Spine最新文献

{"title":"Robust Radiomic Signatures of Intervertebral Disc Degeneration from MRI.","authors":"Terence McSweeney, Aleksei Tiulpin, Narasimharao Kowlagi, Juhani Määttä, Jaro Karppinen, Simo Saarakkala","doi":"10.1097/BRS.0000000000005435","DOIUrl":"10.1097/BRS.0000000000005435","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective analysis.</p><p><strong>Objective: </strong>The aim of this study was to identify a robust radiomic signature from deep learning segmentations for intervertebral disc (IVD) degeneration classification.</p><p><strong>Summary of data: </strong>Low back pain (LBP) is the most common musculoskeletal symptom worldwide and IVD degeneration is an important contributing factor. To improve the quantitative phenotyping of IVD degeneration from T2-weighted magnetic resonance imaging (MRI) and better understand its relationship with LBP, multiple shape and intensity features have been investigated. IVD radiomics have been less studied but could reveal sub-visual imaging characteristics of IVD degeneration.</p><p><strong>Methods: </strong>We used data from Northern Finland Birth Cohort 1966 members who underwent lumbar spine T2-weighted MRI scans at age 45-47 (n=1397). We used a deep learning model to segment the lumbar spine IVDs and extracted 737 radiomic features, as well as calculating IVD height index and peak signal intensity difference. Intraclass correlation coefficients across image and mask perturbations were calculated to identify robust features. Sparse partial least squares discriminant analysis was used to train a Pfirrmann grade classification model.</p><p><strong>Results: </strong>The radiomics model had balanced accuracy of 76.7% (73.1-80.3%) and Cohen's Kappa of 0.70 (0.67-0.74), compared to 66.0% (62.0-69.9%) and 0.55 (0.51-0.59) for an IVD height index and peak signal intensity model. 2D sphericity and interquartile range emerged as radiomics-based features that were robust and highly correlated to Pfirrmann grade (Spearman's correlation coefficients of -0.72 and -0.77 respectively).</p><p><strong>Conclusion: </strong>Based on our findings these radiomic signatures could serve as alternatives to the conventional indices, representing a significant advance in the automated quantitative phenotyping of IVD degeneration from standard-of-care MRI.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333907","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":"C2 Pelvic Angle as a Predictive Measure for Decompensated Spinopelvic Alignment and Its Impact on Health-Related Quality of Life.","authors":"Jun Ouchida, Hiroaki Nakashima, Sadayuki Ito, Naoki Segi, Ippei Yamauchi, Yukihito Ode, Shiro Imagama","doi":"10.1097/BRS.0000000000005436","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005436","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>To evaluate the C2 pelvic angle (C2PA) as a novel compensatory parameter integrating C2 (center of gravity) and pelvic morphology, and its association with physical function and health-related quality of life (HRQOL). The T4-L1-Hip axis concept was applied to assess individualized spinal alignment.</p><p><strong>Background: </strong>Adult spinal deformity (ASD) impairs physical function and HRQOL in older adults. Pelvic retroversion compensates for spinal degeneration to maintain posture, but standardized evaluative indices linking pelvic parameters to outcomes remain limited.</p><p><strong>Methods: </strong>Cross-sectional analysis of 383 community-dwelling adults (mean age 64.1 ± 10.3 y). Whole-spine radiographs, physical function tests (Timed Up and Go, 10-meter walk), and SF-36 HRQOL scores were analyzed. C2PA mismatch (measured C2PA minus normative value [0.4 × pelvic incidence - 13]) and thoracolumbar decompensation (T4PA-L1PA ≥4°) were assessed. ROC analysis identified optimal C2PA mismatch thresholds; propensity score matching (age/sex/BMI) compared groups.</p><p><strong>Results: </strong>C2PA mismatch correlated strongly with lumbar (r=0.668) and thoracolumbar (r=0.707) mismatches. A 13° C2PA mismatch threshold optimally identified decompensated thoracolumbar alignment (AUC=0.819). Participants with>13° C2PA mismatch demonstrated decreased physical function (Timed Up and Go: 6.4 vs. 5.8 seconds; 10-meter walk: 1.4 vs. 1.5 m/s) and lower SF-36 scores (physical functioning: 65.9 vs. 72.8; bodily pain: 63.1 vs. 70.8; physical component summary: 41.8 vs. 45.7).</p><p><strong>Conclusions: </strong>C2PA is a reliable indicator of decompensated spinopelvic alignment, with>13° mismatch (measured C2PA>0.4 × pelvic incidence) The C2PA threshold correlates with decreased physical function and lower HRQOL, providing a clinical benchmark for evaluating and managing patients with spinal alignment degeneration.