Spine Surgery and Related Research最新文献

{"title":"Percutaneous Spondylolysis Repair Using Headless Compression Screws with a Cortical Bone Trajectory: A Technical Description and Case Series.","authors":"Naoki Aoyama, Katsuhito Kiyasu, Ryuichi Takemasa, Nobuaki Tadokoro, Shuhei Mizobuchi, Masahiko Ikeuchi","doi":"10.22603/ssrr.2024-0262","DOIUrl":"10.22603/ssrr.2024-0262","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar spondylolysis (LS) is a stress fracture of the pars interarticularis that can occur in adolescents. Both early- and progressive-stage LS can be successfully treated with conservative therapy consisting of activity modification and external bracing; however, conservative therapy is not suitable for athletes who hope for an early return to sports. We introduce a novel, minimally invasive surgical technique for the treatment of LS that enables an early return to sports and describe surgical results, including bone union rates, time of both bone unions, and return to sports.</p><p><strong>Technical note: </strong>To facilitate an early return to sports in adolescent athletes with early-to-progressive-stage LS, we developed a percutaneous spondylolysis repair technique using cannulated compression headless screws with a cortical bone trajectory. Fourteen adolescent athletes underwent this technique; as a result, all athletes achieved bone union and returned to sports within 3 months.</p><p><strong>Conclusions: </strong>This minimally invasive surgical technique for LS can achieve early bone union in adolescent athletes, thereby facilitating an early return to sports.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"375-380"},"PeriodicalIF":1.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275940","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":"Data-driven Preoperative Albumin Level Predicts Increased Risk of 30-day Surgical Site Infection Following Anterior Cervical Discectomy and Fusion.","authors":"Abhisri Ramesh, John G Parel, Eric Cui, Philip M Parel, Theodore Quan, Thomas Abraham, Addisu Mesfin","doi":"10.22603/ssrr.2024-0296","DOIUrl":"10.22603/ssrr.2024-0296","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative infection remains a significant concern and technical challenge for spine surgeons. Preoperative albumin level may predict risk of infection, but no definitive consensus regarding the optimal preoperative albumin level in anterior cervical discectomy and fusion (ACDF) has been reached. Therefore, this study aimed (1) to determine the impact of preoperative albumin on complications following ACDF and (2) to identify optimal albumin threshold that minimizes the likelihood of infection following ACDF.</p><p><strong>Methods: </strong>A retrospective cohort analysis was performed using a national database. Patients with a preoperative measurement of albumin prior to ACDF were included, whereas patients undergoing multilevel ACDF were excluded. Stratum-specific likelihood ratio (SSLR) analysis was conducted to determine data-driven albumin strata that minimized the likelihood of infectious complications within 30 days of ACDF.</p><p><strong>Results: </strong>A total of 30,896 ACDF patients were included in this study. Stratum-specific likelihood ratio analysis identified two albumin strata: 1-3 and 3+ g/dL prior to surgery. Relative to the 3+ g/dL cohort, the 1-3 g/dL cohort was more likely to experience 30-day infectious complications such as deep surgical site infection (SSI) (OR: 8.02, P<0.001) and SSI domain (OR: 4.85, P<0.001).</p><p><strong>Conclusions: </strong>This study demonstrates a significant association between preoperative albumin level and infectious complications following ACDF. These results emphasize the importance of integrating nutritional management strategies into the broader context of surgical decision-making, thus contributing to enhanced patient outcomes and quality of care in spine surgery.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"392-397"},"PeriodicalIF":1.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817538","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":"Incidence and Causes of In-Hospital Mortality Following Elective Spine Surgery in Elderly Patients: A Retrospective Multicenter Study of a Prospective Cohort.","authors":"Shunsuke Ohira, Yukimasa Yamato, Yuki Taniguchi, Naohiro Kawamura, Tetsusai Iizuka, Akiro Higashikawa, Naoto Komatsu, Yujiro Takeshita, Keiichiro Tozawa, Masayoshi Fukushima, Daiki Urayama, Takashi Ono, Nobuhiro Hara, Kazuhiro Masuda, Seiichi Azuma, Hiroki Iwai, Masahito Oshina, Shurei Sugita, Shima Hirai, Katsuyuki Sasaki, Hiroyuki Nakarai, Nozomu Ohtomo, Hideki Nakamoto, So Kato, Yoshitaka Matsubayashi, Sakae Tanaka, Yasushi Oshima","doi":"10.22603/ssrr.2024-0225","DOIUrl":"10.22603/ssrr.2024-0225","url":null,"abstract":"<p><strong>Introduction: </strong>Despite an increase in the demand for surgical treatment of elderly patients with degenerative spinal disorders, little is known about mortality following spinal surgery in this population. This study aims to identify the incidence and causes of in-hospital mortality in elderly patients after elective spine surgery.