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Identifying Factors for Predicting Postoperative Segmental Motor Paralysis in Patients Undergoing Anterior Cervical Spine Surgery: A Multicenter Study. 确定颈椎前路手术患者术后节段性运动麻痹的预测因素:一项多中心研究。
IF 2.6 2区 医学
Spine Pub Date : 2025-03-15 Epub Date: 2024-10-23 DOI: 10.1097/BRS.0000000000005193
Hiroaki Onuma, Takashi Hirai, Kenichiro Sakai, Motonori Hashimoto, Hiroyuki Inose, Kentaro Yamada, Yu Matsukura, Shingo Morishita, Satoru Egawa, Jun Hashimoto, Kentaro Sakaeda, Satoshi Tamura, Ichiro Torigoe, Masaki Tomori, Kyohei Sakaki, Yutaka Kobayashi, Kazuyuki Otani, Kazuo Kusano, Norihiko Miyake, Tsuyoshi Yamada, Shuta Ushio, Shigeo Shindo, Yoshiyasu Arai, Atsushi Okawa, Toshitaka Yoshii
{"title":"Identifying Factors for Predicting Postoperative Segmental Motor Paralysis in Patients Undergoing Anterior Cervical Spine Surgery: A Multicenter Study.","authors":"Hiroaki Onuma, Takashi Hirai, Kenichiro Sakai, Motonori Hashimoto, Hiroyuki Inose, Kentaro Yamada, Yu Matsukura, Shingo Morishita, Satoru Egawa, Jun Hashimoto, Kentaro Sakaeda, Satoshi Tamura, Ichiro Torigoe, Masaki Tomori, Kyohei Sakaki, Yutaka Kobayashi, Kazuyuki Otani, Kazuo Kusano, Norihiko Miyake, Tsuyoshi Yamada, Shuta Ushio, Shigeo Shindo, Yoshiyasu Arai, Atsushi Okawa, Toshitaka Yoshii","doi":"10.1097/BRS.0000000000005193","DOIUrl":"10.1097/BRS.0000000000005193","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To investigate the incidence of and risk factors for segmental motor paralysis after anterior cervical spine surgery.</p><p><strong>Summary of background data: </strong>Segmental motor paralysis is a potential complication following both anterior and posterior cervical decompression procedures; however, previous studies investigating risk factors for segmental motor paralysis after anterior cervical spine surgery were limited by small sample sizes. Consequently, the exact pathogenesis and risk factors for this complication remain poorly understood, highlighting the need for larger-scale investigations focused exclusively on anterior cervical spine surgeries.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the clinico-demographic and operative factors and postoperative outcomes of 1428 patients undergoing anterior cervical spine surgery at three spine centers in Japan. Postoperative segmental motor paralysis was defined as deterioration of upper extremity muscle strength by ≥1 grade; recovery was defined as a return to preoperative muscle strength levels. Univariate and multivariate analyses were performed to identify risk factors.</p><p><strong>Results: </strong>Ninety-nine patients (6.9%) developed segmental motor paralysis, mostly involving the C5 segment (81.8%), the incidence being highest in patients with ossification of the posterior longitudinal ligament (OPLL) and those undergoing anterior cervical corpectomy and fusion or hybrid fusion (discectomy + corpectomy). Older age, male sex, higher body mass index, OPLL, and cervical corpectomy were independent risk factors for paralysis, with these patients having significantly worse clinical outcomes at 1 year postoperatively. Most patients (74/99, 79.6%) regained preoperative muscle strength levels at a final follow-up.</p><p><strong>Conclusion: </strong>This study identified important clinico-demographic and operative risk factors for segmental motor paralysis after anterior cervical spine surgery. Patients undergoing corpectomy, with or without OPLL, were found to be at particularly high risk. While most patients recover well, worse outcomes with segmental motor paralysis highlight the importance of preventing this complication, particularly for OPLL patients and corpectomy procedures.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"375-382"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508387","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}
引用次数: 0
Letter to the Editor: Single-Position Prone Lateral Interbody Fusion is Associated With Improved Radiographic and Clinical Outcomes at One Year Compared to Single-Position Lateral Interbody Fusion: A Single Institution Experience. 致编辑的信:与单体位侧位椎体间融合术相比,单体位侧位椎体间融合术在一年的放射学和临床预后方面有改善:单一机构的经验。
