Global Spine Journal最新文献

{"title":"Does the Lumbar Paraspinal Muscle Status Have a Role in Predicting Mechanical Complications After Adult Spinal Deformity Surgery?","authors":"Ganesh Kumar, Vikas Tandon, Ankur Nanda, Gururaj Mallikarjun, Rajat Mahajan, Bibhudendu Mohapatra, Tarush Rustagi, Kalidutta Das, Murari Lal Bansal, Neeraj Gupta, Jitesh Manghwani","doi":"10.1177/21925682251330830","DOIUrl":"10.1177/21925682251330830","url":null,"abstract":"<p><p>Study designRetrospective analysis.ObjectivesTo assess the role of paraspinal muscle morphology in predicting complications after adult spinal deformity (ASD) surgery.Materials and MethodsA total of 93 patients who underwent surgery for ASD from 2017 to 2022 were enrolled. Using early postoperative X-ray, they were divided into proportioned (P), moderately proportioned (MP), and severely proportioned (DP) groups based on the Global Alignment and Proportion (GAP) scores. Further, they were classified into two groups: Group A (presence of mechanical complications) and Group B (no mechanical complications). In addition, other parameters including preoperative BMI, smoking status, cross-sectional area (CSA), and grades of paraspinal muscle fatty infiltration (FI) were calculated in all patients using preoperative MRI. These parameters were compared across the groups using a one-way analysis of variance (ANOVA). Post-hoc pairwise testing was done using Bonferroni's method. These were also compared between groups A and B using a 2-sample t-test.ResultsThe mean follow-up period was 32.7 months (24-64 months). 27 (29%) of 93 patients developed mechanical complications following ASD surgery. Of the 27 patients, 6 (22.2%) were proportioned, 10 (37%) were from MP and 11 (40.7%) were from the DP group. Group A had low CSA (<i>P</i> = 0.014), and high FI (<i>P</i> = 0.003) grades compared to group B. Further, 22.2% (6/27) had a history of smoking before surgery (OR = 6.57).ConclusionsWe recommend consideration of preoperative smoking, CSA, and FI of paraspinal muscles in addition to the GAP score to minimize mechanical complications in patients undergoing ASD surgery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251330830"},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752381","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}

{"title":"The AO Spine Upper Cervical Injury Classification System (AO UCIC) - An Umbrella Review of Traumatic Axis Injuries Factors that May Affect Treatment Decision.","authors":"Andrei F Joaquim, Sebastian F Bigdon, Gaston Camino-Willhuber, Cumhur F Öner, Klaus J Schnake, Richard Bransford, Harvinder Singh Chhabra, Mohammad El-Skarkawi, Alexander R Vaccaro, Gregory D Schroeder","doi":"10.1177/21925682251333300","DOIUrl":"10.1177/21925682251333300","url":null,"abstract":"<p><p>Study designAn umbrella systematic review.ObjectiveTo identify historically recognized injury characteristics that may affect treatment decisions of traumatic C2 injuries and help improve the description of the \"modifiers\" presented in the AO Upper Cervical Injury Classification (UCIC).MethodsWe performed an umbrella review of systematic reviews evaluating studies about the management of axis fractures that identify potential modifiers in the treatment of these injuries. These modifiers were grouped according to the new AO UCIC.ResultsEight systematic reviews were included. They were divided into three groups: (1) Axis body fractures - one study, (2) Hangman´s fractures - one study, and (3) Odontoid fractures, six studies. For axis body fractures, most injuries were treated non-operatively, except some Benzel type 3 fractures (AO Type A) with displacement or severe comminution (M1). Hangman´s fractures classified as Effendi I and Levine-Edwards I and II were treated non-operatively with success, with no modifiers identified for non-union or instability. For Levine-Edwards type IIA and III surgery was generally recommended, but these should be classified as AO type B and C respectively without a need for modifiers. For odontoid fractures, fractures in the dens base, with displacement, or in elderly patients were associated with non-union (M1) and patients' specific factors (surgical condition) seem to affect the decision of treatment (M3) for considering surgery.ConclusionsWe identified from the literature some axis injury characteristics that seem to affect the treatment decision in historical series. Knowledge of these modifiers may further enhance the system's clinical utility.