Spine Surgery and Related Research最新文献

{"title":"Clinical Features of Older Patients with Lumbar Spinal Stenosis Who Discontinued Postoperative Follow-Up.","authors":"Takaya Imai, Takehiro Michikawa, Soya Kawabata, Yuki Akaike, Sota Nagai, Hiroki Takeda, Daiki Ikeda, Shinjiro Kaneko, Nobuyuki Fujita","doi":"10.22603/ssrr.2025-0396","DOIUrl":"10.22603/ssrr.2025-0396","url":null,"abstract":"<p><strong>Introduction: </strong>Although follow-up is recommended for 2 years after lumbar spinal stenosis (LSS) surgery, some patients fail to complete all follow-up visits. In recent years, the treatment burden on older adults has attracted increasing attention, with particular emphasis on outpatient visits. Thus, we aimed to clarify the clinical characteristics of older adults who discontinued postoperative follow-up between 1 and 2 years after LSS surgery.</p><p><strong>Methods: </strong>This retrospective study included consecutive patients aged ≥65 years who had undergone surgery for LSS at a single center between April 2020 and June 2023. At follow-up assessments scheduled 1 and 2 years after surgery, patients completed the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and the Zurich Claudication Questionnaire (ZCQ). The preoperative and 1-year postoperative JOABPEQ and ZCQ scores were statistically compared between patients who did and did not complete follow-up and were adjusted using analysis of covariance or the Poisson regression model.</p><p><strong>Results: </strong>Among the 330 patients who attended the 1-year follow-up visit, 252 (76.4%) attended the 2-year visit, whereas the remaining 78 (23.6%) did not. Patients who did not complete follow-up exhibited significantly higher rates of dyslipidemia (p=0.022), cardiovascular disease (p=0.005), and frailty (p=0.014), and a lower prevalence of spondylolisthesis (p<0.001) and fusion surgery (p<0.001), than those who completed the follow-up. Furthermore, patients who did not complete follow-up had worse scores in the psychological disorder domain of the JOABPEQ both preoperatively and at 1 year, and worse 1-year scores across all ZCQ domains than those who completed the follow-up.</p><p><strong>Conclusions: </strong>Several factors were associated with the likelihood of discontinuing postoperative follow-up among older adults with LSS, and their postoperative outcomes were poorer. Therefore, when analyzing data from older adults with LSS at 2 years postoperatively, considering the characteristics of patients who discontinued follow-up is essential.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"10 4","pages":"585-591"},"PeriodicalIF":1.6,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765463","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":"Validation of the Japanese Version of the Muscular Dystrophy Spine Questionnaire in Patients with Flaccid Neuromuscular Scoliosis in Japan.","authors":"Wataru Saito, Masayuki Miyagi, Yusuke Mimura, Yuji Yokozeki, Yoshihide Tanaka, Takayuki Imura, Toshiyuki Nakazawa, Takatoshi Sato, Keiko Ishigaki, Ayano Matsui, Hirofumi Komaki, Masashi Takaso, Gen Inoue","doi":"10.22603/ssrr.2025-0282","DOIUrl":"10.22603/ssrr.2025-0282","url":null,"abstract":"<p><strong>Introduction: </strong>Progressive spinal deformity is frequently observed in children with flaccid-type neuromuscular disease. Reports evaluating activities of daily living (ADL) or quality of life (QOL) for those with flaccid-type neuromuscular disease with spine deformity (fNMS) are limited. In Japan, there is no standard patient-based questionnaire in Japanese to evaluate ADL or QOL for fNMS. We have translated the Muscular Dystrophy Spine Questionnaire (MDSQ) from English into Japanese and evaluated the reliability and validity of the Japanese version of the MDSQ.</p><p><strong>Methods: </strong>We explained the Japanese MDSQ to patients at our regular outpatient clinic. The patients completed the questionnaire at home and mailed it to us. The questionnaire was administered twice, separated by two-week intervals, to establish reliability. We calculated the total score of the Japanese MDSQ and analyzed its correlation with whole spine X-ray parameters. We also analyzed the correlations between the 36-Item Short-Form Survey for QOL and the Japanese MDSQ scores.