North American Spine Society Journal最新文献

{"title":"P42. Full-endoscopic circumferential ligamentum flavum resection: ensuring safety and effectiveness with clinical and radiological comparisons to conventional techniques","authors":"Yoonha Hwang MD","doi":"10.1016/j.xnsj.2025.100666","DOIUrl":"10.1016/j.xnsj.2025.100666","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>In spine surgery, minimally invasive techniques have advanced rapidly, with endoscopic spine surgery gaining global recognition due to significant improvements in endoscopic technology and surgical tools. These advancements have led to favorable surgical outcomes, yet considerable efforts continue to focus on minimizing complications such as dural tears.</div></div><div><h3>PURPOSE</h3><div>We developed the Circumferential Ligamentum Flavum Resection, which maximizes the use of drills to minimize dural tears and neural structure damage, one of the most serious complications. Through radiological and clinical comparisons with the traditional Kerrison’s punch method, we evaluated the safety and efficiency of this endoscopic surgical technique for lumbar central stenosis.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Retrospective, cohort study.</div></div><div><h3>PATIENT SAMPLE</h3><div>Patients included in the study were those treated between August 2023 and August 2024, with indications such as back pain, radicular leg pain, and neurogenic intermittent claudication. Circumferential resection was initiated in March 2024. The prior cohort of 84 patients (127 segments) underwent punch resection, while the subsequent cohort of 80 patients (139 segments) underwent circumferential resection. A comparison was made between these two groups. Exclusion criteria included lumbar disc herniation, segmental instability, grade II or higher spondylolisthesis, infection, and a history of previous lumbar spine surgeries.</div></div><div><h3>OUTCOME MEASURES</h3><div>N/A</div></div><div><h3>METHODS</h3><div>All patients underwent preoperative X-rays and MRIs, with a follow-up MRI at 6 months post-surgery. Perioperative MRI were compared to assess the cross-sectional area of the dural space and the angle of the facet joints, ensuring that the surgery was both sufficient and minimally invasive. The frequency of dural tears and clinical recovery after surgery were evaluated through the patient’s medical records, including surgical notes and outpatient records.</div></div><div><h3>RESULTS</h3><div>Both the CR group and the PR group demonstrated adequate decompression and clinical improvement. There were no significant differences between the two groups in terms of dural sac expansion or facet joint preservation. Surgical time and the degree of clinical improvement were also comparable. However, the incidence of dural tears and neural structure injury was higher in the PR group (3.2%) compared to the CR group (0.5%).</div></div><div><h3>CONCLUSIONS</h3><div>Circumferential Ligamentum Flavum Resection offers a safer and more efficient approach compared to the traditional punch method, with the potential for significant radiological and clinical improvement.</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 100666"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672357","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":"47. Minimally invasive prone lateral retropleural corpectomy vs decubitus lateral transpleural corpectomy: a comparative analysis of clinical outcomes","authors":"Yu-Cheng Yeh MD ,&nbsp;Hsuan Lun Yang MD ,&nbsp;Yung Hsueh Hu MD","doi":"10.1016/j.xnsj.2025.100741","DOIUrl":"10.1016/j.xnsj.2025.100741","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Decubitus lateral transpleural approach has been traditionally applied for tackling thoracic spinal pathologies at the anterior column. However, reposition for posterior instrumentation was often needed for complex pathologies. Recently, minimally invasive prone lateral single-position spinal surgery was introduced to allow simultaneous manipulation of the anterior and posterior columns, avoiding re-draping and improving lordotic alignment. Compared with transpleural approach, minimally invasive retropleural approach has gained popularity as it avoids pleural invasion, diaphragm takedown and one-lung ventilation, thereby reducing postoperative complications like pleural effusion and pneumonia.</div></div><div><h3>PURPOSE</h3><div>By combining these two minimally invasive techniques, this study aims to evaluate the feasibility of prone lateral retropleural corpectomy and compares its pulmonary complications and surgical outcomes with the conventional decubitus lateral transpleural corpectomy.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Retrospective study.</div></div><div><h3>PATIENT SAMPLE</h3><div>From 2016 to 2023, we retrospectively reviewed patients who underwent lateral thoracic corpectomy and posterior instrumentation on the same day for various thoracic spinal pathologies. Those without a postoperative 1-year follow-up or received lateral corpectomy without posterior instrumentation were excluded.