North American Spine Society Journal最新文献

{"title":"2. Development of a fresh porcine cadaver ex vivo model using the L6/S1 spine segment for simulating intraoperative iatrogenic lumbar durotomy with nerve rootlet herniation during full-endoscopic spine surgery","authors":"Jui-Jung Yang MD, PhD","doi":"10.1016/j.xnsj.2025.100696","DOIUrl":"10.1016/j.xnsj.2025.100696","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>There was no effective technique for dural repair during full-endoscopic spine surgery (FESS). Our objective was to develop and evaluate porcine cadavers as an ex vivo animal model for simulating iatrogenic lumbar durotomy with nerve rootlet herniation during FESS.</div></div><div><h3>PURPOSE</h3><div>This model aims to reduce the reliance on live animals in experimental and training settings, facilitating the development of dural repair techniques.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Ex vivo animal study.</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>Fresh porcine lumbosacral segments were dissected to evaluate subdural nerve anatomy and identify traversing nerve rootlets suitable for herniation simulation. FESS was performed on cadaveric porcine spines using a uniportal interlaminar approach, progressing from L6/S1 to cephalic segments. A 0.5 cm dorsal dural defect was created to simulate an iatrogenic durotomy.</div></div><div><h3>RESULTS</h3><div>Anatomical evaluation and ex vivo durotomy simulation revealed that subdural traversing nerve rootlet fibers were identifiable only in the 1 or 2 most caudal segments (L5/6 and L6/S1), reflecting segmental differences in nerve rootlet orientation. No obvious endoscopic images from this ex vivo durotomy simulation at the most caudal segments (L6/S1) showed realistic gross appearances of the thecal sac and subdural nerve tissue. The nerve rootlet herniation from the dural defect effectively simulated iatrogenic durotomy during FESS.</div></div><div><h3>CONCLUSIONS</h3><div>The ex vivo porcine model for simulating lumbar iatrogenic durotomy with nerve rootlet herniation offers a realistic alternative to in vivo FESS models. With comparable anatomy and high realism, it reduces reliance on live animals, serving as a valuable platform for training and advancing dural repair techniques.</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 100696"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672182","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":"43. Comparison of unilateral biportal endoscopic and microscopic tubular paraspinal approach for foraminal and extraforaminal lumbar disc herniation","authors":"Min-Seok Kang MD","doi":"10.1016/j.xnsj.2025.100737","DOIUrl":"10.1016/j.xnsj.2025.100737","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100737"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672240","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":"P16. Controllable vertebral body sliding osteotomy (CVBSO) - a novel modified method for precise measurement and control of anterior sliding of the vertebral body during VBSO in cervical spine surgery","authors":"LeiPo Chen PhD, MD","doi":"10.1016/j.xnsj.2025.100640","DOIUrl":"10.1016/j.xnsj.2025.100640","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Degenerative cervical myelopathy (DCM) is a prevalent and challenging condition caused by spinal cord compression from ossification of the posterior longitudinal ligament (OPLL) or cervical kyphotic deformities. Vertebral Body Sliding Osteotomy (VBSO) has emerged as an effective surgical technique, avoiding complete removal of ossified lesions and reducing risks such as dura rupture and cerebrospinal fluid (CSF) leakage. However, traditional VBSO often suffers from a lack of precision in controlling the anterior sliding distance (ASD), potentially leading to over-resection, structural instability, or inadequate decompression. These limitations emphasize the need for a more precise and reproducible approach to optimize outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;This study introduces Controllable Vertebral Body Sliding Osteotomy (CVBSO), a novel surgical modification designed to overcome the limitations of traditional VBSO by integrating preoperative imaging-guided planning and intraoperative precision.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;This report introduces and describes the development of CVBSO as a novel surgical technique, focusing on its implementation in patients with degenerative cervical myelopathy (DCM). The technique was applied and refined in a tertiary spine surgery center, emphasizing its feasibility, precision, and reproducibility.