Global Spine Journal最新文献

{"title":"Subsidence Rates Associated With Porous 3D-Printed Versus Solid Titanium Cages in Transforaminal Lumbar Interbody Fusion.","authors":"Nathaniel Toop, Joravar Dhaliwal, Andrew Grossbach, David Gibbs, Nihaal Reddy, Alexander Keister, Noah Mallory, David Xu, Stephanus Viljoen","doi":"10.1177/21925682231157762","DOIUrl":"10.1177/21925682231157762","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort Study.</p><p><strong>Objective: </strong>To determine whether 3D-printed porous titanium (3DPT) interbody cages offer any clinical or radiographic advantage over standard solid titanium (ST) interbody cages in transforaminal lumbar interbody fusions (TLIF).</p><p><strong>Methods: </strong>A consecutive series of adult patients undergoing one- or two-level TLIF with either 3DPT or ST \"banana\" cages were analyzed for patient reported outcome measures (PROMs), radiographic complications, and clinical complications. Exclusion criteria included clinical or radiographic follow-up less than 1 year.</p><p><strong>Results: </strong>The final cohort included 90 ST interbody levels from 74 patients, and 73 3DPT interbody levels from 50 patients for a total of 124 patients. Baseline demographic variables and comorbidity rates were similar between groups (<i>P</i> > .05). Subsidence of any grade occurred more frequently in the ST group compared with the 3DPT group (24.4% vs 5.5%, respectively, <i>P</i> = .001). Further, the ST group was more likely to have higher grades of subsidence than the 3DPT group (<i>P</i> = .009). All PROMs improved similarly after surgery and revision rates did not differ between groups (both <i>P</i> > .05). On multivariate analysis, significant positive correlators with increasing subsidence grade included greater age (<i>P</i> = .015), greater body mass index (<i>P</i> = .043), osteoporosis/osteopenia (<i>P</i> < .027), and ST cage type (<i>P</i> = .019).</p><p><strong>Conclusions: </strong>When considering interbody material for TLIF, both ST and 3DPT cages performed well; however, 3DPT cages were associated with lower rates of subsidence. The clinical relevance of these findings deserves further randomized, prospective investigation.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9277659","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":"Radiofrequency Denervation of the Spine and the Sacroiliac Joint: A Systematic Review based on the Grades of Recommendations, Assesment, Development, and Evaluation Approach Resulting in a German National Guideline.","authors":"Stephan Klessinger, Hans-Raimund Casser, Sebastian Gillner, Holger Koepp, Andreas Kopf, Martin Legat, Katharina Meiler, Heike Norda, Markus Schneider, Matti Scholz, Phillipp J Slotty, Volker Tronnier, Martin Vazan, Karsten Wiechert","doi":"10.1177/21925682241230922","DOIUrl":"10.1177/21925682241230922","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review of the literature and subsequent meta-analysis for the development of a new guideline.</p><p><strong>Objectives: </strong>This manuscript summarizes the recommendations from a new clinical guideline published by the German Spine Society. It covers the current evidence on recommendations regarding the indication, test blocks and use of radiofrequency denervation. The guidelines aim is to improve patient care and efficiency of the procedure.</p><p><strong>Methods: </strong>A multidisciplinary working group formulated recommendations based on the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) approach and the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.</p><p><strong>Results: </strong>20 clinical questions were defined for guideline development, with 87.5% consensus achieved by committee members for one recommendation and 100% consensus for all other topics. Specific questions that were addressed included clinical history, examination and imaging, conservative treatment before injections, diagnostic blocks, the injected medications, the cut-off value in pain-reduction for a diagnostic block as well as the number of blocks, image guidance, the cannula trajectories, the lesion size, stimulation, repeat radiofrequency denervation, sedation, cessation or continuation of anticoagulants, the influence of metal hardware, and ways to mitigate complications.</p><p><strong>Conclusion: </strong>Radiofrequency (RF) denervation of the spine and the SI joint may provide benefit to well-selected individuals. The recommendations of this guideline are based on very low to moderate quality of evidence as well as professional consensus. The guideline working groups recommend that research efforts in relation to all aspects of management of facet joint pain and SI joint pain should be intensified.