Global Spine Journal最新文献

{"title":"Role of Surgeon Demographic Factors in the Management of L4-5 Grade I Spondylolisthesis: A Survey by the AO Spine Knowledge Forum Degenerative.","authors":"Sathish Muthu, Samuel K Simister, Hania Shahzad, Hai Van Le, Luca Ambrosio, Stipe Corluka, Gianluca Vadala, Patrick C Hsieh, Michael Virk, Tim Yoon, Samuel K Cho, Ao Spine Knowledge Forum Degenerative","doi":"10.1177/21925682251324469","DOIUrl":"10.1177/21925682251324469","url":null,"abstract":"<p><p>Study DesignCross-sectional survey.ObjectiveWe explore the demographic factors amongst surgeons responsible for decision-making in the management of Grade I L4-5 degenerative lumbar spondylolisthesis(DLS).MethodsA survey presenting three clinical scenarios of DLS with varying degrees of neurological compression and instability was distributed to the AOSpine members globally to ascertain surgical management preferences. Management options such as decompression only or decompression and fusion and the techniques that would be employed were presented to the responders.ResultsAfter dissemination, 479 surgeons responded to the survey. Direct decompression was preferred for all three scenarios with and without neurologic deficits(82.5, 81.2, and 56.8%), with the majority favoring open procedures over minimally invasive or endoscopic procedures. Notably, younger, less experienced, and fellowship-trained surgeons showed a higher inclination toward minimally invasive and indirect decompression methods. A strong preference for surgical fusion over decompression(75.2, 92.5 and 86.6%, respectively) was also significantly observed, reflecting a general consensus on the need to achieve segmental stability.ConclusionThe results of this study demonstrate a pronounced preference for direct decompression and fusion among a group of global surgeons when treating L4-5 Grade I DLS across all demographics. This indicates a consensus on achieving decompression and stability; however, there are some trends indicating the impact of surgical management based on age, experience, and training of the treating providers. These findings suggest an evolution of surgical interventions toward less invasive techniques, particularly among younger surgeons, highlighting the need for global education to adopt innovative approaches in the management of DLS.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251324469"},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656909","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":"Artificial Intelligence in Spinal Cord Injury Management: Comment.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1177/21925682251328679","DOIUrl":"10.1177/21925682251328679","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251328679"},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648300","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 Association Between Preoperative Cannabis Use and Anxiety, Pain Scores and Opioid Consumption in Patients Undergoing Spinal Fusion: A Retrospective Cohort Study.","authors":"Krizia Amoroso, Erika Chiapparelli, Jiaqi Zhu, Ali E Guven, Jennifer Shue, Andrew A Sama, Federico P Girardi, Frank P Cammisa, Alexander P Hughes, Ellen M Soffin","doi":"10.1177/21925682251327986","DOIUrl":"10.1177/21925682251327986","url":null,"abstract":"<p><p>Study DesignRetrospective cohort study.ObjectiveDespite increasing cannabis use, its prevalence in specific surgical groups is unclear, and its impact on perioperative care and outcomes is understudied. This study estimates cannabis use incidence in patients undergoing lumbar spine surgery and explores associations between preoperative use and anxiety, pain scores, and postoperative opioid consumption. We hypothesized a correlation between cannabis use and decreased reliance on opioids for postoperative pain relief.MethodsThis single-center retrospective cohort study included 204 patients undergoing single or multilevel spinal fusion surgery between July 2022 and August 2023. Self-reported cannabis use, demographics, surgical characteristics, numeric rating scale (NRS) pain scores, anxiety, inpatient opioid consumption, and discharge prescribing (total morphine equivalent dose) were extracted from electronic medical records (EMR). Patients were categorized into cannabis users or non-cannabis users, and group differences were analyzed using bivariable and multivariable regression.ResultsOf 204 