Global Spine Journal最新文献

{"title":"Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish: When to Fuse? An Evidence Based Review of Treatment Strategies in Degenerative Spondylolisthesis.","authors":"Christopher T Martin, Luca Ambrosio, Juan P Cabrera Cousiño, Xiaolong Chen, Jason Py Cheung, Waeel Hamouda, Hai V Le, Philip K Louie, Sathish Muthu, Hardeep Singh, Mohamed A R Soliman, Veranis Sotirios, Javad Tavakoli, Sven Y Vetter, Zorica Buser, Andreas K Demetriades, Ashish Diwan, Patrick C Hsieh, Amit Jain, Gianluca Vadalà, Charles G Fisher, S Tim Yoon","doi":"10.1177/21925682251336755","DOIUrl":"10.1177/21925682251336755","url":null,"abstract":"<p><p>Study DesignLiterature review.ObjectiveTo provide a concise review of outcomes of decompression and fusion (D + F) vs decompression (D) alone for degenerative lumbar spondylolisthesis (DLS).Methods6 articles were selected, including 3 randomized clinical trials (RCT), 2 meta-analyses, and 1 radiographic cohort study. Summarized factors affecting the outcomes of D + F vs D alone for DLS and provide expert level clinical recommendations.ResultsGhogawala included DLS patients showing improved SF-36 scores (<i>P</i> = 0.046) and lower re-operation rates (<i>P</i> = 0.05) in D + F patients compared to D alone. Forsth, included patients with stenosis both with and without DLS, and showed no difference in any reported outcome measure or reoperation rate. Austevoll included DLS patients that found that D alone was non-inferior to D + F in the primary outcome measure of ODI reduction at 2-year after surgery. Gadjradi included studies showing higher morbidity in the D + F group, as compared to D alone. Shukla included studies which found there was no difference in the raw patient outcome scores at final follow-up. Blumenthal included DLS patients who received D and reported disc height of >6.5 mm, facet angle >50°, and dynamic motion >1.25 mm were associated with high re-operation rates (45%, 39%, and 54% respectively).ConclusionsThe RCT's and meta-analyses report contradictory conclusions and no blanket statement regarding the efficacy of D + F vs D alone can be made for all patients with DLS. Surgeons should closely review pre-operative imaging for signs of instability in order to better identify appropriate patients for each indication.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251336755"},"PeriodicalIF":2.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274711","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":"Corrigendum to \"Comparison of Stand-Alone Anchored Spacer and Plate-Cage Construct for Surgical Treatment of Multilevel Cervical Degenerative Spondylopathy: A Meta-Analysis\".","authors":"","doi":"10.1177/21925682251349787","DOIUrl":"10.1177/21925682251349787","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251349787"},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266069","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":"Intraoperative Venous Injury During Anterior Lumbar Interbody Fusion: Incidence, Risk Factors, and Complications.","authors":"Henry Avetisian, Camille Flynn, Rakhi Banerjee, Vivek Satish, Joshua Davood, William Karakash, Matthew C Gallo, Mirbahador Athari, Gregory A Magee, Jeffrey C Wang, Raymond J Hah, Ram Alluri","doi":"10.1177/21925682251350942","DOIUrl":"10.1177/21925682251350942","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesTo evaluate the incidence, risk factors, and complications associated with intraoperative venous injury during anterior lumbar interbody fusion (ALIF).MethodsThis retrospective review included patients who underwent one- to four-level ALIF at an academic spine center. Patients <18 years old or those with surgical indications for trauma, infection, or malignancy were excluded. Patients were stratified by the presence of venous laceration requiring primary suture repair. Comparative analyses were performed using Student's <i>t</i> test and Pearson's Chi-squared test. Univariable and multivariable logistic regression identified independent risk factors and postoperative complications.ResultsAmong 554 patients, 92 (16.61%) sustained a venous laceration. Independent predictors included age (aOR: 1.03, <i>P</i> < 0.01), chronic kidney disease (aOR: 5.17, <i>P</i> < 0.01), ALIF at L4-5 (aOR: 3.88, <i>P</i> < 0.01), and two-level ALIF (aOR: 1.70, <i>P</i> < 0.01). ALIF at L5-S1 was protective (aOR: 0.24, <i>P</i> < 0.001). Venous laceration was associated with longer operative times (8.02 ± 2.95 vs 6.48 ± 2.81 hours, <i>P</i> < 0.001), greater mean blood loss (1,271 mL vs 600.71 mL, <i>P</i> < 0.001), and increased risks of deep vein thrombosis (DVT) (aOR: 3.33, [1.59-10.17], <i>P</i> = 0.011), intraoperative transfusion (aOR: 4.43, <i>P</i> < 0.001), and incision and drainage (aOR: 7.45, [1.75-31.62], <i>P</i> < 0.01).ConclusionVenous laceration occurred in 16.61% of ALIF cases, with independent risk factors including age, CKD, L4-5 ALIF, and two-level ALIF. These injuries were associated with prolonged operative times and a markedly elevated risk of DVT. Future research should focus on developing risk reduction strategies for high-risk patients and developing evidence-based VTE prophylaxis protocols tailored to patients with venous injuries.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251350942"},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266070","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":"Surgery for Lumbar Disc Herniation: Surgeon's Clinical Judgment Versus Actual Improvement in Patient Reported Outcomes.","authors":"Leah Y Carreon, Casper F Pedersen, Peter Doering, Søren P Eiskjær, Mikkel Ø Andersen","doi":"10.1177/21925682251350024","DOIUrl":"10.1177/21925682251350024","url":null,"abstract":"<p><p>Study DesignLongitudinal Cohort.ObjectivesTo determine if a surgeon's clinical judgment can predict clinical outcomes after surgery for LDH.MethodsSurgeons provided an opinion on outcomes in patients with lumbar disc herniation (LDH) with a series of seven faces denoting the Global Perceived Effect (GPE) as \"Very bad\" (GPE1), \"Bad\" (GPE2), \"Fairly bad\"(GPE3), \"No change\"(GPE4), \"Fairly good\" (GPE5), \"Good\" (GPE6) and \"Very Good\" (GPE7). Standard demographic, surgical and outcomes were collected prior to and 1 year after surgery. Patients were then stratified based on the surgeon's clinical judgement and change in 1 year outcome measures were compared.ResultsOf 153 subjects, 110 (72%) had 1 year data with 0 GP1, 1 GPE2, 4 GPE3, 5 GPE4, 36 GPE5, 48 GPE6 and 16 GPE 7. Only patients in GPE3 to GPE7 were included in the analysis. There was no difference in demographic or surgical parameters among the GPE groups. Improvements in ODI, EQ5D and SF36PCS were greatest in the GPE7 followed by the GPE6 and GPE5. GPE5 and GPE4 had similar improvements, while GPE3 had less improvement than GPE4. Improvement in VAS back and leg pain was similar the GPE7, GPE6 and GPE5 group, with less improvement seen in the GPE4 and GPE3 groups.ConclusionsThe current study shows that although the significance of mathematical modeling, artificial intelligence and machine learning as an analytical way of predicting outcomes, it is crucial not to underestimate the value of clinical intuition in patient counseling and predicting clinical outcomes after surgery for LDH.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251350024"},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257946","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":"Developing a Deep Learning Radiomics Model Combining Lumbar CT, Multi-Sequence MRI, and Clinical Data to Predict High-Risk Adjacent Segment Degeneration Following Lumbar Fusion: A Retrospective Multicenter Study.","authors":"Congying Zou, Tianyi Wang, Baodong Wang, Qi Fei, Hongxing Song, Lei Zang","doi":"10.1177/21925682251342531","DOIUrl":"10.1177/21925682251342531","url":null,"abstract":"<p><p>Study designRetrospective cohort study.ObjectivesDevelop and validate a model combining clinical data, deep learning radiomics (DLR), and radiomic features from lumbar CT and multisequence MRI to predict high-risk patients for adjacent segment degeneration (ASDeg) post-lumbar fusion.MethodsThis study included 305 patients undergoing preoperative CT and MRI for lumbar fusion surgery, divided into training (n = 192), internal validation (n = 83), and external test (n = 30) cohorts. Vision Transformer 3D-based deep learning model was developed. LASSO regression was used for feature