Journal of neurosurgery. Spine最新文献

{"title":"Letter to the Editor. Do fracture morphology and disability trajectories truly diverge in thoracolumbar burst injuries?","authors":"Shyam Sundar Sah, Abhishek Kumbhalwar","doi":"10.3171/2025.12.SPINE251775","DOIUrl":"https://doi.org/10.3171/2025.12.SPINE251775","url":null,"abstract":"","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-3"},"PeriodicalIF":3.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529992","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. Vertebral bone quality score and secondary fracture risk after vertebroplasty.","authors":"Yifeng Wang, Cong Cheng","doi":"10.3171/2025.11.SPINE251635","DOIUrl":"https://doi.org/10.3171/2025.11.SPINE251635","url":null,"abstract":"","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-2"},"PeriodicalIF":3.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147530065","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":"Opioid use and complications following short-segment fusions in patients with psychiatric disorders.","authors":"Syed I Khalid, Ryan Wang, Tatiana Abou-Mrad, Jakov Tiefenbach, Elie Massaad, Aladine A Elsamadicy, John D Arena, Yohannes Ghenbot, Joshua L Golubovsky, Ali K Ozturk, John H Shin","doi":"10.3171/2025.11.SPINE251056","DOIUrl":"https://doi.org/10.3171/2025.11.SPINE251056","url":null,"abstract":"<p><strong>Objective: </strong>The rising prevalence of psychiatric disorders significantly impacts surgical outcomes. These conditions can adversely affect pain perception and recovery trajectories following lumbar spine procedures. The aim of this study was to investigate the association between specific psychiatric disorders and postoperative opioid use, complications, and 30-day readmission rates after transforaminal lumbar interbody fusion (TLIF).</p><p><strong>Methods: </strong>A retrospective matched cohort study using a national administrative database included patients with and those without psychiatric diagnoses who underwent short-segment TLIF (≤ 3 levels) between January 2018 and April 2022. Patients were exactly matched 1:1 based on demographics and comorbidities. Psychiatric conditions assessed were anxiety disorders, behavioral disorders, depression, impulse control disorders, and schizophrenia. Outcomes measured included postoperative opioid use beyond 30 days, mean morphine milligram equivalents (MME) per day, 30-day readmission rates, and incidences of medical and surgical complications. Multivariate logistic regression was used to delineate independent effects on outcome variables.</p><p><strong>Results: </strong>Patients with psychiatric comorbidities had significantly greater opioid use beyond 30 days postoperatively (90.94% vs 79.48%; OR 2.59, 95% CI 2.48-2.71; p < 0.001) and greater mean MME per day (50.68 ± 50.97 mg vs 46.10 ± 46.99 mg; p < 0.001). Specific psychiatric conditions linked to increased opioid requirements included anxiety disorders (OR 1.26, 95% CI 1.16-1.36; p < 0.001), depression (OR 1.52, 95% CI 1.40-1.64; p < 0.001), behavioral disorders (OR 1.46, 95% CI 1.16-1.86; p = 0.002), and impulse control disorders (OR 4.88, 95% CI 1.54-29.62; p = 0.027). The 30-day readmission rate was higher in patients with psychiatric comorbidities (2.25% vs 1.88%; OR 1.20, 95% CI 1.08-1.34; p < 0.001). Depression (OR 1.15, 95% CI 0.99-1.34; p = 0.057) and schizophrenia (OR 1.83, 95% CI 1.35-2.48; p < 0.001) were associated with increased readmission rates. Patients with psychiatric diagnoses had higher incidences of composite medical complications (15.49% vs 5.20%; OR 3.34, 95% CI 3.16-3.53; p < 0.001) and surgical complications (4.07% vs 2.39%; OR 1.73, 95% CI 1.58-1.89; p < 0.001).</p><p><strong>Conclusions: </strong>Psychiatric comorbidities are associated with increased postoperative opioid requirements, higher complication rates, and greater 30-day readmissions following TLIF. Preoperative identification and personalized management of psychiatric conditions might improve postoperative outcomes and optimize healthcare resource utilization.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529995","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":"Is the chin-brow vertical angle always a reliable parameter for surgical planning in the correction of thoracolumbar kyphosis secondary to ankylosing spondylitis?","authors":"Meng-Han Chang, Bang-Ping Qian, Yong Qiu, Hong-da Bao","doi":"10.3171/2025.10.SPINE25193","DOIUrl":"https://doi.org/10.3171/2025.10.SPINE25193","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this retrospective study was to investigate the correlation between chin-brow vertical angle (CBVA) and osteotomized vertebra angle (OVA) across diverse cervical ranges of motion (CROMs) and to examine the reliability of CBVA in surgical correction design.