Global Spine Journal最新文献

{"title":"Impact of Surgical Resection Without Spinal Fusion for Thoracic Dumbbell Tumors on Postoperative Global Spinal Sagittal Alignment and Clinical Outcomes.","authors":"Toshiki Okubo, Narihito Nagoshi, Osahiko Tsuji, Masahiro Ozaki, Satoshi Suzuki, Yohei Takahashi, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1177/21925682231212724","DOIUrl":"10.1177/21925682231212724","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective comparative study.</p><p><strong>Objectives: </strong>This study investigated radiographical changes in global spinal sagittal alignment (GSSA) and clinical outcomes after tumor resection without spinal fusion in patients with thoracic dumbbell tumors.</p><p><strong>Methods: </strong>Thirty patients with thoracic dumbbell tumors who were followed up for at least 3 years were included in this study. Variations in the outcome variables were analyzed using individual GSSA parameters measured on radiography. Clinical outcomes were assessed using the modified McCormick scale (MMCS), Japan Orthopaedic Association (JOA) score, and visual analog scale (VAS). To assess the impact of the affected levels on these outcomes, we divided the patients into three groups according to the location of the tumor (upper [T1-4], middle [T5-8], or lower [T9-12] thoracic spine).</p><p><strong>Results: </strong>The GSSA parameters (cervical lordosis, T1 slope, thoracic kyphosis [global, upper, middle, and lower], thoracolumbar kyphosis, lumbar lordosis, sacral slope, pelvic incidence, and pelvic tilt) of all the patients did not change significantly after surgery. Eleven of thirty patients had preoperative gait disturbances but they could walk without support (MMCS grade I or II) at the final follow-up. The JOA score and VAS showed significant postoperative improvements. No statistically significant differences were observed in each postoperative sagittal profile or clinical outcome between the upper, middle, and lower groups.</p><p><strong>Conclusions: </strong>Tumor resection without spinal fusion did not affect the various GSSA parameters and resulted in satisfactory clinical outcomes, indicating that spinal fusion may not always be necessary when resecting thoracic dumbbell tumors.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"790-799"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411924","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":"Predicting Progression in Adolescent Idiopathic Scoliosis at the First Visit by Integrating 2D Imaging and 1D Clinical Information.","authors":"Kenneth Chu, Xihe Kuang, Prudence W H Cheung, Sofia Li, Teng Zhang, Jason Pui Yin Cheung","doi":"10.1177/21925682231211273","DOIUrl":"10.1177/21925682231211273","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Objectives: </strong>The prediction of curve progression in patients with adolescent idiopathic scoliosis (AIS) remains an unresolved area in orthopedic surgery. To make a rapid meaningful prediction, easily accessible multi-dimensional data at the patient's first consultation should be used. Current studies use clinical growth parameters and numerical values extracted from radiographs to compile a predictive model, leaving out the radiographs themselves. Such practice inevitably wastes a lot of information. Thus, this study aims to create a neural network that can predict AIS progression among patients with curves indicated for bracing by integrating both one-dimensional (1D) clinical and two-dimensional (2D) radiological data collected at the patient's first visit in a fully automated manner.</p><p><strong>Methods: </strong>513 idiopathic scoliosis patients indicated for and managed with bracing orthosis were recruited. After exclusion, 463 patients were included in deep learning analysis. Processed first-visit growth parameters and posteroanterior radiographs are used as training inputs and the curve progression outcomes obtained in follow ups are used as binary training outputs. The CapsuleNet architecture was modified and trained accordingly to make a prediction.</p><p><strong>Results: </strong>The final model achieved 90% sensitivity with an overall accuracy of 73.9% in the prediction of AIS in-brace curve progression by using first-visit multi-dimensional data, outperforming conventional convolutional neural networks.</p><p><strong>Conclusions: </strong>This first-ever multidimensional-input model shows promise in serving as a screening tool for AIS in-brace curve progression. The incorporation of such a model into routine AIS diagnostic pipeline can assist orthopedics clinicians in personalizing the most appropriate management for each patient.