</p><p><strong>Results: </strong>We analyzed results from 26 patients (average age, 13 years). Those with Duchenne muscular dystrophy (11), spinal muscular atrophy (9), and other congenital diseases were included. The averaged scoliosis Cobb angle was 67.2°, pelvic obliquity (PO) was 19°, the maximum kyphosis Cobb angle was 62.3°, and spinal pelvic obliquity (SPO) was 27.4°. The total Japanese MDSQ scores at the first and second responses were 74.9±21.3 and 75.9±20.9, respectively. The reliability of the Japanese MDSQ was excellent, with an intraclass correlation coefficient of 0.90. Total MDSQ scores correlated with scoliosis Cobb angle, PO, and SPO.</p><p><strong>Conclusions: </strong>The Japanese MDSQ demonstrates excellent reliability and reflects the radiographic parameters of spinal and pelvic deformities in those with fNMS. It appears to be a sufficiently robust instrument for evaluating ADL in children with fNMS with spinopelvic deformity in Japan.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"10 3","pages":"425-431"},"PeriodicalIF":1.6,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253328","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":"Impact of Drop Foot Recovery on Patient-Reported Outcomes following Surgery for Lumbar Degenerative Disease.","authors":"Tatsuya Yamamoto, Momotaro Kawai, Tomohisa Tabata, Yohei Takahashi, Jun Ogawa","doi":"10.22603/ssrr.2025-0314","DOIUrl":"10.22603/ssrr.2025-0314","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with lumbar degenerative diseases (LDDs) presenting with drop foot, surgical outcomes have traditionally been assessed by neurological recovery, while studies using patient-reported outcomes (PROs) have been limited. This study retrospectively investigated whether recovery of drop foot influences improvements in PROs following surgery for LDDs.</p><p><strong>Methods: </strong>We retrospectively analyzed 54 surgically-treated patients with LDDs presenting with drop foot, with a minimum follow-up of 1 year. PROs were evaluated using the visual analog scale, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), the Zurich Claudication Questionnaire, and the Roland-Morris Disability Questionnaire (RMDQ).</p><p><strong>Results: </strong>Patients were divided into recovered (R, manual muscle test [MMT] ≥3) and unrecovered (U, MMT <3) groups. Demographics, etiology, and responsible roots were comparable. The R group had a higher proportion with a preoperative tibialis anterior (TA) MMT score of 2 (64.3% vs. 34.6%, p=0.029) and a shorter paralysis duration (31.7 vs. 70.9 days, p=0.001). Preoperative TA MMT was slightly higher in the R group, which improved to 4.4 at final follow-up compared with 1.3 in the U group (p=0.001). At final follow-up, the R group showed significantly better JOABPEQ walking ability and RMDQ scores. Minimal clinically important difference achievement rates were consistently higher in the R group, although most differences were not statistically significant.</p><p><strong>Conclusions: </strong>TA recovery in drop foot due to LDDs was associated with better walking ability and favorable PRO trends. Although statistical significance was limited, timely intervention and muscle recovery appear crucial for optimizing mid-term functional outcomes.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"10 3","pages":"432-439"},"PeriodicalIF":1.6,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253176","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":"Nationwide Trends and Safety Analysis of Adult Spinal Instrumentation Surgery: A Study using the JSIS-DB.","authors":"Hideyuki Arima, Haruki Ueda, Shunsuke Katsumi, Yusuke Hori, Junya Katayanagi, Atsushi Tagami, Mitsuru Yagi, Ryo Mizukoshi, Koji Yamada, Kimiaki Yokosuka, Yukihiro Matsuyama, Hiroshi Taneichi, Tokumi Kanemura, Akira Matsumura","doi":"10.22603/ssrr.2025-0321","DOIUrl":"10.22603/ssrr.2025-0321","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal instrumentation surgery is increasingly being performed in aging populations; however, comprehensive data regarding the nationwide trends and perioperative safety associated with these procedures in Japan remain limited. This study aimed to evaluate the epidemiological characteristics and complication profiles of adult spinal instrumentation surgery using the Japanese Spinal Instrumentation Society Database (JSIS-DB).