Journal of spine surgery最新文献

{"title":"A 3D navigation-guided surgical resection of a rare case of sacral spine mesenchymal chondrosarcoma: a case report.","authors":"Abdulaziz Saber, Mohammed Khashab, Abdulhadi Turkistani, Moyassar Karami, Saleh Almaymoni, Mohamed Elkhalifa, Abdulhadi Algahtani, Abdullah Alhazmi","doi":"10.21037/jss-24-104","DOIUrl":"https://doi.org/10.21037/jss-24-104","url":null,"abstract":"<p><strong>Background: </strong>Chondrosarcomas are a group of heterogeneous malignant cartilaginous neoplasms that arise from preexisting benign precursors. They can be divided into conventional (primary) chondrosarcomas, which account for 90% of cases, and nonconventional chondrosarcomas, which account for the remaining 10%. Mesenchymal chondrosarcoma (MCS) is a rare high-grade soft tissue tumor variant of nonconventional chondrosarcoma that is histologically characterized by a biphasic pattern of atypical cartilage with small round cells.</p><p><strong>Case description: </strong>A 23-year-old female known case of ovarian cyst presented with a two-year history of low back pain and constitutional symptoms. Pelvic magnetic resonance imaging (MRI) with contrast showed a well-defined lesion with intermediate to high signals located at the right wing of the upper sacrum, at the level of S1-S2. The patient underwent a combined ultrasound and computed tomography-guided biopsy under local anesthesia and the immunochemical profile was positive for CD99 and S100 biomarkers. The patient underwent a two-stage procedure for a wide marginal tumor resection. Stage 1 was performed with an anterior approach; identification of the tumor margins was done followed by designing the cuts of the sacrum to achieve wide margins around the tumor. Stage 2 was performed with a posterior approach exposing L3 vertebrae down to the sacrum. Utilizing O-Arm Navigation for posterior margin allocation in addition to instrumentation. After 12 months post-operation, follow up revealed no evidence of recurrence.</p><p><strong>Conclusions: </strong>Limitation in accessibility to the axial skeleton and the neurovascular component, poses a challenge to treatment. Therefore, using neuro-navigation system and optimal adjuvant therapy should be studied further to improve the prognosis.</p>","PeriodicalId":17131,"journal":{"name":"Journal of spine surgery","volume":"11 1","pages":"197-205"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous spinopelvic fixation technique using external fixation for focal kyphosis reduction in U-type sacral fractures: a case report.","authors":"Monty Khela, Obiajulu Agha, Lisa Bonsignore-Opp, Mark Xu, David Gendelberg, Ashraf N El Naga","doi":"10.21037/jss-24-86","DOIUrl":"https://doi.org/10.21037/jss-24-86","url":null,"abstract":"<p><strong>Background: </strong>Sacral fractures, particularly U-type fractures characterized by a transverse fracture line, result in significant instability and deformity, including focal kyphosis. These fractures challenge biomechanical integrity and neural structures, often leading to long-term disability if not corrected. Surgical approaches vary, but percutaneous spinopelvic fixation offers benefits like reduced soft tissue trauma and expedited recovery. This case report highlights managing a displaced U-type sacral fracture with focal kyphosis using a percutaneous spinopelvic reduction technique followed by fixation, demonstrating its efficacy and potential benefits.</p><p><strong>Case description: </strong>A 30-year-old female with a complex medical history, including opioid use disorder managed with buprenorphine, housing instability, and hypothyroidism, presented with subacute back pain and impaired ambulation following a mechanical fall. The patient experienced persistent back pain, numbness, ambulatory difficulties, and intermittent urinary incontinence. An evaluation revealed pain-limited 4/5 motor strength bilaterally in lower extremity muscles, intact sensation, and preserved perianal sensation with normal rectal tone. Imaging confirmed a displaced U-type sacral fracture with 37.1 degrees of focal kyphosis and no ongoing nerve root compression. Given the focal kyphosis and associated complications, a multidisciplinary team with orthopaedic trauma and spine expertise recommended percutaneous reduction spinopelvic fixation to achieve reduction and stabilization. The patient's significant risk factors, including active drug use and housing instability, raised concerns with a traditional open approach. A percutaneous approach using an external fixator aided reduction, followed by transiliac trans-sacral screw placement and S1-pelvis fixation, was chosen. This technique achieved the desired reduction in sacral kyphosis, improving spinopelvic alignment and reducing postoperative soft tissue complications. Postoperative imaging showed appropriately placed hardware and a 20-degree reduction in sacral kyphosis.