North American Spine Society Journal最新文献

{"title":"30. Clinical significance of pose estimation methods compared to radiographic parameters in adolescent idiopathic scoliosis patients.","authors":"","doi":"10.1016/j.xnsj.2024.100368","DOIUrl":"10.1016/j.xnsj.2024.100368","url":null,"abstract":"<div><p>This abstract contains content that is significantly similar to the authors' previously published abstract in the <em>Spine Surgery and Related Research</em>. For access to the original publication, please visit the following DOI: <span><span>https://doi.org/10.22603/ssrr.2023-0269</span><svg><path></path></svg></span>.</p></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666548424000611/pdfft?md5=f0af906da4e5676747215b4fd4ba6396&pid=1-s2.0-S2666548424000611-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844185","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":"65. Cervical fusion in frail elderly patients with type II dens fractures: a propensity score matched analysis based on the 5-item modified frailty index","authors":"","doi":"10.1016/j.xnsj.2024.100403","DOIUrl":"10.1016/j.xnsj.2024.100403","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><p>Type II dens fractures are a traumatic injury of the second cervical vertebrae that often require surgical fusion to prevent spinal instability and further neurological insult. In elderly patients, clinicians often opt for conservative management over surgery due to an overall higher risk of complications in this population. For patients who do undergo surgery, frailty is often used to evaluate postoperative risk. The Modified Frailty Index 5 (mFI-5) is a concise metric that has been shown to have similar clinical utility as longer scales such as the Charlson Comorbidity Index and mFI-11.</p></div><div><h3>PURPOSE</h3><p>To evaluate and quantify which complications are more common following fusion for type II dens fractures for elderly patients with a high mFI-5 compared to those with a low mFI-5.</p></div><div><h3>STUDY DESIGN/SETTING</h3><p>Retrospective cohort database study.</p></div><div><h3>PATIENT SAMPLE</h3><p>Patients from the American College of Surgeons National Trauma Data Bank (NTDB) from 2017-2021.</p></div><div><h3>OUTCOME MEASURES</h3><p>The primary outcome measures are mortality and hospital length of stay (LOS). Secondary outcome measures entail hospital complications such as pressure ulcers and deep vein thrombosis and discharge disposition such as routine discharge to home and discharge to skilled nursing.</p></div><div><h3>METHODS</h3><p>The NTDB was queried from 2017-2021 for all patients with a traumatic type II dens fracture. Patients younger than 65 years, who did not undergo surgical fusion, or who were missing outcome data were excluded. The mFI-5 was calculated based on the presence of COPD, CHF, diabetes, hypertension, or functional impairment, with one point assigned to each. The categories were mFI-5 of 0, 1, or 2+. Propensity score matching was performed using the k-nearest neighbors algorithm based on patient age, sex, race, ethnicity, insurance type, and Glasgow Coma Scale. Patients with mFI-5 of 1 and 2+ were compared with patients with mFI-5 0 using Student's t-tests and Pearson's chi-square tests.</p></div><div><h3>RESULTS</h3><p>A total of 2278 patients matching the inclusion and exclusion criteria were identified, of which 457 had mFI-5 0, 907 had mFI-5 1, and 914 had mFI-5 2+. Following propensity score matching, 457 patients in each score group were identified. There were no significant post-match differences in outcomes between patients with mFI-5 0 and mFI-5 1. Compared to patients with mFI-5 0, patients with mFI-5 1 had a higher overall complication rate (77.46% vs 54.05%, p&lt;0.01), lower rates of routine discharge to home (16.63% vs 23.41%, p=0.01) and higher rates of discharge to a skilled nursing facility (31.07% vs 23.63%, p=0.01). Patients with mFI-5 2+ similarly had higher complication rates (71.33% vs 54.05%, p&lt;0.01), lower rates of routine discharge to home (9.63% vs 23.41%, p=0.01) and higher rates of discharge to a skilled nursing facility (37.63% vs 23.","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666548424000969/pdfft?md5=286d58ae2f11035d154d168d1b678753&pid=1-s2.0-S2666548424000969-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850174","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":"11. Foraminal decompression technique during ACDF for cervical radiculopathy