Neurospine最新文献

{"title":"Adult-Lifespan Segment-Specific Normative Atlas of Cervical Spinal Cord Morphology, With Exploratory Application in Degenerative Cervical Myelopathy.","authors":"Shuo Duan, Tianhua Rong, Duo Zhang, Guanmei Cao, Lei Wang, Bingxuan Wu, Baining Zhang, Yechuan Mei, Yi Lu, Baoge Liu","doi":"10.14245/ns.26520610.0305","DOIUrl":"10.14245/ns.26520610.0305","url":null,"abstract":"<p><strong>Objective: </strong>To establish an adult-lifespan segment-specific normative atlas of cervical spinal cord morphometry as a physiologically adjusted reference and to explore its application in degenerative cervical myelopathy (DCM).</p><p><strong>Methods: </strong>We included 829 healthy volunteers and 210 surgically treated DCM patients undergoing cervical magnetic resonance imaging (MRI) from 2019 to 2023. Follow-up MRI was obtained in a stratified random sample of 207 healthy volunteers and 42 patients. Axial T2-weighted images at C2-3 to C6-7 were segmented semiautomatically. Cross-sectional area (CSA) was the primary morphometric measure; right-left and anteroposterior diameters (APDs) were complementary measures. In healthy volunteers, sex-stratified, level-specific models including age, age², magnetic field strength, and scanner manufacturer were used to construct the atlas and compute z-scores. In DCM, z-scores were summarized as CompMinZ and NonCompMinZ and explored in relation to clinical outcomes.</p><p><strong>Results: </strong>In healthy volunteers, CSA showed a nonlinear pattern, with smaller values at older ages. Longitudinal changes were age dependent: CSA, right-left diameter, and APD increased in younger adults, were stable in midlife, and declined in older adults. In DCM, z-scores were most negative at compressed levels, while noncompressed segments also frequently fell below the normative mean. Z-score metrics showed exploratory associations with neurological status and postoperative outcomes. In the postoperative subset, CompMinZ showed the strongest association with recovery rate, whereas maximum spinal cord compression was not significantly associated with recovery rate.</p><p><strong>Conclusion: </strong>An adult-lifespan, segment-specific normative atlas of cervical spinal cord morphometry provides a physiologically adjusted reference for interpreting cervical cord morphologic variation and deviation, with exploratory application in surgically treated DCM.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"23 3","pages":"665-676"},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Commentary on \"How to Treat Adjacent-Segment Pathology Following Lumbar Fusion Surgery: Decompression Alone or Decompression With Extended Fusion Surgery?\"","authors":"Jang W Yoon","doi":"10.14245/ns.26521364.0682","DOIUrl":"10.14245/ns.26521364.0682","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"23 3","pages":"564-566"},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STAT3/POSTN/GSTP1/JNK Axis Orchestrates Ferroptosis in Nucleus Pulposus Cells: A Potential Therapeutic Target for Intervertebral Disc Degeneration.","authors":"Zhaoheng Wang, Daxue Zhu, Shijie Chen, Zhaoxi Wang, Yanhu Li, Xuewen Kang","doi":"10.14245/ns.26520334.0167","DOIUrl":"10.14245/ns.26520334.0167","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the role of the STAT3/POSTN/GSTP1/JNK axis in ferroptosis and extracellular matrix (ECM) metabolic imbalance in nucleus pulposus cells (NPCs) during intervertebral disc degeneration (IDD) and to explore therapeutic strategies targeting this axis.</p><p><strong>Methods: </strong>Using integrated multiomics sequencing, transcriptional regulation assays (chromatin immunoprecipitation, dual‑luciferase reporter), protein interaction analysis (CoIP), and other molecular biology approaches, we systematically elucidated the regulatory role of the STAT3/POSTN/GSTP1/JNK axis in ferroptosis of NPCs during IDD. Functional validation was performed in POSTN‑edited cell and rat models as well as in a needle‑puncture‑ induced rat IDD model. A small‑molecule candidate targeting this axis was identified through virtual screening, molecular docking, and molecular dynamics simulations.</p><p><strong>Results: </strong>Periostin (POSTN) expression increased during ferroptosis and induced ferroptosis and ECM metabolic imbalance in NPCs in a concentration- and time-dependent manner. STAT3 was identified as a transcriptional regulator of POSTN and functionally coupled with POSTN to form a self-amplifying positive feedback loop, accelerating ferroptosis progression. Furthermore, POSTN impaired the binding of the GSTP1/JNK complex, leading to the depletion of cellular glutathione. Chemical screening identified pristimerin (PN) as a potential GSTP1-targeting compound, targeting the STAT3/POSTN/GSTP1/JNK axis and delaying IDD progression.