International Journal of Spine Surgery最新文献

{"title":"Augmenting Endoscopic Transforaminal Spinal Decompression Surgery (Full Endoscopic Spine Surgery) Using Stimulated Electromyography Neuromonitoring Dilators.","authors":"Dickson Hong Him Chau, Dhivakaran Gengatharan, Walter-Soon-Yaw Wong","doi":"10.14444/8692","DOIUrl":"https://doi.org/10.14444/8692","url":null,"abstract":"<p><strong>Background: </strong>Full endoscopic spine surgery via a transforaminal approach (FESS-TFA) offers a minimally invasive approach for spinal decompression. However, it carries a risk of nerve root irritation or injury. Existing intraoperative neuromonitoring primarily provides retrospective warnings of potential nerve disturbance.</p><p><strong>Objective: </strong>To introduce the use of stimulated electromyography neuromonitoring dilators in FESS-TFA for proactive nerve protection, enhanced localization, and potential reduction in radiation exposure.</p><p><strong>Methods: </strong>This technical note describes the first use of neuromonitoring dilators in FESS-TFA. A 6-mm dilator tipped with a stimulation electrode is introduced to provide real-time directional feedback regarding nerve proximity, allowing the surgeon to actively avoid accidental injury to the exiting nerve root. With the creation of a safe tract, subsequent introduction of working instruments would theoretically reduce the risk of neural injury.</p><p><strong>Results: </strong>The technique was successfully applied in a case of T11/T12 severe spinal stenosis, facilitating safe instrument passage and nerve localization. We describe the surgical technique and provide illustrative intraoperative details.</p><p><strong>Conclusion: </strong>Neuromonitoring dilators represent a promising innovation in FESS-TFA with the potential to enhance patient safety and possibly streamline the procedure. Larger-scale studies are warranted to quantify the true impact of this technique on complication rates, operative time, and radiation exposure.</p><p><strong>Clinical relevance: </strong>This technique highlights a significant advancement in reducing neural complications during minimally invasive spinal surgeries. By proactively preventing nerve irritation or injury and reducing radiation exposure, it contributes to optimizing surgical workflows and improving patient outcomes.</p><p><strong>Level of evidence: 5: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792514","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":"Standalone Anterior Lumbar Interbody Fusion Without Supplementary Posterior Fixation Is Effective for Treatment of Symptomatic Grade 1 Isthmic Spondylolisthesis.","authors":"James S Toohey, Charlie R Faulks, Dean T Biddau, Matthew H Claydon, Nigel R Munday, Gregory M Malham","doi":"10.14444/8663","DOIUrl":"10.14444/8663","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data examining anterior lumbar interbody fusion (ALIF) with pedicle-screw fixation (ALIF-PSF) or without (standalone, sa-ALIF) for the treatment of low-grade isthmic spondylolisthesis (IS). Treating pathology with sa-ALIF reduces costs, operative times, and posterior access morbidity. This study aimed to investigate the clinical and radiographic outcomes of sa-ALIF for the management of low-grade IS compared with an ALIF-PSF cohort.</p><p><strong>Methods: </strong>Retrospective analysis of prospectively collected data. Consecutive patients from 1 senior spine surgeon performing sa-ALIF or ALIF-PSF for management of low-grade IS. Patient-reported outcome measures (PROMs) were collected at baseline, then postoperatively at 6 weeks, 6 months, 12 months, and a final follow-up timepoint. Computed tomography was conducted at 6 months, 12 months, or until interbody fusion was confirmed.</p><p><strong>Results: </strong>Two cohorts comprised 51 patients (sa-ALIF 22 and ALIF-PSF 29). Both cohorts' PROMs improved from baseline to 12 months postoperatively. There were no significant differences (<i>P</i> = 0.05) in PROMs between the 2 cohorts at 6 months postoperatively, 12 months postoperatively, or at a final follow-up timepoint. There were no significant differences in mean fusion rates 12 months postoperatively (sa-ALIF 82% and ALIF-PSF 88%). Compared with preoperative measurements in sa-ALIF and ALIF-PSF cohorts, listhesis and segmental lordosis showed no significant changes, while disc height significantly increased (<i>P</i> = 0.0001). There were no significant differences in disc L5/S1 radiographic measurements between the cohorts at 12 months. There were 12 complications (sa-ALIF 2 and ALIF-PSF 10). Only 1 patient in the ALIF-PSF cohort required revision surgery.</p><p><strong>Conclusions: </strong>In appropriately selected patients with normal bone density, sacral slope <40°, and a body mass index <35, sa-ALIF is a safe and effective treatment option for grade I IS. The additional morbidity and cost of PSF may not be justified given the satisfactory clinical and radiographic outcomes of sa-ALIF for grade I IS.