Global Spine Journal最新文献

{"title":"Risk Factors for Pelvic Non-responders Even after Pelvic Incidence-Lumbar Lordosis Overcorrection and Their Impact on Surgical Outcomes.","authors":"Se-Jun Park, Dong-Ho Kang, Minwook Kang, Kyunghun Jung, Chong-Suh Lee, Jin-Sung Park","doi":"10.1177/21925682251347909","DOIUrl":"10.1177/21925682251347909","url":null,"abstract":"<p><p>Study DesignRetrospective observation study.ObjectivesDespite pelvic incidence (PI)-lumbar lordosis (LL) overcorrection, some patients exhibit residual pelvic tilt (PT) malalignment, termed pelvic non-responders (PNRs). We aimed to identify risk factors for PNRS after PI-LL overcorrection and its impact on surgical outcomes.MethodsA retrospective analysis of 181 adult spinal deformity (ASD) patients who underwent fusion of ≥ five levels. PNRs were defined as postoperative PT ≥ 20° despite PI-LL overcorrection. Patient-reported outcomes (PROMs) and mechanical complications, such as proximal junctional failure (PJF), were documented. Logistic regression identified significant risk factors for PNRs.ResultsAmong the 181 patients, 30 (16.6%) were classified as having PNRs. Preoperative PI and postoperative PI-LL mismatch were significantly higher in PNRs than in PRs. Multivariate analysis identified higher preoperative PI, postoperative PI-LL ≥ -2°, lordosis distribution index (LDI) < 53%, and increased postoperative thoracic kyphosis as significant risk factors for pelvic non-response. PJF was significantly higher in PNRs (30.0% vs 10.6%, <i>P</i> < 0.01). At 1 year postoperatively, PNRs had lower SRS-22 scores in activity, pain, appearance, and mental health (<i>P</i> < 0.05), but MCID analysis indicated these differences may not be clinically meaningful.ConclusionsLarger preoperative PI, lower postoperative LDI, and higher postoperative PI-LL are significant risk factors for pelvic non-response in ASD patients with PI-LL overcorrection. PNRs are at increased risk of higher rates of PJF. Surgical strategies should prioritize achieving the target PI-LL and an LDI of ≥53% to optimize alignment and reduce the risk of PNRs and associated mechanical complications.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251347909"},"PeriodicalIF":2.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215644","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":"Titanium-Coated Polyetheretherketone Cages Versus Uncoated Polyetheretherketone Cages for Lumbar Spinal Fusion: A Systematic Review and Meta-Analysis.","authors":"Gonzalo Mariscal, Praveer S Vyas, Boyle C Cheng, Jacobus J Arts, Thomay-Claire A Hoelen, Chen Xu, Christopher D Chaput","doi":"10.1177/21925682251336716","DOIUrl":"10.1177/21925682251336716","url":null,"abstract":"<p><p>Study DesignSystematic review and meta-analysis.ObjectiveA systematic review and meta-analysis of comparative studies was performed to compare the fusion rates, functional outcomes, and complications between Titanium-Coated Polyetheretherketone (TiPEEK) and polyetheretherketone (PEEK) cages.MethodsFour databases were systematically searched according to PRISMA. Adult patients who underwent one- or two-level lumbar fusion with TiPEEK or PEEK cages were included in the study. Studies that reported radiographic fusion and functional or complication outcomes were also included. Study quality was assessed using the Cochrane Risk of Bias tool and MINORS criteria. The meta-analysis was performed using Review Manager 5.4. Heterogeneity was assessed using I², and random effects were used to analyze the heterogeneity.Results8 studies (n = 670) were analyzed. TiPEEK showed a significantly higher overall fusion rate (OR 1.83, 95% CI: 1.18-2.83). TiPEEK cages presented significantly higher fusion rates at 6 months (OR 2.52, 95% CI: 1.11 to 5.72), but there were no significant differences at 12 months (OR 1.33, 95% CI: 0.65 to 2.73). No differences were observed in the global ODI (SMD -0.04, 95% CI: -0.15-0.06). There were no significant differences regarding overall subsidence (OR 0.72, 95% CI: 0.48 to 1.07), screw complications (OR 1.25, 95% CI: 0.30-5.27) or reoperations (OR 0.61, 95% CI: 0.11-3.37).ConclusionsThe results from this study suggest that TiPEEK cages may demonstrate earlier fusion as compared to PEEK cages, particularly at 6 months. However, the functional outcomes and safety profiles were comparable.