Spine最新文献

{"title":"Letter to the Editor Regarding the Article \"Multimodal Deep Learning-based Radiomics Approach for Predicting Surgical Outcomes in Patients with Cervical Ossification of the Posterior Longitudinal Ligament\".","authors":"Shangxian Pan, Kuangyang Yang, Kexin Wang","doi":"10.1097/BRS.0000000000005227","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005227","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772465","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 SPINE Letter-to-the-Editor Re: Enhancing the Clinical Applicability of the Novel Classification System for Proximal Junctional Degeneration.","authors":"Riza Mert Cetik, Steven D Glassman, John R Dimar, Mitchell J Campbell, Mladen Djurasovic, Charles H Crawford, Jeffrey L Gum, R Kirk Owens, Kathryn J McCarthy, Leah Y Carreon","doi":"10.1097/BRS.0000000000005234","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005234","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772483","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":"Predictors for Failure to Respond to Erector Spinae Plane Block Following Minimally Invasive Transforaminal Lumbar Interbody Fusion.","authors":"Eric Mai, Joshua Zhang, Amy Z Lu, Patawut Bovonratwet, Eric Kim, Chad Z Simon, Cole Kwas, Myles Allen, Tomoyuki Asada, Nishtha Singh, Olivia Tuma, Kasra Araghi, Maximilian Korsun, Yeo Eun Kim, Annika Heuer, Avani Vaishnav, James Dowdell, Douglas S Wetmore, Sheeraz A Qureshi, Sravisht Iyer","doi":"10.1097/BRS.0000000000004978","DOIUrl":"10.1097/BRS.0000000000004978","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective review of prospectively collected data.</p><p><strong>Objective: </strong>To identify the risk factors associated with failure to respond to erector spinae plane (ESP) block following minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).</p><p><strong>Summary of background data: </strong>ESP block is an emerging opioid-sparing regional anesthetic that has been shown to reduce immediate postoperative pain and opioid demand following MI-TLIF-however, not all patients who receive ESP blocks perioperatively experience a reduction in immediate postoperative pain.</p><p><strong>Methods: </strong>This was a retrospective review of consecutive patients undergoing one-level MI-TLIF who received ESP blocks by a single anesthesiologist perioperatively at a single institution. ESP blocks were administered in the OR following induction. Failure to respond to ESP block was defined as patients with a first numerical rating scale (NRS) score postsurgery of >5.7 (mean immediate postoperative NRS score of control cohort undergoing MI TLIF without ESP block). Multivariable logistic regressions were performed to identify predictors for failure to respond to ESP block.</p><p><strong>Results: </strong>A total of 134 patients were included (mean age 60.6 yr, 43.3% females). The median and interquartile range (IQR) first pain score postsurgery was 2.5 (0.0-7.5). Forty-nine (36.6%) patients failed to respond to ESP block. In the multivariable regression analysis, several independent predictors for failure to respond to ESP block following MI TLIF were identified: female sex (OR 2.33, 95% CI 1.04-5.98, P =0.040), preoperative opioid use (OR 2.75, 95% CI 1.03-7.30, P =0.043), anxiety requiring medication (OR 3.83, 95% CI 1.27-11.49, P =0.017), and hyperlipidemia (OR 3.15, 95% CI 1.31-7.55, P =0.010).</p><p><strong>Conclusions: </strong>Our study identified several predictors for failure to respond to ESP block following MI TLIF, including female gender, preoperative opioid pain medication use, anxiety, and hyperlipidemia. These findings may help inform the approach to counseling patients on perioperative outcomes and pain expectations following MI-TLIF with ESP block.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1669-1675"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029108","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":"Immediate Correction of Idiopathic Scoliosis With Nighttime Braces Created by a Fully Automated Generative Design Algorithm: A Randomized Controlled Crossover Trial.","authors":"Maxence Coulombe, Aymeric Guy, Julie Joncas, Anton Manitiu, Philippe Poirier, Soraya Barchi, Olivier Chémaly, Félix Brassard, Stefan Parent, Hubert Labelle, Carl-Éric Aubin","doi":"10.1097/BRS.0000000000005138","DOIUrl":"10.1097/BRS.0000000000005138","url":null,"abstract":"<p><strong>Study design: </strong>Single-center, double-blinded, prospective crossover randomized controlled trial.</p><p><strong>Objective: </strong>To clinically validate the efficacy of nighttime braces designed automatically by a generative design algorithm to treat idiopathic scoliosis (IS). The tested hypothesis was the clinical equivalence of immediate in-brace correction for the new automatically generated brace design versus a standard Providence-type brace.</p><p><strong>Summary of background data: </strong>Documented efficacy of brace treatment varies between centers, and depends on the empirical expertise of the treating orthotist. Our group previously developed a fully automated generative brace design algorithm that leverages a patient-specific finite-element model (FEM) to optimize brace geometry and correction before its fabrication.