</p><p><strong>Methods: </strong>We extracted the data of patients aged ≥65 years who underwent elective spine surgery between December 12, 2016, and May 31, 2022, from our prospective multicenter cohort. The primary outcome was the in-hospital mortality rate. Univariate analysis was conducted to identify potential risk factors for postoperative mortality. The detailed clinical course of patients who died was retrospectively investigated using medical records.</p><p><strong>Results: </strong>A total of 10,976 eligible patients (5,976 males and 5,000 females), with a mean age of 75.5 years, were identified. There were eight in-hospital deaths (0.07%). Univariate analyses showed that the eight patients were significantly older (82.1 years vs. 75.5 years, P=0.008), were more frequently hemodialysis-dependent (50.0% vs. 2.9%, P<0.001), and had a higher proportion of cases with cervical surgery (62.5% vs. 17.0%, P<0.001) and preoperative American Society of Anesthesiologists Physical Status ≥3 (87.5% vs. 14.6%, P<0.001). Death occurred at a median of 24.5 days postoperatively. The causes of in-hospital death were as follows: gastrointestinal diseases in five cases (ischemic colitis in three cases, panperitonitis in one, and intestinal perforation in one), sepsis due to unknown causes in two, and lethal arrhythmia in one. The initial symptoms preceding the lethal clinical course were mainly common gastrointestinal symptoms, such as abdominal pain, anorexia, diarrhea, and vomiting.</p><p><strong>Conclusions: </strong>The main cause of in-hospital mortality was gastrointestinal disease. Surgeons should be aware that common gastrointestinal symptoms can be the initial symptoms of a subsequent lethal clinical course in elderly patients.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"331-338"},"PeriodicalIF":1.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275938","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":"Biportal Endoscopic Spinal Surgery for Posterior Decompression of Thoracic Myelopathy Caused by Single-level Thoracic Ossification of the Ligamentum Flavum.","authors":"Zhuolin Zhong, Jingjing Ying, Hongwei Wu, Shaohua Zhang, Mingshuai Ying, Qingfeng Hu","doi":"10.22603/ssrr.2024-0094","DOIUrl":"10.22603/ssrr.2024-0094","url":null,"abstract":"<p><strong>Introduction: </strong>Thoracic ossification of the ligamentum flavum (T-OLF), which leads to neurological impairment, is a rare pathologic entity. Open posterior laminectomy is the gold standard treatment for T-OLF. However, the high rates of postoperative complications and perioperative morbidity have raised many concerns among surgeons. This study presented a series of patients with symptomatic single-level T-OLF who underwent posterior decompression using biportal endoscopic spinal surgery (BESS). The objective of this study was to demonstrate our procedure using BESS for T-OLF resection and to evaluate its safety and efficacy.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who previously underwent thoracic posterior decompression with BESS between February 2021 and March 2023. Neurological status was assessed using the revised Japanese Orthopedic Association (JOA) score for thoracic myelopathy before surgery and at the final follow-up, along with the recovery rate (RR) at the final follow-up. The radiological outcome was evaluated by measuring the cross-sectional area (CSA) of the spinal canal from the T2 axial images at the most stenotic level, before and after surgery.</p><p><strong>Results: </strong>Twenty patients (8 male and 12 female; aged between 38 and 79 years) were enrolled in this study. The mean operation time was 89.7±21.8 min. The average JOA score was 5.6±1.1 before surgery and 9.1±1.0 at the final follow-up. The average RR at the final follow-up was 65.6%. Outcomes were classified as excellent in six patients (30.0%), good in nine patients (45.0%), and moderate in five patients (25.0%), with no cases categorized as fair or worsened (0%). The mean preoperative and postoperative CSA were 0.92±0.14 cm² and 1.38±0.22 cm², respectively.</p><p><strong>Conclusions: </strong>BESS is a safe, effective, and minimally invasive alternative to conventional open surgery for single-level T-OLF.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"321-330"},"PeriodicalIF":1.