selection to establish a logistic regression model. ASDeg was defined as adjacent segment degeneration during radiological follow-up 6 months post-surgery. Fourteen machine learning algorithms were evaluated using ROC curves, and a combined model integrating clinical variables was developed.ResultsAfter feature selection, 21 radiomics, 12 DLR, and 3 clinical features were selected. The linear support vector machine algorithm performed best for the radiomic model, and AdaBoost was optimal for the DLR model. A combined model using these and clinical features was developed, with the multi-layer perceptron as the most effective algorithm. The areas under the curve for training, internal validation, and external test cohorts were 0.993, 0.936, and 0.835, respectively. The combined model outperformed the combined predictions of 2 surgeons.ConclusionsThis study developed and validated a combined model integrating clinical, DLR and radiomic features, demonstrating high predictive performance for identifying high-risk ASDeg patients post-lumbar fusion based on clinical data, CT, and MRI. The model could potentially reduce ASDeg-related revision surgeries, thereby reducing the burden on the public healthcare.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251342531"},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247478","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 AO Spine Knowledge Forums: A Decade of Impactful Spine Research.","authors":"Klaus John Schnake, Michael G Fehlings, Niccole Germscheid, Shekar Kurpad, Ilya Laufer, Stephen J Lewis, Gregory D Schroeder, S Tim Yoon, Charles G Fisher","doi":"10.1177/21925682251343521","DOIUrl":"10.1177/21925682251343521","url":null,"abstract":"<p><p>The AO Spine Knowledge Forums are independent expert-driven global study groups dedicated to improving patient care by publishing evidence-based recommendations and conducting high-impact clinical studies. Five Knowledge Forums represent 6 spine pathologies: tumor, deformity, spinal cord injury, degeneration, trauma, and infection. A summary highlighting their most impactful research achievements over the past 10 years is provided. The results illustrate the critical clinical role of these independent Knowledge Forums.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251343521"},"PeriodicalIF":2.6,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247480","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":"AO Spine Clinical Practice Recommendations for the Surgical Management of Acute Traumatic Spinal Cord Injury: Contemporary Concepts.","authors":"Vanessa Hubertus, Jetan H Badhiwala, Nader Hejrati, Aria Nouri, Paula V Ter Wengel, Farzin Farahbakhsh, Christoph Hofstetter, Chris J Neal, Mario Ganau, Nitin Agarwal, Paul Arnold, Paul Koljonen, James Harrop, Bizhan Aarabi, James Guest, Ricardo Rodrigues, Michael G Fehlings, Nathan Evaniew, Konstantinos Margetis, Daipayan Guha, Lukas Grassner, Brian K Kwon, Charles G Fisher, Shekar Kurpad, On Behalf Of The Ao Spine Knowledge Forum Spinal Cord Injury","doi":"10.1177/21925682251350941","DOIUrl":"10.1177/21925682251350941","url":null,"abstract":"<p><p>Study DesignReview of the literature with critical appraisal and clinical recommendations.ObjectiveTo highlight contemporary concepts relating to surgical care for acute traumatic spinal cord injury (SCI) based on recent evidence that may be integrated into clinical practice.MethodsThree recent articles relating to the surgical management of acute traumatic SCI were selected and critically appraised. Clinical practice recommendations were developed and graded as strong or conditional.ResultsArticle 1: Early vs late surgical decompression for central cord syndrome. Strong recommendation to consider early surgery (<24 hours) as an option in patients with ASIA Impairment Scale (AIS) grade C central cord syndrome. Article 2: Extent of decompression in motor complete SCI. Conditional recommendation to consider laminectomy, with or without anterior surgery, to achieve circumferential decompression of the spinal cord. Article 3: Use of intra-operative ultrasound. Conditional recommendation to use ultrasound intra-operatively to confirm the adequacy of surgical decompression.ConclusionsTimely and adequate decompression of the spinal cord are critical priorities in the management of acute traumatic SCI. The importance of timeliness extends to central cord syndrome. Careful consideration and use of operative techniques (e.g., addition of laminectomy) and adjuncts (e.g., intra-operative ultrasound) help achieve safe and adequate decompression of the spinal cord.