Spine最新文献

{"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":"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. Although 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, although 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 through 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 × 10 5 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, histologic 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":"575-585"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","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":"Impact of Knee Osteoarthritis and Arthroplasty on Full-body Sagittal Alignment in Adult Spinal Deformity Patients.","authors":"Mohammad Daher, Alan H Daniels, Ashley Knebel, Mariah Balmaceno-Criss, Renaud Lafage, Lawrence G Lenke, Chrisotpher P Ames, Douglas Burton, Stephen M Lewis, Eric O Klineberg, Robert K Eastlack, Munish C Gupta, Gregory M Mundis, Jeffrey L Gum, Kojo D Hamilton, Richard Hostin, Peter G Passias, Themistocles S Protopsaltis, Khaled M Kebaish, Han Jo Kim, Frank Schwab, Christopher I Shaffrey, Justin S Smith, Breton Line, Shay Bess, Virginie Lafage, Bassel G Diebo","doi":"10.1097/BRS.0000000000005206","DOIUrl":"10.1097/BRS.0000000000005206","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective analysis of prospectively collected data.</p><p><strong>Objective: </strong>This study evaluates the impact of knee osteoarthritis (OA) and knee arthroplasty on alignments and patient-reported outcomes measures (PROMS) of patients undergoing adult spinal deformity (ASD) corrective surgery.</p><p><strong>Background: </strong>The relationship between knee OA and spinal alignment in patients with ASD is incompletely understood. It is also unknown how patients with knee arthroplasty and ASD compare to ASD patients with native knees.</p><p><strong>Methods: </strong>Baseline full-body radiographs were used, and hip and knee OA were graded by two independent reviewers using the KL classification. Spinopelvic parameters and PROMs were compared across the different knee OA groups and compared between patients with knee replacement and native knees.</p><p><strong>Results: </strong>One hundred ninety-nine patients with bilateral nonsevere OA (G1), 31 patients with unilateral severe knee OA (G2), and 60 patients with bilateral severe knee OA (G3). Patients with severe knee OA presented with worse spinopelvic parameters. However, after multivariable regression analysis controlling for age, frailty, PI, T1PA, knee OA was an independent predictor of knee flexion (G1: -0.02±7.3, G2: 7.8±9.4, G3: 4.5±8.7, P <0.001), and ankle dorsiflexion (G1: 2.3±4.0, G2: 6.6±4.5, G3: 5.1±4.1, P <0.001). There was no difference in PROMs ( P >0.05). Secondary analysis included 96 patients: 48 patients (50%) with nonsevere knee OA, and 48 patients (50%) with knee replacement. There was no difference in radiographic parameters or PROMs between the groups.</p><p><strong>Conclusions: </strong>In this study of complex ASD patients, patients with worse spinal deformities were more likely to have concomitant knee OA. Knee OA was shown to be a predictor of knee flexion and ankle dorsiflexion angles, but was not associated with worse PROMs in this study population. Patients with knee arthroplasty, however, had comparable spinal alignment and PROMs relative to those with mild OA.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"508-514"},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590812","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":"Clinical Outcomes of Revision Lumbar Fusion in the Aging Population.","authors":"Rajkishen Narayanan, Omar H Tarawneh, Jonathan Dalton, Robert J Oris, Mark Miller, Nicholas B Pohl, Tariq Z Issa, Matthew Meade, Olivia Opara, Emily Berthiaume, Yunsoo Lee, Yashas Reddy, Grace Bowen, Harry Lightsey, Ian D Kaye, Mark F Kurd, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder","doi":"10.1097/BRS.0000000000005216","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005216","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>To examine the profile of older patients undergoing revision lumbar fusion and to evaluate the impact that advancing age may have on outcomes following revision lumbar fusion.</p><p><strong>Background: </strong>The proportion of older patients undergoing revision lumbar fusion is increasing; however, the benefit of revision lumbar fusion in an aging demographic is not well documented.</p><p><strong>Patients and methods: </strong>Patients aged 55+ who underwent revision lumbar between 2011 and 2022 were included and were stratified into age groups: 55 to 64, 65 to 74, and 75+. Primary outcomes consisted of postoperative emergency department visits, 30 and 90-day readmissions, all-cause reoperations, and the need for secondary revisions. Secondary outcomes included patient-reported outcome measures (PROMs) obtained preoperatively, and at 3 months and 1 year postoperatively.