Global Spine Journal最新文献

{"title":"A New Method for Optimizing Spinal Canal Cross-Sectional Area During Laminoplasty: Lateral Mass Gutter.","authors":"Huajian Zhong, Yifan Wang, Yuefeng Zhu, Haoyi Wang, Guoqing Wen, Chen Xu, Leixin Wei, Huiqiao Wu, Yang Liu, Wen Yuan, Huajiang Chen, Xiaolong Shen","doi":"10.1177/21925682261487161","DOIUrl":"10.1177/21925682261487161","url":null,"abstract":"<p><p>Study DesignRetrospective Cohort Study.ObjectiveTo propose a new technique named \"lateral mass gutter\" and investigate its role in augmenting spinal canal cross-sectional area (SCA) during laminoplasty.MethodsThis study included 105 patients who received cervical laminoplasty from February 2021 to February 2024. Patients were allocated to the conventional (CON) group or the lateral mass (LM) group according to the guttering technique used intraoperatively. Propensity score matching with a caliper of 0.2 was utilized to reduce selection bias. Intergroup comparisons encompassed clinical outcomes (Visual Analog Scale (VAS) of neck pain, Japanese Orthopaedic Association (JOA) score), radiographic measurements (SCA, laminoplasty opening angle (LOA), hinge fractures, hinge fusion, C2-7 Cobb angle) and postoperative complications (cerebrospinal fluid leakage, incisional fat liquefaction, C5 nerve root palsy, axial neck pain, cervical spine instability).ResultsFollowing propensity score matching, baseline parameters were comparable between the CON and LM groups (37 patients per group, P > 0.05). Compared to the CON group, the LM group exhibited a significantly smaller LOA, a lower incidence of hinge fractures, a higher rate of hinge fusion, greater improvement in JOA and a larger expansion in the SCA (P < 0.05). No statistically significant differences were observed between the two groups regarding VAS of neck pain or postoperative complications (P > 0.05).ConclusionCompared to conventional guttering technique, lateral mass gutter significantly reduces hinge fracture, promotes hinge fusion, enhances spinal canal expansion and optimizes postoperative neurological recovery in posterior cervical laminoplasty.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261487161"},"PeriodicalIF":3.1,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900238","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":"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":"10.1177/21925682261485860","DOIUrl":"10.1177/21925682261485860","url":null,"abstract":"<p><p>Study DesignRetrospective study.ObjectivesTo develop and validate a computer-assisted model for planning screw trajectories to support modified cortical bone trajectory (MCBT), cortical bone trajectory (CBT), and pedicle screw (PS) techniques, based on iterative closest point (ICP) registration and weighted k-nearest neighbors (kNN) algorithms.MethodsCT data from 110 patients undergoing lumbar surgery were analyzed, comprising an internal set of 50 younger patients with normal bone density and an external set of 60 patients including younger and older individuals with or without bone loss. L4-L5 segments were reconstructed using Mimics 21.0. Two surgeons manually planned MCBT, CBT, and PS trajectories bilaterally in the internal set to serve as reference standards. A personalized computer-assisted screw planning model was developed using ICP registration and weighted kNN, where the template library consisted of manually generated screw plans. Accuracy was evaluated by comparing algorithm-generated screw trajectories against expert manually planned trajectories to calculate deviations in sagittal inclination (α), axial inclination (β), screw head, pedicle entry point, pedicle crossing point, and screw tip. Hounsfield unit (HU) values along screw trajectories were also measured.ResultsIn the external set (total of 720 screws: 240 PS, 240 CBT, 240 MCBT), deviations for CBT weresagittal inclination (α) 4.117 (2.028, 7.251)°, axial inclination (β) 3.714 (1.901, 6.316)°, screw head 3.382 (2.514, 4.803) mm, pedicle entry point 3.0 (1.999, 4.149) mm, pedicle crossing point 1.511 (1.008, 2.443) mm, screw tip 3.586 (2.465, 4.542) mm. Those for MCBT were 4.865 (2.126, 7.547)°, 3.801 (1.658, 6.147)°, 4.153 (3.14, 5.658) mm, 3.818 (2.43, 6.209) mm, 1.545 (1.061, 2.222) mm, 3.777 (2.768, 5.241) mm, respectively. Computational acceptance rates for PS were 97.06% (HU: 238.4±67.71) in younger normal bone group, 92.71% (173.6±53.83) in older normal bone group, and 97.37% (113.3±58.68) in older bone loss group. For CBT, rates were 100% (477.2±168.6 HU), 100% (338.5±125.8 HU), and 100% (178.1±99.75 HU), respectively. For MCBT, rates were 100% (475.8±131 HU), 98.96% (376.8±104.9 HU), and 97.37% (213.4±106 HU), respectively. MCBT and CBT achieved significantly higher HU values than PS (P < 0.05).ConclusionThe ICP registration and weighted kNN-based planning model demonstrates high computational acceptance rates and excels in planning cortical bone screw trajectories with low breach rates and high HU values.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261485860"},"PeriodicalIF":3.