</p><p><strong>Methods: </strong>Fifty-eight skeletally immature patients diagnosed with IS, aged between 10 and 16 years were recruited. All patients received both a nighttime brace automatically generated by the algorithm (test) and a Providence-type brace designed by an expert orthotist (control). Radiographs were taken for each patient with both braces in a randomized crossover approach to evaluate immediate in-brace correction.</p><p><strong>Results: </strong>The targeted 55 patients (48 females, 7 males) completed the study. The immediate Cobb angle correction was 57% 19 (test) versus 58% 21 (control) for the main thoracic (MT) curve, whereas it was 89% 25 (test) versus 87% 28 (control) for the thoracolumbar/lumbar (TLL) spine. The immediate correction with the test brace was noninferior to that of the Control brace ( P 0.001). The order in which the braces were tested did not have a residual effect on the immediate correction.</p><p><strong>Conclusion: </strong>The fully automated generative brace design algorithm proves to be clinically relevant, allowing for immediate in-brace correction equivalent to that of braces designed by expert orthotists. Patient 2 years follow-up will continue. This method's integration could help design and rationalize the design of braces for the treatment of IS.</p><p><strong>Level of evidence: </strong>Level 2.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1615-1620"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475315","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":"Does Spinal Cord-Canal Mismatch Adversely Affect the Clinical Outcomes of Anterior Cervical Discectomy and Fusion for the Treatment of Cervical Myelopathy?","authors":"Sehan Park, Ji Uk Choi, San Kim, Chang Ju Hwang, Jae Hwan Cho, Dong-Ho Lee","doi":"10.1097/BRS.0000000000005111","DOIUrl":"10.1097/BRS.0000000000005111","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To clarify whether clinical outcomes of anterior cervical discectomy and fusion (ACDF), is affected by presence of spinal canal-cord mismatch (SCCM).</p><p><strong>Summary of background data: </strong>SCCM is considered a factor that would moderately influence surgeons to perform posterior surgery since it could widen the spinal canal, while an anterior approach could only remove degenerative pathologies grown into the spinal canal.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed 186 patients who underwent ACDF and had been followed-up for more than two years. Patients with spinal cord occupation ratio (SCOR) of ≥0.7 were classified into the SCCM group, while those with a SCOR of <0.7 were included in the no-SCCM group. Patient demographics, cervical sagittal parameters, neck pain visual analog scale (VAS), arm pain VAS, and Japanese Orthopedic Association (JOA) score were assessed. JOA score was the primary outcome of the study.</p><p><strong>Results: </strong>One hundred and forty-seven patients (79.0%) were included into the no-SCCM group, while 39 patients (21.0%) were classified into the SCCM group. Postoperative radiographic parameters including C2-C7 lordosis, C2-C7 sagittal vertical axis, and range of motion did not significantly differ between the two groups. Neck pain VAS, arm pain VAS, and JOA score (no-SCCM group, from 13.7±2.5 to 14.6±2.3, P <0.001; SCCM group, from 13.8±1.6 to 15.0±2.0, P <0.001) significantly improved after the operation in both groups, and results were not significantly different between the two groups. Furthermore, SCOR was not significantly associated with JOA recovery rate at two years postoperatively in linear regression analysis.</p><p><strong>Conclusion: </strong>Clinical and radiographic outcomes of ACDF were not affected by the presence of SCCM. Furthermore, SCOR was not significantly associated with neurological recovery at two years of follow-up. Therefore, ACDF can be safely and effectively applied for treating cervical myelopathy, regardless of the presence of SCCM, when other factors favor the anterior approach.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1621-1628"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856622","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 Consensus-Based Best Practice Guidelines for the Perioperative and Postoperative Care of Pediatric Patients With Spinal Deformity and Programmable Implanted Devices.","authors":"Walter H Truong, Hiroko Matsumoto, Jaysson T Brooks, Tenner J Guillaume, Lindsay M Andras, Patrick J Cahill, Ryan E Fitzgerald, Ying Li, Brandon A Ramo, Benhoor Soumekh, Laurel C Blakemore, Christopher Carter, Michelle R Christie, Daniel Cortez, V Vivian Dimas, Christina K Hardesty, Luv R Javia, Benjamin C Kennedy, Peter D Kim, Robert F Murphy, Joseph H Perra, David W Polly, Jeffrey R Sawyer, Brian Snyder, Paul D Sponseller, Peter F Sturm, Burt Yaszay, Tim Feyma, Sara J Morgan","doi":"10.1097/BRS.0000000000005061","DOIUrl":"10.1097/BRS.0000000000005061","url":null,"abstract":"<p><strong>Study design: </strong>Modified Delphi consensus study.</p><p><strong>Objective: </strong>To develop consensus-based best practices for the care of pediatric patients who have implanted programmable devices (IPDs) and require spinal deformity surgery.</p><p><strong>Summary of background data: </strong>Implanted programmable devices (IPDs) are often present in patients with neuromuscular or syndromic scoliosis who require spine surgery. Guidelines for monitoring and interrogating these devices during the perioperative period are not available.