Spine最新文献

{"title":"Wearable Sensors for Pre- and Post-Operative Assessment of Cervical Myelopathy.","authors":"Steven D Glassman, Jeffrey L Gum, Justin Mathew, Charles H Crawford, Mladen Djurasovic, Leah Yacat Carreon","doi":"10.1097/BRS.0000000000005309","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005309","url":null,"abstract":"<p><strong>Study design: </strong>Prospective observational cohort.</p><p><strong>Objectives: </strong>To report on the role of a single wearable sensor in the evaluation of patients with Cervical Spondylotic Myelopathy (CSM).</p><p><strong>Summary of background data: </strong>Clinical evaluation of CSM is limited, as Hoffmann's sign, Romberg testing and Tandem Gait are largely subjective and binary, making deterioration or improvement difficult to document accurately.</p><p><strong>Methods: </strong>Patients scheduled for surgical treatment of CSM underwent in-office and 24-hour continuous at-home data collection using a single wearable sensor. In-office testing consisted of Standing, Romberg testing, Tandem Gait and Timed Up & Go (TUG). Testing was repeated 6-months post-operatively.</p><p><strong>Results: </strong>Statistically significant improvements were seen following surgical treatment in the Romberg test eyes-open maximum antero-posterior sway (P=0.010), eyes-open total path traveled (P=0.048); in Tandem Gait speed (P=0.021), duration (P=0.002), antero-posterior sway (P=0.046) and initial peak acceleration (P=0.001). There was no statistically significant difference in TUG testing. At-home gait pattern revealed a trend toward decreased lateral sway post-operatively (P=0.062) and fewer sleep turns (P=0.078).</p><p><strong>Conclusion: </strong>Wearable sensor data effectively quantifies standard exam findings and identifies new metrics with the potential to assess more accurately pre-operative and post-operative function in patients with CSM. Previously unreported pre-operative to 6-month post-operative changes were seen in speed of gait and ground impact force during Tandem Gait. These metrics were more sensitive as compared to the normal antero-posterior and lateral sway assessment. 24-hour sensor data showed decreased number of turns during sleep post-operatively. This study suggests that wearable sensor data will be a viable source for quantifiable data with the potential to guide treatment for patients with CSM. This capability is based partly on better quantification of existing binary measures, but also on identification of unanticipated patterns within the data.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459562","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 Concerning \"Impact of the Prognostic Nutritional Index on Outcomes in Native Spine Infection\" by Ezeonu et al.","authors":"Mugito Nagayoshi, Masatsugu Tsukamoto, Tadatsugu Morimoto","doi":"10.1097/BRS.0000000000005311","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005311","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459526","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":"Incidence and Predictors of Growth Modulation and Overcorrection after Anterior Vertebral Body Tethering.","authors":"Joshua M Pahys, Steven W Hwang, Maureen McGarry, Alejandro Quinonez, Harsh Grewal, Amer F Samdani","doi":"10.1097/BRS.0000000000005306","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005306","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective review of a prospectively collected single-center adolescent idiopathic scoliosis (AIS) database.</p><p><strong>Objective: </strong>To evaluate the incidence and predictors of growth modulation and overcorrection after vertebral body tethering (VBT) in AIS.</p><p><strong>Background: </strong>Little data exists regarding which AIS patients will exhibit growth modulation and/or overcorrection after VBT compared to those whose curve correction will remain unchanged (no modulation).</p><p><strong>Materials and methods: </strong>A total of 279 patients with AIS with a minimum 2-year follow-up (range 2-10 years) were included. There were 262 thoracic and 65 thoracolumbar VBT surgeries performed. Univariate and multivariate regression analyses were performed to identify the potential clinical/radiographic predictive factors for growth modulation and overcorrection.