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"770-781"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411925","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":"An Automatized Deep Segmentation and Classification Model for Lumbar Disk Degeneration and Clarification of Its Impact on Clinical Decisions.","authors":"Zafer Soydan, Emru Bayramoglu, Recep Karasu, Irem Sayin, Serkan Salturk, Huseyin Uvet","doi":"10.1177/21925682231200783","DOIUrl":"10.1177/21925682231200783","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional database study.</p><p><strong>Objective: </strong>The purpose of this study was to develop a successful, reproducible, and reliable convolutional neural network (CNN) model capable of segmentation and classification for grading intervertebral disc degeneration (IVDD), as well as quantify the network's impact on doctors' clinical decision-making.</p><p><strong>Methods: </strong>5685 discs from 1137 patients were graded separately by four experienced doctors according to the Pfirrmann classification. A ground truth (GT) was established for each disc in accordance with the decision of the majority of doctors. The U-net model is used for segmentation. 1815 discs from 363 patients were used to train and test the U-net. The Inception V3 model is employed for classification. All discs were separated into two distinct sets: 90% in a training set and 10% in a test set. The performance metrics of these models were measured. Reliability tests were performed. The impact of CNN assistance on doctors was assessed.</p><p><strong>Results: </strong>Segmentation accuracy was .9597 with a .8717 Jaccard Index and a .9314 Sorensen Dice coefficient. Classification accuracy is .9346, and the F1 score is .9355. The intraclass correlation coefficient (ICC) and kappa values between CNN and GT were .95-.97. With CNN's assistance, the success rates of doctors increased by 7.9% to 22%.</p><p><strong>Conclusions: </strong>The fully automated network outperformed doctors markedly in terms of accuracy and reliability. The results of CNN were comparable to those of other recent studies in the literature. It was determined that CNN's assistance had a substantial positive effect on the doctor's decision.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"554-563"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10216601","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 Thoracolumbar Inflection Point in a Population of Asymptomatic Volunteers: A Multi-Ethnic Alignment Normative Study Cohort Study.","authors":"Matan Malka, Zeeshan M Sardar, Natalia Czerwonka, Josephine R Coury, Justin L Reyes, Jean-Charles Le Huec, Stephane Bourret, Kazuhiro Hasegawa, Hee-Kit Wong, Gabriel Liu, Hwee Weng Dennis Hey, Hend Riahi, Michael Kelly, Lawrence G Lenke","doi":"10.1177/21925682231193619","DOIUrl":"10.1177/21925682231193619","url":null,"abstract":"<p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Objectives: </strong>To show population variance in the Inflection Point (IP) and its role in defining maximum Thoracic Kyphosis (TK) and Lumbar Lordosis (LL).</p><p><strong>Methods: </strong>468 asymptomatic adult volunteers were included in the Multi-Ethnic Normative Alignment Study (MEANS). To find parameters correlating with IP, the vertebrae and discs were numbered such that C7 was 0, T1 was 1, with T1-T2 disc being 1.5, etc. Statistical analysis was performed by a correlation matrix for IP and the 9 other selected parameters along with linear regressions.</p><p><strong>Results: </strong>The overall mean IP was 12.44 approximately corresponding to T12-L1 disc with the median being 12.50, range was T8-L4. The cohort was then stratified by sex and ethnicity, but there was no significant difference in IP between groups. IP in younger subjects was 13 (L1), compared to 12.5 (T12-L1 disc) in older subjects (<i>P</i> < .05). IP was moderately correlated with the TK apex (r = .66). No strong correlation was found between IP and LL magnitude or apex, TK magnitude, sacral slope, or Pelvic Incidence (PI). In terms of other sagittal parameters, PI and LL demonstrated a significant positive correlation. PI and TK did not have a strong association.</p><p><strong>Conclusions: </strong>The mean IP was at the T12-L1 disc, however IP ranged from T8 to L4. Older subjects tended to have a relatively more cephalad IP. No radiographic variable was found to be a strong predictor of the IP. TK apex was found to have a moderate correlation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"438-444"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10302434","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":"Why Didn't You Walk Yesterday? Factors Associated With Slow Early Recovery After Adult Spinal Deformity Surgery.","authors":"Gregory S Kazarian, Francis Lovecchio, Robert Merrill, John Clohisy, Bo Zhang, Jerry Du, Yusef Jordan, Anthony Pajak, Rachel Knopp, David Kim, Justin Samuel, Jonathan Elysee, Izzet Akosman, Pratyush Shahi, Mitchell Johnson, Frank J Schwab, Virginie Lafage, Han Jo Kim","doi":"10.1177/21925682231197976","DOIUrl":"10.1177/21925682231197976","url":null,"abstract":"<p><strong>Study design: </strong>This is a retrospective case-control study.