International Journal of Spine Surgery最新文献

{"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":"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":"273-278"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075712","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":"Axial Lumber Interbody Fusion as an Alternative \"Salvage\" Approach to Lumbosacral Fixation: A Case Series.","authors":"Paul D Korytkowski, John Panzone, Sean J Cannizzaro, William F Lavelle, Richard A Tallarico","doi":"10.14444/8728","DOIUrl":"10.14444/8728","url":null,"abstract":"<p><strong>Background: </strong>Lumbar interbody fusion is commonly performed to improve spinal stability in the context of degenerative, traumatic, and deformity-related pathologies. The axial lumbar interbody fusion (AxiaLIF) technique, also known as presacral interbody arthrodesis, is the only presacral interbody fusion technique approved by the US Food and Drug Administration. It is a rarely utilized approach to interbody fusion that aims to achieve fusion across L4 to L5 and/or L5 to S1 levels, which are the most susceptible to pseudoarthrosis and hardware failure. This case series describes the utility of the AxiaLIF procedure as a salvage approach when traditional interbody fusion techniques pose significant risks or are not feasible due to rare patient-specific factors.</p><p><strong>Methods: </strong>All identifiable cases of the AxiaLIF procedure performed at a single, academic medical center were reviewed. Operative data were collected and each case presentation is described in detail.</p><p><strong>Results: </strong>Six patients underwent AxiaLIF between July 2010 and May 2022. Indications for AxiaLIF as a salvage approach included hardware failure with a significant risk of recurrence with traditional revision techniques; a lack of segmental fixation at the distal end of the spinal construct; avoiding extensive tissue disruption in the setting of staged realignment surgery or previously compromised tissue; and comorbidities such as muscular dystrophy, abdominal hernias, and severe obesity. Two patients were fused solely across the L5 to S1 level, and 4 patients were fused from L4 to S1. The mean operative time, estimated blood loss, time under fluoroscopy, complications, and follow-up were noted.</p><p><strong>Conclusion: </strong>This case series introduces the utility of AxiaLIF as a salvage approach. We believe the AxiaLIF procedure may be a valuable alternative to traditional lumbar interbody fusion in salvage situations when traditional techniques are not feasible or pose significant risk to the patient. In such situations, surgeon awareness of this approach has the potential to improve patient outcomes and safety.</p><p><strong>Clinical relevance: </strong>AxiaLIF, as a salvage approach, has the potential to improve patient outcomes safely when other surgical options pose significant risk or are not feasible.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"288-295"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744229","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":"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":"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":"302-311"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101969","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":"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":"351-352"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064865","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":"Cervical Myelopathy Secondary to Bilateral Atlantoaxial Pseudoarticulations in Rheumatoid Arthritis: A Case Report.","authors":"Pragadesh Natarajan, Vignaraja Thirunavukarasu, Yingda Li","doi":"10.14444/8735","DOIUrl":"10.14444/8735","url":null,"abstract":"<p><strong>Background: </strong>Cervical myelopathy caused by pseudarthroses is rare, with the exact pathophysiology of its occurrence unclear and reports scarce. To the best of our knowledge, only a few cases have been reported so far. We present a case of cervical myelopathy secondary to bilateral pseudoarticulations in rheumatoid arthritis and discuss possible pathomechanisms with reference to previously published reports.</p><p><strong>Case presentation: </strong>A 61-year-old woman with rheumatoid arthritis and previous C1 to C2 laminectomy suffered from cervical myelopathy. On preoperative imaging as well as surgical exploration, large osteophytes from bilateral pseudoarticulations between the posterior arches of the atlas and axis were seen to be causing severe compression of the spinal cord.</p><p><strong>Case management: </strong>Posterior instrumented C1 to C2 fusion with patient-specific pedicle screws and surgical planning was performed. The patient had significant clinical improvement after fusion.</p><p><strong>Conclusions: </strong>Ligamentous laxity in rheumatoid arthritis can lead to the development of pseudoarticulations, with dynamic forces of neck motion causing osteophytic bony spurs and cord compression. Posterior decompression and fusion was effective in this case of bilateral pseudoarticulations, which produced a posterolateral or \"lateral recess\" pattern of cord compression refractory to previous central decompression alone.