International Journal of Spine Surgery最新文献

{"title":"Spine Surgery Fellowships in Mexico: Web Content and Accessibility.","authors":"Felipe Aguilar-Chavez, Fernando Gonzalez-Gonzalez, Angel Lee, Orlando Alvarez-Medina, Adrian Anchondo-Alvidrez, Maria Elena Martinez Tapia, Carlos A Arellanes-Chavez","doi":"10.14444/8767","DOIUrl":"https://doi.org/10.14444/8767","url":null,"abstract":"<p><strong>Background: </strong>The emergence of spine surgery fellowship programs in Mexico is gaining significance; however, there exists a paucity of available information pertaining to the specific requirements and criteria employed for candidate selection, operational structure, and educational framework, which affects the ability of potential applicants to make informed decisions about their training options.</p><p><strong>Methods: </strong>A systematic web search was executed to identify the official websites of the predominant private and public health care institutions that provide spine fellowship programs in Mexico. This search was carried out by 3 spine surgery fellows between December 2023 and January 2024 utilizing the Google search engine with specific keywords previously employed in similar studies. Subsequently, we performed an evaluation to ascertain the existence of 13 elements that are pertinent to residency candidates and the ease of finding information for each program.</p><p><strong>Results: </strong>Twenty-five spine surgery fellowship programs were identified. Of these, 14 (56%) are endorsed by the Autonomous University of Mexico, 2 (8%) by La Salle University, and the remainder by various universities such as the Autonomous University of Guadalajara and the Autonomous University of Chihuahua, among others. The majority of programs were listed on the website of the Mexican Association of Spine Surgeons, with contact information being readily available in most cases (72%), whereas details about program chairs were primarily found on hospital websites (16%). The simplicity of the search revealed that 88% of programs could be easily located online.</p><p><strong>Conclusions: </strong>Numerous spine surgery training programs are deficient in thorough online information, which creates challenges for prospective national and international applicants seeking details. Most programs depend on their reputation instead of an online presence, indicating a chance to improve marketing and visibility of spine surgery fellowship programs in Mexico.</p><p><strong>Clinical relevance: </strong>The training of spine surgeons is extremely important, so the visibility of training programs helps promote this specialty and, therefore, the training of surgeons.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226992","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":"High-Value Procedures in Endoscopic Spine Surgery: An Analysis of Clinical Outcomes Based on Surgeon Experience, Skill, and Training.","authors":"Kai-Uwe Lewandrowski, Morgan P Lorio, Benedikt W Burkhardt, Alexander R Vaccaro","doi":"10.14444/8705","DOIUrl":"https://doi.org/10.14444/8705","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227058","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":"Higher Incidence of Thrombotic Complications in Thoracic Spine Surgery.","authors":"Gemma S Krautzel, Steve Balsis, Alexandra Foote, Mark S Eskander","doi":"10.14444/8762","DOIUrl":"https://doi.org/10.14444/8762","url":null,"abstract":"<p><strong>Background: </strong>Past studies have examined individual complication rates for cervical, lumbar, and thoracic spine surgery but have typically focused on just 1 region of the spine, making comparisons across spine regions difficult. The purpose of the present study was to analyze the incidence of 5 thrombotic complications, including pulmonary embolism, deep vein thrombosis, myocardial infarction, cardiac arrest, and stroke/cerebrovascular accident, across surgical procedures that target different regions of the spine, including cervical, thoracic, and lumbar.</p><p><strong>Methods: </strong>We conducted a cross-sectional clinical analysis of these 5 thrombotic complications in a relatively large sample. Archival records from the National Surgical Quality Improvement Program database were retrieved and analyzed. We identified 7160 patients in the clinic population who underwent elective cervical, thoracic, or lumbar spine surgery. The records contained diagnoses of each of the 5 thrombotic complications made by a board-certified physician applying American Medical Association assessment procedures.