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317892","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":"Global Inequalities in the Burden of Low Back Pain from 1990 to 2021: Findings from the Global Burden of Disease Study 2021.","authors":"Liang Chen, Jian Chen","doi":"10.1097/BRS.0000000000005433","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005433","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317893","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":"Patterns of Bone Density Change in L4-L5 Spondylolisthesis.","authors":"Brandon Khoo, Nathan M Cross, Scott Telfer","doi":"10.1097/BRS.0000000000005434","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005434","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective analysis of medical imaging data.</p><p><strong>Objective: </strong>This study aimed to determine if there are changes in localized bone density of the L4-L5 vertebrae in patients with spondylolisthesis, with these changes hypothesized to be associated with increasing severity of spinal deformities.</p><p><strong>Summary of background data: </strong>Degenerative spondylolisthesis is a common spinal pathology resulting in pain and functional limitations. The condition may lead to changes in the bone density of the affected vertebrae and subsequent fracture risk and challenges for surgical interventions. However, the specific regions where these changes may occur have not been fully investigated.</p><p><strong>Methods: </strong>Sixty-eight sets of three-dimensional L4-L5 vertebrae models were created from clinical computed tomography (CT) scans, 38 from patients with spondylolisthesis and the remainder matched controls. A calibrated opportunistic quantitative CT approach was used to produce detailed bone density estimates across each vertebrae. The effects of age, sex, and associations with radiographic measures of spinal deformity on bone density patterns were assessed.</p><p><strong>Results: </strong>There was a significant association between diagnosis of spondylolisthesis and full bone density as well as age-related changes, however these overall changes were not found to be associated with any specific measure of deformity. The localized analysis showed that with increasing anterolisthesis, bone density was affected in the anterior, medial, and lateral regions of the L5 body, and the L4-L5 facet joints.</p><p><strong>Conclusions: </strong>These findings demonstrate that there are patterns of region change to L4-L5 bone density associated with spondylolisthesis, however there remains significant variability between patients. Future work will explore if surgical planning of spinal vertebrae correction and assessment of fracture risk may be assisted through detailed bone density mapping for L4-L5 and other vertebrae.</p><p><strong>Level of evidence: </strong>Level 4.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317894","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 Postoperative Physical Therapy Impact Pain, Opioid Consumption, and Clinical Outcomes after Single-Level Lumbar Fusion?","authors":"Jonathan Dalton, Robert J Oris, Michael A McCurdy, Teeto Ezeonu, Rajkishen Narayanan, Abbey Glover, Molly Milano, Alexander Dawes, Ian David Kaye, Mark F Kurd, Barrett I Woods, John J Mangan, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler","doi":"10.1097/BRS.0000000000005431","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005431","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort.</p><p><strong>Objective: </strong>To determine the impact of physical therapy (PT) on opioid consumption, surgical outcomes, and patient-reported outcome measures (PROMs) following single-level lumbar fusion.</p><p><strong>Summary of background data: </strong>Physical therapy following lumbar fusion surgery is variably prescribed, with the goals of pain relief and return to activity. However, existing evidence on the efficacy of postoperative PT after spine surgery is heterogeneous and generally low-quality. Furthermore, the impact of PT on opioid use following lumbar fusion has been minimally studied.</p><p><strong>Methods: </strong>All patients underwent single-level lumbar fusion surgery at a single tertiary academic institution. Insurance claims data was reviewed to determine which patients utilized outpatient PT in the 180 days postoperatively. Patient demographics, surgical variables, surgical outcomes, and PROMs were compared between patients with postoperative PT and those without. The state prescription drug monitoring program (PDMP) database was utilized to record prescription opioid use in the 1-year preoperative and 1-year postoperative periods. Multivariate regression analyses were created to examine the impact of PT on postoperative opioid use.