Spine Surgery and Related Research最新文献

{"title":"A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis.","authors":"Masaki Tatsumura,&nbsp;Shun Okuwaki,&nbsp;Hisarnori Gamada,&nbsp;Reo Asai,&nbsp;Fumihiko Eto,&nbsp;Katsuya Nagashima,&nbsp;Yosuke Takeuchi,&nbsp;Toru Funayama,&nbsp;Masashi Yamazaki","doi":"10.22603/ssrr.2023-0021","DOIUrl":"10.22603/ssrr.2023-0021","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar spondylolysis is a common fatigue fracture of the pars interarticularis of the lamina of the lumbar spine in adolescent athletes presenting with pars clefts. Some pseudarthrotic lumbar spondylolysis causes low back pain or radiculopathy. This study presents a case of pseudarthrotic lumbar spondylolysis that was successfully treated using a modified smiley face rod technique.</p><p><strong>Technical note: </strong>We developed a modified smiley face rod technique, which places pedicle screws in the lateral edge of the pedicle to preserve the erector spinae muscles and inserts a U-shaped rod between the spinous processes to preserve the supraspinous ligament. When a U-shaped rod penetrates the interspinous ligament subcutaneously, the resection of the supraspinous ligaments can be avoided. When the screw head is positioned more anterolaterally, a compression force is applied perpendicular to the surface of the pars cleft by rod clamping. This intrasegmental fusion technique preserves the mobile segment and simultaneously repairs the pars cleft. It is less invasive and more appropriate than interbody fusion for young athletes to avoid the possibility of future adjacent segment disorders.</p><p><strong>Conclusions: </strong>This is a minimally invasive procedure that can easily achieve bone fusion and should be introduced for patients who are suffering from the symptoms of pseudarthrotic lumbar spondylolysis.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/b9/2432-261X-7-0396.PMC10447201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10109061","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}

{"title":"Median Arcuate Ligament and Origin of the Celiac Artery Proximity Change in Patients after Surgery to Correct Adult Spinal Deformity: Potential Risk Factors for Acute Celiac Artery Compression Syndrome.","authors":"Shuhei Ohyama, Toshiaki Kotani, Yasushi Iijima, Takahiro Sunami, Shun Okuwaki, Tsuyoshi Sakuma, Yosuke Ogata, Shuhei Iwata, Tsutomu Akazawa, Kazuhide Inage, Yasuhiro Shiga, Shohei Minami, Seiji Ohtori","doi":"10.22603/ssrr.2023-0051","DOIUrl":"10.22603/ssrr.2023-0051","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to determine whether the proximity of the median arcuate ligament (MAL) and the celiac artery (CA) changes in patients following surgery to correct adult spinal deformity (ASD). We hypothesized that the distance between the MAL and the CA shortens after corrective spinal surgery, which may cause acute celiac artery compression syndrome (ACACS).</p><p><strong>Methods: </strong>A total of 89 patients (68.4±7.6 years; 7 men/82 women) with ASD treated with spinal correction surgery were included in the present retrospective study. The level of the MAL, CA, and distance between the MAL and the CA (DMC) were determined <i>via</i> reconstructed computed tomography. MAL overlap was determined preoperatively and postoperatively.</p><p><strong>Results: </strong>The MAL and CA moved caudally following surgery. On average, after surgery, no changes in DMC were observed. We found preoperative MAL overlap in 32 (36%) patients, who also had postoperative MAL overlap. No patients showed any MAL overlap postoperatively.</p><p><strong>Conclusions: </strong>Contrary to our hypothesis, the distance between the MAL and the CA did not shorten, and emerging MAL overlap was not observed postoperatively.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10710895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68230246","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}