IF 2.6 2区 医学
Spine Pub Date : 2025-03-15 Epub Date: 2025-01-20 DOI: 10.1097/BRS.0000000000005264
Hao-Ju Lo, Tsan-Wen Huang
{"title":"Letter to the Editor: Single-Position Prone Lateral Interbody Fusion is Associated With Improved Radiographic and Clinical Outcomes at One Year Compared to Single-Position Lateral Interbody Fusion: A Single Institution Experience.","authors":"Hao-Ju Lo, Tsan-Wen Huang","doi":"10.1097/BRS.0000000000005264","DOIUrl":"10.1097/BRS.0000000000005264","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E120-E121"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012064","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}
引用次数: 0
Untreated Osteoporosis in Lumbar Fusion Surgery Patients: Prevalence, Risk-factors, and Effect on Bone Metabolism. 腰椎融合术患者未经治疗的骨质疏松症:患病率、危险因素及对骨代谢的影响。
IF 2.6 2区 医学
Spine Pub Date : 2025-03-15 Epub Date: 2024-12-03 DOI: 10.1097/BRS.0000000000005231
Paul Köhli, Jan Hambrecht, Shu-Han Wang, Jiaqi Zhu, Erika Chiapparelli, Lukas Schönnagel, Ali E Guven, Gisberto Evangelisti, Arne Kienzle, Jennifer Shue, Koki Tsuchiya, Marco D Burkhard, Matthias Pumberger, Andrew A Sama, Federico P Girardi, Frank P Cammisa, Alexander P Hughes
{"title":"Untreated Osteoporosis in Lumbar Fusion Surgery Patients: Prevalence, Risk-factors, and Effect on Bone Metabolism.","authors":"Paul Köhli, Jan Hambrecht, Shu-Han Wang, Jiaqi Zhu, Erika Chiapparelli, Lukas Schönnagel, Ali E Guven, Gisberto Evangelisti, Arne Kienzle, Jennifer Shue, Koki Tsuchiya, Marco D Burkhard, Matthias Pumberger, Andrew A Sama, Federico P Girardi, Frank P Cammisa, Alexander P Hughes","doi":"10.1097/BRS.0000000000005231","DOIUrl":"10.1097/BRS.0000000000005231","url":null,"abstract":"<p><strong>Study design: </strong>Secondary analysis of a prospective single-center study.</p><p><strong>Objective: </strong>To analyze the prevalence and risk factors for untreated osteoporosis in patients undergoing lumbar spinal fusion surgery (LFS) and its impact on bone mineral density (BMD) and bone turnover markers.</p><p><strong>Background: </strong>Osteoporosis is a risk factor for mechanical complications in LFS, which can be mitigated by antiosteoporotic treatment. However, there is limited research on factors leading to untreated osteoporosis before LFS and its impact on preoperative bone status.</p><p><strong>Materials and methods: </strong>A secondary analysis of a prospective study enrolling adults undergoing LFS for degenerative conditions (2014-2024) with preoperative quantitative CT osteoporosis screening was performed. Demographic data and medical history were analyzed for prevalence and risk factors of untreated osteoporosis, while BMD, vitamin D, PTH levels, and bone turnover markers were assessed for the effects of lacking treatment.</p><p><strong>Results: </strong>A total of 445 patients (48% female, median age 64) were included, of which 137 patients (31%) had osteoporosis. Of these, 66 (48%) were untreated and 71 (52%) were treated, with 40 (56%) receiving pharmacological and 31 (44%) nonpharmacologic treatment, including vitamin D supplementation and lifestyle modifications. Of the untreated patients, 55 (80%) were identified by preoperative screening. Seventy-one percent of osteoporotic men versus 35% of osteoporotic women were untreated ( P <0.001). Multivariable logistic regression confirmed male sex as a significant contributing factor (OR: 4.3, 95% CI: 1.9-10.1, P <0.001) for untreated osteoporosis. Treated osteoporotic patients had higher BMD ( P <0.001), higher vitamin D levels ( P =0.023), and lower levels of bone resorption parameters ( P =0.004) than untreated patients.</p><p><strong>Conclusion: </strong>Untreated osteoporosis is common before LFS, especially in men, with untreated having lower BMD and higher bone resorption marker levels than treated patients. Identification of osteoporotic cases and subsequent osteological optimization could potentially reduce the risks of adjacent fractures or screw loosening.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"420-428"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772408","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}
