North American Spine Society Journal最新文献

{"title":"9. Detection of cervical ossification of the posterior longitudinal ligament with a Dual-Stage Attention and Multi-Scale Feature Fusion Network","authors":"Chun Tseng PhD, Hsiao Pang Hsuan MD","doi":"10.1016/j.xnsj.2025.100703","DOIUrl":"10.1016/j.xnsj.2025.100703","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Cervical ossification of the posterior longitudinal ligament (C-OPLL) is a significant contributor to cervical myelopathy and presents surgical challenges due to its complex pathology. Magnetic resonance imaging (MRI) is the standard modality for evaluating neural compression in cervical spine disorders. However, in cases involving ossified lesions such as C-OPLL or partially calcified herniated intervertebral discs (HIVD), MRI often falls short in precisely identifying calcified structures. Computed tomography (CT) is required for definitive diagnosis but is associated with increased radiation exposure and higher costs.</div></div><div><h3>PURPOSE</h3><div>Recent advances in artificial intelligence (AI)-based imaging techniques offer a novel solution to enhance MRI’s diagnostic capability. By utilizing deep learning models to improve MRI images, AI-driven approaches could potentially reduce the reliance on CT scans, minimizing radiation exposure and associated costs while maintaining diagnostic accuracy. This study introduces a deep learning model designed to enhance MRI-based detection of C-OPLL and improve diagnostic workflows.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>We propose a deep learning framework, the Dual-Stage Attention and Multi-Scale Feature Fusion Network (DAFNet), for detecting C-OPLL using MRI. The model consists of two stages: segmentation and detection. In the segmentation stage, a dedicated segmentation model extracts the cervical spine region (C2–C6) to enhance image features. The refined images are then processed using the U-Coordinate Attention Mobile Inverted Bottleneck Convolution Network (U-CAMBNet), a model based on U-Net incorporating Agile Inverted Bottleneck Convolution (ABconv) and Coordinate Attention mechanisms. These enhancements enable improved feature extraction, allowing for precise classification and localization of ossified lesions.</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 propose a deep learning framework, DAFNet, for detecting C-OPLL using MRI. The model consists of two stages: segmentation and detection. In the segmentation stage, a dedicated segmentation model extracts the cervical spine region (C2–C6) to enhance image features. The refined images are then processed using the U-CAMBNet, a model based on U-Net incorporating ABconv and Coordinate Attention mechanisms. These enhancements enable improved feature extraction, allowing for precise classification and localization of ossified lesions.</div></div><div><h3>RESULTS</h3><div>Our AI-driven model demonstrated high diagnostic performance, achieving an accuracy of 0.99, precision of 0.76, recall of 0.77, and an F1 score of 0.76. These metrics surpass those of existing studies, highlighting the model’s potential to enhance MRI-based detection of C-OPLL and reduce dependence on CT imaging.</div></div><div><h3>CONCL","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100703"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672550","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":"P37. Effect of intraoperative image-guided spinal navigation technologies on endoscopic lumbar spine surgery: a systematic review and meta-analysis","authors":"Hsu I Chou MD , Yu Che Wang MD , Meng Huang Wu MD, PhD","doi":"10.1016/j.xnsj.2025.100661","DOIUrl":"10.1016/j.xnsj.2025.100661","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Endoscopic lumbar spine surgery (ELSS) is a mainstream procedure that minimizes soft tissue damage, promotes faster recovery, and enhances surgical visualization. However, its adoption involves a steep learning curve, particularly with conventional fluoroscopic guidance, because it requires precise targeting of spinal pathology and navigating endoscopic anatomy. Intraoperative image-guided spinal navigation provides real-time imaging during surgery and can enhance pathology localization, optimize working channel placement, and facilitate the learning process of ELSS.</div></div><div><h3>PURPOSE</h3><div>This study examined whether intraoperative image-guided spinal navigation offers perioperative and clinical advantages in ELSS.