that provides a better outcome: total uncinatectomy vs partial uncoforaminotomy","authors":"","doi":"10.1016/j.xnsj.2024.100349","DOIUrl":"10.1016/j.xnsj.2024.100349","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><p>Anterior cervical discectomy and fusion (ACDF) provides clinical improvement for cervical radiculopathy, even without direct foraminal decompression, because it stabilizes the mobile segment and provides indirect decompression. Recently, it was determined that foraminal decompression via uncinate process resection could lead to faster and greater improvement of arm pain. Total uncinatectomy (TU) and partial uncoforaminotomy (PU) are commonly used for direct foraminal decompression.</p></div><div><h3>PURPOSE</h3><p>However, the advantages and pitfalls of the two techniques remain unknown. We aimed to compare the clinical outcomes and complications of TU and PU to determine the most suitable technique for foraminal decompression during ACDF.</p></div><div><h3>STUDY DESIGN/SETTING</h3><p>N/A</p></div><div><h3>PATIENT SAMPLE</h3><p>N/A</p></div><div><h3>OUTCOME MEASURES</h3><p>N/A</p></div><div><h3>METHODS</h3><p>Consecutive patients (n=306) who underwent single-level ACDF for degenerative cervical radiculopathy and who were followed up for &gt;2 years were retrospectively reviewed. The patients were divided into two groups depending on the surgical technique: Group TU and Group PU. Subsidence, fusion, operative time, estimated blood loss (EBL), complications, and patient-reported outcome measures including arm pain visual analogue scale (VAS) score, neck pain VAS score, and neck disability index (NDI) were assessed and compared between the two groups.</p></div><div><h3>RESULTS</h3><p>Groups TU and PU included 152 (49.7%) and 154 (50.3%) patients, respectively. Group TU had a significantly higher degree of subsidence than Group PU. The 1-year (16 [10.5%] vs 6 [3.9%], p=0.025) and 2-year (11 [7.2%] vs 3 [1.9%], p=0.025) postoperative fusion rates were higher in Group PU than those in Group TU (16 [10.5%] vs 6 [3.9%], p=0.027). Postoperative arm pain VAS score, neck pain VAS score, and NDI scores did not demonstrate significant intergroup differences at all time points. Group TU had a significantly longer operative time (94.21±15.74 vs 81.04±16.92, p &lt; .001), greater EBL (121.34±109.9 vs 71.83±85.71, p&lt;.001), higher dysphasia rate (94 (61.8%) vs 75 (48.7%), p=0.021), and more severe retropharyngeal soft tissue swelling (18.20±5.02 vs 15.98±3.73, p=0.016) than Group PU did. There was one case (0.7%) of cerebral infarction due to vertebral artery injury in Group TU.</p></div><div><h3>CONCLUSIONS</h3><p>PU resulted in lesser complications, shorter operative time, and lesser intraoperative bleeding than did TU. While TU guarantees complete foraminal decompression during ACDF, it requires a longer time. Furthermore, excessive lateral exposure and retraction is needed to palpate the lateral margin of the uncinate for TU. This might cause greater postoperative neck swelling and dysphagia. Moreover, the uncinate process was partially preserved in PU as a potential stabilizer, causing lesser subsidence and higher fusion ","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666548424000428/pdfft?md5=4b69d4cd04e6cccc95a9036f36b6da85&pid=1-s2.0-S2666548424000428-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848608","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":"P19. Risk factors for postoperative bladder dysfunction in lumbar spinal canal stenosis surgery","authors":"","doi":"10.1016/j.xnsj.2024.100423","DOIUrl":"10.1016/j.xnsj.2024.100423","url":null,"abstract":"<div><h3>Background Context</h3><p>The occurrence of postoperative bladder dysfunction is one of the most confusing complications for both patients and surgeons after lumbar spinal canal stenosis surgery.</p></div><div><h3>Purpose</h3><p>To investigate the risk factors for newly-onset postoperative bladder dysfunction.</p></div><div><h3>Study Design/Setting</h3><p>Retrospective study.</p></div><div><h3>Patient Sample</h3><p>The study enrolled 738 cases among the patients who underwent lumbar spinal canal stenosis surgery between 2005 and 2020. Patients with severe preoperative bladder dysfunction (incontinence and urinary retention) or perioperative complications (intraoperative dural injury and long-term urinary catheter placement) were excluded. Patients who had urinary retention for at least 1 week after postoperative urinary catheter removal or who needed intermittent urinary drainage were included in the study.