引用次数: 0
The Arabic Oswestry Disability Index as a Unidimensional Measure: Confirmatory Factor Analysis. 阿拉伯语 Oswestry 残疾指数是一种单维测量方法:探索性和确认性因子分析。
IF 2.6 2区 医学
Spine Pub Date : 2025-03-15 Epub Date: 2024-11-27 DOI: 10.1097/BRS.0000000000005223
Ali H Alnahdi
{"title":"The Arabic Oswestry Disability Index as a Unidimensional Measure: Confirmatory Factor Analysis.","authors":"Ali H Alnahdi","doi":"10.1097/BRS.0000000000005223","DOIUrl":"10.1097/BRS.0000000000005223","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Objective: </strong>To evaluate the structural validity of the Arabic version of the Oswestry disability index (ODI) in patients with low back pain (LBP).</p><p><strong>Summary of background data: </strong>The Arabic ODI is currently used in clinical and research settings to assess disability, but questions remain regarding its structural validity.</p><p><strong>Materials and methods: </strong>Adult patients with LBP were recruited from physical therapy departments of two hospitals in Saudi Arabia. Participants completed the Arabic ODI and the numeric pain rating scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to examine the factor structure of the ODI. Maximum likelihood extraction and parallel analysis were used in the EFA, and the goodness-of-fit indices [χ 2 statistics, Tucker-Lewis index (TLI), comparative-fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean residual (SRMR)] were assessed in the CFA to confirm the factor structure.</p><p><strong>Results: </strong>A total of 113 patients (47.8% male, 52.2% female) participated. The EFA identified a unidimensional structure for the Arabic ODI, with one factor explaining 45.8% of the total variance. All items had significant factor loadings, with loadings ranging from 0.48 (sleeping) to 0.84 (sex life and social life). The CFA confirmed this unidimensional structure, yielding good fit indices [χ 2 =49.53, P <0.04; TLI=0.96; CFI=0.97; RMSEA=0.06 (90% CI=0.07-0.10), SRMR=0.04]. All ODI items exhibited significant positive loadings consistent with the expected correlation between the single latent variable (LBP-related disability) and the ODI items. A high error covariance was observed between items related to walking and standing.</p><p><strong>Conclusion: </strong>The Arabic Oswestry disability index demonstrates sufficient structural validity as a unidimensional measure of disability in Arabic-speaking patients with low back pain. These findings support the continued use of the Oswestry disability index for disability assessment in clinical and research settings and support the validity of using one total score representing the single underlying latent construct.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E103-E109"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732614","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}
引用次数: 0
Minimally Invasive Versus Open Surgery for Thoracolumbar Fractures Treatment : A Meta-analysis of Randomized Controlled Trials and Prospective Studies. 微创与开放手术治疗胸腰椎骨折:随机对照试验和前瞻性研究的荟萃分析。
IF 2.6 2区 医学
Spine Pub Date : 2025-03-15 Epub Date: 2025-01-03 DOI: 10.1097/BRS.0000000000005252
Mohammad Daher, Marven Aoun, Ethan J Cottrill, Zhi Wang, Richard K Hurley, William F Lavelle, Peter G Passias, Bassel G Diebo, Alan H Daniels, Amer Sebaaly
{"title":"Minimally Invasive Versus Open Surgery for Thoracolumbar Fractures Treatment : A Meta-analysis of Randomized Controlled Trials and Prospective Studies.","authors":"Mohammad Daher, Marven Aoun, Ethan J Cottrill, Zhi Wang, Richard K Hurley, William F Lavelle, Peter G Passias, Bassel G Diebo, Alan H Daniels, Amer Sebaaly","doi":"10.1097/BRS.0000000000005252","DOIUrl":"10.1097/BRS.0000000000005252","url":null,"abstract":"<p><strong>Study design: </strong>Meta-analysis.</p><p><strong>Objective: </strong>The purpose of this systematic review and meta-analysis was to pool the available data comparing MIS to open surgery for thoracolumbar fractures and provide a more comprehensive assessment of this topic.