{"title":"Efficacy and Safety of the Ultrasonic Bone Scalpel in Lumbar Laminectomies.","authors":"Anthony M Steinle,&nbsp;Jeffrey W Chen,&nbsp;Alexander O'Brien,&nbsp;Wilson E Vaughan,&nbsp;Andrew J Croft,&nbsp;W Hunter Waddell,&nbsp;Justin Vickery,&nbsp;Robert W Elrod,&nbsp;Hani Chanbour,&nbsp;Julian Lugo-Pico,&nbsp;Scott L Zuckerman,&nbsp;Amir M Abtahi,&nbsp;Byron F Stephens","doi":"10.22603/ssrr.2022-0138","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0138","url":null,"abstract":"<p><strong>Introduction: </strong>Despite recent advances in applied instruments and surgical techniques, the incidence of iatrogenic durotomies caused by traditional techniques remains significant. The ultrasonic bone scalpel (UBS) has been shown to improve speed and reduce complications in laminectomies in the cervical and thoracic spine when compared to traditional methods utilizing high-speed burr, punch forceps, or rongeurs. Thus, in this study, we aim to evaluate whether the use of the UBS in the lumbar spine would result in equivalent safety, efficacy, and patient-reported outcomes (PROs) improvement when compared to traditional methods of laminectomy.</p><p><strong>Methods: </strong>Data from a prospectively collected, single-institution registry was queried between January 1, 2019 and September 1, 2021 for patients with a primary diagnosis of lumbar stenosis who received a laminectomy (with or without fusion) using traditional methods or UBS method. Outcomes included 3-month and 12-month values for all PROs Measurement Information System (PROMIS) subdomains, Numerical Rating Scale (NRS) pain score, Oswestry Disability Index (ODI) percentage, Patient Health Questionnaire 9 (PHQ-9) score, operative complications, reoperations, and readmissions. Covariates selected for matching included age, operation type, and number of levels. A variety of statistical tests were utilized.</p><p><strong>Results: </strong>As per our findings, 2:1 propensity matching resulted in 64 \"traditional group\" patients and 32 \"UBS group\" patients. Post-match analysis found no differences between the traditional and UBS groups for demographic and baseline measures except for race and ethnicity. For the matched sample, no differences were noted in PROs, reoperations, or readmissions. There was a significant difference in rates of durotomies between the traditional and UBS groups (12.5% vs. 0.0%, p=0.049).</p><p><strong>Conclusions: </strong>Results showed the high-frequency oscillation technology implemented by the UBS helps to decrease the rate of injury to the dura, thus reducing the overall incidence of iatrogenic durotomies. We believe these data provide valuable information to surgeons and patients about the safety and efficacy of the UBS in performing lumbar laminectomies.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/8c/2432-261X-7-0242.PMC10257968.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9627326","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}

{"title":"Quantitative Biomechanical Evaluation for Optimal Spinal Instrumentation to Prevent Mechanical Complications in Spinal Fusion from the Lower Thoracic Spine to the Pelvis for Adult Spinal Deformity: A Finite Element Analysis.","authors":"Takuhei Kozaki,&nbsp;Shunji Tsutsui,&nbsp;Ei Yamamoto,&nbsp;Akimasa Murata,&nbsp;Ryuichiro Nakanishi,&nbsp;Hiroshi Yamada","doi":"10.22603/ssrr.2022-0131","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0131","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical complications, such as rod fracture (RF) and proximal junctional kyphosis (PJK), commonly occur after adult spinal deformity (ASD) surgery. A rigid construct is preferred to prevent RF, whereas it is a risk factor for PJK. This controversial issue urged us to conduct a biomechanical study for seeking the optimal construct to prevent mechanical complications.</p><p><strong>Methods: </strong>A three-dimensional nonlinear finite element model, which consisted of the lower thoracic and lumbar spine, pelvis, and femur, was created. The model was instrumented with pedicle screws (PSs), S2-alar-iliac screws, lumbar interbody fusion cages, and rods. Rod stress was measured when a forward-bending load was applied at the top of the construct to evaluate the risk of RF in constructs with or without accessory rods (ARs). In addition, fracture analysis around the uppermost instrumented vertebra (UIV) was performed to assess the risk of PJK.</p><p><strong>Results: </strong>Changing the rod material from titanium alloy (Ti) to cobalt chrome (CoCr) decreased shearing stress at L5-S1 by 11.5%, and adding ARs decreased it by up to 34.3% (for the shortest ARs). Although the trajectory (straightforward vs. anatomical) of PSs did not affect the fracture load for UIV+1, changing the anchor from PSs to hooks at the UIV reduced it by 14.8%. Changing the rod material from Ti to CoCr did not alter the load, whereas the load decreased by up to 25.1% as the AR became longer.</p><p><strong>Conclusions: </strong>The PSs at the UIV in the lower thoracic spine, CoCr rods as primary rods, and shorter ARs should be used in long fusion for ASD to prevent mechanical complications.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/32/2432-261X-7-0276.PMC10257959.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9982417","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}

