North American Spine Society Journal最新文献

{"title":"Qualitative and quantitative retrieval analysis of a ball-and-socket cervical disc replacement","authors":"Jenna M. Wahbeh MS ,&nbsp;Sophia N. Sangiorgio PhD ,&nbsp;Sang-Hyun Park PhD ,&nbsp;G. Bryan Cornwall PhD ,&nbsp;Neha V. Kulkarni BS ,&nbsp;Roberto Chiesa PhD ,&nbsp;Edward Ebramzadeh PhD","doi":"10.1016/j.xnsj.2025.100768","DOIUrl":"10.1016/j.xnsj.2025.100768","url":null,"abstract":"<div><h3>Background</h3><div>The Porous Coated Motion (PCM) is a ball-and-socket cervical disc replacement with excellent reported short-term clinical outcome. However, longer-term studies identified migration as a common cause of implant removal and the device was withdrawn from the market. Given these discrepancies, retrieval analyses are crucial to assess whether preclinical testing accurately predicts clinical performance. This study aimed to quantitatively and qualitatively analyze retrieved PCM devices to identify primary reasons for removal and assess the impact of observed damage on overall device fixation.</div></div><div><h3>Methods</h3><div>Thirty-seven PCM devices were received for postmarket surveillance. Nondestructive analysis included visual examination, photographic documentation, and radiographic review. Analytical measurements were performed using a coordinate measuring machine to assess articulating surfaces or a digital microscope for endplate surface feature characterization. Oxidation analysis was performed on all devices with adequate handling and storage conditions, and histopathology was performed when tissue samples were available.</div></div><div><h3>Results</h3><div>Twenty-five devices met the inclusion criteria for this study. The mean patient age at retrieval was 45.3±13.5 years, with an average time-in-vivo of 121±15.6 days. Anterior migration was the most common reason for removal, reported in 17 cases, with the inferior convex polyethylene component predominately migrating. Additionally, 17 devices had a focalized deviation on the posterior quadrant of the articulating polyethylene ball, 11 of which had evidence of radiographic clinical migration. Histopathology and metrology findings indicated that wear debris did not contribute to clinical failure.</div></div><div><h3>Conclusions</h3><div>The findings of the present study, specifically the minimal bony ongrowth, lack of extraction damage, and radiographic imaging, indicated that most devices were removed due to migration. Metrology analysis revealed a depression on the posterior edge of the inferior endplate polyethylene ball, which correlated with anterior slippage. This may be a distinctive feature of the PCM’s relatively large ball-and-socket design that led to increased stress during extension, causing anterior migration.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"23 ","pages":"Article 100768"},"PeriodicalIF":2.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144748873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical evaluation of lateral interbody fusions using 3D printed PEEK or 3D printed titanium cages","authors":"William Robert Walsh PhD ,&nbsp;Matthew Pelletier PhD ,&nbsp;Dan Wills PhD, BScVet ,&nbsp;Tian Wang PhD ,&nbsp;Max Lloyd BScVet ,&nbsp;Michael Veldman BS ,&nbsp;Nick Cordaro BS ,&nbsp;Mark Brady PhD","doi":"10.1016/j.xnsj.2025.100756","DOIUrl":"10.1016/j.xnsj.2025.100756","url":null,"abstract":"<div><h3>Background</h3><div>PEEK interbody cages are well established. 3D porous PEEK designs can now be produced with additive manufacturing. This study compared the in-vivo response of additive manufactured porous PEEK (3D PEEK) and titanium alloy (3D Ti) cages.</div></div><div><h3>Methods</h3><div>Interbody fusion was performed in 11 adult sheep at 2 levels (L2-3 and L4-5) using 3D PEEK and 3D Ti cages filled with autograft with posterior bilateral pedicle screw fixation. Fusions were evaluated at 8 and 16 weeks via manual palpation, microcomputed tomography (microCT), histology, and histomorphometry.</div></div><div><h3>Results</h3><div>All animals recovered well following surgery with no adverse events. The radiolucent nature of PEEK allowed the fusions to be evaluated using radiographs and microCT. The 3D Ti cages however appeared solid rather than porous in the radiographs and presented artifacts in the microCT scans which precluded definitive determination of the fusions. Range of motion results improved with time for 3D PEEK and 3D Ti while no differences between designs were detected. Histology and histomorphometry confirmed 3D PEEK and 3D Ti supported fusion in this model using autograft.</div></div><div><h3>Conclusions</h3><div>Range of motion and histology results were similar for 3D PEEK and 3D Ti. Radiographs and microCT could be used to assess the fusions with 3D PEEK due to the radiolucent nature. 3D Ti appeared solid in the radiographs and had image artifact in microCT which precluded definitive evaluation of the fusions. 3D PEEK and 3D Ti cages both support interbody fusion in this preclinical model.