Neurospine最新文献

{"title":"Comparison of 3 Different Endoscopic Techniques for Lumbar Spinal Stenosis: Comprehensive Radiological and Clinical Study.","authors":"Abdullah Merter, Mustafa Özyıldıran, Motohide Shibayama, Zenya Ito, Shu Nakamura, Fujio Ito","doi":"10.14245/ns.2448864.432","DOIUrl":"https://doi.org/10.14245/ns.2448864.432","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the clinical and comprehensive radiological outcomes of 3 types of endoscopic decompression surgery: unilateral biportal endoscopic lumbar decompression (UBELD), microendoscopic laminotomy (MEL), and percutaneous endoscopic lumbar decompression (PELD).</p><p><strong>Methods: </strong>Patients with single-level lumbar spinal stenosis without instability were included in this multicenter retrospective study. Visual analogue scale (VAS) scores for each extremity, VAS back pain, and Japanese Orthopaedic Association (JOA) scores at preoperative and postoperative 1st, 6th, and 12th months were used as clinical outcome measures. In order to compare the radiological results of the patients, bilateral superior articular distance (SAD), bilateral lateral recess height (LR height), bilateral lateral recess angle (LR angle), and cross-sectional spinal canal area values were measured.</p><p><strong>Results: </strong>Eighty patients in the UBELD group, 73 patients in the MEL group, and 62 patients in the PELD group were included in the study. There was a statistically significant improvement in VAS scores and JOA scores in all groups compared to the preoperative period. At the 12th month postoperatively, the highest lateral decompression values on the approach side were determined as MEL (SAD: 4.1 mm, LR angle: 38.8°, LR height: 4.0 mm), followed by UBELD (SAD: 3.6 mm, LR angle: 36.2°, LR height: 3.3 mm) and PELD (SAD: 3.0 mm, LR angle: 21.7°, LR height: 2.3 mm), respectively. For the contralateral side, the highest lateral recess decompression values were listed as UBELD > MEL > PELD.</p><p><strong>Conclusion: </strong>Effective decompression can be performed using all endoscopic techniques in lumbar spinal stenosis. However lateral recess decompression values were found to be better in UBELD and MEL techniques, compared to PELD.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"276-285"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003017","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":"Research on the Correlation between Balance Function and Core Muscles in Patients With Adolescent Idiopathic Scoliosis.","authors":"Si-Jia Li, Qing Yue, Qian-Jin Liu, Yan-Hua Liang, Tian-Tian Zhou, Xiao-Song Li, Tian-Yang Feng, Tong Zhang","doi":"10.14245/ns.2448938.469","DOIUrl":"https://doi.org/10.14245/ns.2448938.469","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the correlation between balance function and core muscle activation in patients with adolescent idiopathic scoliosis (AIS), compared to healthy individuals.</p><p><strong>Methods: </strong>A total of 24 AIS patients and 25 healthy controls were recruited. The limits of stability (LOS) test were conducted to assess balance function, while surface electromyography was used to measure the activity of core muscles, including the internal oblique, external oblique, and multifidus. Diaphragm thickness was measured using ultrasound during different postural tasks. Center of pressure (COP) displacement and trunk inclination distance were also recorded during the LOS test.</p><p><strong>Results: </strong>AIS patients showed significantly greater activation of superficial core muscles, such as the internal and external oblique muscles, compared to the control group (p < 0.05). Diaphragm activation was lower in AIS patients during balance tasks (p < 0.01). Although no significant difference was observed in COP displacement between the groups, trunk inclination was significantly greater in the AIS group during certain tasks (p < 0.05).</p><p><strong>Conclusion: </strong>These findings suggest distinct postural control patterns in AIS patients, highlighting the importance of targeted interventions to improve balance and core muscle function in this population.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"264-275"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036897","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":"From the Editor-in-Chief: Featured Articles in the March 2025 Issue.","authors":"Inbo Han","doi":"10.14245/ns.2550270.135","DOIUrl":"https://doi.org/10.14245/ns.2550270.135","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"1-2"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036931","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 \"Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations\".","authors":"Jason Pui Yin Cheung","doi":"10.14245/ns.2550304.152","DOIUrl":"https://doi.org/10.14245/ns.2550304.152","url":null,"abstract":"","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"28-29"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021989","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":"Integrated Optical and Magnetic Navigation for Simplified Percutaneous Transforaminal Endoscopic Lumbar Discectomy: A Novel Approach.","authors":"Xing-Chen Yao, Jun-Peng Liu, Xin-Ru Du, Li Guan, Jincai Yang, Yong Hai, Aixing Pan","doi":"10.14245/ns.2448750.375","DOIUrl":"10.14245/ns.2448750.375","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent TELD for LDH at Beijing Chaoyang Hospital, Capital Medical University from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided TELD (Ng-TELD) group (30 cases), while those treated with the conventional x-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the 2 patient groups.