{"title":"Systematic Literature Review and Meta-Analysis on the Clinical Outcomes of Spine Surgeries in Patients with Concurrent Osteoporosis.","authors":"Mami Ogiri,&nbsp;Kotaro Nishida,&nbsp;HyeJin Park,&nbsp;Anne Rossi","doi":"10.22603/ssrr.2022-0198","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0198","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is common among elderly patients and can result in vertebral fractures requiring surgical treatment. This study assessed clinical outcomes associated with spinal surgery in patients with osteoporosis/osteopenia with an additional focus on Asian patients.</p><p><strong>Methods: </strong>A PRISMA-compliant systematic review and meta-analysis were conducted using the PubMed and ProQuest databases to identify articles published up to May 27, 2021, that included outcomes for patients with osteoporosis or osteopenia undergoing spinal surgery. Statistical analysis was conducted comparing rates of proximal junctional kyphosis (PJK)/proximal junctional failure (PJF), implant loosening, and revision surgery. A qualitative summary of Asian studies was also conducted.</p><p><strong>Results: </strong>A total of 16 studies comprising 133,086 patients were included; among the 15 studies reporting rates of osteoporosis/osteopenia, 12.1% (16,127/132,302) of patients overall and 38.0% (106/279) of Asian patients (n=4 studies) had osteoporosis/osteopenia. The risks of PJK/PJF (relative risk [RR]=1.89; 95% confidence interval [CI]=1.22-2.92, p=0.004), screw loosening (RR=2.59; 95% CI=1.67-4.01, p<0.0001), and revision surgery (RR=1.65; 95% CI=1.13-2.42, p=0.010) were higher in patients with poor bone quality compared with those with healthy bone. In the qualitative review of Asian studies, all studies found that osteoporosis increased the risk of complications and/or revision for spinal surgery patients.</p><p><strong>Conclusions: </strong>This systematic literature review and meta-analysis indicate that spinal surgery patients with compromised bone quality have more complications and higher healthcare utilization than those with normal bone quality. To our knowledge, this is the first study to focus on the pathophysiology and disease burden among Asian patients. Given the high rate of poor bone quality in this aging population, additional high-quality Asian studies, with uniform definitions and data reporting, are needed.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3c/1f/2432-261X-7-0200.PMC10257961.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9982419","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}

{"title":"Letter to the Editor Concerning \"Frequency of Change in Assessment from Bony Union to Nonunion after Lumbar Interbody Fusion: A Multicenter Study\" by Oba et al.","authors":"Masatsugu Tsukamoto,&nbsp;Tadatsugu Morimoto,&nbsp;Tomohito Yoshihara,&nbsp;Masaaki Mawatari","doi":"10.22603/ssrr.2022-0033","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0033","url":null,"abstract":"Letter to the Editor: It was our pleasure to read the article by Oba et al., and we were surprised to find that even with obvious early postoperative bony union, more than a quarter of patients may be in a state of fake union. We agree that careful follow-up is still needed and that weekly teriparatide may be effective in reducing the rate. However, we would like to comment on the authors’ methodology. First, in this study, computed tomography seems to have been performed four times a year, including preoperatively. Considering that this is a very high rate, could the authors have made any effort to reduce the amount of radiation exposure? Second, in addition to bony union, it might have been advisable to evaluate vertebral endplate cysts, which can be a predictor of pseudoarthrosis caused by delayed bone fusion due to micromotion or poor initial fixation. Vertebral endplate cysts are more common, simpler, and easier to evaluate than bony union and may provide new insights on the relationship between the new appearance of cysts and the trend toward increased size and fake union. Third, it is possible that there was no significant difference in the assessment of osteoporosis because the young adult mean (YAM) of the hip was used. Although it might be better to use the YAM of the lumbar spine for the assessment of bone fusion, it should be noted that this YAM is affected by osteophytes and vertebral fractures. Therefore, it would have been better to use the Hounsfield unit of the fixed vertebral body for the evaluation of osteoporosis. Fourth, the results were evaluated with and without osteoporosis drugs, but was there any possibility that the results were altered depending on the contents of the drugs, including bisphosphonate? It is well known that a history of bisphosphonate therapy attenuates the osteogenic effect of teriparatide. Finally, we would like to point out that it may be too early to judge fusion or nonfusion at 6 months postoperatively. Tokuhashi et al. reported that the clear zone around the pedicle screw observed at 6 months postoperatively might show improvement during up to 2 years postoperatively. We would be very interested to know how the fake union increases or decreases at 12 months or 2 years postoperatively. We sincerely hope that the authors will conduct a long-term study.","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/1a/2432-261X-7-0293.PMC10257966.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9999175","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}

