Michael G Fehlings, Nathan Evaniew, Andrea C Skelly, Lindsay A Tetreault, Brian K Kwon
{"title":"Response to \"Proclaim (Best Available) Truth From the Rooftops\": A Community Doc's Alternate View on Dissemination& Implementation of AO Spine/Praxis' 2024 Acute Spinal Cord Injury Guidelines.","authors":"Michael G Fehlings, Nathan Evaniew, Andrea C Skelly, Lindsay A Tetreault, Brian K Kwon","doi":"10.1177/21925682251326926","DOIUrl":"10.1177/21925682251326926","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251326926"},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623770","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}
Wesley M Durand, Theodore Quan, Yesha Parekh, S Tim Yoon, Patrick C Hsieh, Hai Le, Philip K Louie, Stipe Corluka, Hardeep Singh, Samuel K Cho, Sathish Muthu, Zori Buser, Waeel Hamouda, Andreas K Demetriades, Gianluca Vadalà, Amit Jain
{"title":"A Comparative Analysis of Revision Rates in Surgical Treatments for Lumbar Isthmic Spondylolisthesis.","authors":"Wesley M Durand, Theodore Quan, Yesha Parekh, S Tim Yoon, Patrick C Hsieh, Hai Le, Philip K Louie, Stipe Corluka, Hardeep Singh, Samuel K Cho, Sathish Muthu, Zori Buser, Waeel Hamouda, Andreas K Demetriades, Gianluca Vadalà, Amit Jain","doi":"10.1177/21925682251326914","DOIUrl":"10.1177/21925682251326914","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectiveIsthmic spondylolisthesis is frequently encountered in spine surgical practice, though there is a significant variation in surgical management strategies. We sought to evaluate revision rates between patients who underwent anterior-approach lumbar interbody fusion (ALIF) alone, posterolateral fusion (PLF) alone, PLIF/TLIF, and ALIF+PSF.MethodsThis retrospective study utilized a large commercial insurance claims database of patients ≤65 years-old. Patients with isthmic spondylolisthesis who underwent single-level instrumented arthrodesis were included, and those who underwent revision surgery, surgery for deformity, multi-level surgery, or surgery for traumatic, infectious, or neoplastic etiologies were excluded, as determined by ICD-10-CM and CPT codes. Patients were assigned to surgical cohorts of ALIF alone, PLF alone, PLIF/TLIF, and ALIF+PSF based on CPT codes. Additional independent variables included age, sex, decompression at index surgery, and region. The primary outcome was revision arthrodesis or decompression, defined using CPT codes. Kaplan-Meier analysis and Cox Proportional Hazards regression were utilized to assess differences in revision occurrence between cohorts.Results1014 patients who underwent single-level arthrodesis for isthmic spondylolisthesis were included. The mean age was 48.6 years, with a mean follow-up of 637.6 days. The majority of patients underwent PLIF/TLIF (60.6%, n = 614), followed by ALIF+PSF (18.5%, n = 188), PLF alone (14.4%, n = 146), and ALIF alone (6.5%, n = 66). The 5-year revision-rate was 11.0% for all patients in the Kaplan-Meier analysis. In multivariable analysis adjusting for confounding factors, ALIF-alone demonstrated significantly higher occurrence of revision compared to both ALIF+PSF (HR 5.0, <i>P</i> = 0.0026) and PLIF/TLIF (HR 5.8, <i>P</i> < 0.0001) groups. Similarly, PLF alone demonstrated significantly higher occurrence of revision surgery compared to PLIF/TLIF (HR 2.4, <i>P</i> = 0.0379) while other comparisons were not statistically significant.ConclusionsIn this analysis of single-level arthrodesis for isthmic spondylolisthesis, patients who underwent ALIF alone had higher revision rates than those who underwent PLIF/TLIF and ALIF+PSF surgery, and those who underwent PLF alone had higher revision rates than those who underwent PLIF/TLIF. Surgical strategies providing both anterior and posterior column support resulted in lower real-world revision rates.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251326914"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614373","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}
Joost Phj Rutges, Scott L Zuckerman, Paul M Arnold, Chetan Bettegowda, Stefano Boriani, Michelle J Clarke, Michael G Fehlings, Ziya L Gokaslan, Aron Lazary, Laurence D Rhines, Arjun Sahgal, Daniel M Sciubba, James M Schuster, Michael H Weber, Ilya Laufer, Charles G Fisher
