Journal of neurosurgery. Spine最新文献

{"title":"Introduction. Proceedings of Spine Summit 2025.","authors":"Jay D Turner, Dean Chou, Lawrence G Lenke, Laura A Snyder, Melissa Erickson, Erica Bisson, Juan S Uribe","doi":"10.3171/2025.6.SPINE25896","DOIUrl":"https://doi.org/10.3171/2025.6.SPINE25896","url":null,"abstract":"","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957842","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 detailed account of Christopher Reeve's spinal cord injury, its treatment, and its impact upon research 30 years later.","authors":"Kathleen S Botterbush, Maaria Chaudhry, Justin K Zhang, Philippe Mercier, Tobias A Mattei","doi":"10.3171/2025.4.SPINE241302","DOIUrl":"https://doi.org/10.3171/2025.4.SPINE241302","url":null,"abstract":"<p><p>On the screen, Christopher Reeve was Superman. Off-screen, Reeve was an avid equestrian who experienced arguably one of the most famous horse riding accidents to date when a fall from the saddle led to comminuted C1 and C2 fractures with an associated spinal cord injury that left him quadriplegic. Reeve publicly endured a grueling rehabilitation including personalized training plans and experimental treatments coupled with severe depression. With his family and friends by his side, Reeve shocked everyone when he was able to lift a finger on his left hand and feel the hugs of his family several years after being diagnosed with an American Spinal Injury Association grade A injury. He went on to establish the Christopher & Dana Reeve Foundation to advocate for research funding and quality-of-life programs for patients with spinal cord injury. Unfortunately, Christopher Reeve died in 2004. However, his legacy lives on in the lasting impact he made in spinal cord injury awareness and in the continued work of his children through the Christopher & Dana Reeve Foundation. To the authors' knowledge, this is the first comprehensive look at the life, injury, and legacy of Christopher Reeve and his foundation now 30 years after such a fateful accident.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-7"},"PeriodicalIF":3.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957879","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":"Randomized controlled trials comparing cervical disc arthroplasty and anterior cervical discectomy and fusion outcomes in degenerative spine disease: a systematic review and meta-analysis.","authors":"Salim Yakdan, Braeden Benedict, Kathleen Botterbush, Adhya Lagisetty, Muhammad Irfan Kaleem, Rachel Alessio, Angela Hardi, Saad Javeed, Miguel A Ruiz-Cardozo, Alexander T Yahanda, Jing Wang, Mohamad Bydon, Wilson Z Ray, Jacob K Greenberg","doi":"10.3171/2025.4.SPINE241277","DOIUrl":"https://doi.org/10.3171/2025.4.SPINE241277","url":null,"abstract":"<p><strong>Objective: </strong>Anterior cervical discectomy and fusion (ACDF) is an established treatment for cervical degenerative disc disease; however, the procedure can cause loss of cervical spine range of motion and potentially accelerate adjacent segment degeneration. Cervical disc arthroplasty (CDA) seeks to preserve native motion of the cervical spine, which can theoretically reduce the incidence of adjacent level degeneration. The literature regarding the relative efficacy of ACDF versus CDA remains inconsistent. In this study, the authors investigate the difference in outcomes between ACDF and CDA and identify factors contributing to the heterogeneity in the literature.</p><p><strong>Methods: </strong>The Ovid, Embase, Scopus, Cochrane, and ClinicalTrials.gov databases were systematically searched from inception to September 5, 2023, for randomized controlled trials (RCTs) comparing ACDF and CDA for degenerative disc disease. Studies were extracted by two authors and verified by a third. Random-effects meta-analysis was performed. The primary outcome was the difference in clinical outcomes between the two surgical groups. The secondary outcomes were the differences in radiological outcomes, surgical characteristics, complication rates, and hospital lengths of stay. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration no. CRD42023469204) and adhered to the PRISMA guidelines.