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275930","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":"Comparative Study between Full-Endoscopic Transforaminal Approach Lumbar Interbody Fusion (TF-LIF) Using PETLIF System and Minimally Invasive TLIF for Degenerative Lumbar Spine Disorders.","authors":"Katsuhisa Yamada, Ken Nagahama, Hisataka Suzuki, Yuichiro Abe, Shigeto Hiratsuka, Yohei Sodeyama, Daisuke Ukeba, Hiroyuki Tachi, Tsutomu Endo, Takashi Ohnishi, Yuichi Hasegawa, Hideki Sudo, Takahiko Hyakumachi, Norimasa Iwasaki","doi":"10.22603/ssrr.2024-0254","DOIUrl":"10.22603/ssrr.2024-0254","url":null,"abstract":"<p><strong>Introduction: </strong>To compare the clinical outcomes between a full-endoscopic transforaminal approach lumbar interbody fusion (TF-LIF) using the percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) system and a minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).</p><p><strong>Methods: </strong>A total of 102 patients (80 females, 22 males; mean age: 70.0 years) with degenerative lumbar spine disorders who underwent PETLIF and were followed up for 2 years were assigned to the PETLIF group. Based on age, sex, and operated lumbar levels in the PETLIF group, 100 patients (71 women and 29 men; mean age: 68.9 years) who underwent MIS-TLIF were randomly selected and included in the MIS-TLIF group. This retrospective investigation included surgical data, radiographic assessment, and clinical outcomes.</p><p><strong>Results: </strong>The fusion rate was 95.1% and 96.0% in the PETLIF and MIS-TLIF groups, respectively (<i>P</i>=0.38). The decrease in hemoglobin levels from before surgery to 1 day after surgery was significantly lower in the PETLIF group than in the MIS-TLIF group (<i>P</i><0.01). Five patients had detectable transient neurologic disorders after PETLIF that were resolved within 3 months. The increase in the local lordosis angle from before surgery to the final follow-up was significantly higher in the MIS-TLIF group than in the PETLIF group (<i>P</i><0.01). Clinical scores were comparable between the two groups.</p><p><strong>Conclusions: </strong>Compared with MIS-TLIF, PETLIF showed excellent bone fusion rate and clinical outcomes. It was minimally invasive, resulting in less blood loss. However, exiting nerve root injury was a PETLIF-specific complication, and proper preventive management, including techniques to enlarge the Kambin's triangle, is required.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 4","pages":"460-468"},"PeriodicalIF":1.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12330369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817537","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":"Electromagnetic Navigation in Biportal Endoscopic Lumbar Spine Surgery.","authors":"Dhivakaran Gengatharan, Walter Soon Yaw Wong, Lee Kai Lin, John Wen Cong Thng, Huang Yilun","doi":"10.22603/ssrr.2024-0257","DOIUrl":"https://doi.org/10.22603/ssrr.2024-0257","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic Spine Surgery (ESS) has begun to gain traction as an alternative to traditional microscopic spine surgery, particularly for lumbar decompression. However, one of the challenges associated with this approach is the steep learning curve. A recent advancement in this field aims to flatten the learning curve by incorporating navigation into ESS. This technology provides valuable information on the extent of decompression, confirms the working level, and reduces radiation exposure.</p><p><strong>Technical note: </strong>We aimed to describe our experience using electromagnetic navigation in biportal endoscopic spine surgery (BESS). The surgical technique is initiated by positioning the patient prone on a radiolucent table. The navigation field generator is positioned over the caudal end of the patient. The navigation system is set up with patient mappers at the desired working levels. The patient tracker is implanted. The final fluoroscopy images are captured in anteroposterior and lateral views. Subsequently, standard incisions are made, and endoscopic decompression is performed. When required, various instruments can be used to confirm the level, angulation, and extent of decompression.</p><p><strong>Conclusions: </strong>Our experience showed that this approach reduced the need for intraoperative imaging and provided an accurate alternative to repeated intraoperative imaging. However, it does involve a significantly long setup. Further trials of larger scale are required to determine its efficacy.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 2","pages":"258-262"},"PeriodicalIF":1.