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251333300"},"PeriodicalIF":2.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742781","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":"Surgeon-Guided Fluoroscopic Erector Spinae Plane Block (ESPB) versus Anesthetist-Guided Ultrasonic ESPB for Perioperative Analgesia in Lumbar Fusion Surgery- a Prospective Randomized Control Study.","authors":"Gnanaprakash G, Rishi Mugesh Kanna, J Balavenkat Subramanian, Sekar Chelliah, Ajoy Prasad Shetty, S Rajasekaran","doi":"10.1177/21925682251333407","DOIUrl":"10.1177/21925682251333407","url":null,"abstract":"<p><p>Study designProspective, randomized control study.ObjectiveTo assess the safety and efficacy of fluoroscopy-guided vs ultrasound-guided Erector Spinae Plane Block (ESPB) for perioperative analgesia in lumbar fusion surgery.Materials and Methods66 patients requiring single-level lumbar fusion were randomized into 2 groups. One group had fluoroscopy-guided ESPB by the surgeon (Fluoro-ESPB group) and the other group had Ultrasound-guided ESPB by the anesthetist (USG-ESPB). Demographic details, intraoperative parameters (perioperative total opioid consumption, muscle relaxants used, heart rate, blood pressure), and postoperative parameters (VAS score, alertness, satisfaction score) were recorded and analyzed.ResultsDuring the initial 48 hours following the surgery, both groups provided good perioperative analgesia, and reported very low and comparable postoperative pain scores (VAS scale). The mean VAS score was 2.7 ± 0.5 in the Fluoro-ESPB group and 2.7 ± 0.5 in the USG-ESPB group (<i>P</i> = 0.91). The average time taken to deliver the block in the Fluoro-ESPB group (3.01 ± 0.97 mins) was significantly less than in the USG-ESPB group (4.74 ± 1.49 mins) (<i>P</i> = 0.00). The total perioperative opioid consumption (TOC), total intraoperative muscle relaxant consumption, and intraoperative blood loss were similar in both groups (Fluoro- ESPB, USG ESPB) (<i>P</i> > 0.05). The postoperative MOASS score was consistently high across both groups. The satisfaction scores were high and comparable (<i>P</i> = 0.403).ConclusionThe fluoroscopy-guided ESPB is a safe and effective alternative to the traditional ultrasound-guided technique. It can be performed by the surgeon, reducing overall procedure time, and improving workflow.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251333407"},"PeriodicalIF":2.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742779","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":"Utility of Routine Preoperative Urinalysis in Elective Lumbar Spine Fusion Surgery.","authors":"Stevin Lu, Ian Marquez, Hania Shahzad, Jonathan Ochoa, Kanwar Parhar, Muhammad Jawad, Rolando Roberto, Yashar Javidan, Safdar Khan, Eric Klineberg, Hai Le","doi":"10.1177/21925682251330593","DOIUrl":"10.1177/21925682251330593","url":null,"abstract":"<p><p>Study DesignA retrospective cohort study.ObjectiveTo evaluate the utility of routine preoperative urinalysis as a predictor of postoperative complications following elective lumbar fusion surgery (ELFS).MethodsThis study included a retrospective review of patients aged ≥18 years-old who underwent ELFS for degenerative pathology between 2018 to 2022 at a single academic institution. Patients were categorized into 3 groups: No Urinalysis (No-UA), Negative Urinalysis (Negative-UA), and Positive Urinalysis (Positive-UA). A retrospective review of medical records was conducted including patient characteristics and clinical factors of interest. Emergency department (ED) visits and return to the operating room (OR) within 3-months postoperatively were recorded. Statistical analyses were performed using bivariate and multivariate analysis.ResultsA total of 493 patients were included. Despite having higher rates of preoperative antibiotics administered, patients with a positive urinalysis were significantly more likely to present with postoperative urinary tract infections (UTIs) than the No-UA and Negative-UA groups. No significant differences were seen in other types of complications including pneumonia, bacteremia, superficial wound infections, deep wound