Spine最新文献

{"title":"Nonoperative Management is Associated With Similar Long-Term Patient-Reported Outcomes Compared With Surgery for Cervical Radiculopathy: A Systematic Review and Meta-analysis.","authors":"Kush M Kale, Yi Hein Chai, Shaan Patel, Shiva A Nischal, Jamie R F Wilson","doi":"10.1097/BRS.0000000000005704","DOIUrl":"10.1097/BRS.0000000000005704","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Objective: </strong>To compare long-term patient-reported outcomes between surgical and nonoperative management for cervical radiculopathy.</p><p><strong>Summary of background data: </strong>Cervical radiculopathy is a common condition associated with substantial morbidity. While both surgical and nonoperative approaches are effective, it remains unclear which patients benefit most from each strategy and whether earlier operative intervention confers meaningful long-term advantage.</p><p><strong>Materials and methods: </strong>PubMed, Embase, and the Cochrane Library were searched from inception to January 2026 for randomized and observational studies comparing surgical and nonoperative management for cervical radiculopathy. Primary outcomes included visual analog scale (VAS) scores for neck and arm pain, neck disability index (NDI), and overall clinical success. Secondary outcomes included analgesia use and sick leave. Random-effects meta-analyses were performed using restricted maximum likelihood estimation. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence using GRADE.</p><p><strong>Results: </strong>Eleven studies comprising 1154 patients (surgical: 522; nonoperative: 632) were included. Surgery was not associated with superior outcomes in VAS for arm pain (MD: -0.67, 95% CI: -1.59 to 0.26, P =0.12), VAS for neck pain (MD: -0.50, 95% CI: -1.38 to 0.38; P =0.19), or NDI (MD: -3.69, 95% CI: -9.63 to 2.25, P =0.16) after 12 months of treatment, nor in overall success (RR: 1.11, 95% CI: 0.93-1.34, P =0.21). No significant differences were observed in analgesia use ( P =0.54) or sick leave ( P =0.48) at last follow-up. Most studies were rated serious risk of bias and overall certainty of evidence was moderate.</p><p><strong>Conclusion: </strong>Evidence from this pooled analysis suggests that long-term pain, disability, and functional outcomes are comparable between patients selected for nonoperative management and those selected for surgery. These findings reflect outcomes within selected cohorts and should not be interpreted as evidence of therapeutic equivalence.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E487-E499"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634317","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":"Abdominal Aortic Calcification Is Associated With Degeneration of The Paraspinal Muscles​: A Retrospective Cross-sectional Study.","authors":"Friederike Schömig, Lukas Schönnagel, Jiaqi Zhu, Phillip Suwalski, Paul Köhli, Thomas Caffard, Ali E Guven, Erika Chiapparelli, Artine Arzani, Krizia Amoroso, Jennifer Shue, Andrew A Sama, Frank P Cammisa, Federico P Girardi, Alexander P Hughes","doi":"10.1097/BRS.0000000000005027","DOIUrl":"10.1097/BRS.0000000000005027","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The aim of this study was to analyze the relationship of abdominal aortic calcification (AAC) and a reduction in the cross-sectional area (CSA) and the fatty infiltration (FI) of the paravertebral muscles in patients undergoing lumbar fusion surgery.</p><p><strong>Background: </strong>Both AAC and paraspinal muscle degeneration have been shown to be associated with poorer outcomes after surgical treatment of degenerative diseases of the lumbar spine. However, there is a lack of data on the association between AAC and paraspinal muscle changes in patients undergoing spine surgery.</p><p><strong>Methods: </strong>We retrospectively analyzed patients undergoing lumbar fusion for degenerative spinal pathologies. Muscular and spinal degeneration were measured on magnetic resonance imaging (MRI). AAC was classified on lateral lumbar radiographs. The association of AAC and paraspinal muscle composition was assessed by a multivariate regression analysis adjusted for age, sex, body mass index (BMI), comorbidities, and lumbar degeneration.