</p><p><strong>Results: </strong>Findings indicated that the incidence of overall thrombotic complications was relatively low, with only 0.92% of patients (66 of 7160) having any complication. The complication rates differed by type and surgical region of the spine, such that thoracic procedures resulted in a greater percentage of complications (<i>χ</i> ²(1) = 14.83, <i>P</i> < 0.001) than cervical or lumbar procedures. Pulmonary embolism in particular occurred with greater likelihood in thoracic procedures and relatively lower likelihood in cervical and lumbar procedures (<i>χ</i> ²(1) = 16.43, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Thoracic surgeries pose the greatest risk for thrombotic complications. Of the thrombotic complications that may occur during thoracic surgeries, pulmonary embolism is the most common.</p><p><strong>Clinical relevance: </strong>These findings highlight the need for surgeons to pay particular attention to the risk of certain complications when performing surgeries in specific regions of the spine.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Use of Intraoperative Neuromonitoring Justified During Lumbar Anterior Approach Surgery?","authors":"David W Allison","doi":"10.14444/8764","DOIUrl":"10.14444/8764","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064865","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":"Comparison of Stand-Alone Anterior Lumbar Interbody Fusion, 360° Anterior Lumbar Interbody Fusion, and Arthroplasty for Recurrent Lumbar Disc Herniation: Focus on Nerve Decompression and Painful Spinal Instability Resolution.","authors":"Vinicius de Meldau Benites, Matheus Galvão Valadares Bertolini Mussalem, Vinicius Santos Baptista, Emanuelle Sad Pasetti, Izabela Dib Gomes, Alexandre Vinhal Desideri, Milton Kiyonory Uehara, Nuno Rodolfo Colaço Aguiar, Allison Roxo Fernandes, Francisco Cialdine Frota Carneiro Júnior, Aécio Rubens Dias Pereira Filho","doi":"10.14444/8761","DOIUrl":"https://doi.org/10.14444/8761","url":null,"abstract":"<p><strong>Background: </strong>Currently, there are no studies in the literature that specifically compare stand-alone anterior lumbar interbody fusion (ALIF), 360° ALIF, or arthroplasty in patients with recurrent lumbar disc herniation presenting with signs of instability. Thus, the authors sought to fill this knowledge gap by comparing intraoperative and short-term postoperative outcomes of patients with recurrent lumbar disc herniation and signs of instability undergoing stand-alone ALIF), 360° ALIF, or arthroplasty.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a single center from August 2019 to January 2024. Inclusion criteria included patients older than 18 years diagnosed with recurrent lumbar disc herniation and signs of instability undergoing stand-alone ALIF, 360° ALIF, or arthroplasty. Exclusion criteria were incomplete data or other indications. Data collected included demographics, surgical specifics (procedure type, operated levels, graft type, and incision type), and clinical outcomes (intraoperative morbidity and short-term postoperative outcomes).</p><p><strong>Results: </strong>Sixty-five patients were evaluated. No intraoperative complications occurred in any group. Mean operative times were 165.8 ± 61.72 minutes for stand-alone ALIF, 236.25 ± 46.3 minutes for 360° ALIF, and 98.43 ± 45 minutes for arthroplasty (<i>P</i> < 0.0001). The mean postoperative hospital stay was 2.46 ± 1.14 days, with no significant difference between groups (<i>P</i> = 0.515). Postoperative complications were minimal: 1 surgical site infection in the stand-alone ALIF group (<i>P</i> = 0.444) and 4 instances of sympathetic changes (<i>P</i> = 0.477), with 1 occurring in the stand-alone ALIF group, 1 in the 360° ALIF group, and 2 in the arthroplasty group. There was no statistical difference between the groups in relation to the visual analog scale and Oswestry Disability Index scores.</p><p><strong>Conclusion: </strong>There was no significant difference in intraoperative morbidity, short-term postoperative outcomes, or length of stay among the 3 groups. All techniques demonstrated good results with low morbidity and short hospitalizations, suggesting that the choice of technique should be based on the surgeon's experience and the patient's condition and preferences.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101969","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":"Patient Perspectives on Awake Transforaminal Endoscopic Decompression Surgery Outcomes.","authors":"Albert E Telfeian, Rohaid Ali, Sanjay Konakondla, Kai-Uwe Lewendrowski","doi":"10.14444/8763","DOIUrl":"https://doi.org/10.14444/8763","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate patient perceptions of the outcomes following awake transforaminal endoscopic lumbar decompression surgery for treating degenerative spine diseases.</p><p><strong>Methods: </strong>Over a 1-year period from 2022 to 2023, awake transforaminal endoscopic spine surgeries were performed on 183 patients using local anesthesia and sedation, allowing patients to communicate with the surgical team throughout the procedure. A follow-up app-based survey was sent to these patients to assess their perceptions and outcomes related to the surgery.