Global Spine Journal最新文献

{"title":"Does Aspirin Use Influence Rates of Pseudoarthrosis After Anterior Cervical Discectomy and Fusion?","authors":"Kevin T Kim, Ziam Khan, Joseph Stains, Timothy Chryssikos","doi":"10.1177/21925682251393632","DOIUrl":"10.1177/21925682251393632","url":null,"abstract":"<p><p>Study DesignRetrospective propensity-matched cohort study.ObjectivesAspirin's role in bone remodeling after spinal fusion is unclear. We evaluated the relationship between aspirin use and pseudoarthrosis after ACDF surgery.MethodsData was collected from TriNetX, a large research platform including 67 participating healthcare organizations, to identify single- and multi-level ACDF cohorts stratified by no aspirin, aspirin 81 mg and 325 mg daily use. The primary outcome was diagnosis of pseudoarthrosis. Propensity score matching (1:1 ratio) was performed for demographic/clinical variables, followed by risk analyses to determine odds of outcome at 6-months, 1-year, and 2-years. Reoperation rate (additional spinal fusion) was assessed for cohorts with significant results.ResultsThere were significantly lower pseudoarthrosis rates in the 81 mg aspirin group (n = 2504) for single-level ACDF at 6-months, 1-year, and 2-years, and a significantly lower reoperation rate at 2-years, compared to patients not taking aspirin. There were no differences in pseudoarthrosis for single-level ACDF with 325 mg dosing (n = 799) and for multi-level ACDF with 81 mg (n = 2287) or 325 mg (n = 678) dosing.ConclusionsPatients taking 81 mg aspirin had lower pseudoarthrosis rates at 6-months, 1-year, and 2-years and fewer reoperations at 2-years compared with single-level ACDF patients not taking aspirin. No significant associations between aspirin use and pseudoarthrosis were observed for 325 mg dosing or for multi-level ACDF. These results suggest the hypothesis that 81 mg or 325 mg aspirin does not increase the risk of pseudoarthrosis after ACDF. However, changes to clinical practice are not recommended until prospective clinical studies are completed.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1938-1949"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12568543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145388722","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":"Assessment of Preferences for Delivery of Spine Care Information: A ChatGPT and Survey-Based Study.","authors":"Patricia Lipson, Kenneth T Nguyen, Aiyush Bansal, Erika Castaneda, Jack Sedwick, Philip K Louie","doi":"10.1177/21925682251386842","DOIUrl":"10.1177/21925682251386842","url":null,"abstract":"<p><p>Study DesignSurvey-based study.ObjectiveTo identify how to effectively tailor spine care information to different educational backgrounds, beyond general readability.MethodsAn internet-based survey (Connect™, CloudResearch) recruited 600 U.S. adults evenly distributed across age brackets (18-80). <i>Participants were presented with six clinical scenarios, each with a question, five answer choices, and asked to choose the most sensible answer.</i> ChatGPT-4 generated five response levels per question, scored with the Flesch Reading Ease scale to represent varying educational or readability levels. Chi-squared tests and standardized residual analysis compared preferred reading levels across education groups.ResultsOf the 600 participants (mean age 45 ± 15.7, 50.8% female), preferred selections were postgraduate (50.6%) and 8th-12th grade levels (22.1%). Bachelor's degree holders significantly favored postgraduate-level content (55.3%), while postgraduate respondents predominantly preferred 8th-12th grade or simpler (56.2%). Participants with less than a bachelor's degree similarly preferred 8th-12th grade or lower (53.5%). Standardized residual analysis revealed bachelor's participants selected postgraduate content more frequently than expected, whereas postgraduate and below-bachelor participants selected it less than expected.ConclusionsWhile postgraduate-level responses were the most frequently selected overall, preferences varied substantially by education level. Both postgraduate and below-bachelor participants tended to favor simpler content, while bachelor's-level respondents consistently preferred more complex language. These findings underscore that simplifying medical information may improve accessibility across diverse educational backgrounds. <i>When tailoring content by education level is not feasible, aiming for an 8th-12th grade reading level may offer the most effective balance between clarity and comprehensiveness in spine care communication.