International Journal of Spine Surgery最新文献

{"title":"Key Takeaways From the ISASS Webinar Series on Current and Emerging Techniques in Endoscopic Spine Surgery | Part 2: Polytomous Rasch Analysis of Learning Curve and Surgeon Endorsement of Biportal, Interlaminar, and Transforaminal Endoscopic Stenosis Decompression, Discectomy, and Laminectomy in Combination With Interspinous Process Spacers.","authors":"Kai-Uwe Lewandrowski, Gregory W Basil, Brian Kwon, Xinyu Liu, Gabriel Oswaldo Alonso Cuéllar, Paulo Sergio Terxeira de Carvalho, Morgan P Lorio","doi":"10.14444/8673","DOIUrl":"10.14444/8673","url":null,"abstract":"<p><strong>Background: </strong>The International Society for the Advancement of Spine Surgery hosted the second of a series of 4 webinars on endoscopic spine surgery techniques. The second webinar focused on the application of unilateral biportal endoscopy for discectomy and laminectomy in combination with interbody fusion and interspinous process spacers. This series was intended to identify current trends with contemporary modern endoscopic spine surgery techniques.</p><p><strong>Objective: </strong>To analyze the level of surgeon endorsement for the presented endoscopic spine surgery techniques before and after the webinar utilizing polytomous Rasch analysis, as well as to evaluate the potential for these insights to inform clinical guideline recommendations.</p><p><strong>Methods: </strong>A survey was available to 667 potential respondents during the Zoom webinar, collecting data on surgeon endorsements using a Likert scale. The polytomous Rasch model was employed to analyze responses while considering the complexity of decisions against surgeon expertise, developing a logarithmic measurement scale, allowing objective statistical analysis of categorical variables, highlighting incongruent or out of order items vs congruent and in order items, and driving improvement in clinical guidelines.</p><p><strong>Results: </strong>Of the 667 surgeons who participated in the webinar, 224 accessed, 122 started, and 61 completed the prewebinar survey, achieving a 50.0% completion rate. Respondents comprised primarily orthopedic surgeons (70.5%) and neurosurgeons (24.6%), with fellows and medical students each making up 1.6%. These surgeons estimated that mastering the learning curve of endoscopic spine surgery required an average of 18.08 cases corroborated by postwebinar responses averaging 15.78 cases. Descriptive statistics revealed an acknowledgment of a learning curve in mastering endoscopic spine surgery, with a slight increase in recognition postwebinar (81.8% up from 80.3%). The data underscored the importance of cadaver courses and high-volume surgical practice before the webinar and highlighted the value of mentorship afterward, indicating a preference shift toward more interactive learning. The confidence in various endoscopic techniques saw notable changes, particularly for procedures involving interlaminar lateral canal decompression and the combined use of transforaminal endoscopic decompression with interspinous process spacers, which saw an increase in high-level endorsements postwebinar. Polytomous Rasch analysis provided insights into training methods and procedural techniques, with mentorship and cadaver courses emerging as key elements for mastering the learning curve. The analysis also highlighted a general consensus on the effectiveness of percutaneous endoscopic interlaminar decompression for lateral canal stenosis, reflecting evolving surgeon preferences and consensus on best practices. Infit and outfit statistics from the Rasch ","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S23-S37"},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Hierarchy of Evidence.","authors":"Mauricio G Pereira","doi":"10.14444/8677","DOIUrl":"10.14444/8677","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S83-S84"},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Rasch Analysis and High Value Spinal Endoscopy-Another Perspective.","authors":"Daniel K Resnick","doi":"10.14444/8682","DOIUrl":"10.14444/8682","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S87-S88"},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Spinal Langerhans Cell Histiocytosis in Children: A Systematic Review.","authors":"Macherla Haribabu Subramaniam, Victor Moirangthem, Muralidharan Venkatesan","doi":"10.14444/8662","DOIUrl":"10.14444/8662","url":null,"abstract":"<p><strong>Background: </strong>Spinal Langerhans cell histiocytosis can manifest as solitary site unifocal form or as systemic form in children. The management options for solitary spinal site unifocal form are many. They include spontaneous resolution of the lesion and supervised treatment, steroid injection of the lesion, systemic chemotherapy, radiation therapy and surgery. Multiple options create a decision-making dilemma for the treating specialist. The authors sought to formulate a management algorithm of spinal Langerhans cell histiocytosis based on Garg's grading of radiographic vertebral body collapse.