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"23 ","pages":"Article 100756"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P19. Infection following cervical artificial disc replacement","authors":"Adeesya Gausper BA ,&nbsp;Justin K. Scheer MD ,&nbsp;Suhas K Etigunta BS ,&nbsp;Andy M Liu BS ,&nbsp;Alexander Tuchman MD","doi":"10.1016/j.xnsj.2025.100643","DOIUrl":"10.1016/j.xnsj.2025.100643","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Cervical artificial disc replacement (ADR) is a procedure performed for patients with cervical disc degeneration or herniation in the setting of radiculopathy or myelopathy, with a primary advantage of motion preservation compared to fusion procedures. Infection following cervical ADR is poorly understood, with no established guidelines for prevention or management.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;This case series aims to characterize the clinical presentation, microbiological findings, and outcomes of patients who develop cervical ADR infections.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;Retrospective case series.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;We conducted a retrospective review of patients treated at our institution who developed infection following cervical ADR and underwent subsequent revision surgery. Data collected included patient demographics, clinical presentation, infective organism, and type of disc implanted. Infections were identified based on clinical symptoms and radiographical findings and confirmed with microbiological cultures. Infection management, including antibiotic therapy and revision surgery, was recorded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;A total of 23 cases involving 18 patients were included in this study. Five patients (27.8%) required two revision surgeries. Intractable neck pain and cervical radiculopathy were reported in nearly all patients. Upper extremity weakness, muscular spasms, balance issues, and dysphagia were also reported. Head and neck trauma preceded symptom onset in 3 patients. Time from symptom onset to diagnosis ranged from 4 days to 98 weeks (mean 32.7 weeks). Species most commonly isolated from OR cultures were Cutibacterium acnes in 14 cases (60.9%) and Staphylococcus epidermidis in 7 cases (30.4%). Polymicrobial cultures were isolated in 9 cases, and cultures were negative in 3 cases. Intraoperative vancomycin powder was not used in any initial ADR surgery, and vancomycin powder was utilized in 4 revisions. Notably, of the 17 patients who underwent revision of hardware, 100% were eventually converted to fusion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;Infection following cervical ADR is rare but poses significant clinical challenges and most often requires conversion to fusion. Early identification and appropriate management are critical to optimizing patient outcomes. Variability in clinical presentation and time to diagnosis highlights the need to refine perioperative protocols to reduce infection risk and improve success of subsequent procedures. This study reports the largest cohort of patients with infected cervical ADRs to date and provides valuable insights to inform future guidelines for prevention and management.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;FDA Device/Drug Status&lt;/h3&gt;&lt;div&gt;This abstract does not discuss or include any applicable devices or d","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100643"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P22. Surgical outcomes in cervical ossification of posterior longitudinal ligament: a case series and literature review","authors":"Ling Yi Li MD","doi":"10.1016/j.xnsj.2025.100646","DOIUrl":"10.1016/j.xnsj.2025.100646","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Cervical ossification of the posterior longitudinal ligament (OPLL) can cause symptoms such as myelopathy and radiculopathy. Anterior decompression and fusion (ADF) and laminoplasty (LAMP) are common surgical options to decompress the spinal cord and stabilize the spine. ADF provides direct decompression but is associated with greater complexity and higher risks, whereas LAMP is less invasive but may be less effective in severe cases. Ongoing research aims to compare these approaches and guide the selection of the most appropriate treatment.</div></div><div><h3>PURPOSE</h3><div>N/A</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>N/A</div></div><div><h3>PATIENT SAMPLE</h3><div>N/A</div></div><div><h3>OUTCOME MEASURES</h3><div>N/A</div></div><div><h3>METHODS</h3><div>Data collection included demographic characteristics, radiological findings, and the Japanese Orthopaedic Association (JOA) score for cervical myelopathy recorded between 2010 and 2024. Postoperative and last follow-up JOA scores were compared with preoperative values within and between the two groups. Postoperative complications were also assessed. Regression analysis was performed to identify factors associated with achieving a minimal clinically important improvement or difference in the JOA score.</div></div><div><h3>RESULTS</h3><div>The study analyzed 27 patients who underwent either ADF (n = 18) or LAMP (n = 9). Both groups had comparable demographics, although segmental involvement was more common in the ADF group. Preoperative JOA scores were higher in the ADF group, and postoperative improvements were greater, but recovery rates were similar between the two groups. Complications such as reoperation and C5 palsy occurred only in the ADF group, though these differences were not statistically significant. Surgical site infections were observed exclusively in the LAMP group. Factors such as age, BMI, and smoking history did not significantly influence the MCID, but the occupying ratio showed a potential impact (p = 0.0516), underscoring its role as a nuanced predictor of surgical success.