Journal of neurosurgery. Spine最新文献

{"title":"Increasing pelvic tilt after lumbosacral fusion predicts higher frequency of posttreatment sacroiliac joint fusion.","authors":"Kevin T Kim, Matthew Hentschel, Rong Zhao, Maureen Rakovec, Nathan Han, Chixiang Chen, Timothy Chryssikos, Charles A Sansur","doi":"10.3171/2025.1.SPINE241202","DOIUrl":"https://doi.org/10.3171/2025.1.SPINE241202","url":null,"abstract":"<p><strong>Objective: </strong>Sacroiliac joint dysfunction is increasingly recognized as a source of low back pain. Sacroiliac joint dysfunction after lumbosacral fusion is a potential cause of persistent disability and may be difficult to predict. The authors sought to investigate the understudied relationship between spinopelvic parameters and frequency of sacroiliac joint fusion after lumbosacral fusion.</p><p><strong>Methods: </strong>The authors performed a retrospective analysis of patients who underwent lumbar fusion surgery between 2016 and 2022. Patients with < 2 years of follow-up data, lower instrumented vertebra (LIV) above S1, prior spinopelvic fixation, inadequate postoperative standing radiographs, S2-alar-iliac pelvic fixation technique, prior or concomitant sacroiliac joint dysfunction or fusion surgery at the time of the index surgery were excluded. Patients with fusion including S1 with or without iliac fixation were included. Demographic and surgical data were collected. Spinopelvic parameters were measured on standing radiographs. Summary statistics and univariate and multivariable analyses were performed.</p><p><strong>Results: </strong>Ninety patients met the inclusion and exclusion criteria. The patient mean age was 61.33 ± 10.72 years; 61.1% of patients were female. The mean BMI was 30.80 ± 6.80. There were 49 patients (54.4%) with fusion to S1 and 41 patients (45.6%) with fusion to S1 plus iliac fixation. Among the entire cohort, 30 (33.3%) had a positive response to postoperative sacroiliac joint injections and 23 (25.6%) patients underwent sacroiliac joint fusion after a diagnosis of sacroiliac joint dysfunction was confirmed by injection. A head-to-head comparison of patients who did and did not have sacroiliac joint fusion demonstrated no significant differences in age, sex, BMI, smoking status, bone radiodensity (mean Hounsfield units at S1), number of spinal fusion levels, interbody technique at L5-S1, change between preoperative and postoperative spinopelvic parameters, and postoperative pelvic incidence (PI), lumbar lordosis (LL), and sacral slope. There was no head-to-head difference in frequency of sacroiliac joint fusion between patients with and those without iliac fixation. Patients who had sacroiliac joint fusion had a greater postoperative pelvic tilt (PT) (p = 0.002) and higher postoperative PI-LL mismatch (p = 0.004). On multivariable analysis after forward selection, higher postoperative PT (OR 1.102, 95% CI 1.033-1.186, p = 0.003) was an independent and significant predictor of having sacroiliac joint fusion after index lumbosacral fusion surgery.</p><p><strong>Conclusions: </strong>Lumbosacral fusion patients with higher postoperative PT were more likely to have sacroiliac joint fusion after lumbosacral fusion surgery for treatment of sacroiliac joint dysfunction.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025329","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":"Utility of magnetic resonance imaging-based vertebral bone quality score in recognizing patients at risk for secondary fracture after vertebroplasty.","authors":"Aamir Kadri, Daniel Liu, Anna Sorensen, Neil Binkley, Andrew Ross, Paul A Anderson","doi":"10.3171/2025.1.SPINE24976","DOIUrl":"https://doi.org/10.3171/2025.1.SPINE24976","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to determine whether the vertebral bone quality (VBQ) score could identify, among patients undergoing vertebroplasty and having probable low bone mineral density, those who were at risk for secondary fracture.</p><p><strong>Methods: </strong>In this retrospective study, the authors evaluated the medical records of patients with a compression fracture who had undergone vertebroplasty and had preprocedural T1-weighted MRI from January 2016 to January 2021. VBQ scores were calculated as the quotient of the median signal intensity from the L1 to L4 vertebral bodies divided by the signal intensity of L3 cerebrospinal fluid on T1-weighted imaging. A high VBQ score was defined as ≥ 3.0, with receiver operating characteristic curve analysis performed to verify this threshold. Secondary fracture included a fracture at any site after the index vertebroplasty procedure. Time-to-event analysis was performed to determine secondary fracture occurrence.</p><p><strong>Results: </strong>Among 60 patients eligible for the study, the mean time to follow-up was 25.7 ± 15.4 months (mean ± standard deviation), age was 73.65 ± 10.1 years, BMI was 28.93 ± 6.7, and 57% of the patients were female. The mean VBQ score excluding the lumbar fracture level was 3.44 ± 0.82, which was not significantly different from the mean VBQ score including the fracture level (3.40 ± 0.84; p = 0.401). Secondary fracture occurred in 33.3% of the patients, 85% of whom had a high VBQ score. Fracture occurred more than 60 days after the index procedure in 80% of the patients. Based on time-to-event analysis, secondary fracture occurred more often and earlier in patients with a VBQ score ≥ 3.0.