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Risk Factors for Delayed Diagnosis of Pyogenic Spondylitis: A Cross-Sectional Study with Prospective Case Series. 延迟诊断化脓性脊柱炎的危险因素:前瞻性病例系列的横断面研究。
IF 1.2
Spine Surgery and Related Research Pub Date : 2025-04-05 eCollection Date: 2025-07-27 DOI: 10.22603/ssrr.2024-0320
Tomoya Sato, Katsuhisa Yamada, Keigo Yasui, Junichiro Okumura, Masahiro Kanayama, Ryota Hyakkan, Hiroyuki Hasebe, Yuichi Hasegawa, Hiroshi Nakayama, Tsutomu Endo, Daisuke Ukeba, Hiroyuki Tachi, Toshiya Chubachi, Hideki Sudo, Masahiko Takahata, Manabu Ito, Norimasa Iwasaki
{"title":"Risk Factors for Delayed Diagnosis of Pyogenic Spondylitis: A Cross-Sectional Study with Prospective Case Series.","authors":"Tomoya Sato, Katsuhisa Yamada, Keigo Yasui, Junichiro Okumura, Masahiro Kanayama, Ryota Hyakkan, Hiroyuki Hasebe, Yuichi Hasegawa, Hiroshi Nakayama, Tsutomu Endo, Daisuke Ukeba, Hiroyuki Tachi, Toshiya Chubachi, Hideki Sudo, Masahiko Takahata, Manabu Ito, Norimasa Iwasaki","doi":"10.22603/ssrr.2024-0320","DOIUrl":"10.22603/ssrr.2024-0320","url":null,"abstract":"<p><strong>Introduction: </strong>Delayed diagnosis and therapy initiation for pyogenic spondylitis can have severe and fatal consequences. Early diagnosis and intervention are crucial in the treatment of pyogenic spondylitis. This multicenter cross-sectional study with prospective case series aimed to identify factors influencing the time from symptom onset to the diagnosis of pyogenic spondylitis.</p><p><strong>Methods: </strong>Patients hospitalized with pyogenic spondylitis between 2019 and 2023 were included. Patients were classified into 2 groups: the delayed diagnosis group (>30 days from the onset of initial symptoms to the diagnosis of pyogenic spondylitis) and the early diagnosis group (within 29 days). Risk factors for delayed diagnosis were analyzed.</p><p><strong>Results: </strong>A total of 74 patients (42 men and 32 women; mean age: 70.2 years) from 5 institutions were included. Univariate analysis of risk factors for delayed diagnosis revealed that the significant risk factors included advanced age (p=0.03), low white blood cell count (p<0.01), low C-reactive protein level (p<0.05), and semi-rigid spinal level, based on the spinal instability neoplastic score classification (p=0.05). Multivariate analysis for delayed diagnosis showed that the location at the semi-rigid spinal level was a significant risk factor (p=0.02). The vertebral bone destruction rate and abscess cavity index in the delayed diagnosis group were significantly higher than those in the early diagnosis group (p<0.01 and p<0.01, respectively).</p><p><strong>Conclusions: </strong>Significant risk factors for delayed diagnosis of pyogenic spondylodiscitis include infection at the semi-rigid thoracic spinal level. Early diagnosis of spondylodiscitis is crucial because delayed diagnosis can lead to progressive bone destruction and the formation of large abscesses. Increased awareness of thoracic spinal infections, which can easily delay diagnosis, could help in the early diagnosis and treatment of pyogenic spondylodiscitis.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"485-491"},"PeriodicalIF":1.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thoracic Myelopathy with Scheuermann's Disease and Ossification of the Yellow Ligament: A Case Report. 胸椎脊髓病合并舒尔曼病和黄韧带骨化1例报告。
IF 1.2
Spine Surgery and Related Research Pub Date : 2025-04-05 eCollection Date: 2025-07-27 DOI: 10.22603/ssrr.2024-0341
Tomotaka Ichijo, Wataru Saito, Eiki Shirasawa, Yusuke Mimura, Masayuki Miyagi, Takayuki Imura, Toshiyuki Nakazawa, Masashi Takaso, Gen Inoue
{"title":"Thoracic Myelopathy with Scheuermann's Disease and Ossification of the Yellow Ligament: A Case Report.","authors":"Tomotaka Ichijo, Wataru Saito, Eiki Shirasawa, Yusuke Mimura, Masayuki Miyagi, Takayuki Imura, Toshiyuki Nakazawa, Masashi Takaso, Gen Inoue","doi":"10.22603/ssrr.2024-0341","DOIUrl":"10.22603/ssrr.2024-0341","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"492-495"},"PeriodicalIF":1.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Increased Surgical Invasiveness but Favorable Scoliosis Research Society-22 Scores in Adult Idiopathic Scoliosis with Major Thoracic Curves: A Comparative Study with Adolescent Idiopathic Scoliosis. 成人特发性脊柱侧凸伴主要胸椎弯曲的手术侵入性增加但脊柱侧凸研究协会-22评分有利:与青少年特发性脊柱侧凸的比较研究。
