Global Spine Journal最新文献

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Meta-Analysis of Treatment for Adjacent Two-Segment Cervical Spondylotic Myelopathy: A Comparison Between Anterior Cervical Corpectomy and Fusion and Anterior Cervical Discectomy and Fusion. 相邻两节段颈椎脊髓病治疗方法的 Meta 分析:颈椎前路椎间盘切除融合术与颈椎前路椎间盘切除融合术的比较。
IF 2.6 3区 医学
Global Spine Journal Pub Date : 2025-04-01 Epub Date: 2024-10-30 DOI: 10.1177/21925682241297586
Lei Chen, Zhongyi Zhang, Ju Li, Peijian Tong, Taotao Xu
{"title":"Meta-Analysis of Treatment for Adjacent Two-Segment Cervical Spondylotic Myelopathy: A Comparison Between Anterior Cervical Corpectomy and Fusion and Anterior Cervical Discectomy and Fusion.","authors":"Lei Chen, Zhongyi Zhang, Ju Li, Peijian Tong, Taotao Xu","doi":"10.1177/21925682241297586","DOIUrl":"10.1177/21925682241297586","url":null,"abstract":"<p><p>Study DesignA systematic review and meta-analysis comparing the outcomes of Anterior Cervical Discectomy and Fusion (ACDF) vs Anterior Cervical Corpectomy and Fusion (ACCF) in treating adjacent two-segment cervical spondylotic myelopathy.ObjectiveTo assess the clinical effectiveness and safety of ACDF compared to ACCF.MethodsA literature search was conducted in Cochrane Library, Web of Science, PubMed, and Embase up to December 2023. Studies included were prospective and observational involving ACDF or ACCF for adjacent two-segment cervical spondylotic myelopathy. Data were analyzed using RevMan 5.4 software.ResultsTen studies (nine case-control and one RCT) were included. ACDF showed a shorter hospital stay (SMD = -0.29, 95% CI: -0.53 to -0.04, <i>P</i> < 0.05), better Cobb angle (SMD = 0.52, 95% CI: 0.31 to 0.74, <i>P</i> < 0.01), and improved T1S (SMD = 0.54, 95% CI: 0.28 to 0.80, <i>P</i> < 0.01). No significant differences were found in upper limb VAS, neck VAS, JOA scores, NDI, fusion rates, C2-7 SVA, total complications, blood loss, and operation time.ConclusionsACDF and ACCF are both effective for adjacent two-segment cervical spondylotic myelopathy, with ACDF offering advantages in hospitalization duration and cervical curvature restoration, making it the preferred surgical approach. Further research is needed to validate these findings.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1839-1848"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545052","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}
引用次数: 0
Sentient Intelligence to Rescue Healthcare? Reflections on the Commercial Side of Healthcare. 智能拯救医疗?对医疗保健商业化的思考。
IF 2.6 3区 医学
Global Spine Journal Pub Date : 2025-04-01 Epub Date: 2025-03-31 DOI: 10.1177/21925682251318877
Jens Chapman, Jeffrey Wang, Karsten Wiechert
{"title":"Sentient Intelligence to Rescue Healthcare? Reflections on the Commercial Side of Healthcare.","authors":"Jens Chapman, Jeffrey Wang, Karsten Wiechert","doi":"10.1177/21925682251318877","DOIUrl":"10.1177/21925682251318877","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 3","pages":"1487-1489"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Segmental Spinal Aplasia: Anatomical Variations and Treatment Insights. 脊柱节段性发育不良:解剖变异与治疗启示。
IF 2.6 3区 医学
Global Spine Journal Pub Date : 2025-04-01 Epub Date: 2024-06-12 DOI: 10.1177/21925682241263269
Olga M Sergeenko Pavlova, Dmitry M Savin, Alexander V Burtsev, Marat S Saifutdinov, Sergey O Ryabykh, Alexey V Evsyukov
{"title":"Segmental Spinal Aplasia: Anatomical Variations and Treatment Insights.","authors":"Olga M Sergeenko Pavlova, Dmitry M Savin, Alexander V Burtsev, Marat S Saifutdinov, Sergey O Ryabykh, Alexey V Evsyukov","doi":"10.1177/21925682241263269","DOIUrl":"10.1177/21925682241263269","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectiveThe study aimed to analyze anatomical variants of segmental spinal aplasia (SSA) and investigate factors influencing surgical treatment outcomes, with a specific focus on the incidence of complications.MethodsThe study focused on patients with SSA treated at a single medical center, with over two years of follow-up. Neurological function changes were evaluated using the modified Japanese Orthopedic Scale (mJOA). Functional independence was measured using the Functional Independence Measure (FIM/WeeFIM) scale, and complications, well-being, and reoperation instances were documented. Statistical analyses used ANOVA and Kruskal-Wallis test.ResultsThe