patients, 27 (13.2%) were cannabis users and 177 (86.8%) were non-users. Cannabis users were younger (<i>P</i> = 0.007), more likely male (<i>P</i> = 0.028), and Caucasian (<i>P</i> = 0.032) than non-users. Preoperative cannabis use correlated significantly with anxiety disorder (<i>P</i> = 0.023) and higher preoperative (<i>P</i> = 0.016) and postoperative (<i>P</i> = 0.002) NRS pain scores. Multivariable analysis showed cannabis use associated with higher preoperative (<i>P</i> = 0.015) but not postoperative (<i>P</i> = 0.073) pain scores. No significant differences were found in preoperative, discharge opioid prescribing or postoperative opioid consumption.ConclusionThe incidence of cannabis use was low, but positively associated with anxiety and higher preoperative NRS pain scores. Large, well-powered trials are needed to understand cannabis's impact on spine surgery outcomes.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251327986"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633937","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":"MRI-Based Cervical VBQ Scores as Predictors of Cage Subsidence in Cervical Spine Surgery: A Meta-Analysis.","authors":"Song Wang, Hao Yang, Honglin Liao, Ping He, Xiang Zhang, Hao Liu, Bo Qu, Hongsheng Yang","doi":"10.1177/21925682251327381","DOIUrl":"10.1177/21925682251327381","url":null,"abstract":"<p><p>Study DesignSystematic review and meta-analysis.ObjectivePoor bone quality is a major risk factor for complications after cervical spine surgery. The MRI-based cervical vertebral bone quality (C-VBQ) score is a reliable tool for assessing bone quality. This study systematically evaluates, for the first time, the predictive value of C-VBQ for cage subsidence risk in cervical spine surgery patients using meta-analysis.MethodsWe conducted a comprehensive search of relevant literature in electronic databases up to October 16, 2024, to systematically assess the quality of included studies. Publication bias was evaluated by comparing C-VBQ between groups and calculating pooled sensitivity, specificity, and summary receiver operating characteristic (SROC) curves.Results7 studies involving 681 patients were included. Using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, the studies were deemed high quality with low risk of bias. High C-VBQ scores were significantly associated with fusion subsidence, with a pooled odds ratio of 2.98 (95% CI: 1.68-5.30). The C-VBQ cut-off value was 2.94 ± 0.32, and the combined sensitivity and specificity for diagnosing postoperative complications were 0.78 and 0.87, respectively, with an area under the curve of 0.90 (95% CI: 0.87-0.92).ConclusionIn patients undergoing degenerative cervical spine surgery, higher C-VBQ scores were significantly associated with an increased risk of cage subsidence. The C-VBQ score is a reliable tool for preoperative bone quality assessment and serves as an independent predictor of cage subsidence risk following cervical spine surgery.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251327381"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633933","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 \"20-minute Rule\" in Lateral Lumbar Interbody Fusion. Fact or Fiction? A Multi-Center Analysis of 658 Patients.","authors":"Ashish Patel, Michael R McDermott, Gregory M Mundis, Robert K Eastlack, Aaron J Buckland, Cristiano M Menezes, Matthew L Miller, Chester J Tyson, Alfred-John Bayaton, J Alex Thomas","doi":"10.1177/21925682251321490","DOIUrl":"10.1177/21925682251321490","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectiveLateral lumbar interbody fusion (LLIF) is a treatment option for correcting lumbar degenerative pathologies that uses a retroperitoneal, transpsoas corridor to the disc space. Conventional teaching of the LLIF technique has been to perform the procedure 'as efficiently as possible', with a goal of keeping the total retractor time to less than 20 minutes to prevent injuries. This study aims to examine the sensitivity of the \"20-minute\" rule for predicting postoperative femoral nerve palsy.MethodsA multicenter, retrospective cohort of patients who underwent an LLIF was established. Retractor time was recorded and compared to postoperative motor exams for its relationship to motor injury.Results658 total patients were included in the study. The most frequently operated level was L4-5 (71.7%). The average