International Journal of Spine Surgery最新文献

{"title":"Incidence of Traumatic Spinal Injury Following Public Policy Update on Moped Usage in South Carolina.","authors":"Samuel Wood, Danielle Harpen, Chase Gauthier, Richard Bidwell, Gregory Grabowski","doi":"10.14444/8704","DOIUrl":"https://doi.org/10.14444/8704","url":null,"abstract":"<p><strong>Background: </strong>Electric scooters and mopeds have become prevalent modes of transportation for many Americans. On 19 November 2018, South Carolina implemented a law mandating the registration of these vehicles with the South Carolina Department of Motor Vehicles, enabling better regulation of moped and scooter drivers on the roads. This study aims to investigate whether the incidence of vertebral fractures and spinal cord injuries related to moped and scooter accidents decreased after the passage of this 2018 South Carolina law.</p><p><strong>Methods: </strong>Retrospective data from a cohort of 350 patients, 239 before (\"prelaw\") and 111 after the law (\"postlaw\") was implemented, seeking care at a level 1 trauma center for moped or scooter-related spinal injuries between January 2014 and December 2022 were analyzed. Differences in the incidence of vertebral fractures and spinal cord injuries before and after the passage of the South Carolina law were calculated. Vertebral fractures were categorized by location on the spine pre- and postlaw. <i>χ</i> <sup>2</sup>, Wilcoxon rank sum, and Shapiro-Wilk tests were employed to compare variables between groups.</p><p><strong>Results: </strong>A total of 60 traumatic vertebral fractures (47 prelaw and 13 postlaw) and 7 spinal cord injuries involved moped accidents. There was no significant difference in the incidence rate of vertebral fractures (19.7% vs 11.7%, <i>P</i> = 0.09) or spinal cord injuries (2.9% vs 0%, <i>P</i> = 0.1) between those injured prelaw and postlaw, although there were significant differences between the groups in age (43.2 vs 47.4, <i>P</i> < 0.01) and incidence of men injured (87.9% vs 95.5%, <i>P</i> = 0.03). Multivariable logistic regression demonstrated suffering a moped-related traumatic injury before the implementation of the 2018 South Carolina law (OR = 2.08, 95% CI: 1.09-4.23, <i>P</i> = 0.03) and an increase in age at the time of injury (OR = 1.03, 95% CI: 1.01-1.05, <i>P</i> = 0.01) were independently associated with an increase in the odds ratio of suffering traumatic vertebral fractures following a moped accident when controlling for multiple confounding factors.</p><p><strong>Conclusion: </strong>Before the implementation of a 2018 South Carolina law that increased moped regulations, moped drivers had a significantly higher odds ratio for suffering a traumatic vertebral fracture compared with after the implementation of the law when controlling for confounding factors. These findings suggest that public policy surrounding moped use may contribute to a decrease in the overall odds of suffering vertebral fractures resulting from moped use and emphasize the need for continual updates to public policy with public safety in mind. This is not only important from a standpoint of patient safety, but it also helps to decrease the amount of health care resources and dollars used.</p><p><strong>Clinical relevance: </strong>Implementation of public policy surroun","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371255","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":"Passing the Editor in Chief Baton: A Time for Reflection and Future Vision.","authors":"Charles L Branch","doi":"10.14444/8703","DOIUrl":"https://doi.org/10.14444/8703","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190474","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":"Spinopelvic Fixation Using an Osseointegrative Implant: Analysis of Postmarket Surveillance to Determine the Failure Rate.","authors":"Robert K Eastlack, Richard P Menger, Jay D Turner, Kara R Ashcraft, W Carlton Recking, Christopher J Kleck","doi":"10.14444/8720","DOIUrl":"https://doi.org/10.14444/8720","url":null,"abstract":"<p><strong>Background: </strong>Adult spinal deformities, affecting up to 60% of individuals older than 60 years, often require long segment fusions. Constructs spanning the lumbosacral junction commonly include pelvic fixation. Despite robust pelvic fixation, distal junctional failure, such as pseudoarthrosis, bone fracture, and instrumentation failure, occurs in 24%-34% of these cases. A novel implant designed for both durable pelvic fixation and sacroiliac joint fusion was recently cleared by the US Food and Drug Administration. This implant is engineered to address some of the pelvic fixation failure mechanisms by reducing motion at the lumbosacral junction and sacroiliac joint while decreasing stress on S1 pedicle screws and S2AI implants.