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;CVBSO incorporates the Estimated Anterior Sliding Distance (EASD), calculated preoperatively using sagittal CT or MRI. For OPLL, the EASD is defined as the anterior-posterior diameter of the ossified lesion, while in other conditions, it is measured as the vertical distance between a reference line and the compression site. The procedure employs the Smith-Robinson approach, involving discectomy, bilateral longitudinal osteotomy, and real-time measurement of ASD to ensure alignment with the preplanned EASD. Guided cage placement and plate fixation are used to stabilize the construct.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;The CVBSO technique achieved precise control of ASD, preventing over- or under-decompression and reducing risks such as over-resection or structural instability. This approach simplified surgical steps, minimized surgeon-dependent variability, and improved decompression outcomes. Patients undergoing CVBSO demonstrated enhanced neurological recovery and optimized postoperative recovery compared to traditional VBSO techniques.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;CVBSO represents a significant advancement in cervical spine surgery, addressing critical limitations of traditional VBSO. By ensuring precise spinal cord decompression and simplifying the surgical process, CVBSO minimizes complications and enhances clinical outcomes. Future studies in larger cohorts and multi-center settings are warranted to","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100640"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672354","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":"41. Application of modest hypothermia in patients with acute traumatic cervical spine injury: a pilot study","authors":"Sarvdeep Singh Dhatt MBBS, MS","doi":"10.1016/j.xnsj.2025.100735","DOIUrl":"10.1016/j.xnsj.2025.100735","url":null,"abstract":"","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100735"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672408","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":"P13. Fusion lengths in adult scoliosis surgery as a predictor of outcome","authors":"Morteza Sadeh MD, PhD ,&nbsp;Hadeel M Mansour MD ,&nbsp;Yousaf Ilyas BS ,&nbsp;Nauman Chaudhry MD","doi":"10.1016/j.xnsj.2025.100637","DOIUrl":"10.1016/j.xnsj.2025.100637","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Surgery for degenerative adult scoliosis is often associated with multiple complications such as neurological deficits, blood loss, acute infections, and death. Fusion is the primary surgical approach to correct spinal deformity. However, the length of the fusion can be variable, with short fusions (&lt; 3) levels minimizing operative time while longer fusion (=3 levels) has been found to be associated with an increase in certain type of complications.</div></div><div><h3>PURPOSE</h3><div>The literature is lacking on the association of fusion length with post-operative outcomes. To address this gap, our study aims to compare the outcomes of short vs long fusion.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>SRS was queried from 2013-2023 for patients undergoing fusion surgery for degenerative scoliosis. A total of 60 patients were included in the study. Patients were categorized into two groups based on fusion length.</div></div><div><h3>PATIENT SAMPLE</h3><div>Short fusion (3 levels), with 30 patients in each group.</div></div><div><h3>OUTCOME MEASURES</h3><div>Post-operative outcomes such as neurological deficits, perioperative blood loss, revision surgery, acute wound infection, implant complications, and mortality rates were assessed and compared across the two groups using chi square tests and pairwise analysis.</div></div><div><h3>METHODS</h3><div>N/A</div></div><div><h3>RESULTS</h3><div>No significant differences were observed between short and long-fusion groups in terms of neurological deficits, return to surgery, mortality, postoperative wound infections, or implant complications; however, blood loss was significantly lower in the short-fusion group with a mean of 367.5 compared to 951 in the long fusion group.</div></div><div><h3>CONCLUSIONS</h3><div>Short and long fusions shared comparable outcomes for neurological deficits, infections, return to OR, and mortality rates. However, short fusions showed significantly lower rates of blood loss than long fusions, highlighting its advantages in high risk in high-risk patient populations.</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 100637"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672427","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":"26. Impact of obesity on nonfusion risk following anterior cervical discectomy and fusion","authors":"Yu Chang MD ,&nbsp;Shih-Huang Tai PhD ,&nbsp;Yu-Ning Chen MD ,&nbsp;E-Jian Lee MD, PhD","doi":"10.1016/j.xnsj.2025.100720","DOIUrl":"10.1016/j.xnsj.2025.100720","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Anterior cervical discectomy and fusion (ACDF) is a widely performed surgical procedure to treat cervical disc herniation, leading to myelopathy and radiculopathy. The procedure involves removing the affected disc and fusing the vertebrae to restore stability and relieve symptoms. Obesity is a growing concern in the surgical population and has been associated with various postoperative complications. Previous studies suggest that obesity may impact postoperative outcome following spinal surgeries. This study aims to explore how obesity, as measured by BMI, affects fusion rates in patients undergoing single-level ACDF.