IF 1.2
Spine Surgery and Related Research Pub Date : 2025-03-07 eCollection Date: 2025-07-27 DOI: 10.22603/ssrr.2024-0299
Yasuhiro Kamata, Satoshi Suzuki, Kazuki Takeda, Takahito Iga, Yohei Takahashi, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura, Kota Watanabe
{"title":"Increased Surgical Invasiveness but Favorable Scoliosis Research Society-22 Scores in Adult Idiopathic Scoliosis with Major Thoracic Curves: A Comparative Study with Adolescent Idiopathic Scoliosis.","authors":"Yasuhiro Kamata, Satoshi Suzuki, Kazuki Takeda, Takahito Iga, Yohei Takahashi, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.22603/ssrr.2024-0299","DOIUrl":"10.22603/ssrr.2024-0299","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical outcomes for adult patients with residual adolescent idiopathic scoliosis (AdIS) with a major thoracic curve are expected to be inferior to those of AIS but have not been well reported. This study aimed to evaluate surgical, radiographical, and clinical results in adult patients with AdIS and to characterize these patients by comparing their results with those of patients with adolescent idiopathic scoliosis (AIS).</p><p><strong>Methods: </strong>Thirty-five patients with AdIS, who were diagnosed with AIS Lenke type 1 or 2 before the age of 19 years and underwent surgery after the age of 20 years, were included in the study. As a control group, 84 patients with AIS Lenke type 1 or 2 who underwent surgery before the age of 19 were included. Both groups were matched on the basis of the preoperative main thoracic (MT) and proximal thoracic (PT) Cobb angles, causing 30 patients to be selected in each group.</p><p><strong>Results: </strong>The AdIS group exhibited a greater preoperative bending Cobb angle of the MT and PT curves (MT: 35.1° vs. 31.3°, PT: 17.8° vs. 13.8°) and a lower MT curve flexibility index than in the AIS group (36.6% vs. 42.2%). Postoperatively, the AdIS group had a higher number of fused intervertebral segments than did the AIS group (8.2 vs. 7.4), but the correction rate was comparable in the 2 groups. Moreover, the intraoperative time was longer and blood loss was larger in the AdIS group. In the Scoliosis Research Society (SRS)-22 score, self-image and mental health domains were significantly lower preoperatively in the AdIS group. Postoperative improvement of self-image domain was significantly greater in the AdIS group (Δ self-image: 1.6 vs. 0.9), and postoperative satisfaction was similar in the 2 groups.</p><p><strong>Conclusions: </strong>Surgical invasiveness was increased in AdIS, and preoperative SRS-22 scores were lower in self-image and mental health domains than in AIS. However, postoperative SRS-22 scores were comparable, and postoperative self-image improvement was significantly greater in AdIS than in AIS.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"453-459"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes after Cortical Bone Trajectory Screw versus Traditional Pedicle Screw in Single-Level Lumbar Spine Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 皮质骨轨迹螺钉与传统椎弓根螺钉在单节段腰椎手术中的疗效:随机对照试验的系统回顾和荟萃分析。
IF 1.2
Spine Surgery and Related Research Pub Date : 2025-02-21 eCollection Date: 2025-05-27 DOI: 10.22603/ssrr.2024-0292
Muhammad Talal Ibrahim, Cole Veliky, Elizabeth Yu
