Spine最新文献

{"title":"Comparison of Two-Screw Versus Four-Screw Internal Fixation on Fusion Speed in Anterior Cervical Discectomy and Fusion : A Prospective Randomized Controlled Trial.","authors":"Cheng-Yi Huang, Xia-Qing Sheng, Xing-Jin Wang, Zi-Han Peng, Ting-Kui Wu, Kangkang Huang, Yang Meng","doi":"10.1097/BRS.0000000000005334","DOIUrl":"10.1097/BRS.0000000000005334","url":null,"abstract":"<p><strong>Background context: </strong>The insertion process of the new two-screw internal fixation is simpler than that of four-screw internal fixation for anterior cervical discectomy and fusion (ACDF). However, it is unclear whether there is a difference in fusion rate.</p><p><strong>Purpose: </strong>This study aimed to compare the time required to achieve osseous fusion and the clinical efficacy of four-screw versus two-screw internal fixation.</p><p><strong>Study design: </strong>A prospective randomized controlled trial.</p><p><strong>Patient sample: </strong>From October 2021 to April 2023, 80 patients diagnosed with single-level cervical spondylosis were recruited and randomly allocated into a four-screw or two-screw group.</p><p><strong>Outcome measures: </strong>The primary end point was the fusion rate six months postoperatively. Secondary outcomes included the prevalence of complications and patient-reported outcome measures (PROMs), including the Japanese Orthopaedic Association score, Neck Disability Index, and visual analog scale scores for arm and neck pain.</p><p><strong>Methods: </strong>Patients were randomized to receive four-screw internal fixation (n=40) or two-screw internal fixation (n=40).</p><p><strong>Results: </strong>A total of 77 patients completed the trial and were included in the analysis. No significant differences were observed between groups at baseline. The fusion rate in the two-screw group was significantly higher than that in the four-screw group (69.2% vs . 42.1%, P =0.022) at six months postoperatively. No significant difference was found in the fusion rates at 3 and 12 months postoperatively between groups. Overall, PROMs significantly improved after surgery in both groups and did not differ significantly between groups at any follow-up time point. The prevalence of complications was not significantly different between groups.</p><p><strong>Conclusions: </strong>Two-screw internal fixation can achieve osseous fusion faster than four-screw internal fixation in ACDF. Two-screw internal fixation seems to achieve the same PROMs and safety as four-screw internal fixation.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1427-1434"},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693296","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":"Prevalence of Depression in Metastatic Spine Disease Patients Undergoing Surgical Intervention.","authors":"Ellen O'Callaghan, Adedotun Bello, Dana Rowe, Seeley Yoo, Tara Dalton, Michael Goodin, Kerri-Anne Crowell, Margaret O Johnson, Melissa M Erickson, C Rory Goodwin","doi":"10.1097/BRS.0000000000005547","DOIUrl":"10.1097/BRS.0000000000005547","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To evaluate rates of self-reported depression in MSD patients undergoing surgery overall and at each timepoint in the perioperative period, and also to explore associations with sociodemographic factors.</p><p><strong>Summary of background data: </strong>Depression is a common comorbidity in patients with metastatic spine disease (MSD) undergoing surgery. Understanding its prevalence is vital, as it impacts clinical outcomes, recovery, and overall well-being.</p><p><strong>Materials and methods: </strong>Electronic medical records were retrospectively analyzed for MSD patients undergoing surgery at a large academic center between 2015 and 2023. Patients under 18 years old and those without National Comprehensive Cancer Network (NCCN) Distress Thermometer Problem List data were excluded. The overall prevalence of depression was identified as the proportion of patients who reported depression at any timepoint in their perioperative period. Prevalence was also evaluated at baseline (defined as the closest recorded timepoint before surgery within 30 d preoperative), 30 days postoperative, and at 90 days postoperative. The rate of depression was compared across sociodemographic subgroups of race, sex, age, marital status, and insurance type.</p><p><strong>Results: </strong>Of 342 patients, 33.3% reported depression at least once during their perioperative period. At baseline, 17.3% reported depression, at 30 days, 17.3%, and at 90 days, 14.1%. There was no significant difference in depression rates across timepoints or across sociodemographic subgroups.