</div></div><div><h3>CONCLUSIONS</h3><div>Both ADF and LAMP are effective and safe treatments for cervical OPLL. However, patients with a higher occupying ratio may have a reduced likelihood of achieving MCID success.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss or include any applicable devices or drugs.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100646"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3. Automated Lenke classification for preoperative spine surgery by extracting anatomical landmarks from X-ray images using a deep learning approach","authors":"AliAsghar Mohammadi Nasrabadi PhD ,&nbsp;Gemah Moammer FRCSC ,&nbsp;John McPhee PhD","doi":"10.1016/j.xnsj.2025.100697","DOIUrl":"10.1016/j.xnsj.2025.100697","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Spinopelvic assessment (eg, SS, PT, PI, LL, TK, CL, SVA, and Cobb angle) is vital for preoperative spinal surgery planning but is often measured manually, leading to variability. Recent AI and deep learning methods improve automation and accuracy. While promising, these techniques face challenges including computational complexity, small test datasets, lack of surgeon validation, and limited robustness to varied image conditions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;To increase accuracy, reduce complexity, and provide robust preoperative X-ray analysis, we propose a novel, physics-informed deep learning method based on mathematical spinal relations. This approach aims to automatically calculate lateral and AP spinal parameters and promptly perform Lenke classification for each patient.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;We collected 3500 lateral and AP spine X-rays from Grand River Hospital (GRH) in Kitchener, ON, Canada, between 2016 and 2024, encompassing hip/spine implants, varied postures, and poor-contrast or partially visible spines. Image processing filters enhanced annotation accuracy, allowing landmark detection even in incomplete images. The dataset includes conventional and EOS systems, enabling thorough performance evaluation and robust landmark detection. Data was split into 80% training, 10% validation, and 10% testing.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;This study focuses on the automatic extraction of spinopelvic parameters and anatomical landmarks from lateral and AP X-ray images, including SS, PT, PI, LL, SVA, femur center, sacrum end plate, iliac crest, L1–L5, T12–T1, C7–C2, apex, Cobb angle, LSRS, TSM, and CSRS. These measurements enable Lenke classification, identifying curve types (1–6), lumbar modifiers (A, B, C), and thoracic modifiers (–, N, +). To evaluate performance, we use relative root mean square error (RRMSE) to compare predicted values (PR) with manual annotations (MA), while intraclass correlation coefficient (ICC) measures reliability among surgeons, MA, and PR.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;Using our developed physics-informed deep learning method, spinopelvic parameters were extracted from X-ray images and validated against manual annotations. Landmarks were detected as objects with geometric constraints derived from mathematical spinal relations. Performance, compared to three senior spine surgeons, demonstrated excellent correlation, with intraclass correlation coefficients exceeding 0.9, surpassing previously reported literature values. Additionally, we developed an algorithm leveraging these parameters to automate Lenke classification, identifying curve type (1–6), lumbar modifier (A,B,C), and thoracic modifier (–,N,+), significantly aiding triage and preoperative planning.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;We evaluated our model on the dataset, achieving final accuracies of 93.1% (SS), ","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100697"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"List of Contents","authors":"","doi":"10.1016/S2666-5484(25)00182-9","DOIUrl":"10.1016/S2666-5484(25)00182-9","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100762"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"44. Development of a novel machine learning model for prediction of adjacent fracture after cementoplasty in treating osteoporotic vertebral compression fracture","authors":"Yu-Cheng Yao MD ,&nbsp;Po-Hsin Chou MD ,&nbsp;Bruce H Lin MD ,&nbsp;Shih-Tien Wang MD","doi":"10.1016/j.xnsj.2025.100738","DOIUrl":"10.1016/j.xnsj.2025.100738","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;There are approximately 30% of patients with osteoporotic vertebral compression fracture (OVCF) who need cementoplasty for treatment. However, the occurrence of adjacent vertebral fracture (AVF) postoperatively can lead to increased pain, delayed recovery, and poorer prognosis. Current literature identifies over 30 risk factors for AVF, including patient-specific factors, preoperative and postoperative radiographical features, and surgical-related factors. There is no effective predictive model in understanding the probability of AVF occurrence preoperatively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;This study aims to develop a robust AVF predictive model using machine learning method.