</p><p><strong>Conclusions: </strong>The VBQ score was not significantly affected by VCF. A high score (≥ 3.0) was common in patients who had undergone vertebroplasty and sustained a secondary fracture. Most fractures occurred ≥ 60 days from vertebroplasty, suggesting that initiation of anti-osteoporosis therapies after such a procedure may be useful. The VBQ score may be helpful in identifying high-risk patients who may need additional evaluation and anti-osteoporosis therapy.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025195","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":"Enhanced Recovery After Surgery plus preoperative antifrailty in frail patients with adult spinal deformity: a two-step propensity score-matched analysis.","authors":"Shuaikang Wang, Peng Wang, Di Han, Xiangyu Li, Wei Wang, Shibao Lu","doi":"10.3171/2025.1.SPINE241372","DOIUrl":"https://doi.org/10.3171/2025.1.SPINE241372","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the effect of Enhanced Recovery After Surgery plus preoperative antifrailty (PAFERAS) on surgical outcomes of frail patients who underwent long-segment surgery for adult spinal deformity (ASD).</p><p><strong>Methods: </strong>This is a retrospective study using a prospectively collected ASD database. Patients who underwent open long-segment fusion surgery (≥ 5 levels) for ASD between January 2017 and March 2024 were classified as nonfrail (NF; 5-factor modified frailty index [mFI-5] score = 0), prefrail (PF; mFI-5 score = 1), or frail (mFI-5 score ≥ 2) based on their physical activity and comorbidities. For frail patients, the antifrailty interventions of the PAFERAS program focused on preoperative exercise and nutritional optimization. NF/PF patients of the PAFERAS group received preoperative dietary counseling, nutritional education, and standardized rehabilitation advice. Meanwhile, frail patients were divided into non-PAFERAS (before January 2019) and PAFERAS (after January 2019) groups based on whether they received PAFERAS care or not. Frail patients with antifrailty (AF group) were compared with PF patients, NF patients, and frail patients in the non-PAFERAS group. AF patients were propensity score matched 1:1 to the NF, PF, and non-PAFERAS groups patients based on age, pelvic incidence minus lumbar lordosis, and intraoperative estimated blood loss.</p><p><strong>Results: </strong>A total of 286 patients from the PAFERAS group (31.8% in the NF group, 46.9% in the PF group, and 21.3% in the AF group) and 142 patients from the non-PAFERAS group were included in the final analysis. The 1st day of assisted walking occurred, on average, 1 day earlier in the AF group than in frail patients from the non-PAFERAS group (3.52 vs 2.54 days, p = 0.016). The postoperative length of hospital stay (LOS) for frail patients significantly decreased from 14.29 days before PAFERAS to 10.64 days after PAFERAS (p = 0.011). No significant differences were observed between the matched AF and NF/PF groups in the 1st day of assisted walking and the 1st day of bowel movement. There were no differences between the AF and NF/PF groups in postoperative LOS, nonhome discharge rate, rates of severe complications, and rates of minor complications.</p><p><strong>Conclusions: </strong>The PAFERAS protocol significantly improves the return of physiological function and the LOS for frail patients undergoing ASD surgery. After implementing preoperative exercise and nutritional optimization for frail patients, the recovery process of physiological function and LOS in patients with frailty were similar to those in NF or PF patients.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-11"},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988764","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":"The effect of patient body mass on renal function in multilevel spinal fusion for adult spinal deformity to prevent acute kidney injury.","authors":"Fady F Guirguis, Mina F Guirguis, Parker D Smith, Michael S Farid, Srivats Srinivasan, Sruthi Ranganathan, Shravya Kakulamarri, Omar S Akbik, Kristen Hall, Umaru Barrie, James P Caruso, Salah G Aoun, Carlos A Bagley","doi":"10.3171/2025.1.SPINE24978","DOIUrl":"https://doi.org/10.3171/2025.1.SPINE24978","url":null,"abstract":"<p><strong>Objective: </strong>Adult spinal deformity (ASD), a condition characterized by spinal degeneration resulting in abnormal spinal curvature and pain, can be treated with multilevel spinal fusion. Perioperative acute kidney injury (AKI) is associated with prolonged hospital stays, death, and overall poor surgical outcomes. High-volume fluid resuscitation can prevent AKI, however. It is contraindicated in surgeries such as spinal fusion for ASD, given the risk of elevated intraocular pressure resulting in ocular damage when a patient is positioned prone. This study aimed to evaluate how preoperative renal function affects outcomes in ASD spinal fusion and to determine the incidence of and risk factors for developing perioperative AKI in ASD surgery.