International Journal of Spine Surgery最新文献

{"title":"Editor's Introduction: State of the Art in Minimally Invasive Spine Surgery-Detailed Techniques and Pearls of Wisdom From the Masters.","authors":"Neel Anand","doi":"10.14444/8710","DOIUrl":"10.14444/8710","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S6"},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459981","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":"Lateral Transpsoas Interbody Fusion.","authors":"T Barrett Sullivan, Angel Ordaz, Frank M Phillips","doi":"10.14444/8711","DOIUrl":"10.14444/8711","url":null,"abstract":"<p><p>The lateral transpsoas approach to lumbar interbody fusion has gained widespread adoption for a variety of indications. This approach to the interbody space allows for a favorable fusion environment, disc and neuroforaminal height restoration, and powerful alignment correction. Despite its minimally invasive nature, this procedure carries unique risks, the most severe of which include bowel injury, major vascular injury, and lumbosacral plexopathy. This poses a marked learning curve and requires rigorous attention to detail in technique. In this review, we provide a detailed description of our approach to preoperative imaging, patient positioning, and surgical technique, with an emphasis on patient safety and evidence-based decision-making. A brief description of intraoperative neuromonitoring techniques follows. The lateral transpsoas approach to interbody fusion has demonstrated reliable outcomes in regard to fusion rates, pain and function, and deformity correction, all across a widespread variety of lumbar spine pathologies. Here, we depict techniques, pearls, and pitfalls that are critical for any surgeon considering whether to add this technique to their practice.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S7-S18"},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956410","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":"Nuances of the Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Technical Review.","authors":"Daivik B Vyas, Brian J Park, Michael Y Wang","doi":"10.14444/8713","DOIUrl":"10.14444/8713","url":null,"abstract":"<p><strong>Background: </strong>Transforaminal lumbar interbody fusion (TLIF) achieves anterior and posterior spinal arthrodesis through a single approach. Minimally invasive surgery (MIS) methods reduce surgical morbidity while achieving positive outcomes.</p><p><strong>Methods: </strong>The major MIS-TLIF techniques, from tubular to endoscopic approaches, are reviewed with a discussion on the incorporation of new technologies and a comparative review of their outcomes.</p><p><strong>Results: </strong>MIS-TLIF approaches span a spectrum of visualization methods, with technical nuances related to patient and surgeon-specific factors determining optimal fit. To date, the superiority of 1 technique has yet to be definitively determined. Existing techniques may be integrated in a personalized manner to optimize surgical utility.</p><p><strong>Conclusions: </strong>Selection of an MIS-TLIF modality relies on a calculus between patient characteristics and surgeon faculty; proper selection can offer significant benefits to patients with spine disease.</p><p><strong>Clinical relevance: </strong>Emerging technologies for MIS-TLIF comprise a major source of development and clinical translation, while the safe and effective use of these techniques promises greater patient benefit in the right populations.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S28-S36"},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956412","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":"Prone Lateral Transpsoas Approach to the Spine: A Technical Guide for Mastery.","authors":"Juan P Giraldo, Winward Choy, Juan S Uribe","doi":"10.14444/8712","DOIUrl":"10.14444/8712","url":null,"abstract":"<p><strong>Background: </strong>The single-position prone transpsoas (PTP) lateral interbody fusion represents an alternative approach to the traditional lateral lumbar interbody fusion (LLIF) typically performed with the patient in the lateral decubitus position. Advantages of PTP surgery include improved segmental lordosis, single-position surgery, and ease of performing posterior techniques as needed. However, the learning curve of PTP is distinct from that of traditional LLIF surgery performed with the patient in the lateral decubitus position. Here, we highlight the senior author's approach to PTP surgery. The authors review key strategies of the preoperative workup, patient selection, operative techniques, and intraoperative pearls. This technical guide aims to shorten the learning curve for new adopters, optimize workflow for the surgeon, and maximize patient safety.</p><p><strong>Methods: </strong>A detailed analysis of the PTP approach was conducted, incorporating preoperative imaging and planning strategies and technical adjustments in patient positioning to accommodate access following the senior author's technical pearls. The workflow was structured to streamline transitions between levels, minimize time requirements, and reduce physical strain on the surgical team.