</p><p><strong>Methods: </strong>A retrospective observational study was conducted using JSIS-DB data from 2018 to 2022. Adults aged ≥18 years who underwent spinal surgeries involving instrumentation across intervertebral levels were included. Data for demographic characteristics, diagnosis, surgical procedure, operative time, blood loss, and complications within 14 days of surgery were analyzed. The primary outcome was the overall perioperative complication rate, whereas the secondary outcomes included complication rates stratified by age and pathology.</p><p><strong>Results: </strong>A total of 28,832 cases were analyzed (mean age: 67.3±14.4 years; males: 48.7%). The most common diagnosis was degenerative disease (62.9%), followed by spinal deformity (15.4%), trauma (15.2%), tumors (3.5%), and infection (2.6%). The most frequently performed procedure was posterior lumbar interbody fusion (40.8%), followed by posterior or posterolateral fusion (32.6%). The overall complication rate was 11.0%. The specific complication rates were as follows: dural tears, 2.5%; nerve root disorders, 1.4%; epidural hematomas, 1.1%; surgical-site infections, 0.8%; spinal cord disorders, 0.4%; and mortality, 0.1%. Patients aged ≥90 years showed a significantly higher complication rate (18.6%, p<0.001). The complication rates by pathology were as follows: deformities, 13.9%; infections, 13.4%; tumors, 13.3%; trauma, 12.3%; and degenerative diseases, 9.8% (p<0.001).</p><p><strong>Conclusions: </strong>This nationwide registry-based study successfully visualized the real-world practices and risk profiles of adult spinal instrumentation surgery in Japan. Elderly patients and those with deformities, infections, or tumors showed significantly higher perioperative risks, highlighting the need for enhanced preoperative assessments and perioperative care. These findings provide foundational data to improve the safety and quality of spinal surgery.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"10 3","pages":"383-392"},"PeriodicalIF":1.6,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253140","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":"Preoperative Disc Height as a Prognostic Factor in Laminoplasty for Cervical Spondylotic Myelopathy with Degenerative Spondylolisthesis.","authors":"Yuta Doi, Kiyoshi Tarukado, Kazuya Yokota, Kazu Kobayakawa, Hirokazu Saiwai, Kenichi Kawaguchi, Yasuharu Nakashima","doi":"10.22603/ssrr.2025-0249","DOIUrl":"10.22603/ssrr.2025-0249","url":null,"abstract":"<p><strong>Introduction: </strong>Laminoplasty (LP) is widely used to treat cervical spondylotic myelopathy (CSM) with degenerative spondylolisthesis (DS), but predictors of postoperative outcomes remain unclear. This study aimed to identify factors associated with neurological recovery after LP in patients with CSM and DS.</p><p><strong>Methods: </strong>We retrospectively reviewed 136 patients who underwent LP for CSM between 2005 and 2020. Of these, 29 patients (20 men, 9 women) with DS at the responsible level were included. The responsible level was defined as the segment showing intramedullary signal change or cerebrospinal fluid space obliteration on magnetic resonance imaging. The mean age was 71.7 years (range: 50-87), with a mean follow-up of 5.5 years (range: 2-12). Patients were grouped on the basis of achievement of a ≥50% recovery rate (RR) in the Japanese Orthopaedic Association (JOA) score, defined as the minimum clinically important difference (MCID). Radiographic parameters, including C2-7 alignment, C2-7 range of motion (ROM), C7 slope, slip distance, segmental ROM, and disc height at the responsible level, in addition to Pfirrmann grade, were compared.</p><p><strong>Results: </strong>The mean JOA RR was 50.2%, with 66% achieving MCID. No statistically significant differences were found between the two groups in terms of C2-7 alignment, C2-7 ROM, C7 slope, slip distance, segmental ROM, or Pfirrmann grade. However, preoperative disc height was significantly greater in the Good Improvement group (5.9 mm) than in the Poor Improvement group (4.8 mm) (p=0.03).