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251350941"},"PeriodicalIF":2.6,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247477","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 Impact of Body Mass Index and Metabolic Syndrome on Perioperative Outcomes Following Cervical Laminoplasty.","authors":"Ataollah Shahbandi, Pegah Ghamasaee, Abdul Mounnem Yassin Kassab, Saman Shabani","doi":"10.1177/21925682251349993","DOIUrl":"https://doi.org/10.1177/21925682251349993","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectivesObesity and metabolic syndrome have become a common comorbidity among patients undergoing spine surgery. This study aimed to evaluate 30-day postoperative outcomes following cervical laminoplasty, stratified by BMI categories and the presence of metabolic syndrome.MethodsThis study utilized the 2007-2022 ACS-NSQIP database. Patients who underwent cervical laminoplasty were identified and categorized into six BMI groups, according to the World Health Organization guidelines, and based on the presence of metabolic syndrome. The primary outcome was the 30-day occurrence of at least one complication (excluding blood transfusions). Secondary outcomes included rates of complications, hospital length of stay, and total operative time.ResultsA total of 2261 patients were analyzed, including 21 underweight, 510 normal-weight, 782 pre-obese, 565 class I obese, 249 class II obese, and 134 class III obese individuals. The cohort consisted of only 244 individuals with metabolic syndrome. Class II obesity (coefficient 23.585, 95% CI 10.815-36.355; <i>P</i> < 0.001) and class III obesity (coefficient 20.096, 95% CI 4.712-35.479; <i>P</i> = 0.011) were independently associated with longer operative times. Metabolic syndrome was an independent risk factor for deep incisional SSI (OR 3.25, 95% CI 1.07-9.80, <i>P</i> = 0.037), postoperative pneumonia (OR 4.17, 95% CI 1.63-10.63, <i>P</i> = 0.003), and prolonged hospitalization (OR 1.68, 95% CI 1.17-2.41, <i>P</i> = 0.005).ConclusionsPatients with metabolic syndrome face an increased risk of adverse outcomes after cervical laminoplasty. Implementing preoperative preventive interventions may help mitigate complications and associated costs in these patients. Furthermore, preoperative weight loss in class II-III obese patients may help decrease operative time and associated costs.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251349993"},"PeriodicalIF":2.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247481","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":"Rate of Conversion to Fusion Following Cervical Laminectomy Versus Laminoplasty: A Retrospective Analysis of 4,406 Patients.","authors":"Andy M Liu, Adeesya Gausper, Suhas K Etigunta, Alexander Tuchman, Christopher Mikhail, David Skaggs, Vivien Chan","doi":"10.1177/21925682251347502","DOIUrl":"10.1177/21925682251347502","url":null,"abstract":"<p><p>Study DesignRetrospective Administrative Database Analysis.ObjectiveThe purpose of this study was to compare the rate of subsequent cervical fusion surgery between patients that received cervical laminectomy and cervical laminoplasty for degenerative cervical disease.MethodsThe PearlDiver database for years 2010 to 2021 was queried for patients who received either a posterior cervical laminectomy or a cervical laminoplasty for a diagnosis of degenerative cervical disease. A matched analysis was performed using the significant variables. Rates of subsequent fusion surgery were determined for each cohort for 2-year, 5-year, and 10-year after surgery. Survival analysis was performed.ResultsA total of 4406 patients (Laminectomy: 2258; Laminoplasty: 2148) were included in this study. In the matched analysis, the rate of subsequent fusion surgery for laminectomy at 2-year, 5-year, and 10-year were 3.2%, 5.0%, and 5.7%, respectively. The rate