Journal of neurosurgery. Spine最新文献

{"title":"Application of the Ames-International Spine Study Group radiographic modifiers to an asymptomatic population: are the thresholds for \"normal\" appropriate?","authors":"Rémi Pelletier-Roy, Richard Cowley, Taryn Ludwig, Matthew Coyle, W Brent Edwards, Michael Asmussen, Fred Nicholls","doi":"10.3171/2025.2.SPINE241153","DOIUrl":"https://doi.org/10.3171/2025.2.SPINE241153","url":null,"abstract":"<p><strong>Objective: </strong>The Ames-International Spine Study Group (ISSG) classification is a tool for stratifying severity in adult cervical spine deformity. The Ames-ISSG sagittal modifiers include C2-7 sagittal vertical axis (cSVA), T1 slope-cervical lordosis mismatch (TS-CL), and chin-brow vertical angle (CBVA). Each modifier stratifies patients as grade 0, 1, or 2. The study aimed to classify an asymptomatic population according to the Ames-ISSG sagittal modifier grades and assess differences in health-related quality of life (HRQOL) between grades.</p><p><strong>Methods: </strong>A cross-sectional analysis of a prospectively collected database was performed. Five hundred healthy, asymptomatic volunteers between 20 and 40 years of age without prior surgery or diagnosed spinal pathology were enrolled and underwent EOS imaging to measure their Ames-ISSG sagittal modifiers (cSVA, TS-CL, and CBVA). HRQOL questionnaires (the Oswestry Disability Index and Neck Disability Index) were also completed.</p><p><strong>Results: </strong>Four hundred seventy-seven patients were included. The cSVA was not analyzed because 475 of 477 individuals were grade 0 (< 4 cm). The TS-CL modifier was not analyzed because 472 of 477 individuals were grade 0 (< 15°). The CBVA was grade 0 (1°-10°) in 64% of individuals and grade 1 (-10° to 0° or 11°-25°) in 36%. There was no significant difference between grades in HRQOL.</p><p><strong>Conclusions: </strong>The Ames-ISSG classification sagittal modifiers cSVA and TS-CL grade 0 describe normal anatomy. A CBVA grade of 1 is present in 36% of asymptomatic individuals with no difference in HRQOL scores. This study validates the threshold for grade 0 in a normative population for TS-CL and cSVA. It also highlights inconsistency in CBVA and the importance of specific instructions for appropriate evaluation.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-5"},"PeriodicalIF":2.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gain of care independence following surgical intervention for cervical spondylotic myelopathy: a Quality Outcomes Database study.","authors":"Nitin Agarwal, Erica F Bisson, Mohamad Bydon, Anthony L Asher, Andrew K Chan, Michael Y Wang, Regis W Haid, John J Knightly, Oren N Gottfried, Christopher I Shaffrey, Michael S Virk, Mark E Shaffrey, Paul Park, Kevin T Foley, Domagoj Coric, Cheerag D Upadhyaya, Eric A Potts, Luis M Tumialán, Kai-Ming G Fu, Raj Swaroop Lavadi, Sarah E Johnson, Dean Chou, Praveen V Mummaneni","doi":"10.3171/2025.2.SPINE231237","DOIUrl":"https://doi.org/10.3171/2025.2.SPINE231237","url":null,"abstract":"<p><strong>Objective: </strong>Chronic spinal degenerative diseases have been associated with reduced quality of life and dependency on others for personal needs and care. The change between preoperative and postoperative care dependency has yet to be explored in patients with cervical spondylotic myelopathy (CSM). In this retrospective study of a prospectively collected database, the authors evaluated the return to independence in performing self-care following surgical intervention for CSM.</p><p><strong>Methods: </strong>The CSM dataset of the Quality Outcomes Database (QOD) Spine CORe study group was queried. Care dependency was assessed using the personal care component of the Neck Disability Index (NDI) questionnaire, having an ordinal scale from 0 to 5, with 5 representing the inability to independently perform activities of daily living. Numeric rating scale (NRS) scores for arm pain and neck pain were recorded at a 24-months postoperative follow-up. Multivariable logistic regression analyses were performed to identify baseline risk factors for an inability to care for oneself and the symptoms leading to care dependency at 24 months postoperatively. Satisfaction with surgery was measured using the 4-point North American Spine Society (NASS) index.