</p><p><strong>Background: </strong>There remains a debate over whether minimally invasive surgery (MIS) or open fixation provides superior outcomes for patients with thoracolumbar fractures. While several randomized controlled trials and prospective studies have compared these two approaches, the published studies are limited by sample size.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic review of the PubMed, Cochrane, and Google Scholar (pages 1-20) databases was performed on October 1, 2024. The extracted data consisted of complications, surgery-related parameters, early and late postoperative back pain, and postoperative regional kyphosis.</p><p><strong>Results: </strong>Five RCTs and five prospective studies were included in the meta-analysis, including 584 patients, with 299 in the MIS group and 285 in the open group. MIS patients were shown to have less EBL (MD=-155.86; 95% CI: -217.97 to -93.76, P <0.001), a shorter LOS (MD=-3.34; 95% CI: -4.62 to -2.06, P <0.001), lower pain scores during the early postoperative period (MD=-1.14; 95% CI: -1.56 to -0.71, P <0.001), and less regional kyphosis (MD=-5.17; 95% CI: -7.17 to -3.16, P <0.001), even when stratifying by study type. In addition, fluoroscopy time was longer in the MIS group (MD=0.60; 95% CI: 0.21-0.98, P =0.003), although this difference was not seen when looking at RCTs only.</p><p><strong>Conclusions: </strong>Among patients with thoracolumbar fractures, treatment with MIS was associated with decreased EBL, shorter LOS, earlier pain reduction, and less regional kyphosis compared with treatment with open fixation. In addition, higher radiation exposure was seen among patients treated with MIS. While MIS offers several potential benefits, both MIS and open fixation remain safe and reliable options for the treatment of thoracolumbar fractures.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"412-419"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980037","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}
引用次数: 0
Letter to the Editor Regarding Same-Day Versus Staged Spinal Fusion : A Meta-Analysis of Clinical Outcomes. 致编辑关于文章“当日与分期脊柱融合:临床结果的荟萃分析”的信。
IF 2.6 2区 医学
Spine Pub Date : 2025-03-15 Epub Date: 2024-12-25 DOI: 10.1097/BRS.0000000000005251
Yixi Wang, Xinkai Luo, Jian Cui, Paerhati Rexiti
{"title":"Letter to the Editor Regarding Same-Day Versus Staged Spinal Fusion : A Meta-Analysis of Clinical Outcomes.","authors":"Yixi Wang, Xinkai Luo, Jian Cui, Paerhati Rexiti","doi":"10.1097/BRS.0000000000005251","DOIUrl":"10.1097/BRS.0000000000005251","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E118"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898297","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}
引用次数: 0
Response to the Letter to the Editor Regarding Same-Day Versus Staged Spinal Fusion : A Meta-Analysis of Clinical Outcomes. 关于“当日与分期脊柱融合术:临床结果的荟萃分析”的致编辑信的回复。
IF 2.6 2区 医学
Spine Pub Date : 2025-03-15 Epub Date: 2025-01-16 DOI: 10.1097/BRS.0000000000005256
Mohammad Daher, Alan H Daniels
{"title":"Response to the Letter to the Editor Regarding Same-Day Versus Staged Spinal Fusion : A Meta-Analysis of Clinical Outcomes.","authors":"Mohammad Daher, Alan H Daniels","doi":"10.1097/BRS.0000000000005256","DOIUrl":"10.1097/BRS.0000000000005256","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"E119"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012165","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}
引用次数: 0
Impact of the Prognostic Nutritional Index on Outcomes in Native Spine Infection. 预后营养指数对原发性脊柱感染预后的影响
IF 2.6 2区 医学
Spine Pub Date : 2025-03-15 Epub Date: 2024-08-27 DOI: 10.1097/BRS.0000000000005135
Teeto Ezeonu, Rajkishen Narayanan, Samuel Alfonsi, Yunsoo Lee, John Liam Gibbons, Christian McCormick, Jacob Spring, Gabrielle Kozlowski, John J Mangan, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler
{"title":"Impact of the Prognostic Nutritional Index on Outcomes in Native Spine Infection.","authors":"Teeto Ezeonu, Rajkishen Narayanan, Samuel Alfonsi, Yunsoo Lee, John Liam Gibbons, Christian McCormick, Jacob Spring, Gabrielle Kozlowski, John J Mangan, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler","doi":"10.1097/BRS.0000000000005135","DOIUrl":"10.1097/BRS.0000000000005135","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The objective of this study was to determine if a baseline prognostic nutritional index (PNI) score could be used to predict outcomes in patients with native spine infections, including the need for operative intervention.</p><p><strong>Summary of background data: </strong>Nutritional status is an important, potentially modifiable risk factor to consider in the native spine population. The PNI score is a tool that has demonstrated utility as a marker of preoperative nutritional status in patients undergoing surgery; however, it has not yet been studied in the context of native spine infection.</p><p><strong>Methods: </strong>Adult patients (≥18 y) with a diagnosis of spine infection from 2017 to 2022 were retrospectively identified. Native spine infection was defined as a diagnosis of spinal infection in the absence of prior spine surgery within 3 months of diagnosis. PNI was calculated using the equation: PNI=10×serum albumin (g/dL)+0.005 total lymphocyte count (/μL). Patients were stratified into high or low PNI groups based on their PNI being above or below the average, respectively.</p><p><strong>Results: </strong>There were 45 patients in the low PNI group and 56 patients in the high PNI group. Patients in the low PNI group were more likely to require surgery ( P =0.046), had more levels decompressed ( P =0.012), and were more likely to undergo two or more irrigation and debridement procedures ( P =0.016). Patients in the low PNI group were also less likely to be discharged home ( P =0.016). There was no difference in length of stay, inpatient complications, 90-day readmissions, 90-day ED visits, or 1-year reoperations between groups.</p><p><strong>Conclusion: </strong>While postadmission outcomes and inpatient complications were similar across PNI groups, PNI on admission provides useful insight into the severity of infection and predicts the need for operative intervention in patients presenting with native spine infection.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":"389-394"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073920","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}
引用次数: 0
Long-Term Reoperation Rates After Single-Level Lumbar Discectomy: A Nationwide Cohort Study.
IF 2.6 2区 医学
Spine Pub Date : 2025-03-13 DOI: 10.1097/BRS.0000000000005328
Suhas K Etigunta, Andy M Liu, Adeesya Gausper, Vivien Chan, Justin Scheer, Tiffany Perry, David L Skaggs, Corey Walker, Alexander Tuchman
{"title":"Long-Term Reoperation Rates After Single-Level Lumbar Discectomy: A Nationwide Cohort Study.","authors":"Suhas K Etigunta, Andy M Liu, Adeesya Gausper, Vivien Chan, Justin Scheer, Tiffany Perry, David L Skaggs, Corey Walker, Alexander Tuchman","doi":"10.1097/BRS.0000000000005328","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005328","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort Study.</p><p><strong>Objective: </strong>This study aims to evaluate reoperation rates following single-level lumbar discectomy.</p><p><strong>Summary of background data: </strong>Reoperation rates following single-level lumbar discectomy are debated, with reports ranging from 5-24%. Accurately characterizing these rates is essential for provider and patient education.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using the PearlDiver database. Patients aged 18 or older with minimum five years follow-up after a single-level lumbar discectomy were included. The primary outcome was subsequent lumbar surgery rate at five years. Secondary analysis evaluated subsequent lumbar surgery following revision discectomy, lumbar fusion rate after primary or revision discectomy, and risk factors for subsequent lumbar surgery. Kaplan-Meier analysis and Cox regression models were employed.