of subsequent fusion surgery for laminoplasty at 2-year, 5-year, and 10-year were 2.2%, 3.2%, and 3.5%, respectively. There was no significant difference between the 2 groups at 2-year after surgery (<i>P</i> = 0.07). Patients who received cervical laminectomy had a higher rate of subsequent fusion surgery than cervical laminoplasty at 5-year (<i>P</i> < 0.01), and 10-year (<i>P</i> < 0.01) after surgery. Conclusions: In patients with degenerative cervical disease, cervical laminectomy had a significantly higher rate of subsequent fusion surgery than cervical laminoplasty at 5-year and 10-year post-surgery. This is the largest study comparing laminectomy to laminoplasty to date.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251347502"},"PeriodicalIF":2.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233880","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":"Evaluation of Adverse Events and the Impact on Health-Related Outcomes in Patients Undergoing Surgery for Metastatic Spine Tumors: Analysis of the Metastatic Tumor Research and Outcomes Network (MTRON) Registry Dataset.","authors":"Giovanni Barbanti Brodano, Cristiana Griffoni, Francesca Salamanna, Luigi Emanuele Noli, Annalisa Monetta, Alessandro Luzzati, Alexander C Disch, Aron Lazary, Ori Barzilai, Ilya Laufer, Ziya L Gokaslan, Michael G Fehlings, Jorrit-Jan Verlaan, Dean Chou, Laurence D Rhines, John H Shin, William G J Teixeira, Daniel M Sciubba, Chetan Bettegowda, Raphaële Charest-Morin, Stefano Boriani, Tony Goldschlager, Michael H Weber, Michelle J Clarke, John E O'Toole, Cordula Netzer, C Rory Goodwin, Addisu Mesfin, Praveen V Mummaneni, Nicolas Dea, Jeremy J Reynolds, Arjun Sahgal, Charles G Fisher, Alessandro Gasbarrini","doi":"10.1177/21925682251347247","DOIUrl":"10.1177/21925682251347247","url":null,"abstract":"<p><p>Study DesignThis study is part of the AO Spine Metastatic Tumor Research and Outcomes Network [MTRON], an international multicenter prospective observational registry including patients with spinal metastases.ObjectivesThis study aims to elucidate the incidence of surgical complications, their risk factors and consequent effects on survival outcomes, hospital length of stay, and overall health-related quality of life (HRQOL) parameters in a large cohort of patients affected by spinal metastases who were surgically treated.MethodsAvailable data from February 2017 to July 2023 were analyzed. The primary outcome of this study was the evaluation of the incidence of intraoperative and postoperative adverse events (AEs). The secondary outcomes included the assessment of risk factors for surgery-related AEs and the impact of AEs on survival, length of hospital stay and quality of life.ResultsAmong the 1267 patients analyzed, 6.9% experienced intraoperative AEs and 19.3% experienced at least 1 postoperative AE. Several factors resulted to be associated to the occurrence of postoperative AEs: age, smoking habit, poor Eastern Cooperative Oncology Group (ECOG) Performance status, previous radiation therapy at the index target, duration of surgery, number of instrumented levels, simultaneous anterior and posterior approach, presence of metastases at other sites, multiple spinal metastases. Postoperative AEs were associated with reduced survival rates, increased hospital length of stay and poorer HRQOL outcomes, particularly in domains such as neurological function and mental health. In general, surgery substantially improves HRQOL across multiple domains, with these benefits persisting over time despite the occurrence of AEs. However, patients with preoperative risk factors, including comorbidities, smoking, neurological impairment, and prior radiation therapy, experienced less improvement.ConclusionsThe negative impact of AEs on overall survival and HRQOL could be associated with the presence of some preoperative parameters of frailty that are detected as risk factors for AEs occurrence. This finding emphasizes the need for personalized preoperative assessments and optimized perioperative care strategies.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251347247"},"PeriodicalIF":2.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247479","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}