</i></p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1718-1726"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232470","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 Top 100 Cited Articles on Lumbar Disc Arthroplasty: A Bibliometric Analysis.","authors":"Paul G Mastrokostas, Aaron B Lavi, Bruce B Zhang, Nidhi Mahadevan, Eli Berglas, Sean Inzerillo, Leonidas E Mastrokostas, Jad Bou Monsef, Afshin E Razi, Mitchell K Ng","doi":"10.1177/21925682251398462","DOIUrl":"10.1177/21925682251398462","url":null,"abstract":"<p><p>Study DesignBibliometric analysis.ObjectivesTo identify and characterize the 100 most cited articles on lumbar disc arthroplasty (LDA) to better understand influential contributions to the field and highlight key trends in research focus and collaboration.MethodsA Web of Science search for \"lumbar disc arthroplasty\" OR \"lumbar disc replacement\" was conducted on December 1, 2024. The top 100 articles by citation count were screened for inclusion. Extracted variables included number of citations, authorship, journal, publication year, institution, and keyword frequency. Citation trends and networks were analyzed using VOSviewer and the Bibliometrix package in RStudio. ResultsThe 100 most cited articles were published between 2002 and 2018, with citation counts ranging from 27 to 377 (mean 66.6). The most cited study was a 2005 FDA investigational device trial on the CHARITÉ™ disc. Publication volume peaked in 2007. <i>Spine</i> was the leading journal (N = 38), followed by <i>European Spine Journal</i> (N = 20). Mayer HM, Siepe CJ, and McAfee PC were the most prolific authors. Network analysis identified 18 author clusters, demonstrating strong self-citation patterns and institutional concentration in North America and Europe. Keyword analysis showed recurring focus on \"lumbar spine,\" \"degenerative disc disease,\" and \"prosthesis design\".ConclusionsInfluential LDA research has been shaped by a concentrated group of authors, institutions, and journals. While academic interest has been sustained, clinical adoption of LDA has lagged. Aligning future research efforts with clinical application may help support broader integration of motion-preserving technologies in spine surgery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1989-1998"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488344","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":"Transcultural Adaptation and Validation into Spanish of the AO Spine PROST (Patient-Reported Outcome Spine Trauma) Questionnaire.","authors":"Ignacio Cirillo, Pablo Carreño, Guillermo Ricciardi, Ratko Yurac, Gonzalo Kido, Victor Barrientos, Hugo Vilchis, Eduardo Laos","doi":"10.1177/21925682251391792","DOIUrl":"10.1177/21925682251391792","url":null,"abstract":"<p><p>Study DesignMulticenter, cross-sectional study of cross-cultural adaptation and psychometric validation of a patient-reported outcome measure.ObjectiveTo adapt and validate the Spanish version of the AO Spine Patient-Reported Outcome Spine Trauma (PROST) questionnaire for assessing functional outcomes in patients with traumatic spinal injuries.MethodsThe translation followed Beaton's standardized cross-cultural adaptation process: forward translation, synthesis, back-translation, expert committee review, and final version development. Adult patients (≥18 years) with spinal trauma within the last 13 months were recruited from 4 Level 1 trauma centers across Latin America. Exclusion criteria included polytrauma (ISS >15), complete paralysis (ASIA A-B), and cognitive impairment. Participants completed the Spanish PROST and the SF-36. Concurrent validity was evaluated using Spearman's correlation between PROST and SF-36 domains. Internal consistency was assessed via Cronbach's alpha.ResultsA total of 108 patients were included (mean age 46 ± 15.8 years; 57% male). The Spanish PROST showed excellent internal consistency (α > 0.96). It showed a strong correlation with the SF-36 Physical Functioning domain (rs = 0.83; <i>P</i> < 0.0001) and moderate to strong correlations with Vitality, Mental Health, Bodily Pain, and Social Functioning (rs = 0.54-0.64; <i>P</i> < 0.0001). Moderate correlations were also found with Role Physical and Role Emotional.ConclusionThe Spanish AO Spine PROST is a valid, reliable tool for assessing functional outcomes in spinal trauma patients. These findings support its use in both clinical practice and research settings within Spanish-speaking populations.