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697263","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":"How Good Are Surgeons at Achieving Their Preoperative Goal Sagittal Alignment Following Adult Deformity Surgery?","authors":"Justin S Smith, Elias Elias, Tolga Sursal, Breton Line, Virginie Lafage, Renaud Lafage, Eric Klineberg, Han Jo Kim, Peter Passias, Zeina Nasser, Jeffrey L Gum, Robert Eastlack, Alan Daniels, Gregory Mundis, Richard Hostin, Themistocles S Protopsaltis, Alex Soroceanu, David Kojo Hamilton, Michael P Kelly, Stephen J Lewis, Munish Gupta, Frank J Schwab, Douglas Burton, Christopher P Ames, Lawrence G Lenke, Christopher I Shaffrey, Shay Bess","doi":"10.1177/21925682231161304","DOIUrl":"10.1177/21925682231161304","url":null,"abstract":"<p><strong>Study design: </strong>Multicenter, prospective cohort.</p><p><strong>Objectives: </strong>Malalignment following adult spine deformity (ASD) surgery can impact outcomes and increase mechanical complications. We assess whether preoperative goals for sagittal alignment following ASD surgery are achieved.</p><p><strong>Methods: </strong>ASD patients were prospectively enrolled based on 3 criteria: deformity severity (PI-LL ≥25°, TPA ≥30°, SVA ≥15 cm, TCobb≥70° or TLCobb≥50°), procedure complexity (≥12 levels fused, 3-CO or ACR) and/or age (>65 and ≥7 levels fused). The surgeon documented sagittal alignment goals prior to surgery. Goals were compared with achieved alignment on first follow-up standing radiographs.</p><p><strong>Results: </strong>The 266 enrolled patients had a mean age of 61.0 years (SD = 14.6) and 68% were women. Mean instrumented levels was 13.6 (SD = 3.8), and 23.2% had a 3-CO. Mean (SD) offsets (achieved-goal) were: SVA = -8.5 mm (45.6 mm), PI-LL = -4.6° (14.6°), TK = 7.2° (14.7°), reflecting tendencies to undercorrect SVA and PI-LL and increase TK. Goals were achieved for SVA, PI-LL, and TK in 74.4%, 71.4%, and 68.8% of patients, respectively, and was achieved for all 3 parameters in 37.2% of patients. Three factors were independently associated with achievement of all 3 alignment goals: use of PACs/equivalent for surgical planning (<i>P</i> < .001), lower baseline GCA (<i>P</i> = .009), and surgery not including a 3-CO (<i>P</i> = .037).</p><p><strong>Conclusions: </strong>Surgeons failed to achieve goal alignment of each sagittal parameter in ∼25-30% of ASD patients. Goal alignment for all 3 parameters was only achieved in 37.2% of patients. Those at greatest risk were patients with more severe deformity. Advancements are needed to enable more consistent translation of preoperative alignment goals to the operating room.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10816850","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 Comparison of Magnetic Resonance Imaging and SPECT-CT Imaging in Complex Spine Pathology: Does SPECT-CT Provide Additional Diagnostic Information Over Magnetic Resonance Imaging?","authors":"Daniel Thurston, Patrick Hurley, Falaq Raheel, Steven James, Rakesh Gadvi, Rajesh Botchu, Adrian C Gardner, Jwalant S Mehta","doi":"10.1177/21925682231163812","DOIUrl":"10.1177/21925682231163812","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>Magnetic Resonance Imaging (MRI) is often regarded as the gold standard for spinal pathology, as it provides good structural visualisation. SPECT-CT, however, provides combined structural and functional information. There is a paucity of literature comparing SPECT-CT with MRI in the spine. Our aim was to determine whether SPECT-CT provides additional information to MRI in individuals with complex spinal pathology, including deformity, which altered management.</p><p><strong>Methods: </strong>We conducted a retrospective review of all individuals seen at our tertiary spinal unit that were investigated with both MRI and SPECT-CT of the spine between 2007-2020. We reviewed imaging reports, and collated diagnoses, surgical treatment and the relative contributions of MRI and SPECT-CT to management decisions.