Spine最新文献

{"title":"Constructive Suggestions for Enhancing Research on Osteoporotic Vertebral Fractures.","authors":"Yun Zhao, Xingyao Yang, Xiao Liu","doi":"10.1097/BRS.0000000000005292","DOIUrl":"10.1097/BRS.0000000000005292","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E240"},"PeriodicalIF":2.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383341","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":"Impact of the Prognostic Nutritional Index on Outcomes in Native Spine Infection.","authors":"Mugito Nagayoshi, Masatsugu Tsukamoto, Tadatsugu Morimoto","doi":"10.1097/BRS.0000000000005311","DOIUrl":"10.1097/BRS.0000000000005311","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E241"},"PeriodicalIF":2.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459526","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":"Association Between Paraspinal Muscle Parameters and Single-Segment Degenerative Lumbar Spondylolisthesis: Retrospective, Cross-Sectional Cohort Study.","authors":"Shuang Liu, Qi Shi, Wei-Wei Da, Chun-Chun Xue, Lin Chen, Yu-Nan Li, Yong-Peng Xue, Wen-Lan Du, Xiao-Feng Li","doi":"10.1097/BRS.0000000000005140","DOIUrl":"10.1097/BRS.0000000000005140","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective, cross-sectional cohort study.</p><p><strong>Objective: </strong>This study aimed to investigate the association between paraspinal muscle parameters and single-segment degenerative lumbar spondylolisthesis (DLS).</p><p><strong>Summary of background data: </strong>The relationship between lumbar paraspinal muscle morphology and single-segment DLS remains unclear.</p><p><strong>Methods: </strong>A retrospective review was conducted on 115 patients with L4/5 single-segment DLS and 105 subjects without DLS. Two independent investigators assessed the relative cross-sectional area and fat infiltration rate of the multifidus, erector spinae, and psoas major at L3/4, L4/5, and L5/S1 levels, comparing these measurements between the 2 groups. In addition, binary logistic regression analysis was performed with DLS as the dependent variable to analyze the relative cross-sectional area and fat infiltration rate of different paraspinal muscles. Within the DLS group, the correlation between paraspinal muscle characteristics and the anteroposterior diameter of the spinal canal was examined.</p><p><strong>Results: </strong>The fat infiltration rate of multifidus, erector spinae, and psoas major was higher in the DLS group than in the control group, whereas the relative cross-sectional area of multifidus and psoas major was lower in the DLS group. Binary logistic regression analysis revealed a significant correlation between the fat infiltration rate of multifidus and psoas major and DLS. The relative cross-sectional area of multifidus and erector spinae was significantly smaller below the affected segment in the DLS group compared with the control group. A significant positive correlation was observed between the relative cross-sectional area of multifidus and erector spinae and the anteroposterior diameter of the spinal canal.</p><p><strong>Conclusion: </strong>There is a close association between paraspinal muscle degeneration and single-segment DLS, with an increased relative cross-sectional area of the multifidus and psoas major possibly being risk factors for single-segment DLS. The restoration or enhancement of paraspinal muscle function could potentially serve as a pivotal target for the prevention and treatment of single-segment DLS.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"841-848"},"PeriodicalIF":2.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081600","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":"Measuring Academic Productivity in Orthopedic and Spine Surgery.","authors":"Andrew J Schoenfeld, Kaitlyn E Holly","doi":"10.1097/BRS.0000000000005350","DOIUrl":"10.1097/BRS.0000000000005350","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"793-795"},"PeriodicalIF":2.6,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781158","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":"Preoperative Predictors of Poor Outcomes Following Lumbar Discectomy. A Study based on the National Finspine Registry.","authors":"Antti Saarinen, Eetu Suominen, Liisa Pekkanen, Antti Malmivaara, Jukka Huttunen, Katri Pernaa, Henri Salo, Jussi P Repo","doi":"10.1097/BRS.0000000000005425","DOIUrl":"10.1097/BRS.0000000000005425","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To identify predictors for poor outcome after lumbar discectomy for herniated disc.</p><p><strong>Summary of background data: </strong>Lumbar discectomy for herniated disc is a common spinal procedure. Despite the surgical treatment, some patients are left with persistent pain and poor health-related quality of life. We aim to research preoperative predictive factors associated with poor outcome after lumbar discectomy.