</p><p><strong>Results: </strong>A total of 301 patients was included. Patients with AAC showed significantly higher degrees of intervertebral disk and facet joint degeneration as well as higher total endplate scores at the L3/L4 level. The univariable regression analysis showed a significant positive correlation between the degree of AAC and the FI of the erector spinae ( b =0.530, P <0.001) and multifidus ( b =0.730, P <0.001). The multivariable regression analysis showed a significant positive correlation between the degree of AAC and the FI of the erector spinae ( b =0.270, P =0.006) and a significant negative correlation between the degree of AAC and the CSA of the psoas muscle ( b =-0.260, P =0.003).</p><p><strong>Conclusions: </strong>This study demonstrates a significant and independent association between AAC and degeneration of the erector spinae and the psoas muscles in patients undergoing lumbar fusion. As both AAC and degeneration of paraspinal muscles impact postoperative outcomes negatively, preoperative assessment of AAC may aid in identifying patients at higher risk after lumbar surgery.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1407-1413"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877398","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.","authors":"Patricia M Herman, Sam Mann, Lynn L DeBar","doi":"10.1097/BRS.0000000000005737","DOIUrl":"10.1097/BRS.0000000000005737","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E513"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424349","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":"Comparison of Length of Stay and Discharge Disposition After Short-Segment Lumbar Fusion Surgery at Tertiary Care and Nontertiary Care Hospitals: A Propensity Score-Matched Analysis.","authors":"Rajkishen Narayanan, Olivia A Opara, Adam Kohring, Yunsoo Lee, Preston Carey, Rioke M Diejomaoh, Cordero McCall, Sean Lowitz, Julian Takagi-Stewart, Evan Bradley, Mark F Kurd, Ian D Kaye, John J Mangan, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder","doi":"10.1097/BRS.0000000000005070","DOIUrl":"10.1097/BRS.0000000000005070","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objective: </strong>To compare the perioperative and postoperative outcomes among lumbar fusion patients treated at an orthopedic specialty hospital (OSH), a hybrid community hospital (HCH), and a conventional community hospital in comparison to a tertiary care hospital (TCH).</p><p><strong>Summary of background data: </strong>In spine surgery, strategies to reduce length of stay (LOS) include a myriad of pre-, intra-, and postoperative strategies that require a multidisciplinary infrastructure. The sum of these efforts has led to the creation of orthopedic specialty hospitals and protocols that have been adopted by community hospitals as well. There is a notable lack of information regarding the results of these efforts across different healthcare institution models.</p><p><strong>Methods: </strong>This was a retrospective study of patients undergoing elective one or two-level lumbar fusion between 2017 and 2022 at a large urban TCH, an OSH, a HCH, and a conventional CH. Data were collected on patient characteristics, demographics, comorbidities, BMI, smoking status, surgical type, surgical levels, surgery duration, hospital length of stay, readmissions, reoperations, and discharge status within a year. Patients across the four surgical settings were matched based on age, BMI, CCI, type of procedure, and number of levels fused.</p><p><strong>Results: </strong>A total of 1435 patients met the inclusion criteria. Length of hospital stay was significantly longer at TCH compared with OSH, HCH, and CH by an average of 1 to 2 days ( P <0.001). Ninety-day readmissions were higher at TCH compared with OSH ( P =0.001). TCH patients also were less likely to be discharged home than OSH and HCH patients ( P =0.001 and P =0.016, respectively). No significant differences were noted in 1-year reoperation rates across all hospital models.</p><p><strong>Conclusions: </strong>Shorter lengths of stays and more home discharges at the orthopedic specialty hospital and community hospital settings did not compromise surgical quality or postoperative outcomes.