North American Spine Society Journal最新文献

{"title":"Comparison between novel unilateral uniportal endoscopic lumbar interbody fusion and conventional transforaminal lumbar interbody fusion for lumbar degenerative disease with bilateral symptoms: A 1-year follow-up retrospective cohort study","authors":"Kai-Ting Chien MD ,&nbsp;Ping-Chi Tsai MD ,&nbsp;Jian-You Li PhD ,&nbsp;Yueh-Ching Liu MD ,&nbsp;Lei-Po Chen MD, PhD ,&nbsp;Yu-Ching Huang MD, PhD ,&nbsp;Yan-Shiang Lian MD ,&nbsp;Ting-Kuo Chang MD, PhD","doi":"10.1016/j.xnsj.2026.100849","DOIUrl":"10.1016/j.xnsj.2026.100849","url":null,"abstract":"<div><h3>Background Context</h3><div>Full endoscopic lumbar interbody fusion (FELIF) is a minimally invasive alternative to open transforaminal lumbar interbody fusion (open-TLIF) for lumbar degenerative disease (LDD). This study aimed to compare 1-year outcomes of a modified trans-Kambin FELIF, termed Kambin Torpedo FELIF (KT-FELIF), with those of conventional open-TLIF.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, 76 patients with single-level LDD and bilateral symptoms underwent KT-FELIF (n=30) or open-TLIF (n=46) between January 2020 and January 2024. Patients with prior spinal surgery, multilevel disease, or incomplete follow-up imaging were excluded. Perioperative data, pain scores [visual analog scale (VAS)], radiologic outcomes, and complications were compared at ≥12-month follow-up.</div></div><div><h3>Results</h3><div>KT-FELIF showed significantly lower blood loss (72.00±62.00 mL vs. 173.91±134.37 mL, p&lt;.01) and faster ambulation (1.37±0.49 vs. 2.30±0.81 days, p&lt;.01) than conventional open-TLIF. Both groups showed significant VAS score improvement, but KT-FELIF offered better early pain relief (2 weeks and 6 months, p&lt;.01). Fusion rates were similar (97% vs. 91%, p=.654), though open-TLIF had larger fusion mass (p=.005). KT-FELIF led to greater lumbar lordosis (p=.038) and spinal canal area gains (p=.002), while open-TLIF improved foraminal height more. Complication rates were comparable.</div></div><div><h3>Conclusions</h3><div>KT-FELIF is a safe, effective, and less invasive alternative to open-TLIF for LDD with bilateral symptoms, offering benefits in blood loss, recovery time, and early pain relief, with comparable fusion and radiologic outcomes. Further long-term multicenter studies are warranted.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"25 ","pages":"Article 100849"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188412","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":"Stem cell therapy for degenerative disc disease: A systematic review of preclinical evidence, clinical translation, and future directions","authors":"Vinicius Ricieri Ferraz MD ,&nbsp;Carlos R. Goulart MD ,&nbsp;Maria Fernanda Ricieri Ferraz Franco de Souza MD ,&nbsp;Marcelo Ochoa Coelho de Souza Furlan MD ,&nbsp;Philippe Mercier MD, PhD ,&nbsp;Tobias A. Mattei MD, FACS","doi":"10.1016/j.xnsj.2025.100841","DOIUrl":"10.1016/j.xnsj.2025.100841","url":null,"abstract":"<div><h3>Background</h3><div>Degenerative disc disease (DDD) is a leading contributor to chronic low back pain and global disability. Existing therapies, from conservative management to spinal fusion, do not reverse the underlying molecular degeneration, leaving a critical treatment gap. Given its regenerative capabilities the advent of stem-cell therapy may constitute an ideal solution to fulfill such a therapeutic gap.</div></div><div><h3>Methods</h3><div>This PRISMA-compliant systematic review evaluates stem cell–based strategies for intervertebral disc regeneration by examining preclinical evidence, clinical translation, and future directions. Searches of PubMed, Scopus, Web of Science, and related databases (from January 2000–May 2025) identified studies reporting on pain (Visual Analogue Scale), function (Oswestry Disability Index), and structural outcomes (MRI).</div></div><div><h3>Results</h3><div>Preclinical models uniformly demonstrate meaningful regeneration, including restoration of disc height and extracellular matrix. Clinical evidence, however, is limited: thirteen low to moderate-quality trials show modest, albeit statistically significant, improvements in pain and disability, without compelling imaging proof of biological repair. Short to mid-term safety appears acceptable.</div></div><div><h3>Conclusions</h3><div>The use of stem-cell therapy for treatment of degenerative disc disease is constrained by the somewhat hostile and avascular microenvironment of the intervertebral disc. Existing trials exhibit significant methodological weaknesses which substantially impair their application to the daily clinical practice. Future progress will likely depend on incorporating biomaterial-assisted delivery systems, cell-free exosome approaches, biological scaffolds and gene-editing technologies aimed at engineering the disc niche rather than simply focusing on cell replacement.