International Journal of Spine Surgery最新文献

{"title":"Use of Double Cages for Biportal Endoscopic Transforaminal Lumbar Interbody Fusion: A Comparison of 3-Dimensional-Printed Titanium and Polyetheretherketone Cages.","authors":"Dong Hyun Lee, Jin Young Lee, Sung Bum Kim, Choon Keun Park, Kang Taek Lim, Dong Chan Lee, Inbo Han, Jae-Won Jang, Dong-Geun Lee, Il-Tae Jang","doi":"10.14444/8788","DOIUrl":"https://doi.org/10.14444/8788","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare a 3-dimensional (3D)-printed titanium cage with a polyetheretherketone (PEEK) cage in biportal endoscopic transforaminal lumbar interbody fusion (BETLIF) using a double cage construct, evaluate differences in fusion stability and subsidence between the 2 cage types, and analyze factors influencing subsidence.</p><p><strong>Methods: </strong>We retrospectively examined 89 patients who underwent BETLIF using a double cage (3D-printed titanium, 48 levels; PEEK, 46 levels). Fusion status and subsidence were assessed using dynamic plain lateral lumbar spine radiographs and computed tomography images at 6 months and 1 year postoperatively. Fusion was graded according to the Bridwell system, and significant subsidence was defined as ≥2 mm endplate depression on computed tomography. Demographic and clinical variables, including age, sex, body mass index, American Society of Anesthesiologists classification, history of tobacco smoking, diabetes mellitus, bone mineral density measured using dual-energy x-ray absorptiometry, cage length, and cage material, were collected and analyzed as potential risk factors.</p><p><strong>Results: </strong>At 1-year follow-up, fusion grades were I (75.0%, 36 levels), II (20.8%, 10 levels), and III (4.2%, 2 levels) for 3D-printed titanium and I (53.2%, 25 levels), II (40.4%, 19 levels), and III (6.4%, 3 levels) for PEEK. The overall fusion rate (grades I and II) was similar for both cages (95.8% vs 93.6%, <i>P</i> = 0.629), but grade I was more prevalent with 3D-printed titanium than with PEEK (75.0% vs 53.2%, <i>P</i> = 0.027). No significant differences were observed in subsidence or complications between the 2 cages. Multivariate analysis revealed age as the only variable significantly associated with subsidence in BETLIF.</p><p><strong>Conclusions: </strong>Both double 3D-printed titanium and PEEK cages demonstrated high fusion rates with no significant differences in overall success. However, double 3D-printed titanium cages showed better early fusion grades and comparable subsidence to that of PEEK cages. Although long-term follow-up is necessary to ascertain efficacy, these findings suggest that 3D-printed titanium cages offer advantages in early fusion quality in BETLIF. Further research is needed to optimize cage arrangement, cage design, and surgical techniques to improve outcomes.</p><p><strong>Clinical relevance: </strong>The use of double 3D-printed titanium cages is recommended in BETLIF.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972375","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":"Dancing Dorsal Quadrilaterals: Case Report.","authors":"Francisco de Assis Ulisses Sampaio Júnior, Hetevaldo Tavares de Lira Filho, Mateus de Sousa Rodrigues, Laylla Maria Quidute Sampaio, Bartolomeu Souto Queiroz Quidute, José Cássio Falcão da Cunha, Oscar Luís Alves","doi":"10.14444/8779","DOIUrl":"https://doi.org/10.14444/8779","url":null,"abstract":"<p><p>Peripheral injury-induced movement disorders encompass a broad spectrum of conditions characterized by involuntary movements resulting from injuries to the peripheral nervous system. While most reported cases are associated with traumatic events-such as nerve lacerations-surgical interventions are also recognized as potential triggers of such disorders. This article aims to report a rare presentation of dancing dorsal quadrilateral syndrome (DDQS) following spinal surgery with instrumentation. A 63-year-old man presented with back pain and neck pain and was diagnosed with Scheuermann's disease. He underwent thoracic spinal fusion with pedicle screw instrumentation to correct hyperkyphosis. Six months after surgery, he began to experience a burning pain in the bilateral subscapular region along with abnormal and involuntary movements in the dorsal musculature. The motor unit potential followed an ascending-descending pattern, and these findings were