Global Spine Journal最新文献

{"title":"Response to the Letter to the Editor for Surgical Site Infection, Microbiology, and Antibiotic Utilization After Posterior Cervical Spinal Decompression and Fusion: A 10-Year Experience.","authors":"Benjamin J Carnovale, Samuel H Wakelin, Nicole Don, Ayesha Akbar Waheed, Regan M Shanahan, Samuel Adida, Victoria Crall, Karin Byers, Hansen Deng, D Kojo Hamilton, Nitin Agarwal","doi":"10.1177/21925682261495515","DOIUrl":"10.1177/21925682261495515","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261495515"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074266","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 for \"Impact of Immunosuppression Type on 30-Day Postoperative Outcomes Following Anterior Cervical Discectomy and Fusion: A Retrospective National Cohort Study of 66,162 Patients\".","authors":"Rohan A Phadke, Samer G Salman, Connor Welsh, Nathan J Lee","doi":"10.1177/21925682261495509","DOIUrl":"10.1177/21925682261495509","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261495509"},"PeriodicalIF":3.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074271","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":"Interpreting Lumbar Compensation in Severe Adolescent Idiopathic Scoliosis.","authors":"Ercan Yılmaz, Nezihe Koker Özer, Erdem Topal","doi":"10.1177/21925682261495510","DOIUrl":"10.1177/21925682261495510","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261495510"},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074335","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 Image-Guided Screw Placement on Unexpected Return to the Operating Room: A Systematic Review and Meta-Analysis of 91,285 Patients.","authors":"Jaskaran Singh, Marion Sylvain, Mikko Vorster, Bona Baissa, Aazad Abbas, Michael Goytan","doi":"10.1177/21925682261493032","DOIUrl":"10.1177/21925682261493032","url":null,"abstract":"<p><p>Study designSystematic Review and Meta-Analysis.ObjectivesNavigation-guided screw placement improves screw accuracy and may reduce hardware-related revision, yet its effect on overall unexpected return to the operating room (URTO) remains uncertain. This study compares image-guided (navigation and robotics) with freehand screw placement for hardware-related revision, non-hardware reoperation, and URTO following spinal fixation.MethodsA PRISMA-guided systematic review identified comparative studies evaluating image-guided versus freehand screw fixation. Two reviewers performed screening, data extraction, and risk-of-bias assessment. Odds ratios (ORs) were pooled using a random-effects Mantel-Haenszel meta-analysis. Subgroup analyses compared navigated, robotic, and freehand techniques.ResultsTwenty-one studies were included, comprising 91,285 patients (8,743 image-guided; 82,442 freehand). Compared with freehand, image guidance was associated with lower odds of hardware-related revision (OR 0.55, 95% CI 0.40-0.75) and lower odds of URTO (OR 0.69, 95% CI 0.50-0.94), with no difference in non-hardware reoperation (OR 1.03, 95% CI 0.67-1.57). Navigation was associated with lower odds of hardware-related revision (OR 0.51, 95% CI 0.35-0.77) and URTO (OR 0.63, 95% CI 0.51-0.77) versus freehand, whereas robotics showed no significant differences across outcomes. Indirect comparison between navigation and robotics was not statistically significant. Risk of bias was overall high because of retrospective study design, confounding, and inconsistent outcome reporting.ConclusionsNavigation was associated with lower odds of hardware-related revision and lower odds of URTO, without a difference in non-hardware reoperation. Robotics showed no statistically significant advantage over freehand fixation, but its underrepresentation and differing case mix limit comparative conclusions.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261493032"},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069456","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":"Diagnostic Accuracy of Intraoperative Neurophysiologic Monitoring in Spinal Deformity Surgery: Systematic Review and Meta-Analysis.","authors":"Brendan T O'Reilly, Alexandra M Dunker, Drue M Domagala, Allie C Reynolds, Catalina Garcia, Sohan Arakal, Giselle K Henry, David Travis Johnston, Rajiv S Dharnipragada, Stavros Matsoukas, Theodore Gallas, Noah C Fulcomer, Shyon K Ahmadi, Alexander Lee, Eric O Klineberg","doi":"10.1177/21925682261492292","DOIUrl":"10.1177/21925682261492292","url":null,"abstract":"<p><p>Study DesignSystematic review and diagnostic accuracy meta-analysis.ObjectiveTo evaluate the diagnostic accuracy of intraoperative neurophysiologic monitoring (IONM) for detecting postoperative neurologic deficits in spinal deformity surgery and assess performance across monitoring modalities.MethodsA systematic review of PubMed, Embase, and Web of Science (2000-2026) was performed in