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"25 ","pages":"Article 100841"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977247","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":"PMMA-augmentation of the spinous process as an enhancing-protective measure against bone failure in “through the spinous process-vertebropexy”","authors":"Alexandros Tsolakidis MD ,&nbsp;Marie-Rosa Fasser PhD ,&nbsp;Oliver Wigger ,&nbsp;Mazda Farshad MD ,&nbsp;Jonas Widmer PhD","doi":"10.1016/j.xnsj.2025.100842","DOIUrl":"10.1016/j.xnsj.2025.100842","url":null,"abstract":"<div><h3>Background</h3><div>Vertebropexy, a semi-rigid spinal stabilization technique, utilizes the spinous process(SP) as an anchor point for stabilizing tendon-grafts or flexible cerclages. In its primary form, it entailed drilling into the bone of 2 adjacent SPs and threading the materials through the holes. Biomechanical studies have identified the SP as the weakest part of the vertebrae, while cadaveric studies have demonstrated a higher bone failure rate with osteoporosis. We investigated whether cement augmentation of the SP could enhance the biomechanical strength and reduce the fracture-risk in the setting of first-generation Vertebropexy.</div></div><div><h3>Methods</h3><div>Following computed tomographic analysis and measurement of the bone mineral density, 12 lumbar segments were divided in 2 groups (Osteoporotic/ Nonosteoporotic) and then fixed in custom-made 3D-printed clamps. The SPs of 6 segments underwent cement augmentation (PMMA-Group), and a CT scan confirmed adequate augmentation. The other 6 segments remained uncemented. (Native-Group). Posterior decompression, drilling, and instrumentation with bovine tendons were then conducted. Torque-to-failure stress tests were performed on a biaxial static testing machine.</div></div><div><h3>Results</h3><div>The cement-augmentation of the SP significantly increases the torque-to-failure in flexion (p=.00037/ Median &amp; IQR: 13.0 &amp; 5.2 Nm in the Native-Group vs. 26.5 &amp; 11.1 Nm in the PMMA-Group), regardless of the bone quality (p=.008). A statistically significant difference in torque-to-failure between Osteoporotic and NonOsteoporotic groups inside the PMMA and Native groups was determined (p=.015 and p=.025, respectively). A statistically significant correlation between bone density and failure torque was not detected in this cohort, possibly due to the limited sample size (Spearman 0.276, p=.192). A comparison between the torque-to-failure of the Native-NonOsteoporotic SPs and that of the PMMA-Osteoporotic showed no statistical significance (p=.240).</div></div><div><h3>Conclusions</h3><div>Based on the findings of this small-sample cadaveric study, cement-augmentation of the spinous processes can multiply the torque-to-failure/fracture in both osteoporotic and nonosteoporotic conditions and may be used as a salvage technique in first-generation vertebropexy procedures that compromise the spinous process.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"25 ","pages":"Article 100842"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977245","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":"Traditional pedicle screw versus cortical bone trajectory in the upper thoracic spine: A technical description and retrospective comparative review","authors":"Matthew J. Coyle MD, MSc ,&nbsp;Alexandra Bunting MD ,&nbsp;Eve Tsai MD, PhD ,&nbsp;Alexandra Stratton MD, MSc ,&nbsp;Phillipe Phan MD, PhD ,&nbsp;Stephen Kingwell MD, MSc ,&nbsp;Julia Brillinger MSc ,&nbsp;Eugene K. Wai MD, MSc","doi":"10.1016/j.xnsj.2026.100859","DOIUrl":"10.1016/j.xnsj.2026.100859","url":null,"abstract":"<div><h3>Background</h3><div>The cortical bone trajectory (CBT) screw is a relatively new vertebral fixation technique described for use in the lumbar spine by Santoni and Hynes et al. It has been shown to have advantageous biomechanical properties with respect to torsional and pullout strength. The evaluation of CBT in cervical-thoracic fixation has been quite limited. The primary objective of the current study was to determine the mid to long term results of CBT over traditional pedicle screw fixation in the upper thoracic spine.</div></div><div><h3>Methods</h3><div>The current study completed a retrospective chart review of consecutive patients undergoing posterior cervical thoracic fixation in the setting of degenerative, trauma, infection and oncologic etiologies at a single academic centre. Patients with a greater than 1 year radiological follow up were included in the research study. Data was collected by an independent observer, which included patient demographics, complications. Preserved immediate postoperative sagittal alignment at 1 year was considered the primary outcome of this study.