</p><p><strong>Results: </strong>A total of 365 patients were included; 187 patients received postoperative PT while 178 did not. There were no differences in demographics/surgical variables, surgical outcomes, or PROMs between groups. There was no difference in preoperative or postoperative opioid use, total morphine milligram equivalents (MMEs), or total opioid prescriptions between groups. Multivariate regression analyses revealed that the use of PT was not a significant predictor of MME consumption at any time point after surgery.</p><p><strong>Conclusion: </strong>PT does not appear to increase complications after single-level lumbar fusion, and thus is likely a safe consideration during recovery. However, it may not significantly improve outcomes or reduce opioid consumption when implemented routinely for all patients. Surgeons should consider individual patient risk factors when deciding on optimal postoperative management.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302850","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 Indicators of Surgical Outcomes in Degenerative Cervical Myelopathy Assessed Using the JOACMEQ: A Prospective Multicenter Study.","authors":"Narihito Nagoshi, Junichi Yamane, Toshiki Okubo, Kentaro Fukuda, Takeshi Fujii, Reo Shibata, Takahiro Kitagawa, Kentaro Ago, Yasuhiro Kamata, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1097/BRS.0000000000005428","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005428","url":null,"abstract":"<p><strong>Study design: </strong>Prospective multicenter cohort study.</p><p><strong>Objective: </strong>To identify clinical indicators associated with postoperative functional and quality-of-life (QOL) outcomes in patients with degenerative cervical myelopathy (DCM), using the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ).</p><p><strong>Summary of background data: </strong>Although surgical intervention is the standard treatment for DCM, a subset of patients experiences suboptimal postoperative outcomes. The specific impact of surgical treatment on various physical functions in patients with DCM remains inadequately understood.</p><p><strong>Methods: </strong>A total of 935 DCM patients were prospectively enrolled across 10 institutions in Japan. Of these, 852 patients with complete JOACMEQ data were included. Pre- and postoperative assessments at 2 years included JOA score, visual analog scale, and JOACMEQ. Logistic regression analyses were conducted to identify indicators of effective outcomes across JOACMEQ domains.</p><p><strong>Results: </strong>Surgical intervention led to significant improvements in JOA scores and pain reduction. Effective rates by the JOACMEQ domain were 49.6% (cervical function), 48.5% (upper extremity), 35.1% (lower extremity), 23.2% (bladder), and 23.8% (QOL). Multivariate analysis revealed that better cervical function was associated with lower body mass index (BMI) and reduced neck pain at 2 years. Shorter symptom duration and upper limb pain improvement predicted better upper extremity outcomes. Younger age, shorter symptom duration, and reduced lower limb pain were linked to improved lower extremity function. Bladder function was negatively affected by longer symptom duration. Lower QOL was associated with longer symptom duration, cardiovascular comorbidities, and persistent neck and upper limb pain at final follow-up.</p><p><strong>Conclusion: </strong>Surgical intervention for DCM generally improves neurological function and pain. However, JOACMEQ analysis reveals that factors such as disease duration, residual pain, age, and BMI significantly influence physical function and QOL. These findings highlight the importance of surgical timing and adequate informed consent to optimize outcomes in DCM patients.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302848","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":"Postoperative L1 tilt as a Predictor of Proximal Junctional Kyphosis Following Lower Thoracic Spine-To-Pelvis Fusion for Adult Spinal Deformity.","authors":"Se-Jun Park, Jin-Sung Park, Dong-Ho Kang, Kyunghun Jung, Minwook Kang, Chong-Suh Lee","doi":"10.1097/BRS.0000000000005430","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005430","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>To investigate the association between postoperative orientation of the L1 vertebra and proximal junctional kyphosis (PJK) occurrence in adult spinal deformity (ASD) surgery.</p><p><strong>Summary of background data: </strong>PJK remains a common complication, with various risk factors identified. However, the role of the orientation of L1 vertebra has not been well studied.