predominant localization of SSA in 36 own cases occurs near or at the level of the thoracolumbar junction, often accompanied by significant spinal cord narrowing and a low position of the conus medullaris. Additionally, it frequently presents with aplasia of the lower ribs. Cervicothoracic SSA was more commonly associated with segmentation disorders (<i>P</i> = .04). The most common early complications were wound problems (17%) and neurological deterioration (17%); the most common late complications were: non-fusion (34%); 38% of patients required one or more revision surgery. The type, age of surgery, level of surgery, and initial neurological deficient did not significantly influence the incidence of complications or neurological and functional outcomes.ConclusionSSA, a range of anomalies appearing early in childhood, progresses gradually. Surgery involves vertebrectomy followed by interbody fusion and screw fixation, guided by neurophysiological monitoring. Surgery is recommended for worsening neurological symptoms, but conservative options like bracing can be considered, due to a high risk of complications.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1760-1772"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305804","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}
引用次数: 0
Severe (>100 Degrees) Thoracic Adolescent Idiopathic Scoliosis - A Comparison of Surgical Approaches. 严重(>100 度)胸廓青少年特发性脊柱侧凸--手术方法比较。
IF 2.6 3区 医学
Global Spine Journal Pub Date : 2025-04-01 Epub Date: 2024-06-21 DOI: 10.1177/21925682241264768
Lauren E Stone, Peter O Newton, Anthony A Catanzano, Hiroki Oba, Lawrence G Lenke, Oheneba Boachie-Adjei, Michael P Kelly, Munish C Gupta
{"title":"Severe (>100 Degrees) Thoracic Adolescent Idiopathic Scoliosis - A Comparison of Surgical Approaches.","authors":"Lauren E Stone, Peter O Newton, Anthony A Catanzano, Hiroki Oba, Lawrence G Lenke, Oheneba Boachie-Adjei, Michael P Kelly, Munish C Gupta","doi":"10.1177/21925682241264768","DOIUrl":"10.1177/21925682241264768","url":null,"abstract":"<p><p>Study DesignRetrospective.ObjectiveSevere curves >100° in adolescent idiopathic scoliosis (AIS) are rare and require careful operative planning. The aim of this study was to assess baseline, perioperative, and 2-year differences between anterior release with posterior instrumentation (AP), posterior instrumentation with posterior column osteotomies (P), and posterior instrumentation with 3-column vertebral osteotomies (VCR).MethodsTwo scoliosis datasets were queried for primary cases of severe thoracic AIS (≥100°) with 2-year follow-up. Pre- and 2-year postoperative radiographic measures (2D and estimated 3D kyphosis), clinical measurements, and SRS-22 outcomes were compared between three approaches.ResultsSixty-one patients were included: 16 AP (26%), 38 P (62%), 7 VCR (11%). Average age was 14.4 ± 2.0 years; 75.4% were female. Preoperative thoracic curve magnitude (AP: 112°, P: 115°, VCR: 126°, <i>P</i> = 0.09) and T5-T12 kyphosis (AP: 38°, P: 59°, VCR: 70°, <i>P</i> = 0.057) were similar between groups. Estimated 3D kyphosis was less in AP vs P (-12° vs 4°, <i>P</i> = 0.016). Main thoracic curves corrected to 36° in AP vs 49° and 48° for P and VCR, respectively (<i>P</i> = 0.02). Change in estimated 3D kyphosis was greater in AP vs P and VCR (34° vs 13°, <i>P</i> = 0.009; 34° vs 7°, <i>P</i> = 0.046). One incomplete spinal cord injury had residual deficits (P; 1/61, 1.6%). All SRS-22 domains improved postoperatively.ConclusionAll approaches obtained satisfactory coronal and sagittal correction, but AP had smaller residual coronal deformity and greater kyphosis restoration than the other approaches. This information may help inform the decision of whether to include an anterior release for large thoracic AIS curves.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1773-1782"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431799","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}
引用次数: 0
Predictive Factors of Cloxacillin Susceptibility in Primary Bacterial Spinal Infection. 原发性脊柱细菌感染对氯唑西林敏感性的预测因素
IF 2.6 3区 医学
Global Spine Journal Pub Date : 2025-04-01 Epub Date: 2024-05-06 DOI: 10.1177/21925682241251814
Chris Yuk Kwan Tang, Pak Leung Ho