</div></div><div><h3>Results</h3><div>Of the 47 patients who met the inclusion criteria, 18 had undergone upper thoracic spine instrumentation with CBT and 28 had TPS trajectories. The operative time was found to be significantly lower in the CBT group (p&lt;.01). The complication rates were similar between groups with the TPS group having an infection rate of 10.7% while the CBT group had a rate of 4.7%. CBT had a higher rate of preservation of post operative alignment at greater than 1 year follow up (p&lt;.05).</div></div><div><h3>Conclusions</h3><div>Patients who underwent CBT fixation had preserved cervical spine alignment at their final postoperative visit. The use of CBT led to a reduction in total length of OR and trended towards a lower complication rate. Given the early findings of our study and others it is likely that CBT screws in the upper thoracic spine will become much more common place at the end of both cervical-thoracic and thoraco-lumbar fusion constructs given their demonstrated benefits.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"25 ","pages":"Article 100859"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378810","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":"Association between self-reported mental health and resource utilization in patients undergoing elective lumbar fusion","authors":"Matthew J. Solomito PhD ,&nbsp;Heeren Makanji MD","doi":"10.1016/j.xnsj.2026.100851","DOIUrl":"10.1016/j.xnsj.2026.100851","url":null,"abstract":"<div><h3>Background</h3><div>Mental health concerns are increasingly common in patients undergoing lumbar spine fusion. Recent studies have suggested that poor mental health leads to a greater risk of suboptimal recovery. However, few studies have investigated cost and resource allocation associated with patients with poor mental health. Therefore, this study was designed to understand how self-reported mental health, assessed by the PROMIS-10 Global Mental Health T-score (MHT), was associated with both hospital costs and post discharge resource utilization.</div></div><div><h3>Methods</h3><div>A total of 1,211 patients that underwent 1- or 2-level elective lumbar fusion between June 2021 and June 2024, and completed a preoperative PROMIS-10 Global assessment were analyzed for this retrospective review. Patients were grouped based on their MHT: MHT &gt;50 was considered above average (AA), MHT scores between 40 and 50 were average (A), and MHT &lt;40 was considered below average (BA). Multivariate regressions were used to investigate the associations between the MHT score, cost and postdischarge resource utilization.</div></div><div><h3>Results</h3><div>A total of 41.7% of the study cohort was in the A-MHT group, 31.5% was in the AA-MHT group, and 26.8% was in the BA-MHT group. There were no demographic differences among study groups. The AA-MHT group utilized significantly less resources than both the BA-MHT and A-MHT groups. Neither the MHT group nor diagnosed mental illness, were independently associated with cost (p=.572 and p=.646 respectively).</div></div><div><h3>Conclusions</h3><div>The findings of this study demonstrated that patients with below average mental health (MHT scores &lt;40) may not be a risk for increased resource utilization or cost. However, the study results did suggest that patients with above average mental health (MHT scores &gt;50) have better outcomes, and cost less than other groups during the initial recovery phase following elective lumbar fusions.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"25 ","pages":"Article 100851"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188414","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":"Is the antepsoas oblique lumbosacral interbody fusion safe in patients with aortoiliac calcification?","authors":"Chadi Tannoury MD ,&nbsp;Hayley Denwood MD ,&nbsp;Rehan R. Khan BS ,&nbsp;Rutvin J. Kyada BS, MPH ,&nbsp;Olivia T. Zhou BA ,&nbsp;Sara Atassi BS ,&nbsp;Aziz Saade MD ,&nbsp;Mirna N. Chahine PhD ,&nbsp;Tony Tannoury MD","doi":"10.1016/j.xnsj.2026.100867","DOIUrl":"10.1016/j.xnsj.2026.100867","url":null,"abstract":"<div><h3>Background</h3><div>The anterior approaches to lumbar arthrodesis, including direct anterior (ALIF) and antepsoas (ATP)/oblique (OLIF) fusions, require careful manipulation of the abdominal prevertebral vessels for safe and adequate spinal access. Therefore, surgeons who perform anterior lumbar fusions in patients with aortoiliac calcifications are often cautious due to concerns for perioperative vascular complications, as well as the associated risks of concomitant medical comorbidities. This study sought to compare the incidence of perioperative vascular and medical complications in patients with and without abdominal aortoiliac calcification (AAC) undergoing the minimally invasive antepsoas (MIS-ATP) lumbosacral fusion.