</p><p><strong>Conclusions: </strong>This case highlights the successful management of a displaced U-type sacral fracture with focal kyphosis using a percutaneous spinopelvic external fixator-based reduction technique. A minimally invasive approach can achieve significant reduction in deformity while minimizing soft tissue complications, making it viable for patients with complex medical histories. The clinical impact includes improved postoperative recovery and reduced risk of long-term disability. This case underscores the importance of individualized surgical planning and the potential benefits of percutaneous techniques in managing complex sacral fractures.</p>","PeriodicalId":17131,"journal":{"name":"Journal of spine surgery","volume":"11 1","pages":"178-190"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The neutrophil-to-lymphocyte ratio (NLR) levels predicting the surgical site infection in spinal surgery: a systematic review.","authors":"Maryam Salimi, Seyedarad Mosalamiaghili, Asma Mafhoumi, Muhammad Riaz","doi":"10.21037/jss-24-106","DOIUrl":"https://doi.org/10.21037/jss-24-106","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infection (SSI) is a prevalent complication in spinal surgery, associated with significant morbidity, prolonged hospital stays, and increased healthcare costs. The early detection of SSI can lead to timely intervention. Among available diagnostic methods, the neutrophil-to-lymphocyte ratio (NLR) has emerged as a simple, accessible marker with potential predictive value for SSIs. This systematic review aims to evaluate the diagnostic role of NLR, in the early detection of SSIs following spinal surgery.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we conducted a comprehensive literature search in MEDLINE, Web of Science, Embase, and Scopus databases for studies examining the utility of NLR in predicting SSIs in all types of spinal surgery patients. Ultimately, 7 studies met the inclusion criteria; all retrospective in design, with sample sizes ranging from 77 to 384. Studies focused on NLR values measured at different postoperative days, solely or along with some integrating additional markers, including C-reactive protein (CRP) and body mass index (BMI), into predictive models.</p><p><strong>Results: </strong>Our study confirmed that NLR serves as a significant predictor of SSIs post-spinal surgery. Analyses of included studies revealed variable optimal NLR cutoff values, ranging from 3.21 to 4.91, dependent on postoperative day and surgery type. The highest predictive accuracy was observed when NLR was combined with CRP and lymphocyte percentage, enhancing early SSI detection. However, the variability in cutoff values and measurement timing across studies suggests limitations due to heterogeneity in study designs and patient populations, indicating the need for further research to establish standardized protocols.</p><p><strong>Conclusions: </strong>NLR could be of value for early SSI detection in spinal surgery, with its diagnostic accuracy potentially improved by combining it with other markers. However, variability in cutoff values and timing across studies suggests the need for further research to standardize these parameters. Establishing consistent protocols could improve SSI detection, enabling faster interventions and potentially enhancing patient outcomes in spinal surgery.</p>","PeriodicalId":17131,"journal":{"name":"Journal of spine surgery","volume":"11 1","pages":"135-147"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive surgery lateral percutaneous sacroiliac joint fusion in a patient with radicular-type pain: case report and review of the literature.","authors":"Nathan J Winans, Bhargav Ayloo, Dean Chou, Andrew K Chan","doi":"10.21037/jss-24-93","DOIUrl":"https://doi.org/10.21037/jss-24-93","url":null,"abstract":"<p><strong>Background: </strong>Sacroiliac (SI) joint pain represents a common and often misdiagnosed source of low back and buttock pain. Importantly, SI joint pain can present with lower extremity radicular-type pain and closely mimic a herniated vertebral disc. During the physical exam, nearly all patients with back pain should be evaluated using provocative maneuvers that stress the SI joint. Diagnosis can be further supported with local anesthetic SI joint blocks. Plain radiographs and/or computed tomography (CT) imaging often demonstrate sacroiliac joint degeneration (e.g., joint space narrowing, vacuum phenomenon, osteophyte formation, sclerosis). Other diagnostic studies include magnetic resonance imaging (MRI) of the lumbar spine to evaluate the spinal column, spinal canal, and neural foramina and single photon emission computed tomography scan with CT (SPECT/CT) to identify foci with increased metabolic activity that could be pain generators.