Spine Journal最新文献

{"title":"Reply to letter to the Editor regarding “Impact of normalized total psoas area on postoperative mobility and perioperative adverse events in adult spinal deformity surgery”","authors":"Michael Mazzucco BS, Takashi Hirase MD, MPH, Chukwuebuka C. Achebe BS, Myles Allen MBChB, Robert N. Uzzo MBA, Gregory S. Kazarian MD, Hiroyuki Nakarai MD, Han Jo Kim MD, Francis Lovecchio MD","doi":"10.1016/j.spinee.2025.01.009","DOIUrl":"10.1016/j.spinee.2025.01.009","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 5","pages":"Pages 1075-1076"},"PeriodicalIF":4.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to letter to the Editor regarding “Real world clinical outcomes when discontinuing denosumab or bisphosphonates in patients with surgically managed osteoporotic vertebral compression fractures: a population-based cohort study”","authors":"Chuan-Ching Huang MD, PhD , Chih-Chien Hung MD , Ho-Min Chen MS , Jou-Wei Lin MD, PhD , Shau-Huai Fu MD, PhD , Chen-Yu Wang PhD","doi":"10.1016/j.spinee.2025.01.007","DOIUrl":"10.1016/j.spinee.2025.01.007","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 5","pages":"Pages 1078-1079"},"PeriodicalIF":4.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor regarding “Impact of normalized total psoas area on postoperative mobility and perioperative adverse events in adult spinal deformity surgery” by Hirase et al","authors":"Langtao Ma , Guiqian Zhang , Sheng Lu","doi":"10.1016/j.spinee.2024.12.037","DOIUrl":"10.1016/j.spinee.2024.12.037","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 5","pages":"Pages 1073-1074"},"PeriodicalIF":4.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor regarding “Types of high-riding vertebral artery: a classification system for preoperative planning of C2 instrumentation based on 908 potential screw insertion sites” by Klepinowski et al.","authors":"Yuwang Du MD, Hua Jiang MD, PhD","doi":"10.1016/j.spinee.2024.12.038","DOIUrl":"10.1016/j.spinee.2024.12.038","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 5","pages":"Pages 1069-1070"},"PeriodicalIF":4.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the letter to the Editor regarding “Types of high-riding vertebral artery: a classification system for preoperative planning of C2 instrumentation based on 908 potential screw insertion sites”","authors":"Tomasz Klepinowski MD, PhD, Leszek Sagan MD, PhD","doi":"10.1016/j.spinee.2025.01.006","DOIUrl":"10.1016/j.spinee.2025.01.006","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 5","pages":"Pages 1071-1072"},"PeriodicalIF":4.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor regarding “Real world clinical outcomes when discontinuing denosumab or bisphosphonates in patients with surgically managed osteoporotic vertebral compression fractures: a population-based cohort study” by Huang et al","authors":"Yu Chang MD , Da-Wei Huang MD , Jung-Shun Lee MD, MSc","doi":"10.1016/j.spinee.2025.01.008","DOIUrl":"10.1016/j.spinee.2025.01.008","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 5","pages":"Page 1077"},"PeriodicalIF":4.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the influence of cage and instrumentation strategies with oblique lumbar interbody fusion for grade I spondylolisthesis - A comprehensive biomechanical modeling study.","authors":"Mathieu Chayer, Philippe Phan, Pierre-Jean Arnoux, Zhi Wang, Jeremy J Rawlinson, Olumide Aruwajoye, Carl-Éric Aubin","doi":"10.1016/j.spinee.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.04.009","url":null,"abstract":"<p><strong>Background context: </strong>Proper implant selection and placement in oblique lumbar intervertebral fusion (OLIF) are essential to achieve the best possible results for the patient. Key factors such as interbody cage length, height, angle, and material must all be carefully considered to achieve the intended results and minimize complications. Significant challenges remain in selecting the appropriate cage parameters to control spinal alignment while minimizing subsidence risk. Ongoing debates include how long a cage should be to optimize load distribution, as well as how variations in cage angle and placement influence the outcomes.</p><p><strong>Purpose: </strong>This study aims to biomechanically model and investigate how variations in interbody cage dimensions, positioning, and material properties influence indirect decompression, realignment, and resulting stresses involved in cage subsidence.</p><p><strong>Study design: </strong>Computational biomechanical study of interbody cage and OLIF influence on correction outcomes.</p><p><strong>Methods: </strong>A pathological finite element model of the L4-L5 segment presenting a grade I spondylolisthesis was used to simulate 172 different OLIF configurations, evaluating cage position (anterior, central, posterior), angle (6° or 12°), material (PEEK or titanium), length (40-60 mm), and height (10-14 mm). Bilateral pedicle screw fixation was also tested. The simulated outcomes included disc height, foraminal and spinal canal dimensions, segmental lordosis, vertebral slip, endplate stresses, and displacements under various loading conditions. Statistical comparisons were tested to analyze the influence of model, implant, and surgical parameters on correction outcomes.