</p><p><strong>Results: </strong>Of the 1137 patients with CSM and baseline personal care scores, 167 (14.7%) were care dependent at baseline (NDI personal care score ≥ 3). Patients with care dependency at baseline were predominantly Medicare beneficiaries and had a high school or lower level of education. Long-term follow-up rates for this study were 82.5% for NDI, 84.8% for patient satisfaction with surgery, 82.4% for NRS arm pain, and 81.8% for NRS neck pain. Of the care-dependent patients, more than 80% became independently able to care for themselves by the 24-month follow-up. Patients with resolved care dependency at 24 months had demonstrated lower baseline NDI and NRS neck pain scores (p < 0.01 for both). Neck pain was significantly associated with care dependency at 24 months' follow-up (p < 0.01). Patients who reported improvement in their ability to care for themselves noted higher postoperative satisfaction (NASS score 1-2) at the 3-month (89.4% vs 80.2%, p < 0.01) and 24-month (88.2% vs 67.4%, p < 0.01) follow-ups.</p><p><strong>Conclusions: </strong>Fifteen percent of patients with CSM depended on others for care preoperatively. After surgery to treat CSM, 81.8% of those who had depended on others for care became independent. Patients with improvements in care dependency noted higher postoperative satisfaction at the 3-month and 24-month follow-ups. Patients with resolved care dependency on long-term follow-up had lower NDI and NRS neck pain scores at baseline. Surgery had a significant impact on patients' attainment of independence.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-11"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor. Predicting time to pathological fracture in mobile spine metastases postradiotherapy using Hounsfield units.","authors":"Po-Jui Chu, Hung-Kuan Yen, Po-Hao Huang, Ming-Hsiao Hu","doi":"10.3171/2025.3.SPINE2512","DOIUrl":"https://doi.org/10.3171/2025.3.SPINE2512","url":null,"abstract":"","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-2"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biportal endoscopic multisegment decompression laminectomy for cervical spondylotic myelopathy.","authors":"Ji Yeon Kim, Dong Hwa Heo, Su Yong Choi, Dong Chan Lee, Hee Chang Kwon","doi":"10.3171/2025.2.SPINE241142","DOIUrl":"https://doi.org/10.3171/2025.2.SPINE241142","url":null,"abstract":"<p><strong>Objective: </strong>This case series introduces a modified biportal endoscopic technique for treating multilevel cervical spondylotic myelopathy (CSM) and evaluates midterm clinical and radiological outcomes.</p><p><strong>Methods: </strong>Biportal endoscopic decompression laminectomy using the spinous process floating technique was performed on patients with multilevel CSM. Radiographic measurements, including the C2-7 Cobb angle, range of motion, and cross-sectional area (CSA) of the dural sac and extensor muscles, were assessed preoperatively and 1-year postoperatively. Clinical outcomes were analyzed using the visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scale scores, with detailed complications documented.</p><p><strong>Results: </strong>Ten patients with 26 spinal segments underwent this surgery. The mean VAS and JOA scale scores showed significant improvement at the final follow-up: VAS neck score 6.0 ± 1.0 to 3.2 ± 0.4, VAS arm pain score 7.7 ± 0.6 to 2.4 ± 0.7, and JOA score 12.3 ± 0.6 to 15.5 ± 0.5 (all p < 0.05). The mean C2-7 Cobb angle gradually decreased after surgery but this increase was not statistically significant (9.9° ± 7.7° preoperatively, 7.4° ± 8.7° at 1 year, and 7.0° ± 8.6° at final follow-up). The reduction in the CSA of neck extensor muscles was minimal (12.9% ± 9.9% reduction at 1 year). The dural sac CSA expansion was sustained at 1 year (54.6% ± 36.6% increase). Delayed stress fractures of the spinous process occurred in 3-segment operations.</p><p><strong>Conclusions: </strong>Biportal endoscopic posterior cervical laminectomy for multilevel CSM was performed successfully without serious complications. Biportal endoscopic cervical laminoplasty significantly expanded the central canal in patients with CSM and provided favorable clinical outcomes after surgery. This technique offers a minimally invasive alternative to traditional surgery.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female authorship trends in high-impact spine surgery journals.","authors":"Courtney Deaver, Isabel L Bauer, Annemarie Pico, Kristin Nosova, Mahesh Challapalli, Naushaba Khan, Maria Jose Cavagnaro, Giovanni Barbagli, Nikhil Dholaria, James Kelbert, Diego T Soto Rubio, Amna Hussein, Julie Mayeku, Ibrahim A Alhalal, Niels Pacheco, Abdullah Al-Arfaj, Chao Li, Michael Prim, Ali A Baaj","doi":"10.3171/2025.2.SPINE24723","DOIUrl":"https://doi.org/10.3171/2025.2.SPINE24723","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to examine the trends in female authorship in high-impact spine journals and identify barriers present for female authors in spine surgery.