</div></div><div><h3>OUTCOME MEASURES</h3><div>Clinical outcomes, thoracic kyphosis correction, and postoperative pulmonary complications were recorded and analyzed.</div></div><div><h3>METHODS</h3><div>The patients were divided into prone lateral retropleural corpectomy (RP) group (N=27) and conventional decubitus lateral transpleural corpectomy (TP) group (N=54). The outcome measures were compared between the two groups.</div></div><div><h3>RESULTS</h3><div>There were no significant differences in terms of age, sex, body mass index, Charlson comorbidity index, or etiologies between the two groups. The surgical lengths were also comparable (RP: 5.4 ± 2.0 vs TP: 5.5 ± 2.1, p = 0.97), but the RP group has significantly shorter corpectomy level (1.1 ± 0.3 vs 1.5 ± 0.7, p &lt; 0.001). The thoracic kyphosis correction was greater in the RP group than in the TP group (21.0° ± 16.5° vs 8.8° ± 11.4°, p = 0.002). Regarding postoperative pulmonary complications, the RP group revealed a lower incidence of CP angle blunting (44.4% vs 74.1%, p = 0.009) and pneumonia requiring antibiotics (0% vs 18.5%, p = 0.026). Additionally, thoracic drainage duration was significantly shorter in the RP group (4.1 ± 2.9 vs 6.4 ± 4.1 days, p = 0.015), as well as a reduced hospital stay (21.2 ± 16.5 vs 38.2 ± 24.5 days, p &lt; 0.001).</div></div><div><h3>CONCLUSIONS</h3><div>Minimally invasive prone lateral retropleural corpectomy is a safe and feasible alternative for thoracic spinal pathologies, providing superior kyphosis correcti","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100741"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672419","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":"48. Necessity of direct decompression for thoracolumbar junction burst fractures with neurological compromise","authors":"Sarvdeep Singh Dhatt MBBS, MS","doi":"10.1016/j.xnsj.2025.100742","DOIUrl":"10.1016/j.xnsj.2025.100742","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100742"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672420","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":"P10. Anterior versus non-anterior approach in adult spinal deformity surgery: a propensity-score matched analysis using NSQIP data","authors":"Ankit Indravadan Mehta MD ,&nbsp;Kaho Adachi BA ,&nbsp;Adith Srivatsa BS ,&nbsp;Morteza Sadeh MD, PhD","doi":"10.1016/j.xnsj.2025.100634","DOIUrl":"10.1016/j.xnsj.2025.100634","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Surgical interventions for adult spine deformity (ASD) are often required after failed conservative treatment or in cases of spinal decompensation; however, these procedures are associated with high morbidity. Traditionally, the posterior approach has been the standard, but the anterior approach has gained popularity due to its mechanical and biological advantages. Nevertheless, available studies are limited by small sample sizes and report conflicting outcomes when comparing these two approaches.</div></div><div><h3>PURPOSE</h3><div>Our study aims to compare procedures with anterior (anterior group) and without anterior (non-anterior group) approaches for ASD and identify complication rates and hospital outcomes.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Retrospective cohort study using propensity-matched analysis.</div></div><div><h3>PATIENT SAMPLE</h3><div>Patients 18 years and older with ASD who underwent spinal deformity correction surgery.</div></div><div><h3>OUTCOME MEASURES</h3><div>The primary outcome was 30-day postoperative complications. The secondary outcomes were procedural time, length of hospital stay, and rates of readmission and reoperation. Subgroup analysis included procedural detail for scoliosis.</div></div><div><h3>METHODS</h3><div>The National Surgical Quality Improvement Program was queried from 2015 to 2023 for patients 18 years and older with ASD who underwent spinal deformity correction surgery. The patients in the anterior group were propensity-matched with the non-anterior group based on demographic, procedural detail, and comorbid conditions to identify hospital complications and outcomes (p &lt; 0.05). Descriptive statistics were used to perform a subgroup analysis of patients with scoliosis.