</p><p><strong>Results: </strong>From 584 articles uploaded to the Covidence platform for screening, 35 studies derived from 25 RCTs were included in this systematic review and meta-analysis. A total of 4530 patients were treated with ACDF (2081) and CDA (2449). Forty-six percent of the patients (2063) were male, and the mean age of the study cohort was 45 ± 3 years. In terms of the primary outcome, CDA showed higher rates of neurological and overall success. Regarding the secondary outcomes, CDA demonstrated a significantly lower rate of adjacent level disease, higher rate of heterotopic ossification, and greater range of motion at the operated level. Additionally, CDA had lower rates of reoperation but significantly longer operative times than ACDF. The inclusion of myelopathic patients and variations in follow-up between the surgical groups contributed to the observed effect heterogeneity among studies.</p><p><strong>Conclusions: </strong>In this study, CDA showed comparable or potentially greater success in overall and neurological outcomes, along with a lower incidence of adjacent level degeneration and reoperation rates but longer operative times.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-14"},"PeriodicalIF":3.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957839","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 impact of Roussouly sagittal profile changes on postoperative outcomes.","authors":"Oluwatobi O Onafowokan, Pawel P Jankowski, Anthony Yung, Max R Fisher, Nathan Lorentz, Matthew Galetta, Paritash Tahmasebpour, Renaud Lafage, Justin S Smith, Christopher I Shaffrey, Virginie Lafage, Peter G Passias","doi":"10.3171/2025.4.SPINE241520","DOIUrl":"https://doi.org/10.3171/2025.4.SPINE241520","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this retrospective study was to investigate the relationship between postoperative Roussouly sagittal profile changes and patient outcomes.</p><p><strong>Methods: </strong>From a prospectively collected, single-center database, the authors reviewed the records of patients with adult spinal deformity (ASD) who had clinical and radiographic data from baseline to 2 years after surgery. The patients were stratified by their Roussouly curve type (current sacral slope-based and \"theoretical\" pelvic incidence-based types). Means comparison tests (ANOVA and chi-square) were used to assess differences among Roussouly groups. Backstep logistic regression analyses were used to analyze associations between Roussouly sagittal profile changes and patient outcomes, including minimum clinically important differences (MCIDs) in functional metrics.</p><p><strong>Results: </strong>Five hundred twenty-five patients, 79% of whom were female, were included in this study. The mean age of the cohort was 60.8 ± 14.1 years, BMI was 27.2 ± 5.5 kg/m2, and Charlson Comorbidity Index score was 1.72 ± 1.68. According to the Roussouly classification, 8.3% of patients had a Roussouly type 1 (R1) curve, 53.6% type 2 (R2), 26.3% type 3 (R3), and 11.9% type 4 (R4). Overall, 39% of patients had a changed Roussouly shape postoperatively: 59% had R1, 58.5% R2, 48.1% R3, and 26.7% R4 (p < 0.001). Forty-eight percent of patients matched the theoretical Roussouly type postoperatively (41% R1, 41.5% R2, 51.9% R3, and 73.3% R4, p < 0.001). When controlling for baseline clinical and radiographic differences, the Roussouly type changes associated with a higher risk of proximal junctional kyphosis or proximal junctional failure were as follows: R1 to R2 (OR 2.5, 95% CI 1.1-5.6, p = 0.024), R2 to R4 (OR 2.8, 95% CI 1.1-7.7, p = 0.039), and R3 to R4 (OR 2.3, 95% CI 1.1-4.9, p = 0.033). R4 to R3 switches had the highest mechanical complication risks (OR 3.4, 95% CI 1.2-9.4, p = 0.016). R1 to R2 changes had the highest rate of attaining an MCID in the Oswestry Disability Index at 6 weeks (23.5%, p = 0.004). Roussouly type changes were not associated with differences in the MCID on the refined 22-item Scoliosis Research Society patient outcome questionnaire (SRS-22r) up to 2 years after surgery.