</p><p><strong>Objectives: </strong>The objectives of this study are to identify (1) risk factors for delayed ambulation following adult spinal deformity (ASD) surgery and (2) complications associated with delayed ambulation.</p><p><strong>Methods: </strong>One-hundred and ninety-one patients with ASD who underwent posterior-only fusion (≥5 levels, LIV pelvis) were reviewed. Patients who ambulated with physical therapy (PT) on POD2 or later (LateAmb, n = 49) were propensity matched 1:1 to patients who ambulated on POD0-1 (NmlAmb, n = 49) based on the extent of fusion and surgical invasiveness score (ASD-S). Risk factors, as well as inpatient medical complications were compared. Logistic regressions were used to identify risk factors for late ambulation.</p><p><strong>Results: </strong>Of the patients who did not ambulate on POD0-1, 32% declined participation secondary to pain or dizziness/fatigue, while 68% were restricted from participation by PT/nursing due to fatigue, inability to follow commands, nausea/dizziness, pain, or hypotension. Logistic regression showed that intraoperative estimated blood loss (EBL) >2L (OR = 5.57 [1.51-20.55], <i>P</i> = .010) was independently associated with an increased risk of delayed ambulation, with a 1.25 times higher risk for every 250 mL increase in EBL (<i>P</i> = .014). Modified 5-Item Frailty Index (mFI-5) was also independently associated with delayed ambulation (OR = 2.53 [1.14-5.63], <i>P</i> = .023). LateAmb demonstrated a higher hospital LOS (8.4 ± 4.0 vs 6.2 ± 2.6, <i>P</i> < .001). The LateAmb group trended toward an increase in medical complications on POD3+ (14.3% vs 26.5%, <i>P</i> = .210).</p><p><strong>Conclusions: </strong>EBL demonstrates a dose-response relationship with risk for delayed ambulation. Delayed ambulation increases LOS and may impact medical complications.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"534-539"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435089","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":"Long-Term Results of Minimally Invasive Transforaminal Lumbar Interbody Fusion in Elderly Patients: A 5-Year Follow-Up Study.","authors":"Graham S Goh, Adriel You Wei Tay, Gerald J Zeng, Reuben Chee Cheong Soh","doi":"10.1177/21925682231214067","DOIUrl":"10.1177/21925682231214067","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective review of prospective data.</p><p><strong>Objectives: </strong>Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) may be beneficial for elderly patients due to decreased surgical morbidity and faster postoperative recovery. This study compared the clinical and radiological outcomes of MIS-TLIF in elderly patients and younger controls at minimum 5-year follow-up.</p><p><strong>Methods: </strong>There were 120 patients who underwent single-level MIS-TLIF for degenerative spondylolisthesis. Elderly patients (≥70 years; n = 30) and controls (<70 years; n = 90) were matched 1:3 for demographics, comorbidities and preoperative patient-reported outcomes (PROs). The Oswestry Disability Index (ODI), 36-Item Short-Form Physical (SF-36 PCS) and Mental Component Summary (SF-36 MCS), Visual Analogue Scale (VAS) back pain, and VAS leg pain were compared at 6 months, 2 years and 5 years. Radiographic fusion, adjacent segment degeneration (ASD) and revision rates were assessed at mean 7.2 ± 2.0 years.</p><p><strong>Results: </strong>Elderly patients had longer length of stay (4.7 ± 5.8 vs 3.3 ± 1.4 days, <i>P</i> = .035) and more readmissions (10% vs 1%, <i>P</i> = .019), but there was no difference in operative time, transfusions, complications or discharge disposition. All PROs were comparable at 5 years and satisfaction rates were similar (93% elderly vs 91% controls, <i>P</i> = .703). The rates of radiographic fusion in the control group and elderly group were similar (94% vs 97%, <i>P</i> = .605), as were the rates of ASD (40% vs 33%, <i>P</i> = .503). There were 3 revisions (3.3%) in the control group (2 for ASD, 1 for screw loosening) but none in the elderly group (<i>P</i> = .311).</p><p><strong>Conclusions: </strong>Elderly patients undergoing MIS-TLIF achieved similar improvements in pain, disability and quality of life that were sustained at 5 years.<b>Level of Evidence:</b> Level III, retrospective cohort study.