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251336716"},"PeriodicalIF":2.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208411","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":"In for the money only?","authors":"Karsten Wiechert, Jens R Chapman, Jeffrey C Wang","doi":"10.1177/21925682251339903","DOIUrl":"10.1177/21925682251339903","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 5","pages":"2583-2584"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233882","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":"3D-Printed Titanium Cages for Anterior and Lateral Lumbar Interbody Fusion Result in Excellent Fusion Rates One Year After Surgery.","authors":"Anna-Katharina Calek, Bettina Hochreiter, Aaron J Buckland","doi":"10.1177/21925682251344557","DOIUrl":"10.1177/21925682251344557","url":null,"abstract":"<p><p>Study DesignRetrospective study.ObjectiveTo determine the fusion rate in patients undergoing anterior lumbar interbody fusion (ALIF) and/or lateral lumbar interbody fusion (LLIF) with titanium cages.MethodsFusion at 1-year was assessed by computed tomography (CT) using Lenke-Bridwell classification. Flexion-extension lateral radiographs confirmed fusion if motion was <5° through the fused segment. Perioperative metrics including bone graft type, operative time, estimated blood loss, revisions within the first postoperative year, clinical outcome assessed by the Oswestry Disability Index (ODI).ResultsOne hundred patients with a total of 137 fusion levels with 3DPTi cages were identified. In this cohort, 75% underwent primary surgery and 25% had a previous surgery. At 1-year post-op, 97.1% of interbody levels were fused (Grade I) on CT, and all levels appeared fused on flexion-extension radiographs. Four patients (4%) required additional surgery within the first two years. No revisions were required for cage subsidence/migration, or pseudoarthrosis. Median ODI significantly improved from 39 at baseline to 10 at 1-year (<i>P</i> = .001).Conclusion3D-printed titanium cages for ALIF and LLIF result in excellent fusion rates at one year postoperatively without the use of rhBMP-2.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251344557"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198922","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":"Does Intra-Operative Methylprednisolone Improve Outcomes of Surgery for Degenerative Cervical Myelopathy? - A Prospective Randomized Study.","authors":"Saumyajit Basu, Kushal Gohil, Sanjit Singh, Amitava Biswas, Trinanjan Sarangi, Mainak Palit","doi":"10.1177/21925682241309303","DOIUrl":"10.1177/21925682241309303","url":null,"abstract":"<p><p>Study designRandomized controlled trial.ObjectivesIn this study, we hypothesize administering fixed-dose intravenous steroid (Methylprednisolone) intraoperatively would reduce neuroinflammation and enhance functional and radiological outcomes in decompressive surgeries for DCM. Primary objectives were to assess effect of intraoperative MP on modified Japanese Orthopedic Association (mJOA) score, Nurick grade, and MRI signal changes.MethodsThis prospective triple-blinded randomized controlled trial included 65 patients allocated into MP (n = 33) and control (n = 32) groups. MP (dose-1g) was administered intraoperatively at the beginning of decompression. Clinical outcome measures included mJOA score, Nurick grading, mJOA recovery rate (mJOA RR), Nurick recovery rate (NRR), and complication rates in both groups at 1-, 3-and 24-month follow-up. Radiological outcome was assessed by analyzing regression of T2W and T1W SI changes on MRI scans as per Chen's grading at 24-months follow-up.ResultsMP group exhibited greater improvement in mJOA scores at 24-months (mean improvement: +6.69 vs +6.42; difference: +0.27, 95% CI: -0.37 to +0.91) but was statistically insignificant (<i>P</i> = .107). Similarly, mJOA-RR showed a moderate effect size of 0.42 (95% CI: 0.04 to 0.80) and 0.37 (95% CI: -0.01 to 0.75) at 1-and 3-months follow-up respectively. NRR improvements were observed, with effect sizes of 0.40 (95% CI: 0.02 to 0.78) and 0.49 (95% CI: 0.11 to 0.87) at 1- and 3-months respectively, but not statistically significant (<i>P</i> = .28). At 24-months, MP group had significantly better MRI outcome (Chen grading: mean change +1.15 vs +0.83; effect size: -0.71, 95% CI: -1.09 to -0.33; <i>P</i> = .038).Complication rates were comparable between both groups, emphasizing safety of MP administration.ConclusionAlthough null hypothesis was not proven, intraoperative MP administration in DCM surgery demonstrated safety and suggested potential neuroprotective benefits to enhance clinical recovery and reduce spinal cord signal changes. However, further large-scale, multicentric studies are needed to validate these findings and optimize its dose.