International Journal of Spine Surgery最新文献

{"title":"O-Arm Vs Surgivisio for Pedicle Screw Insertion: A Prospective Study on Screw Accuracy and Irradiation on 100 Patients.","authors":"Marc Prod'homme, Maxime Saad, Jérôme Tonetti, Guillaume Cavalié, Gaël Kerschbaumer, Arun Thangavelu, Jean-Loup Gassend, Mehdi Boudissa","doi":"10.14444/8766","DOIUrl":"https://doi.org/10.14444/8766","url":null,"abstract":"<p><strong>Background: </strong>Computerized navigation improves the accuracy of spine procedures. However, intraoperative imaging is plagued by ionizing irradiation and its cancer risk. Advanced technologies attempt to optimize the radiation dose. The goal of this study was to compare radiation exposure and screw accuracy of O-arm navigation and the Surgivisio device (SD) in pedicle screw insertion.</p><p><strong>Methods: </strong>All patients operated on by navigated pedicle screw insertion during a 19-month period were prospectively included in 2 spine centers: the first with the O-arm and the second with the SD. Demographic, operative, and irradiation data were collected. The accuracy of the screw positioning was assessed using the Heary and Gertzbein classifications. The effective dose in millisievert (mSv) was calculated.</p><p><strong>Results: </strong>One hundred patients were included, 50 per group. Five hundred and twelve screws were inserted, among them 228 in 120 vertebrae with the O-am and 284 in 145 vertebrae with the SD. Screw accuracy was 99.1% with the O-arm vs 93.3% with the SD (<i>P</i> = 0.07). Operative times were similar, with 145 vs 139 minutes respectively, <i>P</i> = 0.68. The effective dose was significantly higher in the O-arm group, with 5.43 vs 2.70 mSv with the SD (<i>P</i> < 0.01). The effective dose related to 2-dimensional imaging was significantly lower in the O-arm group than in the SD group, with 0.26 vs 1.16 mSv, respectively, <i>P</i> < 0.01, related to a shorter imaging duration (4 vs 109 seconds respectively, <i>P</i> < 0.01).</p><p><strong>Conclusions: </strong>Accuracy of pedicle screws was higher with the O-arm than with the Surgivisio, but the latter showed less radiation exposure. Despite promising results, improvements in technology should be pursued for ergonomics and surgical safety.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318233","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":"Trends in Lumbosacral-Pelvic Fixation Strategies.","authors":"Pawel P Jankowski, Sohaib Z Hashmi, Elizabeth L Lord, Joshua E Heller, David A Essig, Peter G Passias, Paritash Tahmasebpour, Robyn A Capobianco, Christopher J Kleck, David W Polly, Scott L Zuckerman","doi":"10.14444/8765","DOIUrl":"https://doi.org/10.14444/8765","url":null,"abstract":"<p><strong>Background: </strong>We sought to better understand the current decision-making criteria and surgical strategies for pelvic fixation in spinal surgery.</p><p><strong>Methods: </strong>A 28-question survey was distributed to an international group of practicing spine surgeons. Questions included training, practice type, criteria for using pelvic fixation, and strategies for pelvic fixation, including the type and technique employed.</p><p><strong>Results: </strong>Of the 56 responders, 32% were neurosurgeons, and 67% were affiliated with academic institutions. Factors that most influenced the use of pelvic fixation were 3-column osteotomy (3CO), high-grade spondylolisthesis, and L5 to S1 pseudarthrosis. Most report using a single point of pelvic fixation per side for the following: deformity 4+ levels without 3CO (55%) and spondylolisthesis grade 3 (59%). The upper instrumented vertebra threshold for pelvic fixation in degenerative pathology was L2 (70%) or L3 (16%). Most surgeons chose 2 points of fixation per side in the setting of 4 or more levels with 3CO (69%) and revision of at least 3 levels (68%). The predominant (77.6%) fixation preference was S2-alar-iliac screws. Surgeons report using navigation (70%), fluoroscopy (23%), free hand (21%), and robot-assisted (7%) for screw placement. The most common pelvic screw diameter and length were 8.5 mm and 90 mm, respectively. A 5% to 10% pelvic fixation revision rate was reported, primarily for instrumentation failure or pseudarthrosis.</p><p><strong>Conclusion: </strong>This survey-based study highlights factors influencing surgeons' decisions on pelvic instrumentation. While complex corrections or revisions often require robust fixation, variability arises in simpler cases, influenced by factors like age, obesity, and bone quality.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295055","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":"Risk Factors for Postoperative Urinary Tract Infection in Patients Undergoing Arthrodesis for Spinal Deformity of Different Levels.","authors":"Hannah Shelby, Tara Shelby, Zoe Fresquez, Jeffrey C Wang, Raymond Hah","doi":"10.14444/8724","DOIUrl":"10.14444/8724","url":null,"abstract":"<p><strong>Background: </strong>While studies have identified urinary tract infection (UTI) as a complication after spine fusion, UTI is understudied in the context of fusion for spinal deformity. This study sought to determine both UTI incidence after multilevel posterior fusion for spinal deformity and whether pooled risk factors (RFs) increased UTI risk.