</p></div><div><h3>Outcome Measures</h3><p>The study items included patient background (age, sex, and duration), preoperative JOA score, and surgical factors (surgical procedures and number of decompressed segments). Propensity score-matching was performed at a ratio of 1:2 (postoperative bladder dysfunction group: subject group), and patient background (BMI, smoking history, comorbidities (hypertension, diabetes)), laboratory data (Cre, Chol, TG), imaging findings (lumbar spine alignment, dural canal area at each vertebra, type of cauda equina redundancy), and surgical factors (operation time, blood loss, and history of lumbar surgery) were investigated.</p></div><div><h3>Methods</h3><p>Univariate and multivariate analyses were performed to identify the risk factors for postoperative bladder dysfunction.</p></div><div><h3>Results</h3><p>Postoperative bladder dysfunction occurred in 23 (3.1 %) patients. At 1 year postoperatively, three patients required continued intermittent voiding, and four patients required continued medical treatment. Although the median recovery time in the improvement group was 41 days, only 12 patients (52.2%) showed improvement 3 months after surgery. Patients with postoperative bladder dysfunction were significantly older in all patient data. There were no significant differences in sex, duration, surgical procedures, or the number of decompressed segments. Univariate analysis performed after propensity score matching showed significant differences in imaging findings of curve type of cauda equina, ventral or dorsal deviation of the compressed dura mater, and the lumbar Cobb angle. There were no significant differences in laboratory data, history of lumbar surgery, or dural tube area at the most compressed segment. Multivariate analysis of all three factors was an independent factor.</p></div><div><h3>Conclusions</h3><p>Regardless of the preoperative patient background, surgical procedures, or number of decompressed segments, older patients and those with curve-type cauda equina were at a higher risk of devel","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666548424001161/pdfft?md5=fcf55c5d714e679ed1f8f4699ca26bd8&pid=1-s2.0-S2666548424001161-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849833","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":"P4. Cervical kyphosis increases spinal cord stress and strain in the stenotic cervical spine during neck motion","authors":"","doi":"10.1016/j.xnsj.2024.100408","DOIUrl":"10.1016/j.xnsj.2024.100408","url":null,"abstract":"<div><h3>Background Context</h3><p>Spinal cord stress and strain contributes to the pathophysiology of degenerative cervical myelopathy (DCM) and progressive cervical kyphosis can lead to worsening myelopathy. In DCM, the combination of spinal cord biomechanics, sagittal alignment and cord compression is known to increase spinal cord damage. However, the relationship between these biomechanical factors is not well understood. Quantifying spinal cord biomechanics and its relationship to sagittal alignment in DCM can guide surgical strategies that address adverse spinal cord stress and strain in addition to cord compression.</p></div><div><h3>Purpose</h3><p>To quantify the effect of cervical sagittal alignment on spinal cord stress and strain in the stenotic cervical spine.</p></div><div><h3>Study Design/Setting</h3><p>Finite element analysis.</p></div><div><h3>Patient Sample</h3><p>N/A.</p></div><div><h3>Outcome Measures</h3><p>Spinal cord stress and strain.</p></div><div><h3>Methods</h3><p>A previously validated three-dimensional finite element model of the human cervical spine with spinal cord was used. Three models of cervical alignment were created: lordosis (C2-C7 Cobb angle: 20 degrees), straight (0 degrees) and kyphosis (-9 degrees). Spinal cord prestress and prestrain due to spinal alignment was quantified. Progressive spinal stenosis was simulated at the C5-C6 segment with ventral disk protrusion that reduced the anteroposterior spinal canal diameter to 10mm, 8mm and 6mm. Flexion and extension of the cervical spine was simulated with a pure moment load of 2 Nm. The model was constrained at the inferior surface of the T1 vertebra in all degrees-of-freedom, and the sagittal moment loads were applied at the superior vertebra. An additional follower force of 75N to simulate the head mass and muscle force was applied. Von Mises stress and maximum principal strain of the whole cervical spinal cord was calculated during flexion and extension and added to the prestress and prestrain. The relationship between spinal cord biomechanics, alignment and cord compression was analyzed using linear regression analysis.