</p><p><strong>Clinical relevance: </strong>Clinically, this research continues to suggest that sa-ALIF is a safe and effective method of treatment for low grade IS.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787367","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":"Sequential Anterior Longitudinal Ligament Release With Expandable Spacers for Lordosis Correction in Anterior-to-Psoas Lumbar Interbody Fusion: A Radiographic and Biomechanical Study.","authors":"Joshua P Herzog, Joshua P McGuckin, Jonathan M Mahoney, Jalen Winfield, Brandon S Bucklen","doi":"10.14444/8664","DOIUrl":"10.14444/8664","url":null,"abstract":"<p><strong>Background: </strong>Anterior column realignment is an attractive minimally invasive treatment for sagittal imbalance. Expandable spacers offer controlled tensioning of the anterior longitudinal ligament (ALL) during release, which could optimize correction and anterior column stability. This study investigated the biomechanical and radiographic effects of single-level anterior-to-psoas lumbar interbody fusion (ATP-LIF) with expandable spacers and sequential ALL release.</p><p><strong>Methods: </strong>In vitro range of motion tests were performed on 7 fresh-frozen cadaveric spines (L2-L5) with a ±7.5 Nm load applied in flexion-extension (FE), lateral bending (LB), and axial rotation (AR). After testing intact spines, single-level (L3-L4) ATP-LIFs were performed and supplemented with posterior screws, rods, and integrated lateral screws and tested after (1) no ALL release (ATP-LIF); (2) resection of 1/3 the ALL's width (1/3 ALL release); (3) resection of 2/3 the ALL's width (2/3 ALL release); and (4) complete ALL resection (3/3 ALL release). Following each partial ALL release, rods were removed, and spacers were expanded until the torque limit was reached. Rods were then reapplied, and lateral radiographs were taken to analyze changes in intervertebral angle (IVA), foraminal height, foraminal area, and posterior and anterior disc height (PDH and ADH).</p><p><strong>Results: </strong>In ATP-LIF constructs, range of motion decreased in FE (18% intact), LB (14% intact), and AR (30% intact), while IVA, PDH, ADH, foraminal height, and foraminal area increased. PDH and ADH increased linearly with sequential ALL release and spacer expansion, while LB and AR remained stable. FE increased slightly (+15%-16% intact, <1°) following 2/3 ALL release but remained stable afterward. IVA increased exponentially with sequential ALL release, gaining 8.8° ± 3.2° with complete release.</p><p><strong>Conclusions: </strong>The present study found improved biomechanics and radiographic parameters following ATP-LIF with intact ALL, minimal biomechanical differences between partial and complete ALL release, and greater correction and height restoration with complete release. Future clinical testing is necessary to determine the impact of this finding on patient outcomes.</p><p><strong>Clinical relevance: </strong>Controlled tensioning of the ALL before and after ligament release allows for potential optimization between restoring sagittal balance and maximizing construct stability in a minimally invasive approach.</p><p><strong>Level of evidence: 5: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787357","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":"Response to \"Nonoperative Management of Isolated Thoracolumbar Flexion Distraction Injuries\".","authors":"Reed M Butler, Steven M Theiss","doi":"10.14444/8694","DOIUrl":"10.14444/8694","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773176","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 Editor: Nonoperative Management of Isolated Thoracolumbar Flexion Distraction Injuries: A Single-Center Study.","authors":"Mohamed M Aly, Andrei Fernandes Joaquim","doi":"10.14444/8691","DOIUrl":"10.14444/8691","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773164","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":"Accuracy of Pedicle Screw Placement Using the ExcelsiusGPS Robotic Navigation Platform: An Analysis of 728 Screws.","authors":"Meghana Bhimreddy, Andrew M Hersh, Kelly Jiang, Carly Weber-Levine, A Daniel Davidar, Arjun K Menta, Brendan F Judy, Daniel Lubelski, Ali Bydon, Jon Weingart, Nicholas Theodore","doi":"10.14444/8660","DOIUrl":"10.14444/8660","url":null,"abstract":"<p><strong>Background: </strong>Robotic platforms have increased in sophistication for pedicle screw placement. Here, we review our institutional experience using ExcelsiusGPS to assess the accuracy rate of pedicle screw placement throughout the spine and characterize predictors of placement inaccuracy.