compatible with dyskinesia, specifically DDQS. A joint management approach with a clinical neurologist was indicated, including the prescription of muscle relaxants and the administration of botulinum toxin in the dorsal quadrilaterals, resulting in partial improvement of the condition. Treatment options range from addressing afferent nerve injury, which can sometimes be curative in some focal dyskinesias, to the use of botulinum toxin for symptomatic relief, as presented in the above case. Additional research is warranted to better understand the pathophysiology of DDQS and to optimize treatment strategies for this uncommon but clinically significant condition.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761682","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":"Rates of Osteolysis for Commercially Available Cervical Disc Arthroplasty Devices in the United States: A Manufacturer and User Facility Device Experience Database Analysis.","authors":"Pierce Nunley, Andrew Meyers, Danny Mangual-Perez, Emily Young, Henry Googe, Ian Armstrong, Stacie Tran, Marcus Stone","doi":"10.14444/8772","DOIUrl":"https://doi.org/10.14444/8772","url":null,"abstract":"<p><strong>Background: </strong>Cervical disc arthroplasty (CDA) represents a promising alternative to anterior cervical discectomy and fusion for the treatment of symptomatic degenerative disc disease in appropriately selected patients. It offers the potential benefits of motion preservation and reduced adjacent segment degeneration. However, like any surgical procedure, CDA has associated risks and complications. Among these, postoperative osteolysis, although rare, warrants further investigation to fully understand its incidence, causes, and optimal management strategies. This study's purpose is to elucidate the current incidence of osteolysis following CDA.</p><p><strong>Methods: </strong>The Manufacturer and User Facility Device Experience (MAUDE) database was queried using the \"Brand Name\" function for: \"Mobi C,\" \"Mobi-C,\" \"Prodisc -C,\" \"Prodisc C,\" \"Bryan,\" \"PCM,\" \"Secure-C,\" \"Secure C,\" \"Prestige,\" \"M6,\" and \"Simplify\" from 1 January 2005 to 30 September 2024. Search results were further queried for the word \"osteolysis.\" Osteolysis percentage was calculated as a proportion of a total number of valid reports. The findings from this study were compared with published literature.</p><p><strong>Results: </strong>The total number of osteolysis events reported in the MAUDE database for each disc was 2 Mobi-C, 1 Prodisc-C, 3 Bryan, 0 PCM, 0 Secure-C, 2 Prestige, 138 M6, and 16 Simplify. The highest rate of osteolysis was found in the M6 (36.2%) and Simplify discs (25.8%). Results from the MAUDE database were consistent with previously published literature.</p><p><strong>Conclusion: </strong>While acknowledging the limitations of the MAUDE database, the data presented give rise to substantial concerns regarding the association of osteolysis with the M6 implant. While the reports on the Simplify disc are recent, the current findings indicate a necessity for careful monitoring. Although surgeon participation in the MAUDE database is optional, it is imperative to promptly report any issues with recent technology to ensure fellow surgeons and the public are well informed.</p><p><strong>Clinical relevance: </strong>This report brings to light a clinical concern of osteolysis in cervical TDR surgeries that was not previously discussed. Using these findings, surgeons can look out for signs of osteolysis in earlier follow-up to provide early treatment.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668631","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":"Artificial Intelligence: The Prevalent Coauthor Among Early-Career Surgeons.","authors":"Franziska C S Altorfer, Giuseppe Loggia, Fedan Avrumova, Darren R Lebl","doi":"10.14444/8778","DOIUrl":"https://doi.org/10.14444/8778","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional survey study BACKGROUND: Artificial intelligence (AI) tools are increasingly integrated into various aspects of medicine, including medical research. However, the scope and manner in which early-career surgeons utilize AI tools in their research remain inadequately understood.</p><p><strong>Objective: </strong>This study aimed to investigate the frequency and specific applications of AI tools in medical research among early-career surgeons, including their perceptions, concerns, and outlook regarding AI in research.