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2687-2698"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821521","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":"Response to Letter to the Editor Regarding the Article Entitled \"Trabecular Bone Remodeling After Posterior Lumbar Interbody Fusion: Comparison of the Osseointegration in Three-Dimensional Porous Titanium Cages and Polyether-Ether-Ketone Cages\" by Segi et al.","authors":"Naoki Segi, Hiroaki Nakashima, Sadayuki Ito, Jun Ouchida, Ippei Yamauchi, Tomohiro Matsumoto, Shunsuke Kanbara, Keigo Ito, Shiro Imagama","doi":"10.1177/21925682251332558","DOIUrl":"10.1177/21925682251332558","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2841-2843"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729374","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":"Response to Letter to the Editor Regarding Rod Contour Angle and Postoperative Thoracic Kyphosis: Key Predictors of Proximal Junctional Kyphosis in Pediatric Neuromuscular Scoliosis After Spinopelvic Fusion.","authors":"Pochih Shen, Carson Keeter, Tyler Sullivan, Nancy Hadley-Miller, Mark A Erickson","doi":"10.1177/21925682251333409","DOIUrl":"10.1177/21925682251333409","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2846-2847"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772060","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":"What Radiographic and Spinopelvic Parameters do Spine Surgeons Consider in Decision-Making for Treatment of Degenerative Lumbar Spondylolisthesis?","authors":"Juan P Cabrera, Michael S Virk, Samuel K Cho, Sathish Muthu, Luca Ambrosio, S Tim Yoon, Zorica Buser, Jeffrey C Wang, Ashish D Diwan, Patrick C Hsieh, The Ao Spine Knowledge Forum Degenerative","doi":"10.1177/21925682241306105","DOIUrl":"10.1177/21925682241306105","url":null,"abstract":"<p><p>Study DesignCross-sectional survey.ObjectiveSurgical treatment of degenerative lumbar spondylolisthesis is remarkably varied due to heterogeneity of clinical-radiological presentations. This study aimed to assess which spinopelvic radiological parameters were considered for decision-making.MethodsSurvey distributed to International AO Spine members to analyze surgeons' considerations for treatment. Data collected includes demographics, training background, years of experience, and treatment decisions based on various radiographical findings, including segmental and global spinopelvic parameters.ResultsFrom 479 responses, the most frequently radiological parameter considered was slippage on dynamic X-rays (79.1%), followed by disc height (78.9%), global sagittal balance SVA (71.4%), and PI-LL mismatch (69.7%), while the least important was absolute spondylolisthesis on static lateral radiograph (22.8%). Fellowship-trained surgeons were likelier to use SVA (OR = 1.73, 95% CI = 1.02-2.99, <i>P</i> = 0.049), and disc height (2.13, 1.14-3.98, <i>P</i> < 0.05). There was no difference between orthopedics and neurosurgery in applying SVA and PI-LL mismatch. Surgeons from Asia Pacific emphasizes segmental lordosis (2.39, 1.11-5.15, <i>P</i> = 0.026) as from Latin America (2.55, 1.09-5.95, <i>P</i> = 0.030) and Middle East (4.33, 1.66-11.28, <i>P</i> = 0.003). However, surgeons from Latin America and Middle East also significant consider disc height (2.95, 1.07-8.15, <i>P</i> = 0.037) and (3.03, 1.04-8.83, <i>P</i> = 0.043), respectively. Additionally, the surgeons' age was associated with using angular motion on flexion-extension radiographs, and volume of treated cases yearly with consideration for disc height.ConclusionsTreatment of degenerative lumbar spondylolisthesis was influenced by slippage on dynamic radiographs, disc height, global alignment, and PI-LL mismatch. Surgeons' age and Region, fellowship-trained, and volume of treated cases were significantly associated to apply these radiological parameters.