</p><p><strong>Results: </strong>104 individuals identified, with a mean age of 30 years (89 females and 15 males). Diagnostic categories were adolescent, adult, and congenital deformity, degenerative pathology, and miscellaneous pathology. MRI returned positive findings in 58 (55.8%), and SPECT-CT in 41 (39.4%) cases. SPECT-CT identified 10 cases of facet joint degeneration, 5 of increased uptake around metalwork suggestive of loosening, 1 pseudoarthrosis, 1 partial failure of fusion and 1 osteoid osteoma which were not reported on MRI, all in individuals who had previously undergone spinal instrumentation. Despite this, SPECT-CT only altered management for 6 individuals (5.8%).</p><p><strong>Conclusion: </strong>MRI is less useful in the setting of previous instrumentation due to metal artefact. Where MRI is inconclusive, particularly in individuals with previous spinal instrumentation, SPECT-CT may provide a diagnosis, but is not recommended as primary imaging.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9194138","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":"Magnetic Resonance Imaging-CCCFLS Scoring System: Toward Predicting Clinical Symptoms and C5 Paralysis.","authors":"Shunmin Wang, Jingchuan Sun, Dan Han, Jianping Fan, Yaping Yu Mm, Haiqin Yang Mm, Chunyan Gao, XiaoNan Zhou, Yongfei Guo, Jiangang Shi","doi":"10.1177/21925682231170607","DOIUrl":"10.1177/21925682231170607","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objective: </strong>To develop a new MRI scoring system to assess patients' clinical characteristics, outcomes and complications.</p><p><strong>Methods: </strong>A retrospective 1-year follow-up study of 366 patients with cervical spondylosis from 2017 to 2021. The CCCFLS scores (cervical curvature and balance (CC), spinal cord curvature (SC), spinal cord compression ratio (CR), cerebrospinal fluid space (CFS). Spinal cord and lesion location (SL). Increased Signal Intensity (ISI) were divided into Mild group (0-6), Moderate group (6-12), and Severe group (12-18) for comparison, and the Japanese Orthopaedic Association (JOA) scores, visual analog scale (VAS), numerical rating scale (NRS), Neck Disability Index (NDI) and Nurick scores were evaluated. Correlation and regression analyses were performed between each variable and the total model in relation to clinical symptoms and C5 palsy.</p><p><strong>Results: </strong>The CCCFLS scoring system was linearly correlated with JOA, NRS, Nurick and NDI scores, with significant differences in JOA scores among patients with different CC, CR, CFS, ISI scores, with a predictive model (R² = 69.3%), and significant differences in preoperative and final follow-up clinical scores among the 3 groups, with a higher rate of improvement in JOA in the severe group (<i>P</i> < .05), while patients with and without C5 paralysis had significant differences in preoperative SC and SL (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>CCCFLS scoring system can be divided into mild (0-6). moderate (6-12), severe (12-18) groups. It can effectively reflect the severity of clinical symptoms, and the improvement rate of JOA is better in the severe group, while the preoperative SC and SL scores are closely related to C5 palsy.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9534889","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":"Scoping Review with Topic Modeling on the Diagnostic Criteria for Degenerative Cervical Myelopathy.","authors":"Stavros Matsoukas, Carl Moritz Zipser, Freschta Zipser-Mohammadzada, Najmeh Kheram, Andrea Boraschi, Zhilin Jiang, Lindsay Tetreault, Michael G Fehlings, Benjamin M Davies, Konstantinos Margetis","doi":"10.1177/21925682241237469","DOIUrl":"10.1177/21925682241237469","url":null,"abstract":"<p><strong>Study design: </strong>This study is a scoping review.</p><p><strong>Objective: </strong>There is a broad variability in the definition of degenerative cervical myelopathy (DCM) and no standardized set of diagnostic criteria to date.</p><p><strong>Methods: </strong>We interrogated the Myelopathy.org database, a hand-indexed database of primary clinical studies conducted exclusively on DCM in humans between 2005-2021. The DCM inclusion criteria used in these studies were inputted into 3 topic modeling algorithms: Hierarchical Dirichlet Process (HDP), Latent Dirichlet Allocation (LDA), and BERtopic. The emerging topics were subjected to manual labeling and interpretation.