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Patients from 2017 to 2022 undergoing spinal fusion surgery with ExelsiusGPS-assisted screw implantation at a single tertiary center were retrospectively identified. Patient demographics, preoperative symptoms, and operative details were collected. Postoperative computed tomography was used to classify screw placement accuracy according to the Gertzbein and Robbins scale (GRS). A stepwise multivariable ordered logistic regression analysis determined independent risk factors for clinically inaccurate screws (GRS C/D/E).</p><p><strong>Results: </strong>One hundred and seventeen patients were included. Mean age was 60.6 ± 13.2 years, with 57% men, 72% white, and mean body mass index of 29.9 ± 6.4 kg/m². Seven hundred and twenty-eight screws were placed, predominantly in the thoracic (29.5%) and lumbar (52.6%) regions. Accuracy classification indicated 670 GRS A, 31 GRS B, 22 GRS C, 4 GRS D, and 1 GRS E screws. The clinically acceptable screw placement rate (GRS A/B) was 96%. Male gender (odds ratio [OR]: 2.12, <i>P</i> = 0.03), revision surgery (OR: 2.43, <i>P</i> = 0.02), and thoracic level screw insertion (OR: 2.33, <i>P</i> = 0.01) were independently associated with inaccurate screw placement and explained 8.7% of the variability seen. Of the 728 screws placed, 3 required revision after postoperative imaging revealed loosening or pedicle breach.</p><p><strong>Conclusion: </strong>ExcelsiusGPS-assisted screw insertion has high placement accuracy and low revision rates. Identification of predictors of inaccuracy illustrates that similar variables, such as placement in the thoracic spine and revision surgery status, apply to both freehand and robotic screw placement.</p><p><strong>Clinical relevance: </strong>Robotic spine surgery is an accurate, reliable tool that can improve patient outcomes. Factors like male gender, thoracic screw placement, and revision surgery status are associated with lower screw placement accuracy, and these factors should inform surgical decision-making when using robotic assistance.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733356","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: Positioning Rasch Analysis in Modern Clinical Evidence Grading.","authors":"David A Baron","doi":"10.14444/8678","DOIUrl":"10.14444/8678","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S85-S86"},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576898","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":"Insights From the ISASS Webinar Series on Current and Emerging Techniques in Endoscopic Spine Surgery | Part 1: Polytomous Rasch Analysis of Surgeon Endorsement of Endoscopic Discectomy/Foraminotomy, Interbody Fusion, and Importance of Patient Feedback During Surgery.","authors":"Kai-Uwe Lewandrowski, Paulo Sergio Terxeira de Carvalho, Alvaro Dowling, Zhen-Zhou Li, Martin Knight, Morgan P Lorio","doi":"10.14444/8672","DOIUrl":"10.14444/8672","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The International Society for the Advancement of Spine Surgery hosted the first of a series of 4 webinars on endoscopic spine surgery techniques, focusing on end§oscopic discectomy, foraminotomy, instrumented endoscopic fusion, standalone lumbar interbody fusion with innovative materials, and the role of patient feedback in awake procedures. This series aims to share knowledge and discuss the complexities and clinical evidence of modern endoscopic spine surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To analyze the level of surgeon endorsement for the presented endoscopic spine surgery techniques before and after the webinar, utilizing polytomous Rasch analysis, and to evaluate the potential for these insights to inform clinical guideline recommendations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A survey was available to 1311 potential respondents during the Zoom webinar, collecting data on surgeon endorsements using a Likert scale. The polytomous Rasch model was employed to analyze responses, 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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 4 topics received higher confidence ratings demonstrated by descriptive statistics, highlighting the webinar's effective role in surgeon education and in identifying ongoing trends in spine surgery. The logarithmic transformation of these data during Rasch analysis showed noticeable shifts in surgeon confidence levels postwebinar, with increased endorsement for transforaminal full-endoscopic thoracolumbar interbody fusion for hard disc herniation and standalone endoscopic lumbar interbody fusion. The Wright plot and person-item map analyses demonstrated that the webinar effectively targeted areas of initial low confidence, significantly impacting surgeons' perceptions. Disordered endorsement thresholds remained in the topics of uniportal transforaminal discectomy/foraminotomy and patient feedback during endoscopic spine surgery, indicating issues in response category discrimination or confounding factors not captured by the survey. Ongoing controversies were highlighted