</p><p><strong>Methods: </strong>A total of 312 patients who underwent fusion from the pelvis to the lower thoracic spine (T9-12) were analyzed. Patient, surgical, and radiographic variables were evaluated for risk factor analysis of PJK. L1 tilt and L1 slope at six weeks postoperatively were included to represent the L1 orientation. Multivariate logistic regression analysis was performed to identify risk factors for PJK. Receiver operating characteristics (ROC) curve analysis was used to calculate the cutoff value of predictors for PJK.</p><p><strong>Results: </strong>PJK developed in 109 patients (34.9%). Multivariate regression analysis identified postoperative L1 tilt as the only independent risk factor for PJK (odds ratio=1.173, P<0.001). The cutoff value of L1 tilt for predicting PJK was determined as 8.1° based on ROC curve analysis (area under the curve=0.736, P<0.001). The rates of PJK (50.7% vs. 22.1%, P<0.001) and revision surgery (17.1% vs. 5.2%, P<0.001) were significantly higher in the high L1 tilt group than in the low L1 tilt group. The high L1 tilt group also exhibited significantly greater pelvic tilt, thoracic kyphosis, and T1 pelvic angle, as well as worse clinical outcomes at two years compared to the low L1 tilt group.</p><p><strong>Conclusions: </strong>An L1 tilt greater than 8.1° was associated with a higher risk of PJK, suboptimal sagittal alignment, and worse clinical outcomes at 2 years. Therefore, optimizing L1 orientation may reduce PJK risk and improve long-term surgical outcomes.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302851","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":"Differences in Functional Treadmill Tests in Patients with Adult Symptomatic Lumbar Scoliosis Treated Operatively and Non-operatively at a Minimum Five-Year Follow-up.","authors":"Leah Y Carreon, Steven D Glassman, Justin S Smith, Elizabeth L Yanik, Christine Baldus, Michael P Kelly, Keith H Bridwell","doi":"10.1097/BRS.0000000000005432","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005432","url":null,"abstract":"<p><strong>Study design: </strong>Prospective Longitudinal Cohort.</p><p><strong>Objectives: </strong>To present the long-term Functional Treadmill Test (FTT) results in patients with Adult Symptomatic Lumbar Scoliosis (ASLS) treated operatively (Op) and non-operatively (Non-Op).</p><p><strong>Summary of background data: </strong>A previous study on this cohort showed that at two years after intervention, FTT time ambulated deteriorated in Non-Op patients but improved in Op patients. Post-FTT back and leg pain improved in both groups with greater gains in the Op group.</p><p><strong>Methods: </strong>168 (62%) of 272 surviving subjects who underwent Operative (Op, N=115) or Non-operative treatment (N=53) were included with mean follow-up 7.49 ± 1.61 years. FTT parameters included maximum speed, time to onset of symptoms, distance ambulated, time ambulated, and back and leg pain severity before and after testing.</p><p><strong>Results: </strong>Both groups had deterioration from the two-year to final FTT in maximum selected speed, time ambulated and time to onset of symptoms but the decline was greater in NonOp patients. Patients in the Op group had worse Post-FTT back and leg pain at baseline but improved more than the NonOp at two years and maintained at final FTT.Op patients with two or more revisions had less improvement at two years and at final FTT compared to those who had no revision or only one revision.</p><p><strong>Conclusion: </strong>Patients treated surgically had greater improvements in FTT parameters compared to patients treated nonsurgically at two years that persisted to the final FTT performed at 7 years after their intervention. There was slight deterioration in some parameters from the two year to final FTT but these may be due to aging of the cohort. Patients who had two or more revisions had worse FTT parameters compared to patients with one or no revisions.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302849","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":"Racial/Ethnic Associations With Morbidity and Mortality in Adults With Acute Traumatic Cervical Spinal Cord Injury.","authors":"Aladine A Elsamadicy, Selma Belkasim, Paul Serrato, Sina Sadeghzadeh, Shaila D Ghanekar, Syed I Khalid, Sheng-Fu Larry Lo, Daniel M Sciubba","doi":"10.1097/BRS.0000000000005260","DOIUrl":"10.1097/BRS.0000000000005260","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>This study aimed to investigate the association of race with morbidity and mortality in acute cervical spinal cord injury (cSCI) patients.</p><p><strong>Background: </strong>Racial disparities in spine surgery are associated with adverse outcomes, however, the impact of race on cSCI is understudied.