Global Spine Journal最新文献

{"title":"Neurological Complications Following Anterior Lumbar Interbody Fusion (ALIF): A Systematic Review.","authors":"Takeshi Fujii, Rakesh Kumar, Jihun Cha, Aiyush Bansal, Rafael Garcia de Oliveira, Philip K Louie, Venu M Nemani, Jean-Christophe Leveque, Rajiv K Sethi","doi":"10.1177/21925682251349173","DOIUrl":"10.1177/21925682251349173","url":null,"abstract":"<p><p>Study DesignSystematic review.ObjectiveTo investigate the incidence and risk factors of neurological complications following anterior lumbar interbody fusion (ALIF) for minimizing their occurrence.MethodsA comprehensive literature search was conducted to identify articles reporting neurological complications following an ALIF. Studies evaluating outcomes following a lateral antepsoas or transpsoas approach, abstracts without full text available, and non-English manuscripts were excluded. For outcome measures, we collected information on the type of neurological complications and their incidence.ResultsA total of 16 articles met the final inclusion criteria. The overall rate of neurological complications following an ALIF ranged from 4.1% to 7.7%, While the rates of nerve root injury/lumbar plexus injury in patients undergoing surgery for degenerative pathology were less than 4%, the rates were notably higher in patients undergoing an ALIF at L5-S1 and those with spinal deformity (up to 38.4%). The risk for retrograde ejaculation (RE, due to sympathetic nerve injury) was 0.1-3.2% with a retroperitoneal approach. Reported risk factors for neurological complications included the subluxation of the superior articular facet and excessive traction by the ALIF interbody for nerve root injury, transperitoneal approach, aggressive traction on the plexus, electrocautery use, and the application of recombinant human bone morphogenetic protein. However, technical pearls to avoid neurological complications remain controversial.ConclusionsSeveral neurologic complications have been reported following ALIF procedures across various pathologies. To mitigate the neurological complications following ALIF, careful preoperative surgical planning and meticulous attention to disc space distraction as well as manipulation of critical structures are essential.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251349173"},"PeriodicalIF":2.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225197","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":"Efficacy of Excitatory iTBS on Lower Limb Recovery in iSCI Patients.","authors":"Shengliu Shi, Jingyu Yao, Jing Cai","doi":"10.1177/21925682251343528","DOIUrl":"10.1177/21925682251343528","url":null,"abstract":"<p><p>Study DesignProspective Study.ObjectiveSpinal cord injury leads to severe limitations in autonomy including locomotor function. Intermittent theta burst stimulation (iTBS) has shown promising therapeutic effects on various neuropsychiatric disorders. We analyzed the efficacy of excitatory iTBS on motor and walking functions in patients with incomplete spinal cord injury (iSCI).MethodsThe prospectively selected iSCI patients were divided into the iTBS (n = 69) and sham-iTBS (n = 69) groups, and underwent iTBS and sham-iTBS treatment, respectively, followed by conventional physiotherapy. Clinical assessments were conducted on the muscle strength of quadriceps, gluteus maximus, hamstring, tibialis anterior and gastrocnemius muscle, lower extremity motor score (LEMS), walking speed (WS), stride length (SL), Berg balance scale (BBS), Holden walking ability scale (HWAS) score, the static eyes-open and eyes-closed center of gravity locus length, and the modified Barthel index (MBI) score.ResultsThere were no significant differences among all patients in baseline data. After 9-week treatment, all the patients had notably elevated muscle strength levels of quadriceps, gluteus maximus, hamstring, tibialis anterior and gastrocnemius, WS, SL, and HWAS, BBS, LEMS and MBI scores, as well as decreased static eyes-open and eyes-closed center of gravity locus length, with the changes more remarkable in the patients treated with iTBS. The total effective rate for patients treated with iTBS was 86.96%, which was apparently higher than that of patients treated with sham-iTBS.ConclusionExcitatory iTBS significantly improved lower limb strength and walking function in iSCI patients.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251343528"},"PeriodicalIF":2.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208410","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":"Knockdown of MIF-AS1 Inhibits Pain and Inflammation in Lumbar Disc Herniation by Modulating the miR-185-5p/VEGFA Axis.","authors":"Guangye Li, Jili Lin, Hongtao Zhang, Liusu Lin, Mian Wu, Yingjun Guan, Junling Li","doi":"10.1177/21925682251336711","DOIUrl":"10.1177/21925682251336711","url":null,"abstract":"<p><p>Study DesignProspective Study.ObjectiveThe objective of this investigation was to explore the abnormal expression of migration inhibitory factor antisense RNA 1 (MIF-AS1) in lumbar disc herniation (LDH) patients and its relationship to the degree of pain and inflammatory response in LDH, as well as the molecular mechanism of its involvement in LDH.MethodsThis study included 50 patients with LDH. The expression levels of MIF-AS1 were detected by RT-qPCR. The LDH model was constructed in SD rats, and the paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) of LDH rats were detected by behavioral experiments. Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of TNF-α, IL-6, and IL-1β. The targeted regulatory relationships between MIF-AS1 and miR-185-5p, miR-185-5p and VEGFA were verified by a dual-luciferase reporter gene assay.ResultThe expression of MIF-AS1 was up-regulated in LDH patients and correlated with the degree of pain in patients. Low expression of MIF-AS1 reduced the degree of pain and inflammation in LDH rats. In addition, MIF-AS1 may regulate pain and inflammation induced by LDH by modulating the miR-185-5p/VEGFA axis.ConclusionMIF-AS1/miR-185-5p/VEGFA axis may be a therapeutic target for LDH.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251336711"},"PeriodicalIF":2.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215643","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":"Risk Factors for Pelvic Non-responders Even after Pelvic Incidence-Lumbar Lordosis Overcorrection and Their Impact on Surgical Outcomes.","authors":"Se-Jun Park, Dong-Ho Kang, Minwook Kang, Kyunghun Jung, Chong-Suh Lee, Jin-Sung Park","doi":"10.1177/21925682251347909","DOIUrl":"10.1177/21925682251347909","url":null,"abstract":"<p><p>Study DesignRetrospective observation study.ObjectivesDespite pelvic incidence (PI)-lumbar lordosis (LL) overcorrection, some patients exhibit residual pelvic tilt (PT) malalignment, termed pelvic non-responders (PNRs). We aimed to identify risk factors for PNRS after PI-LL overcorrection and its impact on surgical outcomes.MethodsA retrospective analysis of 181 adult spinal deformity (ASD) patients who underwent fusion of ≥ five levels. PNRs were defined as postoperative PT ≥ 20° despite PI-LL overcorrection. Patient-reported outcomes (PROMs) and mechanical complications, such as proximal junctional failure (PJF), were documented. Logistic regression identified significant risk factors for PNRs.ResultsAmong the 181 patients, 30 (16.6%) were classified as having PNRs. Preoperative PI and postoperative PI-LL mismatch were significantly higher in PNRs than in PRs. Multivariate analysis identified higher preoperative PI, postoperative PI-LL ≥ -2°, lordosis distribution index (LDI) < 53%, and increased postoperative thoracic kyphosis as significant risk factors for pelvic non-response. PJF was significantly higher in PNRs (30.0% vs 10.6%, <i>P</i> < 0.01). At 1 year postoperatively, PNRs had lower SRS-22 scores in activity, pain, appearance, and mental health (<i>P</i> < 0.05), but MCID analysis indicated these differences may not be clinically meaningful.ConclusionsLarger preoperative PI, lower postoperative LDI, and higher postoperative PI-LL are significant risk factors for pelvic non-response in ASD patients with PI-LL overcorrection. PNRs are at increased risk of higher rates of PJF. Surgical strategies should prioritize achieving the target PI-LL and an LDI of ≥53% to optimize alignment and reduce the risk of PNRs and associated mechanical complications.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251347909"},"PeriodicalIF":2.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215644","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":"Titanium-Coated Polyetheretherketone Cages Versus Uncoated Polyetheretherketone Cages for Lumbar Spinal Fusion: A Systematic Review and Meta-Analysis.","authors":"Gonzalo Mariscal, Praveer S Vyas, Boyle C Cheng, Jacobus J Arts, Thomay-Claire A Hoelen, Chen Xu, Christopher D Chaput","doi":"10.1177/21925682251336716","DOIUrl":"10.1177/21925682251336716","url":null,"abstract":"<p><p>Study DesignSystematic review and meta-analysis.ObjectiveA systematic review and meta-analysis of comparative studies was performed to compare the fusion rates, functional outcomes, and complications between Titanium-Coated Polyetheretherketone (TiPEEK) and polyetheretherketone (PEEK) cages.MethodsFour databases were systematically searched according to PRISMA. Adult patients who underwent one- or two-level lumbar fusion with TiPEEK or PEEK cages were included in the study. Studies that reported radiographic fusion and functional or complication outcomes were also included. Study quality was assessed using the Cochrane Risk of Bias tool and MINORS criteria. The meta-analysis was performed using Review Manager 5.4. Heterogeneity was assessed using I², and random effects were used to analyze the heterogeneity.Results8 studies (n = 670) were analyzed. TiPEEK showed a significantly higher overall fusion rate (OR 1.83, 95% CI: 1.18-2.83). TiPEEK cages presented significantly higher fusion rates at 6 months (OR 2.52, 95% CI: 1.11 to 5.72), but there were no significant differences at 12 months (OR 1.33, 95% CI: 0.65 to 2.73). No differences were observed in the global ODI (SMD -0.04, 95% CI: -0.15-0.06). There were no significant differences regarding overall subsidence (OR 0.72, 95% CI: 0.48 to 1.07), screw complications (OR 1.25, 95% CI: 0.30-5.27) or reoperations (OR 0.61, 95% CI: 0.11-3.37).ConclusionsThe results from this study suggest that TiPEEK cages may demonstrate earlier fusion as compared to PEEK cages, particularly at 6 months. However, the functional outcomes and safety profiles were comparable.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251336716"},"PeriodicalIF":2.