{"title":"Outcomes after Cortical Bone Trajectory Screw versus Traditional Pedicle Screw in Single-Level Lumbar Spine Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Muhammad Talal Ibrahim, Cole Veliky, Elizabeth Yu","doi":"10.22603/ssrr.2024-0292","DOIUrl":"10.22603/ssrr.2024-0292","url":null,"abstract":"<p><strong>Background: </strong>Cortical bone trajectory screw (CBTS) is reported to offer increased cortical bone purchase and improved outcomes as compared to the traditional pedicle screw (PS), particularly in osteoporotic patients. The systematic review aims to compare randomized controlled trials comparing CBTS with PS in single-level lumbar spine fusion surgery.</p><p><strong>Methods: </strong>A systematic search was conducted on PubMed (MEDLINE), Scopus, Embase, Web of Science, and Cochrane. Moreover, ClinicalTrials.gov, International Clinical Trials Registry Platform (ICTRP), and China National Knowledge Infrastructure (CNKI) were also searched. Outcome measures included fusion rates, complication rates, perioperative parameters, pain scores, and functionality. (PROSPERO: CRD42024523809).</p><p><strong>Results: </strong>Four manuscripts, reporting on three randomized controlled trials (RCTs) and 416 patients, were included in this review. The follow-up ranged from 24 to 26 months postoperatively. All patients underwent single-level fusion only. There was no significant difference in the fusion rates between CBTS and PS at one-year (risk ratio [RR] 1.05 [0.97, 1.13], p=0.24) or two-year (RR 1.02 [0.96, 1.08], p=0.47) follow-ups. The CBTS group had a lower risk of intraoperative complications (RR 0.44 [0.32, 0.60], p<0.001) but an equal risk of postoperative complications (RR 0.71 [0.42, 1.22], p=0.22). There was no difference in pain, functionality, disability, and quality-of-life scores. CBTS group had better outcomes in incision length (mean difference [MD] -25.44 [-40.76, -10.12], p=0.001), operative time (MD -20.71 [-32.91, -8.51], p=0.009), and blood loss (MD -60.23 [-106.74, -13.72], p=0.01), while there was no difference in length of stay (MD -0.49 [-1.01, 0.04], p=0.07).</p><p><strong>Conclusions: </strong>Although slightly favoring CBTS, RCTs were limited in number and had a serious risk of bias. Future RCTs should use superiority trial designs, have minimal bias, and include implant details, incidence of adjacent segment disease, and quality-of-life metrics.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"289-299"},"PeriodicalIF":1.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Morbidity and Mortality of Adult Spinal Deformity Surgery Using the Japanese Orthopedic Association National Registry/Japanese Society for Spine Surgery and Related Research Database (JOANR/JSSR-DB). 成人脊柱畸形手术的发病率和死亡率使用日本骨科协会国家注册/日本脊柱外科学会和相关研究数据库(JOANR/JSSR-DB)。
IF 1.2
Spine Surgery and Related Research Pub Date : 2025-02-07 eCollection Date: 2025-07-27 DOI: 10.22603/ssrr.2024-0289
Takumi Takeuchi, Hideyuki Arima, Tomoyuki Asada, Satoru Demura, Toru Doi, Akira Matsumura, Hiroki Oba, Ryo Sugawara, Satoshi Suzuki, Shinji Takahashi, Haruki Ueda, Yu Yamato, Kei Watanabe, Naobumi Hosogane
{"title":"Morbidity and Mortality of Adult Spinal Deformity Surgery Using the Japanese Orthopedic Association National Registry/Japanese Society for Spine Surgery and Related Research Database (JOANR/JSSR-DB).","authors":"Takumi Takeuchi, Hideyuki Arima, Tomoyuki Asada, Satoru Demura, Toru Doi, Akira Matsumura, Hiroki Oba, Ryo Sugawara, Satoshi Suzuki, Shinji Takahashi, Haruki Ueda, Yu Yamato, Kei Watanabe, Naobumi Hosogane","doi":"10.22603/ssrr.2024-0289","DOIUrl":"10.22603/ssrr.2024-0289","url":null,"abstract":"<p><strong>Introduction: </strong>The study investigated the complications of adult spinal deformity (ASD) surgery in Japan in 2022 using the Japanese Orthopedic Association National Registry/Japanese Society for Spine Surgery and Related Research Database (JOANR/JSSR-DB).</p><p><strong>Methods: </strong>Among the 158,407 patients registered in JOANR/JSSR-DB, 4,822 patients aged ≥19 years (1,115 males [23.1%], 3,707 females [76.9%]) were included in this study. Diagnoses were scoliosis in 1,961 patients (40.7%), kyphosis in 1,613 patients (33.4%), and kyphoscoliosis in 1,248 patients (25.9%). Intra-operative and postoperative/systemic complications (within 30 days) were investigated.