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>A systematic review and meta-analysis.</div></div><div><h3>PATIENT SAMPLE</h3><div>This analysis included 1390 individuals from 19 studies comparing the outcomes of intraoperative image-guided spinal navigation and conventional C-arm fluoroscopy in ELSS.</div></div><div><h3>OUTCOME MEASURES</h3><div>The primary outcomes included perioperative metrics such as operation time, number of puncture attempts, cannulation time, fluoroscopy use frequency, and radiation dose. Clinical outcomes included length of stay, Visual Analog Scale (VAS) scores, and Oswestry Disability Index (ODI) scores.</div></div><div><h3>METHODS</h3><div>We systematically searched PubMed, Europe PMC, Scopus, Cochrane Library, and ClinicalTrials.gov for studies comparing the outcomes of intraoperative image-guided navigation with conventional C-arm fluoroscopy in ELSS.</div></div><div><h3>RESULTS</h3><div>A total of 19 studies involving 1,390 patients were included for meta-analysis. Intraoperative image-guided spinal navigation in ELSS was significantly associated with a shorter total operation time (mean difference [MD] = -11.18 min, 95% confidence interval [CI] = -14.67 to -7.70, P < .01; I2 = 83%), fewer puncture attempts (MD = -2.94, 95% CI = -5.02 to -0.87, P < .01, I2 = 99%), shorter cannulation time (MD = -12.59 min, 95% CI = -19.45 to -5.74, P < .01, I2 = 97%), lower fluoroscopy use frequency (MD = -14.75 times, 95% CI = -24.36 to -5.13, P < .01, I2 = 100%), lower radiation exposure (standardized MD = -4.18, 95% CI = -5.58 to -2.78, P < .01, I2 = 93%), and shorter hospital stay (MD = -0.44 days, 95% CI = -0.84 to -0.03, P = .03, I2 = 83%) compared with C-arm fluoroscopy. No significant differences in back VAS scores, leg VAS scores, or ODI scores were observed at up to 1 year of follow-up.</div></div><div><h3>CONCLUSIONS</h3><div>Intraoperative image-guided spinal navigation in ELSS significantly reduces the total operation time and radiation exposure for both patients and surgical staff. Additionally, it may facilitate the learning process of ELSS by reducing the number of puncture attempts and the duration of cannulation. Despite these intraoper","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100661"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672555","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":"15. Efficacy and safety of preoperative halo-gravity traction in cervical kyphotic deformity correction","authors":"Hao-Wen Chen MD, PhD","doi":"10.1016/j.xnsj.2025.100709","DOIUrl":"10.1016/j.xnsj.2025.100709","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Severe cervical kyphotic deformities present a significant challenge in spinal correction surgery due to the risks of neurological complications and suboptimal outcomes. Halo-gravity traction (HGT) has been proposed as a preoperative strategy to improve outcomes by gradually realigning the spine, especially for correcting severe kyphotic deformities; however, whether applying HGT as a routine strategy remains controversial.</div></div><div><h3>PURPOSE</h3><div>This study aims to evaluate the effectiveness and safety of preoperative HGT in patients undergoing corrective surgery for severe cervical kyphotic deformities by comparing surgical outcomes with and without preoperative traction.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Retrospective cohort study conducted at a medical center</div></div><div><h3>PATIENT SAMPLE</h3><div>Fifty patients with severe cervical kyphosis were enrolled and divided into two groups: 25 received preoperative HGT for several days before primary correction surgery, and 25 underwent direct correction surgery without HGT.</div></div><div><h3>OUTCOME MEASURES</h3><div>Outcomes measured included total corrected Cobb’s angle, pain relief (visual analog scale, VAS), functional improvement (Oswestry Disability Index, ODI; and Japanese Orthopaedic Association, JOA score), and safety (rate of neurological deficits).</div></div><div><h3>METHODS</h3><div>Statistical analysis, including Student's t-test, Chi-square, and logistic regression model, were performed to compare these parameters between groups.</div></div><div><h3>RESULTS</h3><div>The HGT group demonstrated significantly better correction of Cobb angle (mean improvement of 35.2° vs 28.5°, p &lt; 0.01), more excellent pain relief (VAS score reduction: 5.8 vs 4.2, p &lt; 0.01), and enhanced functional improvement (ODI reduction: 26.7% vs 18.3%; JOA score improvement: 3.5 vs 2.4, p &lt; 0.05). Furthermore, the rate of neurological complications was lower in the HGT group (4% vs 16%, p &lt; 0.05).