</div></div><div><h3>RESULTS</h3><div>There were 389 patients in the anterior and 2,774 in the non-anterior groups. The anterior group had older patients with increased weight (p &lt; 0.001). Smoking (p &lt; 0.01), diabetes mellitus (p = 0.04), and hypertension (p = 0.01) were more prevalent in the anterior group while COPD (p = 0.02) was more frequent in the non-anterior group. The lumbar spine was the most operated region for both groups (31.62% and 19.75% respectively). For hospital complications, the non-anterior group had a higher rate of surgical site infection (SSI) (p=0.01) while unplanned intubation was more prevalent in the anterior group (0.03). The anterior group had a significantly shorter operative time (p=0.01) while hospital stay (p=0.53), reoperation rate (p=0.38), and readmission rate (p=0.57) were similar between the two groups. In the subgroup analysis focusing on scoliosis, the thoracolumbar region was the most operated in the non-anterior group (43.6%), while the lumbar region was the most operated in the anterior group (51.9%).</div></div><div><h3>CONCLUSIONS</h3><div>Our study found that the anterior approach was associated with a shorter operative time and a ","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100634"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672423","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":"P14. Cervical spine pseudogout mimicking ossification of posterior longitudinal ligament: a case report and literature review","authors":"Shao Lun Chen MD","doi":"10.1016/j.xnsj.2025.100638","DOIUrl":"10.1016/j.xnsj.2025.100638","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Calcium pyrophosphate deposition (CPPD) disease, often termed pseudogout, commonly involves peripheral joints, but cervical spine manifestations are rare. When CPPD affects the cervical spine, crystal deposition in ligaments and intervertebral discs can lead to spinal cord or nerve root compression, resulting in significant myelopathy or radiculopathy. Because these presentations often mimic more common degenerative conditions (eg, ossification of the posterior longitudinal ligament), accurate diagnosis is crucial for effective treatment.</div></div><div><h3>PURPOSE</h3><div>To describe a rare case of cervical CPPD with widespread ligamentous and disc involvement that mimicked ossification of the posterior longitudinal ligament, emphasizing the importance of early recognition and appropriate surgical intervention to prevent irreversible neurologic deficits.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Single-patient case report treated at a tertiary neurosurgical center, with a review of relevant literature on cervical spine CPPD.</div></div><div><h3>PATIENT SAMPLE</h3><div>A 69-year-old female presenting with progressive neck pain, radiating right arm pain, hand numbness, gait imbalance, and frequent falls over a two-year period.</div></div><div><h3>OUTCOME MEASURES</h3><div>Neurological function (including strength, reflexes, and gait), pain relief, and imaging studies (CT/MRI) before and after surgical intervention.</div></div><div><h3>METHODS</h3><div>Comprehensive preoperative imaging (CT/MRI) revealed extensive cervical calcifications in the ligamentum flavum, posterior longitudinal ligament, and intervertebral discs, causing multilevel spinal cord compression. The patient underwent combined anterior and posterior decompression with instrumented fusion. Pathological examination of resected tissues confirmed CPPD through identification of positively birefringent crystals under polarized light. Postoperative follow-up was conducted to assess neurological recovery and possible peripheral joint involvement.</div></div><div><h3>RESULTS</h3><div>The patient’s numbness and gait instability improved significantly following decompression and fusion, and no cervical recurrence was noted at two-year follow-up. Persistent right shoulder pain was subsequently attributed to possible CPPD in the supraspinatus tendon, highlighting the multifocal nature of the disease.</div></div><div><h3>CONCLUSIONS</h3><div>Cervical CPPD can mimic other degenerative spinal pathologies and, if unrecognized, may lead to severe neurological compromise. Early identification through imaging and histopathological confirmation is critical. Surgical decompression can yield favorable outcomes, and ongoing vigilance for CPPD in peripheral joints is recommended due to its potential multifocal presentation.</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 100638"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672428","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":"P30. A single-position surgery with transpopliteal intraoperative angiography for complex spinal arteriovenous lesions: a case series","authors":"Guan-Tze Liu MD ,&nbsp;Chao-Hung Kuo MD, PhD ,&nbsp;Li-Yu Fay MD","doi":"10.1016/j.xnsj.2025.100654","DOIUrl":"10.1016/j.xnsj.2025.100654","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Spinal arteriovenous lesions, including arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs), are rare but complex vascular anomalies. Certain subtypes, such as extradural AVMs with intradural drainage or dural AVFs resistant to endovascular treatment, pose significant diagnostic and therapeutic challenges.