</p><p><strong>Methods: </strong>National spine surgery registry was searched for patients who underwent primary discectomy for lumbar disc herniation between 2017 and 2022. All patients had a minimum of 2 years of follow-up. The primary outcome was disability at 12 months postoperatively, assessed using the Oswestry Disability Index (ODI). Patients were categorized into satisfactory (ODI 0-40) and poor outcome groups (ODI 41-100). Logistic regression was used to identify preoperative predictors of poor outcome. Variables for multivariable analysis were selected based on clinical relevance assessed by senior authors and bivariate associations. Secondary outcomes included pain scores and patient-reported satisfaction.</p><p><strong>Results: </strong>In all, 3339 patients were included, of whom 2991 (90%) had minimal to moderate disability and 348 (10%) had severe disability assessed with ODI at the follow-up. Several factors were identified to associate with poor outcome after the surgery: older age (OR 1.03,95%CI 1.02-1.03), female sex (OR 1.28,95%CI 1.03-1.61), higher body mass index (OR 1.06,95%CI 1.02-1.09), cardiologic comorbidity (OR 4.27,95%CI 2.4-7.3), regular preoperative painkiller use (OR 2.2,95%CI 1.5-3.3), and higher number of operated vertebrae (OR 2.4,95%CI 1.6-3.6). Symptom lasting over one year was associated with worse outcomes when compared with symptoms for 3-12 months (OR 0.42,95%CI 0.29-0.60), 6-12 weeks (OR 0.23,95%CI 0.12-0.39), and those with symptoms for less than 6 weeks (OR 0.35,95%CI 0.19-0.62). Employed individuals were significantly associated with better outcomes when compared other statuses. Worse preoperative quality of life scores was associated with poor outcome.</p><p><strong>Conclusion: </strong>Several preoperative factors were associated with poor outcome after lumbar discectomy. Identifying higher-risk patients - such as those with high BMI, older age, or significant comorbidities - can support preoperative counseling and targeted interventions. Optimizing modifiable factors preoperatively may improve outcomes.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286560","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":"Cervical Muscle Composition in Degenerative Dropped Head Syndrome: A Propensity Score Matching Study.","authors":"Thomas Caffard, Bruno Verna, Lukas Schönnagel, Ali E Guven, Artine Arzani, Erika Chiapparelli, Marco D Burkhard, Ranqing Lan, Jennifer Shue, Angela Rosenbohm, Jan Kassubek, Oliver Dobrindt, Andrew A Sama, Federico P Girardi, Frank P Cammisa, Timo Zippelius, Alexander P Hughes","doi":"10.1097/BRS.0000000000005424","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005424","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cross-sectional.</p><p><strong>Objective: </strong>To compare cervical muscle composition in patients with non-neuromuscular DHS caused by degenerative disease of the cervical spine to patients without DHS who underwent anterior cervical discectomy and fusion (ACDF).</p><p><strong>Summary of background data: </strong>Dropped Head Syndrome (DHS) is characterized by severe weakness of the cervical paraspinal muscles, particularly of the neck extensors that leads to a chin-on-chest deformity. This forward flexion prevents them from lifting their heads against gravity or maintaining a forward gaze, resulting in gait disturbance and impairment in activities of daily life.</p><p><strong>Methods: </strong>Propensity score matching was conducted, calculated based on age, sex, and BMI, to compare cervical muscle fat infiltration (FI) across three groups: 1) patients with DHS, 2) non-DHS patients who underwent 1-2 level ACDF, and 3) non-DHS patients who underwent 3 or more levels of ACDF. The cervical muscles were segmented on axial T2 MRI from C3 to C7 and the percent FI was measured using a previously validated Matlab software.</p><p><strong>Results: </strong>Patients with DHS showed significantly higher FI in the anterior muscle group compared to those undergoing ACDF at all levels (P<0.005) except for C3 (P=0.243). At all levels, patients with DHS demonstrated significantly higher FI in the posterolateral (P<0.001), posteromedial (P<0.01), scalenus (P<0.01), and trapezius muscle groups (P<0.005). At the C4 level, DHS patients had significantly higher FI in the sternocleidomastoid muscle group compared to ACDF groups (P=0.005).</p><p><strong>Conclusion: </strong>This study is the first to quantify FI in the cervical muscles of DHS patients without neurodegenerative/neuromuscular disease. DHS patients showed significant muscular decompensation, with pronounced atrophy in both extensor and anterior muscles compared to ACDF groups. Further studies are needed to explore these relationships and evaluate muscle in DHS with neurodegenerative conditions.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286558","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":"Current Concepts on Imaging and Artificial Intelligence of Osteosarcopenia in the Aging Spine - A Review for Spinal Surgeons by the SRS Adult Spinal Deformity Task Force on Senescence.","authors":"Corey T Walker, Robin Babadjouni, Wende Gibbs, Elizabeth Lord, Adeesya Gausper, Joseph Osorio, Camilo Molina, Kristen Jones, Miranda van Hooff, Alexander Theologis, Mitsuru Yagi, Laurel Blakemore, Suken Shah, Serena Hu, Marinus de Kleuver, Javier Pizones, Michael Kelly, Ferran Pellise, Christopher Ames, Robert Eastlack","doi":"10.1097/BRS.0000000000005426","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005426","url":null,"abstract":"<p><strong>Study design: </strong>Narrative review.