</p></div><div><h3>Results</h3><p>Spinal cord prestress and prestrain was greatest for the kyphotic spine (7.53 kPa, 5.4%) and least for the lordotic spine (0.68 kPa, 0.3%). Progressive kyphosis and stenosis were associated with increase in spinal cord stress (R²=0.99) and strain (R²=0.99). For every 1 degree increase in kyphosis, average cervical spinal cord stress increased by 0.196 kPa and for every 1% increase in spinal cord compression, the von Mises stress increased by 1.86 kPa. Compared to straight and lordotic alignment, cervical kyphosis was associated with greater spinal cord stress and strain during neck flexion-extension and the magnitude of the difference was greater with increasing stenosis.</p></div><div><h3>Conclusions</h3><p>Cervical kyphosis increases spinal cord stress and strain and the effect is mag","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266654842400101X/pdfft?md5=48aac21d804def9ca04ca788fcbabd1c&pid=1-s2.0-S266654842400101X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840110","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":"15. Long-term outcomes of vertebral body sliding osteotomy for the treatment of cervical myelopathy: a minimum of 5-year follow-up","authors":"","doi":"10.1016/j.xnsj.2024.100353","DOIUrl":"10.1016/j.xnsj.2024.100353","url":null,"abstract":"<div><p>This abstract has been previously published as part of the 2023 Spineweek proceedings. For full access to the abstract, please visit the following URL: <span><span>https://www.sosort.org/resources/Documents/Spineweek_2023_oral_abstracts_final-1.pdf</span><svg><path></path></svg></span>.</p></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666548424000465/pdfft?md5=213341fada5cfdc7804f2ffafbd3067b&pid=1-s2.0-S2666548424000465-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850485","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":"5. Are atypical Hangman's fractures becoming typical?","authors":"","doi":"10.1016/j.xnsj.2024.100343","DOIUrl":"10.1016/j.xnsj.2024.100343","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><p>A traditional Hangman's fracture (HF) is a bilateral fracture traversing the pars interarticularis of C2, but there is wide variability in the fracture patterns that separate the anterior elements of the C2 vertebrae from the posterior elements. One type of fracture that is increasingly being observed is the atypical HF, in which the posterior aspect of the C2 vertebral body, not the bilateral pars, is involved. While a typical HF separates the anterior elements from the posterior elements of the C2 vertebrae and increases the available space for the spinal cord, the space remaining for the spinal cord does not increase secondary to fracture in the case of an atypical HF, leading to a higher risk of neurologic injury.</p></div><div><h3>PURPOSE</h3><p>In this study, we review HFs treated at a single tertiary care university hospital, especially focusing on the fracture pattern and clinical characteristics associated with HFs.</p></div><div><h3>STUDY DESIGN/SETTING</h3><p>N/A</p></div><div><h3>PATIENT SAMPLE</h3><p>N/A</p></div><div><h3>OUTCOME MEASURES</h3><p>N/A</p></div><div><h3>METHODS</h3><p>The subjects of this study are the 35 HF cases treated at our institution between 2010 and 2021, comprised of 22 males and 13 females with an average age of 60.6 years. The etiology, fracture pattern, neurological status, and vertebral artery (VA) integrity were retrospectively examined from hospital records.