</div></div><div><h3>PURPOSE</h3><div>Intraoperative angiography via a transfemoral approach is useful for real-time lesion evaluation but requires patient repositioning, which can be inefficient. This study examines the feasibility of a single-position surgical approach incorporating transpopliteal intraoperative angiography for managing complex spinal arteriovenous lesions.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Patients underwent laminectomy for decompression, with optional fixation, followed by lesion obliteration under transpopliteal intraoperative angiography and intraoperative neurophysiological monitoring (IONM). All procedures were performed in the prone position, with the popliteal area prepped for vascular access. A diagnostic catheter was introduced through the left popliteal artery for real-time intraoperative imaging.</div></div><div><h3>PATIENT SAMPLE</h3><div>Case 1: 48-year-old male presented with progressive bilateral lower limb numbness and urinary retention. MRI identified a vascular lesion at the left T9 level. Transpopliteal intraoperative angiography confirmed an AVM at the left T9-T10 intervertebral foramen, fed by the left 9th radicular artery with intradural venous drainage. Surgical excision was performed under IONM and with the assistance of transpopliteal intraoperative angiography. Case 2: 71-year-old female presented with acute bilateral lower limb weakness and numbness (muscle power 2/5). MRI revealed serpentine intradural vessels and dorsal spinal cord compression at the T8-T11 level. Spinal angiography confirmed a spinal dural AVF with a feeder from the right 8th thoracic segmental artery. The patient underwent lesion removal and spinal cord decompression under the same protocol. Case 3: 53-year-old female reported intermittent left lower limb weakness that had recently worsened. MRI showed serpentine intradural vessels, spinal cord edema, and intradural extramedullary flow voids at T11-L1. Spinal angiography confirmed a spinal dural AVF at the left L1 lumbar artery with engorged perimedullary veins. An attempted endovascular obliteration was deemed unfeasible due to poor accessibility and high risk. The patient underwent T12 and L1 laminectomy for decompression and AVF obliteration under the same protocol.</div></div><div><h3>OUTCOME MEASURES</h3><div>N/A</div></div><div><h3>METHODS</h3><div>N/A</div></div><div><h3>RESULTS</h3><div>All three patients demonstrated preserved or improved neurophysiological signals intraoperatively. Transpopliteal intraoperative angiography played a crucial role in lesion localization before durotomy. After obliterati","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100654"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672514","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":"P1. A review on the management strategies for cerebrospinal fluid leak after spinal surgery","authors":"Thirrisha Murugan MBBS","doi":"10.1016/j.xnsj.2025.100625","DOIUrl":"10.1016/j.xnsj.2025.100625","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Cerebrospinal fluid leak (CSF) is a common and serious complication of spinal surgery with an incidence rate of up to 15%. Consequences can be serious, including meningitis or even life-threatening conditions such as status epilepticus, acute subdural hematomas or cerebellar hemorrhage. Yet, at present there are no unified guidelines regarding optimal management and measures to mitigate risk of CSF leak.</div></div><div><h3>PURPOSE</h3><div>This review aims to consolidate current strategies available in literature to provide an evidence-based guide for incorporation in day-to-day practice.</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>A review of available literature was performed to summarize papers from 2005 to 2025 published on the topic of CSF leaks following spinal surgery. Forty-two papers were identified and summarized to identify key suggestions, points of contention and areas for future research.</div></div><div><h3>RESULTS</h3><div>Key suggestions identified can be classified into three categories: strategies to mitigate risk of dural breach, intraoperative management of intention durotomy and iatrogenic dural tears and management of post-operative suspected/confirmed CSF leak. Mitigating risk of dural breach can be achieved through early identification of at-risk patients and optimizing the choice of operative equipment for adequate visualization. In the case of intention durotomy and iatrogenic dural tear, there is consensus recommendation for attempting primary dural defect closure with sutures where possible. However, measures that remain contentious include choice and use of adjunctive sealants and grafts and prophylactic use of subfascial drains. Post-operative management measures include the use of lumbar drains as supported by three studies. Prolonged bed rest, use of acetazolamide and broad spectrum prolonged use of prophylactic antibiotics do not demonstrate proven benefit.