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"838-845"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71521157","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":"Comprehensive Assessment of Indirect Decompression Through Lateral Lumbar Interbody Fusion for Degenerative Lumbar Spinal Stenosis: A Japanese Orthopedic Association Back Pain Evaluation Questionnaire-Based Analysis.","authors":"Akihiko Hiyama, Daisuke Sakai, Hiroyuki Katoh, Masato Sato, Masahiko Watanabe","doi":"10.1177/21925682231204254","DOIUrl":"10.1177/21925682231204254","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objective: </strong>This study aimed to comprehensively evaluate the clinical outcomes of lateral lumbar interbody fusion (LLIF) as an indirect decompression technique for degenerative spondylolisthesis (DS) and concomitant degenerative lumbar spinal stenosis (DLSS) patients. We utilized the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) to assess treatment success and its impact on patient's quality of life (QOL).</p><p><strong>Methods: </strong>We included 124 patients who underwent LLIF. Pre- and postoperative JOABPEQ evaluations indicated treatment success. Subgroup analysis categorized patients' perceptions of surgery as beneficial or non-beneficial.</p><p><strong>Results: </strong>89% of patients (110/124) reported satisfaction with LLIF. Lateral lumbar interbody fusion achieved successful indirect decompression, increasing canal diameter and central canal area. Significant improvements occurred across all JOABPEQ domains, notably for low back pain, lumbar function, walking ability, social life function, and mental health. Patients who perceived the surgery as beneficial experienced fewer postoperative complications, lower numeric rating scale scores for pain relief, and greater functional outcome improvements compared to non-beneficial patients.</p><p><strong>Conclusions: </strong>Our findings highlight the utility of JOABPEQ as a valuable and sensitive tool for assessing treatment effectiveness and patient-reported outcomes in DS and concomitant DLSS patients. Patients undergoing LLIF. The results affirm the favorable outcomes of LLIF as a surgical option for DLSS patients and emphasize the importance of considering patient perspectives when evaluating overall treatment success. The study provides valuable insights into the impact of indirect decompression on patients' QOL, supporting the effectiveness of LLIF as a minimally invasive technique for DLSS and DS management.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"656-667"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41124870","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":"Preoperative Disability Influences Effectiveness of Minimal Clinically Important Difference and Patient Acceptable Symptom State in Predicting Patient Improvement Following Cervical Spine Surgery.","authors":"Pratyush Shahi, Omri Maayan, Tejas Subramanian, Nishtha Singh, Sumedha Singh, Kasra Araghi, Olivia Tuma, Tomoyuki Asada, Maximilian Korsun, Evan Sheha, James Dowdell, Sheeraz A Qureshi, Sravisht Iyer","doi":"10.1177/21925682231215765","DOIUrl":"10.1177/21925682231215765","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>To compare the characteristics of the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) metrics when interpreting Neck Disability Index (NDI) following cervical spine surgery.</p><p><strong>Methods: </strong>Patients who underwent primary cervical fusion, discectomy, or laminectomy were included. NDI and global rating change (GRC) data at 6 months/1 year/2 years were analyzed. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MCID and PASS in predicting improvement on GRC were calculated for the overall cohort and separately for patients with minimal (NDI <30), moderate (NDI 30 - 49), and severe (NDI ≥ 50) preoperative disability. Two groups with patients who achieved PASS but not MCID and patients who achieved MCID but not PASS were analyzed.</p><p><strong>Results: </strong>141 patients (206 responses) were included. PASS had significantly greater sensitivity for the overall cohort (85% vs 73% with MCID, <i>P</i> = .02) and patients with minimal disability (96% vs 53% with MCID, <i>P</i> < .001). MCID had greater sensitivity for patients with severe disability (78% vs 57% with PASS, <i>P</i> = .05). Sensitivity was not significantly different for PASS and MCID in patients with moderate preoperative disability (83% vs 92%, <i>P</i> = .1). 17% of patients achieved PASS but not MCID and 9% of patients achieved MCID but not PASS. Most of these patients still reported improvement with no significant difference between the 2 groups (89% vs 72%, <i>P</i> = .13).</p><p><strong>Conclusion: </strong>PASS and MCID are better metrics for patients with minimal and severe preoperative disability, respectively. Both metrics are equally effective for patients with moderate preoperative disability.