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1414-1417"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427689","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":"Delayed Yet Durable Functional Recovery Following Posterior Cervical Decompression and Fusion for Mild Degenerative Cervical Myelopathy.","authors":"Joydeep Baidya, Mitchell Ng, William A Green, Gregorio Baek, Jonathan Dalton, Jarod Olson, Robert J Oris, Chloe Herczeg, Rachel Huang, Yulia Lee, Joshua Mathew, Yasmine Eichbaum, Morgan Hitchner, Michael Carter, Andrew Vanichkachorn, Ashley Thommana, Thomas D Cha, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler","doi":"10.1097/BRS.0000000000005590","DOIUrl":"10.1097/BRS.0000000000005590","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>This study was designed to: (1) compare functional recovery after PCDF across baseline severity groups, (2) determine the rate of achieving a severity-adjusted minimum clinically important difference (MCID) in modified Japanese Orthopaedic Association (mJOA) scores, and (3) assess how these outcomes evolve over two years.</p><p><strong>Background: </strong>Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord dysfunction in older adults. Posterior cervical decompression and fusion (PCDF) is a well-accepted option for moderate and severe disease, yet its role in mild DCM remains uncertain.</p><p><strong>Methods: </strong>We retrospectively reviewed adults undergoing elective PCDF for DCM at a single tertiary care center from 2010 to 2022. Patients were stratified by preoperative mJOA score as mild (15-17), moderate (12-14), or severe (<12). Severity-adjusted MCID thresholds were defined as mJOA increases of +1, +2, and +3 points, respectively. Patient-reported outcomes were collected preoperatively and at 6, 12, and 24 months postoperatively. Multivariate logistic regression identified predictors of MCID achievement at 1 year.</p><p><strong>Results: </strong>One hundred thirty-seven patients were included (62 mild, 48 moderate, and 27 severe) with similar baseline demographics across groups. At 12 months, moderate (OR: 2.92, 95% CI: 1.25-7.02) and severe (OR: 3.40, 95% CI: 1.26-9.48) patients were significantly more likely to achieve MCID than mild cases ( P  < 0.02). By 24 months, MCID achievement rates converged (41.9% mild, 42.9% moderate, and 46.7% severe; P  = 0.95).</p><p><strong>Conclusions: </strong>Greater preoperative myelopathy severity predicts larger early functional gains and higher MCID achievement after PCDF. However, by two years, patients with mild disease achieve MCID at similar rates to more severe cases, suggesting a delayed but meaningful benefit. These findings may guide surgical decision-making and patient counseling, particularly in the mild DCM population.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1347-1353"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145810858","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":"Multimodal Imaging Predictors of FEA-Derived Lumbar Vertebral Compression Strength.","authors":"Anna-Maria Mielke, Soji Tani, Koji Ishikawa, Marco D Burkhard, Bruno Verna, Ali E Guven, Ek T Tan, John A Carrino, Jiaqi Zhu, Jennifer Shue, Federico P Girardi, Andrew A Sama, Frank P Cammisa, Alexander P Hughes","doi":"10.1097/BRS.0000000000005730","DOIUrl":"10.1097/BRS.0000000000005730","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cross-sectional study.</p><p><strong>Objective: </strong>To identify multimodal imaging predictors of lumbar vertebral compression strength (CS), focusing on volumetric bone mineral density (vBMD), vertebral bone quality (VBQ), abdominal aortic calcification (AAC), and multifidus fatty infiltration (FI), and to evaluate the cumulative and incremental predictive value of these routinely available imaging and patient-level factors for FEA-derived CS.</p><p><strong>Summary of background data: </strong>Preoperative assessment of vertebral strength is essential in spine surgery. While quantitative CT (QCT)-derived vBMD and MRI-based VBQ have been proposed as surrogate markers of bone integrity, their relative predictive value for biomechanical failure remains unclear. Paraspinal muscle FI has been associated with poorer functional and postoperative outcomes, yet its contribution to vertebral CS is underexamined.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 76 patients undergoing lumbar fusion with preoperative CT and MRI (2014-2020) was performed. Vertebral CS at L1 was calculated using CT-based finite element analysis (FEA). vBMD at L1-L2 was measured using asynchronous QCT. VBQ L1/2 was derived from T1-weighted MRI normalized to cerebrospinal fluid. Multifidus FI was quantified at L4 on axial T2-weighted MRI. AAC was graded on lateral lumbar radiographs. Spearman correlation and multivariable linear regression were used to identify CS predictors.