</p><p><strong>Results: </strong>The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients' lumbar function and quality of life had significantly improved compared to preoperative levels (p < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43 ± 12.37 minutes vs. 83.23 ± 25.90 minutes), catheter placement time (5.83 ± 1.09 minutes vs. 15.94 ± 3.00 minutes), decompression time (47.17 ± 11.98 minutes vs. 67.29 ± 24.23 minutes), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (p < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (p > 0.05).</p><p><strong>Conclusion: </strong>This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":" ","pages":"297-307"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024140","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":"Dissecting Causal Relationships Between Gut Microbiota, 1400 Blood Metabolites, and Intervertebral Disc Degeneration.","authors":"Yuxi Liu, Daxiong Feng, Hong Zhang, Likun Wang","doi":"10.14245/ns.2449172.586","DOIUrl":"https://doi.org/10.14245/ns.2449172.586","url":null,"abstract":"<p><strong>Objective: </strong>The precise mechanisms driving intervertebral disc degeneration (IVDD) development remain unclear, but evidence suggests a significant involvement of gut microbiota (GM) and blood metabolites. We aimed to investigate the causal relationships between GM, IVDD, and blood metabolites using Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>We utilized the summary statistics of GM from the MiBioGen consortium, 1400 blood metabolites from the genome-wide association studies (GWAS) Catalog, and IVDD data from the FinnGen repository, which are sourced from the largest GWAS conducted to date. Employing bidirectional MR analyses, we investigated the causal relationships between GM and IVDD. Additionally, we conducted 2 mediation analyses, 2-step MR and multivariable MR (MVMR), to identify potential mediating metabolites.</p><p><strong>Results: </strong>Five bacterial genera were causally associated with IVDD, while IVDD did not show a significant causal effect on GM. In the 2-step MR analysis, Eubacteriumfissicatenagroup, RuminococcaceaeUCG003, Lachnoclostridium, and Marvinbryantia genera, along with metabolites X-24949, Pimeloylcarnitine/3-methyladipoylcarnitine (C7-DC), X-24456, histidine, 2-methylserine, Phosphocholine, and N-delta-acetylornithine, were all significantly associated with IVDD (all p < 0.05). MVMR analysis revealed that the associations between Eubacteriumfissicatenagroup genus and IVDD were mediated by X-24949 (8.1%, p = 0.024); Lachnoclostridium genus and IVDD were mediated by histidine (18.1%, p = 0.013); and RuminococcaceaeUCG003 genus and IVDD were mediated by C7-DC (-7.5%, p = 0.041).</p><p><strong>Conclusion: </strong>The present MR study offers evidence supporting the causal relationships between several specific GM taxa and IVDD, as well as identifying potential mediating metabolites.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"211-221"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028923","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":"Comparative Analysis of Romosozumab Versus Vertebroplasty With Denosumab: Efficacy, Safety, and Secondary Bone Mineral Density Outcomes.","authors":"Hyun Woong Mun, Jong Joo Lee, Hyun Chul Shin, Tae-Hwan Kim, Seok Woo Kim, Jae Keun Oh","doi":"10.14245/ns.2449228.614","DOIUrl":"https://doi.org/10.14245/ns.2449228.614","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the efficacy and safety of romosozumab, a bone anabolic agent, versus vertebroplasty, a conventional surgical intervention, in treating osteoporotic vertebral compression fractures (OVCFs).</p><p><strong>Methods: </strong>A retrospective analysis included 86 thoracic/lumbar compression fracture patients from 2014 to 2022 at a medical center. Forty-two patients received romosozumab (monthly injections for 1 year) followed by 1 year of denosumab, while 44 underwent vertebroplasty followed by denosumab injections biannually for 2 years. Outcomes were assessed using the Numerical Rating Scale (NRS) for pain, bone mineral density (BMD), vertebral compression ratio, and Cobb angle over 12 months.</p><p><strong>Results: </strong>At 12 months, the romosozumab group showed a greater reduction in NRS scores (4.90 ± 1.01 vs. 4.27 ± 1.34, p = 0.015) and a higher increase in lumbar BMD (0.8 ± 0.5 vs. 0.5 ± 0.3, p = 0.000) compared to the vertebroplasty group. There were no significant differences in changes in hip total BMD and femur neck BMD (p = 0.190, p = 0.167, respectively). Radiographic assessments showed no significant differences in vertebral compression ratio (14.7% vs. 14.8%; p = 0.960) or Cobb angle (4.2° vs. 4.9°; p = 0.302). The incidence of major osteoporotic fractures was lower in the romosozumab group (7.1% vs. 25.0%, p = 0.051), with similar rates of cardiovascular events in both groups (4.8% vs. 9.1%, p = 0.716).</p><p><strong>Conclusion: </strong>Romosozumab has demonstrated superior pain reduction and lumbar BMD improvement compared to vertebroplasty at 12 months, with no significant differences in radiographic outcomes or adverse events, suggesting it as an alternative to vertebroplasty for OVCF.