accordance with PRISMA guidelines. Studies reporting intraoperative neuromonitoring and postoperative neurologic outcomes were included. Diagnostic accuracy metrics were calculated from contingency tables and pooled using random-effects models. Subgroup analyses were performed by monitoring modality.ResultsA total of 43 studies were included in the systematic review. Of these, 38 had constructable 2x2 tables and contributed to the specificity and false-positive rate analyses, while 36 contributed to the sensitivity, false-negative rate, and diagnostic-odds ratio models. Pooled sensitivity was 90.1% (95% CI, 83.8-94.2%), and pooled specificity was 95.4% (95% CI, 93.0-97.0%). The diagnostic odds ratio was 206.8 (95% CI, 92.8-460.9). Heterogeneity was observed (I² = 56.7% for sensitivity and 95.3% for specificity). Sensitivity and specificity remained broadly comparable across conventional monitoring modalities, and between-modality differences were not statistically significant.ConclusionsIONM demonstrates high specificity and strong sensitivity for detecting neurologic injury in spinal deformity surgery. Performance was similar across conventional modalities, although sensitivity and false-negative rates varied across studies. These findings support the continued use of IONM as an intraoperative safety tool while highlighting the need for standardized reporting and improved interpretation of monitoring signals.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492292"},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069484","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":"Spinal Fusion Surgical Site Infections Caused by Gram-Negative Bacilli.","authors":"Leonard A Mermel","doi":"10.1177/21925682261495553","DOIUrl":"10.1177/21925682261495553","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261495553"},"PeriodicalIF":3.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069513","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":"Cost-Effectiveness of Minimally Invasive Tubular vs. Open Laminectomy for Pure Lumbar Spinal Stenosis: A Markov State-Transition Analysis.","authors":"Rohan A Phadke, Samer G Salman, Imaad Virani, James Burnett, Maryam Y Jawid, Arnav Kak, Alexander Mihas, Lorenzo Deveza","doi":"10.1177/21925682261494612","DOIUrl":"10.1177/21925682261494612","url":null,"abstract":"<p><p>Study DesignDecision-analytic cost-effectiveness analysis using a Markov state-transition model.IntroductionLumbar spinal stenosis (LSS) is the most common indication for spine surgery in older adults. Minimally invasive surgery (MIS) tubular decompression and open laminectomy produce equivalent one-year outcomes, but their long-term cost-effectiveness for pure decompression is unknown. We modeled 10-year cost-effectiveness from the U.S. payer perspective.MethodsWe built a five-state Markov model for a simulated cohort of 10,000 patients aged 65 with pure LSS (no instability, deformity, spondylolisthesis, or prior surgery), using 3-month cycles, a 10-year horizon, and 3% annual discounting. QALYs used SPORT EQ-5D utilities. Perioperative complication rates came from the Nerland 2015 propensity-matched cohort (10.6% vs. 14.6%; risk difference 4.1 percentage points, 95% CI -2.6 to 10.7). Recurrence, postoperative utility, and perioperative mortality were equalized across arms. One-way, threshold, and probabilistic sensitivity analyses (PSA) were performed, including wide-uncertainty sampling of the complication difference across its confidence interval.ResultsMIS yielded 5.95 QALYs at $26,283 versus 5.91 QALYs at $30,450 for open laminectomy, saving $4,167 per patient (MIS dominant). MIS was cost-effective in 81% of PSA iterations at $50,000/QALY and in 82% to 88% under wide-uncertainty sampling, and remained cost-effective at $100,000/QALY unless its complication rate exceeded 17.5%. Without any complication advantage, MIS still saved $3,454 with equal QALYs.ConclusionFor pure LSS, MIS tubular decompression was cost-effective and, in the base case, dominant over open laminectomy. The advantage reflects the complication difference and the lower index cost, and should inform rather than determine coverage policy.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261494612"},"PeriodicalIF":3.1,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060255","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: \"Does Distal Fusion Increase Pain-or Reflect Baseline Pain Risk in Adolescent Idiopathic Scoliosis With Spondylolysis?