</p><p><strong>Results: </strong>Patients with growth modulation and those with no modulation after thoracic VBT were significantly more immature (younger, premenarchal, lower Sanders score/Risser grade, open triradiate cartilage [TRC]) and physically smaller (lower height, weight, and body mass index [BMI]; P<0.02). Patients with growth modulation vs. no modulation after thoracolumbar VBT had lower preoperative Sanders score, weight, and BMI (P<0.04). Preoperative and first-erect thoracic and lumbar curve magnitudes did not affect growth modulation vs. no modulation. Patients with thoracic overcorrection were physically smaller (lower height/weight/BMI) and had lower preoperative and first-erect thoracic curves than patients with growth modulation without overcorrection (P<0.04). Patients with thoracolumbar overcorrection had open-TRC and lower first-erect lumbar curves than patients with growth modulation without overcorrection (P<0.04). Open-TRC (odds ratio: 6.8, P<0.001) and lower BMI (P<0.001) were the only significant predictive factors for thoracic growth modulation in multivariate analysis; none were identified for thoracolumbar growth modulation. Sixty-four percent of patients with overcorrection required revision surgery versus 18% of those with no modulation (P<0.001).</p><p><strong>Conclusion: </strong>AIS patients with open-TRC and lower BMI had a statistically higher rate of thoracic growth modulation and overcorrection after VBT in multivariate analysis. Preoperative and first-erect curve magnitudes did not affect the incidence of growth modulation.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459485","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":"Characterization of Spine Implant Device Recalls: A 21-Year Analysis.","authors":"Haseeb E Goheer, Mina Botros, Yasmine S Ghattas, Phillip T Yang, Rebecca M Irwin, Varun Puvanesarajah","doi":"10.1097/BRS.0000000000005304","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005304","url":null,"abstract":"<p><strong>Study design: </strong>Observational epidemiological study.</p><p><strong>Objective: </strong>To identify and comprehensively assess reasons for recalls of spinal implant devices used in patients over the past 21 years.</p><p><strong>Summary of background data: </strong>The number of spine implant devices on the market continues to rise. Although the Food and Drug Administration (FDA) regulates the safety of these devices, there is a paucity of literature on the reasons spine implant devices are recalled.</p><p><strong>Methods: </strong>The FDA device recall database was queried using the search term \"spine\" for recalls between 2003 and 2024. Data were collected regarding recall class, recall reason, FDA 510(k)/premarket approval decision date, product manufacturer, and device indication. The data was then reviewed to identify recalls for spine implant devices.</p><p><strong>Results: </strong>A total of 386 spine implant devices were identified between January 2003 and December 2024. Among all recalls classified, 3.4% (n=13) were class I, 88.1% (n=340) were class II, and 8.5% (n=33) were class III. The most common reasons for recall were \"Device/Component design\" (52.8%) and \"Packing/Processing Control\" (24.1%). The median number of devices recalled by manufacturers included in the study was two with the highest being 41 devices.</p><p><strong>Conclusions: </strong>Overall, 76.9% of spine implant recalls reviewed were primarily due to issues with device design and processing control. 88.1% of recalls were classified with a class II FDA designation. This is the first study to present a retrospective regulatory analysis of FDA spine implant recalls and highlights the importance of premarket analysis and postmarketing surveillance to improve device safety.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459513","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":"Impact of Cervical Micro-Endoscopic Laminotomy on Postoperative Neck Pain and Range of Motion: A Case-Control Study.","authors":"Hiroshi Kobayashi, Takuya Nikaido, Kazuyuki Watanabe, Kinshi Kato, Yoshihiro Kobayashi, Masataka Nakamura, Miho Sekiguchi, Michiyuki Hakozaki, Takuya Kameda, Yoichi Kaneuchi, Koji Otani, Shoji Yabuki, Shin-Ichi Konno, Yoshihiro Matsumoto","doi":"10.1097/BRS.0000000000005305","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005305","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective case-control study.</p><p><strong>Objective: </strong>To evaluate clinical outcomes of cervical microendoscopic laminotomy (CMEL) and segmental partial laminectomy (SPL) in patients with cervical spondylotic myelopathy (CSM).</p><p><strong>Summary of background data: </strong>CSM often requires posterior decompression surgery. Conventional techniques such as laminoplasty and SPL are associated with significant challenges, including axial neck pain and reduced cervical range of motion (ROM). In contrast, CMEL, a minimally invasive approach, may offer superior outcomes. However, direct comparisons with SPL remain limited.