Global Spine Journal最新文献

{"title":"Surgical versus Non-Surgical Treatment of Thoracolumbar Burst Fractures in Neurologically Intact Patients: A Prospective International Multicentre Cohort Study.","authors":"Marcel F Dvorak, Cumhur F Öner, Charlotte Dandurand, Klaus John Schnake, Richard J Bransford, Eugen Cezar Popescu, Mohammed El-Sharkawi, Shanmuganathan Rajasekaran, Lorin M Benneker, Greg D Schroeder, Jin W Tee, John C France, Jérôme Paquet, Richard Allen, William F Lavelle, Miguel Hirschfeld, Spyros Pneumaticos, Emiliano Vialle, Alexander R Vaccaro","doi":"10.1177/21925682251356910","DOIUrl":"10.1177/21925682251356910","url":null,"abstract":"<p><p>Study designProspective cohort study.ObjectivesTreatment for thoracolumbar (TL) burst fractures in neurologically intact patients remains controversial. The goal of this study was to utilize the international equipoise to determine whether surgery leads to a more rapid improvement of disability measured by minimal clinically important difference (MCID) in Oswestry Disability Index (ODI).MethodsThe primary endpoint was time to achieve an improvement in ODI of more than 12.8 points within 1 year after baseline (MCID). A post hoc analysis was conducted to assess time to minimal disability (ODI of <20). Time-to-event analyses were applied, including log rank test for equality of survivor functions, Kaplan Meier survival curves and Cox proportional hazard models.ResultsOne hundred and ninety-eight patients were included (122 surgical and 76 non-surgical patients). Median time to achieve MCID in ODI (12.8 points) from baseline was similar between the two groups (25.0 days vs 25.5 days, <i>P</i> = 0.517). Post hoc analysis showed a potential trend towards a short time to achieve minimal disability for the surgical group (69.0 days vs 82.0 days, <i>P</i> = 0.057). Similar results were obtained when excluding all patients with suspected PLC injury.ConclusionSurgically and non-surgically treated patients with thoracolumbar burst fractures without neurological injury were similar in terms of time to reaching MCID in ODI at 1 year. Surgical patients may reach minimal disability faster than nonsurgical patients, but additional large scale studies are warranted.Level of EvidenceTherapeutic Prospective Comparative Cohort Study Level II.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251356910"},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553328","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":"Management of Dural Tears in Spine Surgery: A Worldwide Survey of Current Practices and Complications.","authors":"Sameh M Abolfotouh, Omar Alnori, Zorica Buser, Patrick C Hsieh, Mostafa A Abolfotouh","doi":"10.1177/21925682251358167","DOIUrl":"10.1177/21925682251358167","url":null,"abstract":"<p><p>Study DesignCross-sectional survey.ObjectivesTo determine the prevalence and predictors of incidental durotomy (ID) among AO Spine surgeons globally, and assess current management strategies and associated complications.MethodsAn electronic questionnaire was distributed to 937 AO Spine surgeon members in October-November 2024, to collect data on surgeon demographics, work characteristics, experience with ID, and preferred management techniques. Logistic regression identified predictors of frequent IDs (>5% of surgeries). Significance was set at <i>P</i> ≤ 0.05.ResultsSurgeons reported ID frequencies ranging from 1% to >20%. Overall, 12% reported frequent IDs. Longer surgical experience (OR = 0.406, <i>P</i> = 0.031) was protective, while working in a public/ governmental hospital (OR = 1.775, <i>P</i> = 0.023) was a risk factor. Medium-sized IDs (1-10 mm) were most common in lumbar surgery (52.2%). Sutures and sealants were commonly used for medium and large tears. Prolene sutures (76.5%) and autologous grafts (53.8%) were preferred. Subfascial drains without suction were frequently used. Management of large and medium tears commonly included 48 and 24 hours of bed rest, respectively. Immediate ambulation was most frequent for small tears. Most surgeons (79.2%) reported occasional or rare complications from dural tears, with a significant association with dural graft repair (OR = 1.946,<i>P</i> < 0.001). Disclosure of IDs to patients was nearly universal (97.3%).ConclusionThe study highlights the frequency with which incidental durotomy occurs globally during spinal surgery. Longer surgical experience was a protective factor of frequent ID, while working in a public/ governmental hospital was a risk factor. Standardized protocols for small tears or guidelines for deciding between repair and non-repair are recommended.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251358167"},"PeriodicalIF":2.