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1910-1916"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345032","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":"Augmented Reality-Guided Pedicle Screw Placement With 2D-3D Registration: Proof-Of-Concept Using 151 Cadaveric Trajectories.","authors":"Jose A Castillo, Gabriel Urreola, Venina Kalistratova, Michael Le, Alan M Harris, Hania Shahzad, Dustin H Massel, Nicholas Shepard, Chris Cook, Richard Lim, Safdar Khan, Richard L Price","doi":"10.1177/21925682251387550","DOIUrl":"10.1177/21925682251387550","url":null,"abstract":"<p><p>Study DesignProspective, single-center cadaveric study.ObjectivesTo evaluate the accuracy of augmented reality (AR) head-mounted display navigation using a 2D-3D registration method for pedicle screw placement that integrates preoperative CT scans with intraoperative X-ray images, eliminating the need for intraoperative 3D imaging.MethodsA prospective, single-center cadaveric study was conducted using six human cadaveric specimens. Five board-certified spine surgeons placed 151 pedicle screws across cervical (n = 36), thoracic (n = 54), lumbar (n = 41), and sacroiliac (n = 20) regions using an AR navigation system. The system utilized preoperative CT scans registered with intraoperative X-ray images. Accuracy was assessed stereotactically (angular and translational errors) and clinically (Gertzbein-Robbins and Heary classifications).ResultsOf 151 pedicle screws placed, 147 (97.4%) were accurately positioned in the \"safe zone\" (Gertzbein-Robbins grades A/B or Heary classifications I/II). The 99% upper bound limit for angular errors was <3 and translational errors was < 3 mm in both axial and sagittal planes across all vertebral levels.ConclusionsThe 2D-3D registration methodology with AR visualization demonstrates high accuracy for pedicle screw placement comparable to conventional navigation techniques. This approach effectively addresses key limitations of existing navigation paradigms while maintaining high accuracy standards without requiring intraoperative 3D imaging capabilities. AR-assisted navigation with 2D-3D registration represents a promising technological advancement that may enhance the precision and efficiency of spinal instrumentation procedures.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1804-1813"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299813","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":"Long-Term Impact of Total Hip Arthroplasty on Subsequent Lumbar Spine Surgery in Patients with Hip-Spine Disease: A Nationwide Analysis of Risk Factors and Outcomes.","authors":"Ali Issani, William J Karakash, Aidan Lindgren, Daniel Rusu, Henry Avetisian, MirBahadur Athari, Dil Patel, Raymond J Hah, Ram K Alluri, John C Liu, Jeffrey C Wang","doi":"10.1177/21925682251387072","DOIUrl":"10.1177/21925682251387072","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectiveTo evaluate whether undergoing total hip arthroplasty (THA) influences the risk of subsequent lumbar intervention in patients with lumbar degenerative disease (LDD) and hip osteoarthritis (HOA), and to identify patient-specific risk factors and procedural characteristics associated with post-THA lumbar intervention.MethodsUtilizing the PearlDiver Mariner Database (2010-2023), 1 194 269 patients with LDD and HOA were included, 16.3% of whom underwent THA. Patients with prior lumbar surgeries, trauma, infection and malignancy were excluded. Multivariable logistic regression adjusted for demographics, comorbidities, and scoliosis was performed. Subgroup analyses assessed procedural characteristics, lumbar pathologies, and comorbidities within the THA cohort.ResultsTHA was associated with reduced odds of lumbar decompression (OR 0.42, 95% CI [0.41-0.44]) and fusion (OR 0.42, 95% CI [0.40-0.44], both <i>P</i> < 0.001). Predictors of lumbar surgery after THA included preoperative opioid use, obesity, fibromyalgia, depression, diabetes, scoliosis, spondylolisthesis, myelopathy, radiculopathy, stenosis, and spondylolysis. Unilateral THA was associated with significantly higher odds of subsequent lumbar intervention compared with the reference group, whereas bilateral THA was associated with significantly lower odds of subsequent lumbar intervention compared with the same reference group. Risk was highest in patients aged 60-69 years but decreased in those over 69. THA also delayed the average time to lumbar intervention.ConclusionTHA, particularly bilateral procedures, was protective against future lumbar surgery in patients with HOA and LDD. Unilateral THA was less protective, potentially reflecting spinopelvic imbalance. These findings refine understanding of hip-spine syndrome and support prioritizing timely hip arthroplasty in high-risk patients with severe HOA.