</p><p><strong>Level of evidence: 5: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"346-350"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742584","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 and Viability of Anterior Lumbar Interbody Fusion in Complex Revision Lumbar Spine Surgeries: Insights From a Case Series of 135 Patients on Transforaminal Lumbar Interbody Fusion/Posterior Lumbar Interbody Fusion Cage Removal.","authors":"Aécio Rubens Dias Pereira Filho, Matheus Galvão Valadares Bertolini Mussalem, Vinicius Santos Baptista, Vinicius de Meldau Benites, Milton Kiyonory Uehara, Nuno Rodolfo Colaço Aguiar, Arthur Cristiano Baston, Alexandre Vinhal Desideri, Francisco Cialdine Frota Carneiro Júnior","doi":"10.14444/8753","DOIUrl":"10.14444/8753","url":null,"abstract":"<p><strong>Background: </strong>Anterior lumbar interbody fusion (ALIF) has emerged as a valuable technique for managing lumbar degenerative conditions and revision surgeries, particularly for addressing complications associated with transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) cages. However, there is limited evidence documenting its safety and feasibility in the context of revision procedures involving cage removal.</p><p><strong>Objective: </strong>To evaluate intraoperative outcomes of ALIF for TLIF/PLIF cage removal, focusing on complications, surgical times, and blood loss in a substantial case series.</p><p><strong>Methods: </strong>This case series analyzed data from 135 patients who underwent ALIF for TLIF/PLIF cage removal between January 2019 and May 2023. Surgical indications included pseudarthrosis, cage migration, and infection. Outcomes assessed included intraoperative complications, surgical duration, and estimated blood loss.</p><p><strong>Results: </strong>Of the 135 patients (median age: 47 years, range: 15-78), vascular injuries occurred in only 4 cases, all involving the left iliac vein, and were managed intraoperatively without sequelae. No injuries to retroperitoneal, neural, or organ structures were observed. Median surgical time was 100 minutes (range: 50-210), with most cases resulting in less than 150 mL of blood loss. These findings demonstrate the feasibility of ALIF for managing TLIF/PLIF complications.</p><p><strong>Conclusion: </strong>ALIF is a safe and effective option for revision surgeries involving TLIF/PLIF cage removal, offering a low complication profile and manageable intraoperative challenges. A critical factor contributing to these favorable outcomes is the multidisciplinary approach, where the collaboration between access and spine surgeons ensures meticulous handling of anatomical and vascular challenges.</p><p><strong>Clinical relevance: </strong>This study provides valuable data for further prospective research to explore long-term outcomes and refine surgical techniques.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"261-268"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053218","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":"Postmyelography Acute Paraplegia in Patients With Spinal Cord Stimulators: Case Series and Review of Literature.","authors":"César Carballo Cuello, Jay Kumar, Gabriel Flores-Milan, Diego Soto Rubio, Bryan Clampitt, Puya Alikhani","doi":"10.14444/8760","DOIUrl":"10.14444/8760","url":null,"abstract":"<p><strong>Background: </strong>Computed tomography (CT) myelography is an important imaging modality utilized in patients who cannot tolerate magnetic resonance imaging (MRI) due to severe artifact or because of the presence of MRI incompatible medical devices. In the setting of thoracic stenosis and a spinal cord stimulator (SCS), it can predispose patients to develop acute weakness and paraplegia after myelography.</p><p><strong>Case presentation: </strong>We present 2 patients with symptomatic thoracic stenosis who developed acute paraplegia after a CT myelogram. Both patients had SCSs due to a history of back pain and were taken emergently to the operating room for SCS removal and thoracic spine decompression.</p><p><strong>Conclusion: </strong>To our knowledge, these are the first reported cases of acute paraplegia postmyelography in the presence of an SCS in the thoracic spine. This report serves as an important warning and possible emerging contraindication for ordering CT myelography in patients with thoracic stenosis in the presence of an SCS.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"312-315"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052471","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":"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":"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":"269-272"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181425","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":"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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988508","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}