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"69-77"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046206","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":"Robotic-Assisted Trans-Superior Articular Process Endoscopic Decompression: A Case Illustration and Technical Overview.","authors":"Tamara Lee Ting Soh, Zachary Chu, Christoph P Hofstetter, Jacob Yoong-Leong Oh","doi":"10.14245/ns.2449082.541","DOIUrl":"https://doi.org/10.14245/ns.2449082.541","url":null,"abstract":"<p><p>The growth of minimally invasive techniques in spine surgery has accelerated in recent years, leading to development of new techniques and technology such as robotic-assisted spine surgery and full-endoscopic surgery. While robotic spine surgery offers the potential of increased precision and accuracy in instrumentation, endoscopic techniques are beneficial in reducing collateral tissue damage and allowing patients a faster return to function. We describe a case where we combine a robotic guidance system with a full-endoscopic technique, the trans-superior articular process decompression. We aim to share our experience as well as an overview of the surgical technique.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"128-133"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990455","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":"Fixation of the Sacroiliac Joint: A Cadaver-Based Concurrent-Controlled Biomechanical Comparison of Posterior Interposition and Posterolateral Transosseous Techniques.","authors":"Oluwatodimu Richard Raji, Jason E Pope, Steven M Falowski, Michael Stoffman, Jeremi M Leasure","doi":"10.14245/ns.2448940.470","DOIUrl":"https://doi.org/10.14245/ns.2448940.470","url":null,"abstract":"<p><strong>Objective: </strong>Our study aimed to compare the posterior interposition technique against the posterolateral transosseous technique in the same cadaver specimens.</p><p><strong>Methods: </strong>Computer and cadaver models of 2 fixation techniques were developed. The computer model was constructed to analyze bone volume removed during implant placement and the bony surface area available for fusion. The cadaver model included quasi-static multidirectional bending flexibility and dynamic fatigue loading. Relative motions between the sacrum and ilium were measured intact, after joint destabilization, after fixation with direct-posterior and posterolateral techniques, and after 18,500 cycles of fatigue loading. Relative positions between each implant and the sacrum and ilium were measured after fixation and fatigue loading to ascertain the quality of the bone-implant interface. The 2 techniques were randomized to the left and right sacroiliac joints of the same cadavers.</p><p><strong>Results: </strong>The posterior interposition technique removed less bone volume and facilitated a larger surface area available for bony fusion. Posterior interposition significantly reduced the nutation/counternutation motion of the sacroiliac joint (42% ± 8%) and reduced it more than the posterolateral transosseous technique (14% ± 4%). Upon fatigue loading, the posterior interposition implant maintained the bone-implant interface across all specimens, while the posterolateral transosseous implant migrated or subsided in 20%-50% of specimens.</p><p><strong>Conclusion: </strong>Posterior interposition fixation of the sacroiliac joint reduces joint motion. The amount of fixation from the posterior technique is superior and more durable than the amount of fixation achieved by the posterolateral technique.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"185-193"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034527","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 Ever-Evolving Regulatory Landscape Concerning Development and Clinical Application of Machine Intelligence: Practical Consequences for Spine Artificial Intelligence Research.","authors":"Massimo Bottini, Seung-Jun Ryu, Adrian Elmi Terander, Stefanos Voglis, Nicolai Maldaner, David Bellut, Luca Regli, Carlo Serra, Victor E Staartjes","doi":"10.14245/ns.2449186.593","DOIUrl":"https://doi.org/10.14245/ns.2449186.593","url":null,"abstract":"<p><p>This paper analyzes the regulatory frameworks for artificial intelligence/machine learning AI/ML-enabled medical devices in the European Union (EU), the United States (US), and the Republic of Korea, with a focus on applications in spine surgery. The aim is to provide guidance for developers and researchers navigating regulatory pathways. A review of current literature, regulatory documents, and legislative frameworks was conducted. Key differences in regulatory bodies, risk classification, submission requirements, and approval pathways for AI/ML medical devices were examined in the EU, US, and Republic of Korea. The EU AI Act (2024) establishes a risk-based framework, requiring regulatory review based on device risk, with high-risk devices subject to stricter oversight. The US applies a more flexible approach, allowing multiple submission pathways and incorporating a focus on continuous learning. The Republic of Korea emphasizes possibilities of streamlined approval and with growing use of real-world data to support validation. Developers must ensure regulatory alignment early in the development process, focusing on key aspects like dataset quality, transparency, and continuous monitoring. Across all regions, the need for technical documentation, quality management systems, and bias mitigation are essential for approval. Developers are encouraged to adopt adaptable strategies to comply with evolving regulatory standards, ensuring models remain transparent, fair, and reliable. The EU's comprehensive AI Act enforces stricter oversight, while the US and Korea offer more flexible pathways. Developers of spine surgery AI/ML devices must tailor development strategies to align with regional regulations, emphasizing transparent development, quality assurance, and postmarket monitoring to ensure approval success.</p>","PeriodicalId":19269,"journal":{"name":"Neurospine","volume":"22 1","pages":"134-143"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020391","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}