</p><p><strong>Results: </strong>A total of 914 patients were included: 55 to 64 years (n = 512, mean: 61.1 yr), 65 to 74 years (n = 296, mean: 69.1 yr), and 75+ (n = 106, mean: 78.9 yr). Adjacent segment disease as a revision indication significantly increased with age (P = 0.001). A circumferential approach was used most (N = 200, 39.7%) in patients 55 to 64, whereas a posterior-only approach was used in 86.3% of patients 75+ (P < 0.001). Levels decompressed increased with age, from 1.67 in the youngest group to 2.04 in the oldest (P < 0.001). The number of levels fused showed no significant difference (P = 0.068). Ninety-day readmissions and the need for secondary revisions did not vary by age. Age groups were not independently associated with ΔPROMs at 1 year, but the oldest groups continued to experience improvement in PROMs in line with their younger counterparts.</p><p><strong>Conclusion: </strong>Patients 75 years and older derive similar benefits from revision lumbar fusion compared with their younger counterparts with no increased risk of emergency department visits, readmissions, or reoperations. Clinicians should be advised that there remains significant value in revising older patients when indicated.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":"50 8","pages":"E151-E157"},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711361","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":"Outcomes Following Two-Level Cervical Disc Arthroplasty Relative to Two-Level Anterior Cervical Discectomy.","authors":"Philip P Ratnasamy, Michael J Gouzoulis, Sahir S Jabbouri, Arya G Varthi, Jonathan N Grauer","doi":"10.1097/BRS.0000000000005131","DOIUrl":"10.1097/BRS.0000000000005131","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To evaluate postoperative adverse events, readmissions, and 5-year survival to reoperation for 2-level cervical disc arthroplasty (CDA) relative to 2-level anterior cervical discectomy and fusion (ACDF).</p><p><strong>Background: </strong>CDA and ACDF are both treatment options for degenerative cervical spine pathology. Relative to ACDF, CDA is a relatively novel treatment option, and limited research exists comparing outcomes between 2-level CDA and 2-level ACDF.</p><p><strong>Patients and methods: </strong>Patients undergoing 2-level CDA or 2-level ACDF were isolated from the PearlDiver M165Ortho database. These 2 cohorts were matched 1:1 based on patient age, sex, and Elixhauser Comorbidity Index scores. The odds of 90-day postoperative adverse events were compared between the two groups by multivariable analysis. Overall cost-of-care for the first 90 days postoperatively and 5-year survival to cervical spine reoperation were then assessed.</p><p><strong>Results: </strong>Of the 2-level cases identified, only 3.9% had CDA, and the rest had ACDF. After matching, there were 4224 patients in each of the study groups. With controlling for patient age, sex, and Elixhauser Comorbidity Index on multivariable analysis, patients undergoing 2-level CDA had significantly lower odds of experiencing 90-day dysphagia [odds ratio (OR): 0.60, P < 0.0001 driving aggregated any adverse event (OR: 0.65, P < 0.0001)] and readmission (OR: 0.69, P = 0.0002). The median 90-day cost of care was greater for patients undergoing 2-level ACDF ($4776.00 vs . $3191.00, P < 0.0001). No significant difference in 5-year survival to cervical spine reoperation was identified ( P = 0.7).</p><p><strong>Conclusions: </strong>Relative to patients undergoing 2-level ACDF, patients undergoing 2-level CDA were found to have significantly lower odds of 90-day readmissions and minor adverse events (dysphagia), while rates of major adverse events (pulmonary embolism, deep vein thrombosis, sepsis, etc .) were comparable between the groups. Further, patients undergoing CDA had lower cost of overall care, but no difference in 5-year survival to cervical spine reoperation. Thus, it may be appropriate to further consider CDA when 2-level surgery is pursued.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"548-554"},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073922","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 \"Does Spinal Cord-canal Mismatch Adversely Affect the Clinical Outcomes of Anterior Cervical Discectomy and Fusion for the Treatment of Cervical Myelopathy?\" by Park et al.","authors":"Weijing Fang, Zhan Wang","doi":"10.1097/BRS.0000000000005230","DOIUrl":"10.1097/BRS.0000000000005230","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E158"},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772464","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":"The Benefits of Awake Spinal Surgery on Minimizing Positioning-related Complications: A Narrative Review.","authors":"Maria L M Assis, Elird Bojaxhi, Kingsley O Abode-Iyamah, Jennifer S Patterson, Kate E White, Shaun E Gruenbaum, Ferenc Rabai, Marie L De Ruyter, Kevin T Riutort, Zachary J Fleissner, Stephen M Pirris, Maria Barbosa, Benjamin F Gruenbaum","doi":"10.1097/BRS.0000000000005219","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005219","url":null,"abstract":"<p><strong>Study design: </strong>Literature review and institutional analysis.</p><p><strong>Objective: </strong>This review examines the potential advantages of awake spinal surgery under neuroaxial anesthesia in minimizing positioning-related complications compared with traditional general anesthesia.</p><p><strong>Summary of background data: </strong>Spinal surgeries performed in the prone position under general anesthesia are associated with perioperative complications, such as ocular injury and vision loss, nerve damage, and pressure ulcers.