</div></div><div><h3>PURPOSE</h3><div>N/A</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>This cohort study utilized the TriNetX network database, spanning from 2008 to 2023, to identify patients who underwent single-level ACDF.</div></div><div><h3>PATIENT SAMPLE</h3><div>Patients undergoing single-level ACDF were included.</div></div><div><h3>OUTCOME MEASURES</h3><div>The primary outcome was the incidence of nonfusion, identified by the International Classification of Disease-10 code M96.0, within 6 months to 2 years postoperatively.</div></div><div><h3>METHODS</h3><div>Patients were categorized based on their BMI into two groups: BMI &lt; 30 and BMI = 30. Propensity score matching (PSM) performed based on patient characteristic and comorbidities.</div></div><div><h3>RESULTS</h3><div>Following 1:1 propensity score matching, the final cohorts comprised 12,733 patients in each group, with balanced demographics and comorbidities between the two groups. At 6 months postoperatively, 15.27% of patients with BMI &lt; 30 (1,827 nonfusions in 11,965 patients) experienced nonfusion, compared to 14.07% of patients with BMI = 30 (1,690 non-fusions in 12,012 patients), with an odds ratio (OR) of 1.101 (95% CI: 1.025–1.182). At 1 year postoperatively, 17.73% of patients with BMI &lt; 30 (1,957 nonfusions in 11,041 patients) experienced nonfusion, compared to 16.24% of patients with BMI = 30 (1,800 nonfusions in 11,082 patients), with an OR of 1.111 (95% CI: 1.036–1.192). At 2 years postoperatively, the nonfusion rate was 17.64% for patients with BMI &lt; 30 (2,058 nonfusions in 11,669 patients) and 16.39% for patients with BMI = 30 (1,920 nonfusions in 11,712 patients), with an OR of 1.092 (95% CI: 1.02–1.169).</div></div><div><h3>CONCLUSIONS</h3><div>This study found a significant association between obesity (BMI = 30) and an increased risk of non-fusion following single-level ACDF surgery. The elevated risk was observed at 6 months, 1 year, and 2 years postoperatively, indicating that obesity negatively impacts the likelihood of successful fusion after surgery.</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 100720"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672447","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":"P3. Preoperative risk assessment calculators in spine surgery","authors":"Serge Rasskazoff MD, FRCSC","doi":"10.1016/j.xnsj.2025.100627","DOIUrl":"10.1016/j.xnsj.2025.100627","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Spinal surgeries carry significant risks, requiring careful preoperative assessment to optimize patient outcomes. Traditional risk evaluation relies on clinical judgment, often leading to variability in decision-making. To address this, multiple preoperative risk calculators have been developed, providing objective, data-driven estimates of complications, length of hospital stay, and post-surgical recovery.</div></div><div><h3>PURPOSE</h3><div>This study reviews existing preoperative risk assessment tools in spine surgery, evaluating their applicability, and limitations. The goal is to provide clinicians with insights into selecting appropriate calculators for individualized patient risks stratification.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>N/A</div></div><div><h3>PATIENT SAMPLE</h3><div>N/A</div></div><div><h3>OUTCOME MEASURES</h3><div>N/A</div></div><div><h3>METHODS</h3><div>A literature review was conducted using the PubMed database. Articles published in English from all countries were included if they specifically described, analyzed, or validated preoperative risk calculators for spine surgery. Studies on general surgical risk assessment tools were excluded.</div></div><div><h3>RESULTS</h3><div>A comprehensive review of over 30 studies identified seven major risk calculators: SpineSage, Seattle Spine Score, Lubelski Web-Based Calculators, Carolina Semmes Grading Scale, Global Spine Tumor Group Risk Calculator, The Dialogue Support, and Modified Frailty Index. These calculators assess various factors, including patient demographics, comorbidities, surgical complexity, and expected postoperative outcomes. While all tools demonstrated utility in predicting complications, their applicability varied based on patient populations and surgical settings.