</p><p><strong>Objective: </strong>To explore the intersection of osteoporosis, sarcopenia, radiomics, and machine learning in spine surgery, with a focus on clinical applications and opportunities for advancing assessment and predictive modeling methods.</p><p><strong>Summary of background data: </strong>Osteoporosis and sarcopenia are significant contributors to negative outcomes in the aging adult spine. Current methodologies for evaluating these disease states remain limited, with significant variability and poor standardization. Advances in computational medicine provide a novel opportunity to improve quantitative assessment of osteosarcopenia, as demonstrated in other areas of medicine. Using radiomic approaches for predictive outcome modeling in spine surgery remains largely untapped.</p><p><strong>Methods: </strong>A comprehensive literature search was performed. Articles were identified using the search terms \"osteoporosis,\" \"sarcopenia,\" \"osteosarcopenia,\" \"radiomics,\" \"spine surgery,\" and \"machine learning.\" Relevant studies were selected based on their focus on the intersection of these topics, emphasizing clinical, imaging, and computational methodologies in spine surgery.</p><p><strong>Results: </strong>This review highlights the existing conventional and research methods of assessing both osteoporosis and sarcopenia, particularly regarding their clinical application in spine surgery. Areas of research within the radiomic space for both conditions are also discussed to describe opportunities for growth of future research and areas of focus needed to advance the field of spine surgery alongside the rapid growth of artificial intelligence.</p><p><strong>Conclusion: </strong>Understanding the relationship between osteoporosis, sarcopenia, and frailty is essential to improving outcomes in spine surgery. Advanced imaging and machine learning approaches offer the potential for more precise assessments and tailored interventions. The Scoliosis Research Society Adult Spinal Deformity Task Force on Senescence has identified this as an area of maximal importance for strategic growth and development of the field.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286559","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":"Risk Factors for Postoperative Coronal Malalignment in Degenerative Lumbar Scoliosis and Its Impact on Clinical Outcomes: A Systematic Review and Meta-Analysis.","authors":"Dongfan Wang, Yan Zhang, Stone Sima, Zuoran Fan, Weiguo Zhu, Xiaolong Chen, Shibao Lu","doi":"10.1097/BRS.0000000000005429","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005429","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and meta-Analysis.</p><p><strong>Objective: </strong>To identify risk factors for postoperative coronal malalignment (CM) and evaluate its impact on clinical outcomes in patients with degenerative lumbar scoliosis (DLS).</p><p><strong>Background: </strong>Postoperative CM is a common complication after DLS surgery, with an incidence ranging from 20.7% to 38.9%. Identifying its risk factors and impact on surgical outcomes may enhance understanding of the condition and help optimize clinical management strategies.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with the PRISMA guidelines. Relevant studies were retrieved from PubMed, Embase, Scopus, Cochrane Library, and ClinicalTrials.gov. The inclusion criteria were: (1) comparative studies analyzing CM versus non-CM in DLS patients, (2) outcomes reported including demographic data, surgical details, radiographic parameters, and patients-reported outcomes, and (3) observational studies published in English from the inception of the databases to January 2024.</p><p><strong>Results: </strong>Seven studies with a total of 617 patients (191 CM, 426 non-CM) were included. Compared to the non-CM group, patients in the CM group had a higher proportion of females (P=0.03), larger major Cobb angle (P=0.005), greater LS curve Cobb angle (P<0.001), increased L4 tilt angle (P=0.01), L5 tilt angle (P<0.001), and AVT (P<0.001) preoperatively. Postoperatively, CM patients showed higher residual LS curve Cobb angle (P=0.02), L4 tilt angle (P=0.04), and L5 tilt angle (P<0.001), as well as a lower LS curve Cobb angle correction rate (P=0.005). Additionally, the CM group exhibited higher ODI score (P=0.003).</p><p><strong>Conclusion: </strong>Female sex, more severe preoperative coronal deformity, and insufficient correction of the lumbosacral curve are significant factors for postoperative CM following DLS surgery. The presence of CM is associated with diminished functional improvement after surgery.