</p><p><strong>Conclusions: </strong>While a significant portion of patients matched their postoperative theoretical Roussouly type, many of those matched at baseline were prone to become unmatched postoperatively. Postoperative Roussouly shape changes influence patient outcomes and should be accounted for when planning ASD surgery.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-7"},"PeriodicalIF":3.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957864","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":"Five-year follow-up after minimally invasive transforaminal lumbar interbody fusion versus decompression alone for grade 1 spondylolisthesis: are there any differences in outcomes?","authors":"Andrew K Chan, Vardhaan S Ambati, Pavan Upadhyayula, Dean Chou, Mohamad Bydon, Erica F Bisson, Steven D Glassman, Kevin T Foley, Christopher I Shaffrey, Eric A Potts, Chun-Po Yen, Domagoj Coric, John J Knightly, Paul Park, Michael Y Wang, Kai-Ming Fu, Jonathan R Slotkin, Anthony L Asher, Michael S Virk, Regis W Haid, Praveen V Mummaneni","doi":"10.3171/2025.5.SPINE25324","DOIUrl":"https://doi.org/10.3171/2025.5.SPINE25324","url":null,"abstract":"<p><strong>Objective: </strong>The Spinal Laminectomy Versus Instrumented Pedicle Screw trial reported the superiority of fusion compared to laminectomy alone for patients with grade 1 degenerative spondylolisthesis. However, it remains unclear if the advantages of fusion extend to using minimally invasive surgical (MIS) techniques. This study compared 60-month outcomes following minimally invasive transforaminal lumbar interbody fusion (TLIF) versus decompression for grade 1 spondylolisthesis.</p><p><strong>Methods: </strong>The authors analyzed patients who underwent single-segment MIS TLIF or MIS tubular decompression for grade 1 degenerative lumbar spondylolisthesis from the prospective Quality Outcomes Database's 12 highest enrolling sites (SpineCORe team). Uni- and multivariable analyses compared outcomes including the Oswestry Disability Index (ODI), numeric rating scale (NRS) for back pain (NRS-BP), NRS for leg pain (NRS-LP), EuroQol-5D (EQ-5D), North American Spine Society (NASS) satisfaction score, and cumulative related reoperation rate.</p><p><strong>Results: </strong>Of 608 total patients, 143 underwent MIS TLIF (n = 72, 50.3%) or MIS decompression (n = 71, 49.7%). The overall study cohort's 60-month follow-up rate was 86.8%. The MIS TLIF cohort was significantly younger (mean 62.1 ± 10.6 vs 72.3 ± 9.7 years), had lower rates of diabetes (9.7% vs 22.5%), higher rates of private insurance utilization (65.3% vs 26.8%), was more likely to be employed preoperatively (54.2% vs 23.9%), and had higher baseline NRS-BP scores (mean 6.9 ± 2.6 vs 5.6 ± 3.2, p < 0.05). Otherwise, the cohorts were similar in baseline characteristics. Sixty months postoperatively, both cohorts had significant mean improvements in ODI, NRS-LP, NRS-BP, and EQ-5D scores compared to their respective baselines (p < 0.05). MIS TLIF had a significantly lower reoperation rate (2.8% vs 15.5%, p = 0.008). The minimal clinically important difference rates for the ODI, NRS-LP, NRS-BP, and EQ-5D were equivalent (p > 0.05). MIS TLIF demonstrated significantly larger reductions in NRS-BP scores (-4.0 ± 3.5 vs -2.2 ± 3.4) and higher rates of satisfaction (NASS score 1 or 2 = 87.7% vs 74.5%; p < 0.05) but similar absolute 60-month ODI, NRS-LP, NRS-BP, and EQ-5D scores (p > 0.05). On multivariable analyses, fusion significantly reduced the odds of reoperation (OR 0.07, 95% CI 0.008-0.39; p = 0.006), but fusion status was neither a significant predictor of ODI, NRS-LP, NRS-BP, or EQ-5D scores, nor NASS satisfaction scores.</p><p><strong>Conclusions: </strong>Regardless of the surgical approach, a dorsal-based MIS technique was associated with clinical benefits in patients with grade 1 spondylolisthesis. These 60-month results demonstrate that MIS TLIF and MIS decompression are associated with similar patient-reported outcomes. However, MIS TLIF is associated with significantly fewer reoperations.