</p><p><strong>Methods: </strong>We retrospectively analyzed 105 patients (58 with CMEL and 47 with SPL) who underwent posterior decompression surgery for CSM between 2003 and 2020. The evaluated outcomes included intraoperative parameters, postoperative clinical measures (e.g., Neck Disability Index (NDI), Japanese Orthopaedic Association (JOA) scores, including recovery rate and treatment satisfaction), radiographic assessments, and complication rates.</p><p><strong>Results: </strong>Compared to SPL, CMEL resulted in reduced blood loss, shorter hospital stay, less postoperative neck pain, ROM preservation, and fewer complications at 1 year postoperatively.</p><p><strong>Conclusions: </strong>CMEL is a minimally invasive alternative to SPL, providing reduced morbidity and improved outcomes. This is particularly true for aging populations that require functional preservation and quality of life improvement. By avoiding instruments such as interlaminar spacers and implants, CMEL can potentially reduce healthcare costs.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459440","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":"Dual Sustained-Release BMP7-Nanoparticle Hydrogel Scaffolds for Enhanced BMSC Neuronal Differentiation and Spinal Cord Injury Repair.","authors":"Xudong Sun, Heng Zhang, Shiyuan Huang, Kuanxin Li, Xuyi Wang","doi":"10.1097/BRS.0000000000005307","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005307","url":null,"abstract":"<p><strong>Study design: </strong>Preclinical experimental study.</p><p><strong>Objective: </strong>To explore the use of hydrogels as bioactive scaffolds for encapsulating bone marrow mesenchymal stem cells (BMSCs) to enhance their therapeutic potential in spinal cord injury (SCI). This study further aims to evaluate the added value of a BMP7 nanoparticle delivery system in overcoming the limitations of BMSCs alone for SCI repair.</p><p><strong>Summary of background data: </strong>SCI leads to significant neuron loss and functional impairment. While BMSC-based stem cell therapies show promise, their efficacy is limited by challenges such as the instability of bone morphogenetic protein (BMP)-7 in inducing neuronal differentiation. High concentrations of BMP7, though effective in promoting neuronal differentiation, may cause inflammation, necessitating the development of a delivery system for sustained and localized release.</p><p><strong>Methods: </strong>BMSCs were isolated from Sprague-Dawley rats, and BMP-7's effects on neuronal differentiation were assessed via western blotting. BMP7-loaded nanoparticles (NPs) and BMSCs were co-loaded into a gelatin methacrylate (Gel-MA) hydrogel scaffold, with a cell loading density of 1 × 10⁵ cells/μl. BMP7 was encapsulated at a 0.04% (w/V) concentration, corresponding to approximately 0.4 ng BMP7 per μl of hydrogel. Optimization was performed using mechanical, cytotoxicity, and neuronal marker analyses. Scaffold properties, including water absorption, BMP7 release, and BMSC morphology, were characterized. Therapeutic efficacy was evaluated in a rat SCI model using motor function recovery, histological analysis, and molecular assessments.</p><p><strong>Results: </strong>BMP-7 effectively promoted BMSC differentiation into neurons while suppressing glial cell development. The BMP7-NPs/Gel-MA scaffold ensured sustained BMP7 release, achieving optimal differentiation at a 0.04% (w/V) BMP7 concentration. In vivo, the scaffold combined with BMSCs enhanced neuronal proliferation and differentiation, stimulated myelin regeneration, reduced lesion volume, and significantly improved motor function recovery.</p><p><strong>Conclusion: </strong>The BMP7-NPs/Gel-MA scaffold provides sustained delivery of BMP-7, effectively directing BMSC differentiation into neuron-like cells while avoiding glial commitment. Combined with BMSCs, it offers a promising therapeutic strategy for SCI repair.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459435","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":"Implementation of the Minimum Clinically Important Difference for the Neck Disability Index is Often Problematic: A Methodological Review.","authors":"Nathan Evaniew, Armaan K Malholtra, Raphaële Charest-Morin, Alex Soroceanu, W Bradley Jacobs, David W Cadotte, Greg McIntosh, Nicolas Dea","doi":"10.1097/BRS.0000000000005300","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005300","url":null,"abstract":"<p><strong>Study design: </strong>Systematic Review.</p><p><strong>Objective: </strong>To determine the incidence of inappropriate or uncertain implementation of the Minimally Important Clinical Difference (MCID) for the Neck Disability Index (NDI).</p><p><strong>Summary of background data: </strong>The NDI consists of 10 items that yield a total score out of 50, but some users double the scale to report total scores out of 100. The most used MCID for the NDI is 7.5 out of 50. Implementation of the MCID can be problematic if users are not attentive to the scale of the NDI.