</p><p><strong>Objective: </strong>To determine the failure rate of a novel osseointegrative implant for spinopelvic fixation/fusion.</p><p><strong>Study design: </strong>Analysis of manufacturer postmarket surveillance database.</p><p><strong>Methods: </strong>A postmarket surveillance database was analyzed to determine the type and rate of complaints and revisions of a novel osseointegrative implant. These were then compared with the published literature.</p><p><strong>Results: </strong>A total of 15,628 implants were identified in 6907 patients. The postmarket surveillance of the novel screw fusion device revealed a low complaint rate of 0.75% and no postoperative implant breakage. Revision procedures were mostly due to set screw dissociation (0.4%) and implant loosening (0.15%), which was primarily linked to pre-existing conditions or infection. The mean (SD) time from index procedure to the complaint was 7.1 (5.4) months.</p><p><strong>Conclusions: </strong>Compared with published literature, this novel osseointegrative implant demonstrates a significantly lower incidence of set screw dissociation than traditional pelvic screws with no incidence of breakage or back out, underscoring its durable integration with bone, with low rates of revisions and mechanical failures.</p><p><strong>Clinical relevance: </strong>A novel osseointegrative implant offers reduced rates of mechanical failures and revisions, helping to reduce complications in pelvic fixation procedures.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075712","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 Recovery Following Uniportal Endoscopic Vs Open Lumbar Spine Surgery: Objective Analysis of Postoperative Mobility and Gait Patterns Using Wearable Sensors.","authors":"Alison Ma, Ralph J Mobbs, Monish M Maharaj","doi":"10.14444/8718","DOIUrl":"https://doi.org/10.14444/8718","url":null,"abstract":"<p><strong>Background: </strong>There has been a gradual shift from open spine surgery to minimally invasive techniques such as endoscopic spine surgery to reduce approach-related trauma, collateral damage, and complications. While recovery following surgery has been measured using subjective measures including patient-reported outcome measures, the introduction of smart wearable devices now provides both an objective and continuous method of patient assessment. This prospective study compares patient recovery after uniportal endoscopic and open lumbar spine surgery by analyzing mobility and gait metrics captured by a wearable sensor.</p><p><strong>Methods: </strong>Participants included 24 patients who underwent a single-level uniportal endoscopic lumbar decompression or open posterior lumbar fusion. During the first 48 hours after surgery, patients wore a sensor that continuously monitored position, step count, and gait metrics.</p><p><strong>Results: </strong>In the immediate postoperative period, endoscopic spine surgery patients experienced a quicker return to mobility, with less time lying down, higher step count, faster gait velocity, lower double support percentage, and reduced variability, compared with open spine surgery patients.</p><p><strong>Conclusion: </strong>There are key differences in patient mobility and gait following uniportal endoscopic and open spine surgery. Endoscopic spine surgery patients had faster recovery, which can guide resource allocation toward the development of training programs and support the advancement of spine endoscopy to address a broader range of pathologies. This pilot study highlights the potential for wearable devices to be used in further studies to form spine surgery recovery trajectories, allowing targeted rehabilitation and prompt intervention for deviations in patient recovery.</p><p><strong>Clinical relevance: </strong>This study demonstrates the benefits of endoscopic spine surgery for improved postoperative recovery in terms of mobility and gait metrics. Additionally, it highlights the potential for wearable sensor technology to provide an objective and continuous method for assessing postoperative outcomes and for the development of individualized rehabilitation protocols. These findings support the broader adoption of endoscopic techniques and emphasize the value of incorporating wearable devices into postoperative monitoring to optimize patient care.