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019191","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":"Does Sagittal Spinal Alignment Predict Future Fall-Related Fractures in Community-Dwelling Women with Osteoporosis?","authors":"Ryoma Asahi, Yutaka Nakamura, Masayoshi Kanai, Kohei Maruya, Satoshi Asano","doi":"10.22603/ssrr.2024-0248","DOIUrl":"10.22603/ssrr.2024-0248","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal alignment in women with osteoporosis tends to deteriorate with advancing age, and this misalignment may serve as an indicator of future fall-related fractures. Vertebral fractures, which commonly occur in patients with osteoporosis, have distinct characteristics compared with other fall-related fractures and should therefore be separately evaluated. This study aimed to investigate the association between future fall-related fractures and sagittal spinal alignment, excluding vertebral fractures.</p><p><strong>Methods: </strong>A total of 333 women with osteoporosis were recruited and followed up between November 2013 and July 2024. At baseline, information on medication status and bone mineral density in the lumbar spine and femoral neck was obtained from the patients' medical record. Furthermore, the locomotive syndrome (LOCOMO) stage was assessed via risk tests, and sagittal alignment parameters, including sagittal vertical axis (SVA), thoracic kyphosis (TK), pelvic incidence (PI), and lumbar lordosis (LL), were evaluated. In addition, Cox proportional hazards regression analysis was conducted to determine the risk of fall-related fractures based on all variables.</p><p><strong>Results: </strong>The mean follow-up period was 5.4 years. The final sample for assessing fall-related fracture incidence consisted of 214 participants. Fall-related fractures occurred in 31 of the 333 participants (9.3%). Cox proportional hazards regression analysis, adjusted for all variables, revealed that SVA (hazard ratio [HR]=1.011, 95% confidence interval [CI] 1.003-1.02), LL (HR=1.039, 95% CI 1.007-1.072), LOCOMO stage (HR=1.801, 95% CI 1.127-2.879), and presence of parathyroid hormone (HR=0.165, 95% CI 0.031-0.891) are independent risk factors for future fall-related fractures.</p><p><strong>Conclusions: </strong>Awareness of fall-related fracture risks can be increased by monitoring the SVA, LL, and LOCOMO stage as well as administering parathyroid hormone medications. While the deterioration of sagittal spinal alignment is a well-known factor in vertebral fractures, this study suggests that future fall-related fractures, excluding vertebral fractures, are influenced by sagittal spinal alignment.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"350-357"},"PeriodicalIF":1.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275934","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":"Risk Factors and Consequences of Cage Subsidence after Single-level Posterior or Transforaminal Lumbar Interbody Fusion: A Retrospective Multicenter Study.","authors":"Hoai T P Dinh, Hiroki Ushirozako, Tomohiko Hasegawa, Shigeto Ebata, Tetsuro Ohba, Hiroki Oba, Keijiro Mukaiyama, Yu Yamato, Go Yoshida, Tomohiro Banno, Hideyuki Arima, Shin Oe, Koichiro Ide, Tomohiro Yamada, Kenta Kurosu, Toshiyuki Ojima, Jun Takahashi, Hirotaka Haro, Yukihiro Matsuyama","doi":"10.22603/ssrr.2024-0241","DOIUrl":"10.22603/ssrr.2024-0241","url":null,"abstract":"<p><strong>Introduction: </strong>Cage subsidence (CS) after posterior or transforaminal lumbar interbody fusion (PLIF or TLIF) is challenging; however, its impact on health-related quality of life (HRQOL) remains unclear. This study aimed to explore the impact of CS occurrence on HRQOL and identify the risk factors in patients following PLIF or TLIF.</p><p><strong>Methods: </strong>A total of 138 patients (mean age, 67 years; follow-up period, 12 months) who underwent single-level PLIF or TLIF were retrospectively analyzed. CS was defined as >1 mm sinking of the intervertebral cage evaluated via computed tomography. The patients were divided into the CS and nonsubsidence (NS) groups. HRQOL was assessed using the Oswestry Disability Index (ODI) scores.</p><p><strong>Results: </strong>Among the 138 patients, 30 (22%) developed CS following PLIF or TLIF. All cases with TLIF surgery (n=25) involved the use of one cage. A significant difference was observed in the use of two cages between the CS and NS groups (20.0% vs. 48.1%; <i>P</i>=0.006). The CS group had lower occupancy rate of autograft soon after the operation than the NS groups (<i>P</i>=0.002), and the occupancy rate of autograft tended to decrease in the CS group compared with the NS group over time. The ODI scores improved in both groups postoperatively; however, the NS group exhibited greater improvements in ODI scores from 4 months postoperatively. The CS group had a significantly lower proportion of patients with intervertebral osseous union at 6 and 12 months postoperatively compared with the NS group (<i>P</i>=0.003 and <i>P</i><0.001, respectively).