</p><p><strong>Methods: </strong>Patients who had posterior fusion for spinal deformities between 2010 to 2019 were queried from the PearlDiver database, separated by the number of levels operated on (<7, 7-12, and >12), matched for age/gender, and analyzed for UTI incidence within 1 week and 1, 2, and 3 months. Any patient with a note of diabetes, obesity, rheumatoid arthritis, or coronary artery disease within 1-year prior to surgery and who contracted UTI within 1 month after fusion was included in the RF group for each level span. Patients of each level span with any RF were compared with those without any RFs. <i>χ</i> ² tests were used for statistical analyses.</p><p><strong>Results: </strong>A total of 20,893 patients underwent posterior fusion for spinal deformities from 2010 to 2019. After matching, each level set had 2239 patients. At 1, 2, and 3 months, the >12 levels subgroup showed statistically higher UTI incidence than the 7 to 12 and <7 levels subgroups. At 3 months, UTI was similar between the <7 and 7 to 12 subgroups, with 3.8% and 3.9%, respectively (<i>P</i> = 0.41), and UTI was statistically higher in the >12 subgroup at 4.6% (<7 vs 7-12: <i>P</i> = 0.005; <7 vs >12: <i>P</i> < 0.001). For each level group, the RF groups had significantly higher UTI rates at 1, 2, and 3 months. ORs were significantly greater than 1 for RF groups across all level subgroups (<7 OR = 2.8, <i>P</i> < 0.001; 7-12 OR = 2.1, <i>P</i> < 0.001; >12 OR = 2.3, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Diabetes, obesity, rheumatoid arthritis, and coronary artery disease were associated with a higher risk of UTI after posterior fusion for spinal deformity for all level sets. patients who underwent procedures for more than 12 levels had the highest rate of UTI. This is the first study to analyze and compare UTI incidence following fusion for spinal deformity.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"296-301"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516830","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: Police Enforcement and Policy Impact on Moped-Related Spinal Injuries.","authors":"Niyousha Rahimimovaghar, Vafa Rahimi-Movaghar","doi":"10.14444/8750","DOIUrl":"10.14444/8750","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"353-354"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990124","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":"Early Clinical and Radiologic Evaluation of Endoscopic Unilateral Laminectomy for Bilateral Decompression in Degenerative Lumbar Spinal Stenosis: A Retrospective Study.","authors":"Chunliang Guo, Tao Ding, Jianqing Zheng, Xiule Fang, Zhiyun Feng, Yuntao Xue","doi":"10.14444/8725","DOIUrl":"10.14444/8725","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic unilateral laminectomy for bilateral decompression (ULBD) is gaining attention as a minimally invasive procedure for treating spinal stenosis. However, comprehensive studies on its outcomes remain limited.</p><p><strong>Purpose: </strong>This study aims to evaluate the changes in radiologic parameters and clinical outcomes associated with endoscopic ULBD for treating spinal stenosis.</p><p><strong>Methods: </strong>A retrospective study was conducted on 53 patients with central lumbar spinal stenosis who underwent endoscopic ULBD decompression surgery. Pre- and postoperative visual analog scale and Oswestry Disability Index scores were collected to assess the impact on activities of daily living. Parameters such as operation time, intraoperative blood loss, postoperative drainage volumes (first and second day), total hospital stay, and postoperative hospital stay were recorded. Additionally, pre- and postoperative imaging changes were documented, and MacNab functional scores were evaluated at 6 months postoperatively to assess clinical efficacy.</p><p><strong>Results: </strong>No nerve injuries occurred during the operation. Two cases of cerebrospinal fluid leakage were successfully treated with pressure dressings, and no postoperative complications such as incision infection or dehiscence were observed. At 6-month follow-up, postoperative visual analog scale scores and Oswestry Disability Index showed significant improvement compared with preoperative levels (<i>P</i> < 0.05). Postoperative lumbar computed tomography images revealed a statistically significant enlargement in the anterior-posterior diameter of the spinal canal and the diameter of the bilateral lateral recesses (<i>P</i> < 0.05). All patients experienced either improvement or resolution of clinical symptoms. The MacNab functional scores at the 6-month follow-up indicated excellent outcomes in 37 cases, good in 15 cases, and fair in 1 case, resulting in an overall good rate of 98.11%.