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559971","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":"Analysis of Cervical Sagittal Alignment and Its Relationship With Spino-Pelvic Parameters in 410 Asymptomatic Children and Adolescents.","authors":"Shuaiqi Zhu, Chong Zhao, Yonghao Wu, Chenjun Liu, Haiying Liu","doi":"10.1177/21925682251357011","DOIUrl":"10.1177/21925682251357011","url":null,"abstract":"<p><p>Study DesignRetrospective study.ObjectivesTo investigate the prevalence of cervical kyphosis, identify factors influencing cervical sagittal alignment and analyze its relationship with spino-pelvic parameters in asymptomatic children and adolescents.Methods410 asymptomatic children and adolescents aged 4-18 years were included. Cervical sagittal alignment types and radiographic parameters were measured in the full-length spine X-ray. Three groups were assigned according to Toyama method: lordotic group, straight and sigmoid group, kyphotic group. Participants were stratified by gender and age, and differences in spinal parameters were analyzed. To determine factors influencing cervical sagittal alignment, a multinomial logistic regression was conducted.ResultsAmong the 410 participants, 119 (29.0%) were classified as lordotic, 170 (41.5%) as straight, 5 (1.2%) as sigmoid, and 116 (28.3%) as kyphotic of the cervical sagittal alignment. Females exhibited a higher prevalence of kyphosis compared to males (35.8% vs 19.0%). Furthermore, kyphosis prevalence increased with age, from 0% in the 4-6-year-old group to 39.2% in the 16-18-year-old group. Strong positive correlations were observed between T1 slope and C2-C7 Cobb angle (r = 0.667, <i>P</i> < 0.01), as well as between lumbar lordosis and sacral slope (r = 0.758, <i>P</i> < 0.01). Age and C2-C7 Cobb angle were identified as predictors of cervical sagittal alignment via multinomial logistic regression analysis.ConclusionsThis study revealed that cervical kyphosis prevalence was comparable to lordosis in asymptomatic pediatric population, which challenged the traditional view of kyphosis as pathological. Additionally, cervical sagittal alignment showed significant gender- and age-related differences. These findings contribute to understanding pediatric cervical morphology and refining surgical strategies.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251357011"},"PeriodicalIF":2.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553325","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":"Letter to the Editor Regarding the Article\"Comparison of 2 Anesthetic Methods for Transforaminal Endoscopic Lumbar Discectomy: A Prospective Randomized Controlled Study\".","authors":"Dazhi Li, Hongbin Wang","doi":"10.1177/21925682251357904","DOIUrl":"10.1177/21925682251357904","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251357904"},"PeriodicalIF":2.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553327","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":"Investigation of <i>LBX1, TIMP2, GPR126</i> and <i>CHD7</i> Gene Polymorphisms in Adolescent Idiopathic Scoliosis Patients.","authors":"Erkan Bilgin, Havva Tezcan Unlu, Gulsah Cecener, Huri Sema Aymelek, Yucel Bilgin, Burak Akesen","doi":"10.1177/21925682251356933","DOIUrl":"10.1177/21925682251356933","url":null,"abstract":"<p><p>Study DesignProspective genetic cohort study.ObjectiveAdolescent idiopathic scoliosis (AIS) is a common spinal disorder affecting individuals aged 10-18 years without other underlying health conditions. This study aimed to examine the potential etiologic association between AIS and polymorphisms in the <i>LBX1</i> (rs11190870, rs625039, rs11598564), <i>TIMP2</i> (rs8179090), <i>GPR126</i> (rs6570507), and <i>CHD7</i> (rs121434341) genes in Turkish patients. Additionally, the relationships of these polymorphisms with sex, age, age at diagnosis, and Cobb angle were evaluated.MethodsThe study included 301 individuals: 201 patients with AIS (aged 10-18 years, Cobb angle ≥10°, no genetic disorders or related diseases), and 100 healthy controls (aged 10-18 years, no scoliosis diagnosis). The study analyzed rs625039, rs11598564, rs6570507, rs121434341, rs11190870, and rs8179090 polymorphisms in patients with AIS and controls using RT-PCR, confirmed the SNP regions through DNA sequencing, and performed statistical analysis.ResultsIn this study, the rs11190870 polymorphism of the <i>LBX1</i> gene demonstrated a statistically significant difference between patients with AIS and the control group (<i>P</i> < .001), but no significance was observed for the other polymorphisms analyzed. Sex-based analysis revealed a significant association for the <i>LBX1</i> rs11598564 polymorphism, with a higher frequency observed in females (<i>P</i> = .029); no significant differences were identified for the other polymorphisms in terms of sex. The rs8179090 and rs121434341 polymorphisms, previously associated with AIS in other populations, showed no statistically significant association in the present study cohort.ConclusionThe <i>LBX1</i> gene rs11190870 polymorphism was found to be associated with AIS in Turkish patients.