</div></div><div><h3>Methods</h3><div>This was a retrospective matched cohort study including 482 adult patients undergoing MIS-ATP lumbosacral fusions at a single institution between 2014 and 2020 (227 with AAC and 255 without AAC), matched by sex and American Society of Anesthesiologists (ASA) scores. Through preoperative standing lateral lumbar radiographs, using Kaupilla et al.’s AAC grading system, we graded anterior and posterior aortic wall calcification from L1 to L4. Electronic medical records were reviewed to identify and collect the perioperative complications.</div></div><div><h3>Results</h3><div>While there was no occurrence of intraoperative vascular injuries in either group, patients with AAC were more likely to develop medical complication (34.8% vs. 13.3%, p &lt; .001), with anemia (18.9% vs. 9.2%), ileus (16.3% vs. 2.7%) and acute kidney injury (6.6% vs. 5.5%) being the most common. Overall, individuals with AAC had 2.62 times increased odds of developing a postoperative medical complication. Moreover, moderate AAC was found to be a significant risk factor (OR = 3.48).</div></div><div><h3>Conclusions</h3><div>Presence of AAC in patients undergoing MIS-ATP fusion was not associated with increased risk of direct surgical or exposure related vascular complications. However, patients with AAC were significantly more likely to experience medical complications following MIS-ATP fusion.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"25 ","pages":"Article 100867"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515362","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":"Dynamic posterior stabilization for traumatic lumbar facet fracture: A case report","authors":"Allison Kelliher MD ,&nbsp;Tan Chen MD","doi":"10.1016/j.xnsj.2026.100852","DOIUrl":"10.1016/j.xnsj.2026.100852","url":null,"abstract":"<div><div>This case report describes an 18-year-old woman who presented after a high-speed motor vehicle collision with a large displaced right L5 superior facet fracture, noted to be neurologically intact. She sustained multiple associated injuries, including small-bowel trauma with hemoperitoneum requiring exploratory laparotomy and double enterectomy. Following a trial of conservative management with thoracolumbosacral orthosis (TLSO), upright radiographs demonstrated progressive L4–5 coronal and sagittal deformity with facet distraction, her neurologic examination remained normal throughout follow-up. Given her age and the concern for adjacent-segment disease with fusion, we proceeded with total posterior spine (TOPS) arthroplasty at the level of L4–L5. Surgery included laminectomy, bilateral complete facetectomies, pedicle-screw instrumentation, and TOPS implantation. The postoperative course was uncomplicated, with intact neurology and progressive improvement in mobility. This case describes the novel utilization of motion-preserving posterior arthroplasty in traumatic facet injury, allowing for deformity correction while potentially minimizing the long-term morbidity associated with lumbar fusion.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"25 ","pages":"Article 100852"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188415","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":"Diminishing usage of halo-vest orthoses: Characterization of evolving trends","authors":"Albert H. Lee MSE ,&nbsp;Rahul H. Jayaram BS ,&nbsp;Jonathan N. Grauer MD ,&nbsp;Raj J. Gala MD","doi":"10.1016/j.xnsj.2026.100858","DOIUrl":"10.1016/j.xnsj.2026.100858","url":null,"abstract":"<div><h3>Background</h3><div>Halo-vest orthoses may be considered for spinal immobilization and deformity correction. Recent usage patterns remain poorly characterized. Patients receiving halo-vest orthoses were identified from the 2010 to 2022 M170Ortho PearlDiver database. Yearly trends and overall distributions of utilization rates, Elixhauser Comorbidity Index (ECI), sex, primary indications, and rates/timing of subsequent surgery.</div></div><div><h3>Methods</h3><div>Usage and patient ages were trended over the years and characterized. Patients were further subcategorized as pediatric (&lt;18 years), adult (18-65 years), and geriatric (&gt;65 years). Across age cohorts, trends and distributions of ECI, sex, primary indications, and rates/timing of subsequent surgery were determined. Simple linear regression with overall F-tests and Kaplan-Meier survival analyses with log-rank tests were used to determine differences.