</p><p><strong>Conclusions: </strong>This study demonstrates that endoscopic ULBD can provide favorable outcomes for single-segment central lumbar spinal stenosis under local anesthesia at a relatively low cost.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"338-345"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573994","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":"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":"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":"355-361"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226992","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":"Canal Bone Ratio for Predicting Bone Mineral Density in Lumbar Degenerative Diseases.","authors":"Akihiko Hiyama, Daisuke Sakai, Hiroyuki Katoh, Masato Sato, Masahiko Watanabe","doi":"10.14444/8727","DOIUrl":"10.14444/8727","url":null,"abstract":"<p><strong>Background: </strong>Despite its clinical importance, osteoporosis remains underdiagnosed, particularly in spinal surgery patients, where bone quality affects surgical outcomes. Existing screening methods are often costly or inaccessible, highlighting the need for a simpler alternative.</p><p><strong>Objective: </strong>The purpose of the present study was to assess the canal bone ratio (CBR) as a predictive tool for bone mineral density (BMD) in patients with lumbar degenerative diseases and establish a specific cutoff value for diagnosing osteoporosis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of 102 patients older than 50 years who underwent lumbar spine surgery at our institution from 2016 to 2024. Eligible patients underwent dual-energy x-ray absorptiometry (DXA), full-spine x-ray imaging, and computed tomography within 3 months before their surgery. CBR measurements were obtained by analyzing x-ray images for the inner and outer diameters of the femoral shaft 7 cm below the lesser trochanter. The Youden index based on <i>T</i> score thresholds from DXA scans determined the optimal cutoff value for diagnosing osteoporosis using CBR.</p><p><strong>Results: </strong>The cutoff value for CBR was 0.501, which was identified by analyzing BMD data from the lumbar spine and femoral neck regions. This cutoff demonstrated a strong correlation with low BMD scores, exhibiting a sensitivity of 0.656 and a specificity of 0.671 for identifying osteoporosis among the included patients. Additionally, CBR values negatively correlated with <i>T</i> scores and computed tomography-based Hounsfield units values obtained from lumbar and femoral regions, reinforcing its validity as a screening tool.</p><p><strong>Conclusion: </strong>CBR correlates with <i>T</i> scores from DXA and Hounsfield units values, establishing itself as a feasible and practical screening tool for osteoporosis in patients with lumbar degenerative disease.</p><p><strong>Clinical relevance: </strong>CBR facilitates early intervention and improves management in populations at high risk for bone fragility.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"330-337"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573972","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":"Risk Analysis of Neurological Deterioration Associated With Fluid Insufflation in Uniportal Spine Endoscopy: A Case Series and Literature Review.","authors":"Daniel Liu, Ralph Jasper Mobbs","doi":"10.14444/8730","DOIUrl":"10.14444/8730","url":null,"abstract":"<p><strong>Background: </strong>Uniportal spine endoscopy is a minimally invasive technique gaining widespread popularity, but fluid insufflation during the procedure poses risks of neurological deterioration. The present study examines these risks through a case series and literature review.</p><p><strong>Methods: </strong>A review of the literature was conducted to identify reported complications related to fluid insufflation. Additionally, we present a case series of 3 patients who experienced neurological deterioration associated with irrigation pressures.</p><p><strong>Results: </strong>Key findings from the literature include complications such as raised intracranial pressure, seizures, durotomy-induced injuries, and unintended fluid migration. This case series describes novel complications, including transient ipsilateral weakness and lumbosacral plexopathy, linked to high irrigation pressures.</p><p><strong>Conclusion: </strong>Neurological deterioration, though rare, is a significant risk in uniportal spine endoscopy. Future research should focus on defining optimal irrigation parameters and pressure management strategies.Clinical RelevanceBy understanding the mechanisms in which fluid insufflation may cause neurological deterioration and by consequently adopting preventive strategies, surgeons can reduce complications and improve patient outcomes.