</p><p><strong>Results: </strong>The age distribution was 468 (9.7%) aged 19-39, 855 (17.7%) aged 40-64, 1,779 (36.9%) aged 65-74, and 1,720 (35.7%) individuals aged ≥75 years, with 72.6% of the total population aged ≥65 years. The total complication rate was 11.8% (567 patients), with 6.2% in patients aged 19-39 years, 12.6% in patients aged 40-64 years, 11.6% in patients aged 65-74 years, and 13.0% in patients aged ≥75 years, whose rate was significantly higher (p<0.001). Intra-operative complications occurred in 215 patients (4.5%). Dural tear in 110 patients (2.3%), massive bleeding (>2,000 ml) in 54 (1.1%), implant-related complications in 14 (0.3%), and intra-operative nerve injury in 10 patients (0.2%). Postoperative complications occurred in 266 patients (5.5%). Lower extremity paralysis in 99 patients (2.0%), surgical site infection in 55 (1.1%), vertebral body or endplate injury in 25 (0.5%), epidural hematoma in 18 (0.4%), and weakness of the iliopsoas muscle due to lateral lumbar interbody fusion in 21 patients (0.4%). Systemic complications occurred in 162 patients (3.4%) with urinary tract infection in 29 (0.6%) and postoperative delirium in 26 (0.5%).</p><p><strong>Conclusions: </strong>While the 11.8% total complication rate was lower than previous reports, rates were higher in patients aged ≥75, indicating the need for careful perioperative management in elderly patients.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"426-435"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk Factors for Correction Loss of Vertebral Slippage after Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery for Lumbar Degenerative Spondylolisthesis. 微创经椎间孔腰椎椎体间融合术治疗腰椎退行性滑脱后椎体滑移矫正损失的危险因素。
IF 1.2
Spine Surgery and Related Research Pub Date : 2025-02-07 eCollection Date: 2025-07-27 DOI: 10.22603/ssrr.2024-0285
Yoshiaki Hiranaka, Shingo Miyazaki, Kohei Kuroshima, Masao Ryu, Shinichi Inoue, Takashi Yurube, Kenichiro Kakutani, Ko Tadokoro
{"title":"Risk Factors for Correction Loss of Vertebral Slippage after Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery for Lumbar Degenerative Spondylolisthesis.","authors":"Yoshiaki Hiranaka, Shingo Miyazaki, Kohei Kuroshima, Masao Ryu, Shinichi Inoue, Takashi Yurube, Kenichiro Kakutani, Ko Tadokoro","doi":"10.22603/ssrr.2024-0285","DOIUrl":"10.22603/ssrr.2024-0285","url":null,"abstract":"<p><strong>Introduction: </strong>Some cases of postoperative correction loss have been observed in the reduction of vertebral slippage using a percutaneous pedicle screw system for lumbar degenerative spondylolisthesis. We aimed to identify the risk factors for correction loss after minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and to determine the effect of postoperative correction loss on postoperative clinical outcomes.</p><p><strong>Methods: </strong>In this retrospective study, a total of 111 patients (mean age 69.5 years, 37 men and 74 women) who underwent single-level MIS-TLIF with slippage reduction for lumbar degenerative spondylolisthesis and were followed up for >1 year were included in the study. The correction loss group (group L) included those with a correction loss of ≥3 mm between immediately after surgery and 1 year after surgery, and the correction maintenance group (group M) included those with a correction loss <3 mm. Demographic data, preoperative and postoperative radiographic measurements, and clinical outcomes were collected, and the risk factors in group L and clinical outcomes in the two groups were analyzed statistically.</p><p><strong>Results: </strong>Groups L and M comprised 19 and 92 cases, respectively. High pelvic incidence-lumbar lordosis (odds ratio [OR]: 1.16, 95% confidence interval [CI]: 1.07-1.25, p<0.001), high slip vertebra slope (OR: 1.22, 95% CI: 1.07-1.39, p<0.001), and ≥10° segmental angulation (OR: 15.00, 95% CI: 3.04-73.95, p=0.0022) were risk factors for correction loss; however, low bone density was not. The Oswestry Disability Index and Visual Analog Scale scores for low back pain, leg pain, and leg numbness were not significantly different between both groups; however, the bone union rate at 6 months postoperatively was significantly lower in group L (p=0.0020).