</div></div><div><h3>CONCLUSIONS</h3><div>HGT is an effective and safe adjunctive strategy for managing moderate to severe cervical kyphotic deformities, leading to superior surgical outcomes and reduced complications. Routine implementation of preoperative HGT is recommended in appropriate cases to optimize deformity correction and patient safety.</div></div><div><h3>FDA Device/Drug Status</h3><div>Anjon Bremer Halo System (K171863) (Approved for this indication).</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100709"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672607","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":"P35. Comprehensive analysis of novel uniportal trans-Kambin endoscopic lumbar interbody fusion with over one year of CT-based fusion evaluation and clinical follow-up","authors":"Kai Ting Chien MD","doi":"10.1016/j.xnsj.2025.100659","DOIUrl":"10.1016/j.xnsj.2025.100659","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Full-endoscopic lumbar interbody fusion (FELIF) is an evolving technique for lumbar degenerative disease (LDD). Among FELIF approaches, the novel FELIF technique, a modified trans-Kambin approach called Kambin Torpedo FELIF (KT-FELIF), enables bilateral decompression through a unilateral trajectory while allowing extensive discectomy and thorough endplate preparation. This study analyzes clinical, radiological, and procedural trends in KT-FELIF, including fusion progression, structural changes, and surgical refinements.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;This study aims to evaluate the clinical and radiological outcomes of KT-FELIF, particularly focusing on its effectiveness in achieving direct bilateral decompression, fusion progression, and structural stability. Additionally, it examines the influence of patient factors, surgical experience, and instrumentation refinements on fusion rates, surgical efficiency, and complication profiles.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;This is a retrospective observational study conducted at a single institution, analyzing patients who underwent KT-FELIF with a minimum follow-up period of one year. Clinical and radiological outcomes were systematically assessed using validated scoring systems and imaging modalities, including computed tomography (CT) for fusion evaluation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;The study included 75 patients diagnosed with lumbar degenerative disease (LDD), encompassing a total of 100 treated spinal segments.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;Postoperative pain relief, including back pain and bilateral radiculopathy, was assessed to evaluate clinical improvement. Fusion progression was analyzed using CT scans and Bridwell grading to determine the extent of bony integration. Imaging assessments included changes in disc height, lordotic angle, foraminal expansion, spinal canal cross-sectional area, and adjacent segment stability. Surgical efficiency was measured based on operative time trends, while complication rates, including vertebral osteolysis, cage-related issues, infection, nerve injury, and heterotopic ossification, were documented.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;A retrospective analysis was conducted on 75 patients with lumbar degenerative disease (LDD), encompassing 100 treated spinal segments. The study followed patients for at least one year, assessing demographic factors including age, smoking status, osteoporosis medication use, and comorbidities in relation to endoscopic fusion outcomes. Clinical outcomes were evaluated preoperatively and postoperatively, including back pain severity, radiculopathy, and pain intensity on both ipsilateral and contralateral sides. Imaging assessments included adjacent segment stability, changes in disc height, lordotic change before and after surgery, foraminal expansion, and spinal canal cross-sectional area increase. We also analyzed the impact of Modic","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100659"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672172","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":"P18. Factors influencing the lowest visible level on lateral cervical fluoroscopy during anterior cervical discectomy and fusion","authors":"Siddharth A. Badve MD","doi":"10.1016/j.xnsj.2025.100642","DOIUrl":"10.1016/j.xnsj.2025.100642","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Obtaining adequate intraoperative visualization of cervical vertebra can prove challenging during anterior cervical discectomy and fusion (ACDF). There is little information about patient and surgeon factors that can effectively predict the degree of intraoperative visualization of cervical vertebral level. We hypothesize that the degree of cervical visualization is impacted by specific patient variables, preoperative lateral upright radiographic parameters, and intraoperative patient positioning technique.