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the American College of Surgeons Trauma Quality Programs database to compare outcomes for acute cSCI patients between racial/ethnic identities: non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic/Latino (HIS), and other (OTH). Demographics, comorbidities, injury type, treatment modality, and adverse events (AEs) were assessed. Multivariable logistic regression was used to identify independent predictors of AEs, non-routine discharge (NRD), and in-hospital mortality.</p><p><strong>Results: </strong>There were 71,048 patients stratified by race/ethnicity: 44,639 (62.8%) NHW, 13,555 (19.1%) NHB, 5820 (8.2%) HIS, and 7034 (9.9%) OTH. NHB and HIS-identifying patients had the greatest rates of any AE (NHW: 20.7% vs. NHB: 25.0% vs. HIS: 24.6% vs. OTH: 22.0%, P < 0.001) and the longest mean length of stay (NHW: 11.3 ± 13.5 d vs. NHB: 15.5 ± 20.2 d vs. HIS: 15.0 ± 20.5 d vs. OTH: 12.6 ± 17.5 d, P < 0.001). NRDs were lowest for HIS-identifying patients (NHW: 74.8% vs. NHB: 75.5% vs . HIS: 69.5% vs . OTH: 75.4%, P < 0.001), whereas, in-hospital mortality was lowest for NHB-identifying patients (NHW: 12.8% vs . NHB: 10.1% vs . HIS: 12.4% vs . OTH: 13.4%, P < 0.001). On multivariable analyses, NHB odds ratio (OR: 1.16, P < 0.001), HIS (OR: 1.22, P < 0.001), and OTH (OR: 1.14, P = 0.004) cohorts had significantly increased odds of AEs. The NHB cohort had significantly increased odds (OR: 1.25, P < 0.001), whereas, the HIS cohort had significantly decreased odds (OR: 0.78, P = 0.001) of NRD. Only the NHB cohort had significantly decreased odds of in-hospital mortality (OR: 0.69, P <0 .001).</p><p><strong>Conclusion: </strong>Our study suggests there may be racial disparities in outcomes and discharge disposition for acute cSCI patients.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"823-831"},"PeriodicalIF":2.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012164","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 Condoliase on Health-related Quality of Life in Participants With Radicular Leg Pain Associated With Lumbar Disk Herniation: Results From a United States Phase 3 Clinical Trial.","authors":"Kevin E Macadaeg, Kee D Kim, Pragya B Gupta, Jose Rivera, Anand Patel, Kinsuk Chauhan, Jun Watanabe, Takayuki Seo, Evan Zucker, Kenneth Candido","doi":"10.1097/BRS.0000000000005327","DOIUrl":"10.1097/BRS.0000000000005327","url":null,"abstract":"<p><strong>Study design: </strong>An exploratory analysis of a randomized, double-blind, sham-controlled, phase three study.</p><p><strong>Objective: </strong>To evaluate the impact of SI-6603 (condoliase) on health-related quality of life (HRQoL)-related outcomes in patients with lumbar disk herniation (LDH)-associated radicular leg pain from the Discovery 6603 study (NCT03607838).</p><p><strong>Summary of background data: </strong>Condoliase is a novel chemonucleolytic agent that selectively degrades chondroitin sulfate in the nucleus pulposus. Condoliase is approved in Japan for the treatment of radicular leg pain associated with LDH. Recently, the Discovery 6603 study demonstrated the efficacy and tolerability of condoliase in the United States (US).</p><p><strong>Methods: </strong>Adults with LDH and unilateral radicular leg pain were randomized to receive a single intradiscal injection of condoliase (1.25 units) or sham, followed by 52 weeks of observation. Exploratory HRQoL-related outcomes included change from baseline (CFB) in EuroQol Group 5-Dimension Quality of Life instrument, 5-Level version (EQ-5D-5L), and visual analogue scale (EQ-VAS), CFB in the 36-item Short Form Health Survey (SF-36), Patient Global Impression of Change (PGIC), Clinical Global Impression of Change (CGIC), and CFB in Work Productivity and Activity Impairment (WPAI) scores. EQ-5D-5L and SF-36 measures were assessed using a longitudinal analysis model.</p><p><strong>Results: </strong>Of 352 randomized participants, 341 constituted the modified intention-to-treat population (condoliase: 169; sham: 172). Condoliase showed numerically greater improvements in EQ-5D-5L self-care and pain/discomfort dimensions at week 13 and week 52 compared with sham ( P <0.05). The SF-36 physical component and WPAI scores numerically favored condoliase compared with sham. Patients and clinicians more frequently reported \"very much improved\" in overall status following condoliase treatment versus sham.</p><p><strong>Conclusions: </strong>Previous findings confirmed the efficacy and tolerability of condoliase for LDH management. Condoliase showed notable improvements in exploratory HRQoL-related outcomes, which were consistent across multiple patient-reported measures. Condoliase has the potential to enhance QoL and work productivity in individuals with LDH.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"796-803"},"PeriodicalIF":2.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606161","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}