</p><p><strong>Conclusion: </strong>This study identified the important role of the STAT3/POSTN/GSTP1/JNK axis in regulating ferroptosis and ECM metabolism in NPCs and highlighted PN as a promising candidate therapeutic agent for IDD. These findings provide new insights into the molecular mechanisms underlying IDD and offer new targeted therapeutic avenues for IDD.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"23 3","pages":"644-664"},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Treat Adjacent-Segment Pathology Following Lumbar Fusion Surgery: Decompression Alone or Decompression With Extended Fusion Surgery?","authors":"Mohamed Elmekaty, Anders Joelson, Peter Försth, Paul Gerdhem, Nils P Hailer, Yohan Robinson, Anna MacDowall","doi":"10.14245/ns.26520806.0403","DOIUrl":"10.14245/ns.26520806.0403","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare the risk of subsequent surgery following surgical treatment of clinical adjacent-segment pathology (CASP) after lumbar fusion, specifically evaluating decompression alone versus decompression with extension of the fusion.</p><p><strong>Methods: </strong>Using the Swespine registry, we included patients who had surgical treatment for CASP following index lumbar fusion surgery, 1997-2019. The cohort was divided according to CASP treatment: decompression alone or decompression with extended fusion. A comparison of subsequent surgeries was made with Kaplan-Meier analysis and Cox regressions adjusted for potential confounders (age, sex, body mass index, smoking status, number of operated levels at CASP surgery, number of fused levels at index fusion surgery, and diagnosis for CASP surgery).</p><p><strong>Results: </strong>A total of 2,521 patients were included, 1,176 (47%) in the decompression-group and 1,345 (53%) in the extended fusion group and the mean follow-up was 6.1±4.4 years. Mean age at CASP surgery was 61 years and 1,588 (63%) were females. The median time to subsequent surgery was 1.7 years (range, 0.9-3.7 years). Kaplan-Meier-estimated probability of subsequent surgeries at 5 years was 18% (95% confidence interval [CI], 15%-20%) for the decompression-group and 25% (95% CI, 22%-27%) for the extended fusion group. The hazard ratio was 1.26 (95% CI, 1.02-1.56; p=0.032) for those with extended fusion.</p><p><strong>Conclusion: </strong>Extension of fusion for CASP was associated with significantly higher risk of subsequent surgery, but causality should be interpreted with caution as radiographic information on instability, deformity, or foraminal stenosis could not be verified.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"23 3","pages":"549-560"},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nationwide Registry Study Comparing Long-term Risk of Adjacent Segment Disease Requiring Reoperation Following Anterior Cervical Discectomy and Fusion Versus Cervical Disc Arthroplasty.","authors":"Zehra Nazar, Victor Gabriel El-Hajj, Erik Edström, Adrian Elmi-Terander, Victor Egon Staartjes","doi":"10.14245/ns.26520482.0241","DOIUrl":"10.14245/ns.26520482.0241","url":null,"abstract":"<p><strong>Objective: </strong>Adjacent segment disease (ASD) is a recognized long-term complication after anterior cervical discectomy and fusion (ACDF). Cervical disc arthroplasty (CDA) was introduced as a motion-preserving alternative, thought to reduce stress at adjacent levels and lower ASD risk. This study aimed to compare the risk of ASD requiring reoperation after ACDF and CDA and identify factors associated with ASD.</p><p><strong>Methods: </strong>This retrospective cohort study used prospectively collected data from the Swedish Spine Registry (Swespine) and included adult patients undergoing anterior cervical surgery for degenerative cervical disease between 2006 and 2026. ASD was defined as a secondary operation at an adjacent level ≥12 months after the index procedure. Cumulative incidence was estimated using Kaplan-Meier analysis, and associations with ASD were evaluated using multivariable Cox proportional hazards regression. Radiological or conservatively treated ASD were not assessed.</p><p><strong>Results: </strong>A total of 9,338 patients were included (ACDF, n=9,005; CDA, n=333). During 45,666 person-years follow-up, 509 ASD events occurred (incidence rate 11.1 per 1,000 person-years). Cumulative incidence was 4.9% at 5 years and 10.4% at 10 years. CDA was associated with lower ASD hazard than ACDF (hazard ratio [HR], 0.61) though this association was not significant after propensity score matching (HR, 0.88). Multilevel procedures (HR, 0.61), increasing age (HR, 0.96 per year), and radiculopathy were associated with lower risk, while myelopathy or stenosis was associated with higher risk (HR, 1.22).