Global Spine Journal最新文献

{"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}

{"title":"Letter to the Editor Regarding \"Testosterone Replacement Therapy in Posterior Lumbar Fusion Patients: A Propensity Score-matched Analysis of Long-Term Outcomes\".","authors":"Zhiwan Chen, Hongsheng Lin","doi":"10.1177/21925682261493095","DOIUrl":"10.1177/21925682261493095","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261493095"},"PeriodicalIF":3.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038143","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 \"Testosterone Replacement Therapy in Posterior Lumbar Fusion Patients: A Propensity Score-Matched Analysis of Long-Term Outcomes\".","authors":"Mark Miller, Blake Delgadillo, Matthew Meade, Hunter Smith, Omar Sbaih, Ruchir Nanavati, Nithin Gupta, William DiCiurcio, Charles Middleton, Shannon Fehr, Mitch Ng, Gregory Schroeder, Christopher Kepler, Barrett Woods","doi":"10.1177/21925682261493089","DOIUrl":"10.1177/21925682261493089","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261493089"},"PeriodicalIF":3.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038178","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 \"Nonoperative Management of the Adult Spinal Deformity Patient: A Biopsychosocial Intervention versus Care-as-usual - A Comparative Treatment-Based Cohort Study with One-Year Follow-Up\".","authors":"Evelien H W Hoevenaars, Michiel Beekhuizen, Ahmet Alanay, Yann Philippe Charles, Frank Kleinstueck, Ibrahim Obeid, John O'Dowd, Ferran Pellisé, Javier Pizones, Maarten Spruit, Marinus de Kleuver, Miranda L van Hooff","doi":"10.1177/21925682261492687","DOIUrl":"10.1177/21925682261492687","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492687"},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024587","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 \"Streamlining the MRI-Derived Vertebral Bone Quality Score for Preoperative Osteoporosis and Osteopenia Screening\".","authors":"Paul Köhli, Jennifer Shue, Marco D Burkhard, Alexander P Hughes","doi":"10.1177/21925682261492309","DOIUrl":"10.1177/21925682261492309","url":null,"abstract":"<p><p>We thank the authors for their thoughtful and constructive comments on our simplified MRI-derived vertebral bone quality score using L1/L2 measurements VBQ_L1/2. We agree with the authors that multicenter studies incorporating heterogeneous scanners and acquisition protocols are necessary before absolute VBQ cutoff values can be broadly applied. Our study was designed to assess whether VBQ measurement could be simplified from L1-4 to L1/L2 without compromising performance, rather than to establish a universal threshold. VBQ_L1/2 showed excellent agreement with VBQ_L1-4 and comparable discrimination for osteoporosis and impaired bone quality. We therefore consider VBQ an opportunistic pre-screening tool rather than a substitute for DXA or quantitative CT. Given the high burden of undiagnosed or untreated osteoporosis in lumbar fusion patients and the limitations of general-population screening criteria, spine-specific strategies may benefit from combining clinical risk factors with opportunistic imaging biomarkers. Ongoing work on inter-scanner reliability and automated MRI analysis may facilitate the larger multicenter validation studies required to validate or refute the clinical utility of VBQ.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492309"},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024671","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":"Comments on \"Nonoperative Management of the Adult Spinal Deformity Patient: A Biopsychosocial Intervention versus Care-as-usual - A Comparative Treatment-Based Cohort Study with One-Year Follow-Up\".","authors":"Fatih Kaplan, Bilge Kurnaz Kaplan","doi":"10.1177/21925682261492689","DOIUrl":"10.1177/21925682261492689","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492689"},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024652","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 Effect of Preoperative Sagittal Malalignment on Clinical Outcomes in Short-Segment Lumbar Interbody Fusion.","authors":"Yukitoshi Shimamura, Masahiro Kanayama, Fumihiro Oha, Michihaya Kono, Ryo Fujita, Shogo Fukase, Kohei Shiota, Tsutomu Endo, Tomoyuki Hashimoto, Norimasa Iwasaki","doi":"10.1177/21925682261492228","DOIUrl":"10.1177/21925682261492228","url":null,"abstract":"<p><p>Study Designretrospective case-control study.ObjectivesThe objective is to investigate how preoperative sagittal malalignment affects clinical outcomes in short-segment lumbar interbody fusion.MethodsA total of 684 patients who underwent short-segment lumbar interbody fusion were reviewed with a minimum follow-up of 2 years. According to the SRS-Schwab Adult Spinal Deformity Classification, preoperative sagittal malalignment was defined as a sagittal vertical axis (SVA) ≥ 95 mm or pelvic tilt (PT) ≥ 30 degrees or Pelvic incidence (PI) - Lumbar lordosis (LL) ≥ 20 degrees in