retractor time was 17.5 ± 8.0 minutes. The injury rate of the cohort was 1.8% (12/658). There was no difference in average retractor time for non-injured vs injured patients (17.5 ± 8.0 min vs 19.6 ± 11.2 min, <i>P</i> = 0.367). Analysis of the \"20-minute\" rule for LLIF revealed a sensitivity of 50%, a specificity of 73.8%, and a positive predictive value of 3.4%. There were 174 patients with retractor times >20 minutes and six injuries, yielding a false positive rate of 96.6%.ConclusionPost-operative quadriceps motor palsy after lateral lumbar interbody fusion does not appear to be caused by prolonged retractor time greater than 20 minutes. The authors recommend surgical efficiency without the need to rush through the procedure because the \"20-Minute\" threshold is approaching. Limiting retractor time to under 20 minutes was a poor predictor of post-operative quadriceps injury.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251321490"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633935","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":"Association Between Traumatic Spinal Cord Injury and Psychiatric Disorders, Mental Illness and Dementia: A Systematic Review and Meta-Analysis.","authors":"Li Li, Tiantian Wang, Huimin Du, Yuantong Zang","doi":"10.1177/21925682241307597","DOIUrl":"10.1177/21925682241307597","url":null,"abstract":"<p><p>Study DesignSystematic review and meta-analysis.ObjectivesMeta-analysis was used to evaluate the association between traumatic spinal cord injury and mental disorders, psychological disorders, and dementia onset, and to provide a scientific basis for the prevention of traumatic spinal cord injury.MethodsA computerized search of English databases such as PubMed, Web of Science, Embase, and other English databases for retrospective studies on the associations between traumatic spinal cord injury and psychiatric disorders, mental illnesses, and dementia was carried out within a timeframe of from the creation of the databases to 7 April 2024, and two researchers independently carried out the screening of the literature, extracted and collated the baseline and endpoint indicators, and assessed the quality of the literature, before conducting meta-analysis by using the Stata 15.1 software for meta-analysis.ResultsEleven papers were included, and meta-analysis showed that patients with traumatic spinal cord injury were at significantly higher risk of anxiety, depression, psychosis, dementia, insomnia, adjustment disorders, mood disorders, personality disorders, alcohol-related disorders, substance-use disorders, adjustment reactions, drug dependence, and central pain relative to patients with nontraumatic spinal cord injury (<i>P</i> < 0.05); there was no significant correlation between traumatic spinal cord injury and PTSD.ConclusionsTraumatic spinal cord injury may increase the risk of developing anxiety, depression, psychiatric disorders, and dementia; with national regional differences in the risk of developing anxiety. Clinical staff should be alert to the possibility of co-existence of psychiatric disorders, psychological disorders and dementia when diagnosing patients with traumatic spinal cord injury.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682241307597"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633916","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 Sagittal Parameters Can Guide the Indications for Anterior Release in Thoracic AIS ≥70°.","authors":"Taylor J Jackson, Carrie E Bartley, Tracey P Bryan, Michael P Kelly, Suken A Shah, Stefan Parent, Firoz Miyanji, Peter O Newton","doi":"10.1177/21925682251325833","DOIUrl":"10.1177/21925682251325833","url":null,"abstract":"<p><p>Study DesignRetrospective, multicenter.ObjectivesThis study aims to evaluate the immediate postoperative effect of, and define indications for, an anterior release (discectomy) in large AIS curves utilizing 3D deformity analysis.MethodsA multicenter registry was queried for AIS patients with main thoracic curves ≥70° treated with either anterior/posterior (AP) or posterior-only surgery and biplanar stereoradiographic pre-operative and first-erect (FE) postoperative images. Standard 2D radiographic and 3D parameters were analyzed using custom MATLAB software. 