</p><p><strong>Conclusion: </strong>Depression affects a substantial portion of MSD patients and remains consistent across the perioperative course. Its prevalence appears independent of sociodemographic factors, highlighting the importance of routine, universal psychological assessment and support for this vulnerable population.</p><p><strong>Oxford centre levels of evidence: </strong>Level IV-retrospective cohort study.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1495-1500"},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402068","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":"Should We Re-Instrument the Originally Fused Level in ACDF Revision for Adjacent Segment Disease?: A Quality Outcomes Database Study.","authors":"James F Bathon, Omar Zakieh, Claudia Davidson, Alicia M Hymel, Jacquelyn S Pennings, Mason W Young, Mitchell F Bowers, Amir M Abtahi, Raymond J Gardocki, Julian G Lugo-Pico, Scott L Zuckerman, Byron F Stephens","doi":"10.1097/BRS.0000000000005584","DOIUrl":"10.1097/BRS.0000000000005584","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>To investigate differences in perioperative variables, patient-reported outcomes measures (PROMs), and reoperation rates between revision involving reinstrumentation of the originally fused level versus fusion of the adjacent segment alone in revision ACDF patients.</p><p><strong>Summary of background data: </strong>Adjacent segment disease (ASD) continues to be a significant issue for patients undergoing anterior cervical discectomy and fusion (ACDF) surgery. Reinstrumenting the originally fused segment provides greater biomechanical stability. However, there remains a paucity of research investigating the differences in outcomes between patients undergoing reinstrumentation of the originally fused level versus only the adjacent segment level.</p><p><strong>Methods: </strong>Patients who underwent single-level, adjacent segment revision ACDF were identified from the Quality Outcome Database. The primary exposure was reinstrumentation of the original segment. Patient characteristics were compared. Outcomes were perioperative variables, 3-month and 12-month reoperation, and 3-month, 12-month, and 24-month PROMs, including numeric rating scale for neck and arm pain, neck disability index, EuroQol 5 Dimensions, and modified Japanese Orthopaedic Association scores. Multivariable regression models were fitted for each outcome.</p><p><strong>Results: </strong>Of the 767 patients undergoing revision ACDF, 25.0% had reinstrumentation. On analysis, patients with reinstrumentation had greater blood loss (60.7±11.6 vs. 40.9±10.8 mL, P  < 0.001), operative time (123.8±8.0 vs. 93.8±7.4 mins, P  < 0.001), and hospital length of stay (1.63±0.35 vs. 1.30±0.26 d, P  = 0.004) than patients with single-level fusion alone. There was no difference in neck and arm pain, NDI, and mJOA PROMs at 3-months, 12-months, and 24-months between groups ( P  > 0.05). Further, there was no difference in reoperation rates at 3-months (4.3% vs. 3.2%, P  = 0.154) and 12-months (5.7% vs. 4.5%, P  = 0.194).</p><p><strong>Conclusions: </strong>Given comparable PROMs and reoperation rates, when clinically feasible, surgeons may consider avoiding reinstrumentation of the original ACDF fusion, opting for a more conservative single-level revision to minimize the negative risks/complications associated with increased perioperative blood loss, operative time, and length of stay.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1448-1455"},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757188","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":"Intracranial, Intra-, and Epidural Pressure Changes During Endoscopic Lumbar Discectomy: A Comparison Between Transforaminal and Interlaminar Approach.","authors":"Alexandra Stauffer, Jana F Schader, Carl M Zipser, Najmeh Kheram, Marie-Rosa Fasser, José M Spirig, Jonas Widmer, Vincent Hagel, Mazda Farshad","doi":"10.1097/BRS.0000000000005758","DOIUrl":"10.1097/BRS.0000000000005758","url":null,"abstract":"<p><strong>Study design: </strong>Cadaveric laboratory study.</p><p><strong>Objectives: </strong>To characterize and compare intracranial, intradural (cervical, thoracic, lumbar), and lumbar epidural pressure changes during transforaminal and interlaminar endoscopic lumbar procedures under gravity and pump irrigation, with and without simulated outflow occlusion.</p><p><strong>Summary of background data: </strong>High-pressure irrigation improves visualization and hemostasis during endoscopic lumbar discectomy but may increase spinal canal and intracranial pressures and contribute to neurological complications if not well controlled.