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887174","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":"Testosterone Replacement Therapy is Associated With Increased Risk of Pseudarthrosis After Single-Level Anterior Cervical Discectomy and Fusion: A Propensity Matched Analysis.","authors":"William Han, Kyle Stump, Karim Gubara, Prabhat Gottipati, Stephan Aynaszyan, Theresa Pazionis","doi":"10.1177/21925682261487188","DOIUrl":"10.1177/21925682261487188","url":null,"abstract":"<p><p>ObjectiveTo evaluate whether preoperative testosterone replacement therapy (TRT) use is associated with increased risks of pseudarthrosis and reoperation following single-level anterior cervical discectomy and fusion (ACDF).MethodsThe TriNetX Research Network was queried to identify adult males aged 18 to 89 years who underwent single-level ACDF. Patients were separated into a TRT exposure group within 1 year before initial ACDF procedure as well as comparator cohort without TRT exposure that was matched 1:1 using propensity score matching based on age, race, and relevant medical comorbidities. Patients were followed longitudinally for 2 years from the index procedure to assess postoperative outcomes. The primary outcomes were pseudarthrosis and reoperation. Risk ratios and time-to-event hazard ratios were calculated along with 95% confidence intervals.ResultsAfter propensity score matching, 494 matched pairs reached balance across all baseline characteristics. Patients receiving TRT demonstrated a 70% increased risk of pseudarthrosis (RR 1.70, CI 1.20-2.39; HR 1.71 CI 1.19 - 2.46) compared to the non-TRT cohort. TRT use was not associated with an increased risk of reoperation (RR 0.92 CI 0.59-1.43; HR 0.87, CI 0.55-1.38) following ACDF.ConclusionsPreoperative testosterone replacement therapy was associated with increased risk of pseudarthrosis, but not reoperation following ACDF. These findings suggest that TRT may represent an important patient-specific risk marker in patients undergoing ACDF. Given the observational design and potential for residual confounding, these findings should not be interpreted as evidence of a causal effect.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261487188"},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887110","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":"Characteristics of Patients Achieving Clinically Meaningful Improvement in Neuropathic Pain After Surgery for Degenerative Cervical Myelopathy.","authors":"Narihito Nagoshi, Junichi Yamane, Toshiki Okubo, Hitoshi Kono, Kentaro Fukuda, Takeshi Fujii, Yosuke Horiuchi, Yasuhiro Kamata, Norihiro Isogai, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1177/21925682261488031","DOIUrl":"10.1177/21925682261488031","url":null,"abstract":"<p><p>Study DesignRetrospective analysis of a prospectively maintained multicenter cohort.ObjectivesTo identify clinical characteristics associated with clinically meaningful improvement in neuropathic pain and to evaluate its relationship with postoperative functional outcomes in patients with degenerative cervical myelopathy (DCM).MethodsAmong 816 patients with complete Neuropathic Pain Symptom Inventory (NPSI) data, 597 with baseline total NPSI scores ≥7 were included in the primary analysis because they were eligible to achieve the predefined minimal clinically important difference (MCID) of a 7-point reduction. Patients were classified as responders or non-responders according to MCID achievement at 2 years postoperatively. Clinical outcomes included the cervical Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS), Short Form-36 (SF-36), and JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ).ResultsOf the 597 patients, 323 (54.1%) achieved the NPSI MCID. Responders had significantly higher preoperative total NPSI scores than non-responders, whereas no significant differences were observed in baseline JOA, VAS, or SF-36 scores. Responders demonstrated greater improvement in upper-extremity pain and numbness and in the SF-36 mental component summary score. They also showed significantly higher effectiveness rates in the upper-extremity, lower-extremity, bladder, and quality-of-life domains of the JOACMEQ.ConclusionsClinically meaningful improvement in neuropathic pain after surgery for DCM was associated with broader postoperative recovery across pain-related, functional, mental health, and quality-of-life outcomes. Assessment of neuropathic pain may provide clinically relevant information complementary to conventional measures of neurological function.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261488031"},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880137","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: Surgical Timing and Neurological Outcomes in Traumatic Central Cord Syndrome: A Single-Center Retrospective Cohort Study.","authors":"Zitong Wang","doi":"10.1177/21925682261484602","DOIUrl":"10.1177/21925682261484602","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682261484602"},"PeriodicalIF":3.