</p><p><strong>Results: </strong>Of 1676 reports, 120 papers (7.16%) had well-defined inclusion criteria and were subjected to topic modeling. Four topics emerged from the HDP model: disturbance from extremity weakness and motor signs; fine-motor and sensory disturbance of upper extremity; a combination of imaging and clinical findings is required for the diagnosis; and \"reinforcing\" (or modifying) factors that can aid in the diagnosis in borderline cases. The LDA model showed the following topics: disturbance to the patient is required for the diagnosis; reinforcing factors can aid in the diagnosis in borderline cases; clinical findings from the extremities; and a combination of imaging and clinical findings is required for the diagnosis. BERTopic identified the following topics: imaging abnormality, typical clinical features, range of objective criteria, and presence of clinical findings.</p><p><strong>Conclusions: </strong>This review provides quantifiable data that only a minority of past studies in DCM provided meaningful inclusion criteria. The items and patterns found here are very useful for the development of diagnostic criteria for DCM.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140039118","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":"Is Minimally Invasive Bipolar Technique a Better Alternative to Long Fusion for Adult Neuromuscular Scoliosis?","authors":"Stéphane Wolff, Pierre-Emmanuel Moreau, Lotfi Miladi, Guillaume Riouallon","doi":"10.1177/21925682231159347","DOIUrl":"10.1177/21925682231159347","url":null,"abstract":"<p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Objectives: </strong>To report the results for an alternative technique based on minimally invasive fusion-less surgery. This approach is original in that it corrects deformities by proximal and distal fixation, with reliable pelvic fixation through the use of iliosacral screws on osteoporotic bones.</p><p><strong>Methods: </strong>Adult cerebral palsy patients requiring spinal correction surgery were included prospectively between 2015 and 2019. The technique involved the use of a double-rod construct anchored proximally by four clawed hooks and distally by iliosacral screws, in a minimally invasive approach. Cobb angle and pelvic obliquity were measured before and after initial surgery and at final follow-up. Complications and functional results were reviewed. This group (P) was compared with a second group (R) of patients who underwent surgery between 2005 and 2015, for whom data were collected retrospectively.</p><p><strong>Results: </strong>Thirty-one patients were included in group P, and 15 in group R. The two groups were comparable for demographic data and deformity. At most recent follow-up (3 years for group P [2-6] and 5 years for group R [2-16]), neither correction nor surgical complications differed between the two groups. However, group P had 50% less blood loss and a lower medical complication rate than group R.</p><p><strong>Conclusions: </strong>Our results confirm the effectiveness of this minimally invasive technique for neuromuscular scoliosis in adults. The results were similar to those obtained with the usual techniques, but with fewer medical complications. Confirmation of these results is now required for a longer follow-up period.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10752222","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":"Anterior Column Realignment Using an Anterior-To-Psoas Approach: A Radiographic-Anatomic Feasibility Study at L1-L5.","authors":"Takashi Hirase, Caleb Shin, Jeyvikram Thirumavalavan, Venkat Boddapati, Tiffany Lee, Varan Haghshenas, Rex Aw Marco","doi":"10.1177/21925682231161577","DOIUrl":"10.1177/21925682231161577","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional radioanatomic study.</p><p><strong>Objective: </strong>To determine the feasibility of performing an anterior column realignment (ACR) using an anterior-to-psoas (ATP) approach at L1-L5.</p><p><strong>Methods: </strong>Axial magnetic resonance images (MRI) of the L1-L5 disc levels obtained at a single institution were obtained and analyzed. The feasibility of performing an ACR was assessed using a combination of the size of the left oblique corridor (OC), the psoas morphology using the modified Moro classification, and the anterior disc edge to great vessel distance.</p><p><strong>Results: </strong>Three hundred MRI studies obtained from 300 patients were included. All patients had a measurable left OC at the L1-L4 levels. Twenty patients (6.7%) had no measurable OC at the L4-L5 level. According to the modified Moro's classification, a high-rising psoas was seen in 4 patients (1.3%) at the L3-L4 level and 57 patients (19.0%) at the L4-L5 level. An ALL release was considered high risk due to no measurable space between the anterior disc edge and the great vessels in 54 patients (18.0%) at the L1-L2 level, 39 patients (13.0%) at the L2-L3 level, 119 patients (39.7%) at the L3-L4 level, and 226 patients (75.3%) at the L4-L5 level.