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075671","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":"https://doi.org/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":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","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":"Preoperative Evaluation of Oswestry Disability Index in Lumbar Spinal Stenosis: New Evidence of Time Independence of Variation Up to 1 Year.","authors":"Juho Hatakka, Katri Pernaa, Joel Kostensalo, Keijo Mäkelä, Inari Laaksonen","doi":"10.14444/8699","DOIUrl":"https://doi.org/10.14444/8699","url":null,"abstract":"<p><strong>Background: </strong>The Oswestry Disability Index (ODI) is a well-validated and widely used patient-reported outcome instrument to evaluate lumbar spinal stenosis (LSS) patients' treatment outcomes. The objective of the present study was to determine long the average interval between 2 preoperative measurements can be before a clinically significant difference of 10 points or more might appear.</p><p><strong>Methods: </strong>This was a retrospective observational study utilizing prospectively collected data from a single university hospital database, which was compatible with the national registry. One hundred and four surgically treated LSS patients were included in this observational study using systematic sampling. The preoperative ODI score was obtained at 2 timepoints. The 2-month mark as a potential turning point was of special interest, as the registry in question excludes preoperative data as outdated if the data are older than 2 months. Possible time dependence of the change in ODI scores was explored using a linear mixed-effects model with ODI as the dependent variable and interval length, sex, age, body mass index (BMI), and the presence of a concomitant disease as fixed effects.</p><p><strong>Results: </strong>The mean ODI score was 41.7 points (SD = 16.0) at the first and 41.1 points (SD = 15.5) at the second measurement. Mean time between the ODI scores was 74 days (range 8-361). On average, ODI changed by 9.17 points (SD = 7.16) between the 2 measurements, increasing for 48 patients, remaining unchanged for 9 patients, and decreasing for 47 patients. The arithmetic mean of the changes was -0.60 points and the median was 0.00 points. The estimated change in the population mean was -0.0005 points/day (95% CI [-0.022, 0.022], <i>P</i> = 0.97), meaning that we have strong evidence that the change in the mean is not clinically significant for up to 15 months (95% CI between ±10 points). Furthermore, no evidence was found that age, sex, BMI, or concomitant diseases were associated with the change of ODI score over time. Furthermore, the probability to observe a clinically significant change in a patient did not depend on the number of days between the 2 measurements (OR 1.003, 95% CI [0.997, 1.010], <i>P</i> = 0.30). Variance in ODI change did not grow over time.</p><p><strong>Conclusions: </strong>The probability of observing a clinically significant differences does not depend on the length of the observation interval, and ODI scores can be considered equally reliable for a significantly longer time than 2 months, even up to 1 year.</p><p><strong>Clinical relevance: </strong>Preoperative ODI scores do not lose reliability up to 1 year in patients undergoing operatively treatment for LSS.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068413","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":"Radiation Exposure Analysis on 274 Patients With Vertebral Augmentation Using the Surgivisio Intraoperative Navigation System.","authors":"Mehdi Boudissa, Gaël Kerschbaumer, Guillaume Cavalié, Jean-François Desrousseaux, Alexis Perrin, Georges Naïm Abi Lahoud, Julien Decaudain, Amélie Léglise, John Sledge, Benjamin Bénac, Jérémy Ouali, Jérôme Tonetti","doi":"10.14444/8701","DOIUrl":"https://doi.org/10.14444/8701","url":null,"abstract":"<p><strong>Background: </strong>Surgeons' reliance on intraoperative fluoroscopy during vertebroplasty procedures has raised concerns regarding the level of patient and surgeon radiation. Navigation systems have shown a potential to reduce the overall patient and medical staff exposure during dose exposure studies. The main objective of this study was to determine whether the Surgivisio platform (eCential Robotics, France), a unified imaging and navigation platform, lowers the patient dose during routine clinical usage as compared with published fluoroscopy and other navigation options that are published in the literature.