{"title":"Advancing Metastatic Spine Tumor Research: A Review of AO Spine Knowledge Forum Tumor's Scientific Contributions Derived From the EPOSO Network, 2014-2024.","authors":"Joost Phj Rutges, Scott L Zuckerman, Paul M Arnold, Chetan Bettegowda, Stefano Boriani, Michelle J Clarke, Michael G Fehlings, Ziya L Gokaslan, Aron Lazary, Laurence D Rhines, Arjun Sahgal, Daniel M Sciubba, James M Schuster, Michael H Weber, Ilya Laufer, Charles G Fisher","doi":"10.1177/21925682251326515","DOIUrl":"10.1177/21925682251326515","url":null,"abstract":"<p><p>Study DesignNarrative Review.ObjectivesTo summarize the work of the AO Spine Knowledge Forum Tumor, specifically studies from the Epidemiology, Process and Outcomes in Spine Oncology (EPOSO) study.MethodsA narrative review of all published manuscripts from the EPOSO study was undertaken. EPOSO represents a multicenter, prospective registry effort across 10 North American and European sites to enroll patients with metastatic disease of the spine.ResultsThe current review summarized all studies from the EPOSO network, divided into the following five sections: (1) quality of life and satisfaction, (2) overall survival, (3) spinal instability, (4) neurologic outcome in patients with metastatic epidural spinal cord compression or radicular pain, and (5) patient and tumor-specific factors. Several important findings were elucidated. Patient evaluation should include SINS, nutritional status, severity and duration of neurologic deficit, extent of metastatic tumor burden, and differentiation of axial from radicular pain. Moreover, SOSGOQ2.0 serves as a useful and validated instrument for patient-reported outcome instrument. Despite the palliative nature of metastatic spine surgery, clear improvement in quality-of-life is seen. Even in patients with short-survival, the remaining weeks and months of life result in improved quality-of-life. Metastatic spine surgery often improves neurologic function, potentially enhancing survival through increased performance status.ConclusionsSeveral noteworthy results have come from the EPOSO network, highlighting important trends in metastatic spine care. The AO Spine Knowledge Forum Tumor has helped advancing metastatic spine tumor research as well as ensure these new findings reach and benefit clinicians and their patients.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251326515"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614375","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}
Mohsen Rostami, Sadegh Bagherzadeh, Faramarz Roohollahi, Ricardo B V Fontes
{"title":"Spinal Osteotomies for Cervicothoracic Sagittal Imbalance Correction: A Systematic Review and Meta-Analysis.","authors":"Mohsen Rostami, Sadegh Bagherzadeh, Faramarz Roohollahi, Ricardo B V Fontes","doi":"10.1177/21925682251325829","DOIUrl":"10.1177/21925682251325829","url":null,"abstract":"<p><p>Study DesignSystematic Review.ObjectivesCervicothoracic junction (CTJ) deformities, particularly kyphosis, significantly impact patients' quality of life, causing pain, dysphagia, and inability to maintain horizontal gaze. Various surgical osteotomy techniques are available to correct CTJ kyphosis, but their relative effectiveness and associated complications remain unclear. This systematic review and meta-analysis aim to provide an evidence-based comparison of different surgical techniques for correcting cervicothoracic sagittal imbalance.MethodsA comprehensive search of PubMed, Scopus, Embase, and Web of Science was conducted up to August 2024. Studies included in the analysis involved adult patients undergoing cervical or upper thoracic osteotomy for sagittal imbalance correction. Data on radiographic outcomes, complication rates, and surgical factors were extracted and analyzed using random-effects models. Publication bias and heterogeneity were assessed using Begg's test and I<sup>2</sup> statistics, respectively.ResultsTwenty-three studies met the inclusion criteria, with a total of 995 patients. Pedicle subtraction osteotomy (PSO) provided the greatest correction for cervical sagittal vertical alignment (cSVA) and cervical lordosis (CL) compared to anterior cervical osteotomy (ACO) and Smith-Petersen osteotomy (SPO). Upper thoracic osteotomies showed superior correction of T1 slope (TS) and chin-brow vertical angle (CBVA). ACO had the lowest complication rate, while SPO showed the highest neurological complication rate, particularly at the C7-T1 level.ConclusionCervicothoracic osteotomy techniques, while effective, present significant risks. PSO provides the most powerful correction but is associated with greater surgical risks, while ACO offers lower complication rates. These findings highlight the need for careful surgical planning based on patient-specific deformities and risk factors.