</p><p><strong>Methods: </strong>Patients with ASD who underwent long-segment thoracolumbar fusion for abnormal spinal curvature between 2016 and 2021 were included. Blood urea nitrogen and creatinine values from within 24 hours prior to surgery were used. KDIGO (Kidney Disease Improving Global Outcomes) guidelines were used to define AKI, and the Cockroft-Gault equation was used to calculate creatinine clearance. Univariate analyses assessed perioperative factors affecting AKI development and associations with chronic kidney disease.</p><p><strong>Results: </strong>A total of 235 consecutive patients were included, of whom 155 were women. The average age was 69.6 years (SD 8.0 years). Forty patients (17%) developed AKI postoperatively. Anesthesia duration (289.2 vs 293.3 minutes, p = 0.739), blood loss (1.65 vs 1.58 L, p = 0.663), and number of levels fused (9.0 vs 9.4, p = 0.459) were similar in patients with and without AKI. Patients developing AKI were more likely to have higher BMI (31.8 vs 27.5 kg/m2, p < 0.001). Intraoperative colloid (1.10 vs 1.07 L, p = 0.771), crystalloid (2.35 vs 2.61 L, p = 0.160), and total fluid volumes (4.92 vs 5.08 L, p = 0.702) were similar in patients with and without AKI. Multivariate analysis found that total fluid volume (p = 0.404) and weight-adjusted total fluid volume (p = 0.249) were not significantly predictive of AKI when controlling for BMI. Patients with BMI > 27.34 kg/m2 were more likely to develop AKI. Patients with chronic kidney disease (7.23%) did not develop AKI at a higher rate than patients without it (p = 0.200).</p><p><strong>Conclusions: </strong>Perioperative AKI occurred regardless of the volume of colloid, crystalloid, or total fluid administered intraoperatively. Therefore, a more cautious approach to fluid resuscitation is recommended to mitigate the risk of ocular damage in patients undergoing spinal fusion for ASD.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997713","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":"Prevention of lower instrumented vertebra pedicle screw failure in multilevel constructs for adult spinal deformity surgery using hybrid hook-screw constructs.","authors":"Jae-Koo Lee, Seung-Jae Hyun, Ki-Jeong Kim","doi":"10.3171/2025.1.SPINE24974","DOIUrl":"https://doi.org/10.3171/2025.1.SPINE24974","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the effectiveness of hybrid hook-screw constructs in preventing distal junctional failure (DJF) and to assess radiographic outcomes in multilevel adult spinal surgery.</p><p><strong>Methods: </strong>This retrospective study analyzed 53 patients who underwent multilevel thoracolumbar fixation from January 2014 to December 2020, with a minimum follow-up of 1 year. DJF was categorized into bony failure, ligamentous failure, and screw failure. Patients were divided into 2 groups according to receiving a pedicle screw (PS)-only construct (PS group) or hybrid hook-screw construct (hybrid group). Kaplan-Meier analysis and logistic regression were used to evaluate survival rates and predictors of DJF.</p><p><strong>Results: </strong>No significant differences in demographic or surgical characteristics were observed between the 2 groups. Screw failure rates were significantly lower in the hybrid group (5.6%) compared with the PS group (42.9%, p = 0.042). Kaplan-Meier analysis revealed a 1-year survival rate for avoiding screw failure of 100% in the hybrid group versus 50% in the PS group (p = 0.031). However, ligamentous failure occurred more frequently in the hybrid group (33.3%) compared with none in the PS group (p = 0.002). Overall, DJF rates did not differ significantly between the 2 groups.</p><p><strong>Conclusions: </strong>Hybrid hook-screw constructs reduced screw failure but were associated with an increased incidence of ligamentous failure. Although overall DJF rates remained comparable, careful patient selection and further investigation are warranted to optimize the clinical utility of hybrid constructs in multilevel spinal surgeries.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017708","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":"Artificial intelligence image analysis for Hounsfield units in preoperative thoracolumbar CT scans: an automated screening for osteoporosis in patients undergoing spine surgery.","authors":"Emily Feng, Nishantha M Jayasuriya, Karim Rizwan Nathani, Konstantinos Katsos, Laura A Machlab, Graham W Johnson, Brett A Freedman, Mohamad Bydon","doi":"10.3171/2025.1.SPINE24900","DOIUrl":"https://doi.org/10.3171/2025.1.SPINE24900","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop an artificial intelligence (AI) model for automatically detecting Hounsfield unit (HU) values at the L1 vertebra in preoperative thoracolumbar CT scans. This model serves as a screening tool for osteoporosis in patients undergoing spine surgery, offering an alternative to traditional bone mineral density measurement methods like dual-energy x-ray absorptiometry.