</p><p><strong>Conclusions: </strong>Postoperative correction loss was influenced by preoperative sagittal alignment and instability rather than bone density. Patients with correction loss tend to have prolonged bone union and should be closely monitored.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"443-452"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Abnormal Paravertebral Muscle Activity and Cervical Extensor Muscle Condition Affect Dynamic Spinal Balance during Gait in Dropped Head Syndrome. 异常椎旁肌活动和颈伸肌状况影响落头综合征步态中的脊柱动态平衡。
IF 1.2
Spine Surgery and Related Research Pub Date : 2025-02-07 eCollection Date: 2025-07-27 DOI: 10.22603/ssrr.2024-0263
Kotaro Sakashita, Kousei Miura, Hideki Kadone, Tomoyuki Asada, Takahiro Sunami, Takane Nakagawa, Yosuke Ogata, Shun Okuwaki, Tomoaki Shimizu, Hisanori Gamada, Hiroshi Noguchi, Hiroshi Takahashi, Toru Funayama, Masao Koda, Masashi Yamazaki
{"title":"Abnormal Paravertebral Muscle Activity and Cervical Extensor Muscle Condition Affect Dynamic Spinal Balance during Gait in Dropped Head Syndrome.","authors":"Kotaro Sakashita, Kousei Miura, Hideki Kadone, Tomoyuki Asada, Takahiro Sunami, Takane Nakagawa, Yosuke Ogata, Shun Okuwaki, Tomoaki Shimizu, Hisanori Gamada, Hiroshi Noguchi, Hiroshi Takahashi, Toru Funayama, Masao Koda, Masashi Yamazaki","doi":"10.22603/ssrr.2024-0263","DOIUrl":"10.22603/ssrr.2024-0263","url":null,"abstract":"<p><strong>Introduction: </strong>The pathogenesis of dropped head syndrome (DHS) involves factors like fat infiltration of the cervical extensor muscle, cervical degeneration, and sarcopenia, which are typically assessed using conventional imaging. Previous studies have demonstrated cervical and thoracic anterior tilt deterioration during gait in patients with DHS. However, the relationship between dynamic spinal balance and conventional imaging findings has not been investigated. The purpose of this study was to investigate the walking posture of patients with DHS using 3D gait motion analysis and to analyze the relationship between dynamic posture and conventional imaging factors, leading to the investigation of the pathophysiology of cervical imbalance during gait in patients with DHS.</p><p><strong>Methods: </strong>Twenty-two patients with DHS were included. Global and cervical static alignments were assessed using whole spine radiography. 3D gait motion analysis was performed, and dynamic kinematic variables were segmented into the cervical and thoracic regions. The paraspinal muscle activity was assessed using wireless surface electromyography. The cervical deep extensor muscle (C-DEM) condition was assessed using magnetic resonance imaging. Correlations of changes in dynamic kinematic variables with paraspinal muscle activity and C-DEM condition were determined.</p><p><strong>Results: </strong>A significant change in the anterior cervical and thoracic spine tilt was observed during gait. These changes were inversely correlated with thoracic paraspinal muscle activity. The change in the cervical anterior tilt was significantly correlated with the fat-free C-DEM at C3/C4 and C4/C5 and the fat infiltration rate of the C-DEM at C5/C6 and C7/T1.</p><p><strong>Conclusions: </strong>The thoracic paraspinal muscle activity failed to respond to the deterioration of the thoracic anterior tilt, indicating a notable contribution to postural endurance during gait and to DHS pathogenesis. Evaluating the condition of the C-DEM could be an alternative for evaluating dynamic postural endurance and is clinically important when considering patient complaints regarding difficulties in daily activities.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"398-406"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical and Imaging Characteristics of Patients with Cervical Compressive Myelopathy Presenting with Unilateral Motor Deficits. 以单侧运动障碍为表现的颈压迫性脊髓病的临床和影像学特征。
IF 1.2