</p><p><strong>Conclusions: </strong>The use of two intervertebral cages may enhance initial stability and reduce CS risk after PLIF. Initial intervertebral stability was crucial to preventing CS occurrence, as evidenced by the high occupancy rates of autograft in patients without CS. Surgical factors, including surgical strategy and intraoperative techniques, should be considered to prevent CS occurrence and to improve surgical outcomes and patient satisfaction.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"339-349"},"PeriodicalIF":1.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275942","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":"Complete Resolution of Hematoma after Vertebroplasty in Epidural Hematoma Associated with Acute Osteoporotic Vertebral Fracture: A Case Report.","authors":"Jong-Pil Kim, Ho-Min Lee, Chan-In Seo","doi":"10.22603/ssrr.2024-0170","DOIUrl":"10.22603/ssrr.2024-0170","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"381-383"},"PeriodicalIF":1.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275932","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":"\"Koshimagari Exercise\" for Adult Spinal Deformity in Older Adults: Assessment of Home-Based Exercise Outcomes in a Prospective Multicenter Study.","authors":"Hidetomi Terai, Shinji Takahashi, Masatoshi Hoshino, Hiroshi Taniwaki, Koji Tamai, Toshimitsu Ohmine, Tamotsu Nakatsuchi, Goya Shinbashi, Masatoshi Teraguchi, Masakazu Minetama, Kei Watanabe, Naritoshi Sato, Takuya Kitamura, Masaru Kanda, Tadao Tsujio, Yuichi Takeuchi, Tatsuki Mizouchi, Katsuhito Ishizu, Toshihito Ebina, Yasunari Muraoka, Tomonori Sodeyama, Hiroshi Mikami, Yuji Kasukawa, Takahiko Hyakumachi, Kazuhiro Ishida, Kazufumi Miyagishima, Yosuke Oishi, Kiyonori Yo, Ryota Kimura, Hiromichi Sato, Keiji Nagata, Yu Yamato, Ko Matsudaira, Naohisa Miyakoshi, Yukihiro Matsuyama, Hirotaka Haro, Hiroshi Hashizume, Hiroshi Yamada, Takashi Kaito","doi":"10.22603/ssrr.2024-0273","DOIUrl":"10.22603/ssrr.2024-0273","url":null,"abstract":"<p><strong>Introduction: </strong>Adult spinal deformity (ASD) is prevalent among older adults, considerably affecting their quality of life. Although surgical interventions are effective, they have high complication rates and medical costs. Furthermore, there is a lack of evidence supporting the effectiveness of nonsurgical treatments (e.g., physical therapy) in patients with ASD. This study aimed to investigate the impact of \"Koshimagari exercise,\" a specific home-based exercise regimen designed for patients with ASD, and to evaluate its effects on clinical outcomes in older adults.</p><p><strong>Methods: </strong>A total of 144 participants aged 50-80 years with chronic low back pain (LBP) due to spinal deformities were included in this multicenter prospective study. Qualified physiotherapists conducted intervention sessions at the hospital once a week, and self-exercise was performed at home three times a week. After 3 months, the frequency of self-exercise at home increased to four times a week. Clinical evaluations were conducted using the Oswestry Disability Index (ODI), five-level classification system of EuroQol-5 Dimensions (EQ-5D), Japanese edition of Scoliosis Research Society-22r (SRS-22r), and visual analog scale (VAS) for LBP at baseline and 3, 6, and 12 months. Radiographic evaluations were performed in standing and supine positions.</p><p><strong>Results: </strong>Of 130 participants who provided written informed consent, 98 completed the 6-month follow-up and were included in the analysis. Significant improvements observed in ODI, EQ-5D, and VAS scores were observed at 3 months, with SRS-22r scores improving throughout the study period. Radiographically, there were significant differences in the sagittal vertical axis and pelvic tilt at 12 months. Sufficient compliance with the self-exercise program was reported by 96%, 86%, and 73% of participants at 3, 6, and 12 months, respectively.</p><p><strong>Conclusions: </strong>The \"Koshimagari Exercise\" program led to significant short-term improvements in health-related quality of life and pain among elderly patients with ASD. This home-based self-exercise program is an excellent nonsurgical treatment option for patients with ASD.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"9 3","pages":"358-367"},"PeriodicalIF":1.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275928","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}