{"title":"Intraosseous Aggressive Schwannoma in the Lumbar Spine: A Case Report.","authors":"Takashi Hirai,&nbsp;Toshitaka Yoshii,&nbsp;Hiroyuki Inose,&nbsp;Yu Matsukura,&nbsp;Yuki Funauchi,&nbsp;Satoru Egawa,&nbsp;Kurando Utagawa,&nbsp;Jun Hashimoto,&nbsp;Mariko Nishizawa,&nbsp;Kohei Yamamoto,&nbsp;Atsushi Okawa","doi":"10.22603/ssrr.2022-0168","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0168","url":null,"abstract":"A 66-year-old man was presented at another hospital with increased urinary frequency and lower limb numbness and was diagnosed with lumbar spinal canal stenosis (LSCS). Although he received prostaglandin as treatment for cauda equine caused by LSCS, the symptoms did not resolve. Results of the subsequent magnetic resonance imaging (MRI) revealed a solid tumor in the fifth lumbar vertebra (L5) and spinal canal (Fig. 1A-E). Interestingly, the tumor did not extend to the intervertebral foramen and did not form a dumbbell shape. He was referred to our hospital for surgical treatment. A computed tomography scan after myelogram was performed to investigate the dural sac in the spinal canal. The tumor was observed to completely fill the canal such that the dural sac was not detectable (Fig. 1F and G). There was no other tumor in the canal. Transpedicular biopsy revealed a cluster of spindle cells and the partial presence of a necrotic lesion, which was suspected to be intraosseous schwannoma. Because the facet joint at L5/S1 was disrupted due to scalloping caused by the tumor, L4-S1 posterior lateral fusion (PLF) with instrumentation as well as L5 and S1 laminectomy were performed to remove the giant tumor. After fenestration, remarkable compression of the dural sac caused by the giant tumor was confirmed (Fig. 2A). The tumor contents were completely removed using an ultrasonic aspirator (CUSA Clarity, Integra LifeSciences, Tokyo, Japan). Although foraminotomy was performed after a sufficient mass reduction in order to identify the inlet nerve root, we could not locate the nerve tissue that resembled a spinal nerve root. Finally, a capsule of the tumor and an adhesive band linked to the right L5 nerve root were isolated (Fig. 2B). Histological examination revealed schwannoma with 2.1% Ki-67-positive cells (Fig. 2C). Artificial bone cement containing polymethyl methacrylate (SpinePlex; Stryker Corporation, Kalamazoo, MI) was placed into the defect, and PLF was performed (Fig. 3A-D). Postoperative MRI showed that the tumor was completely removed, while scar tissue remained in front of the dural sac (Fig. 3E). His lower limb numbness gradually improved, and there was no tumor recurrence during the 2-year follow-up period; however, the urinary disorder persisted. Clinically, although schwannoma is a benign neural tumor and can occur anywhere in the body, intraosseous presentation is extremely rare, accounting for 0.2% of primary tumors. Notably, only 10 cases with aggressive intraosseous schwannoma in the lumbar spine have been reported to date (Table 1). Although spinal nerve sheath schwannoma often grows into the spinal canal and intervertebral foramen, thereby forming a dumbbell tumor usually with sclerotic and clear margins, aggressive intraosseous schwannoma can lead to invasive and osteolytic bone destruction in the vertebrae. Therefore, it is important in terms of radiological evaluation to understand the difficulty in differentiating between maligna","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/dd/2432-261X-7-0288.PMC10257963.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9680510","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}

{"title":"A Prospective Study to Evaluate the Clinical and Diffusion Tensor Imaging (DTI) Correlation in Patients with Lumbar Disc Herniation with Radiculopathy.","authors":"Roop Singh,&nbsp;Neeraj Khare,&nbsp;Shalini Aggarwal,&nbsp;Mantu Jain,&nbsp;Svareen Kaur,&nbsp;Harshil Deep Singh","doi":"10.22603/ssrr.2022-0159","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0159","url":null,"abstract":"<p><strong>Introduction: </strong>Conventional magnetic resonance imaging findings frequently do not correlate with the symptoms of lumbar disc herniation (LDH). Diffusion-weighted imaging can reveal important details about the microstructure of tissues. This study assessed the role of diffusion-weighted imaging (DTI) in LDH with radiculopathy and explored the relationship between DTI values and clinical scores.</p><p><strong>Methods: </strong>Forty-five patients with LDH with radiculopathy were evaluated via DTI at the intraspinal (IS), intraforaminal (IF), and extraforaminal (EF) levels. A visual analog scale (VAS) was used for low back and leg pain. The Japanese Orthopaedic Association (JOA) scoring system, Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RMDQ) were used for functional evaluation.</p><p><strong>Results: </strong>There was a statistically significantly (p<0.05) difference between the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values on the affected side compared with those on contralateral normal side. The VAS score had a weak positive correlation with RMDQ score (r=0.279, P=0.050). The JOA score had a moderate negative correlation with RMDQ score (r=-0.428, P=0.002), whereas the ODI score had a moderate positive correlation with RMDQ score (r=0.554, P<0.001). There was a moderate positive correlation between ADC values at the IF level and the RMDQ score on the affected side (r=0.310, P=0.029). There was no correlation between FA values and JOA score. ODI had a significantly positive correlation with the contralateral normal side FA values at the IF (r=0.399, P=0.015), EF (r=0.368, P=0.008) and IS (r=0.343, P=0.015) levels. RMDQ had a weak positive correlation with the contralateral normal side FA values at the IF (r=0.311, P=0.028), IS (r=0.297, P=0.036) and EF (r=0.297, P=0.036) levels.</p><p><strong>Conclusions: </strong>The decrease in FA values and the increase in ADC values are useful markers of compression. ADC correlates well with the patient's neurological symptoms and functional status. Conversely, FA correlates well with the patient's neurological symptoms, but is not correlated well with the functional status.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/fb/2432-261X-7-0257.PMC10257965.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9627327","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}

