. The proportion of wound complications was estimated along with a 95% confidence interval. Multivariable logistic regression analysis was utilized to determine if there was a significant association between T21 patients and wound outcomes.Results64% of T21 patients experienced a wound complication (9/14; 95% CI = 35.63-86.02) while only 3% of the AIS patients experienced a wound complication (2/70; 95% CI = .50-10.86). Patients with T21 had 56.6 times the odds of having a wound complication compared to matched AIS patients (OR = 56.57; 95% CI = 8.12-394.35; <i>P</i> < .001), controlling for age at surgery, BMI percentile, and propensity score. T21 patients had 10.4 times the odds of reoperation compared to AIS patients (OR = 10.36; 95% CI = 1.62-66.02; <i>P</i> = .01).ConclusionT21 patients have 10.4× the odds of reoperation and 56.6× the odds of overall wound complication when compared to AIS patients in a 1:5 matched cohort with appropriate controls. This is important for surgical planning, surgeon awareness, and communication with families preoperatively.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1526-1532"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876255","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":"Revision Strategy for Proximal Junctional Failure: Combined Effect of Proximal Extension and Focal Correction.","authors":"Renaud Lafage, Han-Jo Kim, Robert K Eastlack, Alan H Daniels, Bassel G Diebo, Greg Mundis, Marc Khalifé, Justin S Smith, Shay R Bess, Christopher I Shaffrey, Christopher P Ames, Douglas C Burton, Munish C Gupta, Eric O Klineberg, Frank J Schwab, Virginie Lafage","doi":"10.1177/21925682241254805","DOIUrl":"10.1177/21925682241254805","url":null,"abstract":"<p><p>Study designRetrospective review of a prospectively-collected multicenter database.ObjectivesThe objective of this study was to determine optimal strategies in terms of focal angular correction and length of proximal extension during revision for PJF.Methods134 patients requiring proximal extension for PJF were analyzed in this study. The correlation between amount of proximal junctional angle (PJA) reduction and recurrence of proximal junctional kyphosis (PJK) and/or PJF was investigated. Following stratification by the degree of PJK correction and the numbers of levels extended proximally, rates of radiographic PJK (PJA >28° & ΔPJA >22°), and recurrent surgery for PJF were reported.ResultsBefore revision, mean PJA was 27.6° ± 14.6°. Mean number of levels extended was 6.0 ± 3.3. Average PJA reduction was 18.8° ± 18.9°. A correlation between the degree of PJA reduction and rate of recurrent PJK was observed (r = -.222). Recurrent radiographic PJK (0%) and clinical PJF (4.5%) were rare in patients undergoing extension ≥8 levels, regardless of angular correction. Patients with small reductions (<5°) and small extensions (<4 levels) experienced moderate rates of recurrent PJK (19.1%) and PJF (9.5%). Patients with large reductions (>30°) and extensions <8 levels had the highest rate of recurrent PJK (31.8%) and PJF (16.0%).ConclusionWhile the degree of focal PJK correction must be determined by the treating surgeon based upon clinical goals, recurrent PJK may be minimized by limiting reduction to <30°. If larger PJA correction is required, more extensive proximal fusion constructs may mitigate recurrent PJK/PJF rates.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1644-1652"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911986","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":"Topping-Off a Long Thoracic Stabilization With Semi-Rigid Constructs May Have Favorable Biomechanical Effects to Prevent Proximal Junctional Kyphosis: A Biomechanical Comparison.","authors":"Chloe Cadieux, Pawel Brzozowski, Renan J R Fernandes, Martine E McGregor, Radovan Zdero, Christopher S Bailey, Stewart D McLachlin, Parham Rasoulinejad","doi":"10.1177/21925682241259695","DOIUrl":"10.1177/21925682241259695","url":null,"abstract":"<p><p>Study DesignIn-vitro cadaveric biomechanical study.ObjectivesLong posterior spinal fusion is a standard treatment for adult spinal deformity. However, these rigid constructs are known to alter motion and stress to the adjacent non-instrumented vertebrae, increasing the risk of proximal junctional kyphosis (PJK). This study aimed to biomechanically compare a standard rigid construct vs constructs \"topped off\" with a semi-rigid construct. By understanding semi-rigid constructs' effect on motion and overall construct stiffness, surgeons and researchers could better optimize fusion constructs to potentially decrease the risk of PJK and the need for revision surgery.MethodsNine human cadaveric spines (T1-T12) underwent non-destructive biomechanical range of motion tests in pure bending or torsion and were instrumented with an all-pedicle-screw (APS) construct from T6-T9. The specimens were sequentially instrumented with semi-rigid constructs at T5: (i) APS plus sublaminar bands; (ii) APS plus supralaminar hooks; (iii) APS plus transverse process hooks; and (iv) APS plus short pedicle screws.ResultsAPS plus transverse process hooks had a range of motion (ie, relative angle) for T4-T5 and T5-T6, as well as an overall mechanical stiffness for T1-T12, that was more favourable, as it reduced motion at adjacent levels without a stark increase in stiffness. Moreover, APS plus transverse process hooks had the most linear change for range of motion across the entire T3-T7 range.ConclusionsPresent findings suggest that APS plus transverse process hooks has a favourable biomechanical effect that may reduce PJK for long spinal fusions compared to the other constructs examined.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1685-1694"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199667","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":"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}