</p><p><strong>Methods: </strong>We performed a methodological review of studies that cited the MCID for the NDI. We defined appropriate implementation as congruent magnitude of the scales used for NDI data and the MCID. We evaluated study characteristics associated with appropriate implementation using multivariable logistic regression.</p><p><strong>Results: </strong>Among 163 included studies, twenty (12%) reported a 0-50 scale for the NDI, 66 (40%) reported a 0-100 scale, and the remaining 77 (47%) did not report which scale was used. Fifty-seven (35%) reported an MCID of 7.5, 37 (23%) reported an MCID of 15, and the remaining 69 (42%) did not report which value of the MCID used. Appropriate implementation of the MCID occurred in 39 studies (24%), while implementation was inappropriate in 16 (10%) and uncertain due to poor reporting in 108 (66%). Studies published more recently (OR 1.20 per year, 95% CI 1.02 to 1.40, P=0.03) and studies that were RCTs (OR 4.85, 95% CI 1.25 to 18.79, P=0.02) had greater odds of being associated with appropriate implementation.</p><p><strong>Conclusions: </strong>Inappropriate implementation of the MCID for the NDI is problematic and occurs often, and uncertain implementation due to poor reporting is also common. Evidence users should be cautious when interpreting studies that implement the NDI, and should consider whether the magnitude of the scales used for the NDI and the MCID are congruent.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459482","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":"Validating the Hierarchical Nature of the AO Spine Upper Cervical Spine Injury Classification System.","authors":"Rajkishen Narayanan, Jonathan Dalton, Richard Bransford, Marcel R Dvorak, Harvinder Singh Chhabra, Andrei F Joaquim, Mohammad El-Sharkawi, Lorin M Benneker, Klaus Schnake, Cumhur Oner, Charlotte Dandurand, Jose A Canseco, Christopher K Kepler, Alexander R Vaccaro, Gregory D Schroeder","doi":"10.1097/BRS.0000000000005297","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005297","url":null,"abstract":"<p><strong>Study design: </strong>Global cross-sectional survey.</p><p><strong>Objective: </strong>To validate the hierarchical nature of the AO Spine Upper Cervical Spine Injury Classification (UCIC) across AO geographical regions/practice experience.</p><p><strong>Summary of background data: </strong>In order to create a universally validated scheme with prognostic value, AO Spine established an upper cervical spine injury classification involving three elements: injury morphology (region: I - occipital condyle and craniocervical junction; II - C1 ring and C1-2 joint; III - C2 and C2-3 joint), and (subtype: A - isolated bony injury; B - bony/ligamentous injury; C - displaced/translational injury), neurologic status (N0 - intact; N1 - transient deficit; N2 - radiculopathy; N3 - incomplete spinal cord injury (SCI); N4 - complete SCI, and NX - unable to examine), and case-specific modifiers (M1 - injuries at risk of nonunion; M2 - injuries at risk of instability; M3 - patient specific factors; M4 - vascular injury).</p><p><strong>Methods: </strong>151 AO Spine members (orthopaedic and neurosurgery) were surveyed globally regarding the severity (zero - low severity to 100 - high severity) of each UCIC variable. Primary outcomes were differences in perceived injury severity score (ISS) over various geographic/practice settings, level of experience, and subspecialty.</p><p><strong>Results: </strong>148 responses were received. There was an increase in median perceived severity as each anatomic region (I-III) progressed from types A to B to C. Neurologic status progressed similarly, except N1 and N2 were perceived similarly. Modifier M2 was perceived more severely than M3. There were no differences in ISS amongst levels of surgeon experience. There were small geographic differences with respondents from North and Central and South America perceiving types IC (P=0.003), IIB (P=0.003), and IIIB (P=0.003) somewhat more severely than other regions. Neurosurgeons perceived types IB (P=0.002) and IIIB (P=0.026) as more severe than orthopaedic spine surgeons.</p><p><strong>Conclusions: </strong>The AO Spine UCIC has overall excellent hierarchical progression in subtype ISS. These findings are consistent across geographic regions, spine subspecialty training and experience levels.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441644","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":"Assessing the Impact of Preoperative MRI-Based Vertebral Bone Quality Scores on Five-Year Prognosis in Lumbar Spine Surgery.","authors":"Hiroshi Taniwaki, Masatoshi Hoshino, Yuki Kinoshita, Akira Matsumura, Takashi Namikawa, Minori Kato, Shinji Takahashi, Hiroaki Nakamura","doi":"10.1097/BRS.0000000000005040","DOIUrl":"10.1097/BRS.0000000000005040","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To assess the utility of preoperative vertebral bone quality (VBQ) scores in predicting the five-year clinical outcomes following lumbar spine surgery.