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"279-287"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617538","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":"Sexual Dysfunction and Urinary Incontinence in Female Patients Following Primary Anterior Lumbar Interbody Fusion: A Survey of 84 Patients.","authors":"Tabea Annina Roth, Yael Rachamin, Emin Aghayev, Elena Albertazzi, Lukas Kouba, Peter Diel, Regula Teuscher, Lorin Michael Benneker, Paul Ferdinand Heini","doi":"10.14444/8768","DOIUrl":"10.14444/8768","url":null,"abstract":"<p><strong>Background: </strong>Anterior lumbar interbody fusion (ALIF) surgery can damage nerve fibers and has been linked to retrograde ejaculation in men. In women, sexual dysfunction following ALIF is rarely investigated. The aim of this study was to investigate the frequency of postoperative changes in sexual function and incontinence in women following ALIF.</p><p><strong>Methods: </strong>For this study, 173 female patients aged 18 to 60 years who had undergone a primary ALIF surgery in 2015 to 2022 in a large spine center to retrospectively answer a questionnaire about sexual function and incontinence pre- and postoperatively; they were also asked to rate their satisfaction with the surgery. McNemar tests were used to compare the prevalence of specific problems pre- vs postoperatively.</p><p><strong>Results: </strong>Of all respondents (<i>n</i> = 84), 23 (27%) reported a worsening of sexual function following ALIF surgery, and these changes were persistent in 83% of those patients. Among individual symptoms of sexual dysfunction, the highest increase was observed for the prevalence of vaginal dryness, which increased from 12% preoperatively to 32% postoperatively (<i>P</i> < 0.001), followed by dyspareunia, which increased from 8% to 21% (<i>P</i> = 0.001). Urinary incontinence increased from 25% to 41% (<i>P</i> < 0.001). Patient age, level of surgery, and fusion material were not associated with worsening of sexual function. However, worsening of sexual function was associated with a lower level of satisfaction with the surgery outcome and a lower proportion of patients who would have the surgery again.</p><p><strong>Conclusions: </strong>Female patients undergoing ALIF should receive adequate preoperative information about potential changes in sexual function to enable them to make an informed decision.</p><p><strong>Clinical relevance: </strong>An improved understanding among patients will lead to more realistic patient expectations and higher patient satisfaction.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"316-323"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250109","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":"Lumbar Intramuscular Myxoma: Microsurgical Resection With Assistance From an Endoscopic Microinspection Tool.","authors":"Juan Antonio Ponce-Gómez, María Fernanda Tejada-Pineda, Marco Muñuzuri-Camacho, Sergio Moreno-Jiménez, Samuel Romano-Feinholz, Victor Alcocer-Barradas, Marcela Amparo Osuna-Zazueta, José Pablo Zárate-García, Júlia Moscardini-Martelli, Luis Alberto Ortega-Porcayo","doi":"10.14444/8733","DOIUrl":"10.14444/8733","url":null,"abstract":"<p><strong>Background: </strong>Intramuscular myxomas (IMs) are rare benign neoplasms of fibroblastic origin, typically presenting in adults, with a female predominance. IMs are uncommonly located in the skeletal muscles, most frequently in the thighs, but rarely in the paraspinal region. IM may be located deeply in this region and that could present a challenge for complete resection.</p><p><strong>Case presentation: </strong>A 66-year-old woman presented with progressive lower back pain and radicular symptoms, which were due to a paraspinal IM.</p><p><strong>Case management: </strong>The patient underwent a minimally invasive microsurgical resection assisted by a 45° endoscopic microinspection tool (QEVO) to enhance visualization and access the lateral compartment of the tumor. Microsurgical dissection assisted with endoscopic visualization allowed successful resection of the tumor, including its lateral compartment, without extensive muscle transection. No complications occurred during or after surgery, and the patient reported complete symptom relief with no recurrence after 2 years.</p><p><strong>Technology: </strong>This case demonstrates the value of integrating endoscopic tools in spinal surgery, particularly in cases where conventional microsurgical techniques are insufficient for complete tumor resection using less invasive approaches. The enhanced visualization provided by the 45° endoscope facilitated the successful resection of a paraspinal lesion, improving surgical precision and patient outcomes.</p><p><strong>Conclusions: </strong>The QEVO microinspection tool is an effective adjunct to microsurgical techniques, offering enhanced visualization and precision during tumor resection. This case highlights its potential to address the challenges posed by deeply located paralumbar tumors. As further research explores its use in spine surgery, this microinspection tool could become an important asset in minimally invasive spinal tumor resections, improving patient outcomes through better tissue preservation and complete resection.</p><p><strong>Level of evidence: 5: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"324-329"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774430","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}