</p><p><strong>Conclusions: </strong>Greater preoperative disc height was associated with better neurological recovery, suggesting its potential utility as a simple prognostic marker in CSM with DS.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"10 3","pages":"376-382"},"PeriodicalIF":1.6,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253308","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":"Delayed Hemothorax following Adult Spinal Deformity Surgery: A Case Report.","authors":"Fumihiro Arizumi, Keishi Maruo, Akifumi Nakamura, Kazuya Kishima, Tetsuto Yamaura, Masaru Hatano, Toshiya Tachibana","doi":"10.22603/ssrr.2025-0251","DOIUrl":"10.22603/ssrr.2025-0251","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"10 2","pages":"315-317"},"PeriodicalIF":1.6,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692408","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":"Oblique-View Method Improves the Detection of cement leakage in Cement-Augmented Pedicle Screw Fixation.","authors":"Kazuya Kishima, Keishi Maruo, Fumihiro Arizumi, Tetsuto Yamaura, Masaru Hatano, Hayato Oishi, Kazuma Nagao, Kei Takagi, Yuki Ishida, Toshiya Tachibana","doi":"10.22603/ssrr.2025-0307","DOIUrl":"10.22603/ssrr.2025-0307","url":null,"abstract":"<p><strong>Introduction: </strong>Cement-augmented pedicle screws (CAPS) are increasingly used in surgeries for osteoporotic vertebral fractures (OVFs); however, cement leakage (CL) remains a concern. Lateral-view (LV) fluoroscopy, the conventional method for monitoring cement injection, has limited sensitivity in detecting early leakage. The oblique-view (OV) method may provide improved detection, although its role in CAPS fixation remains unclear.</p><p><strong>Methods: </strong>Data from 116 patients and 535 screws who underwent CAPS fixation for OVFs using the LV or OV method were retrospectively compared. Patient demographics, surgical factors, and CL incidence were analyzed. A novel computed tomography-based grading system for segmental vein CL was developed as follows: grade 0 (no CL), grade 1 (≤10 mm), grade 2 (>10 mm without exceeding the anterior border or ≤10 mm beyond the anterior border), and grade 3 (>10 mm beyond the anterior border).</p><p><strong>Results: </strong>Baseline demographics and surgical factors were comparable between the groups. Overall, CL was observed in 56% of the patients and 20.9% of the screws. The screw-based incidence of CL was significantly lower in the OV group than in the LV group (15.0% vs. 22.9%, p=0.047), although the CL severity did not differ. Intraoperative CL detection was significantly more effective in the OV group than in the LV group (37.2% vs. 91.7%, p<0.01), including grade 1 and 2 cases, and 67% of leakages were identified within 0.4 mL of injection. No major complications, such as pulmonary embolism, occurred.</p><p><strong>Conclusions: </strong>The OV method enhanced the intraoperative detection of CL during CAPS fixation for OVFs, facilitating the early recognition of minor leakage and reducing the overall leakage frequency without increasing the incidence of severe complications. These findings support the clinical utility of the OV method and the proposed grading system, which may guide safe cement injection in patients with osteoporosis.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"10 3","pages":"440-447"},"PeriodicalIF":1.6,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253167","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":"Cervical Spinal Cord Injury without Major Bone Injury Initially Misdiagnosed as Acute Ischemic Stroke: Thrombolysis-Associated Retropharyngeal Hematoma Requiring Airway Emergency.","authors":"Akio Kawamoto, Takashi Kageyama, Tadashi Yahata, Hokuto Morii, Koichi Inokuchi","doi":"10.22603/ssrr.2025-0316","DOIUrl":"10.22603/ssrr.2025-0316","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"10 2","pages":"318-319"},"PeriodicalIF":1.6,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692370","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":"Enhanced