</p><p><strong>Materials and methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses-2020 guidelines were followed in conducting the review and studies were filtered from established medical databases. Articles published between 2003 and 2022 were included after applying strict inclusion and exclusion criteria. The first and second authors reviewed the abstracts of filtered studies before including them. The study was registered with Prospero. The bias assessment of included studies was assessed using the MINOR's criteria.</p><p><strong>Results: </strong>Eight retrospective case series were analyzed. Within these studies, a total of 116 children (mean age 7.4 years) had undergone treatment. The mean follow-up period was 52.1 months. Among these patients, there were 37 tumors in the cervical spine, 40 in the thoracic spine, 25 in the lumbar spine, and a single tumor in the sacrum. Systemic chemotherapy has been found to reduce the risk of radiographic vertebral body collapse (p < 0.05). Surgery provides optimal outcomes in patients with Garg's grade IB , II spinal tumors and restores vertebral body height (p < 0.05). No case series were found pertaining to grade III. Reconstitution of vertebral body height, an important radiological parameter indicating the endpoint or healing of the lesion, was early achieved with surgery followed by systemic chemotherapy, bracing, and supervised management.</p><p><strong>Conclusion: </strong>Observation can be preferred in Garg's grade IA. Grade IB and II tumors respond well to surgery. Treatment for grade III tumors needs to be tailored on an individual basis.</p><p><strong>Grade of recommendation: </strong>C.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Outpatient Anterior Lumbar Interbody Fusion Surgery: A Systematic Review With Meta-Analyses.","authors":"Luke J Weisbrod, Brandon L Staple, Danielle M Westmark, Andrew P Gard, Daniel L Surdell","doi":"10.14444/8661","DOIUrl":"10.14444/8661","url":null,"abstract":"<p><strong>Background: </strong>Due to rapidly rising health care costs, leveraging outpatient surgery to reduce hospital inpatient burden is being explored. This study provides a systematic review of the literature on outpatient anterior lumbar interbody fusion (ALIF) with pooled analysis to determine its safety and feasibility.</p><p><strong>Methods: </strong>Embase (Elsevier), MEDLINE (National Library of Medicine), CINAHL (EBSCO), and the Cochrane Library (Wiley) were searched on 8 April 2024 for articles mentioning the following search concepts: (1) ambulatory; (2) outpatient; and (3) ALIF surgery. Included studies had (1) patients undergoing outpatient ALIF; (2) an inpatient control group; (3) a sample size of ≥5 in each cohort; and (4) a population aged ≥18 years. Outcome data were extracted from studies meeting inclusion criteria, and Newcastle-Ottawa scores were assigned to included studies lacking a prospective, randomized design. Fixed and random effects models were used to establish ORs and mean difference with 95% CIs for each outcome.</p><p><strong>Results: </strong>Pooled analysis included results from 4 studies. A total of 2070 patients underwent outpatient ALIF and 12,554 underwent inpatient ALIF. The results showed that compared with inpatient ALIF, outpatient ALIF resulted in a statistically significant decrease in postoperative adverse events (OR -0.89, 95% CI [-1.69, -0.09], <i>I</i> ² = 54.88%, <i>P</i> = 0.03), comparable readmission rates (OR 0.02, 95% CI [-0.16, 0.20], <i>I</i> ² = 0%, <i>P</i> = 0.816), and nearly statistically significant decrease in reoperation rates (OR -0.41, 95% CI [-0.83, -0.00], <i>I</i> ² = 0%, <i>P</i> = 0.05).</p><p><strong>Discussion: </strong>These meta-analyses suggest that outpatient ALIF is associated with a statistically significant decrease in postoperative adverse events without a significant difference in hospital readmission or reoperation rates. These results suggest that in carefully selected patients, outpatient ALIF is safe and feasible. This study is limited by pooled analysis of retrospective data.</p><p><strong>Clinical relevance: </strong>This systematic review contributes to the assessment of the safety of outpatient ALIF spine surgery.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Would Minimally Invasive Spinal Surgery Not Be Preferable for Metastatic Spine Disease?","authors":"Si Jian Hui, Jiong Hao Tan, Sahil Athia, Priyambada Kumar, Renick Lee, Shahid Ali, Seok Woo Kim, Naresh Kumar","doi":"10.14444/8658","DOIUrl":"10.14444/8658","url":null,"abstract":"<p><strong>Background: </strong>Metastatic spine tumor surgery (MSTS) is an important treatment modality of metastatic spinal disease (MSD). Open spine surgery (OSS) was previously the gold standard of treatment till the early 2010s. However, advancements in MSTS in recent years have led to the advent of minimally invasive spinal surgery (MISS) techniques for the treatment of MSD. The clear benefits of MISS have resulted in a current paradigm shift toward today's gold standard of MISS and early adjuvant radiotherapy in treating MSD patients. Nonetheless, despite improvements in surgical techniques and the rise of literature supporting MISS for MSD, there are still certain situations whereby MISS is not desirable or even suitable. There has also yet to be any literature describing the considerations of not using MISS in MSD in today's clinical context.