</p><p><strong>Conclusion: </strong>ACR using an ATP approach is the most radioanatomically feasible at L2-L3. The L4-L5 level has the highest risk with regards to both the ATP approach and the ALL release for an ACR due to high rates of unmeasurable left OC and space between the anterior disc edge and the great vessels.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10794537","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":"Do Preoperative Supine Radiographs Predict Postoperative Residual Lumbar Curvatures in Adolescent Idiopathic Scoliosis? A Retrospective Cohort Study.","authors":"Prashant V Rajan, Richard Steiner, Todd F Ritzman, Trey Moberly, Lorena V Floccari","doi":"10.1177/21925682231162556","DOIUrl":"10.1177/21925682231162556","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective comparative study.</p><p><strong>Objectives: </strong>This study compares supine vs bending flexibility radiographs and evaluates their ability to predict residual postoperative lumbar curvature after selective thoracic fusion for Lenke 1 and 2 curves across different lumbar modifiers (A, B, and C) in adolescent idiopathic scoliosis (AIS).</p><p><strong>Methods: </strong>This was a retrospective review of AIS Lenke 1 and 2 patients who underwent posterior fusion. All patients had preoperative flexibility radiographs including side-bending and supine posteroanterior (PA) films, in addition to pre- and post-operative standing PA and lateral radiographs. We used SurgiMap 2.0 software for all radiographic measurements. Pearson correlations and linear regression models were developed in SAS.</p><p><strong>Results: </strong>A total of 86 patients were included mean age 14.9 years and follow-up 72.3 months<b>.</b> Preoperative supine lumbar Cobb angle and preoperative side-bending Cobb angles had similar, positive correlations with postoperative lumbar Cobb angle, <i>r</i> = .55 (<i>P</i> < .001) and <i>r</i> = .54 (<i>P</i> < .001), respectively. Three regression models were built to predict postoperative lumbar Cobb angles from preoperative information: Model S (R² = .39) uses preoperative supine lumbar curve; Model B (R² = .44) uses preoperative side-bending lumbar curve; Model SB (R² = .49) uses both preoperative supine and side-bending lumbar curves. Model S and B performed just as well as Model SB.</p><p><strong>Conclusion: </strong>Either supine or side-bending radiographs alone may be used to estimate mean residual postoperative lumbar curvature after selective posterior thoracic fusion, but little is to be gained by taking both supine and side-bending radiographs.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10867138","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":"Anterior Thoracic Discectomy and Fusion for Symptomatic Ventral Bone Spur Associated Type I Cerebrospinal Fluid Leak: A Technical Report and Operative Video.","authors":"Joseph S Hudson, David Fernandes-Cabral, Prateek Agarwal, Andrew Legarreta, Anthony Schulien, Hansen Deng, Vikas Agarwal, David O Okonkwo","doi":"10.1177/21925682231161303","DOIUrl":"10.1177/21925682231161303","url":null,"abstract":"<p><strong>Study design: </strong>Technical Report.</p><p><strong>Objective: </strong>Cerebrospinal fluid (CSF) leak secondary to anterior osteophytes at the cervico-thoracic junction is a rare cause of intracranial hypotension. In this article we describe a technique for anterior repair of spontaneous ventral cerebrospinal fluid leaks in the upper thoracic spine.</p><p><strong>Methods: </strong>In this technical report and operative video, we describe a 23-year-old male who presented with positional headaches and bilateral subdural hematoma. Dynamic CT myelography demonstrated a high flow ventral cerebrospinal fluid leak associated with a ventral osteophyte at the level of the T1-T2 disc space. Targeted blood patch provided only temporary improvement in symptoms. An anterior approach was chosen to remove the offending spur and micro-surgically repair the dural defect.</p><p><strong>Results: </strong>The patient had complete resolution of his preoperative symptoms after primary repair.</p><p><strong>Conclusions: </strong>In select cases, an anterior approach to the upper thoracic spine is effective to repair Type 1 cerebrospinal fluid leaks.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9373169","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}