</p><p><strong>Materials and methods: </strong>Three fresh-frozen human cadavers were instrumented with pressure probes in the lumbar epidural space (L3-4), intradural space at C5-6, T8-9, and L3-4, and intracranially. At L3-4, transforaminal and interlaminar uniportal approaches were performed using gravity irrigation (50, 100, 130 cm H2O) and two pump systems (30-120 mm Hg; arthroscopy pump and spine-certified pump). Each setting was tested with open outflow and with temporary outflow occlusion by blocking the working channel. Pressure readings were recorded as relative increases (delta mm Hg) from baseline.</p><p><strong>Results: </strong>Without occlusion, the interlaminar approach produced higher lumbar epidural pressure increases than the transforaminal approach across all irrigation modalities (up to 10 mm Hg). Differences at intradural levels and intracranially were small (<5 mm Hg). With outflow occlusion, the pressure differential narrowed or reversed, with transforaminal access producing higher lumbar epidural and intradural pressures at higher pump settings. Intracranial pressure differences remained modest, with only small increases under occlusion at higher pump settings.</p><p><strong>Conclusions: </strong>Irrigation generates compartment- and approach-specific pressure responses. Interlaminar access shows higher baseline lumbar epidural pressure, whereas transforaminal access is more susceptible to pressure surges during occlusion. Even small intracranial pressure increases may be clinically important in susceptible patients; careful irrigation pressure control and avoidance of prolonged outflow occlusion are recommended.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E530-E537"},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043928","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 Longitudinal Effects of Posterior Spinal Fusion With Derotation on Axial Deformity in Adolescent Idiopathic Scoliosis.","authors":"Gabriel S Linden, Akshitha Adhiyaman, Colson P Zucker, Ankush Thakur, Jenna L Wisch, Howard J Hillstrom, Benjamin N Groisser, Douglas N Mintz, Matthew E Cunningham, Ram Haddas, Michael T Hresko, John S Blanco, Roger F Widmann, Jessica H Heyer","doi":"10.1097/BRS.0000000000005021","DOIUrl":"10.1097/BRS.0000000000005021","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Objective: </strong>The aim of this study was to characterize the change in angle of trunk rotation (ATR), axial vertebral rotation (AVR), and body surface rotation (BSR) in patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion (PSF) with en-bloc derotation across multiple postoperative visits.</p><p><strong>Summary of background data: </strong>Previous research has documented ATR, AVR, and BSR correction for AIS patients after surgery. However, there is a lack of evidence on the sustainability of this correction over time.</p><p><strong>Methods: </strong>This was a retrospective study from a single-center prospective surface topographic registry of patients with AIS, age 11 to 20 at time of surgery, who underwent PSF with en-bloc derotation. Patients with previous spine surgery were excluded. ATR was measured with a scoliometer, AVR through EOS radiographic imaging, and BSR via surface topographic scanning, Data collection occurred at: preoperative, 6-week, 3-month, 6-month, 1-year, and 2-year postoperative visits. BSR and AVR were tracked at the preoperative apical vertebral level, and the level with maximum deformity, at each respective time point. Generalized estimating equations models were used for statistical analysis. Covariates included age, sex, and body mass index.</p><p><strong>Results: </strong>A total of 49 patients (73.4% female, mean age: 14.6±2.2 yr, mean preoperative coronal curve angle 57.9±8.5°, and 67% major thoracic) were evaluated. ATR correction was significantly improved at all postoperative time points and there was no significant loss of correction. AVR max and AVR apex were significantly improved at all time points but there was a significant loss of correction for AVR apex between the 6-week and 1-year visit ( P =0.032). BSR max achieved significant improvement at the 3-month visit. BSR apex was significantly improved at the 3-month and 1-year visit.</p><p><strong>Conclusions: </strong>ATR and AVR demonstrated significant axial plane correction at 2 years postoperatively in patients undergoing PSF for AIS. BSR did not maintain significant improvement by the 2-year visit.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1472-1477"},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851440","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":"Development of the Forgotten Spine Surgery Score for Cervical Spine Surgery (FS3-C): An Adapted Method to Assess Surgical Success After Cervical Disc Replacement.","authors":"Chad Z Simon, Cole T Kwas, Arsen M Omurzakov, Gregory S Kazarian, Joshua Zhang, Tomoyuki Asada, Sheeraz A Qureshi, Sravisht Iyer","doi":"10.1097/BRS.0000000000005612","DOIUrl":"10.1097/BRS.0000000000005612","url":null,"abstract":"<p><strong>Study design: </strong>Prospective questionnaire development and validation study.