Neurospine最新文献

{"title":"From the Editor-in-Chief: Featured Articles in the June 2025 Issue.","authors":"Inbo Han","doi":"10.14245/ns.2550894.447","DOIUrl":"10.14245/ns.2550894.447","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 2","pages":"309-310"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584423","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":"Surgical Strategy Analysis of Chiari Malformation With or Without Type II Basilar Invagination According to the Morphological Types of the Atlanto-Occipital Joint: A Retrospective Study of 212 Patients.","authors":"Qinguo Huang, Junhua Ye, Yanyu Wu, Qiang Zhou, Hong Li, Lin Peng, Yuntao Lu","doi":"10.14245/ns.2449314.657","DOIUrl":"10.14245/ns.2449314.657","url":null,"abstract":"<p><strong>Objective: </strong>Our previous study categorized atlanto-occipital joint (AOJ) morphology into 3 types, with types II and III-AOJ associated with Chiari malformation (CM) with and without type II basilar invagination (II-BI), respectively. This study aimed to assess the feasibility of tailoring surgical strategies for patients with CM based on AOJ morphological types.</p><p><strong>Methods: </strong>We retrospectively studied 212 CM patients who underwent foramen magnum decompression (FMD) or combined occipitocervical fusion (OCF). Patients were divided into 4 groups: (1) pure CM with II-AOJ who underwent FMD (CM-II-FMD); (2) pure CM with III-AOJ who underwent FMD+OCF (CM-III-OCF); (3) CM-III-FMD; and (4) CM+ II-BI with III-AOJ who underwent FMD+OCF (BI-III-OCF). Clinical data, including manifestations, imaging findings, surgical details, and neurological assessments, were analyzed at the final follow-up to assess surgical efficacy.</p><p><strong>Results: </strong>Patients in the BI-III-OCF, CM-III-OCF, and CM-II-FMD groups exhibited a significant improvement in clinical symptoms (pain, sensory disturbances, motor weakness, gait ataxia, and bladder and bowel dysfunction) compared to preoperative levels (p<0.05). Results from the Japanese Orthopaedic Association scale and Neck Disability Index indicated a significant reduction in the degree of neurological impairment within these groups (p<0.05). Furthermore, the Chicago Chiari Outcome Scale scores indicated superior surgical outcomes for patients in these groups. Imaging analyses demonstrated significant reductions in the syringomyelic segment, syringomyelia width, and tonsillar herniation distance among these patients (p<0.05). However, the CM-III-FMD group did not significantly improve in these areas (p>0.05). Postoperative complications occurred in 4.3% of FMD+OCF patients and 3.3% of FMD-only patients.</p><p><strong>Conclusion: </strong>AOJ morphological types can guide surgical treatment strategies for CM with or without II-BI. FMD alone is suitable for II-AOJ cases, whereas III-AOJ cases should be treated with FMD combined with OCF.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":" ","pages":"500-513"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003015","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":"Preoperative Opioid Misuse Associations With Delayed Opioid Cessation, Pain, and Negative Affect After Spine Surgery.","authors":"Jennifer M Hah, Shana C Levine, Saneel Khairnar, Luke Pirrotta, Alma Rechav Ben-Natan, Emily Tse, Gabrielle Hettie, Todd Alamin, Anand Veeravagu, Serena Hu, Tina Hernandez-Boussard","doi":"10.14245/ns.2550394.197","DOIUrl":"10.14245/ns.2550394.197","url":null,"abstract":"<p><strong>Objective: </strong>Preoperative opioid misuse is associated with worse postoperative outcomes. This prospective longitudinal cohort study evaluated the association between preoperative opioid misuse and prolonged pain and opioid use after elective spine surgery; and examined postoperative trajectories of patient-reported outcomes over one year.</p><p><strong>Methods: </strong>Fifty-two patients undergoing elective spine surgery completed presurgical and weekly postoperative longitudinal assessments of pain and opioid use and monthly assessments of depression, anxiety, sleep disturbance, and physical function. Cox regression analyzed the effect of preoperative opioid misuse on time to pain and opioid cessation while linear mixed-effects models examined longitudinal changes in postoperative outcomes.</p><p><strong>Results: </strong>Adjusting for age, sex, operative region, number of spinal levels, and any preoperative opioid use, preoperative opioid misuse (COMM-Positive) was associated with a delayed return to baseline opioid dose (hazard ratio [HR], 0.35; 95% confidence interval [CI], 0.14-0.88; p=0.02) and delayed opioid cessation (HR, 0.25; 95% CI, 0.09-0.59; p=0.008). All patients experienced comparable reductions in current and average pain intensity, and pain interference over time. COMM-Positive patients reported a normalization of postoperative anxiety and depression 1 month after surgery with a rebound at 3 months while patients without preoperative opioid misuse remained stable over time.