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208411","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":"In for the money only?","authors":"Karsten Wiechert, Jens R Chapman, Jeffrey C Wang","doi":"10.1177/21925682251339903","DOIUrl":"10.1177/21925682251339903","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 5","pages":"2583-2584"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233882","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-Printed Titanium Cages for Anterior and Lateral Lumbar Interbody Fusion Result in Excellent Fusion Rates One Year After Surgery.","authors":"Anna-Katharina Calek, Bettina Hochreiter, Aaron J Buckland","doi":"10.1177/21925682251344557","DOIUrl":"10.1177/21925682251344557","url":null,"abstract":"<p><p>Study DesignRetrospective study.ObjectiveTo determine the fusion rate in patients undergoing anterior lumbar interbody fusion (ALIF) and/or lateral lumbar interbody fusion (LLIF) with titanium cages.MethodsFusion at 1-year was assessed by computed tomography (CT) using Lenke-Bridwell classification. Flexion-extension lateral radiographs confirmed fusion if motion was <5° through the fused segment. Perioperative metrics including bone graft type, operative time, estimated blood loss, revisions within the first postoperative year, clinical outcome assessed by the Oswestry Disability Index (ODI).ResultsOne hundred patients with a total of 137 fusion levels with 3DPTi cages were identified. In this cohort, 75% underwent primary surgery and 25% had a previous surgery. At 1-year post-op, 97.1% of interbody levels were fused (Grade I) on CT, and all levels appeared fused on flexion-extension radiographs. Four patients (4%) required additional surgery within the first two years. No revisions were required for cage subsidence/migration, or pseudoarthrosis. Median ODI significantly improved from 39 at baseline to 10 at 1-year (<i>P</i> = .001).Conclusion3D-printed titanium cages for ALIF and LLIF result in excellent fusion rates at one year postoperatively without the use of rhBMP-2.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251344557"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198922","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":"Does Intra-Operative Methylprednisolone Improve Outcomes of Surgery for Degenerative Cervical Myelopathy? - A Prospective Randomized Study.","authors":"Saumyajit Basu, Kushal Gohil, Sanjit Singh, Amitava Biswas, Trinanjan Sarangi, Mainak Palit","doi":"10.1177/21925682241309303","DOIUrl":"10.1177/21925682241309303","url":null,"abstract":"<p><p>Study designRandomized controlled trial.ObjectivesIn this study, we hypothesize administering fixed-dose intravenous steroid (Methylprednisolone) intraoperatively would reduce neuroinflammation and enhance functional and radiological outcomes in decompressive surgeries for DCM. Primary objectives were to assess effect of intraoperative MP on modified Japanese Orthopedic Association (mJOA) score, Nurick grade, and MRI signal changes.MethodsThis prospective triple-blinded randomized controlled trial included 65 patients allocated into MP (n = 33) and control (n = 32) groups. MP (dose-1g) was administered intraoperatively at the beginning of decompression. Clinical outcome measures included mJOA score, Nurick grading, mJOA recovery rate (mJOA RR), Nurick recovery rate (NRR), and complication rates in both groups at 1-, 3-and 24-month follow-up. Radiological outcome was assessed by analyzing regression of T2W and T1W SI changes on MRI scans as per Chen's grading at 24-months follow-up.ResultsMP group exhibited greater improvement in mJOA scores at 24-months (mean improvement: +6.69 vs +6.42; difference: +0.27, 95% CI: -0.37 to +0.91) but was statistically insignificant (<i>P</i> = .107). Similarly, mJOA-RR showed a moderate effect size of 0.42 (95% CI: 0.04 to 0.80) and 0.37 (95% CI: -0.01 to 0.75) at 1-and 3-months follow-up respectively. NRR improvements were observed, with effect sizes of 0.40 (95% CI: 0.02 to 0.78) and 0.49 (95% CI: 0.11 to 0.87) at 1- and 3-months respectively, but not statistically significant (<i>P</i> = .28). At 24-months, MP group had significantly better MRI outcome (Chen grading: mean change +1.15 vs +0.83; effect size: -0.71, 95% CI: -1.09 to -0.33; <i>P</i> = .038).Complication rates were comparable between both groups, emphasizing safety of MP administration.ConclusionAlthough null hypothesis was not proven, intraoperative MP administration in DCM surgery demonstrated safety and suggested potential neuroprotective benefits to enhance clinical recovery and reduce spinal cord signal changes. However, further large-scale, multicentric studies are needed to validate these findings and optimize its dose.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2687-2698"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821521","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":"2841-2843"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","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}

{"title":"Response to Letter to the Editor Regarding Rod Contour Angle and Postoperative Thoracic Kyphosis: Key Predictors of Proximal Junctional Kyphosis in Pediatric Neuromuscular Scoliosis After Spinopelvic Fusion.","authors":"Pochih Shen, Carson Keeter, Tyler Sullivan, Nancy Hadley-Miller, Mark A Erickson","doi":"10.1177/21925682251333409","DOIUrl":"10.1177/21925682251333409","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2846-2847"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772060","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}