{"title":"Predictive Factors of Cloxacillin Susceptibility in Primary Bacterial Spinal Infection.","authors":"Chris Yuk Kwan Tang, Pak Leung Ho","doi":"10.1177/21925682241251814","DOIUrl":"10.1177/21925682241251814","url":null,"abstract":"<p><p>Study DesignPrognostic study.ObjectivesThe objective of this study is to identify predictive factors for cloxacillin susceptibility in spinal infections.MethodsA retrospective analysis was conducted using data from January 1, 1997, to December 31, 2021. The study included patients presenting with back pain and either a positive bacterial culture from the spine or radiological evidence of spinal infection (spondylodiscitis and/or epidural abscess) along with positive bacterial blood culture.ResultsAmong 171 patients (127 males, 44 females), 53.2% had <i>Staphylococcus</i> isolates, with 40.4% showing cloxacillin resistance. Lower globulin levels (<33.5 g/L), recent hospitalization within 90 days, and residence in an old age home predicted gram-positive bacteria with cloxacillin resistance and gram-negative bacteria as causative organisms (<i>P</i><.05). The 30-day and 1-year all-cause mortality rates were 0% and 8.2%, respectively. Higher red cell distribution width (RDW >16.1%) and Charlson comorbidity index (CCI) scores predicted 1-year all-cause mortality (<i>P</i><.05). Intensive care unit admission was required for 9.9% of patients.ConclusionsThis study identified predictive factors for spinal infection by gram-positive bacteria with cloxacillin resistance and gram-negative bacteria. Patients with lower globulin levels (<33.5 g/L), recent hospitalization within 90 days, or residency in an old age home upon admission should avoid standalone cloxacillin therapy and consider antibiotics with gram-negative coverage. Higher RDW (>16.1%) and CCI scores were associated with increased 1-year all-cause mortality. These findings contribute to treatment decision-making and improving patient outcomes in spinal infections.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1572-1581"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863970","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}
引用次数: 0
Sickle Cell Disease Has No Impact on 10-Year Cumulative Incidence and Indications for Revision Lumbar Fusion. 镰状细胞病对腰椎融合术十年累积发病率和翻修指征没有影响。
IF 2.6 3区 医学
Global Spine Journal Pub Date : 2025-04-01 Epub Date: 2024-05-09 DOI: 10.1177/21925682241253154
B Tanner Seibold, Abhisri Ramesh, Philip M Parel, Theodore Quan, Rachel A Ranson, Addisu Mesfin, Tushar Ch Patel
{"title":"Sickle Cell Disease Has No Impact on 10-Year Cumulative Incidence and Indications for Revision Lumbar Fusion.","authors":"B Tanner Seibold, Abhisri Ramesh, Philip M Parel, Theodore Quan, Rachel A Ranson, Addisu Mesfin, Tushar Ch Patel","doi":"10.1177/21925682241253154","DOIUrl":"10.1177/21925682241253154","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectivesPatients with sickle cell disease (SCD) experience distinct physiological challenges that may alter surgical outcomes. There has been no research establishing 10-year lumbar fusion (LF) implant survivorship rates among individuals with SCD. This study aims to determine the 10-year cumulative incidence and indications for revision LF between patients with and without SCD.MethodsA national database was queried to identify patients with and without SCD who underwent primary LF. SCD patients undergoing LF were propensity-score matched in a 1:4 ratio by age, gender, and Charlson Comorbidity Index (CCI) to a matched LF control. In total, 246 SCD patients were included along with 981 and 100,000 individuals in the matched and unmatched control cohorts, respectively. Kaplan-Meier survival analysis was utilized to determine the 10-year cumulative incidence rates of revision LF. Furthermore, multivariable analysis using Cox proportional hazard modeling was performed to compare indications for revisions and surgical complications between cohorts including hardware removal, drainage and evacuation, pseudoarthrosis, and mechanical failure.ResultsNo significant differences were found in the cumulative incidence of 10-year all-cause revision LF between patients in the SCD cohort and either of the control cohorts (<i>P</i> > .05 for each). Additionally, there were no significant differences between the SCD cohort and either of the control cohorts in regards to the indications for revision or surgical complications in LF (<i>P</i> > .05 for each).ConclusionsThis study indicates that SCD patients do not have increased risk for revision LF, nor any of its indications.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1592-1597"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896907","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}