</p><p><strong>Methods: </strong>A panel was assembled consisting of 25 experts (i.e., spinal deformity surgeons, neurosurgeons, neuroelectrophysiologists, cardiologists, and otolaryngologists). Initial postulates were based on a literature review and results from a prior survey. Postulates addressed the following IPDs: vagal nerve stimulators (VNS), programmable ventriculoperitoneal shunts (VPS), intrathecal baclofen pumps (ITBP), cardiac pacemakers and implantable cardioverter-defibrillators (ICD), deep brain stimulators (DBS), and cochlear implants. Cardiologist and otolaryngologist participants responded only to postulates on cardiac pacemakers or cochlear implants, respectively. Consensus was defined as ≥80% agreement, items that did not reach consensus were revised and included in subsequent rounds. A total of 3 survey rounds and 1 virtual meeting were conducted.</p><p><strong>Results: </strong>Consensus was reached on 39 total postulates across 6 IPD types. Postulates addressed general spine surgery considerations, the use of intraoperative monitoring and cautery, the use of magnetically controlled growing rods (MCGRs), and the use of an external remote controller to lengthen MCGRs. Across IPD types, consensus for the final postulates ranged from 94.4% to 100%. Overall, experts agreed that MCGRs can be surgically inserted and lengthened in patients with a variety of IPDs and provided guidance for the use of intraoperative monitoring and cautery, which varied between IPD types.</p><p><strong>Conclusion: </strong>Spinal deformity correction surgery often benefits from the use of intraoperative monitoring, monopolar and bipolar cautery, and MCGRs. The final postulates from this study can inform the perioperative and postoperative practices of spinal deformity surgeons who treat patients with both scoliosis and IPDs.</p><p><strong>Level of evidence: </strong>V-Expert opinion.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1636-1644"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301650","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":"Social Vulnerability Index Provides Greater Granularity Compared With the Area Deprivation Index When Assessing Outcomes Following Elective Lumbar Fusion.","authors":"Phillip T Yang, Hashim Shaikh, Alexander Akoto, Emmanuel N Menga, Robert W Molinari, Paul T Rubery, Varun Puvanesarajah","doi":"10.1097/BRS.0000000000005089","DOIUrl":"10.1097/BRS.0000000000005089","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective review of a single institution cohort.</p><p><strong>Objective: </strong>To determine whether area deprivation index (ADI) or social vulnerability index (SVI) is more suitable for evaluating minimum clinically important difference (MCID) achievement following elective lumbar fusion as captured by the Patient-Reported Outcomes Measurement Information System (PROMIS).</p><p><strong>Summary of background data: </strong>A total of 182 patients who underwent elective one-level to two-level posterior lumbar fusion between January 2015 and September 2021.</p><p><strong>Materials and methods: </strong>ADI and SVI values were calculated from patient-supplied addresses. Patients were grouped into quartiles based on values; higher quartiles represented greater disadvantage. MCID thresholds for Pain Interference (PI) and Physical Function (PF) were determined through a distribution-based method. Multivariable logistic regression was performed to identify factors impacting MCID attainment. Univariate logistic regression was performed to determine which themes comprising SVI values affected MCID achievement. Statistical significance was set at P <0.05.</p><p><strong>Results: </strong>Multivariable logistic regression demonstrated that ADI and SVI quartile assignment significantly impacted achievement of MCID for PI ( P =0.04 and 0.01, respectively) and PF ( P =0.03 and 0.02, respectively). Specifically, assignment to the third ADI and SVI quartiles were significant for PI (OR: 0.39 and 0.23, respectively), and PF (OR: 0.24 and 0.22, respectively). Race was not a significant predictor of MCID for either PI or PF. Univariate logistic regression demonstrated that among SVI themes, the socioeconomic status theme significantly affected achievement of MCID for PI ( P =0.01), while the housing type and transportation theme significantly affected achievement of MCID for PF ( P =0.01).</p><p><strong>Conclusion: </strong>ADI and SVI quartile assignment were predictors of MCID achievement. While ADI and SVI may both identify patients at risk for adverse outcomes following lumbar fusion, SVI offers greater granularity in terms of isolating themes of disadvantage impacting MCID achievement.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1676-1684"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617159","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 \"Postoperative Sclerotic Modic Changes After Transforaminal Lumbar Interbody Fusion\": The Prevalence, Risk Factors, and Impact on Fusion.","authors":"Yang Xiao, Ce Zhu, Peng Xiu, Liang Wang, Zhuang Zhang, Zhipeng Deng, Yueming Song, Xi Yang","doi":"10.1097/BRS.0000000000005067","DOIUrl":"10.1097/BRS.0000000000005067","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E405-E406"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331735","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":"How Accurate Are Anatomical Surface Topography Parameters in Indicating the Presence of a Scoliosis?","authors":"Adrian Gardner, Fiona Berryman, Paul Pynsent","doi":"10.1097/BRS.0000000000004990","DOIUrl":"10.1097/BRS.0000000000004990","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective analysis of a longitudinal cohort.