</p><p><strong>Methods: </strong>A narrative review was conducted for this manuscript. All studies related to OSS and MISS in MSTS were included.</p><p><strong>Results: </strong>A total of 54 studies were included in this review. These studies discussed various advantages of MISS for MSD in today's clinical context, including the patient profile, location of vertebrae involved with metastasis requiring treatment, tumor characteristics, as well as equipment availability.</p><p><strong>Conclusion: </strong>This study establishes situations in which MISS can be less applicable despite the advantages it may confer over traditional OSS. MSTS should be individualized, depending on the experience of the surgeon. OSS is a time-tested approach that still holds weight in MSTS and should be readily utilized depending on the clinical situation.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized Approaches to Spine Surgery.","authors":"Arati Patel, Abraham Dada, Satvir Saggi, Hunter Yamada, Vardhaan S Ambati, Elianna Goldstein, Edward C Hsiao, Praveen V Mummaneni","doi":"10.14444/8644","DOIUrl":"10.14444/8644","url":null,"abstract":"<p><p>Patient-centric decision-making has imbued all aspects of health care, including spine surgery. This review describes how spine surgeons can use evolving technologies and knowledge of disease and pain states to tailor their surgical approach to the individual patient. This includes preoperative screening for and optimization of low bone mineral density, intraoperative selection of implant material and customization of interbody cages and screws, and postoperative personalization of pain regimens and rehabilitation courses. By working in a multidisciplinary fashion, spine surgeons can avail themselves of these advances to provide individualized care.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis Investigating Optimal Timing of Chemoprophylaxis for Venous Thromboembolism in Operatively Managed Blunt Spinal Injuries.","authors":"Faisal A AlGhamdi, Mohammed O Alzayer, Mohammed M AlKabbani, Renad M AlJoaid, Nasser A AlJoaib, Kawther M Hadhiah, Nisreen H AlMaghraby","doi":"10.14444/8656","DOIUrl":"10.14444/8656","url":null,"abstract":"<p><strong>Background: </strong>Blunt spinal injuries (BSIs) are associated with substantial morbidity and mortality. Management typically involves stabilization of the spinal column and may include chemoprophylaxis for venous thromboembolism (VTE) prevention. The optimal timing of chemoprophylaxis initiation in operatively managed BSI patients remains debated.</p><p><strong>Objective: </strong>Analyze available literature on optimal chemoprophylaxis timing for the prevention of VTE in patients postinjury undergoing operative repair.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and MEDLINE were searched for studies assessing chemoprophylaxis timing in adult BSI patients. Inclusion criteria focused on operatively managed BSIs and anticoagulant usage assessment.</p><p><strong>Results: </strong>Three studies involving 4345 patients were included. Early chemoprophylaxis initiation was associated with significantly lower deep vein thrombosis (DVT) and overall VTE incidence compared with late initiation. No significant differences were found in pulmonary embolism (PE) incidence or mortality.</p><p><strong>Conclusion: </strong>Early anticoagulant administration after spinal fixation for BSI reduces DVT and overall VTE risk without impacting PE incidence or mortality. Further research is recommended to solidify these findings and address existing gaps in the literature.</p><p><strong>Clinical relevance: </strong>Early chemoprophylaxis initiation in operatively managed BSI patients reduces DVT and overall VTE risk without affecting PE incidence or mortality LEVEL OF EVIDENCE: 2.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Postoperative Bracing Following Spinal Fusion for Degenerative Lumbar Conditions: An Updated Meta-Analysis of Randomized Controlled Trials.","authors":"An-Ping Feng, Shang-Feng Yu, Ming-Tao Zhu, Li-Ru He, Guang-Xun Lin","doi":"10.14444/8598","DOIUrl":"10.14444/8598","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of consensus on the use of postoperative bracing for lumbar degenerative conditions. Spine surgeons typically determine whether to apply postoperative braces based primarily on clinical experience rather than robust, evidence-based medical data. Thus, the present study sought to assess the impact of postoperative bracing on clinical outcomes, complications, and fusion rates following lumbar fusion surgery in patients with degenerative spinal conditions.