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957836","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 the vertebral bone quality score to predict complications after spine surgery: a systematic review.","authors":"Jacob D Greisman, Esteban Quiceno, Mohamed A R Soliman, Raphael Bastianon Santiago, Asham Khan, Jeffrey P Mullin, John Pollina","doi":"10.3171/2025.4.SPINE241473","DOIUrl":"https://doi.org/10.3171/2025.4.SPINE241473","url":null,"abstract":"<p><strong>Objective: </strong>The MRI-based vertebral bone quality (VBQ) score has emerged as a safe, convenient alternative to dual energy x-ray absorptiometry (DEXA) and CT for preoperative bone health assessment, which correlates with the outcomes of spine surgery. In this study, the authors aimed to systematically review the literature characterizing the utility of the VBQ score in predicting postoperative complications to inform operative planning and patient management.</p><p><strong>Methods: </strong>This systematic review was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration no. CRD42024542755) and adhered to PRISMA guidelines. PubMed, Embase, and Cochrane databases were searched for all original research published between January 1, 2020, and May 20, 2024, that had analyzed the VBQ score as a predictor of postoperative complications following spine surgery including pedicle screw loosening (PSL), cage subsidence (CS), adjacent segment disease (ASD), proximal junctional kyphosis (PJK) or proximal junctional failure (PJF), distal junctional kyphosis (DJK) or distal junctional failure (DJF), vertebral refracture, and need for reoperation. Applications of the VBQ score and its derivatives were characterized across methods, demographics, and outcomes. The Newcastle-Ottawa Scale was used for study quality assessment.</p><p><strong>Results: </strong>Twenty-seven studies comprising 4068 patients, 60.5% of whom were female, with a mean age of 58.5 ± 17.0 years were eligible for study inclusion. Sixteen studies used the traditional VBQ score calculation (L1-4/L3); alternatives included C3-6/C2 (5 studies), C3-6/C5 (1 study), L1-5/L3 (1 study), L4-5/L3 (1 study), and S1/L3 (3 studies). The VBQ score significantly predicted PSL (ranges: thresholds 2.9-3.175, areas under the curve [AUCs] 0.72-0.77, ORs 1.02-5.778), CS (thresholds 2.68-4.10, AUCs 0.785-0.99, ORs 1.513-23.158), ASD (thresholds 2.91-2.95, AUCs 0.934-0.963, ORs 1.509-1.601), PJK or PJF (thresholds 2.715-3.205, AUCs 0.721-0.943, ORs 1.745-26.49), DJK or DJF (threshold 2.66, AUC 0.935, OR 1.46), refracture (combined T1- and T2-weighted VBQ nomogram threshold 0.73, and ratio of adjacent to injured vertebral levels VBQ score < 1.4; AUCs 0.753-0.838, ORs 0.32-2.239), and reoperation (threshold 2.6 to > 3, AUCs 0.702-0.808, ORs 1.569-2.096).</p><p><strong>Conclusions: </strong>The data suggested that the VBQ score serves as a safe, convenient measure to predict complications after spine surgery. The lowest thresholds reported across all complications were 2.66 in the cervical spine and 2.6 in the lumbar spine, which may serve as rough cutoffs for prompting further patient testing. However, methodological heterogeneity limits guideline development. Future research with consistent methodology is necessary. Systematic review registration no.: CRD42024542755 (www.crd.york.ac.uk/prospero).</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957408","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":"Can artificial intelligence write science? A comparative analysis of human-written and artificial intelligence-generated scientific writings.","authors":"Karim Rizwan Nathani, Ali-Muhammad Nathani, Maliya Delawan, Aleeza Safdar, Mohamad Bydon","doi":"10.3171/2025.4.SPINE25519","DOIUrl":"https://doi.org/10.3171/2025.4.SPINE25519","url":null,"abstract":"<p><strong>Objective: </strong>Artificial intelligence (AI) is increasingly capable of academic writing, with large language models such as ChatGPT showing potential to assist or even generate scientific manuscripts. However, concerns remain regarding the quality, reliability, and interpretive capabilities of AI-generated content. The authors' study aimed to compare the quality of a human-written versus an AI-generated scientific manuscript to evaluate the strengths and limitations of AI in the context of academic publishing.