</p><p><strong>Methods: </strong>A bibliometric analysis of seven spine surgery journals was conducted, covering publications from 2016 to 2021. First and senior author genders were determined using Genderize.io, supplemented by manual verification for ambiguous cases. Geographic and specialty-specific trends were analyzed, focusing on neurosurgery and orthopedic surgery.</p><p><strong>Results: </strong>Among 11,757 identified first authors and 11,231 identified senior authors, 13.4% of first authors and 9.3% of senior authors were female. Gender concordance analysis showed that with a female senior author, 26.7% of first authors were female compared with 12.5% with male senior authors (p < 0.00001). In 2021, there was no significant difference in the proportion of female senior authors between orthopedic (2.7%) and neurosurgery (1.2%) specialties. Papers with female authors were published in higher-impact factor journals, with the average impact factor for female first authors being 3.08 compared with the male average of 3.02, and for female senior authors, the average impact factor was 3.10 compared with their male counterparts' average of 3.02 (female first authors: p < 0.05, female senior authors: p < 0.001). US publications had fewer female first authors compared with international publications (p < 0.001).</p><p><strong>Conclusions: </strong>This study underscores the need for targeted strategies to overcome barriers to female participation and advancement in spine surgery. Enhancing mentorship and addressing implicit biases are essential to attract and retain more women in this field, ultimately benefiting the specialty and patient care.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor. Rethinking the gold standard: limitations and implications for validation processes.","authors":"Jonathan Pluemer, Rod J Oskouian, Jens R Chapman","doi":"10.3171/2025.2.SPINE25206","DOIUrl":"https://doi.org/10.3171/2025.2.SPINE25206","url":null,"abstract":"","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-2"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduction of traumatic unilateral locked facet of the subaxial cervical spine: what predicts successful closed skeletal traction, and is anterior or posterior surgery superior after unsuccessful closed reduction?","authors":"Bradley Wilhelmy, Riccardo Serra, Parantap Patel, Jesse Stokum, Ovais Hasan, Rong Zhao, Chixiang Chen, Kristopher Hooten, Ross Puffer, Steven Ludwig, Kenneth Crandall, Gary Schwartzbauer, Charles Sansur, Bizhan Aarabi, Timothy Chryssikos","doi":"10.3171/2025.3.SPINE241107","DOIUrl":"https://doi.org/10.3171/2025.3.SPINE241107","url":null,"abstract":"<p><strong>Objective: </strong>Closed skeletal traction (CST) to reduce unilateral locked facets in the subaxial cervical spine can expedite spinal realignment prior to definitive surgery but is not always successful. What predicts successful closed reduction is not completely understood. In addition, whether open anterior or posterior surgery is superior for achieving successful reduction after failed closed skeletal traction has not been investigated. The authors sought to assess predictors of successful closed reduction with skeletal traction and to compare the efficacy of anterior versus posterior surgery after failed closed reduction.</p><p><strong>Methods: </strong>The authors performed a retrospective analysis of patients presenting to a single level I trauma center with a de facto unilateral locked facet between 2008 and 2024. Patients with a complex facet fracture without a locked facet, bilateral locked facet, and/or no attempted CST were excluded. Fractures involving discrete, structurally relevant bony elements and other pathological features, and variables of reduction technique were recorded. Successful reduction was determined by restoration of anatomical alignment on fluoroscopy prior to surgery and verified with postoperative CT.</p><p><strong>Results: </strong>Fifty-five patients met the inclusion criteria. The population was 71% male, and the mean age was 47 ± 18 years. Closed reduction was successful in 56% of patients. The mean maximum weight applied was 60 ± 33 lb. Awake CST had a 48% success rate and CST under general anesthesia (GA) had an overall success rate of 61%. Upfront CST under GA (without prior unsuccessful awake CST) had a success rate of 83%, but no cases of failed awake CST were successfully reduced with subsequent CST under GA. On multivariate analysis, a contralateral perched facet increased the odds of successful closed reduction by 32-fold and presence of neurological injury (AIS grades A-D) reduced the odds of successful closed reduction by 21-fold. In patients requiring open surgical reduction after failed CST, posterior surgery was significantly more successful than anterior surgery (100% vs 45%, p = 0.026). Of the 6 patients in whom open reduction failed via an anterior approach, 5 underwent successful reduction during subsequent posterior surgery.