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251325829"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614386","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}
Brent Rosenstein, Meaghan Rye, Alexa Roussac, Neda Naghdi, Luciana G Macedo, James Elliott, Richard DeMont, Michael H Weber, Véronique Pepin, Geoffrey Dover, Maryse Fortin
{"title":"Comparison of Combined Motor Control Training and Isolated Extensor Strengthening Versus General Exercise on Lumbar Paraspinal Muscle Health and Associations With Patient-Reported Outcome Measures in Chronic Low Back Pain Patients: A Randomized Controlled Trial.","authors":"Brent Rosenstein, Meaghan Rye, Alexa Roussac, Neda Naghdi, Luciana G Macedo, James Elliott, Richard DeMont, Michael H Weber, Véronique Pepin, Geoffrey Dover, Maryse Fortin","doi":"10.1177/21925682251324490","DOIUrl":"10.1177/21925682251324490","url":null,"abstract":"<p><p>Study DesignProspective Randomized Controlled Trial.ObjectivesTo investigate the effect of combined motor control and isolated lumbar strengthening exercise (MC + ILEX) vs general exercise (GE) on upper lumbar paraspinal muscle volume and composition, strength and patient outcomes in individuals with chronic low back pain (LBP).Methods50 participants with nonspecific chronic LBP were randomly allocated (1:1) to each group (MC + ILEX or GE) and underwent a 12-week supervised intervention program 2 times per week. Magnetic resonance imaging was performed at baseline, 6-weeks and 12-weeks to examine the impact of each intervention on multifidus (MF) and erector spinae (ES) muscle volume (cm<sup>3</sup>) and fatty infiltration (%FI) at L1-L2, L2-L3 and L3-L4.ResultsOur results revealed no significant between-groups findings for MF and ES %FI and volume, and patient-reported psychosocial measures. However, both groups had significant within-groups decreases in MF %FI at L1-L2, L2-L3 and L3-L4, with concomitant decreases in MF volume at L1-L2 and L2-L3, and at L3-L4 in the GE group. Each group displayed significant improvements in Kinesiophobia, while only MC + ILEX had significant improvements in pain catastrophizing, anxiety, depression and sleep. Lastly, significant correlations were found between change in Kinesiophobia and upper lumbar MF %FI, and between change in strength and lower lumbar MF and ES size.ConclusionsBoth exercise interventions may help reduce upper lumbar MF %FI in individuals with chronic LBP, while MC + ILEX could significantly improve important patient outcomes. Our results support the idea that improvements in paraspinal muscle health associate with better patient outcomes. Further high-quality imaging studies are needed to explore these relationships.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251324490"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604629","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}
Po-Jui Chu, Hung-Kuan Yen, Po-Hao Huang, Ming-Hsiao Hu
{"title":"Comparison of Hounsfield Units and Vertebral Bone Quality Score for the Prediction of Time to Pathologic Fracture in Mobile Spine Metastases Treated With Radiotherapy.","authors":"Po-Jui Chu, Hung-Kuan Yen, Po-Hao Huang, Ming-Hsiao Hu","doi":"10.1177/21925682251325173","DOIUrl":"10.1177/21925682251325173","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251325173"},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541202","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}
Global Spine JournalPub Date : 2025-03-01Epub Date: 2024-01-27DOI: 10.1177/21925682241230965
Paal K Nilssen, Nakul Narendran, Ida Chen, Linda E Kanim, Corey T Walker, Hyun W Bae, David L Skaggs, Alexander Tuchman