</p><p><strong>Summary of background data: </strong>Osteoporosis poses a significant concern in older adults undergoing spinal surgery. The VBQ score, assessed through preoperative magnetic resonance imaging (MRI), is associated with subsequent osteoporotic fractures and postoperative complications. However, previous report on the impact of VBQ score on mid-term clinical outcomes after lumbar spine surgery remains lacking.</p><p><strong>Materials and methods: </strong>A total of 189 patients who underwent lumbar surgery (≤3 disc levels) for lumbar spinal stenosis between 2010 and 2016 were enrolled. Patients were classified into high (>3.35), middle (2.75-3.35), and low (<2.73) VBQ score groups based on tertiles. Clinical scores, including Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and Short Form-36 (SF-36), were recorded preoperatively and one, two, and five years postoperatively.</p><p><strong>Results: </strong>Comparative analysis showed significant differences among the VBQ groups throughout the study period in low back pain ( P =0.013), walking ability ( P =0.005), social life function ( P =0.010) of JOABPEQ, and physical component summary of the SF-36 ( P =0.018) following lumbar spine surgery. A higher VBQ score was significantly correlated with worse five-year postoperative outcomes for all domains except for lumbar function of the JOABPEQ using multiple linear regression analysis, adjusting for age, sex, BMI, hyperlipidemia, surgical procedures, and each preoperative score.</p><p><strong>Conclusion: </strong>A high preoperative VBQ score is a risk factor for poor five-year clinical outcomes after lumbar spine surgery. Evaluation of the VBQ score through routine preoperative MRI facilitates osteoporotic screening in lumbar patients without radiation exposure and health care costs, while also demonstrating its potential as a prognostic indicator of postoperative clinical outcomes.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"259-265"},"PeriodicalIF":2.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945547","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":"Genetic Variants Can Predict the Outcome of Brace Treatment in Patients With Adolescent Idiopathic Scoliosis.","authors":"Zhicheng Dai, Kaixing Min, Zhichong Wu, Leilei Xu, Zhenhua Feng, Yong Qiu, Zezhang Zhu","doi":"10.1097/BRS.0000000000005137","DOIUrl":"10.1097/BRS.0000000000005137","url":null,"abstract":"<p><strong>Study design: </strong>A genetic case-control study.</p><p><strong>Objectives: </strong>To investigate the association between AIS progression-associated SNPs reported by GWAS studies and the effectiveness of brace treatment.</p><p><strong>Summary of background data: </strong>Bracing is the most effective conservative method to treat adolescent idiopathic scoliosis (AIS). Several factors have been reported to be associated with bracing failure in AIS patients. Genetic markers associated with AIS have potential prognostic value.</p><p><strong>Methods: </strong>A retrospective cohort of AIS patients undergoing brace treatment was enrolled in this study and divided into success and failure groups based on treatment outcome. Clinical characteristics of AIS patients were documented. Candidate SNPs were selected from previous GWAS studies of AIS, which were known to be associated with curve progression and validated across diverse populations. Genotype and allele frequencies between the success and failure groups were compared using χ 2 analysis.</p><p><strong>Results: </strong>A total of 259 female AIS patients were included in this study, 30.5% of the well-braced patients had curve progression exceeding 5° and 69.5% of the patients undergo an improvement or progression of <5°. Allele C of rs10738445 ( BNC2 ) could significantly add to the risk of bracing failure, with odds ratio of 1.59. No significant association with bracing outcomes was found for rs12946942 ( SOX9/KCNJ2 ), rs1978060 ( TBX1 ), rs1017861 ( CHD7 ), and rs35333564 ( MIR4300HG ).</p><p><strong>Conclusions: </strong>SNP rs10738445 were significantly associated with brace treatment effectiveness. The other four SNPs were not significantly associated with the outcome of bracing. More SNPs and predictors should be included in future study to develop a more accurate predictive model for clinical application.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"238-242"},"PeriodicalIF":2.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112303","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}