3D thoracic kyphosis (3DTK) was calculated by removing the error induced by axial rotation and coronal deformity.Results109 patients were included, 21 AP and 88 posterior-only. The AP group had larger (89° vs 76°, <i>P</i> < .001), less flexible (9% vs 21%, <i>P</i> = .001) curves, though greater percent correction (79% vs 71%, <i>P</i> = .003), producing similar postoperative curve magnitude (19° vs 22°, <i>P</i> = 0.1). The AP group had less preoperative 3DTK (-15° vs -3°, <i>P</i> < .001), though similar postoperative 3DTK (24° vs 20°, <i>P</i> = .1), nearly double the improvement (39° vs 23°, <i>P</i> < .001). No cases with preoperative 3DTK < -18° achieved postoperative 3DTK >25° without anterior release. Segmental data of each motion segment demonstrated anterior release led to greater change in the coronal (<i>P</i> < .001) and sagittal (<i>P</i> = .003) planes, though not axial rotation of the apical vertebra (<i>P</i> = .157).ConclusionIn a cohort of AIS patients with thoracic curve magnitude >70°, 3D analysis comparing anterior/posterior vs posterior-only approach demonstrated improved correction in the coronal and sagittal, but not the axial plane. If 3DTK preop was <-18° only anterior release patients achieved postoperative 3DTK >25°.Level of EvidenceIII.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251325833"},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624380","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":"A Controlled Single-Centre Pilot Study to Evaluate the Effect of Prophylactic Surgery in Asymptomatic Degenerative Cervical Cord Compression.","authors":"Zdenek Kadanka, Martin Nemec, Richard Chaloupka, Ludek Ryba, Karel Maca, Dusan Matejicka, Tomas Rohan, Milos Kerkovsky, Tomas Horak, Magda Horakova, Eva Vlckova, Josef Bednarik","doi":"10.1177/21925682251323862","DOIUrl":"10.1177/21925682251323862","url":null,"abstract":"<p><p>Study DesignSingle-centre controlled pilot study.ObjectivesTo evaluate the effect of prophylactic surgery and to review the biases of a therapeutic trial in asymptomatic degenerative cervical cord compression (ADCC) patients.MethodsPatients with ADCC and at least 1 predictor of progression to symptomatic degenerative cervical cord myelopathy (DCM) were offered either prophylactic surgery or standard structured rehabilitation. Recruited patients were clinically followed to detect the development of symptomatic DCM.ResultsForty-one patients treated surgically and 68 patients treated non-surgically completed the minimum 36 months' follow-up; 3 recruited patients were lost from evaluation. The surgical group had a higher Neck Disability Index score and more severe MRI compression. A matched subgroup of 41 non-surgical patients was created to reduce potential bias. During the follow-up period we observed progression to symptomatic DCM in 1 surgical case (2.4%) compared to 9 patients in the non-surgical group (13.2%, <i>P</i> = 0.054) and 7 cases in the matched non-surgical group (17.1%, <i>P</i> = 0.029). We observed non-serious early postoperative complications in 4 patients, which resolved spontaneously or after surgical revision. In 9 patients with progression to DCM, the myelopathy was mild with mJOA scale 15-17. One patient in the non-surgical group and 1 patient in the surgical group who progressed to DCM underwent surgery with a good outcome.ConclusionsProphylactic surgery led to a significant decrease in proportion of ADCC patients with progression to DCM. The results justify the organisation of a large randomized multicentre trial that may demonstrate the benefit of prophylactic surgery in ADCC patients.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251323862"},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623704","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":"\"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":"Cristian Arvinte","doi":"10.1177/21925682251326931","DOIUrl":"10.1177/21925682251326931","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251326931"},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624379","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: 'The Safety of Spinal Surgery in Patients Over 80 Years of Age: Propensity Score Matching Study' by Bang C et al.","authors":"Yabin Liu, Xiaohua Jiang, Xicun Han, Guowu Chen","doi":"10.1177/21925682251327367","DOIUrl":"10.1177/21925682251327367","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251327367"},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623736","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}