</p><p><strong>Methods: </strong>To accomplish this, we evaluated the radiation exposure dose during routine vertebroplasty procedures in which the surgeon was not trying to limit radiation and then compared the results to best-case dose assessment studies. Since a decreased radiation dose can lead to decreased image quality, we also quantified the surgeon's perception of image quality and ease of use. Two hundred and seventy-four Surgivisio-assisted vertebral augmentations were pooled from a broader 1694-patient protocol (not focusing on radiation outcomes) and analyzed.</p><p><strong>Results: </strong>We measured a median dose-area product and effective dose equal to 3.47 Gy.cm² and 0.81 mSv. The 3-dimensional image acquisitions contributed to 56.3% of the total dose-area product. When screening the literature, fluoroscopy dose levels (8.37-15.1 Gy.cm²) and navigation dose levels (9.12-9.83 Gy.cm²) were generally higher than those delivered with the Surgivisio protocol. Surgeon satisfaction for image quality and overall system experience was 95.8% and 85% for ease of use.</p><p><strong>Conclusions: </strong>The Surgivisio platform provided surgeons with high-quality images and ease of use. Since the surgeon is out of the room during the 3-dimensional image acquisition, this also substantially decreased their radiation exposure. This study demonstrates the efficiency of the Surgivisio platform to assist surgeons during vertebral augmentations, as the reported radiation levels are reduced in routine cases compared with published scenarios reported for other guidance methods.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013513","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":"Selective Direct Vertebral Rotation Instrumentation for the Correction of Adolescent Idiopathic Scoliosis Lenke 5 Curve.","authors":"Emmanuel Alonge, HongQi Zhang, Chaofeng Guo, Wang Yuxiang","doi":"10.14444/8700","DOIUrl":"https://doi.org/10.14444/8700","url":null,"abstract":"<p><strong>Background: </strong>Direct vertebral rotation (DVR) effectiveness in improving scoliosis correction outcomes remains unclear and requires further investigation.</p><p><strong>Purpose: </strong>This study aimed to evaluate the effectiveness of short and extended fusion techniques using en-bloc DVR in correcting adolescent idiopathic scoliosis (AIS) classified as Lenke 5 curve (5C).</p><p><strong>Materials and methods: </strong>This retrospective study included 90 randomly selected AIS patients with Lenke 5C who underwent posterior spinal instrumentation surgery using en-bloc DVR between 2014 and 2021. Patients were divided into 2 groups: (1) extended fusion, Group A (<i>n</i> = 40): upper instrumented vertebra = upper-end vertebra +1 or +2 or (2) short fusion, Group B (<i>n</i> = 50): upper instrumented vertebra = upper-end vertebra. Radiographic parameters were compared preoperatively and at postoperative follow-ups of 6 months, 3 years, and more.</p><p><strong>Results: </strong>The mean follow-up duration was 37.5 ± 6 months for Group A and 40.0 ± 8 months for Group B (<i>P</i> = 0.596). The coronal balance correction rate was comparable between the 2 groups, with no significant differences observed at the final follow-up. Significant differences were noted in the fused segment, with Group A having an average fusion rate of 6.8 ± 0 compared with 6.3 ± 0 in Group B (<i>P</i> = 0.001). TK and lumbar lordosis measurements at the final follow-up did not show significant differences between the groups. However, substantial differences were observed in rib hump correction, with Group A demonstrating a better correction rate than Group B at both 6 months and the last follow-up (<i>P</i> = 0.001 for both time points).</p><p><strong>Conclusion: </strong>Selective DVR spinal instrumentation effectively corrects AIS Lenke 5C. However, extended fusion demonstrates more efficient correction and greater improvement in the patient's cosmetic appearance, including better thoracic curve correction, rib hump correction, and shoulder balance, compared with short-level fusion.