</p><p><strong>Methods: </strong>The authors analyzed all ankylosing spondylitis (AS) patients with thoracolumbar kyphosis who had undergone single-level lumbar or thoracic pedicle subtraction osteotomy between January 2015 and December 2019 and had at least 2 years of follow-up. The patients were categorized into 3 groups based on their CROM: group A, CROM ≤ 10°; group B, 10° < CROM ≤ 20°; and group C, CROM > 20°. The correlation between ΔCBVA (change in CBVA from preoperatively to immediately postoperatively) and ΔOVA (change in the Cobb angle of the osteotomized vertebra from preoperatively to immediately postoperatively) was evaluated across the 3 CROM groups, identifying the subgroups as the cervical ankylosis (CA) group and cervical nonankylosis (CNA) group. The Cobb angle from C2 to C7, CBVA, Cobb angle from C0 to C7, global kyphosis, sagittal vertical axis C7-S1, and pelvic tilt were measured to enable comprehensive intergroup and intragroup comparisons of preoperative and postoperative parameters.</p><p><strong>Results: </strong>Among the 64 patients included in this study, a significant correlation between ΔCBVA and OVA was observed in patients from group A (p < 0.001) and group B (p < 0.001); however, no correlation was evident in group C (p = 0.31). Consequently, patients from groups A and B were amalgamated into the CA group, whereas those from group C were classified into the CNA group. Both subgroups attained satisfactory orthopedic outcomes following the surgical intervention. Notably, postoperative evaluations revealed significant kyphosis changes in the cervical spine in the CNA group (change 20.25°) compared to those in the CA group (change 4.97°).</p><p><strong>Conclusions: </strong>For AS patients with thoracolumbar kyphosis, CBVA is not consistently reliable for determining the OVA necessary for deformity correction, with its reliability closely linked to CROM. When the CROM is extensive (CROM > 20°) in patients with AS, the CBVA is not recommended as a reliable parameter for guiding the design of the OVA.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529939","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 role of spinal stereotactic radiosurgery in the treatment of renal cell carcinoma spinal metastases.","authors":"Shovan Bhatia, Suchet Taori, Samuel Adida, Michael R Kann, Akshath Rajan, Steven A Burton, John C Flickinger, James C Bayley, Pascal O Zinn, Roberta K Sefcik, Peter C Gerszten","doi":"10.3171/2025.11.SPINE25946","DOIUrl":"https://doi.org/10.3171/2025.11.SPINE25946","url":null,"abstract":"<p><strong>Objective: </strong>Renal cell carcinoma (RCC) spinal metastases can lead to intractable pain and neurological deficits and are traditionally considered radioresistant to conventional radiotherapy. Spinal stereotactic radiosurgery (SRS) has emerged as a minimally invasive management modality to deliver high doses of conformal radiation while sparing critical structures to overcome radioresistance. The aim of this large, single-institution study was to evaluate outcomes following SRS for patients with RCC spinal metastases.</p><p><strong>Methods: </strong>Eighty-one patients who underwent SRS for 152 primary RCC spinal metastases met inclusion criteria. The primary outcome was local control (LC). Secondary outcomes were overall survival (OS), pain palliation, and adverse radiation effects (AREs). Univariable and multivariable Cox proportional hazards regression analyses were conducted to assess prognostic factors related to study outcomes.</p><p><strong>Results: </strong>At a median follow-up of 10 (range 1-125) months, 40 lesions (26%) demonstrated radiographic progression. The median time to progression was 9 (range 3-60) months. Following SRS, the 6-month, 1-year, and 2-year crude LC rates were 91%, 78%, and 65%, respectively. The median OS was 15 (range 1-129) months, with rates of 6-month, 1-year, and 2-year OS of 84%, 57%, and 39%, respectively. Tumors with extension into the paraspinal musculature (HR 2.70, 95% CI 1.17-6.26; p = 0.020) and those causing radiographic spinal misalignment (HR 3.79, 95% CI 1.43-10.06; p = 0.008) were associated with worsened LC. No predictors were found for OS. Clinical improvement or stability in pain was observed in 97%, 88%, and 81% of lesions at 1, 3, and 6 months after SRS, respectively. Twenty-six AREs (17%) were observed, including 14 vertebral compression fractures (VCFs, 9%). Baseline VCF at the irradiated level (HR 6.00, 95% CI 1.29-27.87; p = 0.023) was significantly associated with VCF following SRS.