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;The purpose of this study is to identify patient variables and surgeon positioning variables that influence lowest visible vertebra on intraoperative radiographs for patients undergoing ACDF.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;Retrospective chart review at a regional multicenter hospital.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;Adult patients who underwent ACDF&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;Identification of predictive demographic factors for intraoperative visualization, as well as a novel cervical visualization score calculated based on intraoperative vertebral level difference from preoperative baseline upright cervical radiographs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;This retrospective study examined adult patients who underwent ACDF in a large, integrated system. Patient demographic factors were obtained to identify predictors of intraoperative visualization based on a series of radiographic cervical parameters measured on upright radiographs. A novel cervical visualization score was calculated based on intraoperative vertebral level difference from preoperative baseline level. Patient demographic and radiographic parameters were analyzed using a multivariate backward linear regression. Differences in pre-and-intraoperative visualization among traction versus non-traction techniques were determined with a two-sample t-test. One-way ANOVA and post hoc analyses were used to identify differences in visualization scores in traction and non-traction groups separately. Inter-rater reliability was assessed for all radiographic measurements made by two independent researchers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;There were 151 electronically identified patients included. Elevated BMI and use of traction significantly reduced visualization scores. High T1 slope modestly improved visualization. Traction group visualization scores at lowest visualized vertebra (C7 lower half and C7-T1 disc) showed a significant decrease compared to non-traction group with equal preoperative visualization. Pairwise comparisons for traction stabilized patients showed a significantly reduced visualization at the preoperative C7-T1 disc level compared to C6 upper half. ANOVA analysis within the non-traction group showed no statistical significance. The averaged ICC of 0.90 demonstrates excellent inter-rate reliability (ICC range of 0.75-0.97)&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100642"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672356","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":"33. Low molecular weight heparin prophylaxis is safe in patients undergoing staged thoracolumbar fusion","authors":"Harsh Wadhwa MD ,&nbsp;Jayme Koltsov PhD ,&nbsp;Serena S Hu MD","doi":"10.1016/j.xnsj.2025.100727","DOIUrl":"10.1016/j.xnsj.2025.100727","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Longer thoracolumbar fusions are sometimes performed in a staged approach, which carries higher deep vein thrombosis (DVT) and pulmonary embolism (PE) risks. Low molecular weight heparin (LMWH) prophylaxis may ameliorate these risks.</div></div><div><h3>PURPOSE</h3><div>To assess rates of DVT and PE among patients who did or did not receive LMWH undergoing staged and unstaged thoracolumbar fusion.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Retrospective cohort study.</div></div><div><h3>PATIENT SAMPLE</h3><div>Adults undergoing thoracolumbar fusion of =5 levels (single institution 2014-2024).</div></div><div><h3>OUTCOME MEASURES</h3><div>Ninety-day complications, readmissions, and reoperations.</div></div><div><h3>METHODS</h3><div>Patient demographics, comorbidities, perioperative data (EBL, transfusions, etc.), and postoperative data (90-day complications, readmissions, reoperations) were collected. Analyses were performed separately for staged and unstaged patients, with differences with LMWH assessed via chi-squared and Fisher’s exact tests (a=0.05).