infections, and wound dehiscence between the 3 groups. Additionally, rates of return to OR, return to ED, reinsertion of foley catheters, duration of indwelling catheterization, and hospital length of stay had no significant differences between the groups.ConclusionThis study suggests there may be a limited role in performing routine preoperative urinalysis prior to ELFS. This study may help further improve preoperative assessment guidelines and assist with patient counseling and considerations prior to elective lumbar fusion surgery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251330593"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729421","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":"Adherence to the Lamartina-Berjano Classification and Suggested Surgical Treatment Decreases the Rate of Postoperative Mechanical Failures in Adult Deformity Patients. A Retrospective Observational Study With a Minimum 10 Years Follow-Up.","authors":"D Compagnone, L La Verde, A Redaelli, D Solano, F Langella, M Damilano, D Vanni, C Lamartina, P Berjano, R Cecchinato","doi":"10.1177/21925682251332555","DOIUrl":"10.1177/21925682251332555","url":null,"abstract":"<p><p>Study DesignRetrospective cohort analysis.ObjectivesTo evaluate the effectiveness of the Lamartina-Berjano (L-B) classification in reducing mechanical complications in patients with adult spinal deformities, with a minimum follow-up of 10 years.MethodsThe study included cases of adult deformity with at least 10 years of follow-up. The rate of clinically-relevant mechanical complications, defined as any implant-related issue requiring revision surgery, was estimated. The independent variable was adherence to the treatment guidelines of the L-B classification. The analysis was limited to patients with thoracolumbar deformities, and the population was stratified according to postoperative alignment using GAP scores.ResultsA total of 121 patients met the inclusion and exclusion criteria. In this cohort, the revision surgery rate for clinically-relevant mechanical complications was 49.6% (60 out of 121 patients). Of these, 90 patients (74%) had surgery following the L-B classification guidelines. A lower risk of complications was observed in aligned patients whose surgeries adhered to the L-B classification. Additionally, the survival curve showed significant differences between patients who followed L-B guidelines and those who did not.ConclusionOur retrospective analysis shows that following the L-B classification guidelines leads to a reduction in mechanical complications in patients with thoracolumbar deformities, particularly in a long-term follow-up scenario.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251332555"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729577","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":"Letter Re: \"Effect of Baseline Adjacent Segment Degeneration on Clinical Outcomes After Lumbar Fusion\".","authors":"Leevi A Toivonen, Heikki Mäntymäki, Lorin M Benneker, Hannu Kautiainen, Marko H Neva","doi":"10.1177/21925682251330264","DOIUrl":"https://doi.org/10.1177/21925682251330264","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251330264"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742775","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":"Letter to \"Effect of Baseline Adjacent Segment Degeneration on Clinical Outcomes After Lumbar Fusion\".","authors":"Zeyu Wang, Jinhua Zhao, Xiangzheng Qin","doi":"10.1177/21925682251330285","DOIUrl":"https://doi.org/10.1177/21925682251330285","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251330285"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742777","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: Current Systemic Oncological Treatments with the Largest Impact on Patients with Metastatic Spinal Disease.","authors":"Marcin Czyz, Emerens G Wensink, Brian Coimbra, Michael Galgano, Shreyaskumar Patel, Kristin Redmond, Joost Rutges, Jiong Hao Jonathan Tan, Ori Barzilai, Nicolas Dea, Alessandro Gasbarrini, Ilya Laufer, Aron Lazary, Cordula Netzer, Jeremy J Reynolds, Laurence D Rhines, Arjun Sahgal, Charles G Fisher, Jorrit-Jan Verlaan","doi":"10.1177/21925682251324138","DOIUrl":"10.1177/21925682251324138","url":null,"abstract":"<p><p>Study DesignLiterature review with clinical recommendation.ObjectiveTo