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251356933"},"PeriodicalIF":2.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553326","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 Association Between Comorbidities and Medical Complications for Adult Spinal Deformity Surgery: What Factors Have the Greatest Impact on Adverse Events and Outcomes?","authors":"Shin Oe, So Kato, Stephen J Lewis, Lawrence G Lenke, Yong Qiu, Yukihiro Matsuyama","doi":"10.1177/21925682231202376","DOIUrl":"10.1177/21925682231202376","url":null,"abstract":"<p><p>Study designNarrative review.ObjectiveIt is known that adult spinal deformity surgery (ASD) is associated with a high medical complication rate. However, it remains unclear which comorbidities impact these adverse events. The purpose of this study was to review the current knowledge regarding the association between postoperative medical complications and comorbidities.MethodsThe literatures in English were searched using PubMed. The search method involved a combination of keywords including \"adult spinal deformity,\" \"complication,\" and each specific risk factor. The search was limited to items listed in PubMed by February 15, 2022. The odds ratio (OR) of medical complications and mortality were evaluated.ResultsA total of 94 publications were reviewed. The risk factors with the higher OR for medical complications were frailty (OR: 4.4, 95% CI: 2.0-9.9), ASA class 4 (OR: 3.58, 95% CI: 2.00-6.39), male sex (OR: 3.52, 95% CI: 1.78-6.96), malnutrition (OR: 2.89, 95% CI: 1.69-4.93), and pathologic weight loss (OR: 2.38, 95% CI: 2.01-2.81). Similarly, the risk factors with the higher OR for mortality were liver disease (OR: 36.09, 95% CI: 16.16-80.59), pathologic weight loss (OR: 7.28, 95% CI: 4.36-12.14), renal failure (OR: 5.51, 95% CI: 2.57-11.82), chronic heart failure (OR: 5.67, 95% CI: 3.3-9.73), and age over 65 (OR: 3.49, 95% CI: 2.31-5.29).ConclusionThis review demonstrates the impact of a patient's comorbidities on postoperative medical complications. Understanding the level of risk involved can help to provide surgeons and patients with the information required to determine the suitability for surgery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 3_suppl","pages":"75S-86S"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591074","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":"Minimally Invasive Surgery in Adult Spinal Deformity and the Future.","authors":"Shashank V Gandhi, S Harrison Farber, Juan P Giraldo, Christopher Shaffrey, Juan S Uribe","doi":"10.1177/21925682241282277","DOIUrl":"10.1177/21925682241282277","url":null,"abstract":"<p><p>Study DesignNarrative review.ObjectivesThe purpose of this literature review is to evaluate various MIS techniques, assesses their roles in ASD when compared to traditional open surgery, and highlight potential future directions in minimally invasive spine surgery. Correction of spinal malalignment and decompression of neural elements through surgical intervention in adult spinal deformity (ASD) has demonstrated significant improvements in health-related quality of life (HRQOL) metrics. Historically, open surgery has been the primary approach to ensure sufficient decompression and alignment in ASD patients. However, advancements in MIS techniques, equipment, and extensive experience in managing degenerative pathologies have enabled effective corrections using less invasive methods.MethodsAn extensive review of MIS and open techniques for ASD was conducted.ResultsThis review evaluates various MIS techniques, assesses their roles in ASD when compared to traditional open surgery, and highlights potential future directions in minimally invasive spine surgery.ConclusionsThe evaluation of various minimally invasive surgery (MIS) techniques in treating adult spinal deformity (ASD) compared to traditional open surgery reveals significant advantages. MIS has progressed from initially treating simple degenerative pathologies to effectively addressing complex ASD cases. This evolution underscores the increasing role of MIS in ASD treatment. Over the past two decades, there has been a noticeable shift towards the mainstream adoption of MIS techniques, reflecting their growing prevalence and acceptance within the medical community. Looking ahead, ongoing advancements and innovations in minimally invasive spine surgery suggest exciting potential future directions for improving outcomes in ASD patients and expanding the application of MIS in spine deformity correction.