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"884-890"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176070","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":"Prevalence and Characteristics of Lumbar Spondylolysis in White and Black Patients.","authors":"Hiroyuki Yoshihara, Winston Yen, Evan Horowitz, Vidushan Nadarajah","doi":"10.1177/21925682231216107","DOIUrl":"10.1177/21925682231216107","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Objective: </strong>To the best of our knowledge, the prevalence of lumbar spondylolysis in white and black populations has never been studied using computed tomography (CT). The purpose of this study was to examine and compare the prevalence and characteristics of lumbar spondylolysis in white and black patients.</p><p><strong>Methods: </strong>This study is a cross sectional study. Patients aged 20-79 who underwent abdominal and pelvic CT for trauma screening in the New York City area and whose race was classified as \"white\" and \"black\" on the questionnaire were recruited to the study. A total of 1200 white patients (600 women, 600 men) and 1200 black patients (600 women, 600 men) were included for the analysis. The presence of lumbar spondylolysis, level, unilateral/bilateral, and the presence of spondylolisthesis at lumbar spondylolysis level were evaluated using CT.</p><p><strong>Results: </strong>The prevalence of lumbar spondylolysis was 3.0% (n = 36) for white patients and .8% (n = 10) for black patients, with 3.3% (n = 20) and 1.0% (n = 6) for white and black females, respectively; and 2.7% (n = 16) and .7% (n = 4) for white and black males, respectively. The prevalence of lumbar spondylolysis was significantly higher in white patients compared with that in black patients (<i>P</i> < .0001). Lumbar spondylolysis was at L5 in 44/46 patients (95.7%) and bilateral in 41/46 patients (89.1%). Spondylolisthesis at lumbar spondylolysis level was found in 40/46 patients (87.0%).</p><p><strong>Conclusions: </strong>The prevalence of lumbar spondylolysis was 3.0% for white patients and .8% for black patients. The prevalence of lumbar spondylolysis was significantly higher in white patients compared with that in black patients.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"916-920"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138290774","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":"An Update in Complication Rates Associated With Anterior Lumbar Surgery: A Systematic Review and Meta-Analysis.","authors":"Tariq Z Issa, Teeto Ezeonu, Mason Sellig, Chester J Donnally, Rajkishen Narayanan, Brian A Karamian, Parthik D Patel, Srikanth N Divi, William A Robinson, Kartik Shenoy, Christopher K Kepler, Alexander R Vaccaro, Jose A Canseco","doi":"10.1177/21925682241279526","DOIUrl":"10.1177/21925682241279526","url":null,"abstract":"<p><strong>Study design: </strong>Systematic Review and meta-analysis.</p><p><strong>Objective: </strong>To conduct an updated systematic review and meta-analysis of complications associated with different anterior fusion techniques/approaches and adjuvant resources (i.e., computed tomography angiography (CTA), rhBMP-2, and access surgeons).</p><p><strong>Methods: </strong>A systematic review was conducted from 1/1/2014-4/1/2024 for studies evaluating the incidence of complications associated with anterior lumbar procedures. Comparisons of complications were made between surgical approach, use of CTA, rhBMP-2, and access surgeons. Meta-analyses were conducted using a generalized linear mixed model.</p><p><strong>Results: </strong>54 studies were included in the final analysis with 8066 patients and an average follow-up of 31.2 months. The overall complication rate associated with anterior lumbar surgery was 13.1%, including an intraoperative complication rate of 3.8%, postoperative complication rate of 7.4%, infection rate of 1.5%, and reoperation rate of 1.7%. Forest plot analysis showed no significant difference in overall complication rates between open and mini-open techniques, although mini-open techniques were associated with lower overall reoperation rates. The use of CTA was associated with an increase in intraoperative and overall complications, and the use of an access surgeon was associated with a decreased risk of reoperation. The use of rhBMP-2 was not associated with overall complication risk.</p><p><strong>Conclusions: </strong>While anterior lumbar surgery provides numerous benefits, surgeons and patients alike should be aware of the complication and safety profile prior to surgery. High quality studies are warranted to help elucidate the true benefit of certain techniques and adjuvant resources in reducing complications.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"1419-1434"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092725","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}