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was conducted for articles published from 1986 to 2023 focusing on awake spinal surgery and positioning-related complications. In addition, insights from the Mayo Clinic team were incorporated to assess the potential benefits of awake spine surgery.</p><p><strong>Results: </strong>The review identified several positioning-related complications associated with prone positioning during spine surgery, including perioperative visual loss, neuropathies, pressure ulcers, and intra-abdominal hypertension leading to systemic cardiovascular effects and potential organ dysfunction. Advances at the Mayo Clinic have enabled the use of awake spinal surgery under neuroaxial anesthesia for complex procedures such as robotic transforaminal lumbar interbody fusion. The use of awake lumbar spine surgery has demonstrated advantages, including reduced positioning-related complications, immediate patient feedback to avoid harmful maneuvers, shorter operating room times, and improved hemodynamic stability.</p><p><strong>Conclusions: </strong>Awake lumbar spine surgery offers notable advantages in reducing positioning-related complications and presents a promising alternative to general anesthesia.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":"50 8","pages":"555-561"},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711322","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":"Comparative Efficacy and Safety of Endovascular Versus Surgical Treatment in Spinal Dural Arteriovenous Fistulas : A Systematic Review and Meta-analysis.","authors":"Basel Musmar, Joanna M Roy, Atakan Orscelik, Sonu Bhaskar, Saman Sizdahkhani, Elias Atallah, Sravanthi Koduri, Stavropoula I Tjoumakaris, Michael Reid Gooch, Robert H Rosenwasser, Pascal Jabbour","doi":"10.1097/BRS.0000000000005226","DOIUrl":"10.1097/BRS.0000000000005226","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Objective: </strong>This study aims to compare the efficacy and safety of surgical and endovascular treatments for SDAVFs.</p><p><strong>Summary of background data: </strong>Spinal dural arteriovenous fistulas (SDAVFs) result from an abnormal connection between the radiculomeningeal artery and the radicular vein, leading to venous hypertension and potential neurological damage. The two primary treatment strategies are surgical closure and endovascular obliteration of the fistula.</p><p><strong>Methods: </strong>PubMed, Scopus, and Web of Science databases were searched from inception to July 2024. We defined the successful treatment as fistula occlusion with sufficient embolic material penetration or obliteration during surgery.</p><p><strong>Results: </strong>A total of 1192 articles were identified, with 40 studies meeting the inclusion criteria, comprising 1818 patients (surgical: 804, endovascular: 1014). The surgical group demonstrated higher rates of complete occlusion at the last follow-up (96.8%, 363/375) compared with the endovascular group (72.5%, 470/648) (OR: 0.16; CI: 0.09-0.28, P < 0.01). Surgical treatment also had higher successful treatment rates (97.5%, 392/402) compared with endovascular treatment (66.7%, 529/793) (OR: 0.11; CI: 0.06- 0.19, P < 0.01). Recurrence rates were lower in the surgical group (OR: 6.04; CI: 3.45-10.57, P < 0.01) and retreatment rates were also lower (OR: 7.16; CI: 4.11-12.48, P < 0.01). Initial treatment failure was significantly higher in the endovascular group (32.2%, 329/1023) compared with the surgical group (2.3%, 19/804) (OR: 8.97; CI: 5.56-14.45, P < 0.01).</p><p><strong>Conclusions: </strong>Surgical treatment for SDAVFs achieves higher rates of complete occlusion and successful treatment compared with endovascular treatment, with lower rates of recurrence, retreatment, and initial treatment failure. Although both treatments show similar improvements in neurological status and periprocedural complications, surgery remains the preferred approach for definitive results. Treatment decisions should be individualized based on patient-specific factors and anatomical characteristics. Further research is needed to confirm these results.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"562-574"},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012095","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":"Accuracy of Phantomless Calibration of Routine Computed Tomography Scans for Opportunistic Osteoporosis Screening in the Spine Clinic.","authors":"Riza M Cetik, Charles H Crawford, Steven D Glassman, John R Dimar, Jeffrey L Gum, Mladen Djurasovic, Leah Y Carreon","doi":"10.1097/BRS.0000000000005080","DOIUrl":"10.1097/BRS.0000000000005080","url":null,"abstract":"<p><strong>Study design: </strong>Diagnostic accuracy study.</p><p><strong>Objective: </strong>To establish a simple method of phantomless bone mineral density (BMD) measurement by using preoperative lumbar computed tomography (CT) scans, and compare the accuracy of reference tissue combinations to diagnose low BMD against uncalibrated Hounsfield units (HUs).