</p><p><strong>Results: </strong>Out of 183 recipients, 102 patients completed the survey. At the 1-year follow-up, 89.2% of the respondents reported better outcomes in comparison to traditional spine surgeries, and 98% expressed willingness to recommend the procedure to others with similar conditions.</p><p><strong>Conclusions: </strong>The findings demonstrate notable advancements in minimally invasive spine surgery, with awake transforaminal endoscopic decompression showing high satisfaction rates tied closely to meeting patient expectations. The study also identifies areas for improvement, particularly in managing postoperative pain and aligning patients' expectations with clinical results.</p><p><strong>Clinical relevance: </strong>Effective preoperative communication and consistent pain management practices are critical in enhancing patient satisfaction and postoperative recovery, along with the integration of conservative treatments such as physical therapy and acupuncture to maximize surgical outcomes.</p><p><strong>Level of evidence: 2: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102451","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":"A New Chapter for the <i>International Journal of Spine Surgery</i>: Global Perspective, Rapid Publishing, and Author-Centered Innovation.","authors":"James S Harrop, Kai-Uwe Lewandrowski, Oscar L Alves, Albert E Telfeian, Isaac L Moss","doi":"10.14444/8758","DOIUrl":"https://doi.org/10.14444/8758","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":"19 2","pages":"129-130"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988508","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":"Postoperative Brace Prescription Practices for Elective Lumbar Spine Surgery: A Questionnaire-Based Study of Spine Surgeons in Japan.","authors":"Michita Noma, Yujiro Takeshita, Kota Miyoshi, Fumiko Saiki, Naohiro Kawamura, Akiro Higashikawa, Nobuhiro Hara, Takashi Ono, So Kato, Yoshitaka Matsubayashi, Yuki Taniguchi, Sakae Tanaka, Yasushi Oshima","doi":"10.14444/8719","DOIUrl":"10.14444/8719","url":null,"abstract":"<p><strong>Introduction: </strong>The efficacy of postoperative braces for degenerative lumbar disorders has long been debated, with conflicting reports regarding the promotion of bone fusion and pain relief. The current aspects of postoperative brace prescriptions have been previously reported in Western countries but not in Asia. This study aimed to elucidate prescription practices in Japan and identify factors influencing prescription decisions.</p><p><strong>Materials and methods: </strong>The survey was conducted at a spine group research meeting comprising spine surgeons from multiple institutions. The questionnaire assessed aspects of postoperative brace prescription, including the type, purpose, and duration of usage, categorized by surgical procedures for degenerative lumbar disorders: endoscopic decompression, open surgery decompression, and fusion involving 1 or more than 3 levels. The respondents' backgrounds, scientific knowledge of postoperative braces, nonscientific reasons, and basis for prescription decisions were also investigated.</p><p><strong>Results: </strong>There were 63 valid responses. The overall postoperative brace prescription rate was 83%, with 66% for decompression and 98% for fusion procedures, surpassing the rates reported in Western studies. The primary prescription purpose was to slow down patient activity (83%, double the previously reported rates). Prescription rates for endoscopic and open surgical decompression were significantly correlated with facility attributes and annual number of surgeries. Scientific knowledge of postoperative braces was lacking in 56% of respondents, with scientific evidence being the least frequent decision for brace prescription (14%). Nonscientific reasons influenced the prescription decisions of 84% of participants.</p><p><strong>Conclusion: </strong>The postoperative brace prescription rate among spine surgeons in Japan was significantly higher than that in Western studies, largely due to nonscientific factors such as physician reassurance and the intention to slow down patient activity. Comprehensive, evidence-based guidelines are needed regarding consistent brace usage to optimize patient outcomes.</p><p><strong>Clinical relevance: </strong>This study highlights the high postoperative brace prescription rates among spine surgeons in Japan, which are significantly influenced by nonscientific factors, such as tradition, physician reassurance, and patient satisfaction, rather than scientific evidence. These findings underscore the need for evidence-based guidelines to improve consistency in postoperative brace usage. The results are particularly relevant in regions with aging populations and a high prevalence of osteoporosis, providing insights for improving postoperative management strategies and patient outcomes in Japan as well as in similar demographic settings globally.