</p></div><div><h3>RESULTS</h3><p>The injury was caused by a traffic accident in 12 cases, a fall in 12 cases, tripping in 9 cases, and struck by a falling object in 2 cases. There were 6 cases of spinal cord injury (SCI) in this series, of which 2 cases with polytrauma died soon after arriving at the hospital: one traffic accident case and another case in that was struck by a falling steel plate. According to the Levine and Edwards Classification, there were 23 cases with Type 1, 6 cases with Type 2, 2 cases with Type 2a, and 4 cases with Type 3 injuries (of which 2 are the cases that died). There were 13 typical HFs and 22 atypical HFs in which the posterior aspect of the C2 vertebral body and not the pars was involved in at least one side. The pattern of fracture of atypical HFs, according to the Li classification, was 10 cases of Type A1, 1 case of Type A2, 7 cases of Type B1, and 4 cases of Type B2. There was no significant difference in the number of cases with SCI between the typical and atypical HF cases. Twenty<em>^-</em>four cases had VA integrity examined either through enhanced CT or MR angiography and 7 cases (20%) were diagnosed with VA injury. All 7 cases were closely followed without any intervention and no complications were observed. VA hypoplasia was suspected in 3 cases, and no VA injury was found the remaining 14 cases.</p></div><div><h3>CONCLUSIONS</h3><p>In our series, more atypical cases with vertebral body involvement were observed than traditional HFs, suggesting that atypical HFs m","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666548424000362/pdfft?md5=8831c0bafe5d0e3ce769431a04c2ad7c&pid=1-s2.0-S2666548424000362-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841869","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":"14. Does posterior cord compression by ligamentum flavum adversely affect clinical outcome of anterior cervical discectomy and fusion?","authors":"","doi":"10.1016/j.xnsj.2024.100352","DOIUrl":"10.1016/j.xnsj.2024.100352","url":null,"abstract":"<div><p>This abstract has been previously published as part of the 2024 International Meeting on Advanced Spine Techniques proceedings. For full access to the abstract, please visit the following URL: <span><span>https://www.srs.org/Files/IMAST/IMAST2024/Documents/IMAST24-Final-v6-4web.pdf</span><svg><path></path></svg></span>.</p></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666548424000453/pdfft?md5=385c6f45172d52f74d139e7df59e86f4&pid=1-s2.0-S2666548424000453-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843632","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":"33. Comparative clinical outcomes of minimally invasive decompression alone for patients with degenerative scoliosis: a focus on severe cases over 20°","authors":"","doi":"10.1016/j.xnsj.2024.100371","DOIUrl":"10.1016/j.xnsj.2024.100371","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><p>Degenerative scoliosis (DS) is a prevalent condition in the elderly population. Minimally invasive (MI) decompression, preserving posterior soft tissues and posterior ligamentous complex, is one of the treatment options for lumbar canal stenosis with DS. While MI decompression is a recognized treatment for lumbar canal stenosis in DS patients, its efficacy specifically in severe DS (Cobb angle &gt;20°) is not well-documented.</p></div><div><h3>PURPOSE</h3><p>This study aimed to evaluate the clinical outcomes of MI decompression with severe. degenerative scoliosis and identify predictors of poor outcomes.</p></div><div><h3>STUDY DESIGN/SETTING</h3><p>Retrospective review of a prospectively collected multi-surgeon registry.</p></div><div><h3>PATIENT SAMPLE</h3><p>Patients who underwent MI lumbar decompression alone were included and divided into DS and control groups based on a Cobb angle threshold of 20°.</p></div><div><h3>OUTCOME MEASURES</h3><p>We compared Patient-Reported Outcomes and Measures (PROMs), including ODI, VAS back, VAS leg, SF-12 PCS and MCS, and PROMIS-PF between groups at the postoperative ≤3 months and ≥1 year postoperatively, focusing on MCID achievement at ≥1 year time point.</p></div><div><h3>METHODS</h3><p>Data on demographics, comorbidities, spinal alignment, normalized total psoas area (NTPA), and surgical levels were collected. Decompression locations were labeled \"scoliosis-related\" when the decompression levels included the range of end vertebrae of the Cobb angle, and \"outside\" when the decompression operative levels did not include the end vertebrae. Matched cohorts were created by variable-ratio greedy matching for comparison, and multivariable regression analysis identified factors impending MCID achievement in ODI for DS patients.</p></div><div><h3>RESULTS</h3><p>A total of 253 patients were included in the study, with 41 patients in the DS group and 212 in the control group, all of whom underwent MI decompression. After matching for age, gender, osteoporosis status, NTPA, and preoperative ODI, the final matched cohort included 33 DS and 58 control patients. At ≥1 year time point, the DS groups exhibited a significantly lower rate of MCID achievement in ODI (DS: 45.5% vs control 69.0%, P=0.047) and SF-12 PCS (DS: 41.4% vs control 70.6%, P=0.020). The multivariable analysis conducted in the DS group revealed that scoliosis-related decompression (Odds ratio: 9.9, P=0.028) was an independent factor associated with failure to achieve MCID in ODI at the ≥1-year postoperative time point.