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873933","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":"Recommendations of the International Consensus Meeting (ICM) 2025 on Spinal Infections: Part B Tubercular Spondylodiscitis.","authors":"Shanmuganathan Rajasekaran, Gnanaprakash Gurusamy, Sathish Muthu, Javad Parvizi","doi":"10.1177/21925682261454366","DOIUrl":"10.1177/21925682261454366","url":null,"abstract":"<p><p>Study DesignSystematic review with guidelines.ObjectiveTo develop evidence-based, globally applicable recommendations for diagnosis and management of Tubercular spondylodiscitis (TBSD) as a part of the International Consensus Meeting (ICM) 2025 on Spinal Infection.MethodsThis article represents a structured, multi-phase international consensus process conducted under the auspices of ICM 2025. Systematic literature reviews were performed using PubMed, Scopus, Web of Science, and ClinicalTrials.gov in accordance with Cochrane methodology. Evidence synthesis was integrated with structured expert deliberation. Consensus statements were developed across 7 domains: screening and initial evaluation, imaging, microbiological diagnosis, anti-tubercular therapy, response monitoring and conservative management, surgical indications, and surgical techniques. Recommendations were finalised through structured voting, with levels of evidence assigned to each statement.ResultsThe consensus emphasises early recognition, routine HIV screening, lesion-specific tissue diagnosis with drug-susceptibility testing, and a multimodal diagnostic strategy. MRI remains the primary imaging modality but lacks specificity for etiological differentiation. Six months of rifampicin-based chemotherapy is sufficient in clinically responding patients, irrespective of surgery. Surgery is indicated for neurological deficit associated with instability or deformity, progressive deterioration, or failure of conservative management. Posterior-only approaches are appropriate in most thoracic and lumbar cases, with anterior surgery reserved for selected indications.ConclusionThe ICM 2025 recommendations provide a comprehensive, evidence-informed framework for the diagnosis and management of TBSD and aim to standardise care while guiding future research priorities worldwide.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"16 3_suppl","pages":"71S-107S"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864579","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":"Temporary Occiput-C2 Fixation for Unstable Atlas Fractures: A Reliable Alternative to Halo-Vest? Minimum Two-Year Clinical Outcomes.","authors":"Abdülhalim Akar, Muhammed Fatih Serttaş, Tuna Pehli̇vanoğlu, Uğur Özdemi̇r, Mehmet Aydoğan","doi":"10.1177/21925682261419050","DOIUrl":"10.1177/21925682261419050","url":null,"abstract":"<p><p>Study DesignRetrospective study.ObjectivesThis study aimed to assess clinical and radiological outcomes of temporary occiput-C2 fixation(TOC2F) as an alternative to halo-vest immobilization in unstable atlas fractures.MethodsAfter ethics approval, 43 patients treated for C1 fractures between 2011-2018 were reviewed.Inclusion criteria were acute traumatic C1 fractures managed with TOC2F and at least two years of follow-up after implant removal. Exclusion criteria were polytrauma affecting follow-up, pathological fractures, prior cervical surgery, congenital anomalies, and incomplete data. Preoperative imaging included MRI, CT, MR angiography, and X-ray. Union was evaluated with CT at 3 and 6 months. Functional outcomes were assessed using NDI, SF-36 (MCS/PCS), and goniometric cervical rotation.ResultsThe cohort consisted of 23 patients(16 male,7 female).According to Landells classification,78.2% had type II and 21.7% type III fractures. Radiological union was achieved in all patients by 6 months, with hardware removal at a mean of 6.3 months. Cervical rotation significantly improved from 103.78° ± 12.02 at day 4 to 153.78° ± 9.29 at two years(<i>P</i> < .05).NDI scores improved from 12.21 ± 3.66 to 2.14 ± 0.94(<i>P</i> < .05).Final SF-36 MCS/PCS scores were favorable 56.33/56.09).No neurological deterioration occurred; one superficial wound complication was documented.ConclusionTOC2F demonstrates potential as a viable and effective alternative for the management of unstable C1 burst fractures.This technique provides immediate postoperative stability, facilitates reliable fracture union, and allows restoration of physiological cervical motion following implant removal.The favorable functional outcomes, low complication rate, and preserved long-term mobility observed in this study suggest that temporary fixation may offer substantial advantages over halo-vest immobilization and permanent fusion in appropriately selected patients.