</div></div><div><h3>RESULTS</h3><div>Overall, 191 staged (131 [68.6%] female, 66.7±9.2 years) and 216 unstaged (146 [67.6%] female, 67.7±9.8 years) patients were included. LMWH was given in 133 (70%) of staged surgeries and 107 (50%) of unstaged surgeries. Among staged patients, rates of PE were 3.1% (95% CI 1.2, 7.8) with LMWH vs 9.1% (4.0, 19.6) without LMWH (p=0.132), and rates of DVT were 4.7% (2.2, 9.9) with LMWH vs 5.5% (1.9, 14.9) without LMWH (p&gt;0.999). Patients receiving LMWH had higher BMI (29.1 [28.2, 30.1] vs 27.0 [25.7, 28.2], p=0.011). Among unstaged patients, rates of PE were 3.9% (1.5, 9.6) with LMWH vs 3.1% (1.1, 8.8) without LMWH (p=0.185) and rates of DVT were 2.9% (1.0, 8.2) with LMWH vs 4.2% (1.6, 10.2) without LMWH (p=0.338). In both staged and unstaged cohorts, transfusion rates (and amounts) were comparable with vs without LMWH (Staged: 96.4% [87.7, 99.0] vs 92.1% [86.1, 95.7], [p=0.352]; Unstaged: 73.8% [64.6, 81.3] vs 76.0% [66.6, 83.5], p=0.387). Complications, readmission, and 6-month reoperation were also comparable with vs without LMWH.</div></div><div><h3>CONCLUSIONS</h3><div>In the largest study to date directly comparing long thoracolumbar fusion with vs. without LMWH prophylaxis, LMWH did not increase bleeding or transfusions. LMWH may provide benefits, particularly in PE reduction; however, large population-based study is needed for confirmation.</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 100727"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672410","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":"36. Carbon fiber implants for spinal tumors: outcomes and complications","authors":"Lancelot Benn MD ,&nbsp;Andrew Z Mo MD ,&nbsp;Addisu Mesfin MD","doi":"10.1016/j.xnsj.2025.100730","DOIUrl":"10.1016/j.xnsj.2025.100730","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Due to advances in the detection and treatment of cancer, life expectancy for cancer patients has increased. There is a shift towards less invasive approaches for metastatic spine disease. Carbon fiber implants provide better postop visualization for radiation therapy planning and for obtaining imaging for surveillance purposes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;To evaluate the outcomes and complications of using carbon fiber implants for spine stabilization in patients undergoing surgery for spine tumors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;A retrospective case series of spinal tumor patients were managed from 12/2020-12/2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;A retrospective case series of spinal tumor patients were managed from 12/2020-12/2024.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;A total of 30 patients undergoing 31 procedures (14 percutaneous and 17 open) with 159 carbon fiber screws and one carbon fiber corpectomy cage.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;A retrospective case series of spinal tumor patients were managed from 12/2020 - 12/2024. Inclusion criteria were patients with primary or metastatic spine tumors undergoing carbon fiber instrumentation. Patient demographics (age, sex, race/ethnicity) as well as tumor histology, levels of surgery, type of implants used (open pedicle screw, percutaneous pedicle screws) and hybrid constructs (combination of titanium screws and rods with carbon fiber implants) and number of screws. Intraoperative, postop surgical/implant complications, length of follow-up, and patient survival were collected.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;A total of 30 patients undergoing 31 procedures (14 percutaneous and 17 open) with 159 carbon fiber screws and one carbon fiber corpectomy cage met the inclusion criteria. The demographics were: average age 60.2 years (15-83), 12 females, 18 males, 13 Whites, 14 Blacks, and 3 Hispanics. Tumor types were multiple myeloma (4), colon cancer (4), breast (4), lung (4), thyroid (3), prostate (2), pancreatic (2), (1), squamous cell (1), aneurysmal bone cyst (ABC) (2), endometrial (1), hepatocellular (1), esophageal (1) and lymphoma (1). Tumor locations were lumbar (n=14), thoracic (n=13), and sacral (n=3). The average estimated blood loss (EBL) was 530.5 ml (50-2000), with the percutaneous implant group having significantly less blood loss compared to the open group (442.5 ml vs 602.9 ml, p&lt; 0.05). Most patients (N=23) had a carbon fiber-only construct, and 7 had a hybrid construct where carbon fiber rods