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 3_suppl","pages":"172S-189S"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591068","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":"Alignment Goals in Adult Spinal Deformity Surgery.","authors":"Javier Pizones, Jeffrey Hills, Michael P Kelly, Fatemeh Alavi, Susana Nuñez-Pereira, Justin S Smith, Zeeshan M Sardar, Lawrence G Lenke, Stephen J Lewis, Ferran Pellisé","doi":"10.1177/21925682251331048","DOIUrl":"10.1177/21925682251331048","url":null,"abstract":"<p><p>Study DesignNarrative review.ObjectivesAdult spinal deformity (ASD) surgery has progressively transitioned from mean regional alignment targets to individualized segmental alignment goals, and from health-related quality of life (HRQL) alignment goals to the prevention of mechanical complications.MethodsNarrative review discussing sagittal alignment concepts and goals in ASD surgery.ResultsTraditional metrics for measuring sagittal spinal alignment such as pelvic incidence - lumbar lordosis (PI-LL), thoracic kyphosis, and sagittal vertical axis (SVA) may lack the specificity necessary for individualized alignment planning. Compensatory pelvic retroversion and knee flexion are critical determinants of maintaining the upright position. Research has been conflicting as to whether postoperative sagittal alignment is associated with improvements in HRQOL's. However, this may reflect a lack of sensitivity in the traditional alignment targets and PROM's measures, rather than a true lack of relationship between sagittal alignment and functional outcomes. Recent studies show that sagittal parameters have a limited impact on HRQL scores in non-operated patients, but significantly impact post-operative HRQOL measures and mechanical complications in patients treated with spinal fusion. Latest evidence suggests that compensatory mechanisms need to be eliminated and the ideal shape needs to be restored with surgery, to reduce postoperative mechanical complications. Multiple alignment strategies are proposed for that purpose.ConclusionsWhile best evidence shows an improvement in ASD alignment strategies over the last decade, mechanical failures and reoperations are still a cause for concern. This narrative review analyzes the strengths and weaknesses of the different alignment strategies and identifies the main areas of debate.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 3_suppl","pages":"108S-122S"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591053","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":"Patient Reported Outcome Measurements in Adult Spinal Deformity: A Narrative Review.","authors":"Michael P Kelly, Justin S Smith, Miranda van Hooff","doi":"10.1177/21925682231188811","DOIUrl":"10.1177/21925682231188811","url":null,"abstract":"<p><p>Study DesignNarrative review.ObjectivesTo review the current state-of-the-art in patient reported outcome measurements (PROMs) in adult spinal deformity (ASD) surgery.MethodsPubMed was queried for publications related to PROM usage in ASD. PROM properties including responsiveness to change and thresholds for clinically relevant change were reviewed.ResultsDespite many reports using PROMs in ASD, there are little data to support superiority of any particular PROM. The Scoliosis Research Society-22r is a disease-specific measure that is responsive to change across pain, function, and self-image domains. The Patient Reported Outcome Measurement Information System (PROMIS) is a domain-specific measure available in computer adaptive tests, which may reduce question burden and ease administration for both patients and providers. Minimum clinically important differences, minimum detectable changes, and patient-acceptable symptom states have been proposed.ConclusionsPROMs are an essential component of modern, value-based ASD care, irrespective of academic pursuits. The SRS-22r is a validated disease specific measure, though this may be supplanted by computer-adaptive tests such as PROMIS to reduce the question burden. There is no PROMIS question set for self-image, which must be developed to cover all pertinent ASD domains.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 3_suppl","pages":"87S-94S"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591070","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":"Introduction to the AO Spine Knowledge Forum Deformity Focus Issue: Adult Spinal Deformity: Where We Are, What We Know, Where We Need to Go.","authors":"Stephen J Lewis","doi":"10.1177/21925682251329366","DOIUrl":"10.1177/21925682251329366","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 3_suppl","pages":"5S-6S"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591057","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}