</p><p><strong>Conclusion: </strong>Preoperative opioid misuse is a significant risk factor for delayed opioid cessation even after adjusting for preoperative opioid use, and is associated with a transient normalization of anxiety and depressive symptoms with a rebound 3 months following spine surgery. Targeted screening and risk reduction strategies are needed for patients reporting preoperative opioid misuse before spine surgery.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 2","pages":"451-464"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584427","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 \"Proximal Thoracic Alignment Change Influences Cervical Sagittal Alignment After Correction Surgery in Patients With Lenke Type 2 Adolescent Idiopathic Scoliosis\".","authors":"Seung Woo Suh","doi":"10.14245/ns.2550796.398","DOIUrl":"10.14245/ns.2550796.398","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 2","pages":"364-365"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584407","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":"Establishing a Standardized Fellowship Curriculum for Advanced Minimally Invasive Spine Interventions: A Multidisciplinary Approach to Training and Competency.","authors":"Denis Patterson, Joseph Cheng, Michael Dorsi, David Lee, Eric Lee, Jennifer Lee, Ramana Naidu, Lawrence Poree, Jeffrey Roh, Peter Staats, Michael Y. Oh","doi":"10.14245/ns.2550730.365","DOIUrl":"10.14245/ns.2550730.365","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 2","pages":"332-334"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584420","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":"Optimization of Paravertebral Foramen Screw Placement: A Stepwise Approach Considering O-arm Navigation Errors: Technical Note and Case Series.","authors":"Yu Yamamoto, Yusuke Nishimura, Motonori Ishii, Nobuhisa Fukaya, Eisuke Tsukamoto, Ryuta Saito, Masahito Hara, Masakazu Takayasu","doi":"10.14245/ns.2550110.055","DOIUrl":"10.14245/ns.2550110.055","url":null,"abstract":"<p><strong>Objective: </strong>Paravertebral foramen screws (PVFSs) have been developed for better pullout strength than lateral mass screws do and lower the risk of vertebral artery and nerve injury than do pedicle screws. While the original method involves insertion using lateral fluoroscopy, its reliability may be limited. This report is the first to assess the accuracy of PVFS insertion under navigation. Given the inherent inaccuracies associated with navigation systems, the authors propose and evaluate a novel stepwise method of inserting PVFSs, called stepwise PVFS with a focus on achieving the correct screw tip location for good cortical bone purchase.</p><p><strong>Methods: </strong>The authors conducted a retrospective analysis of 12 patients (78 screws) who underwent cervical spine fixation with stepwise PVFS under O-arm navigation between October 2022 and February 2024. The accuracy of screw placement was evaluated using postoperative computed tomography (CT) scans.</p><p><strong>Results: </strong>A total of 78 PVFSs were inserted in 5 men and 7 women, with an average age of 75 years (range, 52-85 years). The mean follow-up period was 471 days (range, 47-834 days). There were no adverse events related to screw insertion. Postoperative CT scans revealed that 70 screws (90%) were placed in the ideal position. Among the 8 screws that did not achieve the ideal position, 4 had lateral deviation (located in a lateral mass), whereas the other 4 were too short. There were no cases of screw loosening at the final follow-up.</p><p><strong>Conclusion: </strong>The present study demonstrates that the stepwise PVFS method under navigation guidance achieves higher accuracy in PVFS placement compared with conventional fluoroscopy-guided PVFS, as reported in previous studies.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 2","pages":"514-522"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584426","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":"Proximal Thoracic Alignment Change Influences Cervical Sagittal Alignment After Correction Surgery in Patients With Lenke Type 2 Adolescent Idiopathic Scoliosis.","authors":"Xi Lin, Satoshi Suzuki, Kazuki Takeda, Takahito Iga, Toshiki Okubo, Masahiro Ozaki, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.14245/ns.2449254.627","DOIUrl":"10.14245/ns.2449254.627","url":null,"abstract":"<p><strong>Objective: </strong>To examine the factors influencing cervical sagittal alignment (CSA) after posterior correction and fusion surgery (PSF) for patients with Lenke type 2 adolescent idiopathic scoliosis (AIS).