</p><p><strong>Methods: </strong>A survey comprising 25 questions was distributed among members of an international club of early-career spine surgeons (<10 years of experience). The survey assessed demographics, AI tool utilization, access to AI training resources, and perceptions of AI benefits and concerns in research.</p><p><strong>Results: </strong>Sixty early-career surgeons participated, with 86.7% reporting AI tool use in their research. ChatGPT was the most frequently utilized tool, with a usage rate of 93.1%. AI tools were primarily used for grammatical proofreading (69.6%) and rephrasing (64.3%), while 26.8% of participants used AI for statistical analysis. While 80.4% perceived improved efficiency as a key benefit, 70.0% expressed concerns about reliability. None of the participants had received formal AI training, and only 15.0% had access to AI mentors. Despite these challenges, 91.6% anticipated a positive long-term impact of AI on research.</p><p><strong>Conclusion: </strong>AI tools are widely adopted among early-career surgeons for various research tasks, extending from text generation to data analysis. However, the absence of formal training and concerns regarding the reliability of AI tools underscore the necessity of training for AI integration in medical research.</p><p><strong>Clinical relevance: </strong>This study provides timely insights into AI adoption patterns among early-career surgeons, highlighting the urgent need for formal AI training programs to ensure responsible research practices.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638346","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":"Accuracy of 2D Sagittal Radiological Analysis vs 3D Templating for Pedicle Screw Fixation of C2 Vertebral Body.","authors":"Adarsh Suresh, Takashi Hirase, Scott A Buhler, Rex A W Marco","doi":"10.14444/8775","DOIUrl":"https://doi.org/10.14444/8775","url":null,"abstract":"<p><strong>Background: </strong>There are currently no studies that directly compare the previously established 2-dimensional (2D) sagittal technique with 3-dimensional (3D) templating for C2 pedicle screw.</p><p><strong>Objective: </strong>To verify the accuracy of sagittal radiological analysis for safe placement of a C2 pedicle screw by performing a direct comparison between 2D planning with 3D templating methods.</p><p><strong>Methods: </strong>In this retrospective analysis, forty-six sets of computed tomography scans that contained 2-mm bony cuts and 2D reconstructions in the axial, sagittal, and coronal planes of skeletally mature patients were analyzed. StealthStation S7 (Medtronic Surgical Navigation, Minneapolis, Minnesota, United States) trajectory planning was used to plan the ideal placement, maximum diameter pedicle screw into the C2 pedicle. Based on the parameters of ≤3 mm screw diameter as high risk, >3 mm and <5 mm as moderate risk, and ≥5 mm as low risk, frequency and percentage values were calculated for the left, right, and bilateral pedicle screws.</p><p><strong>Results: </strong>Out of the 46 patients analyzed in this study, only 1 patient (2.2%) was classified as low risk (≥5 mm) bilaterally, 5 were classified as high risk (≤3 mm) bilaterally (10.8%), and 25 patients (54.3%) showed variability in pedicle width between the left and right sides. With analysis of both left and right pedicle, 7 out of 92 pedicles (7.6%) analyzed were classified as low risk (≥5 mm), 67 out of 92 (72.8%) were at moderate risk (>3 mm and <5 mm), and 18 out of 92 (19.6%) were at high risk (≤3 mm).</p><p><strong>Conclusion: </strong>Both the previously described 2D sagittal planning method and the current 3D templating method allow for accurate preoperative planning for the placement of ≤4 mm C2 pedicle screws, which is important given the limited availability and amount of resources utilized for the 3D templating model. However, the 3D templating method more precisely identifies C2 pedicles where 3.0 to 4.5 mm screws can feasibly be placed.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592541","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":"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":"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":"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}