</p><p><strong>Objective: </strong>To develop and validate a new \"Forgotten Spine Surgery Score for Cervical Spine Surgery\" (FS3-C) to assess patient outcomes after CDR beyond the traditional measures: the ability to forget the presence of the implanted disc in daily life.</p><p><strong>Summary of background data: </strong>The Forgotten Joint Score (FJS) has demonstrated superior discrimination in high-functioning total joint arthroplasty patients due to low ceiling and floor effects compared with legacy patient-reported outcome measures (PROMs). To date, there is no similar outcome measure to assess \"forgottenness\" following spine surgery. Such measures may be critical for evaluating subtle differences in high-performance surgeries like cervical disc replacement (CDR).</p><p><strong>Materials and methods: </strong>A 20-item pilot questionnaire was developed based on published patient expectations and expert opinion, utilizing a five-point Likert scale. This was administered to 41 patients who underwent primary one-level or two-level CDR (minimum three-month follow-up, 2016-2023) for item selection and internal validity assessment. The final 12-item FS3-C was validated in 97 patients and correlated with the Neck Disability Index (NDI) to determine convergent validity.</p><p><strong>Results: </strong>In the pilot cohort (mean age 44.7±7.9 yr), four items were excluded due to high missing responses or ceiling effects. The remaining 16 items demonstrated high internal consistency (Cronbach alpha 0.95-0.96). Pairwise correlation analysis reduced the questionnaire to 12 items. In the validation cohort (mean age 44.3±9.0 yr, 56.7±24.2 mo postsurgery), FS3-C demonstrated high internal consistency with minimal ceiling effects. Mean FS3-C and NDI scores were 86.4±18.9 and 9.8±12.6, respectively, with a strong correlation ( r =-0.606, P  < 0.001).</p><p><strong>Conclusion: </strong>The FS3-C demonstrates high internal consistency, low ceiling effects, and strong convergent validity with NDI, enabling spine surgeons to evaluate CDR success beyond traditional symptom improvement measures.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1441-1447"},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967084","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":"Three-Level Anterior Cervical Discectomy and Fusion (ACDF) is Associated With Higher Rates of Instrumentation Failure and Shorter Time to Reoperation Than One-Level or Two-Level ACDF.","authors":"Manjot Singh, Alejandro Perez-Albea, Ishan Shah, Maria Jensen, Alan H Daniels, Bryce A Basques","doi":"10.1097/BRS.0000000000005543","DOIUrl":"10.1097/BRS.0000000000005543","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>Evaluate the impact of increasing levels of cervical fusion on alignment and outcomes.</p><p><strong>Background: </strong>One-level anterior cervical discectomy and fusion (ACDF) adequately restores cervical alignment and offers favorable postoperative outcomes. However, comparative studies following increasing levels of fusion are lacking.</p><p><strong>Materials and methods: </strong>Patients who underwent one-level to three-level ACDFs were identified. Demographics, spinopelvic alignment, and clinical outcomes were compared up to one-year postoperatively. Multivariate regressions, accounting for age, gender, Charlson comorbidity index (CCI), osteoporosis, and baseline cervical deformity were performed to examine the association between levels of ACDF and postoperative outcomes. Cox regression analysis was also performed to evaluate the association between levels of ACDF and time to reoperation.</p><p><strong>Results: </strong>Among 279 patients (mean age: 54.1 yr, 49% female, mean CCI: 0.6), 110 had one-level, 137 had two-level, and 32 had three-level ACDFs. Perioperatively, estimated blood loss (19.1 vs. 25.3 vs. 33.8 mL) was comparable and procedure time (131.2 vs. 167.9 vs. 225.9 mL) increased with increasing levels of ACDF, with regression analysis revealing higher odds of both in three-level ACDFs ( P <0.05). Postoperatively, instrument failure (1% vs. 4% vs. 13%, P =0.008) and cage subsidence (15% vs. 28% vs. 44%, P =0.001) rates increased with increasing levels of ACDF, with regression analysis showing higher odds of both in three-level ACDFs ( P <0.05). Cox regression revealed a hazards ratio of 1.2 (95% CI=0.5-3.3) for two-level ACDF and 25.9 (95% CI=2.8-239.8) for three-level ACDF in predicting time to reoperation relative to one-level ACDF. Lordotic correction and improvement in PROMs were comparable across cohorts ( P >0.05).