by the influence of confounding factors, stemming from preconceived notions and limited familiarity with high-grade evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The first in the 4-part webinar series effectively shifted professional confidence and acceptance of innovative surgical approaches among spine surgeons. Observations indicated a high level of interest in applying the endoscopic surgery platform with other advanced technologies. The polytomous Rasch analysis provided nuanced insights into ongoing trends and areas in need of further clarification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;Assessing surgeon confidence and acceptance","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S10-S22"},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583908","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":"Key Takeaways From ISASS Webinar Series on Endoscopic Spine Surgery Techniques | Part 4: Advancing the Curve on Surgeons' Experience With Complex Lumbar Revision Scenarios, Grades 1 to 3 Spondylolytic Spondylolisthesis, Cervical Foraminotomy, and Cervical Spondylotic Myelopathy.","authors":"Kai-Uwe Lewandrowski, Christian Morgenstern, Martin Knight, Yi Jiang, Zhang Xifeng, Paulo Sergio Terxeira de Carvalho, Morgan P Lorio","doi":"10.14444/8675","DOIUrl":"10.14444/8675","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The fourth webinar in a 4-part series hosted by the International Society for the Advancement of Spine Surgery explored contemporary endoscopic spine surgery techniques. This session covered complex revision strategies, endoscopic management of grades 1-3 spondylolytic spondylolisthesis, cervical foraminotomy, and decompression techniques for cervical spondylotic myelopathy (CSM).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim was to assess surgeon endorsement of the discussed endoscopic spine surgery techniques both before and after the webinar using polytomous Rasch analysis. Additionally, the analysis sought to determine how these insights might shape clinical guideline recommendations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Before the webinar, which was attended by 868 potential participants, a survey was distributed to collect data on the level of support for various techniques using a Likert scale. The polytomous Rasch model analyzed these responses by evaluating decision complexity relative to surgeon expertise. This approach helped develop a logarithmic scale to objectively analyze categorical responses, distinguish between congruent and incongruent items, and contribute to the enhancement of clinical guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 868 surgeons, 263 accessed, 150 started, and 118 completed the prewebinar survey, with a completion rate of 78.7%. The participants were mainly orthopedic surgeons (59.3%) and neurosurgeons (34.7%) but also included residents (2.5%), fellows (1.7%), and interventional radiologists (1.7%). In the postwebinar phase, 298 participants accessed the survey, 169 started it, and 128 completed it, achieving a 75.7% completion rate. The demographics of postwebinar participants closely mirrored the initial group: 66.4% orthopedic surgeons, 23.4% neurosurgeons, 3.6% residents, 2.9% fellows, 0.7% medical students, and 2.9% interventional radiologists. The Rasch analysis confirmed high surgeon confidence for the posterior cervical foraminotomy and endoscopic treatment of spondylolytic spondylolisthesis grades 1 to 3 and posterior endoscopic decompression for CSM. Both pre- and postwebinar responses showed a good fit to the Rasch model for these endoscopic techniques, indicating minimal bias, supported by differential item functioning analysis. The application of the endoscopic surgery platform for procedures such as lumbar revision surgery for adjacent segment disease or failed interbody fusion cages and posterior decompression of CSM saw little shift in endorsement, as evidenced both in descriptive and the logarithmically transformed Rasch statistics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This webinar highlighted the evolving consensus on best practices in endoscopic spine surgery, displaying wide acceptance of endoscopic debridement of spondylolytic spondylolisthesis, cervical foraminotomy for herniated disc and bony stenosis, and posterior endoscopic decompression for CSM.&lt;/p&gt;&lt;p&gt;&lt;stron","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S54-S65"},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640058","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":"Invited Commentary: Rasch Analysis and High-Value Spinal Endoscopy.","authors":"Zoher Ghogawala","doi":"10.14444/8684","DOIUrl":"10.14444/8684","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S8-S9"},"PeriodicalIF":1.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576878","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}