</p><p><strong>Methods: </strong>Two manuscripts were developed using identical titles, abstracts, and tables of a simulated analysis: one authored by a physician with multiple publications, and the other generated by ChatGPT-4o. Three independent and blinded reviewers-two human and one AI-assessed each manuscript across five domains: clarity and readability, coherence and flow, technical accuracy, depth, and conciseness and precision. Each category was scored on a 10-point scale, and qualitative feedback was collected to highlight specific strengths and weaknesses. Additionally, all reviewers were asked to deduce authorship of the manuscripts.</p><p><strong>Results: </strong>The AI-generated manuscript scored higher in clarity and readability (mean 9.0 vs 7.2), but lower in technical accuracy (mean 6.3 vs 9.3) and depth (mean 5.5 vs 7.5). However, reviewers noted that the AI version lacked depth, critical analysis, and contextual interpretation. All reviewers accurately identified the authorship of each manuscript and tended to rate the version more favorably when it aligned with their own origin (human or AI); i.e., human reviewers assigned higher scores to the human-written manuscript, while the AI reviewer scored the AI-generated manuscript higher.</p><p><strong>Conclusions: </strong>Although AI models can improve some aspects of scientific writing, particularly clarity and readability, they fall short in critical reasoning and contextual understanding. This reinforces the importance of human authorship and oversight in maintaining the critical analysis and scientific accuracy essential for academic publishing. AI may be used as a complementary tool to support, rather than replace, human-led scientific writing.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-6"},"PeriodicalIF":3.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957822","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":"Impact of barbed suture use in complex back closure on operative time, cost, and safety profile.","authors":"Stephanie Francalancia, Carole S L Spake, Luke Soliman, Julia L Lerner, Nikhil Sobti, Vinay Rao, Daniel Kwan, Paul Y Liu, Albert S Woo","doi":"10.3171/2025.4.SPINE241540","DOIUrl":"https://doi.org/10.3171/2025.4.SPINE241540","url":null,"abstract":"<p><strong>Objective: </strong>Complex locoregional closure of back wounds following spine surgery via muscle flap closure, as opposed to traditional layer-by-layer approximation, decreases rates of complications such as seroma, infection, and dehiscence. However, the impact of barbed suture use on operative time, surgical cost, and patient outcomes for these cases remains unknown. In this study, the authors aimed to evaluate the complication profile, time, and cost savings of barbed suture in complex flap closure of back wounds following the placement of spinal instrumentation.</p><p><strong>Methods: </strong>An IRB-approved retrospective analysis was conducted on the medical records of all patients who underwent spine surgery followed by locoregional muscle flap complex closure at the authors' institution between January 2016 and July 2021. Patients were in either the barbed or conventional suture cohort. Odds ratios and 95% confidence intervals were computed using multivariable logistic regression with Firth's correction. Estimated cost savings were calculated using literature-reported figures.</p><p><strong>Results: </strong>A total of 110 patients with comparable baseline demographics were included. Rates of seroma (p > 0.99), infection (p = 0.21), and dehiscence (p = 0.66) were statistically similar between groups. After adjusting for the length of surgical closure, the mean times were 3.1 mins/cm and 4.6 mins/cm for the barbed and conventional suture cohorts, respectively, resulting in a time savings of 1.5 mins/cm (p < 0.001). The calculated time savings for muscle flap closure of an average incision length was 34.5 minutes (95% CI 18.6-50.4 minutes), and the overall financial savings were calculated to be $1094.10 (95% CI $513.75-$1674.45) per case.