</p><p><strong>Objective: </strong>To identify the presence of scoliosis from surface data.</p><p><strong>Summary of background data: </strong>Identifying AIS can be difficult. Screening is not universal for reasons including high false positive and negative rates. These difficulties can lead to some adolescents missing out on bracing.</p><p><strong>Methods: </strong>Logistic regression analysis of ISIS2 surface topography images only was performed. The x,y positions of the shoulders (Sh), axillae (Ax), waist (waist) and the x,y,z positions of the most prominent points over the posterior torso (scap) were used for the thoracic, thoracolumbar/lumbar and whole spine. The models were used to identify the presence of a 20-degree or larger scoliosis. Differences in the position of the landmarks were analyzed comparing left and right, with the suffix \"Ht\" representing a difference in the y coordinate, \"Off\" the x coordinate, and \"Depth,\" the z coordinate. Model accuracy was assessed as both percentages and ROC curves with the coefficients as odds ratios.</p><p><strong>Results: </strong>There were 1283 images (1015 females and 268 males) all with a diagnosis of AIS. The models identified scoliosis in the thoracic spine with an 83% accuracy (AUC 0.91), thoracolumbar/lumbar spine with 74% accuracy (AUC 0.76), and whole spine with 80% accuracy (AUC 0.88). Significant parameters were AxDiffHt, AxDiffOff, WaistDiffHt, ScapDiffOff, and ScapDiffHt for the thoracic curves, AxDiffHt, AxDiffOff, WaistDiffHt for the thoracolumbar/lumbar curves, and AxDiffHt, AxDiffOff, WaistDiffHt and ScapDiffHt for the whole spine.</p><p><strong>Conclusions: </strong>The use of fixed anatomical points around the torso, analyzed using logistic regression, has a high accuracy for identifying curves in the thoracic, thoracolumbar/lumbar, and whole spines. While coming from surface topography images, the results raise the future use of digital photography as a tool for the identification of small scoliosis without using other imaging techniques.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1645-1651"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176542","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":"Experimentally Dissociating the Acute Mechanisms of Endplate Fracture Lesions and Schmorl's Node Injuries Using a Porcine Cervical Spine Model.","authors":"Michael I Watson, Jackie D Zehr, Jack P Callaghan","doi":"10.1097/BRS.0000000000005026","DOIUrl":"10.1097/BRS.0000000000005026","url":null,"abstract":"<p><strong>Study design: </strong>This is an in vitro biomechanical study.</p><p><strong>Objective: </strong>This study evaluated the influence of localized trabecular bone strength deficits and loading rate as determinants of Schmorl's node and fracture lesion incidence. The failure load (ultimate compression tolerance [UCT]), loading stiffness, and failure morphology were assessed after acute compression loading and failure.</p><p><strong>Summary of background data: </strong>The cartilaginous endplate is vulnerable to injuries such as Schmorl's nodes and fracture lesions. While both injuries are associated with acute compression traumas, the factors that distinguish their incidence are poorly understood.</p><p><strong>Methods: </strong>Forty-eight porcine spinal units (domestic hog, 5-10 mo, ~110 kg) were assigned to one of eight experimental groups that differed by initial condition (control, sham, experimentally produced chemical fragility, and structural void) and loading rate (3 kN/s, 9kN/s). A servo-hydraulic materials testing system was used to perform acute compression testing until observed failure in the specimen. Post-loading dissection was performed to classify injury morphologies. Between group differences in UCT and loading stiffness were evaluated using a general linear model and injury distributions were evaluated using chi-squared statistics.</p><p><strong>Results: </strong>Schmorl's nodes occurred exclusively in chemical fragility (63%) and structural void groups (37%) and were more prevalent with a 9 kN/s (75%) loading rate compared with 3 kN/s (25%). In contrast, fracture lesions occurred in all FSUs assigned to the control groups (100%) and the majority of those assigned to the sham groups (92%). No between-group differences were observed for UCT and loading stiffness.</p><p><strong>Conclusion: </strong>Pre-existing strength deficits of the subchondral trabecular bone can alter endplate injury morphology, particularly when coupled with high loading rates, but the localized strength deficits that were associated with Schmorl's nodes did not appreciably influence measured joint properties.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1629-1635"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868183","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}