</p><p><strong>Conclusion: </strong>Multilevel ACDF yielded comparable improvements in sagittal cervical alignment and PROMs, but was associated with worse in-hospital and out-of-hospital outcomes than single-level ACDF. In addition, it lowered the time to reoperation following the initial procedure. Surgeons should, thus, carefully select operative levels based on clinical and radiographic factors.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1478-1485"},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303487","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":"Estimated Three-Dimensional Thoracic Kyphosis Supplements Radiographic Bone Age in Predicting Adolescent Idiopathic Scoliosis Curve Progression.","authors":"Lane McCoy, Neset Tang, Brian A Kelly, Kirsten Brouillet, Scott J Luhmann","doi":"10.1097/BRS.0000000000005780","DOIUrl":"10.1097/BRS.0000000000005780","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To evaluate whether estimated three-dimensional thoracic kyphosis (e3DTK) adds predictive value to radiographic bone age in identifying patients with adolescent idiopathic scoliosis (AIS) at risk for curve progression.</p><p><strong>Summary of background data: </strong>Accurate prediction of curve progression in AIS remains challenging. Radiographic bone age is commonly used for risk stratification; however, three-dimensional spinal morphology may better reflect the biomechanical factors influencing progression.</p><p><strong>Materials and methods: </strong>Patients with AIS were retrospectively identified at a single tertiary pediatric center. Progression was defined as a ≥6° increase in Cobb angle or progression to ≥50°. e3DTK was estimated from standard radiographs using a validated equation. Predictive performance was assessed using ROC analysis, DeLong testing, and likelihood ratio comparisons. In addition, patients were stratified by Sanders score and e3DTK risk category to evaluate subgroup progression rates.</p><p><strong>Results: </strong>A total of 126 patients were included (79.4% female; 109 braced). e3DTK ( r =0.25, P =0.005) and Sanders score ( r =-0.33, P <0.001) were both correlated with curve magnitude change. Sanders score demonstrated strong predictive performance (AUC=0.80). Adding e3DTK to Sanders did not improve model performance (AUC=0.69; P =0.15). e3DTK alone showed good discrimination for progression (AUC=0.89) with an optimal threshold of 22.7°. However, this did not outperform Sanders-based prediction or improve combined models. Stratified analyses showed higher progression rates in high-risk e3DTK groups across Sanders stages ( P =0.022), suggesting within-stratum risk differentiation.</p><p><strong>Conclusion: </strong>e3DTK is associated with AIS curve progression and demonstrates discriminatory ability in univariate analysis; however, it does not improve predictive performance beyond Sanders skeletal maturity staging. While it may help characterize risk heterogeneity within maturity strata, its role appears complementary rather than independently additive in AIS progression prediction.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E514-E518"},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369890","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 \"Risk Factors for Early (Three-Month) Postoperative Mortality in Metastatic Spine Tumor Surgery: A JASA Multicenter Prospective Study By Uto et al.","authors":"Hui Lu, Yan Cui","doi":"10.1097/BRS.0000000000005715","DOIUrl":"10.1097/BRS.0000000000005715","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1501"},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781422","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":"Response to Letter to the Editor Regarding \"Risk Factors for Early 3-Month Postoperative Mortality in Metastatic Spinal Tumor Surgery: A JASA Multicenter Prospective Study\".","authors":"Takaaki Uto, Satoshi Kato, Noriaki Yokogawa, Takaki Shimizu, Satoru Demura, Yuki Shiratani, Akinobu Suzuki, Koji Tamai, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Hideaki Nakajima, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Haruki Funao, Koji Uotani, Shinji Tanishima, Koichi Sairyo, Ko Hashimoto, Chizuo Iwai, Shoji Seki, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Shiro Imagama, Kota Watanabe, Gen Inoue, Takeo Furuya","doi":"10.1097/BRS.0000000000005775","DOIUrl":"10.1097/BRS.0000000000005775","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E538-E539"},"PeriodicalIF":3.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593167","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}