this study. Patients were divided into a well-alignment group and a malalignment group. Spinopelvic parameters such as thoracic kyphosis (TK), LL, lower LL (LLL), sacral slope (SS), PT, PI, SVA, T1 pelvic angle (TPA), and segmental lordosis (SL), as well as Visual Analog Scale (VAS) of low back pain and leg pain, Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RDQ) were measured preoperatively and at the final follow-up.ResultsThe well-alignment group included 443 patients, and the malalignment group included 241 patients. In the malalignment group, PT, PI, SVA<u>, and TPA</u> were higher, whereas TK, LL, LLL, and SL were lower than in the well-alignment group. There were no significant differences between the groups regarding ΔVAS of low back pain, ΔVAS of leg pain, ΔODI, and ΔRDQ. The satisfaction rate was lower in the malalignment group.ConclusionThis study demonstrated that preoperative sagittal malalignment and spinopelvic parameters were not associated with clinical outcomes except for the satisfaction rate in short-segment lumbar interbody fusion.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492228"},"PeriodicalIF":3.1,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030428","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: When to Operate in Lumbar Disc Herniation.","authors":"Gianluca Vadalà, Luca Ambrosio, Xiaolong Chen, Juan P Cabrera, Hai V Le, Javad Tavakoli, Cristiano M Menezes, Sathish Muthu, Vadim Byvaltsev, Sven Y Vetter, Jason P Y Cheung, Waeel O Hamouda, Prashanth J Rao, Sonja Häckel, Stipe Ćorluka, Ahmet Karagöz, Josefin Åkerstedt, Amit Jain, Patrick Hsieh, Andreas K Demetriades, Ashish Diwan, Jin-Sung Kim, Vincenzo Denaro, Charles G Fisher, Sam K Cho","doi":"10.1177/21925682261492223","DOIUrl":"10.1177/21925682261492223","url":null,"abstract":"<p><p>Study DesignLiterature review with consensus clinical recommendations.ObjectiveTo review key studies on surgical vs. non-operative treatment for lumbar disc herniation (LDH) and present recommendations for how the practicing clinician should use this evidence.MethodsTwo randomized controlled trials (RCTs), two RCTs with concomitant observational cohorts, one prospective study, and one retrospective study were summarized, methodologically assessed, and assigned an expert clinical recommendation.ResultsKim et al. demonstrated that selected surgical candidates who prefer to avoid surgery can achieve similar long-term outcomes with non-surgical management, although with slower recovery. Lurie et al. demonstrated surgical superiority in as-treated analyses across pain and disability up to 8 years, but substantial crossover limited intention-to-treat findings. Peul et al. showed that early surgery versus prolonged conservative management yields equivalent 1-year outcomes, with the primary benefit of faster pain relief. Bailey et al. demonstrated that for persistent sciatica (4-12 months), microdiscectomy outperforms conservative care at 6 months. Petr et al. found that in the case of acute motor deficit, surgery within 48 hours yields faster neurological recovery. Thomé et al. identified 3 days as the critical cutoff for complete recovery in moderate-to-severe deficits, with 8 days applicable for mild deficits.ConclusionsThe evidence suggests that, for patients without motor deficits, symptom duration, severity, and patient preference should drive treatment selection, with increasing benefit of surgery as symptom duration grows. For patients with motor deficits, decompression within 3 days should be the goal for moderate-to-severe paresis to maximize the likelihood of complete neurological recovery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492223"},"PeriodicalIF":3.1,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016515","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":"Comment on: \"Development and Validation of a Computer-Assisted Screw Trajectory Planning Model Based on Iterative Closest Point Registration and Weighted K-Nearest Neighbors Algorithms for Cortical Bone and Pedicle Screw Techniques\".","authors":"Sharath Raj, Vijay Goni","doi":"10.1177/21925682261492298","DOIUrl":"10.1177/21925682261492298","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492298"},"PeriodicalIF":3.1,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016497","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 \"Development and Validation of a Computer-Assisted Screw Trajectory Planning Model Based on Iterative Closest Point Registration and Weighted K-Nearest Neighbors Algorithms for Cortical Bone and Pedicle Screw Techniques\".","authors":"Abudusalamu Tuoheti, Gufuding, Musitapa Mijiti, Jitao Yang, Hali Habulihan, Awuzhaer Abuliken, Yilixiati Mamuti, Paerhati Rexiti","doi":"10.1177/21925682261492286","DOIUrl":"10.1177/21925682261492286","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261492286"},"PeriodicalIF":3.1,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016432","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}