</p><p><strong>Results: </strong>The application of PTP has demonstrated successful segmental lordosis correction and stable fusion across lumbar levels without requiring patient repositioning. The integrated workflow enabled sequential access and mastery of the PTP technique. These technical pearls have improved the efficiency of the PTP approach, according to the surgeon's expertise.</p><p><strong>Conclusion: </strong>The PTP technical strategies offer a viable and effective alternative to traditional LLIF. Surgeons can enhance the safety and efficiency of the PTP approach, maximize procedural benefits, and minimize potential risks using these technical strategies for preoperative planning, patient positioning, and intraoperative monitoring.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":"S19-S27"},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013511","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":"Passing the Editor in Chief Baton: A Time for Reflection and Future Vision.","authors":"Charles L Branch","doi":"10.14444/8703","DOIUrl":"https://doi.org/10.14444/8703","url":null,"abstract":"","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190474","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":"Comparison of Clinical Efficacy in the Treatment of Lumbar Degenerative Disease: Posterior Lumbar Interbody Fusion, Posterior Lumbar Fusion, and Hybrid Surgery.","authors":"Zhenbiao Zhu, Anwu Xuan, Cheng Xu, Chaofeng Wang, Qing He, Liang Tang, Dike Ruan","doi":"10.14444/8659","DOIUrl":"10.14444/8659","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Numerous studies have confirmed that both posterior lumbar interbody fusion (PLIF) and posterior lumbar fusion (PLF), have their advantages and disadvantages. However, the inconsistent results of these studies make it difficult to reach a consensus on which fusion method is superior.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the clinical outcomes of PLIF, PLF, and hybrid surgery combining PLIF and PLF in the treatment of lumbar degenerative disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective review was conducted, collecting clinical records and radiological data of patients with lumbar degenerative disease from 2014 to 2022. Patients were divided into 3 groups based on surgical strategy: PLIF group, PLF group, and hybrid group. Clinical data included patient-reported outcomes such as the Japanese Orthopedic Association score, Oswestry Disability Index score, visual analog scale score, 36-item Short Form Health Survey score, and the occurrence of complications. Radiological data included Cobb angle, fusion rate, adjacent segment degeneration (ASDeg), adjacent segment disease (ASDis), and cage subsidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 378 patients were divided into 3 groups: PLIF group (&lt;i&gt;n&lt;/i&gt; = 122), PLF group (&lt;i&gt;n&lt;/i&gt; = 126), and hybrid group (&lt;i&gt;n&lt;/i&gt; = 130). The baseline characteristics were balanced among the 3 groups. As the follow-up time increased, visual analog scale scores showed varying degrees of improvement (all &lt;i&gt;P&lt;/i&gt; &lt;sub&gt;measure time&lt;/sub&gt; &lt; 0.001), but there were no significant differences observed between the groups (all &lt;i&gt;P&lt;/i&gt; &lt;sub&gt;measure time * group&lt;/sub&gt; &gt; 0.05). Oswestry Disability Index scores improved over time (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;measure time&lt;/sub&gt; = 939, &lt;i&gt;P&lt;/i&gt; &lt;sub&gt;measure time&lt;/sub&gt; &lt; 0.001), with the hybrid group showing more significant improvement (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;measure time * group&lt;/sub&gt; = 2.826, &lt;i&gt;P&lt;/i&gt; &lt;sub&gt;measure time * group&lt;/sub&gt; = 0.006). The 36-item Short Form Health Survey scores and Cobb angles also improved significantly during the follow-up period, with no significant differences observed among the groups. The overall fusion rates for the hybrid group and PLIF group were 93% and 91%, significantly higher than the fusion rate of the PLF group (84%; &lt;i&gt;P&lt;/i&gt; = 0.031). The postoperative complication rate was significantly higher in the PLIF group (24.4%) compared with the PLF group (16.4%) and the hybrid group (12.5%; &lt;i&gt;P&lt;/i&gt; = 0.022). There was no significant difference in the overall 5-year ASDeg occurrence rate (38% vs 36%) and ASDis occurrence rate (11.3% vs 8.3%) between the PLIF group and PLF group for single-level fusion (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). The occurrence rate of ASDeg for multilevel fusion in the hybrid group was 29%, significantly lower than that in the PLIF group (42%) and PLF group (37%; &lt;i&gt;P&lt;/i&gt; = 0.044). The overall 5-year ASDis occurrence rates for multilevel fusion were 12.3%, 9.9%, and 7.6% for the PLIF group, PLF group, and hybrid g","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818831","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":"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}