Spine Surgery and Related Research Pub Date : 2025-02-07 eCollection Date: 2025-07-27 DOI: 10.22603/ssrr.2024-0264
Masatsune Sato, Hisanori Mihara, Hyonmin Choe, Takanori Niimura, Yuji Kawashima, Yutaka Inaba
{"title":"Clinical and Imaging Characteristics of Patients with Cervical Compressive Myelopathy Presenting with Unilateral Motor Deficits.","authors":"Masatsune Sato, Hisanori Mihara, Hyonmin Choe, Takanori Niimura, Yuji Kawashima, Yutaka Inaba","doi":"10.22603/ssrr.2024-0264","DOIUrl":"10.22603/ssrr.2024-0264","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical compressive myelopathy is a leading cause of spinal cord dysfunction in middle-aged and older adults. Although the pathological classification of cervical myelopathy is well established, the quantitative analysis of its imaging features remains underexplored. This study quantitatively evaluated the imaging characteristics of unilateral motor deficit cervical compressive myelopathy.</p><p><strong>Methods: </strong>This retrospective observational study included patients who underwent surgery for cervical compressive myelopathy between 2009 and 2023. Pre-operative cervical magnetic resonance imaging (MRI) and postmyelographic computed tomography (CTM) axial images were assessed for spinal cord rotation, deformity, available space, and signal changes. Patients were classified into unilateral motor deficit (Group U) and symmetric transverse (Group ST) types, and were analyzed for specific imaging parameters.</p><p><strong>Results: </strong>The final analysis included 119 of the 812 identified patients. Group U patients were younger (59.1±13.8 years) and had higher Japanese Orthopaedic Association scores (10.6±2.7) compared with Group ST patients (71.1±11.0 years, 8.4±2.3). Group U showed significant morphological differences, including a reduced anterior-subarachnoid space and increased spinal cord rotation on the affected side. Group U exhibited significant differences in the median fissure rotation angle (7.4°±6.7°) and anterior-aspect rotation angle ratio (1.26±0.31) compared with Group ST (4.14°±3.87°, 1.10±0.14). Receiver operating characteristic curve analysis identified specific cutoff values for distinguishing Group U (2.80° for median fissure rotation angle and 1.116 for anterior-aspect rotation angle ratio). The MRI-based detection sensitivity was lower in Group U (27.6%) compared with in Group ST (68.9%).</p><p><strong>Conclusions: </strong>Unilateral motor deficits are associated with distinctive spinal cord rotational deformities, including a greater median fissure rotation angle and anterior-aspect rotation angle ratio. CTM is better than MRI for detecting unilateral motor deficits. Future research to improve treatment outcomes should focus on spinal cord circulation assessment using advanced imaging techniques.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"407-415"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between Health-Related Quality of Life and Sagittal Whole-Body Alignment, Standing Balance, and Skeletal Muscle Mass. 与健康相关的生活质量与矢状面全身对齐、站立平衡和骨骼肌质量的关系
IF 1.2
Spine Surgery and Related Research Pub Date : 2025-02-07 eCollection Date: 2025-07-27 DOI: 10.22603/ssrr.2024-0276
Shun Hatsushikano, Kazuhiro Hasegawa, Kei Watanabe, Ryuta Sasamoto
{"title":"Relationship between Health-Related Quality of Life and Sagittal Whole-Body Alignment, Standing Balance, and Skeletal Muscle Mass.","authors":"Shun Hatsushikano, Kazuhiro Hasegawa, Kei Watanabe, Ryuta Sasamoto","doi":"10.22603/ssrr.2024-0276","DOIUrl":"10.22603/ssrr.2024-0276","url":null,"abstract":"<p><strong>Introduction: </strong>Impaired standing alignment and postural instability diminish health-related quality of life (HRQOL). Reduced trunk muscle mass is correlated with worsened spinal alignment and HRQOL in patients with spinal disease. However, the interplay among standing balance, whole-body alignment, muscle mass, and HRQOL remains unclear. This study aimed to elucidate this relationship.