</div></div><div><h3>Results</h3><div>A total of 6,016 patients receiving halo-vest orthoses were identified. From 2010 to 2022, halo utilization declined 69.1% (p&lt;.001) and average patient age declined from 48.9 to 38.8 (p=.001). Of these, 1,334 (22.2%) were pediatric, 2,830 (47.0%) were adult, and 1,852 (30.8%) were geriatric. Pediatric proportion of use increased (p&lt;.001), while adult and geriatric use decreased (p=.002; p&lt;.001) over the years. Average ECI increased across all age groups (p&lt;.001).</div><div>Spinal deformity was the most common indication in the pediatric population, while upper cervical fractures were most common in the adult and geriatric populations. Of the 37.2% of pediatric patients who proceeded to subsequent surgery, half were within 25 days, and of the 20.6% of geriatric patients undergoing subsequent surgery, half were within 1 week.</div></div><div><h3>Conclusions</h3><div>The current study characterized the decreasing use of halo-vest orthosis over the years, with greatest use for younger patients with deformity and older patients with upper cervical fractures. More recently, usage in the pediatric population has surpassed usage in the geriatric population. Of those going onto subsequent surgery, most were early, suggesting use as a temporizing or reduction measure.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"25 ","pages":"Article 100858"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277310","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":"Artificial intelligence in spine care: A scoping review of treatment applications","authors":"Victoria A. Bensel DC, MS, MPH ,&nbsp;Anne Habeck MPH ,&nbsp;Marcda Hilaire Brunot DC, MPH ,&nbsp;Eleni-James Becton DC ,&nbsp;Monika Ray PhD ,&nbsp;Alexandria L. Brackett ,&nbsp;Anthony J. Lisi DC","doi":"10.1016/j.xnsj.2025.100827","DOIUrl":"10.1016/j.xnsj.2025.100827","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) is increasingly applied in healthcare to support decision-making, personalize treatment, and improve outcomes. In spine care, AI has been used for both operative and nonoperative interventions, including surgical planning, outcome prediction, and digital tools for chronic low back pain (cLBP). However, evidence remains fragmented and variable in quality, limiting its utility for clinicians and researchers. This review maps the current literature on AI in spinal disorder treatment and highlights gaps for future research.</div></div><div><h3>Methods</h3><div>This scoping review followed Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines. Ovid MEDLINE, AMED, Embase, Cochrane CENTRAL, Web of Science, and Scopus were searched from January 2019 to December 2024. Eligible studies were English-language, peer-reviewed, involved AI applied to treatment interventions in human participants, included a comparison group, and provided sufficient methodological detail. No geographic restrictions were applied. Studies were evaluated by AI technology, treatment modality, outcomes, and quality. Methodological quality was assessed using a 19-point scoring system covering study design, reporting clarity, data validation, and feature selection.</div></div><div><h3>Results</h3><div>The search yielded 1,782 manuscripts; 16 met inclusion criteria. Of these, 3 originated from the United States, 8 were single-country studies, and 5 were international collaborations. Fourteen studies focused on nonoperative management of musculoskeletal pain, particularly cLBP, using chatbots, AI-driven exercise platforms, and decision-support systems. These demonstrated modest improvements in pain, disability, and quality of life, with high adherence and satisfaction. Two studies investigated operative applications, reporting favorable results. Methodological scores ranged from 8.5 to 17/19, with common limitations in data validation and feature selection.</div></div><div><h3>Conclusions</h3><div>Current literature demonstrates AI applications in nonoperative management of cLBP and in operative contexts such as surgical planning and outcome prediction. Most studies addressed cLBP, with limited exploration of neck pain, highlighting an area for future investigation.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"25 ","pages":"Article 100827"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798463","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":"Commentary on “Undetected low bone mineral density in patients undergoing lumbar fusion surgery: Prevalence and risk factors”","authors":"Melissa Baker MD ,&nbsp;Zorica Buser PhD, MBA","doi":"10.1016/j.xnsj.2025.100839","DOIUrl":"10.1016/j.xnsj.2025.100839","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"25 ","pages":"Article 100839"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926567","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}