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1786-1793"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250888","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":"Postoperative Complications of Single-Level Lumbar Spine Fusion in Patients With Preoperative Vitamin D Deficiency: A Retrospective Cohort Study.","authors":"Diego Garcia, Jonathan Sayegh, Bryce R Michael, Yazin Hindosh, Arturo Lujan, Rami Khoshaba, Isam Sami Moghamis, Peter Du, Abduljabbar Alhammoud","doi":"10.1177/21925682251386808","DOIUrl":"10.1177/21925682251386808","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesTo assess whether preoperative vitamin D deficiency is associated with increased postoperative complications after single-level lumbar fusion.MethodsWe queried a national EHR network for adults undergoing posterior/posterolateral single-level lumbar fusion. Vitamin D deficiency was defined by the most recent preoperative 25-hydroxyvitamin D <20 ng/mL. Patients with multilevel fusion, <2-year follow-up, scoliosis, or spinal cord neoplasm were excluded. Propensity-score matching (1:1) on demographics, Charlson Comorbidity Index, obesity, osteoporosis, nicotine dependence, vitamin D supplementation, celiac disease, inflammatory bowel disease, chronic pancreatitis, and cystic fibrosis yielded 1365 patients per cohort (from 1372 deficient and 89,165 non-deficient). Outcomes included 90-day incidence of readmission, emergency department (ED) utilization, deep vein thrombosis (DVT), pulmonary embolism (PE), pneumonia, sepsis, acute kidney injury (AKI), urinary tract infection (UTI), surgical site infection (SSI), and death. Instrumentation failure, pseudoarthrosis, and revision were assessed at 90 days, 1 year, and 2 years. Risk differences and relative risks (RR) were calculated; statistical significance was set to <i>P</i> < 0.05.ResultsVitamin D deficiency was associated with higher 90-day risk of readmission (RR = 1.19), ED use (RR = 1.32), AKI (RR = 1.77), SSI (RR = 2.06), death (RR = 2.40), and pseudoarthrosis (RR = 1.47). Pseudoarthrosis risk remained higher at 1 year (RR = 1.43) and 2 years (RR = 1.40), and revision surgery was higher at 2 years (RR = 1.69).ConclusionPreoperative vitamin D deficiency was associated with increased short-term medical complications and higher long-term risks of pseudoarthrosis and revision after single-level lumbar fusion. These findings support assessing vitamin D status preoperatively to identify patients at greater risk.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1745-1753"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257747","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 Expression Level of miR-93-5p in Patients With Lumbar Disc Herniation is Related to the Severity of the Disease.","authors":"Zhen Wang, Jichen Liu, Haishan Xu, Wei He, Xijing He","doi":"10.1177/21925682251386860","DOIUrl":"10.1177/21925682251386860","url":null,"abstract":"<p><p>Study DesignRetrospective Study.ObjectiveLumbar disc herniation (LDH) can cause low back pain and sciatica, and lead to nerve damage. This study aims to explore whether the severity of LDH and the risk of its onset are related to the dysregulation of miR-93-5p.MethodsFirstly, the level of miR-93-5p in the nucleus pulposus (NP) of LDH patients and patients with traumatic lumbar fractures was detected by RT-qPCR. The compression degree of the lumbar disc on the nerve was evaluated by using the Pfirrmann classification. The VAS score and JOA score were used to evaluate the degree of pain and functional impairment. We also analyzed the relationship between the concentration of miR-93-5p and inflammatory factors (TNF-α, IL-6, IL-1β). Finally, the risk factors influencing LDH were explored through binary logistic regression.ResultsmiR-93-5p was downregulated in LDH patients. The higher the Pfirrmann grade is, the lower the level of miR-93-5p is. Additionally, as the degree of pain increases, the level of miR-93-5p gradually begins to decrease. Contrary to this result, miR-93-5p was positively correlated with the JOA score. Inflammatory factors in the NP tissues of LDH patients increase and there is a negative correlation with miR-93-5p. More importantly, the decrease of miR-93-5p may be an independent risk factor leading to LDH.ConclusionThe decrease of miR-93-5p is a risk factor for LDH and is negatively correlated with the clinical severity. The reduction of this molecule may lead to intensified pain and activation of inflammation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1767-1774"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12578625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421122","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":"A