</p><p><strong>Methods: </strong>A total of 102 female patients with Lenke 2 AIS and a minimum 2-year follow-up were included. The upper instrumented vertebra was T2 in all patients. Sagittal and coronal parameters were measured before and 2 years after surgery. Patients were categorized into cervical malalignment (CM) and noncervical malalignment (NCM) groups following Passias' criteria. Radiographic factors influencing CSA were analyzed.</p><p><strong>Results: </strong>Preoperatively, 57 patients (55.9%) were assigned to the CM group and 45 patients (44.1%) to the NCM groups. The cervical lordosis (CL) in CM group was more kyphotic (19.3° vs. 3.3°), smaller proximal thoracic kyphosis (PTK; 9.7° vs. 15.4°), and smaller T1 slope (7.1° vs. 14.0°) than those in the NCM group. Main thoracic kyphosis (MTK) did not show significantly difference between the 2 groups (11.3° vs. 14.4°). Two years after surgery, the CM group demonstrated significant improvements in CSA. PTK increased from 9.7° to 13.5°, T1 slope increased from 7.1° to 10.5°, and cervical kyphosis improved from -19.3° to -8.8°, while MTK remained unchanged (11.3° vs. 11.6°).</p><p><strong>Conclusion: </strong>PSF significantly improved CSA in patients with preoperative CM. Increased PTK, correlated with improved CL, suggests that PSF-induced PTK enhancement, rather than MTK, drives T1 slope and subsequent CSA improvement.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 2","pages":"354-363"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584428","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 \"Establishing a Standardized Fellowship Curriculum for Advanced Minimally Invasive Spine Interventions: A Multidisciplinary Approach to Training and Competency\".","authors":"Gyu Yeul Ji","doi":"10.14245/ns.2550850.425","DOIUrl":"10.14245/ns.2550850.425","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 2","pages":"335-336"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584405","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":"Anterior Corpectomy Versus Posterior Pedicle Screw Fixation With 5.5-mm Rods for Metastatic Spinal Tumor Located in the Cervicothoracic Junction.","authors":"Sun Woo Jang, Hong Kyung Shin, Sang Ryong Jeon, Sung Woo Roh, Danbi Park, Chongman Kim, Jin Hoon Park","doi":"10.14245/ns.2449230.615","DOIUrl":"10.14245/ns.2449230.615","url":null,"abstract":"<p><strong>Objective: </strong>This study compared the efficacy of posterior pedicle screw fixation with 5.5-mm rods (PPSF5.5) with anterior corpectomy (AC) for metastatic cervicothoracic junction (CTJ) tumors.</p><p><strong>Methods: </strong>This retrospective analysis included patients with CTJ tumors who underwent PPSF5.5 or AC from January 2000 to December 2023. Data collected included demographics, surgical details, clinical outcomes (visual analogue scale scores for neck or back pain, Spinal Instability Neoplastic Scale score, McCormick scale, Nurick grade, and Eastern Cooperative Oncology Group score), radiologic results (cervical segmental Cobb angle), and surgical complications (instrumentation failure, tumor regrowth, and wound infection).</p><p><strong>Results: </strong>The AC group showed a tendency for short-level fusion. Patients in this group had tumors primarily located near C7 and generally confined to the vertebral body. AC was associated with more significant postoperative kyphotic changes in the index vertebra during follow-up than PPSF5.5. Moreover, AC was associated with a higher incidence of instrumentation failure, necessitating revision surgeries. Conversely, patients in the PPSF5.5 group tended to require revision surgery due to tumor regrowth.</p><p><strong>Conclusion: </strong>For CTJ metastatic tumors, PPSF5.5 provides superior resistance to forward bending and collapse prevention and minimizes instrumentation failure rate compared to AC. Moreover, AC may reduce the risk of tumor recurrence, but this approach is recommended only if the tumor is confined to the vertebral body and located at the upper level of the CTJ.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":" ","pages":"603-612"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990621","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":"Artificial Intelligence (AI) Agents Versus Agentic AI: What's the Effect in Spine Surgery?","authors":"Wongthawat Liawrungrueang","doi":"10.14245/ns.2550308.154","DOIUrl":"10.14245/ns.2550308.154","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 2","pages":"473-477"},"PeriodicalIF":3.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584413","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}