</p><p><strong>Case description: </strong>We present the case of a 76-year-old woman with a 1-year history of progressive left-sided low back pain that progressed along an S1 radicular distribution and became debilitating, interfering with their activities of daily living. Specifically, the pain radiated along the left buttocks, down the posterior aspect of the leg, and into the heel. SPECT/CT demonstrated non-specific, symmetric radiotracer uptake within the bilateral SI joints. She had a positive response to two SI joint injections. The patient was ultimately treated with a SI joint fusion. This case raises questions regarding the sensitivity and specificity of SPECT/CT for SI joint pain. A minimally invasive surgery (MIS) lateral SI joint fusion using navigated and fenestrated screws can provide significant pain relief.</p><p><strong>Conclusions: </strong>This case illustrates the diverse presentation of SI joint pain, the diagnostic process including the use of SPECT/CT, and the application of MIS fusion techniques for treatment.</p>","PeriodicalId":17131,"journal":{"name":"Journal of spine surgery","volume":"11 1","pages":"191-196"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The modern application of anterior lumbar interbody fusion (ALIF): a narrative review of perioperative considerations and surgical pearls.","authors":"Monty Khela, Obiajulu Agha, Andrew Sawires, Lionel Metz","doi":"10.21037/jss-24-85","DOIUrl":"https://doi.org/10.21037/jss-24-85","url":null,"abstract":"<p><strong>Background and objective: </strong>Anterior lumbar interbody fusion (ALIF) has become a pivotal technique in managing chronic back pain, radiculopathy, neurogenic claudication, and spinal deformity. This review aims to compare ALIF with other fusion methods, highlight its advantages and disadvantages, and provide surgical insights to enhance perioperative outcomes.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using databases such as PubMed, Embase, and Cochrane Library, focusing on publications from the past two decades. Articles were selected based on relevance, study design, and the inclusion of key perioperative considerations and surgical techniques. Only English-language studies were considered.</p><p><strong>Key content and findings: </strong>This review examines the historical evolution of ALIF, its current clinical applications, and the development of associated surgical techniques. It discusses preoperative evaluations, imaging strategies, and patient selection criteria. Key findings highlight that ALIF offers superior disc height restoration and segmental lordosis compared to other fusion techniques. However, it presents unique challenges such as potential vascular and visceral injuries. The review also outlines critical surgical pearls for effective ALIF execution and strategies to mitigate common complications like subsidence and nerve root injuries.</p><p><strong>Conclusions: </strong>ALIF is a robust technique for lumbar spine pathology, providing significant benefits in appropriate patient populations. This review underscores the importance of meticulous surgical planning and technique to optimize outcomes. Future research should focus on long-term comparative studies and the development of enhanced surgical instruments and protocols. Implementing these insights into clinical practice may improve patient outcomes and influence surgical guidelines and policies.</p>","PeriodicalId":17131,"journal":{"name":"Journal of spine surgery","volume":"11 1","pages":"148-165"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The legal and socioeconomic considerations of spine telemedicine in Canada.","authors":"Youngkyung Jung, Shawn Baldeo, Markian Pahuta, Sunjay Sharma, Daipayan Guha","doi":"10.21037/jss-24-72","DOIUrl":"https://doi.org/10.21037/jss-24-72","url":null,"abstract":"<p><p>Telemedicine, or virtual care offers a platform for remote assessments, for either initial consultations or follow-up care. Telemedicine is a broad term and may refer to video conferences/assessments, telephone visits, messages through online platforms, and remote monitoring applications. The restrictions during the coronavirus disease 2019 (COVID-19) crisis had accelerated the use of telemedicine in Canadian healthcare. Several years after the pandemic, after this initial trial of widespread telemedicine, there remains significant uncertainty as to its efficacy and future directions. There are inherent challenges to telemedicine, including questions of clinical reliability and privacy, balanced against the possibility of efficiency and increased access to specialists. The Canadian healthcare system also poses significant challenges in the evaluation and systemic implementation of telemedicine, given the lack of a national legal framework and separate provincial or territorial regulation systems across the country. Telemedicine is of a particular interest to spinal surgeons, given the prevalence, morbidity, and economic costs associated with spinal pathologies. Prior to the COVID-19 pandemic, few spine surgeons offered telemedicine, due to the perceived challenges of remote assessment and diagnosis with spine pathologies. There has been little subsequent data to examine the role and suitability for remote acre in spine surgery. Herein, we review the current landscape of telemedicine in Canadian healthcare, with applications to spine surgery.