Short Distance Between Pedicle Screw Tip and Upper Endplate as a Risk Factor for Upper Instrumented Vertebra Fracture Following Adult Spinal Deformity Surgery.","authors":"Ben-Hai Wang, Min-Min Zhang, Qing-De Wang, Yi-Hsun Huang, Erh-Ti Ernest Lin, Xue-Peng Wei, Chun-Hao Tsai, Yi-Chin Fong, Yen-Jen Chen, Hsien-Te Chen, Yuan-Shun Lo","doi":"10.1177/21925682251390764","DOIUrl":"10.1177/21925682251390764","url":null,"abstract":"<p><p>Study DesignRetrospective cohort comparative study.ObjectiveTo investigate whether specific upper instrumented vertebra (UIV) pedicle screw characteristics-particularly screw slope (UIV SS), tip-to-endplate distance (TED), and tip-to-anterior cortex distance (TAD)-are associated with the development of upper instrumented vertebra fracture (UIVF) following adult spinal deformity (ASD) surgery.MethodsThis retrospective study included 132 patients (mean age: 68.4 years) who underwent corrective surgery from 2013 to 2022, with a minimum follow-up of 2 years. The radiographic parameters and UIV screw characteristics were analyzed. Patients were categorized into UIVF and non-UIVF groups. Logistic regression and Receiver Operating Characteristic (ROC) curve analyses were used to identify the risk factors and cutoff values.ResultsUIVF occurred in 28.8% (38/132) of the patients. Post-thoracic kyphosis (Post-TK) and TED of the upper UIV screw (Post-TED_upper) were independently associated with UIVF. Cutoff values predictive of UIVF were post-TK > 36.5° and Post-TED_upper < 6.5 <i>mm</i>. Patients with a TED_upper < 6.5 <i>mm</i> had a significantly higher incidence of UIVF (HR = 2.417, <i>P</i> = 0.010). Kaplan-Meier analysis showed that UIVF commonly occurred within 3 months postoperatively. Progressive reduction in TED was observed over time, particularly in the UIVF group.ConclusionPost- TK > 36.5° and Post-TED_upper < 6.5 <i>mm</i> are significant predictors of UIVF. Based on the study findings, a postoperative TED of ≥ 6.5 mm may be associated with a reduced risk, and could be considered as a potential target in surgical planning, while acknowledging the limitations of the retrospective design and the model's moderate predictive accuracy.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1878-1888"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307760","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":"Proton Pump Inhibitors and Histamine-2 Receptor Antagonists in Spinal Fusion: A Systematic Review.","authors":"Nicholas Frappa, Danil Chernov, Matthew G Alben, Morgan Dillon, Aidan G Papalia, Ryan Riley, Zachary Troiani, Christopher Lucasti","doi":"10.1177/21925682251396451","DOIUrl":"10.1177/21925682251396451","url":null,"abstract":"<p><p>Study DesignSystematic Review.ObjectivesTo evaluate the impact of proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2 blockers) on spinal fusion outcomes.MethodsA systematic search of PubMed (MEDLINE) was conducted for studies published between January 2000 and July 2025 using Title/Abstract terms for PPIs, H2 blockers, spine, and fusion. Eligible studies were English-language articles assessing the relationship between acid suppression and spinal fusion outcomes. Two reviewers independently screened studies and extracted data.ResultsOf 798 records screened, five studies met inclusion criteria: three retrospective cohort studies, one animal study, and one prospective study evaluating H2 blocker use. Four of the five studies evaluated PPIs. All three clinical studies observed higher pseudarthrosis rates among postoperative PPI users undergoing spinal fusion. The animal model found no significant fusion impairment. The H2 blocker study showed reduced inflammatory markers but did not assess osseous union.ConclusionsCurrent evidence suggests an association between PPI use and impaired spinal fusion, particularly in the cervical and lumbar spine. In contrast, H2 blockers appear to have a more neutral skeletal profile, though no studies have directly evaluated their impact on spinal fusion or pseudarthrosis rates. Most available data on PPIs are derived from retrospective studies or animal models, with substantial heterogeneity in surgical level, fusion construct, PPI type, and follow-up duration. Future research should prioritize prospective, randomized studies or large registry-based analyses to clarify the causal relationship between acid suppression therapy and spinal fusion.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1973-1979"},"PeriodicalIF":3.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451668","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}