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"237-245"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068479","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":"Key Considerations in Surgical Decision-Making on the Side of Approach for Lumbar Lateral Transpsoas Interbody Fusion Techniques.","authors":"Brian Owler, Vijidha Shree Rajkumar, Yi Yuen Wang","doi":"10.14444/8721","DOIUrl":"10.14444/8721","url":null,"abstract":"<p><strong>Objectives: </strong>Lumbar lateral transpsoas interbody fusion is a powerful technique for addressing various spinal pathologies, enabling effective anterior column reconstruction. A critical decision in performing this procedure is selecting the appropriate side for the approach to the lumbar spine, whether in the prone or lateral decubitus position. This article outlines a decision-making framework to assist surgeons in deciding the optimal approach for direct lateral surgery to achieve the desired surgical outcome.</p><p><strong>Study design: </strong>Technical note for lateral spinal fusion approaches.</p><p><strong>Methods: </strong>The article explores anatomical considerations, surgical indications, and patient-specific factors relevant to the choice of approach in lateral lumbar transpsoas fusions. Through case examples, various factors influencing side selection are discussed.</p><p><strong>Results: </strong>While many traditionally learn and perform direct transpsoas fusions through left-sided approaches, it is essential to consider pertinent anatomical features or variations, surgical pathologies, and patient-specific symptoms. The optimal side of the approach may vary based on these factors and remain key considerations for a holistic decision.</p><p><strong>Conclusions: </strong>A thoughtful assessment of the factors highlighted here can significantly improve the likelihood of a successful prone or lateral transpsoas fusions. Although comprehensive studies are needed to better guide decisions between right- and left-sided approaches, surgeons currently rely on their clinical judgment and expertise to navigate these choices to maximize safety and efficacy for each patient.</p><p><strong>Clinical relevance: </strong>This study highlights minimizing surgical risk through holistic patient-centered decision-making.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"145-155"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574191","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":"Patient Satisfaction Following Lumbar Fusion Is Associated With Functional Status and Pain More Than the Attainment of Minimal Clinically Important Difference: Implications for Value-Based Medicine.","authors":"Matthew J Solomito, Heeren Makanji","doi":"10.14444/8757","DOIUrl":"https://doi.org/10.14444/8757","url":null,"abstract":"<p><strong>Background: </strong>In an era of value-based medicine, patient-perceived benefit and satisfaction are of paramount importance. However, current metrics of success such as the minimal clinically important difference (MCID) do not always correlate with overall patient satisfaction. Therefore, the purpose of this study was to understand the relationships between self-reported pain, Oswestry Disability Index (ODI) scores, reaching the MCID, and overall patient satisfaction in patients undergoing elective lumbar fusions.</p><p><strong>Methods: </strong>A retrospective study including patients between the ages of 18 and 89 years old who underwent a 1- or 2-level elective lumbar fusion between June 2021 and June 2023. Patients were stratified using this overall level of satisfaction with their procedure. Differences in clinical metrics and patient-reported outcome scores among satisfaction levels were assessed, and predictive analytics were used to determine whether clinical metrics were associated with satisfaction.</p><p><strong>Results: </strong>A total of 343 patients were included in this study; 81% indicated they were satisfied with their overall outcomes. There were differences in both clinical metrics and patient-reported outcomes based on satisfaction level. Current pain and function were found to be independent predictors of satisfaction, while ODI scores and reaching MCID were not.</p><p><strong>Clinical relevance: </strong>Relying on meeting statistically defined benchmarks of success, such as the MCID, may not provide an accurate depiction of procedural success or patient satisfaction, and additional clinically relevant benchmarks should also be assessed.</p><p><strong>Conclusions: </strong>Pain and current function were significantly associated with patient satisfaction; therefore, these metrics may play a larger role in patient satisfaction and perceived benefit than assessment through the ODI alone.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":"19 2","pages":"200-206"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003051","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}