</p><p><strong>Results: </strong>There were 308,979 patients included in this study. The five-year subsequent lumbar surgery rate was 14.4% and the five-year subsequent lumbar fusion rate was 6.1%. There were 67,098 patients who received revision discectomy. Of those, five-year subsequent lumbar surgery rate was 18.2% and subsequent lumbar fusion rate was 12.4%. Kaplan-Meier curves demonstrated that the probability of avoiding subsequent lumbar surgery decreased more rapidly within the first year following both index and revision discectomy. Cox regression identified obesity (HR=1.12, 95% CI=[1.097, 1.141]) and higher Elixhauser Comorbidity Index (HR=1.06, 95% CI=[1.060, 1.068]) as significant predictors of subsequent lumbar surgery following index discectomy.</p><p><strong>Conclusion: </strong>Five-year subsequent lumbar surgery rate following single-level lumbar discectomy was 14.4%, with a higher rate of 18.2% following revision discectomy. This is the largest cohort to date studying reoperation rates after single-level lumbar discectomy. Patients should be counseled regarding the significant risk of subsequent surgeries, particularly after revision discectomy. Fusion procedures were more frequently performed after revision discectomy, underscoring the need to carefully consider surgical planning and patient selection in recurrent lumbar disc herniation cases.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630732","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}
引用次数: 0
The Application of 3D-Printed Microporous Laminae in Kyphosis Correction Surgery for Ankylosing Spondylitis: Minimum Two-Year Follow-Up.
IF 2.6 2区 医学
Spine Pub Date : 2025-03-13 DOI: 10.1097/BRS.0000000000005331
Chao Li, Hong Li, Xiangning Meng, Beiyu Xu, Yao Zhao, Longtao Qi, Chunde Li, Yu Wang
{"title":"The Application of 3D-Printed Microporous Laminae in Kyphosis Correction Surgery for Ankylosing Spondylitis: Minimum Two-Year Follow-Up.","authors":"Chao Li, Hong Li, Xiangning Meng, Beiyu Xu, Yao Zhao, Longtao Qi, Chunde Li, Yu Wang","doi":"10.1097/BRS.0000000000005331","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005331","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objective: </strong>This study designed an innovative 3D-printed microporous lamina and aimed to evaluate the feasibility and effectiveness in kyphosis correction surgery for patients with ankylosing spondylitis (AS).</p><p><strong>Summary of background data: </strong>Spinal osteotomy is a widely employed treatment for severe kyphotic deformities in AS. However, mitigating complications associated with osteotomy remains a significant clinical challenge.</p><p><strong>Methods: </strong>A total of 72 consecutive patients with ankylosing spondylitis who underwent kyphosis correction surgery were analyzed. Customized 3D-printed microporous laminae were designed based on preoperative imaging and three-dimensional modeling of each patient's spinal anatomy. Patients were divided into two groups: Group A (25 patients), treated with the 3D-printed microporous lamina technique, and Group B (47 patients), treated using the traditional technique. Radiological assessments included bone fusion rate, global kyphosis (GK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), osteotomy angle (OA), pelvic index (PI), pelvic tilt (PT), sacral slope (SS), and sagittal vertical axis (SVA). Clinical outcomes assessed were surgery-related complications, reoperation rates, operative time, estimated blood loss, postoperative hospital stay, and Scoliosis Research Society Outcomes Instrument-22 (SRS-22). All patients were followed up for at least two years postoperatively.</p><p><strong>Results: </strong>The bone fusion rate in the 3D-printed microporous lamina group was 96%. There were no statistically significant differences between the two groups in terms of surgery-related complications, reoperation rate, estimated blood loss, postoperative stay, GK, TLK, LL, OA, PI, PT, SS, SVA, or SRS-22. Although the mean operative time was longer in Group A than in Group B, this difference was not statistically significant.</p><p><strong>Conclusion: </strong>The use of 3D-printed microporous laminae in kyphosis correction surgery for ankylosing spondylitis provides a promising method for achieving high bone fusion rates through effective laminar reconstruction.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630815","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}
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