</p><p><strong>Results: </strong>Longer (left-to-right dimension) cages (60 mm), which overhang on both sides of the vertebrae and sit on the apophyseal ring, significantly reduced vertebral endplate displacements and stresses by 33 % compared to shorter cages (40 mm) (p < 0.05). Posterior cage positioning improved the decompression but raised stresses by 45 % and reduced segmental lordosis by 28 %. Lowering cage height from 14 to 10 mm and increasing the angle from 6° to 12° reduced endplate stresses by 53 % and 33 %, respectively. BPS fixation decreased stresses by 36 % on average. The trends observed concurred with recently published OLIF clinical studies.</p><p><strong>Conclusions: </strong>This study highlights the biomechanical influence of implant characteristics and positioning on OLIF results and subsidence risks. Competing factors unveil an optimization problem that can be effectively addressed with the help of accurate, robust, and reproducible numerical simulations and regression models. This study further confirms that the developed tools not only accurately simulate the surgical approach and corroborate clinical findings but also offer a relevant framework for in-depth analysis.</p><p><strong>Clinical significan","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Future Academic Faculty Appointment After Spine Surgery Fellowship Training.","authors":"Jason Silvestre, Sydney Seeger, Robert A Ravinsky, James P Lawrence, James D Kang, Charles A Reitman","doi":"10.1016/j.spinee.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.04.005","url":null,"abstract":"<p><strong>Background context: </strong>Understanding optimal training environments for future academic leaders is a topic of increasing interest in spine surgery.</p><p><strong>Purpose: </strong>This study determined the association between surgeon factors and future academic faculty appointment after spine surgery fellowship training.</p><p><strong>Study design/setting: </strong>This was a retrospective observational study of spine surgery fellows in the United States (2016-2017 to 2022-2023).</p><p><strong>Patient sample: </strong>N/A OUTCOME MEASURES: The primary outcome of interest was future academic faculty appointment, which was assigned if the spine surgeon was employed at a teaching hospital. Demographic, bibliometric, and training characteristics of spine surgery fellows were obtained.</p><p><strong>Methods: </strong>Bivariate analyses were performed to determine the association between surgeon factors and future academic faculty appointment.</p><p><strong>Results: </strong>There were 654 spine surgery fellows and 243 were appointed to academic faculty positions (37.2%). There was no difference in the rate of future academic faculty appointment between male and female spine surgeons (36.7% vs 45.7%, P=0.368). Allopathic graduates were more likely to obtain academic faculty positions than osteopathic graduates (40.6% vs 12.5%, P<0.001). Compared to spine surgeons in private practice, spine surgeons in academic practice had more peer-reviewed publications during medical school (1 ± 3 vs 0 ± 2, P<0.001) and orthopaedic surgery residency training (5 ± 13 vs 3 ± 5, P<0.001). Several characteristics of spine surgery fellowship programs were associated with future academic faculty appointment including geographic region (P=0.013), Accreditation Council for Graduate Medical Education (ACGME) accreditation status (P<0.001), and a greater volume of annual fellows (P=0.003).</p><p><strong>Conclusions: </strong>Several factors were associated with future academic faculty appointment in spine surgery including higher scholarly output during medical school and orthopaedic residency. These data may ultimately help trainees and fellowship selection committees in spine surgery align on desired academic career objectives.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative teriparatide intervention is cost-effective for osteoporotic patients undergoing lumbar fusion: A break-even cost analysis.","authors":"Muhammad Waheed, Dhiraj Patel, Paul Anderson, Rakesh D Patel, Ilyas Aleem","doi":"10.1016/j.spinee.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.04.007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background context: &lt;/strong&gt;Lumbar spinal fusion is a common procedure increasingly being performed in older patients many of whom have poor bone quality. Poor bone quality is associated with increased risk of bone related complications and need for revision surgery. Preoperative bone health optimization has been proposed to address this poor bone health using anti-osteoporosis medications. However, there remains ongoing controversy regarding the use of bisphosphonates and teriparatide for osteoporotic patients and few studies have explored the cost-effectiveness of teriparatide in lumbar spinal fusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The aim of the study is to determine the cost-effectiveness, quantified in terms of absolute risk reduction (ARR) and number needed to treat (NNT), of teriparatide to prevent symptomatic pseudarthrosis following lumbar spinal fusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design/setting: &lt;/strong&gt;Economic analysis, Level of Evidence 3 PATIENT SAMPLE: The present break-even