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2645-2651"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768295","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":"Risk Factors for de Novo Postoperative Urinary Retention in Posterior Lumbar Spine Surgery.","authors":"Hideaki Nakajima, Kazuya Honjoh, Shuji Watanabe, Naoto Takeura, Arisa Kubota, Akihiko Matsumine","doi":"10.1177/21925682241308508","DOIUrl":"10.1177/21925682241308508","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectiveDe novo postoperative urinary retention (POUR) after lumbar posterior decompression surgery for lumbar spinal canal stenosis (LSCS) is a statistically known but uncommon complication for both patients and spine surgeons. The aim of this study is to review clinical data and imaging findings and identify preoperative predictors of de novo POUR.MethodsThe subjects were 738 surgically treated patients with LSCS, without preoperative bladder dysfunction or perioperative complications. Univariate and multivariate analyses using propensity score matching were performed to identify prognostic factors for POUR lasting for at least 1 week after postoperative urinary catheter removal.ResultsPOUR occurred in 23 patients (3.1%). The median recovery time was 41 days and only 12 patients (52.2%) showed improvement within 3 months. Patients with POUR were significantly older, and the lumbar Cobb angle, location of compressed dura mater (ventral or dorsal), and type of cauda equina redundancy (curve-type) were identified as independent prognostic factors. POUR had no association with sex, comorbidities, surgical procedures, number of decompressed segments, or degree of dura mater compression.ConclusionsThis study suggests that older age and curve-type stenosis with ventral or dorsal compression of the dura mater are risk factors for development of de novo POUR. Such preoperative imaging findings may indicate a higher risk of intraoperative thermal and nerve injuries, and possible uneven cauda equina flow improvement after decompression.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2669-2678"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806399","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":"Role of Magnetic Resonance Spectroscopy and T2 Relaxometry as Imaging Biomarker of Early Lumbar Intervertebral Disc Degeneration.","authors":"Pushpa Bhari Thippeswamy, Shanmuganathan Rajasekaran, Karthik Ramachandran, Murugesh Easwaran, Shalini Sivakumar Ramadevi, K S Sri Vijay Anand, Ajoy Prasad Shetty, Rishi Mugesh Kanna","doi":"10.1177/21925682241311515","DOIUrl":"10.1177/21925682241311515","url":null,"abstract":"<p><p>Study DesignObservational comparative study.ObjectiveTo study the role of magnetic resonance spectroscopy (MRS) and T2 relaxometry (T2r) as imaging biomarkers for identifying early lumbar disc degeneration.MethodsWe evaluated 236 discs in normal volunteers and 215 discs in low back pain (LBP) patients by MRS and T2r to document the molecular spectra of various metabolites as well as disc hydration and collagen content, respectively. All volunteer discs were Pfirrmann grade 1 (PF1), whereas patients with LBP had PF 1 (n = 156) and PF 2 (n = 59). The study population was compared in three age groups: A (20-30 years), B (30-40 years), and C (40-50 years).ResultsT2r, an indicator of collagen and hydration, was higher in volunteers (121.8 ± 31.1), compared to PF 1 patients (110.68 ± 23.96) and PF 2 patients (90.15 ± 25.81) (<i>P</i> = 0.001). Proteoglycan assessed by MRS was more stable for volunteers (3.39 ± 1.69) and PF 1 patients (3.6 ± 1.69) but reduced in PF 2 patients (2.86 ± 1.47), showing that structural molecules did not alter within the PF 1. However, lactate and other metabolites showed a difference even within PF1 between volunteers and LBP patients. We were able to identify a unique subset of PF 1 that had a normal value of proteoglycan and T2r but altered metabolite distribution, which may represent early disc degeneration (DD).ConclusionMRS and T2r can be used as imaging biomarkers for early DD by identifying altered metabolic activity with an intact matrix.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2736-2743"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871916","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}