</p><p><strong>Methods: </strong>Only randomized controlled studies published between January 1990 and 20 October 2023 were included in this meta-analysis. The primary outcome measures consisted of pre- and postoperative assessments of the Oswestry Disability Index (ODI) and visual analog scale (VAS) scores. Improvements in VAS and ODI scores were analyzed in the early postoperative period (1 month after operation) and at final follow-up, respectively. The analysis also encompassed fusion rates and complications.</p><p><strong>Results: </strong>Five studies with 362 patients were included in the present meta-analysis. In the early postoperative period, the brace group showed a relatively better improvement in ODI scores compared with the no-brace group (19.47 vs 18.18), although this difference was not statistically significant (<i>P</i> = 0.34). Similarly, during the late postoperative period, the brace group demonstrated a slightly greater improvement in VAS scores in comparison to the no-brace group (4.05 vs 3.84), but this difference did not reach statistical significance (<i>P</i> = 0.30). The complication rate was relatively lower in the brace group compared with the no-brace group (14.9% vs 17.4%), although there was no statistical difference between the 2 groups (<i>P</i> = 0.83). Importantly, there were no substantial differences in fusion rates between patients with or without braces.</p><p><strong>Conclusion: </strong>The present meta-analysis revealed that the implementation of a brace following lumbar fusion surgery did not yield substantial differences in terms of postoperative pain relief, functional recovery, complication rates, or fusion rates when compared with cases where no brace was employed.</p><p><strong>Clinical relevance: </strong>This meta-analysis provides valuable insights into the clinical impact of postoperative bracing following lumbar fusion surgery for degenerative spinal conditions.</p><p><strong>Level of evidence: 1: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"540-550"},"PeriodicalIF":1.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Biportal Endoscopic Decompressive Laminectomy in Octogenarians With Severe Lumbar Spinal Stenosis.","authors":"Sang-Min Park, John I Shin, Jin-Ho Park, Jonghun Jung, Jiwon Park, Ho-Joong Kim, Jin S Yeom, Hyun-Jin Park","doi":"10.14444/8649","DOIUrl":"10.14444/8649","url":null,"abstract":"<p><strong>Background: </strong>Lumbar spinal stenosis (LSS) is prevalent among octogenarians, causing significant pain and disability. Surgical intervention is often required because of the ineffectiveness of conservative treatments. This study investigates the efficacy and safety of biportal endoscopic decompressive laminectomy (BED) in octogenarians with severe LSS, evaluating its potential as a minimally invasive surgical option.</p><p><strong>Methods: </strong>This retrospective study included 107 patients aged 80 years or older who underwent BED for LSS between March 2017 and December 2022. Data were collected from electronic medical records, including demographic information, clinical outcomes, and surgical details. Patients with fractures, infectious spondylitis, herniated discs, and follow-up less than 12 months were excluded. Clinical outcomes were assessed using the visual analog scale, Oswestry Disability Index, European Quality of Life-5 Dimensions, and painDETECT at baseline and at 3, 6, and 12 months after surgery.</p><p><strong>Results: </strong>The mean age of the 107 patients was 84.1 years, with 59% being women. Significant improvements were observed in visual analog scale scores for lower back and lower extremities pain, Oswestry Disability Index, European Quality of Life-5 Dimensions, and painDETECT scores, indicating reduced pain, decreased disability, and enhanced quality of life. There were no significant differences in outcomes between patients aged 80 to 84 and those 85 or older. Surgery-related outcomes such as operation time, blood loss, and complications were similar in both age groups.</p><p><strong>Conclusions: </strong>BED is a safe and effective treatment for LSS in octogenarians, providing significant pain relief and functional improvement. This minimally invasive technique is also viable for patients older than 85 years, without increased risk of complications, supporting its broader indications in managing LSS in the elderly.</p><p><strong>Clinical relevance: </strong>This study highlights the efficacy and safety of BED for LSS in octogenarians, demonstrating its potential to improve quality of life and function with low risks, making it a feasible option for elderly patients.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"482-489"},"PeriodicalIF":1.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}