</div></div><div><h3>CONCLUSIONS</h3><div>To conclude, strategies for CSF leak prevention and management following spinal surgery have differing levels of evidence to support their use. While measures such as primary closure of dural defect with sutures remain the gold standard, options such as the use of prophylactic subfascial drains show evidence of benefit but require further refinement and nuance before incorporation. Future research should thus pay particular attention to identifying the indications and optimizing the protocols for use of subfascial and lumbar drains as well as identifying the ideal choice of sealants and grafts for use in dural defect closure.</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 100625"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672511","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":"6. Comparative study for complications of unilateral biportal endoscopic spine surgery between using and not using Kerrison punches (no-punch technique)","authors":"Jwo-Luen Pao MD","doi":"10.1016/j.xnsj.2025.100700","DOIUrl":"10.1016/j.xnsj.2025.100700","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Unilateral biportal endoscopic (UBE) spine surgery has gained worldwide popularity and extended indications in recent years. We have proposed the “no-punch technique” to effectively reduce the complication rate in decompression surgery for degenerative lumbar spinal stenosis by not using the Kerrison punch at all.</div></div><div><h3>PURPOSE</h3><div>To evaluate the effectiveness of the “no-punch technique” in reducing the complication rate in the UBE surgeries for the extended surgical indications of degenerative spinal disorders.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>A retrospective comparative study of two cohorts receiving UBE surgeries of different surgical techniques.</div></div><div><h3>PATIENT SAMPLE</h3><div>This study included 914 consecutive patients with various degenerative spine disorders who received UBE surgery between October 2018 and July 2023. These patients were divided into Group A, which included 660 patients (830 segments) receiving UBE surgeries with the Kerrison punches, and Group B, which included 254 patients (330 segments) receiving UBE surgeries with the “no-punch technique.”</div></div><div><h3>OUTCOME MEASURES</h3><div>N/A</div></div><div><h3>METHODS</h3><div>The “no-punch technique” uses electric high-speed drills and chisels of different curve angles as the principal surgical instruments to replace the Kerrison punches. The decompression was performed by resecting the peripheral bony margin and then removing the ligamentum flavum as a whole piece or pieces. The operation notes and medical charts were reviewed to evaluate the occurrence of surgical complications and their distribution in subcategories of surgical procedures.</div></div><div><h3>RESULTS</h3><div>There were 63 surgical complications (58 in Group A and 5 in Group B), including accidental dural tears, nerve root injuries, incomplete decompression, epidural hematoma, and broken instruments were identified. The overall complication rate and the incidence of dural tears were significantly reduced in Group B (8.8% vs 2.0% and 3.9% vs 0). The incidence of neural injuries, including dural tears and nerve root injuries, was also significantly reduced in Group B (5.3% vs 0.4%), especially in the subcategories of decompression surgeries (5.0% vs 0.8%) and revision surgeries (9.9% vs. 0). The incidence of incomplete decompression and epidural hematoma and distribution of such complications in the subcategories of surgical procedures did not differ significantly between Group A and B.</div></div><div><h3>CONCLUSIONS</h3><div>The “no-punch technique” effectively reduces the overall complication rate and the incidence of neural injuries in UBE surgeries. This modification of the surgical technique makes UBE surgery a safer endoscopic procedure with guaranteed treatment outcomes.</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 100700"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672186","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":"P15. Combining laminoplasty with artificial disc replacement for the treatment of cervical spondylotic myelopathy","authors":"Zhao-Quan Liu MD","doi":"10.1016/j.xnsj.2025.100639","DOIUrl":"10.1016/j.xnsj.2025.100639","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100639"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672429","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":"22. Differences in outcomes following circumferential cervical fusion at three levels compared to ACDF alone: an interim analysis of 12- and 24-month results from a prospective randomized IDE trial","authors":"Bruce Michael McCormack MD ,&nbsp;Pierce D Nunley MD","doi":"10.1016/j.xnsj.2025.100716","DOIUrl":"10.1016/j.xnsj.2025.100716","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100716"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672610","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}