</p><p><strong>Methods: </strong>This study evaluated the influence of whole-body alignment, standing balance, skeletal muscle mass (SMM), aging, and sex on HRQOL in healthy volunteers (HV; men/women: 37/63, median age: 45), patients with lumbar degeneration (LD; men/women: 100/100, median age: 65), and patients with spinal deformity (SD; men/women: 16/84, median age: 71). HRQOL was assessed using the Scoliosis Research Society-22 (SRS-22r). Whole-body alignment and standing balance were measured using EOS Imaging combined with simultaneous force plate measurements. SMM was measured using a medical body composition analyzer. Based on univariate analysis and multicollinearity, 10 selected parameters were used in multivariate logistic regression analysis to identify factors affecting SRS-22r.</p><p><strong>Results: </strong>The SRS-22r score was significantly higher in the HV group than in the LD and SD groups; however, there were no significant differences between men and women. The whole-body alignment and standing balance were better in the HV group, followed by the LD and SD groups. The total-body SMM (SMM.total) of men was significantly lower in the LD and SD groups than in the HV group. In females, the SMM.total was significantly lower in the SD group than in the HV and LD groups. However, trunk SMM did not significantly differ among the three groups. Based on the multivariate analyses, diagnosis, body mass index (BMI), SMM.total, lumbar lordosis (LL), and T1 pelvic angle (TPA) were correlated with the SRS-22r score.</p><p><strong>Conclusions: </strong>HRQOL was negatively affected by spinal disease, as well as by higher BMI, lower SMM.total, and sagittal malalignment (smaller LL and greater TPA).</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"416-425"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation the Efficiency of Braces for Degenerative Scoliosis: A Systematic Review of Literature. 评估支架治疗退行性脊柱侧凸的有效性:文献系统综述。
IF 1.2
Spine Surgery and Related Research Pub Date : 2025-02-07 eCollection Date: 2025-05-27 DOI: 10.22603/ssrr.2024-0162
Mohammad Taghi Karimi, Parvaneh Bazipour
{"title":"Evaluation the Efficiency of Braces for Degenerative Scoliosis: A Systematic Review of Literature.","authors":"Mohammad Taghi Karimi, Parvaneh Bazipour","doi":"10.22603/ssrr.2024-0162","DOIUrl":"10.22603/ssrr.2024-0162","url":null,"abstract":"<p><strong>Background: </strong>Degenerative scoliosis is a progressive side-to-side deformity of the spine that is common in mature individuals, characterized by a Cobb angle of >10°. Current treatment options vary and can be categorized as conservative or non-conservative (surgery), with the primary goal of pain reduction. However, there is conflicting evidence regarding which treatment option is most effective. The aim of this study was to determine the effectiveness of braces in this group of subjects.</p><p><strong>Methods: </strong>A systematic search was conducted in databases including PubMed, Web of Science, Scopus, and Embase for the period between 1950 and 2024. Keywords used were: (degenerative scoliosis OR adult scoliosis) AND (conservative treatment OR brace OR orthosis). The quality of the selected studies was evaluated using the Downs and Black tool.</p><p><strong>Results: </strong>Of 500 papers identified in the search, a total of 11 studies were chosen for final analysis. Most of the selected studies focused on the effects of various types of braces on pain intensity, quality of life, and functional performance in subjects with degenerative scoliosis.</p><p><strong>Conclusions: </strong>Based on the available literature and the lack of strong studies on the effectiveness of braces, it cannot be definitively concluded that the use of braces reduces the severity of scoliosis curves in adults with degenerative scoliosis. However, braces may have an impact on quality of life and pain severity in this group of subjects.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"283-288"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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