\"","authors":"Mutaleeb A Shobode, Josiah J Wolf, Asahi Murata, Anirejuoritse Bafor, Kirsten Tulchin-Francis, Walter P Samora, Reid C Chambers, Allen Kadado","doi":"10.1177/21925682261492691","DOIUrl":"10.1177/21925682261492691","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492691"},"PeriodicalIF":3.1,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060190","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":"Fully Automated Deep Learning-Based Lenke Classification for Adolescent Idiopathic Scoliosis Using Multi-View Full-Spine Radiographs: Development and Clinical Validation.","authors":"Sheyang Xu, Yongda Xu, Xianglong Meng","doi":"10.1177/21925682261488408","DOIUrl":"10.1177/21925682261488408","url":null,"abstract":"<p><p>Study DesignRetrospective validation study.ObjectivesTo develop and validate a fully automated deep learning framework for radiographic measurement and Lenke classification in adolescent idiopathic scoliosis (AIS) using multi-view full-spine radiographs.MethodsConsecutive patients with AIS from 3 hospitals who underwent standardized 4-view full-spine radiography between January 2019 and January 2026 were retrospectively reviewed. The automated framework incorporated vertebral detection, vertebra-level landmark estimation, radiographic parameter computation, and rule-based Lenke classification. Expert manual measurements and consensus Lenke classification served as the reference standard. Performance was assessed on an independent test set using detection and keypoint metrics, Cobb angle measurement agreement, classification accuracy, clinician agreement, and workflow efficiency.ResultsIn 76 independent test cases, the framework achieved a vertebral detection AP@0.75 of 0.858 and an overall keypoint AP of 0.951. Cobb angle measurement showed a mean absolute error of 2.4°, with excellent agreement with expert measurements (ICC = 0.991; Pearson correlation = 0.987; Spearman correlation = 0.983). Accuracy was 0.895 for Lenke curve type, 0.868 for lumbar modifier, 0.908 for sagittal thoracic modifier, and 0.816 for the complete Lenke label. Agreement between the AI system and the senior surgeon was high ( <i>κ</i> = 0.873 for curve type; <i>κ</i> = 0.781 for complete label). Mean processing time was 12.3 seconds per case, and AI-assisted review reduced mean review time from 8.2 to 1.5 minutes per case.ConclusionsThis fully automated deep learning framework achieved accurate radiographic measurement and Lenke classification with strong agreement with spine surgeons and marked efficiency gains. The method may serve as an interpretable decision-support tool for preoperative AIS assessment.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261488408"},"PeriodicalIF":3.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038165","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 Mild Degenerative Cervical Myelopathy: Contemporary Concepts.","authors":"Chris J Neal, Lukas Grassner, Ricardo Rodrigues-Pinto, Nitin Agarwal, Aminul I Ahmed, David B Anderson, Paul Arnold, Nader Hejrati, Mahmoud Fouad Ibrahim, Konstantinos Margetis, Lindsay Tetreault, Carl Zipser, Charles André Carazzo, Nathan Evaniew, James Harrop, Michael G Fehlings, Charles G Fisher, Shekar Kurpad","doi":"10.1177/21925682261492222","DOIUrl":"10.1177/21925682261492222","url":null,"abstract":"<p><p>Study DesignLiterature review with critical appraisal and clinical recommendations.ObjectiveTo highlight contemporary concepts involving the management of mild degenerative cervical myelopathy (DCM) and facilitate integration into clinical practice.MethodsFour articles relating to mild DCM were selected and critically appraised. Clinical practice recommendations were developed and evaluated using the GRADE framework and expert opinion.ResultsBased on low evidence in the Tetreault et al paper, it is <b>conditionally recommended</b> that the severity of DCM should be based on the mJOA score with the following thresholds: mild (15-17), moderate (12-14), and severe (≤11). <b>No clinical recommendation</b>, based on very low level of evidence for the Al-Shawwa et al article, on the routine use of MRI parameters to predict neurological deterioration or guide decisions on timing of surgical intervention in mild DCM. With low quality evidence presented by Badhiwala et al, there is a <b>conditional recommendation</b> for surgery in mild DCM patients with high levels of baseline pain and Neck Disability Index scores. A <b>conditional recommendation</b>, based on very low quality of evidence in the Ozaki et al paper, is that patients should be counseled that upper extremity sensory deficits frequently persist after decompression and that angular-edged spinal cord deformity on axial MRI should be considered a risk factor for residual postoperative upper extremity sensory impairment.ConclusionsThe management of mild DCM is an evolving field. Using established nomenclature and understanding the nuances of clinical and radiographic presentation may allow for more appropriate counselling and surgical candidate selection.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492222"},"PeriodicalIF":3.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038203","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}