</p>","PeriodicalId":17131,"journal":{"name":"Journal of spine surgery","volume":"11 1","pages":"166-177"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of patient-specific spine rods on spinopelvic parameters after short segment degenerative lumbar fusions.","authors":"Katherine Drexelius, Eren O Kuris, Anna Sater, Evalina L Burger, David C Ou-Yang, Vikas V Patel, Christopher J Kleck","doi":"10.21037/jss-24-75","DOIUrl":"https://doi.org/10.21037/jss-24-75","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patient-specific spine rods (PSSRs) are custom-designed pre-operatively to align with individual spinopelvic parameters, aiming to optimize post-operative alignment. While effective in correcting adult spinal deformities, their utility in degenerative lumbar fusions remains relatively understudied. This study seeks to assess the outcomes of PSSR utilization in degenerative lumbar fusions by comparing them to a previously published cohort by Leveque &lt;i&gt;et al.&lt;/i&gt; in 2018. Through this analysis, we aim to contribute to the understanding of PSSR efficacy and its potential role in improving surgical outcomes in degenerative lumbar conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fifty patients who underwent primary lumbar fusion with PSSRs were included, excluding those with prior lumbar fusion or significant deformities. The study cohort was compared to a historical cohort using conventional rods. Radiographic outcomes were evaluated over a 2-year period, with follow-ups at 6 weeks, 6 months, 1 year, and 2 years postoperatively. Pre-operative and post-operative measurements of pelvic incidence (PI) and lumbar lordosis (LL) were used to assess changes in changes in PI-LL alignment. Statistical analyses included one-way analysis of variance (ANOVA) tests and one/two sample &lt;i&gt;t&lt;/i&gt;-tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Patients undergoing fusion PSSRs demonstrated a greater degree of change in pre-operative to post-operative PI-LL alignment compared to non-PSSR patients (-4.2° &lt;i&gt;vs.&lt;/i&gt; -0.1°, P&lt;0.001). Among the PSSR group, post-operative analysis revealed that 37 patients (74%) were categorized as preserved, indicating maintenance of PI-LL alignment within a predefined range. Additionally, nine patients (18%) were classified as restored, representing an improvement in PI-LL alignment post-operatively. Conversely, two patients (4%) were categorized as not corrected and worsened, indicating no significant change or deterioration in PI-LL alignment post-operatively, respectively. Comparison between the PSSR and non-PSSR groups showed higher restored spinopelvic parameters after surgery in the PSSR group compared to the non-PSSR group (18% &lt;i&gt;vs.&lt;/i&gt; 8.7%, P=0.05). Conversely, fewer patients in the PSSR group had not corrected parameters compared to the non-PSSR group (4% &lt;i&gt;vs.&lt;/i&gt; 21.3%, P&lt;0.01). These findings suggest that fusion with PSSRs was associated with greater improvement in PI-LL alignment post-operatively and a higher likelihood of achieving restored spinopelvic parameters compared to fusion without PSSRs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;PSSRs demonstrate significant improvement in spinopelvic parameters, particularly in reducing PI-LL mismatch, in degenerative lumbar fusion surgery. This improvement suggests a potential for enhanced patient outcomes. Follow-up assessments indicate that these improvements are sustained over a 2-year period. However, our findings underscore the need for further research to va","PeriodicalId":17131,"journal":{"name":"Journal of spine surgery","volume":"11 1","pages":"65-73"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative biomechanical study of a non-threaded triangular titanium implant versus a fully threaded screw: assessing pullout strength of two sacroiliac joint fixation implant designs.","authors":"Kingsley R Chin, Erik Spayde, William M Costigan, Vito Lore, Hope Estevez, Chukwunonso C Ilogu, Jason A