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2966-2974"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994420","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 \"Laminoplasty Versus Laminectomy and Fusion in the Treatment of Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis of Cost and Patient-Centered Outcomes in the United States\".","authors":"Ahmad Shafi Antar","doi":"10.1177/21925682261422212","DOIUrl":"10.1177/21925682261422212","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"3701"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118754","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":"Femoral Bone Mineral Density Shows Stronger Correlation With Pedicle Screw Insertional Torque than Lumbar Bone Mineral Density or Hounsfield Units: A Retrospective in Vivo Study.","authors":"Yoji Ogura, Taisei Kato, Yuichiro Nishiyama, Keisuke Otsuka, Kenta Fujimura, Arya Varthi, Yoshihisa Suzuki","doi":"10.1177/21925682251415346","DOIUrl":"10.1177/21925682251415346","url":null,"abstract":"<p><p>ObjectivesInstrumentation failure remains a significant complication in spinal surgery. Preoperative bone health assessment is critical prior to spinal fusion surgery. Currently, bone mineral density (BMD) and Hounsfield Unit (HU) are common preoperative assessments, although it remains unclear which is more predictive of screw fixation strength. We aimed to identify the most reliable preoperative evaluation method for predicting screw insertional torque in patients undergoing lumbar fusion surgery.MethodsPatients who underwent lumbar fusion surgery utilizing pedicle screws between 2021 and 2023, were prospectively registered in our database. All participants underwent preoperative lumbar CT and Dual-Energy X-ray Absorptiometry (DEXA) scans. We analyzed data from 109 patients who underwent lumbar fusion surgery with 6.5 mm pedicle screws. Preoperative BMD was measured via DEXA (lumbar spine and femur), and HU values were obtained from preoperative lumbar CT scans. Insertional torque of the screws was measured intraoperatively using a calibrated torque wrench. Correlations between insertional torque and BMD/HU as well as patients' demographic/lab data were analyzed.ResultsA total of 335 pedicle screws were analyzed. Femoral BMD exhibited the strongest correlation with insertional torque (r = 0.557, <i>P</i> < 0.001), compared with lumbar BMD and HU. Age, ASA grade, BMI, serum calcium, and albumin showed weak correlations.ConclusionsFemoral BMD demonstrated the strongest, although still moderate, association with intraoperative insertional torque among all preoperative bone quality measures evaluated, suggesting that it may offer a more informative estimate of underlying bone strength in patients undergoing lumbar fusion.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"2846-2854"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12764419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896483","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":"Mortality After Operatively Treated Cervical Spine Fractures - A National FinSpine Register Study.","authors":"Nils Danner, Nikolai Klimko, Henri Salo, Ville Leinonen, Jukka Huttunen","doi":"10.1177/21925682261442458","DOIUrl":"10.1177/21925682261442458","url":null,"abstract":"<p><p>Study DesignNationwide register study.ObjectiveThe incidence of cervical spine fractures and related surgeries are increasing in the ageing population, yet population-based outcome data remain limited. This study aimed to identify factors associated with mortality and to analyze causes of death following surgical treatment for cervical spine fractures in a nationwide cohort.MethodsA cohort of 979 patients undergoing surgery for cervical spine fractures (2017-2024) was identified from the nationwide FinSpine register. Independent risk factors for mortality were identified with Cox proportional hazards models. Patient data were linked with national records on mortality and causes-of-death. Standardized mortality ratios (SMRs) were calculated for comparison with the age- and sex-matched general population.ResultsThe 1-year mortality rate was 11.8%, increasing with age from 3.9% in patients younger than 65 years to 24.9% in those aged 85 years or older. Increasing age (HR 1.06 per year) and spinal cord injury (HR 1.71) predicted mortality. Compared with the general population, mortality was significantly elevated across all age groups, with highest standardized mortality ratio in patients younger than 65 years (SMR 8.3) and lowest for patients aged ≥85 years (SMR 2.0). External causes (accidents and violence) were the leading causes of death and highly over-represented (SMR 22.7) in the patients.ConclusionsIncreasing age and spinal cord injury predict mortality after surgery for cervical spine fractures. The low relative excess mortality in elderly patients, compared to the general population, supports the potential role of operative management with careful patient selection even in advanced age.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"3560-3568"},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13083284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689822","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}