引用次数: 0
Effectiveness of a Preoperative Bowel Preparation Protocol for Patients With Adolescent Idiopathic Scoliosis to Decrease Postoperative Gastrointestinal Morbidities and the Hospital Length of Stay. 青少年特发性脊柱侧凸患者术前肠道准备方案对减少术后胃肠道疾病和住院时间的效果。
IF 2.6 3区 医学
Global Spine Journal Pub Date : 2025-04-01 Epub Date: 2024-05-20 DOI: 10.1177/21925682241249107
Alzakri Abdulmajeed
{"title":"Effectiveness of a Preoperative Bowel Preparation Protocol for Patients With Adolescent Idiopathic Scoliosis to Decrease Postoperative Gastrointestinal Morbidities and the Hospital Length of Stay.","authors":"Alzakri Abdulmajeed","doi":"10.1177/21925682241249107","DOIUrl":"10.1177/21925682241249107","url":null,"abstract":"<p><p>Study DesignRandomised controlled trial.ObjectiveThis study aimed to determine the effectiveness of a preoperative bowel preparation protocol comprising bisacodyl to minimize postoperative gastrointestinal morbidities and the hospital length of stay for patients with adolescent idiopathic scoliosis.Summary of Background DataPatients who undergo scoliosis correction surgery frequently experience postoperative gastrointestinal morbidities and a prolonged hospital length of stay. Emesis, paralytic ileus and constipation are the most common gastrointestinal morbidities. Opioid medication is a well-known risk factor for gastrointestinal complications after scoliosis correction surgery.MethodsEighty-seven patients (22 boys [25.3%] and 65 girls [74.7%]) with a mean age of 17.7 years (standard deviation [SD], ±2.2 years) diagnosed with adolescent idiopathic scoliosis were enrolled in this study and randomized into 2 groups. Group A comprised 44 patients who received a preoperative bowel preparation comprising bisacodyl. Group B comprised 43 patients who did not receive any preoperative medication. Demographic data, height, weight, medical and surgical comorbidities, Risser status, number of instrumented levels and preoperative opioid consumption of all patients were evaluated.ResultsGroup A experienced fewer postoperative abdominal symptoms than group B. The mean hospital length of stay was 4.1 days (SD, ±.6 days; median, 4 days; range, 3-5 days) for group A; however, it was 5.3 days (SD, ±.8 days; median, 5 days; range, 4-7 days) for group B (<i>P</i> = .01).ConclusionThe use of a bowel preparation protocol before scoliosis correction surgery for patients with adolescent idiopathic scoliosis can effectively decrease postoperative gastrointestinal morbidities and the hospital length of stay.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1552-1555"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065119","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}
引用次数: 0
Reduced Subsidence With PEEK-Titanium Composite Versus 3D Titanium Cages in a Retrospective, Self-Controlled Study in Transforaminal Lumbar Interbody Fusion. 在经椎间孔腰椎椎体融合术的回顾性自我控制研究中,PEEK-钛复合材料与三维钛椎体笼相比下沉更少。
IF 2.6 3区 医学
Global Spine Journal Pub Date : 2025-04-01 Epub Date: 2024-05-23 DOI: 10.1177/21925682241253168
Ali Chahlavi
{"title":"Reduced Subsidence With PEEK-Titanium Composite Versus 3D Titanium Cages in a Retrospective, Self-Controlled Study in Transforaminal Lumbar Interbody Fusion.","authors":"Ali Chahlavi","doi":"10.1177/21925682241253168","DOIUrl":"10.1177/21925682241253168","url":null,"abstract":"<p><p>Study DesignRetrospective Study.ObjectivesTo compare subsidence and radiographic fusion rates of titanium-surface polyetheretherketone (PEEK-Ti) and 3D-Titanium (3D-Ti) cages, implanted within the same patient concurrently, during multi-level transforaminal lumbar interbody fusions (TLIF).MethodsForty-eight patients were treated with both PEEK-Ti and 3D-Ti cages during 2- or 3-level TLIF and instrumented posterolateral fusion (108 spinal levels in all). Equivalent bone graft material was implanted within each patient. Radiographic analysis of CT and/or X-ray imaging was performed retrospectively for each spinal level throughout 12-month follow-up period. Fusion was defined as bridging trabecular bone and subsidence