{"title":"Median Arcuate Ligament Resection before Surgery for Adult Spinal Deformity in Patient with Preoperative Stenosis of Celiac Artery: A Case Report.","authors":"Toshiaki Kotani,&nbsp;Shinichi Okazumi,&nbsp;Tsuyoshi Sakuma,&nbsp;Yasushi Iijima,&nbsp;Shun Okuwaki,&nbsp;Shuhei Ohyama,&nbsp;Shuhei Iwata,&nbsp;Kotaro Sakashita,&nbsp;Takahiro Sunami,&nbsp;Tsutomu Akazawa,&nbsp;Kazuhide Inage,&nbsp;Yasuhiro Shiga,&nbsp;Shohei Minami,&nbsp;Seiji Ohtori","doi":"10.22603/ssrr.2022-0176","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0176","url":null,"abstract":"1) Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan 2) Department of Surgery, Toho University Sakura Medical Center, Sakura, Japan 3) Department of Orthopedic Surgery, University of Tsukuba, Tsukuba, Japan 4) Department of Orthopedic Surgery, St. Marianna University, School of Medicine, Kawasaki, Japan 5) Department of Orthopedic Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/69/2432-261X-7-0284.PMC10257958.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9627325","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}

{"title":"Time Course and Characteristics of the Nutritional Conditions in Acute Traumatic Cervical Spinal Cord Injury.","authors":"Tetsuo Hayashi,&nbsp;Yuichi Fujiwara,&nbsp;Muneaki Masuda,&nbsp;Kensuke Kubota,&nbsp;Hiroaki Sakai,&nbsp;Osamu Kawano,&nbsp;Yuichiro Morishita,&nbsp;Kazuya Yokota,&nbsp;Takeshi Maeda","doi":"10.22603/ssrr.2022-0158","DOIUrl":"https://doi.org/10.22603/ssrr.2022-0158","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective cohort study aimed to examine the nutritional time course and elucidate the critical period of undernutrition following acute traumatic cervical spinal cord injury (CSCI).</p><p><strong>Methods: </strong>The study was performed at a single facility that treated spinal cord injuries. We examined individuals with acute traumatic CSCI admitted to our hospital within 3 days of injury. Both prognostic nutritional index (PNI) and controlling nutritional status (CONUT) scores, which objectively reflect nutritional and immunological conditions, were assessed at admission and 1, 2, and 3 months after the injury. The American Spinal Injury Association impairment scale (AIS) categorizations and severity of dysphagia were evaluated at these time points.</p><p><strong>Results: </strong>A total of 106 patients with CSCI were evaluated consecutively for 3 months after injury. Individuals with AIS categorizations of A, B, or C at 3 days after injury were significantly more undernourished than those with an AIS categorization of D at 3 months after injury, indicating that individuals with mild paresis better maintained their nutritional condition after injury. Nutritional conditions, as assessed by both PNI and CONUT scores, improved significantly between 1 and 2 months after injury, whereas no significant differences were found between admission and 1 month after injury. Nutritional status and dysphagia were significantly correlated at each time point (p<0.001), indicating that swallowing dysfunction is an important factor associated with malnutrition.</p><p><strong>Conclusions: </strong>Nutritional conditions showed significant gradual improvements from 1 month after the injury. We must pay attention to undernutrition, which is associated with dysphagia, especially in individuals with severe paralysis during the acute phase following injury.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/b6/2432-261X-7-0219.PMC10257967.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9680505","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}