</p><p><strong>Results: </strong>Higher vBMD was associated with greater CS across all models (β=64.7-67.3 N per mg/cm³; all P <0.001). Neither VBQ L1/2 nor AAC showed independent associations with CS or improved model performance. Multifidus FI showed a positive but nonsignificant association with CS (β=51.3 N per % increase; P =0.078), representing a trend, and its inclusion modestly increased overall model fit (adjusted R ²=0.781). Sex remained a significant predictor in all models ( P <0.001).</p><p><strong>Conclusion: </strong>vBMD was the only imaging biomarker reliably predicting vertebral CS, underscoring its central role in preoperative bone quality assessment. VBQ, AAC, and multifidus FI did not independently predict CS. Although multifidus FI was not statistically significant, its modest improvement of model performance suggests a potential secondary contribution to vertebral biomechanics. CT-based evaluation remains essential for identifying patients at risk of vertebral fragility.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E500-E508"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875758","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":"Hospital Care for Children With Neuromuscular Spine Disease in the United States: Utilization, Charges, Comorbidities, and Deaths (2003-2019).","authors":"Muhammad Ghauri, Ryan Sindewald, Misa Fang, Lauren E Stone, Michael P Kelly, Peter O Newton, Rajiv R Iyer, Mark S Katsma, David D Gonda, Vijay M Ravindra","doi":"10.1097/BRS.0000000000005561","DOIUrl":"10.1097/BRS.0000000000005561","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cross-sectional study.</p><p><strong>Objective: </strong>We analyzed inpatient health care utilization, costs, and outcomes for pediatric neuromuscular scoliosis (NMS) in the US from 2003 to 2019. We describe hospitalization characteristics and identify predictors of perioperative complications.</p><p><strong>Summary of background data: </strong>The Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) collects nationally representative weighted data samples of pediatric hospital discharges.</p><p><strong>Methods: </strong>We identified hospitalizations related to spinal fusion procedures for NMS in children from 2003, 2006, 2009, 2012, 2016, and 2019. Hospitalizations were categorized as surgical (initial spinal fusion, wound dehiscence, wound infection) and complication-related (pneumonia, urinary tract infection, paralytic ileus, respiratory failure). Weighted national estimates of admissions, inflation-adjusted charges (2019 USD), length of stay (LOS), and hospital days were calculated. Survey-weighted logistic regression identified independent predictors of perioperative complications.</p><p><strong>Results: </strong>Admissions for NMS rose >30-fold from 235 in 2006 to 7242 in 2019. Total charges increased from $22 million to $1.31 billion, and the mean charge per hospitalization increased from $99,700 to $182,100. Hospital days increased from 1942 to 58,528, and median LOS remained consistent at 8 days. In 2019, NMS accounted for 0.1% of pediatric admissions, 0.25% of hospital days, and 0.6% of hospital charges in the United States. Surgical wound complications were <0.5% of encounters but incurred mean charges exceeding $456,000 and median LOS of 30 days. Among 15,821 weighted encounters, overall mortality was 0.7%. The likelihood of perioperative complications was higher among children transferred from another facility or covered by public or \"other\" insurance, whereas age older than or equal to 10 years and Black race were associated with lower odds of complications ( P <0.05).</p><p><strong>Conclusions: </strong>Over the past two decades, pediatric NMS has become substantially more resource-intensive, driven particularly by rising procedure costs, despite stable LOS and low mortality. Strategies for reducing perioperative complications may mitigate the economic burden of this vulnerable population.