{"title":"Risk Factors for Reoperation Following Single-Level Cervical Disc Arthroplasty as Utilized in a Representative Sample of United States Clinical Practice: A Retrospective PearlDiver Study.","authors":"Paal K Nilssen, Nakul Narendran, Ida Chen, Linda E Kanim, Corey T Walker, Hyun W Bae, David L Skaggs, Alexander Tuchman","doi":"10.1177/21925682241230965","DOIUrl":"10.1177/21925682241230965","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort.</p><p><strong>Objectives: </strong>Most data regarding cervical disc arthroplasty (CDA) outcomes are from highly controlled clinical trials with strict inclusion/exclusion criteria. This study aimed to identify risk factors for CDA reoperation, in \"real world\" clinical practice using a national insurance claims database.</p><p><strong>Methods: </strong>The PearlDiver database was queried for patients (2010-2020) who underwent a subsequent cervical procedure following a single-level CDA. Patients with less than 2 years follow-up were excluded. Primary outcome was to evaluate risk factors for reoperation. Secondary outcome was to evaluate the types of reoperations. Risk factors were compared using descriptive statistics. Multivariate regression analyses were used to ascertain the association among risk factors and reoperation.</p><p><strong>Results: </strong>Of 14,202 patients who met inclusion criteria, 916 (6.5%) underwent reoperation. Patients undergoing reoperation were slightly older with higher Elixhauser Comorbidity Index (ECI) scores, however both were not risk factors for reoperation. Patients with diagnoses such as smoking, myelopathy, inflammatory disorders, spinal deformity, trauma, or a history of prior cervical surgery were at greater risk for reoperation. No association was found between the year of index surgery and reoperation risk. The most common reoperation procedure was cervical fusion.</p><p><strong>Conclusions: </strong>As billed for in the United States since 2010, CDA was associated with a 6.5% reoperation rate over a mean follow-up time of 5.3 years. Smoking, myelopathy, inflammatory disorders, spinal deformity, and a history of prior cervical surgery or trauma are risk factors for reoperation following CDA. Though patients who underwent a reoperation were older, age was not found to be an independent risk factor for a subsequent procedure.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1186-1192"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139566963","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}
Global Spine JournalPub Date : 2025-03-01Epub Date: 2024-07-27DOI: 10.1177/21925682241270098
Cangxu Zhang, Shicheng Xie
{"title":"We Read With Great Interest the Recent Article by Juan P. Sardi et al Entitled \"Opioid Use Prior to Adult Spine Deformity Correction Surgery is Associated with Worse Pre- and Postoperative Back Pain and Prolonged Opioid Demands\".","authors":"Cangxu Zhang, Shicheng Xie","doi":"10.1177/21925682241270098","DOIUrl":"10.1177/21925682241270098","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1461-1462"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765876","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 Clinical and Imaging Outcome of the Tandem Growing Rod Technique in Early-Onset Scoliosis With the Proximal Upper Thoracic Curve Progression: A Modified Technique of Growing Rod.","authors":"Weiran Hu, Hongqiang Wang, Guang Yang, Haohao Ma, Xiaonan Wu, Yanzheng Gao","doi":"10.1177/21925682231224774","DOIUrl":"10.1177/21925682231224774","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The orthopaedic ability of traditional GR for severe EOS is limited. The proximal upper thoracic curve may progress during the lengthening procedure, which may lead to coronal imbalance and inhibit the longitudinal growth of the spine. In this retrospective cohort study, we investigated the clinical outcome of tandem GR.</p><p><strong>Methods: </strong>We modified the traditional technique by using two groups of GR devices to control the major and the proximal upper thoracic curve, connected the two groups of GR in series, and named it tandem GR. The clinical and imaging outcomes of the new technique were evaluated and compared with traditional technique.