provide the readers with a concise curation of the latest literature in recent advances in systemic oncological therapies and their implications for decision-making in patients with metastatic spinal disease. This review aims to enhance spine specialist's understanding of modern oncological treatments to facilitate optimal timing and planning of local interventions.MethodsThe latest literature in the topic of advances in oncology was reviewed by a multidisciplinary group of experts in metastatic spinal disease and clinical recommendations were formulated. The recommendations were dichotomously graded into strong and conditional (weak) based on the integration of scientific methodology and content expert opinion. This opinion considered experience and practical issues such as risks, burdens, costs, patient values, and circumstances.ResultsFour high-impact studies were reviewed, demonstrating significant advancements in systemic treatments for metastatic cancers commonly affecting the spine. These studies showed improved survival outcomes and efficacy across breast cancer, colorectal cancer, prostate cancer, and renal cell carcinoma. The findings have important implications for surgical/radiotherapy planning, including considerations for timing of interventions, wound healing, and the potential for extended survival affecting construct durability requirements.ConclusionsRecent advances in systemic oncological treatments have important implications for managing metastatic spinal disease. Understanding these developments is crucial for spine specialists to optimize decision-making through a multidisciplinary approach, particularly regarding timing of local interventions, strategy of the surgical approach and reconstruction.[Formula: see text].</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251324138"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735762","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":"Obstructive Sleep Apnea is Associated With Increased Rates of Acute Respiratory Failure, Length of Stay, and Hospital Costs in Patients Undergoing Elective Single-Level Anterior Cervical Discectomy and Fusion.","authors":"Paul G Mastrokostas, Mohamed Said, Christian Cassar, Leonidas E Mastrokostas, Aaron B Lavi, Arya Varthi, Jad Bou Monsef, Afshin E Razi, Mitchell K Ng","doi":"10.1177/21925682251333324","DOIUrl":"10.1177/21925682251333324","url":null,"abstract":"<p><p>Study designRetrospective cohort study.ObjectivesTo examine differences in postoperative complications, recovery course, and costs between patients with and without obstructive sleep apnea (OSA) undergoing single-level anterior cervical discectomy and fusion (ACDF).MethodsThe National Inpatient Sample (NIS) database was queried to identify patients undergoing single-level ACDF between 2016 and 2022. After exclusions, patients were divided into OSA and control groups. Propensity score matching (1:2) controlled for age, sex, obesity, and year of surgery to balance characteristics. Postoperative outcomes, including complications, length of stay (LOS), hospital costs, and discharge disposition, were compared using chi-square tests for categorical variables and t-tests for continuous variables. A Bonferroni correction was applied, with significance set at <i>P</i> < 0.002.ResultsA total of 36,000 matched cases were analyzed (12,000 OSA and 24,000 controls). OSA patients had significantly higher rates of acute respiratory failure (4.7% vs 1.9%; <i>P</i> < 0.001) and mechanical ventilation (1.5% vs 0.6%; <i>P</i> < 0.001). The OSA cohort also had a longer LOS (2.3 vs 1.9 days; <i>P</i> < 0.001), higher hospital costs ($23,300 vs $21,100; <i>P</i> < 0.001), and greater non-routine discharge rates (20.4% vs 16.8%; <i>P</i> < 0.001).ConclusionsOSA is associated with increased respiratory complications, prolonged LOS, and higher costs in single-level ACDF. These findings underscore the importance of preoperative screening and tailored perioperative management to improve outcomes in this high-risk population.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251333324"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735764","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":"21925682251332558"},"PeriodicalIF":2.6,"publicationDate":"2025-03-27","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}