was incursion into one/both vertebral bodies >20% cage height. Outcomes were analyzed with Fisher's exact test.ResultsAt 6-months post-operative follow-up, incidence of subsidence was significantly lower for PEEK-Ti cages, with 4.8% subsidence, compared to a 27.9% subsidence rate for 3D-Ti cages (<i>P = .007</i>). Fusion rates were comparable at 100% for PEEK-Ti and 95.5% for 3D-Ti. Results at 12-months showed similar but not statistically significant trends of less subsidence with PEEK-Ti than 3D-Ti cages (14.3% PEEK-Ti, 37.5% 3D-Ti), and similar fusion rates of 100% for PEEK-Ti and 91.7% for 3D-Ti. Thirty-nine out of 48 total patients were available for follow-up at 6 months and 20 patients at 12 months. CT availability at 6 and 12-months was 100% and 90%, respectively.ConclusionsA significantly lower subsidence rate was associated with a PEEK-Ti cage, compared to 3D-Ti, 6 months after TLIF. Results may not be generalized across technologies due to differences in cage designs; additional research studies are warranted.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1598-1607"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081223","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}
引用次数: 0
Is Endoscopic Surgery a Safe and Effective Treatment for Lumbar Disc Herniation? A Meta-Analysis of Randomized Controlled Trials. 内窥镜手术是腰椎间盘突出症安全有效的治疗方法吗?随机对照试验的元分析。
IF 2.6 3区 医学
Global Spine Journal Pub Date : 2025-04-01 Epub Date: 2024-11-04 DOI: 10.1177/21925682241299326
Bo-Tao Cai, Fan Yang, Deng-Chao Wang
{"title":"Is Endoscopic Surgery a Safe and Effective Treatment for Lumbar Disc Herniation? A Meta-Analysis of Randomized Controlled Trials.","authors":"Bo-Tao Cai, Fan Yang, Deng-Chao Wang","doi":"10.1177/21925682241299326","DOIUrl":"10.1177/21925682241299326","url":null,"abstract":"<p><p>Study DesignSystematic Review.ObjectiveThis meta-analysis systematically evaluates the safety and effectiveness of endoscopic techniques in the treatment of lumbar disc herniation (LDH).MethodsA comprehensive computerized search was conducted on PubMed, Embase, Cochrane Library, China National Biomedical Literature Database (CBM), VIP Database, China National Knowledge Infrastructure (CNKI) and Wanfang Database. Randomized controlled trials (RCTs) comparing endoscopic techniques with non-endoscopic techniques for the treatment of LDH were identified. Meta-analysis was performed using RevMan 5.4 software.ResultsSeventeen RCTs involving 1748 LDH patients were analyzed. The meta-analysis revealed that, compared to the non-endoscopic discectomy (NED) group, the endoscopic discectomy (ED) group exhibited significantly lower intraoperative blood loss [MD = -74.45 mL, 95% CI (-124.88, -24.02), <i>P</i> = .004], shorter hospitalization duration [MD = -4.07 days, 95% CI (-6.67, -1.48), <i>P</i> = .002], lower Visual Analogue Scale (VAS) pain scores at the last follow-up [MD = -.35, 95% CI (-.63, -.07), <i>P</i> = .01], and a lower incidence of complications [RR = .35, 95% CI (.25, .48), <i>P</i> < .00001]. Moreover, the ED group exhibited a higher ratio of excellent and good therapeutic effects postoperatively [RR = 1.05, 95% CI (1.01, 1.10), <i>P</i> = .01]. However, there were no statistically significant differences between the 2 groups in terms of the Oswestry Disability Index (ODI) scores at the last follow-up [SMD = -.49, 95% CI (-1.14, .17), <i>P</i> = .14] and operation time [MD = -10.17 min, 95% CI (-27.05, 6.71), <i>P</i> = .24].ConclusionEndoscopic techniques in the treatment of LDH exhibit significant superiority in intraoperative blood loss, hospitalization duration, postoperative pain, complication rates, and postoperative therapeutic effects. This provides patients with a safer and more effective treatment option.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1855-1868"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566975","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}
引用次数: 0
Mapping the Degenerative Cervical Myelopathy Research Landscape: Topic Modeling of the Literature. 绘制颈椎退行性脊髓病研究地图:文献主题建模。
IF 2.6 3区 医学
Global Spine Journal Pub Date : 2025-04-01 Epub Date: 2024-05-17 DOI: 10.1177/21925682241256949
Mert Karabacak, Pemla Jagtiani, Carl Moritz Zipser, Lindsay Tetreault, Benjamin Davies, Konstantinos Margetis
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