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1418-1425"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145445941","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 on: Predicting Postoperative Neurological Outcomes in Metastatic Spinal Tumor Surgery Using Machine Learning.","authors":"Hui Lu, Yan Cui","doi":"10.1097/BRS.0000000000005725","DOIUrl":"10.1097/BRS.0000000000005725","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E509"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781766","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":"Establishing Maximal Outcome Improvement Threshold for SRS-22r in Patients With Moderate-to-Severe Spinal Deformity: An Anchor-Based Analysis With a Minimum of Two-Year Follow-Up.","authors":"Di Liu, Xiangjie Yin, Shengru Wang, Ning Zhang, Andrew Yanzhe Xu, Terry Jianguo Zhang, Nan Wu","doi":"10.1097/BRS.0000000000005619","DOIUrl":"10.1097/BRS.0000000000005619","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To establish the maximal outcome improvement (MOI) threshold for moderate-to-severe spinal deformity.</p><p><strong>Background: </strong>Interpretation of patient-reported outcome measures (PROMs) is often limited by ceiling effects and inadequate consideration of baseline status when determining clinically meaningful thresholds.</p><p><strong>Methods: </strong>One hundred seven patients who underwent surgery for moderate-to-severe spinal deformity and completed ≥ 2-year follow-up were retrospectively included. The Scoliosis Research Society-22 revised (SRS-22r) was administered preoperatively and at ≥ 2-year follow-up to determine the MOI threshold using the anchor-based method. Anchor questions were derived from the SRS-22r satisfaction domain, with postoperative satisfaction defined as scores ≥ 4 on both questions. The MOI was calculated as the changes in SRS-22r scores relative to the total possible improvement. Receiver operating characteristic (ROC) curve analysis identified the optimal MOI threshold. Logistic regression analysis evaluated predictors associated with achieving the MOI threshold.</p><p><strong>Results: </strong>Significant radiographic and clinical improvements were obtained at ≥ 2-year follow-up. Dissatisfied patients had lower postoperative SRS-22r satisfaction (3.1±0.4 vs. 4.5±0.4, P <0.001) and subtotal scores (3.7±0.4 vs. 4.0±0.3, P <0.001). The determined MOI threshold for the SRS-22r score was 43.5%. Adolescents demonstrated a significantly higher mean MOI percentage than adults (50.3% vs. 42.8%, P =0.001), although the proportion achieving the MOI threshold was comparable between groups (73.4% vs. 62.8%, P =0.242). Male sex (OR=0.8, P =0.022) and surgical complications (OR=0.7, P <0.001) significantly decreased the likelihood of achieving the MOI threshold. Conversely, preoperative neurological deficits were associated with increased odds of meeting this threshold (OR=1.6, P =0.041).</p><p><strong>Conclusions: </strong>The MOI threshold for the SRS-22r in moderate-to-severe spinal deformity was 43.5%. Male sex and perioperative complications were negative predictors, whereas preoperative neurological deficits increased the probability of achieving clinically meaningful improvement.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"1399-1406"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990491","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 the Letter to the Editor Regarding \"Predicting Postoperative Neurological Outcomes in Metastatic Spinal Tumor Surgery Using Machine Learning\".","authors":"Satoshi Maki, Yuki Shiratani, Sumihisa Orita, Akinobu Suzuki, Koji Tamai, Takaki Shimizu, Kenichiro Kakutani, Yutaro Kanda, Hiroyuki Tominaga, Ichiro Kawamura, Masayuki Ishihara, Masaaki Paku, Yohei Takahashi, Toru Funayama, Kousei Miura, Eiki Shirasawa, Hirokazu Inoue, Atsushi Kimura, Takuya Iimura, Hiroshi Moridaira, Hideaki Nakajima, Shuji Watanabe, Koji Akeda, Norihiko Takegami, Kazuo Nakanishi, Hirokatsu Sawada, Koji Matsumoto, Masahiro Funaba, Hidenori Suzuki, Haruki Funao, Tsutomu Oshigiri, Takashi Hirai, Bungo Otsuki, Kazu Kobayakawa, Koji Uotani, Hiroaki Manabe, Shinji Tanishima, Ko Hashimoto, Chizuo Iwai, Daisuke Yamabe, Akihiko Hiyama, Shoji Seki, Kenji Kato, Masashi Miyazaki, Kazuyuki Watanabe, Toshio Nakamae, Takashi Kaito, Hiroaki Nakashima, Narihito Nagoshi, Gen Inoue, Shiro Imagama, Kota Watanabe, Satoshi Kato, Seiji Ohtori, Takeo Furuya","doi":"10.1097/BRS.0000000000005790","DOIUrl":"10.1097/BRS.0000000000005790","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E510-E512"},"PeriodicalIF":3.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424333","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}