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286561","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":"Minimum Clinically Important Difference for Oswestry Disability Index Three Months following Lumbar Discectomy is Lower when Anchored to Patient Leg Pain Symptoms.","authors":"Issa Mutyaba, Rebekah Kleinsmith, Nicholas Banfield, Haley Puckett, Scott Mitchell, Kevin Mullaney, Brian Cunningham","doi":"10.1097/BRS.0000000000005427","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005427","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Objective: </strong>The primary objective of this study is to assess the change in patient reported outcomes from baseline to three months following lumbar discectomy for lumbar disc herniation.</p><p><strong>Summary of background data: </strong>Delayed surgical intervention may result in worse Patient-Reported Outcomes. Patient-reported outcome measures (PROMs) such as the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) are essential tools for assessing care for patients with low back pain and are widely used to track outcomes following discectomy.</p><p><strong>Methods: </strong>A total of 207 study participants were included in this retrospective case series study where PRO data was prospectively collected for all individuals who underwent discectomy within a single metropolitan healthcare system between 2018 and 2023. Data on the ODI and VAS were collected at baseline and again 3 months after discectomy.</p><p><strong>Results: </strong>ODI, VAS leg pain, and VAS back pain all improved significantly from baseline to 3 months post discectomy. There was no correlation between age or BMI and baseline PROs (r < 0.14).</p><p><strong>Conclusion: </strong>At 3 months post discectomy, there was a significant decrease in the VAS for back and leg pain as well as significant decrease in the ODI. The anchor-based MCID for ODI differs significantly when anchored based on patient leg pain versus patient back pain. Regardless, discectomy is an effective procedure that produces clinically significant improvement in patient reported outcomes at 3 months post procedure with over 55% of patients meeting MCID regardless of the anchoring question.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275925","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":"Investigating the Impact of Home Care Services after Lumbar Fusion on Readmission, Reoperation, and Patient Reported Outcomes.","authors":"Jonathan Dalton, Jarod Olson, Robert J Oris, Rajkishen Narayanan, Michael McCurdy, Jeremy Heard, Abbey Glover, Aryan Gajjar, James Kim, Mina Ebrahimi, Akshay Khanna, Barrett I Woods, Mark F Kurd, Ian David Kaye, Thomas D Cha, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder","doi":"10.1097/BRS.0000000000005422","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005422","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>Investigate how home care (HC) services impact utilization of postoperative resources and outcomes after lumbar fusion.</p><p><strong>Summary of background data: </strong>Utilization of spinal fusion has increased over the past decade-it has become important to coordinate postoperative discharge that maximizes rehabilitation and cost-effectiveness.</p><p><strong>Methods: </strong>Bundled payment information of lumbar fusion episodes of care from a private payer (2019-2021) was reviewed to identify patients. Manual chart review was conducted to evaluate demographic/surgical details, complications, and readmissions. Insurance claims data was reviewed to identify HC utilization after discharge-disposition was designated as home with HC versus no HC.</p><p><strong>Results: </strong>758 patients were included (13.6% HC, 86.4% no HC). Patients with HC were older (68.6±9.76 vs. 59.5±11.2;P<0.001), had higher BMI (31.1±6.17 vs. 30±5.9;P<0.001), and CCI (1.07±1.24 vs. 0.59±0.91;P=0.002), and longer operative time (211±86.7 vs.178±78.9;P<0.001). HC was associated with 90-day reoperation (13.6% vs. 1.07%;P<0.001), and readmission (30-day:7.77% vs. 1.98%;90-day:12.6% vs. 3.51%;P<0.001). HC was associated with reoperation for compressive fluid/dural repair (2.91% vs. 0.31%), and wound complication/infections (3.88% vs. 0%), and with medical readmissions (4.85% vs. 1.53%;P<0.001). On multivariate analysis, HC was an independent predictor of further healthcare utilization-office visits (incidence rate ratio (IRR):1.14;P=0.049), phone calls (IRR:1.38;P=0.02), and ED visits (IRR:6.5;P<0.001). Despite similar preoperative physical function scores (SF-12 PCS), HC was associated with worse 6-month (P<0.001) and 1-year scores (P=0.05).</p><p><strong>Conclusion: </strong>Patients receiving HC were older, sicker, and had longer surgeries. Patients with HC experienced more readmissions and reoperations particularly for wound and medical issues. HC independently predicted further postoperative healthcare utilization via office calls/visits and ED visits. These findings suggest that patients requiring HC are a particularly vulnerable population and that HC does not exert a protective effect against additional healthcare utilization. Further research is needed to identify proactive interventions that can decrease cost and improve outcomes.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249686","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}