</p><p><strong>Conclusions: </strong>A contralateral perched facet predicted successful CST, whereas any neurological deficit (AIS grade A-D) predicted failed CST. GA increased the odds of successful closed reduction but did not salvage failed awake CST attempts. In patients in whom CST failed and open surgical reduction was required, posterior surgery was significantly more successful than anterior surgery for reestablishing anatomical alignment.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-11"},"PeriodicalIF":2.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study on the effect of age on Neck Disability Index improvement at 24 months after surgical intervention for cervical spondylotic myelopathy: a Quality Outcomes Database study.","authors":"Ken Porche, Brandon A Sherrod, Spencer Rosero, Andrew K Chan, Christopher I Shaffrey, Oren N Gottfried, Mohamad Bydon, Anthony L Asher, Domagoj Coric, Eric A Potts, Kevin T Foley, Michael Y Wang, Kai-Ming Fu, Michael S Virk, John J Knightly, Scott Meyer, Cheerag D Upadhyaya, Mark E Shaffrey, Juan S Uribe, Luis M Tumialán, Jay D Turner, Dean Chou, Regis W Haid, Praveen V Mummaneni, Paul Park, Erica F Bisson","doi":"10.3171/2025.3.SPINE24598","DOIUrl":"https://doi.org/10.3171/2025.3.SPINE24598","url":null,"abstract":"<p><strong>Objective: </strong>Cervical spondylotic myelopathy (CSM) is often accompanied by neck pain, which, along with more recognized neurological deficits like motor and sensory changes, significantly impacts patients' quality of life. The authors examined whether age influences improvements in neck disability and related quality-of-life measures after surgery for CSM. Using the Neck Disability Index (NDI) as the primary outcome, they compared long-term outcomes at 24 months among patients aged ≥ 65, ≥75, and < 65 years, exploring the effects of surgical intervention on both pain-related disability and functional recovery in older adults.</p><p><strong>Methods: </strong>Using the Quality Outcomes Database, the authors conducted a detailed propensity score-matched analysis on cohorts aged ≥ 65 and ≥ 75 years compared with a < 65-year-old cohort while controlling for baseline NDI scores, other demographic variables, health status, underlying pathology, number of levels, indication for surgery, surgical approach, and type of surgery. Differences in NDI total and subdomain scores at 24 months postoperatively were the primary measures of improvement. Age-related variability in NDI differential was assessed. EQ-5D and calculated SF-6D were secondary measures.</p><p><strong>Results: </strong>Of the 1141 patients in the cohort (January 2016 to December 2018), 687 patients were < 65 years, 325 were 65 to < 75 years, and 129 were ≥ 75 years of age. After propensity score matching, 197 patients each were well matched in the ≥ 65-year (mean 71.4 years) and < 65-year (mean 55.3 years) cohorts; similarly, 57 patients each were matched in the ≥ 75-year (mean 78.3 years) and < 65-year (mean 55.8 years) cohorts. Improvements in NDI scores and subdomain scores, EQ-5D, and calculated SF-6D were consistent at 3, 12, and 24 months postoperatively across all cohorts. At 24 months, patients ≥ 65 years showed NDI score improvements (-14.7 ± 22.3) similar to those < 65 years (-13.0 ± 21.3, p = 0.454), and patients ≥ 75 years demonstrated NDI improvements (-15.0 ± 19.7) comparable to those < 65 years (-17.6 ± 20.4, p = 0.499). A sensitivity analysis for linear relationship found that NDI improvement was statistically greater in older patients (7.5 points every 30 years, p < 0.0001), but this difference was below the minimal clinically important difference. Other clinical outcomes were similar between cohorts.</p><p><strong>Conclusions: </strong>Surgical intervention for CSM yields substantial and similar improvements in NDI scores and other metrics among various age groups, including those aged at least 65 and 75 years. These results highlight the effectiveness of surgery across a broad patient demographic, underscoring its value in treating CSM irrespective of age.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-16"},"PeriodicalIF":2.