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;Retrospective cohort study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;A total of 238 patients with OVCF who underwent single level cementoplasty were included for analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;Adjacent fracture.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;This is a retrospective cohort analysis. Patients with OVCF who underwent single level cementoplasty between January 2016 and December 2021 were included. Exclusion criteria were pathological fractures, patients with prior cementoplasty or spinal surgeries, and follow-up less than 12 months. Total 32 preoperative clinical and radiographic features were recorded, include patient demographics, DXA, chronic diseases, vertebral height (VH), wedge angle (WA) of fracture vertebra, local kyphotic angle (LKA), presence of posterior wall fracture (PostWall), and presence of diffuse idiopathic skeletal hyperostosis (DISH), CT vertebral Hounsfield units (HU), CT psoas lumbar vertebral index (PLVI). Ten different machine learning algorithms were used to find the best model. Confusion matrix and related indicators include Accuracy, sensitivity (Se), specificity (Sp) and ROC-AUC were used to evaluate the model performance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;A total of 238 patients were included for analysis, with an average age of 77 years and 69% were female. Most fractures located at the TL junction (64%). The AVF rate was 27.3% during the follow-up and it occurred at postoperative 3.2 months. We found the random forest model had the best performance with 83% accuracy, AUC 0.92, Se: 82%, and Sp: 85%. Among the total 32 features, we found that the 11 most important features by orders were PostWall, HU_L2, DISH, L4_PLVI, WA, MVH, BMI, LKA, Age, and fracture level. Even using those 11 features alone, the model performance could reach 78% accuracy, AUC 0.88, Se: 80%, and Sp 76%.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;The novel machine learning model for predicting AVF using preoperative features demonstrated excellent performance, achieving an AUC of 0.92. This model can assist clinicians and patients with OVCF in understanding the probability of AVF occurrence after cementoplasty. For patients identified as high-risk, pro","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100738"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P11. Endoscopic decompression for radiculopathy in scoliosis","authors":"Jun Rui Don Koh MBChB, BS","doi":"10.1016/j.xnsj.2025.100635","DOIUrl":"10.1016/j.xnsj.2025.100635","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Adult degenerative scoliosis is a spinal deformity resulting in an unbalanced spine, the further progression of which results in associated conditions such as disc herniation, ligament hypertrophy and facet ossification. Patients with scoliosis therefore frequently suffer from both axial back pain as well as radicular pain.</div></div><div><h3>PURPOSE</h3><div>N/A</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Case Series</div></div><div><h3>PATIENT SAMPLE</h3><div>N/A</div></div><div><h3>OUTCOME MEASURES</h3><div>N/A</div></div><div><h3>METHODS</h3><div>We report a case series of two middle aged patients with severe scoliosis who presented to our department complaining of both back and radicular pain.</div></div><div><h3>RESULTS</h3><div>These patients subsequently underwent minimally invasive endoscopic decompression of the affected levels following a failure of conservative management, with no fusion to address the scoliosis. The patients report good relief of their radicular pain post-operatively, although the axial back pain remained.</div></div><div><h3>CONCLUSIONS</h3><div>Endoscopic decompression is a potential surgical option which should be considered for the management of radicular pain in patients with scoliosis.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss or include any applicable devices or drugs.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100635"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"27. Open door versus double door laminoplasty in the treatment of cervical OPLL: a 10-year retrospective analysis","authors":"Sunjoon Yoo MD","doi":"10.1016/j.xnsj.2025.100721","DOIUrl":"10.1016/j.xnsj.2025.100721","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Cervical ossification of the posterior longitudinal ligament (OPLL) is a common cause of cervical myelopathy, often requiring surgical intervention. Laminoplasty, with two main approaches—open-door (OD) and double-door (DD)—is widely performed. However, while previous studies have reported on the clinical and radiological outcomes of these techniques, none have examined a 10-year follow-up with a significant number of patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;This study aims to compare the long-term outcomes of open-door and double-door laminoplasties in patients with cervical OPLL over a 10-year follow-up period.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;A 10-year retrospective cohort analysis conducted at a single institution.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;A total of 109 patients with cervical OPLL, comprising 63 patients in the open-door laminoplasty group and 46 patients in the double-door laminoplasty group.