Seale","doi":"10.21037/jss-24-99","DOIUrl":"https://doi.org/10.21037/jss-24-99","url":null,"abstract":"<p><strong>Background: </strong>Considering that implant backout is a recognized mode of failure, evaluating the pullout strength is critical for assessing anchoring efficacy. The Sacrix^® fully threaded screw (TS) was designed specifically for Less Exposure Spine Surgery (LESS) to reduce incision size, surgical time, and blood loss, using two implants for sacroiliac joint (SIJ) fixation. This study compares the Sacrix^® design with the SI-Bone iFuse non-threaded triangular titanium implant (TTI) design, which is widely regarded as the industry standard, and represents the first comparative biomechanical pullout strength study of these implant designs currently used in SIJ fusions.</p><p><strong>Methods: </strong>We conducted mechanical static axial pullout tests on three 7.0 mm × 45 mm iFuse non-threaded TTIs and six 8.0 mm × 40 mm Sacrix^® fully TS embedded in polyurethane foam blocks. An INSTRON 8874 Bi-Axial Tabletop Servohydraulic Dynamic Testing System was used to perform the tests by applying a 2.5 kN axial load.</p><p><strong>Results: </strong>The effective surface areas of the iFuse non-threaded TTI and Sacrix^® fully threaded TS were comparable, measuring 294.15 and 289.81 mm², respectively. The TS exhibited a significantly higher mean static axial pullout strength of 814.90 N [standard deviation (SD), ±99.428 N] compared to the TTI 200.14 N (SD, ±14.428 N). Statistical analyses, including Welch's <i>t</i>-test and Mann-Whitney <i>U</i> test, revealed significant differences in pullout strength between the two implants (P<0.05). Variance analysis confirmed the differences in pullout strength variances between the implants (P=0.040), suggesting that the variability in pullout strength was distinct for each implant.</p><p><strong>Conclusions: </strong>The Sacrix^® fully threaded TS demonstrated a threefold increase in pullout strength compared with the SI-Bone iFuse non-threaded TTI, suggesting that future SIJ fusion designs should favor threaded over non-threaded implants for improved anchoring capability.</p>","PeriodicalId":17131,"journal":{"name":"Journal of spine surgery","volume":"11 1","pages":"88-95"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preface on minimally invasive techniques in spine surgery and trend toward ambulatory surgery.","authors":"Cameron Kia","doi":"10.21037/jss-2024-03","DOIUrl":"https://doi.org/10.21037/jss-2024-03","url":null,"abstract":"","PeriodicalId":17131,"journal":{"name":"Journal of spine surgery","volume":"11 1","pages":"210-211"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A safe and reproducible anterior column restoration technique for Kümmell's disease: transpedicular bone packing.","authors":"Chul Gie Hong, Woo Dong Nam, Jinwon Jang","doi":"10.21037/jss-24-121","DOIUrl":"https://doi.org/10.21037/jss-24-121","url":null,"abstract":"<p><strong>Background: </strong>Kümmell's disease (KD), delayed post-traumatic vertebral collapse, is diagnosed with characteristic radiologic findings such as intravertebral vacuum cleft (IVC). Because patients with KD are elderly, have many underlying diseases, poor bone quality, and relatively limited surgical outcomes compared to other spinal diseases. The aim of this study is to describe a minimally invasive surgical technique and to evaluate the clinical and radiological outcomes of this technique.</p><p><strong>Methods: </strong>As a surgical treatment method for KD, we performed bone substitute packing via small pedicle holes with a posterior instrumented fusion. Ten consecutive patients underwent surgery for KD. Clinical outcomes and radiologic parameters were evaluated pre- and post-operatively.</p><p><strong>Results: </strong>The average operation time was 150.5±19.64 min with a mean estimated blood loss of 252±173.32 mL. The mean Visual Analog Scale (VAS) score for back pain was reduced from preoperative 8.7±0.82 to 2.8±1.14 (P<0.001), and the mean Oswestry Disability Index (ODI) score improved from 30.6±3.2 preoperatively to 11.6±4.81 (P<0.001) at the final follow-up. The sagittal Cobb angles decreased from 23.19±9.52 degrees preoperatively to 11.59±10.06 degrees (P<0.001) immediately after surgery, and 13.31±10.43 (P=0.002) degrees at the final follow-up. Except for 1 case of minor screw migration, there were no serious perioperative complications.</p><p><strong>Conclusions: </strong>Transpedicular bone packing does not involve technically demanding procedures such as corrective osteotomy, vertebral column resection, and insertion of large metal cage. Therefore, it may be minimally invasive and reproducible surgical option.</p>","PeriodicalId":17131,"journal":{"name":"Journal of spine surgery","volume":"11 1","pages":"104-113"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}