</p><p><strong>Conclusions: </strong>Spinal SRS is a safe and effective treatment modality that confers high rates of tumor control and symptomatic pain relief for patients with RCC spinal metastases.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-11"},"PeriodicalIF":3.1,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504153","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":"Same-day spine surgery at an ambulatory surgical center versus hospital outpatient department: a propensity-matched analysis of complications and patient-reported outcomes using the Michigan Spine Surgery Improvement Collaborative Registry.","authors":"Sapan D Gandhi, Daniel K Park, Jianhui Hu, Philip Zakko, Doris Tong, Lonni Schultz, Victor Chang, David R Nerenz, Ilyas Aleem, Noojan Kazemi, Kevin Taliaferro, Muwaffak Abdulhak, Richard Easton, Miguelangelo Perez-Cruet, Jad G Khalil","doi":"10.3171/2025.10.SPINE25901","DOIUrl":"https://doi.org/10.3171/2025.10.SPINE25901","url":null,"abstract":"<p><strong>Objective: </strong>Although many authors have shown the safety of outpatient spine surgery, few have compared same-day spine surgery in the ambulatory surgical center (ASC) versus the hospital outpatient department (HOPD). The purpose of this study was to compare the safety of anterior cervical arthrodesis/arthroplasty or lumbar decompression with same-day discharge performed at the ASC versus HOPD.</p><p><strong>Methods: </strong>After IRB approval, a retrospective, propensity-matched, comparative cohort analysis of a statewide, prospective, multicenter, spine-specific database (Michigan Spine Surgery Improvement Collaborative [MSSIC]) was undertaken. Patients who underwent lumbar decompression or anterior cervical arthrodesis/arthroplasty (1 or 2 levels) with same-day discharge from January 1, 2021, to June 30, 2023, were reviewed. The HOPD/ASC matched cohorts were created at a ratio of 4:1 based on BMI, American Society of Anesthesiologists physical status class (ASA), and operative levels. The primary outcome variables investigated included any complication, return to operating room (OR) within 90 days, and emergency department (ED) visit or readmission within 30 and 90 days. Secondary outcome measures investigated included patient-reported outcome (PRO) measures at 90 days and 1 year and return to work at 90 days and 1 year. Differences between HOPD and ASC patients were tested using univariate comparisons for both the anterior cervical and lumbar decompression cohorts. Multivariate analysis was performed for the lumbar decompression group.</p><p><strong>Results: </strong>After matching, 3351 patients who underwent outpatient lumbar decompression (2679 HOPD and 672 ASC) and 806 patients who underwent anterior cervical arthrodesis/arthroplasty (644 HOPD and 162 ASC) were included in the analysis. In the univariate analysis for anterior cervical arthrodesis/arthroplasty, there were no differences between HOPD and ASC groups in terms of any complication, PROs at 90 days or 1 year, and return to work at 90 days and 1 year (p > 0.05). In the univariate analysis of the lumbar decompression group, there were higher rates of complications and return to the OR for the ASC group compared to the HOPD group (8% vs 5.5% [p = 0.01] and 4.9% vs 2.1% [p < 0.001], respectively), which remained in the multivariate analysis (incidence rate ratio [IRR] 1.5 [p = 0.001] and IRR 2.3 [p < 0.001], respectively). There were no differences between the groups in terms of PROs at 90 days and 1 year.</p><p><strong>Conclusions: </strong>Although both outpatient anterior cervical surgery and lumbar decompression can be performed safely and effectively in ASC and HOPD, there is a slightly higher risk of return to the OR for patients who undergo lumbar decompression in the ASC. Given similar outcomes, future studies should focus on patient and payer cost differences between ASC and HOPD.