Fixation Strength of Pedicle Screws Using Calcium Phosphate Cement: Development of a Novel Augmentation Technique for Percutaneous Insertion.","authors":"Daisuke Inoue, Takayuki Fujiyoshi, Tomohiko Hasegawa, Haruo Kanno","doi":"10.22603/ssrr.2025-0283","DOIUrl":"10.22603/ssrr.2025-0283","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal surgery for osteoporotic vertebral fractures using implants often results in implant failure owing to poor bone quality. We developed a new augmentation technique using calcium phosphate cement (CPC) for percutaneous pedicle screws (PPSs). This study evaluated the reinforcement effect of CPC on the initial fixation strength of PPSs in synthetic bone specimens.</p><p><strong>Methods: </strong>Using the X-Needle^Ⓡ, developed for screw hole preparation and CPC injection, a 40 mm deep pilot hole was created in 40×40×60 mm bone specimens. A commercially available CPC (BIOPEX-R^Ⓡ) was mixed at a powder-to-liquid ratio of 12 g/3.4 mL, and 0.5 mL was injected into the pilot hole 6 minutes (min) after mixing. Screws were then inserted using the standard PPS technique. Pull-out strength (N) was measured seven times in four groups: without CPC (control group), immediately after CPC injection (CPC0 group), 10 mins after CPC injection (CPC10 group), and 24 hours after CPC injection (CPC24 group). Toggle tests were conducted six times in the control and CPC24 groups to measure the number of cycles/load (N) required to achieve 2 mm screw head displacement.</p><p><strong>Results: </strong>In the pull-out test, the maximal pull-out strength in the CPC24 group was significantly greater than that in the control and CPC0 groups. Pull-out strength in the CPC10 and CPC24 groups increased to 121.1% and 165.1% of that of the control group, respectively. In the toggle test, the CPC24 group showed significantly higher values for both cycles and load compared to the control group.</p><p><strong>Conclusions: </strong>The X-Needle^Ⓡ enables simple, minimally invasive CPC injection into the pilot hole, facilitating PPS augmentation. Additionally, screws augmented with CPC showed increased pull-out and toggle strengths. PPS augmentation using CPC may serve as a preventive measure against implant failure in spinal surgery for patients with poor bone quality.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"10 2","pages":"296-302"},"PeriodicalIF":1.6,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692406","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":"Bone Growth Stimulators to Enhance Spinal Fusion Outcomes.","authors":"Tristen P Melvin, Asia Elbooz, Devon Foster, Jonathan Brutti, Alexandra Lee, Asher Voros","doi":"10.22603/ssrr.2025-0202","DOIUrl":"10.22603/ssrr.2025-0202","url":null,"abstract":"<p><p>Bone growth stimulators serve as a critical adjunct in spinal-fusion procedures, particularly in patients at risk of nonunion or delayed healing. This review analyzes three primary modalities: biological, electrical, and ultrasound-based stimulators. Biological stimulators, including bone morphogenic proteins and platelet-rich plasma, use growth factors to promote osteogenesis but carry risks such as ectopic bone formation and inflammatory responses. Electrical stimulators, such as direct current stimulation and pulsed electromagnetic fields, leverage the piezoelectric properties of bone to activate osteogenic pathways and have indicated significant efficacy in promoting fusion in high-risk populations. Low-intensity pulsed ultrasound offers a noninvasive alternative that accelerates bone healing through mechanical and angiogenic pathways. The review also evaluates the preclinical application of bone growth stimulators in animal models, exploring the integration of advanced biomaterials to further enhance osteogenesis. Future research should prioritize optimizing the efficacy, safety, and cost-effectiveness of these modalities to improve spinal-fusion outcomes.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":"10 3","pages":"343-353"},"PeriodicalIF":1.6,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253404","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}