or cages were combined with titanium implants. There was 1 intraop complication. Postop one patient with carbon fiber-only implants underwent revision surgery within 2 weeks of surgery to reposition a right S1 symptomatic percutaneous screw. Three patients who were treated for sacral tumors developed surgical site infection postop that required incision and drainage. Nine patients had passed away a","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100730"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672413","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":"P12. Endoscopic techniques for multilevel spine degeneration do we need fusion?","authors":"Aloysius Bambang Darwono MD, PhD","doi":"10.1016/j.xnsj.2025.100636","DOIUrl":"10.1016/j.xnsj.2025.100636","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100636"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672425","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":"23. Effects of preemptive intravenous dexamathasone on patients undergoing MIS-TLIF","authors":"Koopong Siribumrungwong MD","doi":"10.1016/j.xnsj.2025.100717","DOIUrl":"10.1016/j.xnsj.2025.100717","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Enhancing postoperative outcomes after minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using preemptive intravenous dexamethasone administered preoperatively. The primary objective was to determine whether dexamethasone improves postoperative clinical outcomes with minimal adverse effects, particularly on fusion status.</div></div><div><h3>PURPOSE</h3><div>Evaluate the effects of preemptive dexamethasone on patients undergoing MIS-TLIF procedure.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Double blind RCT.</div></div><div><h3>PATIENT SAMPLE</h3><div>Thirty in each group.</div></div><div><h3>OUTCOME MEASURES</h3><div>Postoperative visual analog scale (VAS) scores at rest and during motion at 24 hours, 2 weeks, 6 weeks, and 12 weeks - mean morphine-equivalent consumption - Side effects between the two groups (surgical site infection, hyperglycemia, nausea/vomiting) - Length of stay - Fusion status at 1 year.</div></div><div><h3>METHODS</h3><div>Patients undergoing primary MIS-TLIF for spinal stenosis, spondylolisthesis, or degenerative disc disease were randomized to receive either preemptive intravenous dexamethasone (0.15 mg/kg, max 12 mg) or placebo preoperatively. Postoperative assessments included VAS scores for pain at rest and during motion, morphine consumption, postoperative nausea, blood glucose levels, surgical site infections, total length of stay, and spinal fusion status, with data collected up to 1 year.</div></div><div><h3>RESULTS</h3><div>Sixty patients were included in the study, with 30 patients in each group. No significant differences were observed between the two groups regarding age, sex, diagnosis, BMI, preoperative VAS scores (rest and motion), or preoperative blood glucose levels. VAS scores for pain at rest and during motion were significantly lower in the dexamethasone group at 24 hours postoperatively (p = 0.001 for both) but showed no differences from 2 weeks to 12 weeks postoperatively. Morphine consumption and nausea were significantly lower in the dexamethasone group (p = 0.001 for both). Length of stay, surgical site infections, serum glucose levels (p = 0.82), and fusion rates (96.7% in both groups, p = 1) showed no significant differences.</div></div><div><h3>CONCLUSIONS</h3><div>Preemptive intravenous dexamethasone for patients undergoing MIS-TLIF statistically reduces postoperative pain at rest and during motion, morphine consumption, and postoperative nausea compared to placebo. It demonstrates a high safety profile and does not affect fusion status.</div></div><div><h3>FDA Device/Drug Status</h3><div>Dexamethasone (Approved for this indication).</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100717"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672444","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":"29. Perioperative and safety outcomes following tissue-sparing posterior cervical fusion to revise a pseudarthrosis: a multi-center retrospective review of 150 cases","authors":"Bruce Michael McCormack MD ,&nbsp;Pierce D Nunley MD ,&nbsp;Rahul V. Shah MD","doi":"10.1016/j.xnsj.2025.100723","DOIUrl":"10.1016/j.xnsj.2025.100723","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100723"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672450","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}