</div></div><div><h3>CONCLUSIONS</h3><div>Preoperative risk calculators enhance decision-making in spine surgery by offering individualized risk assessments. While these tools provide valuable predictive insights, they should complement, rather than replace, clinical judgment. The adoption of such calculators by clinicians in developing countries like Uzbekistan could improve patient counseling and perioperative management, bridging the gap between global advancements and local healthcare practices. Future research should focus on the applicability of these models for broader demographics and populations.</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 100627"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672513","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":"P39. Efficacy of modified full endoscopic spine surgery with standard instruments","authors":"Jinhwa Eum MD","doi":"10.1016/j.xnsj.2025.100663","DOIUrl":"10.1016/j.xnsj.2025.100663","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Full endoscopic spine surgery (FESS) is a good minimally invasive method for diverse pathologic spine diseases. But we cannot use large or curved standard spine surgery instruments due to a limited working channel size. To solve this problem, we modified the working channel to allow for FESS with conventional instruments and angled nerve root retractors instead of long and not sturdy expensive tools.</div></div><div><h3>PURPOSE</h3><div>In this report, we describe the application of modified FESS for spine surgeries and discuss its advantages and pitfalls.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>We used a modified full endoscopic spine surgery system with standard durable instruments.</div></div><div><h3>PATIENT SAMPLE</h3><div>The following surgical procedures are conducted: lumbar unilateral laminotomy and bilateral decompression (n=2); lumbar foraminotomy (n=1); lumbar laminotomy and discectomy (n=3) transforaminal lumbar interbody fusion(n=1); and cervical laminotomy and discectomy (n=3).</div></div><div><h3>OUTCOME MEASURES</h3><div>VAS scores were improved from 8.2 preoperatively to 2.6 at 3 months follow-up visit.</div></div><div><h3>METHODS</h3><div>N/A</div></div><div><h3>RESULTS</h3><div>All surgical operations were successfully completed. None of the procedures had to be stopped due to technical issues. No surgical complications were noted that could be related with modified FESS. VAS scores improved significantly after surgery.</div></div><div><h3>CONCLUSIONS</h3><div>There are several advantages with modified FESS such as the capability of using large or curved standard surgical instruments, a more acceptable learning curve, and a reasonable cost. Modified FESS seems to be an effective alternative compared to a conventional full endoscopic spine surgery. With further refinement of the system, the modified FESS might become the next generation of full endoscopic spine surgery.</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 100663"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672556","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":"30. Vacuum discs are associated with greater sagittal imbalance and disability in adult spine deformity patients","authors":"Kira Skaggs MD ,&nbsp;Javier Castro MD ,&nbsp;Matthew Follett MD ,&nbsp;Tanmaya Sambare MD ,&nbsp;Jayme Koltsov PhD ,&nbsp;John Kleimeyer MD ,&nbsp;Alexa Pius MD ,&nbsp;Kirkham B. Wood MD ,&nbsp;Todd F. Alamin MD ,&nbsp;Geoffrey Riley MD ,&nbsp;Eugene J Carragee MD ,&nbsp;Serena S Hu MD","doi":"10.1016/j.xnsj.2025.100724","DOIUrl":"10.1016/j.xnsj.2025.100724","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Intervertebral vacuum discs (VDs), characterized by intradiscal gas accumulation, signify advanced degenerative changes in the spine and are frequently observed in older patients. Despite VDs’ prevalence, their clinical implications in adult spinal deformity (ASD) remain underexplored.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;This study aims to assess the prevalent characteristics of VDs and their impact on spinal alignment, pain, and surgical outcomes within an ASD cohort.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN/SETTING&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;N/A&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;This retrospective analysis included all consecutive patients (2013-2019) undergoing surgery for spinal deformity with lumbar spine CT scans from a single institution. Preoperative CTs were evaluated in all planes at each intervertebral space between T12 and S1 for the presence and size of VDs. Identification of a VD was made from a well-demarcated hypointensity within the intervertebral disc space. Radiographic parameters, including agittal vertebral axis (SVA), coronal balance, pelvic tilt (PT), lumbar lordosis (LL), pelvic incidence (PI), and segmental lordosis (SL), were measured both preoperatively and postoperatively. Patient-reported outcome measures (NPRS leg and back pain, Oswestry Disability Index [ODI]) were systematically collected at the initial preoperative visit and postoperatively at 6 weeks, 6 months, 1 year, and 2 years. Details of the surgical interventions were collected from the EMR. Data