</p><p><strong>Conclusions: </strong>Knotless barbed suture use in complex closure of back wounds results in decreased operative time and hospital cost while conferring similar complication rates to conventional suture.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-9"},"PeriodicalIF":3.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859313","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":"Association of insulin-like growth factor 1 serum levels with early recovery and in-hospital complications after spinal fusion.","authors":"Annika Bay, Han Jo Kim, Atahan Durbas, Luis Colón, Stephane Owusu-Sarpong, Quante Singleton, Farah Musharbash, Andrea Pezzi, Tomoyuki Asada, Sereen Halayqeh, Adrian Lui, Tarek Harhash, Eric Zhao, Tejas Subramanian, Robert N Uzzo, Justin T Samuel, Gregory S Kazarian, Kasra Araghi, Francis C Lovecchio","doi":"10.3171/2025.5.SPINE25346","DOIUrl":"https://doi.org/10.3171/2025.5.SPINE25346","url":null,"abstract":"<p><strong>Objective: </strong>Sterile surgical trauma triggers a hormonal stress response that promotes a catabolic state, leading to fatigue, muscle loss, and impaired recovery. This postoperative catabolism is mediated, in part, by a decrease in insulin-like growth factor 1 (IGF-1), a key anabolic hormone regulated by human growth hormone (HGH). Given the established role of IGF-1 in muscle maintenance, tissue regeneration, and as a sensitive marker of nutritional status, the authors aimed to determine whether baseline IGF-1 levels, assessed using age- and sex-adjusted z-scores, predict short-term postoperative medical complications and discharge disposition following spinal fusion surgery.</p><p><strong>Methods: </strong>Preoperative serum IGF-1 levels were collected within 1 month before spinal fusion surgery and assessed using standardized sex- and age-adjusted z-scores. Primary outcomes included medical complications (according to the International Spine Study Group-AO Spine criteria) and self-sufficiency at discharge, defined as discharge home without the need for home health care (vs daily home nursing or a rehabilitation facility), and were retrospectively analyzed. Independent predictors were identified by multivariate regression analysis adjusted for age, the number of levels fused, estimated blood loss, BMI, Charlson Comorbidity Index (CCI), and IGF-1 z-scores.</p><p><strong>Results: </strong>Seventy-nine patients (44 male, mean age of 68 years) with a mean of 3.2 levels fused were included in the analysis. In-hospital complications, discharge needs, and progress with physical therapy were associated with IGF-1 z-scores. The regression analysis revealed that a higher IGF-1 z-score (p = 0.004) and shorter operative duration (p = 0.007) were independently associated with fewer in-hospital complications. The regression model controlled for confounders and correctly classified 93.7% of patients. Similarly, a higher IGF-1 z-score (p = 0.006), reduced intraoperative blood loss (p = 0.004), and lower CCI (with age adjustment, p = 0.001) were independently associated with a higher likelihood of achieving self-sufficiency at discharge in a model that correctly classified 77.2% of patients.</p><p><strong>Conclusions: </strong>Higher preoperative IGF-1 z-scores were independently associated with fewer medical complications and increased self-sufficiency at discharge. The HGH/IGF-1 axis might be a target for therapeutic interventions designed to improve early recovery.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859312","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":"Editorial. Paraspinal musculature and bone quality: the answer to the mode of proximal junctional kyphosis.","authors":"Isabelle G Stockman, Mohamed A R Soliman, Jeffrey P Mullin","doi":"10.3171/2025.5.SPINE25687","DOIUrl":"https://doi.org/10.3171/2025.5.SPINE25687","url":null,"abstract":"","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-2"},"PeriodicalIF":3.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804324","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}