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of suboccipital craniectomy versus suboccipital cranioplasty in foramen magnum decompression for adult Chiari malformation.","authors":"Hangeul Park, Woojin Kim, Jungbo Sim, Hosung Myeong, Jun-Hoe Kim, Chang-Hyun Lee, Chun Kee Chung, Chi Heon Kim","doi":"10.3171/2025.2.SPINE241362","DOIUrl":"https://doi.org/10.3171/2025.2.SPINE241362","url":null,"abstract":"<p><strong>Objective: </strong>Foramen magnum decompression (FMD) by suboccipital craniectomy, which aims to restore CSF flow and alleviate symptoms, is the conventional treatment for symptomatic Chiari malformation (CM). However, suboccipital cranioplasty is considered to maintain cervical alignment, prevent headaches, improve cosmetic outcomes, and provide protection against trauma. The aim of this study was to compare two surgical techniques, suboccipital craniectomy and suboccipital cranioplasty, to evaluate clinical outcomes, radiological results, and medical costs.</p><p><strong>Methods: </strong>This retrospective analysis included 64 patients (mean age 37.6 ± 12.7 years) who underwent FMD for CM at a single tertiary referral center from January 2003 to March 2024. Patients were divided into two groups according to whether they underwent suboccipital craniectomy or suboccipital cranioplasty. Clinical data, radiological findings, surgical time, estimated blood loss (EBL), and medical costs were analyzed and compared between the groups.</p><p><strong>Results: </strong>Both surgical techniques significantly improved preoperative symptoms, and no significant differences were observed in surgical time or EBL between the groups. Radiologically, the suboccipital craniectomy group demonstrated a greater increase in subarachnoid space (mean 215.3 ± 113.6 mm2) compared with the suboccipital cranioplasty group (mean 141.4 ± 97.3 mm2, p = 0.008), although the reduction in syrinx size was similar for both groups. The suboccipital cranioplasty group incurred higher daily medical costs (mean $1568.4 ± $455.5) compared with the suboccipital craniectomy group (mean $887.1 ± $340.5, p < 0.001), primarily due to the additional expenses related to bony reconstruction materials such as plates and screws (mean $343.3 ± $81.6).</p><p><strong>Conclusions: </strong>Suboccipital craniectomy and cranioplasty both effectively improve symptoms for patients with CM. However, suboccipital cranioplasty involves additional costs, which should be discussed in the shared decision-making process.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responsiveness of the PROMIS Global Health-10 Survey compared with the Oswestry Disability Index in patients undergoing 1- and 2-level lumbar fusions.","authors":"Matthew J Solomito, Heeren Makanji","doi":"10.3171/2025.2.SPINE241315","DOIUrl":"https://doi.org/10.3171/2025.2.SPINE241315","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the responsiveness of the mental health T-score (MHT) and physical health T-score (PHT) of the Patient-Reported Outcomes Measure Information System Global Health-10 Survey (PROMIS-10) compared with the Oswestry Disability Index (ODI) and to determine if the patient-reported outcome measures (PROMs) provided a similar assessment of patient outcomes.</p><p><strong>Methods: </strong>A total of 379 patients who underwent 1- or 2-level lumbar fusions between June 2021 and June 2023 were analyzed in this retrospective study. All patients completed their preoperative PROMs as well as their 3-, 6-, and 12-month follow-up PROMs. A responsiveness analysis to assess floor and ceiling effects, the correlation between the PHT and ODI as well as the MHT and ODI, and effect size indices (ESIs) was conducted to determine the responsiveness and construct validation of the MHT and PHT compared with the ODI.</p><p><strong>Results: </strong>Neither the ODI nor the MHT or PHT demonstrated a floor effect; however, up to 16% of the study cohort showed a ceiling effect with the PROMIS, whereas no patients reached the maximum score for the ODI. The PHT was strongly correlated with the ODI score at all time points with the correlation coefficients ranging between -0.71 and -0.82, while the MHT showed weak to moderate correlation (r = 0.48-0.67). The ESI demonstrated that the ODI was the most responsive of the tools assessed followed by the PHT; the MHT was noted to show limited responsiveness.</p><p><strong>Conclusions: </strong>The PROMIS-10 PHT provided similar responsiveness and construct validity as seen with the ODI at detecting functional changes after elective lumbar fusion. The PROMIS-10 MHT provides valuable insight into the patient's current mental health but was not overly responsive to change. The ODI remains the most responsive and accurate tool to assess low back function and postoperative improvement, but the PROMIS-10 can provide additional meaningful data that could be used to augment information gained from the ODI.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}