</p><p><strong>Summary of background data: </strong>HUs are used as a measure of BMD; however, associations between HU and T-scores vary widely. Quantitative CT (qCT) scans are more accurate, but they require density calibration with an object of known density (phantom), which limits feasibility. As an emerging technique, phantomless (internal) calibration of routine CT scans may provide a good opportunity for screening.</p><p><strong>Materials and methods: </strong>Patients who were scheduled to undergo lumbar surgery, with a preoperative CT scan, and a dual-energy x-ray absorptiometry (DXA) scan within six months were included. Four tissues were selected for calibration: subcutaneous adipose (A), erector spinae (ES), psoas (P), and aortic blood (AB). The HUs of these tissues were used in linear regression against ground-truth values. Calibrations were performed by using two different internal tissues at a time to maintain simplicity and in-office applicability.Volumetric bone mineral densities (vBMD) derived from internally calibrated CT scans were analyzed for new threshold values for low bone density. Areas under the curve (AUC) were calculated with 95% CI.</p><p><strong>Results: </strong>Forty-five patients were included (M/F=10/35, mean age: 63.3). Calibrated vBMDs had stronger correlations with DXA T -scores when compared with HUs, with L2 exhibiting the highest coefficients. Calibration by using A and ES with the threshold of 162 mg/cm 3 had a sensitivity of 90% in detecting low BMD (AUC=0.671).</p><p><strong>Conclusions: </strong>This novel method allows simple, in-office calibration of routine preoperative CT scans without the use of a phantom. Calibration using adipose and erector spinae with a threshold of 162 mg/cm 3 is proposed for low bone density screening with high sensitivity (90%).</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E142-E150"},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451583","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":"Course and Predictors of Adult Spinal Sagittal Disorders: A 10-Year Prospective Case Series.","authors":"Heidi Mannström, Juhani Multanen, Jari Ylinen, Arto Hautala, Arttu Peuna, Lauri Karttunen, Liisa Pekkanen, Kati Kyrölä","doi":"10.1097/BRS.0000000000005177","DOIUrl":"10.1097/BRS.0000000000005177","url":null,"abstract":"<p><strong>Study design: </strong>Prospective case series.</p><p><strong>Objective: </strong>To study the natural course of adult spinal deformity (ASD) over a 10-year period and the determinants associated with postural malalignments.</p><p><strong>Summary of background data: </strong>ASD comprises a heterogeneous spectrum of abnormalities of the thoracolumbar spine throughout adulthood. Radiographic deterioration of sagittal alignment is a combination of decreased lumbar lordosis (LL), PI-related retroversion of the pelvic tilt (PT), anteriorizing sagittal vertical axis (SVA), and increased T1 pelvic angle (TPA).</p><p><strong>Materials and methods: </strong>The full spine radiographs were taken to measure the SRS-Schwab sagittal modifiers PI-LL, PT, and SVA to measure the possible change in severity of deformity from the 204 volunteer participants (mean age 62.7 yr, 61% female), which were 32% of the 637 consecutive patients with prolonged back pain who originally joined the study in 2012-2013. Each participant completed the Scoliosis Research Society 22r (SRS-22r) questionnaire.</p><p><strong>Results: </strong>The mean change in the SRS-Schwab score was 0.4 units (baseline 1.1 vs . follow-up 1.5, P <0.001) implying deterioration of the spinal deformity. The SRS-Schwab score decreased (n=76, 37%), remained the same (n=102, 50%), or improved (n=26, 13%). Four predictive factors for a change of sagittal alignment were found, of which the poor score in the SRS-22r function domain ( P =0.049) and severe pelvic tilt (PT greater than 30°, P =0.006) predicted the change.</p><p><strong>Conclusion: </strong>This study showed the variability in how sagittal alignment of the spine changes during the 10-year follow-up period. The ASD patients with poor self-assessed functional ability and disturbed pelvic position were associated with the risk of deterioration in spinopelvic alignment. The diversity in the natural course of ASD and the known risk factors highlight the need for tailored advice when planning preventive treatment procedures for ASD patients.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"522-527"},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508376","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":"Response to Letter to the Editor Regarding: Multimodal Deep Learning-Based Radiomics Approach for Predicting Surgical Outcomes in Patients With Cervical Ossification of the Posterior Longitudinal Ligament.","authors":"Satoshi Maki, Takeo Furuya, Keiichi Katsumi, Hideaki Nakajima, Kazuya Honjoh, Shuji Watanabe, Takashi Kaito, Shota Takenaka, Yuya Kanie, Motoki Iwasaki, Masayuki Furuya, Gen Inoue, Masayuki Miyagi, Shinsuke Ikeda, Shiro Imagama, Hiroaki Nakashima, Sadayuki Ito, Hiroshi Takahashi, Yoshiharu Kawaguchi, Hayato Futakawa, Kazuma Murata, Toshitaka Yoshii, Takashi Hirai, Masao Koda, Seiji Ohtori, Masashi Yamazaki","doi":"10.1097/BRS.0000000000005296","DOIUrl":"10.1097/BRS.0000000000005296","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E159-E160"},"PeriodicalIF":2.6,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391770","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}