</p></div><div><h3>CONCLUSIONS</h3><p>Our findings suggest that in DS patients with a Cobb angle &gt;20 degrees, MI lumbar decompression may yield suboptimal disability and physical function improvements. These results underscore the need for careful surgical planning, particularly regarding decompression at the end vertebrae of the Cobb angle.</p></div><div><h3>FDA Device/Drug Status</h3><p>This abstract","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666548424000647/pdfft?md5=6dfd52bdd83f677887dedd67931babee&pid=1-s2.0-S2666548424000647-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842406","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":"P32. Morphological analysis of OPLL progression in cervical spinal cord injury cases treated with posterior fusion","authors":"","doi":"10.1016/j.xnsj.2024.100436","DOIUrl":"10.1016/j.xnsj.2024.100436","url":null,"abstract":"<div><h3>Background Context</h3><p>The patients with cervical ossification of the posterior longitudinal ligament (OPLL) have a high frequency in Asian, with a reported incidence of 6.3% in Japan. The presence of OPLL is a risk factor for cervical spinal cord injury, with some cases resulting from minor trauma such as falls. In previous studies, the characteristics of OPLL after surgery were mentioned, however, there is no consensus on cervical spinal cord injury with OPLL after fusion surgery.</p></div><div><h3>Purpose</h3><p>To investigate the natural progress of ossification in cervical spinal cord injury cases with OPLL treated by posterior fusion surgery.</p></div><div><h3>Study Design/Setting</h3><p>Study design is retrospective study.</p></div><div><h3>Patient Sample</h3><p>The subjects included 42 cases of cervical spinal cord injuries with OPLL that underwent posterior fusion surgery between 2017 and 2021 and were amenable to follow-up with CT for more than 6 months.</p></div><div><h3>Outcome Measures</h3><p>N/A.</p></div><div><h3>Methods</h3><p>We investigated the presence or absence of union of the OPLL at the level of the spinal cord injury on postoperative CT and the presence or absence of ossification of the anterior longitudinal ligament (OALL) on CT at the time of injury. We measured the thickness of OPLL at the level of injury by CT at the time of injury and 6 months after surgery and calculated the difference in the thickness of OPLL. We divided the subjects into two groups: one with the union of OPLL after surgery and one without union. We performed comparative analyses between the two groups and binary logistic regression analyses on the differences in thickness of OPLL, DM, and OALL. In addition, we assessed the rates of union for OPLL and OALL longitudinally at intervals of 3 months, 6 months, 1 year, and 2 years postoperatively.</p></div><div><h3>Results</h3><p>The mean age at the time of injury was 69.0 (44-87) years, the mean observation period was 15.9 (6-63) months, including 38 males and 4 females, the mean BMI was 25.0 (19.0-34.6) kg/m², and 14 cases had DM. At the final observation, 30 cases (71.4%) got the union of OPLL at the level of the injury, and the mean time from injury to the union of OPLL was 8.4 (2-28) months. Thirty patients had OALL on CT at the time of injury. The mean difference in the thickness of the OPLL between the time of injury and 6 months after surgery was -0.07 (-1.2-0.6) mm, with no diameter enlargement. There were no significant differences between the 2 groups in age, gender, BMI, presence of DM, and the difference in the thickness of OPLL. In the group with the union of OPLL, they had OALL at the time of injury significantly by Pearson's chi-square test (p=.007). We found OALL as an independent factor in the binary logistic regression analysis. the rate of transformation into continuous type both OPLL and OALL at intervals of 3 months, 6 months, 1 year, and 2 years were as follo","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266654842400129X/pdfft?md5=7996a8affd61ce0fcf8f7eed3d0ce549&pid=1-s2.0-S266654842400129X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853578","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}