analysis considers simulated patients with and without osteoporosis undergoing primary posterior lumbar spinal fusion. The analysis is independent of the total number of annual surgeries and can be applied to any sized cohort of patients with osteoporosis undergoing primary posterior lumbar spinal fusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;We calculated the final break-even cost rate of pseudoarthrosis, the absolute risk reduction, and the number need to treat to prevent one symptomatic pseudoarthrosis event while breaking even on cost utilization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The MEDLINE database was queried for prior literature regarding the cost of teriparatide and revision lumbar fusion surgery for symptomatic pseudarthrosis in the United States as well as the rate of symptomatic bony nonunion in osteoporotic patients undergoing spinal fusion. Two break-even cost analyses were performed utilizing the surgical cost alone and the total overall cost to calculate the ARR in pseudarthrosis required to deem teriparatide as cost-effective. The ARR was then used to calculate the number of patients that would require teriparatide, NNT, to prevent one pseudarthrosis event while breaking-even on overall cost expenditure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;When observing surgical cost alone, daily-use teriparatide was determined to be positively cost effective at initial rates of pseudarthrosis &gt; 53.4% in osteoporotic patients. Utilization of the total overall cost in our break-even model showed daily-use teriparatide to be cost effective when the initial nonunion rate exceeded 30.6%. Teriparatide was not cost-effective at lower initial rates of pseudarthrosis for osteoporotic patients. In both scenarios of investigating total overall cost and surgical cost alone, the ARR decreases as the cost of symptomatic pseudarthrosis treatment rises. At higher costs of revision surgery and higher initial pseudarthrosis rates, teriparatide becomes cost-effective at a ","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerated Biological Aging in Patients with Degenerative Spine Diseases: The Impact of Modifiable Lifestyle Factors on Phenotypic Age.","authors":"Mitsuru Yagi, Ryo Mizukoshi, Ryosuke Maruiwa, Norihiro Isogai, Haruki Funao, Retsu Fujita","doi":"10.1016/j.spinee.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.04.001","url":null,"abstract":"<p><strong>Background: </strong>Aging is influenced by genetic, environmental, and lifestyle factors, and chronological age alone may fail to capture one's true biological aging. Degenerative spinal disease (DSD) is associated with accelerated health decline, which could manifest as an increased Phenotypic Age (PhenoAge).</p><p><strong>Purpose: </strong>This study aimed to investigate the association between Phenotypic Age (PhenoAge) and degenerative spine disease (DSD) in a Japanese population using a cross-sectional analysis complemented by a follow-up analysis, while also exploring the impact of modifiable lifestyle factors on biological aging.</p><p><strong>Design/setting: </strong>A cross-sectional design was employed using data from a large health examination program in Japan.</p><p><strong>Patient sample: </strong>A total of 10,205 individuals who underwent health examinations formed the reference cohort. Separately, two distinct clinical cohorts were analyzed: an OA cohort of 306 patients with hip or knee osteoarthritis who underwent arthroplasty, and a DSD cohort of 397 patients with adult spinal deformity (ASD) or lumbar spinal stenosis (LSS) who also underwent surgery.</p><p><strong>Outcome measures: </strong>PhenoAge was calculated using clinical biomarkers, and the difference between PhenoAge and chronological age was expressed as PhenoAgeAccel. Additional inflammatory and metabolic markers (e.g., CRP, WBC) were evaluated alongside lifestyle factors such as smoking status, body mass index, and physical activity.</p><p><strong>Method: </strong>Propensity score matching was used to compare PhenoAge between patients and controls. Linear regression examined the influence of lifestyle factors on PhenoAgeAccel. A subgroup analysis assessed differences between ASD and LSS, as well as between hip OA and knee OA. Individuals re-examined in 2023 were followed to evaluate the 3-year change in PhenoAgeAccel.</p><p><strong>Results: </strong>Japanese participants had a mean PhenoAgeAccel of -8.0 ± 4.0 years (p < 0.01, Cohen's d = 0.8). DSD patients showed a 4.2-year elevation in PhenoAge over controls, accompanied by higher CRP and WBC levels (both p < 0.01 Cohen's d = 0.65). Subgroup analyses revealed no significant differences in PhenoAge between ASD vs. LSS or hip OA vs. knee OA. Smoking (β = 0.6; p < 0.01) and obesity (β = 1.5; p < 0.01) raised PhenoAgeAccel, while physical activity lowered it (β = -0.2; p = 0.03). Non-risk individuals improved by -0.5 years, whereas risk individuals worsened by +0.5 years over three years.</p><p><strong>Conclusion: </strong>These findings suggest that PhenoAge may serve as a more sensitive marker of biological aging in DSD patients, although the retrospective design and potential confounding variables warrant cautious interpretation.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}