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504162","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 posterior approach for removal of all thoracic disc herniations: a single-surgeon experience using the partial transpedicular approach with ultrasonic bone aspiration and ultrasound guidance in 108 consecutive patients.","authors":"Brian Fabian Saway, Parker Dhillon, Rishishankar Suresh, Noah L A Nawabi, Matheus P Pereira, Thomas Eckert, Conor Cunningham, Habib Emil Rafka, Julio Isidor, Rahim Abo Kasem, Mahdi Sowlat, Aimee Weber, Stephen P Kalhorn","doi":"10.3171/2025.11.SPINE25904","DOIUrl":"https://doi.org/10.3171/2025.11.SPINE25904","url":null,"abstract":"<p><strong>Objective: </strong>Thoracic disc herniation (TDH) remains a complex surgical challenge due to its ventral location, frequent calcification, and potential for severe neurological compromise. Anterior and lateral approaches, though effective, are associated with significant morbidity and technical demands. Posterior approaches offer a familiar alternative but have historically been limited in access and safety. The integration of intraoperative ultrasound (IOUS) and ultrasonic aspiration (UA) may enhance the safety and efficacy of posterior decompression techniques. The objective of this study was to evaluate the safety, efficacy, and versatility of a posterior partial transpedicular approach using IOUS and UA for symptomatic TDH in a large single-surgeon cohort.</p><p><strong>Methods: </strong>A retrospective review was performed on 108 consecutive patients (137 TDHs) who underwent posterior partial transpedicular discectomy using IOUS and UA by a single surgeon between 2012 and 2024. Clinical, radiographic, and operative data were collected. Frankel grades were assessed preoperatively, at 3-6 months, and at final follow-up. Multivariate regression was used to identify predictors of neurological improvement.</p><p><strong>Results: </strong>The mean ± SD age was 58.6 ± 13.8 years, and 54.7% of patients were female. Most patients presented with myelopathy (86.1%) and giant disc herniations (> 40% stenosis) (68.6%). IOUS and UA facilitated safe decompression in all cases. The mean Frankel grade improved from 3.77 preoperatively to 4.54 at last follow-up (p < 0.001), with 61.1% of patients improving by at least 1 grade. The complication rate requiring reoperation was 9.3%. Comorbidities such as diabetes and obesity were associated with less neurological improvement.</p><p><strong>Conclusions: </strong>This large single-surgeon series demonstrated that the posterior partial transpedicular approach augmented with IOUS and UA is a safe, effective, and widely applicable technique for TDH, including large and calcified lesions. The method provides significant neurological improvement with an acceptable complication profile and can be readily adopted by general spine surgeons.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-8"},"PeriodicalIF":3.1,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504194","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":"Risk factors for nonresolving neurological deficits after spinal meningioma surgery: an integrated clinical and volumetric analysis of 202 patients.","authors":"Obada T Alhalabi, Mustafa A Mahmutoglu, Ahmed Gamal Abouarab, Dorothea Mitschang, Daniel Freist, Einar Ismail-Zade, Kirill Mironov, Lukas Klein, Stefan Heene, Gerhard Jungwirth, Vincent Landré, Martin Bendszus, Christel Herold-Mende, Klaus Zweckberger, Sandro M Krieg, Andreas W Unterberg, Alexander Younsi","doi":"10.3171/2025.10.SPINE25813","DOIUrl":"https://doi.org/10.3171/2025.10.SPINE25813","url":null,"abstract":"<p><strong>Objective: </strong>Functional outcome after resection of spinal meningiomas (SMs) is mostly considered satisfactory. However, patients with nonresolving neurological symptoms show a reduced quality of life. This study examined factors that determine full neurological recovery after resection of SMs.</p><p><strong>Methods: </strong>A single-center retrospective analysis of consecutive patients undergoing surgery on SM between 2007 and 2022 integrated clinical and surgical data with MRI-based automated volumetric tumor analyses. Patients with a favorable outcome (Frankel grade E) were compared to patients with nonresolving neurological symptoms (Frankel grade A-D) at final follow-up.</p><p><strong>Results: </strong>A total of 202 patients with a histologically diagnosed SM were included. The cohort consisted of 159 females (78.7%) and had a median age of 65 (interquartile range [IQR] 55-74) years. Upon admission, clinical examination in 97 patients (48.0%) revealed a Frankel grade of A-D. Gross-total resection was achieved in 193 patients (95.5%) with a surgical complication rate of 8.9% (n = 18). After a median follow-up of 479 (IQR 193-1049) days, 135 patients (66.8%) showed intact neurological function (Frankel grade E). A univariate analysis revealed an overrepresentation of advanced age (OR for age ≤ 60 years = 0.14, p < 0.0001) and higher rates of preoperative neurological deficits (OR 7.39, p < 0.0001) in patients without complete recovery. No significant differences were noted in tumor volume between both groups (mean 2.34 [SD 1.69] vs 2.36 [SD 1.75] cm3, p = 0.962). In a multivariate analysis, age > 60 years, preoperative Frankel grade A-D, and Ki-67/MIB-1 index < 5% were significantly associated with nonresolving deficits at the final follow-up.