</p><p><strong>Results: </strong>Twenty one patients were enrolled in the tandem GR group, and 30 patients were treated with traditional GR as the control. The baseline parameters were consistent between the two groups. In the tandem GR group, the secondary curve progressed from 24.9 ± 3.9° to 31.4 ± 3.2° (<i>P</i> = .006) in the procedure with the traditional GR and improved to 18.4 ± 4.5° (<i>P</i> = .001) after the switch. Meanwhile, the clavicular angle aggravated from 1.6 ± 1.0° to 2.6 ± .7° (<i>P</i> = .041), and improved to 1.7 ± .8° after changed to the tandem GR (<i>P</i> = .033). At the final of the follow-up, the secondary curve was higher in the control group (27.1 ± 8.3° vs 18.4 ± 4.5°, <i>P</i> = .034), the clavicle angle was 2.4 ± 1.1° in control and 1.7 ± .8° in the tandem GR group (<i>P</i> = .028), the T1-S1 height was 28.2 ± 4.8 cm in the control and 33.3 ± 3.0 cm in the tandem GR group (<i>P</i> = .027). The average growth rate was 1.0 ± .3 cm/year in the control and 1.2 ± .4 cm/year in the tandem GR group (<i>P</i> = .046).</p><p><strong>Conclusion: </strong>Tandem GR can effectively improve the proximal upper thoracic curve progression during the treatment of EOS. Compared with the traditional GR, tandem GR can achieve better curve correction, better shoulder balance, and retains more capacity for longitudinal spine growth.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1121-1128"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073774","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}
Global Spine JournalPub Date : 2025-03-01Epub Date: 2024-02-21DOI: 10.1177/21925682241235605
Marco Manzetti, Alberto Ruffilli, Giovanni Viroli, Matteo Traversari, Marco Ialuna, Francesca Salamanna, Simona Neri, Cesare Faldini
{"title":"Frailty Influence on Postoperative Surgical Site Infections After Surgery for Degenerative Spine Disease and Adult Spine Deformity. Can a Frailty Index be a Valuable Summary Risk Indicator? A Systematic Review and Metanalysis of the Current Literature.","authors":"Marco Manzetti, Alberto Ruffilli, Giovanni Viroli, Matteo Traversari, Marco Ialuna, Francesca Salamanna, Simona Neri, Cesare Faldini","doi":"10.1177/21925682241235605","DOIUrl":"10.1177/21925682241235605","url":null,"abstract":"<p><strong>Study design: </strong>Metanalysis.</p><p><strong>Objective: </strong>Surgical site infections (SSI) is one of the commonest postoperative adverse events after spine surgery. Frailty has been described as a valuable summary risk indicator for SSI in spine surgery. The aim of this metanalysis is to evaluate the influence of frailty on postoperative SSI in this cohort and provide hints on which index can predict the risk of SSI.</p><p><strong>Methods: </strong>Papers describing the postoperative SSI rate in adult degenerative spine disease or adult spine deformity patients with varying degrees of frailty were included in the analysis. The SSI rate in different grades of frailty was considered for outcome measure. Meta-analysis was performed on studies in whom data regarding patients with different levels of frailty and occurrence of postoperative SSI could be pooled. <i>P</i> < .05 was considered significant.</p><p><strong>Results: </strong>16 studies were included. The frailty prevalence measured using mFI-11 ranged from 3% to 17.9%, these values were inferior to those measured with mFI-5. Significant difference was found between frail and non-frail patients in postoperative SSI rate at metanalysis (z = 5.9547, <i>P</i> < .0001 for mFI-5 and z = 3.8334, <i>P</i> = .0001 for mFI-11).</p><p><strong>Conclusion: </strong>This is the first meta-analysis to specifically investigate the impact of frailty, on occurrence of SSI. We found a relevant statistical difference between frail and non-frail patients in SSI occurrence rate. This is a relevant finding, as the ageing of population increases alongside with spine surgery procedures, a better understanding of risk factors may advance our ability to treat patients while minimizing the occurrence of SSI.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1338-1355"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930803","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}