analysis was performed using mixed effects models, multivariable models, and linear regression (two-sided a=0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;The final cohort included 135 patients (60% female, aged 70 [68, 72] years). VDs were present in 86% of patients. Preoperatively, patients with VDs experienced greater leg pain (+0.9 [0.3, 1.6] vs no VD; p=0.004). Patients with large VD had higher preoperative back pain vs those with small VD (+1.0 [0.5, 1.6]; p&lt; 0.001) or no VD (+0.6 [0.1, 1.1]; p&lt; 0.027). Patients with VDs exhibited significant sagittal imbalance, with lower preoperative lumbar lordosis (-6.3 [95% CI: 8.8, 3.8] vs no VD; p&lt; 0.001), greater LL-PI mismatch (+4.9 [95% CI: 2.4, 7.4] vs no VD; p&lt; 0.001), and lower SL (-2.0 [95% CI: -3.6, -0.5] vs no VD; p&lt; 0.001). Surgical interventions, particularly anterior lumbar interbody fusions (ALIFs), were more frequently utilized at levels with VDs (ALIFs: 17.5% VD vs 6.5% no VD, p&lt; 0.001). ALIFs were associated with a greater change in segmental lordosis than AntLat (+7.0 [2.5, 11.5]; p&lt; 0.001) and no interbody fusion (+8.8 [4.4, 13.1]; p&lt; 0.001) when a VD was present. Additionally, VD at any level was associated with larger pre- to postoperative increases in LL (+3.4 [95% CI: 0.7, 6.0] vs no VD, p=0.015) and larger decreases in PI-LL mismatch (-4.0 [95% CI: -7.1, -1.0] vs n","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100724"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672611","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":"4. A comparison of two implant materials in an in vivo rabbit model","authors":"Boyle C. Cheng PhD ,&nbsp;Daniel T. Altman MD, FACS","doi":"10.1016/j.xnsj.2025.100698","DOIUrl":"10.1016/j.xnsj.2025.100698","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>The study of the relationship between the musculoskeletal system and the immune system has become an increasingly important consideration in biomaterials research. Investigation of the immune response provides insight on the efficacy of current design materials in spinal implant devices and also offers a potential clinical understanding of complications. The potential for adverse events, including a fibrotic response, presents challenges that should be addressed. Studies involving the pro-inflammatory cytokine response inform on the mechanism of fibrous development pathway which has been reported with PEEK spinal interbody implants. With bone grafting materials, the probability of arthrodesis and bone apposition increases due to the selected materials. It is hypothesized that bone contact with PEEK devices would be different compared to titanium and the various surface finishes that can be applied.</div></div><div><h3>PURPOSE</h3><div>The purpose of this study was to compare the in vivo bone response to PEEK as an implant material compared to titanium with different surface roughness as an implant material. Specifically, microCT data was used to quantify new bone formation within the peri-prosthetic region, and histology was used to evaluate bone apposition and the presence of soft tissue at the bone-implant interface</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>A rabbit distal femur model with two distinct material cohorts was conducted to investigate the immune response and bone growth surrounding PEEK dowels compared to titanium dowels.</div></div><div><h3>PATIENT SAMPLE</h3><div>N/A</div></div><div><h3>OUTCOME MEASURES</h3><div>N/A</div></div><div><h3>METHODS</h3><div>A rabbit distal femoral condyle bone defect model with two separate materials was conducted. PEEK and titanium dowels (4.5mm diameter x 8mm) with a central graft window were implanted into skeletally mature New Zealand White rabbits (3-4 kg). Implants did not contain graft material in the graft chamber and were randomized to either the left or right distal femoral condyle. Test subjects were randomized into either 4- or 8-week cohorts and histological or immunological analyses (4 subjects per cohort). Samples retrieved at necropsy were fixed, and radiographic imaging completed using a SkyScan 1172 desktop MicroCT (16 µm isotropic voxel size). All scans were reconstructed with a constant attenuation coefficient to enable comparison of bone mineral density and volume (CTAn, Bruker).</div></div><div><h3>RESULTS</h3><div>When observing inflammatory cytokine production, our ELISA data showed a significant decrease in TNFα and IL-1ß in PEEK implants. We also observed a difference in IL-1ß production from MSCs in culture titanium when compared to PEEK alone on Day 7, and a significant difference by Day 14. Mineralization data measured from microCT on harvested distal femurs of implanted rabbits was analyzed using a one-way ANOVA with multiple c","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100698"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672184","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}