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;The clinical outcomes assessed in this study included Visual Analog Scale (VAS) scores, Japanese Orthopedic Association (JOA) scores, and recovery rates. Radiological outcomes evaluated were the C2-7 Cobb angle, range of motion (ROM), occupying ratio, and K-line type.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;For cervical myelopathy caused by OPLL, we performed OD and double-door DD laminopasties at a single institution. A total of 63 patients in the OD group and 46 patients in the DD group were evaluated for 10 years’ follow-up. The following criteria were evaluated: demographic information, range of operation, occupying ratio, K-line, type of OPLL, Cobb angle of C2-C7, and range of motion. Clinical outcomes were assessed using the VAS, JOA score and recovery rate.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Age, sex, symptom duration, and comorbidities were not significantly different between the groups. No significant differences in K-line type, canal occupying ratio were found. There were 6 patients in each group who underwent reoperation. Between the two groups, there was no difference in the change in the C2-7 cobb angle preoperative, immediate after surgery, and 2 years after surgery. However, at 10 years after surgery, the angle during extension decreased in the DD group, and the ROM also decreased statistically significantly (12.61 vs 8.4, p=0.02; 18.87 vs 13.62, p=0.016). However, the ROM decreased in both groups from before surgery to the last follow-up, with no significant difference (-14.43 vs -18.07, p=0.221). The VAS scores for neck and arm were significantly lower in the DD group immediately after surgery (p=0.044, 0.022), but no difference was observed between the groups 10 years post-surgery. JOA scores showed a similar improvement 10 years postoperatively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;Both laminoplasty methods are effective for treating cervical OPLL over a 10-year period. However, the ROM decreased significant","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100721"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P2. Concurrent intramedullary cervical spine abscess and intraventricular empyema","authors":"Shao Lun Chen MD","doi":"10.1016/j.xnsj.2025.100626","DOIUrl":"10.1016/j.xnsj.2025.100626","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Intramedullary spinal cord abscess (ISCA) and intraventricular empyema are both rare, severe infections that can result in significant neurological impairment or death if not managed promptly. Although each condition alone poses diagnostic and therapeutic challenges, the simultaneous occurrence of ISCA and intraventricular empyema is exceedingly uncommon. Recognizing these pathologies early and initiating aggressive treatment is essential to prevent irreversible CNS damage.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;To present a rare case of concurrent cervical intramedullary spinal cord abscess and intraventricular empyema, highlighting the diagnostic difficulties, the necessity of early surgical intervention, and the importance of comprehensive antibiotic coverage in managing complex central nervous system infections.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;This is a single-patient case report treated at a tertiary neurosurgical center, coupled with a review of the pertinent literature to contextualize the rarity and management of such concurrent CNS infections.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;A 43-year-old female patient, with a history of cervical spine surgery (for ossification of the posterior longitudinal ligament), presented with a two-week history of fever, acute left upper limb weakness, numbness, and neck pain.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;Key measures included neurological status (motor strength, level of consciousness), radiological evolution of the spinal and intraventricular infections (MRI findings), and response to antimicrobial therapy and surgical interventions (abscess drainage, external ventricular drainage, and shunt placement).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;An urgent surgical decompression and drainage of the intramedullary abscess at the C3–4 level was performed via a posterior approach. Antibiotics were initially broad-spectrum, then tailored to culture results identifying oral flora (Prevotella species and Fusobacterium nucleatum). When the patient’s mental status worsened, follow-up brain imaging revealed intraventricular empyema, requiring external ventricular drainage. After infection control was achieved, ventriculoperitoneal shunts were placed to address persistent hydrocephalus.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Despite initial deterioration in motor strength post-surgery, the patient demonstrated gradual neurological improvement with appropriate antibiotic therapy and serial interventions for both the spinal cord abscess and the intraventricular empyema. Final discharge status showed partial but meaningful recovery of left-sided strength, normal alertness, and resolution of severe headaches attributed to hydrocephalus.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;Concurrent spinal cord abscess and intraventricular empyema demand high clinical suspicion and a coordinated, multidisciplinary approach. Early recognition, comprehensive antibiot","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100626"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}