</p><p><strong>Methods: </strong>The authors utilized two CT scan datasets, comprising 501 images, which were split into training, validation, and test subsets. The nnU-Net framework was used for segmentation, followed by an algorithm to calculate HU values from the L1 vertebra. The model's performance was validated against manual HU calculations by expert raters on 56 CT scans. Statistical measures included the Dice coefficient, Pearson correlation coefficient, intraclass correlation coefficient (ICC), and Bland-Altman plots to assess the agreement between AI and human-derived HU measurements.</p><p><strong>Results: </strong>The AI model achieved a high Dice coefficient of 0.91 for vertebral segmentation. The Pearson correlation coefficient between AI-derived HU and human-derived HU values was 0.96, indicating strong agreement. ICC values for interrater reliability were 0.95 and 0.94 for raters 1 and 2, respectively. The mean difference between AI and human HU values was 7.0 HU, with limits of agreement ranging from -21.1 to 35.2 HU. A paired t-test showed no significant difference between AI and human measurements (p = 0.21).</p><p><strong>Conclusions: </strong>The AI model demonstrated strong agreement with human experts in measuring HU values, validating its potential as a reliable tool for automated osteoporosis screening in spine surgery patients. This approach can enhance preoperative risk assessment and perioperative bone health optimization. Future research should focus on external validation and inclusion of diverse patient demographics to ensure broader applicability.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026047","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":"Sociodemographic and hospital-level predictors of muscle flap reconstruction in spinal fusion surgeries: a propensity score-matched analysis.","authors":"Anthony J Tang, Dylan K Kim, Matthew A Wright, Dean Chou, Christine H Rohde, Andrew K Chan","doi":"10.3171/2025.1.SPINE241090","DOIUrl":"https://doi.org/10.3171/2025.1.SPINE241090","url":null,"abstract":"<p><strong>Objective: </strong>Spinal fusion is associated with risks of surgical site infection and wound dehiscence. Muscle flap reconstruction during surgery may mitigate these risks. While the benefits of muscle flap reconstruction have been established, sociodemographic and hospital-level influences on access to this procedure remain unexplored. This study identifies sociodemographic predictors of muscle flap reconstruction after spinal fusion surgeries using a nationwide database.</p><p><strong>Methods: </strong>Patients who underwent spinal fusion of two or more vertebral levels (n = 606,408) were identified from the 2012-2020 National Inpatient Sample database. The primary investigated outcome was utilization of muscle flap reconstruction. Cases without and with muscle flap reconstruction were 2:1 propensity score matched based on covariates for clinical severity and surgical complexity. Binary logistic regression identified significant sociodemographic and hospital-level predictors of receiving muscle flap reconstruction (p < 0.05).</p><p><strong>Results: </strong>Of 606,408 discharges with spinal fusion cases, 1991 (0.3%) included muscle flap reconstruction. After matching (n = 5973), patient-level factors including private insurance status, residence in large metropolitan counties, and high median zip code income quartile, and hospital-level factors including urban teaching hospital status, higher institutional plastic surgery case volume, and private not-for-profit hospital ownership, all predicted a higher likelihood of muscle flap reconstruction (p < 0.05).</p><p><strong>Conclusions: </strong>Multiple sociodemographic variables predict use of muscle flap reconstruction after spinal fusion surgery. These disparities may stem from multiple underlying factors, including lack of access to specialized plastic surgery care and centralization of more complex cases at quaternary care hospitals. A better understanding of these factors may help inform further efforts to increase access to muscle flap reconstruction, thereby reducing the risk of wound healing complications.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-14"},"PeriodicalIF":2.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018876","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":"Factors associated with cervical instability in cervical myelopathy patients.","authors":"Chao Li, Beiyu Xu, Yao Zhao, Longtao Qi, Lei Yue, Ranlyu Zhu, Chunde Li","doi":"10.3171/2025.1.SPINE241183","DOIUrl":"10.3171/2025.1.SPINE241183","url":null,"abstract":"<p><strong>Objective: </strong>Cervical instability may influence the development and progression of cervical spondylotic myelopathy (CSM). This study aimed to investigate the prevalence of cervical instability in patients with CSM and identify associated factors.