</p><p><strong>Conclusion: </strong>The long-term risk of ASD requiring reoperation was lower than previously reported. After adjustment, CDA was associated with lower ASD risk compared to ACDF, although the absolute difference was small, and the clinical significance remains uncertain.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"23 3","pages":"526-535"},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Commentary on \"A Nationwide Registry Study Comparing Long-term Risk of Adjacent Segment Disease Requiring Reoperation Following Anterior Cervical Discectomy and Fusion Versus Cervical Disc Arthroplasty\".","authors":"Samuel K Cho","doi":"10.14245/ns.26521202.0601","DOIUrl":"10.14245/ns.26521202.0601","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"23 3","pages":"536-537"},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Commentary on \"Feasibility of Minimally Invasive Scoliosis Surgery in Adolescent Idiopathic Scoliosis Exceeding 80° of Curve Magnitude\".","authors":"Ibrahim Obeid","doi":"10.14245/ns.26521268.0634","DOIUrl":"10.14245/ns.26521268.0634","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"23 3","pages":"577-579"},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering Intraoperative Hip Positioning in Single-Position Lateral Lumbar Interbody Fusion - A Commentary on \"Optimal Positioning for Single-Position Lateral Lumbar Interbody Fusion\".","authors":"Jiayi Chen","doi":"10.14245/ns.26520514.0257","DOIUrl":"10.14245/ns.26520514.0257","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"23 3","pages":"754-755"},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rape of the Spine: Endoscopic Innovation and the Imperative of Restraint.","authors":"Jin-Sung Kim","doi":"10.14245/ns.26520356.0178","DOIUrl":"10.14245/ns.26520356.0178","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"23 3","pages":"515-518"},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacral Slanting in Adolescent Idiopathic Scoliosis: Definition, Pathomechanism, and Surgical Implications: A Narrative Review.","authors":"Chang Ju Hwang, Choon Sung Lee, Hyung Rae Lee, Gumin Jeong, Dong-Ho Lee, Jae Hwan Cho, Sung Tan Cho, Sehan Park","doi":"10.14245/ns.26521046.0523","DOIUrl":"10.14245/ns.26521046.0523","url":null,"abstract":"<p><p>Sacral slanting-defined as the oblique tilt of the upper sacral endplate measurable on standing anteroposterior whole-spine radiographs-is a distinctive and clinically underappreciated finding in adolescent idiopathic scoliosis (AIS). Its etiology is multifactorial and incidence among AIS patients reaches 40%. The direction and degree of sacral slanting interact with the distal lumbar curve type (L4-left vs. L4-right) to influence the pattern of postoperative radiographic changes at the distal spine and shoulder. In patients with L4-left curves and left-sided slanting, stopping fusion at L3 generally prevents coronal decompensation. Furthermore, 5-year data show that the disc wedge angle below the lowermost instrumented vertebra (LIV) does not progress when LIV is L3, and patient-reported outcomes are preserved without revision surgery. When fusion extends to L4 in patients with high sacral slanting, coronal decompensation is more frequent, yet functional outcomes remain comparable and no revision has been required in published series to date, indicating that the decompensation observed is radiographically significant but clinically tolerable within the medium term. In Lenke 1A patients with right-sided sacral slanting (L4-right type), the slanting lowers the last touching vertebra and may facilitate distal adding-on. In Lenke 2A patients with right-sided slanting, distal adding-on serves as a natural shoulder-rebalancing mechanism and may be reasonably monitored conservatively rather than reflexively treated, pending further validation in independent cohorts, unless progressive or symptomatic. Across all scenarios, the optimal distal fusion level remains an unresolved dilemma requiring further long-term prospective study. This review synthesizes the available literature to characterize sacral slanting as a promising radiographic parameter that may serve as a potentially useful adjunct in distal fusion level planning, while highlighting the need for prospective multicenter validation before its routine incorporation into surgical decision-making in AIS.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"23 3","pages":"677-689"},"PeriodicalIF":5.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}