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013515","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":"Prone Lateral Transpsoas Approach to the Spine: A Technical Guide for Mastery.","authors":"Juan P Giraldo, Winward Choy, Juan S Uribe","doi":"10.14444/8712","DOIUrl":"https://doi.org/10.14444/8712","url":null,"abstract":"<p><strong>Background: </strong>The single-position prone transpsoas (PTP) lateral interbody fusion represents an alternative approach to the traditional lateral lumbar interbody fusion (LLIF) typically performed with the patient in the lateral decubitus position. Advantages of PTP surgery include improved segmental lordosis, single-position surgery, and ease of performing posterior techniques as needed. However, the learning curve of PTP is distinct from that of traditional LLIF surgery performed with the patient in the lateral decubitus position. Here, we highlight the senior author's approach to PTP surgery. The authors review key strategies of the preoperative workup, patient selection, operative techniques, and intraoperative pearls. This technical guide aims to shorten the learning curve for new adopters, optimize workflow for the surgeon, and maximize patient safety.</p><p><strong>Methods: </strong>A detailed analysis of the PTP approach was conducted, incorporating preoperative imaging and planning strategies and technical adjustments in patient positioning to accommodate access following the senior author's technical pearls. The workflow was structured to streamline transitions between levels, minimize time requirements, and reduce physical strain on the surgical team.</p><p><strong>Results: </strong>The application of PTP has demonstrated successful segmental lordosis correction and stable fusion across lumbar levels without requiring patient repositioning. The integrated workflow enabled sequential access and mastery of the PTP technique. These technical pearls have improved the efficiency of the PTP approach, according to the surgeon's expertise.</p><p><strong>Conclusion: </strong>The PTP technical strategies offer a viable and effective alternative to traditional LLIF. Surgeons can enhance the safety and efficiency of the PTP approach, maximize procedural benefits, and minimize potential risks using these technical strategies for preoperative planning, patient positioning, and intraoperative monitoring.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013511","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":"Short- and Mid-Term Outcomes Following ALIF and TLIF in L5-S1 Isthmic Spondylolisthesis Patients.","authors":"Jialun Chi, Kate S Woods, Ved A Vengsarkar, Zhiwen Xu, Hanzhi Yang, Abhishek Kumar, Yi Zhang, Zhichang Zhang, Jesse Wang, Lawal Labaran, Li Jin, Xudong Li","doi":"10.14444/8696","DOIUrl":"https://doi.org/10.14444/8696","url":null,"abstract":"<p><strong>Background: </strong>A limited number of studies have compared the outcomes of anterior lumbar interbody fusion (ALIF) to transforaminal lumbar interbody fusion (TLIF) for the treatment of isthmic spondylolisthesis. This study aims to compare postoperative complications between these two surgical approaches.</p><p><strong>Methods: </strong>A retrospective review was performed using a large national database. The study population included all patients older than 18 years who underwent single-level ALIF or TLIF with a diagnosis of L5 to S1 isthmic spondylolisthesis. A 1:2 propensity score was used to match ALIF and TLIF cohorts for age, sex, and relevant comorbidities, including smoking status. Multivariate logistic regression was used to compare 3-month and 2-year medical and surgical complications, including 5-year reoperation rates.</p><p><strong>Results: </strong>Five hundred and seventy-eight ALIF patients were paired with 1,156 TLIF patients following the match. The analysis revealed a higher 3-month ileus rate in ALIF patients (<i>P</i> = 0.009) and a lower, though not significant difference in, reoperation rate for ALIF within 2 years at 7.1% compared with TLIF at 7.7% (<i>P</i> = 0.696). Five-year reoperation rates were comparable (9.5% vs 10.8%; <i>P</i> = 0.612).</p><p><strong>Conclusions: </strong>Aside from the increased rate of ileus in the ALIF group, there was no significant difference in both short- and mid-term complications, including overall reoperation rate, between the 2 techniques. Spine surgeons should select the optimal technique for a given patient.</p><p><strong>Clinical relevance: </strong>ALIF and TLIF offer comparable mid-term postoperative outcomes for treating 1-level L5/S1 isthmic spondylolisthesis.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979801","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}