</p><p><strong>Methods: </strong>The authors examined the clinical and radiological characteristics of 167 patients aged 40-80 years diagnosed with CSM who required hospitalization between June 2022 and June 2024. Cervical spine radiography was used to evaluate cervical instability, which was defined as a ≥ 3-mm translational motion between adjacent vertebrae on flexion-extension views. Factors potentially associated with cervical instability were compared between patients with and without instability and further investigated using multivariate logistic regression.</p><p><strong>Results: </strong>The mean patient age was 57.7 ± 10.3 years, and 115 patients (68.9%) were men. Cervical instability was identified in 72 patients (43.1%). Multivariate logistic regression identified cervical facet joint degeneration, a difference between the T1 slope and cervical lordosis, and visual analog scale score for neck pain as significantly associated factors for cervical instability.</p><p><strong>Conclusions: </strong>This study revealed a high prevalence (43.1%) of cervical instability among patients with CSM and identified significantly associated factors. Spine surgeons should pay special attention to these factors in the surgical decision-making process.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"673-678"},"PeriodicalIF":2.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012416","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":"Lessons from the pandemic: a retrospective study and literature comparative review of provider and patient experiences with telemedicine in spine care.","authors":"Srivats Srinivasan, Sapan Patel, Taimur Hassan, Pooja Venkatesh, Michael Farid, Mina Guirguis, Kristen Hall, Umaru Barrie, Mazin Al Tamimi, Carlos A Bagley, Salah G Aoun","doi":"10.3171/2025.1.SPINE24959","DOIUrl":"https://doi.org/10.3171/2025.1.SPINE24959","url":null,"abstract":"<p><strong>Objective: </strong>Telemedicine use for patient care in spine surgery drastically increased after the advent of the COVID-19 pandemic. The authors aimed to examine factors influencing telemedicine utilization during this period by comparing perspectives from patients and spine surgeons to better guide the use of telehealth beyond the pandemic.</p><p><strong>Methods: </strong>Between June 2021 and December 2021, a survey was administered to spine care patients receiving virtual visits at a single multidisciplinary spine center to assess their telemedicine experience, including visit quality, overall communication, and technical challenges. Furthermore, a systematic review using the PubMed, Google Scholar, Embase and Web of Science databases in accordance with the PRISMA guidelines was conducted to identify survey studies of spine surgeons and patients assessing telemedicine experiences.</p><p><strong>Results: </strong>A total of 407 patients were included in our survey; 65.6% were female, and 82.8% were at least 55 years of age. Most patients were White (86.2%) and had at least a bachelor's degree (81.6%). The majority of respondents (96.8%) reported being satisfied or very satisfied with their telemedicine visits. Explanations at the end of visit (p < 0.001), time spent during the visit (p < 0.001), and absence of technical issues (p < 0.001) were significantly associated with increased patient satisfaction. Barriers to access such as education level, age, or race were not significantly associated with patient satisfaction (p > 0.05). The authors also performed a systematic review that identified 10 studies on patient attitudes toward telemedicine with 3569 respondents in North America and 10 surveys of spine surgeons with 3043 respondents internationally. Most telemedicine visits were pre- or postoperative (56.3%, 1914/3399; range 42%-95%), and the majority of patients reported traveling less than 25 miles for in-person visits (63.3%, 815/1287; range 57%-68%). Nine patient studies revealed a high patient satisfaction level with telemedicine (79.7%, 2248/2821; range 36%-93%). The virtual physical examination was of greater concern for surgeons (48.6%, 433/891; range 10%-91%) than for patients (15.5%, 156/1007; range 2%-74%).</p><p><strong>Conclusions: </strong>This study highlights the high level of patient satisfaction with telemedicine in spine care, emphasizing factors including clear explanations, sufficient time during visits, and minimal technical issues. Despite concerns about the virtual physical examination, especially among surgeons, telemedicine was effectively utilized for pre- and postoperative care. Telemedicine can continue to play a valuable role in spine care beyond the pandemic, provided that technical challenges are addressed, and communication remains clear and thorough.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-16"},"PeriodicalIF":2.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025277","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":"Erratum. Predictors of spinal trauma care and outcomes in a resource-constrained environment: a decision tree analysis of spinal trauma surgery and outcomes in Tanzania.","authors":"Andreas Leidinger","doi":"10.3171/2025.3.SPINE22763a","DOIUrl":"10.3171/2025.3.SPINE22763a","url":null,"abstract":"","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"797-798"},"PeriodicalIF":2.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970582","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}