</p><p><strong>Conclusions: </strong>This volumetry-informed series of patients with SM revealed older age and a low Ki-67 index, along with preoperative neurological deficits, constitute a higher risk of nonresolving neurological symptoms after resection. An early surgical intervention in oligosymptomatic young patients could therefore help preserve excellent long-term neurological function.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-12"},"PeriodicalIF":3.1,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504155","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":"Intrathecal baclofen pump complications in adults: rates, risk factors, and spinal cord injury insights from a longitudinal cohort study.","authors":"Alejandro García-Rudolph, José Manuel Mendez, Lidia Ledesma, Alejandro Del Arco, Jesus Benito-Penalva, Joan Vidal","doi":"10.3171/2025.10.SPINE25358","DOIUrl":"https://doi.org/10.3171/2025.10.SPINE25358","url":null,"abstract":"<p><strong>Objective: </strong>This study analyzed a cohort of adult patients who underwent intrathecal baclofen (ITB) pump and catheter implantation at a large tertiary neurorehabilitation center. The objectives were 1) to describe the rate and types of ITB-associated complications in patients with diverse neurological conditions, 2) to compare baseline clinical and demographic characteristics between patients with spinal cord injury (SCI) who experienced a complication and those who did not, and 3) to identify potential risk factors associated with the occurrence of complications in patients with SCI.</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent ITB implantation at a single center (1989-2025). Patients with SCI who had complications were compared with those without complications across multiple baseline variables, including age, sex, ambulation status, BMI, diabetes status, neurological level of injury, American Spinal Injury Association Impairment Scale (AIS) grade, and motor Functional Independence Measure (FIM). Cox proportional hazards models were used to assess the association between patient-related factors and the risk of experiencing a first complication event.</p><p><strong>Results: </strong>Among 281 patients (205 male, mean age 43.1 years) who underwent ITB pump implantation, the most prevalent conditions were SCI (203/281, 72.2%), multiple sclerosis (29/281, 10.3%), and cerebrovascular accident (16/281, 5.7%). Overall, 22.4% of patients experienced an ITB-related complication. Complications included device erosion (20/281, 7.1%), catheter malfunction (16/281, 5.7%), infection (14/281, 5.0%), CSF leakage (10/281, 3.6%), and pump malfunction (8/281, 2.8%). Additionally, 28 patients (10.0%) had \"other\" complications, which included a range of issues (e.g., seromas and hematomas). Among the patients with SCI, those with a complication (25.1%) were significantly younger at the time of implantation (mean age 38.1, SD 14.4, years) compared with those without a complication (mean age 45.3, SD 15.7, years; p = 0.004). No significant differences were observed between groups in terms of AIS grade, ambulation, diabetes, BMI, or neurological level. Patients who developed complications had a higher motor FIM score at baseline (mean 51.3 [SD 24.9] vs 44.4 [SD 25.0]), although this difference did not reach statistical significance (p = 0.056). Multivariable Cox proportional hazards analysis identified younger age at implantation as the only significant predictor of complication risk (HR 0.97 [95% CI 0.95-0.99], p = 0.013; C-index = 0.714).</p><p><strong>Conclusions: </strong>One in four patients with SCI had complications, half of which occurred within the first year. Younger patients were at higher risk, likely due to increased activity, emphasizing the need for early monitoring and targeted prevention strategies.</p>","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1-11"},"PeriodicalIF":3.1,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504136","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. Incomplete (A3) versus complete (A4) thoracolumbar burst fractures: results from a prospective international multicenter cohort study.","authors":"Jin W Tee","doi":"10.3171/2026.1.SPINE25285a","DOIUrl":"https://doi.org/10.3171/2026.1.SPINE25285a","url":null,"abstract":"","PeriodicalId":16562,"journal":{"name":"Journal of neurosurgery. Spine","volume":" ","pages":"1"},"PeriodicalIF":3.1,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504142","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}