Spine Journal最新文献

{"title":"Tri-cortical Pedicle Screw Fixation in the Most Cranial Instrumented Segment to Prevent Proximal Junctional Kyphosis.","authors":"Liu Zhen, Tang Ziyang, Li Jie, Hu Zongshan, Qin Xiaodong, Shi Benlong, Mao Saihu, Qiu Yong, Zhu Zezhang","doi":"10.1016/j.spinee.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.02.002","url":null,"abstract":"<p><strong>Background context: </strong>Proximal junctional kyphosis (PJK) is a common complication of deformity correction for degenerative kyphoscoliosis (DKS) with an incidence between 20% and 40%. Multiple techniques have been proposed to prevent PJK, however, the clinical efficacy of these techniques remains unclear. Here, we investigate the influence of thoracic tri-cortical pedicle screw (TPS) in the most cranial instrumented segment on PJK.</p><p><strong>Purpose: </strong>To evaluate the clinical outcomes and mechanical complications in corrective surgery for DKS at a minimum 2-year follow-up using TPS compared to a control group.</p><p><strong>Study design: </strong>Retrospective study PATIENT SAMPLE: 115 patients with DKS from January 2020 to April 2022 OUTCOME MEASURE: Patient reported outcome measures included: SRS-22, ODI, VAS scores. Radiographic measures included: Cobb angle, coronal balance distance (CBD), regional kyphosis (RK), and sagittal vertical axis (SVA).</p><p><strong>Methods: </strong>Patients were divided into two groups: 67 patients in TPS group and 48 patients who with traditional pedicle screws in the most cranial instrumented segment in control group. The radiographic parameters were measured pre-, post-operative period, and at the last follow-up. Complications, including PJK, proximal junctional failure (PJF), and intercostal neuralgia were recorded. PJK was defined as: 10° or higher increase in kyphosis angle which between the inferior endplate of upper instrumented vertebra (UIV) and the superior endplate of the UIV + 2 (PJA). PJF was defined as: fracture of UIV or UIV + 1, need for proximal extension of fusion, or implant failure of UIV.</p><p><strong>Results: </strong>There was no significant difference in pre-operative radiographic parameters between two groups. After surgery, the Cobb angle of the major curve improved significantly in both groups (36.7°±20.4° to 15.3°±11.5° in TPS group, 37.1°±16.0° to 16.8°±9.0° in control group, P<0.001). Significant improvements in RK, CBD, and SVA were observed after surgery, and no loss of correction was found during follow-up (P > 0.05). Patients in both groups had significant improvement in health-relative quality of life (HRQoL) scores, including SRS-22, ODI score (46.5±16.2 to 21.3±13.2 in TPS group; 44.7±18.6 to 23.8±16.4 in control group; P < 0.05), and VAS (6.5±2.2 to 2.1±1.6 in TPS group; 6.0±2.9 to 2.3±2.2 in control group; P < 0.05). During the follow-up period, two patients in TPS group developed PJK (3.0%), compared to 13 patients in the control group (27.1%) (P<0.001). Notably, 5 patients in TPS group developed intercostal neuralgia which was not observed in control group, though all had full recovery following conservative treatment during three weeks.</p><p><strong>Conclusion: </strong>TPS fixation technique at the most cranial segment can produce satisfactory clinical outcomes in the surgical correction of DKS with a lower risk of PJK. However, it does in","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494509","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":"Failure forces of different interspinous vertebropexy techniques.","authors":"Jonas Widmer, Anna Schuler, Anna-Katharina Calek, Agnese Beretta-Piccoli, Oliver Wigger, Reto Graf, Luca Kiener, Ramon Rohner, Marie-Rosa Fasser, Mazda Farshad","doi":"10.1016/j.spinee.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.02.005","url":null,"abstract":"<p><strong>Background context: </strong>Challenges of vertebropexy such as spinous process fractures and tendon pull-out under high flexion loads need to be further investigated to ensure long-term stability of the construct.</p><p><strong>Purpose: </strong>Vertebropexy is a technique using a tendon as a posterior tension band to stabilize vertebral segments. Failure modes include pull-out or spinous process fractures under high flexion loads. This study simulates physiological risk loads in a biomechanical test to compare different interspinous vertebropexy techniques STUDY DESIGN: : Biomechanical cadaveric study.</p><p><strong>Methods: </strong>EIGHTEEN VERTEBRAL SEGMENTS WERE STABILIZED USING BOVINE FLEXOR TENDONS WITH THREE METHODS: \"Tunnel only\" (twice through spinous process holes), \"Tunnel + cortical wrapping\" (once through holes, once around spinous processes), and \"Cortical wrapping only\" (twice around spinous processes). Segments were subjected to cyclic, load-controlled flexion until failure. Force differences, bone failure modes, and the impact of bone quality on spinous process resistance were evaluated and compared.</p><p><strong>Results: </strong>The \"Cortical wrapping only\" technique achieved the highest mean torque (25.8 Nm), significantly outperforming the \"Tunnel only\" technique (13.4 Nm; p=0.024). The \"Tunnel + cortical wrapping\" technique (18.1 Nm) showed no significant difference from either \"Tunnel only\" or \"Cortical wrapping only\" (p=0.700; p=0.190). Bone failure modes, such as tendon cutting into bone and spinous process fractures, were consistent across technique. Bone density influenced failure resistance only in techniques involving cortical wrapping.</p><p><strong>Conclusions: </strong>The \"Cortical wrapping only\" method doubled the failure loads compared to the \"Tunnel only\" method while avoiding common failure modes like spinous process fractures. Additionally, bone density is a crucial factor to consider when using cortical bone as an abutment for the vertebropexy loop.</p><p><strong>Clinical significance: </strong>This study proposes alternative vertebropexy techniques to enhance spinal stabilization and minimize failure risks.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494506","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":"The Dural Deviation Ratio: A Novel Indicator for Preoperative Differentiation of Intradural Extension in Spinal Dumbbell Tumors Schwannomas Using Axial T2-weighted MRI.","authors":"Rei Kimura, Ko Hashimoto, Kohei Takahashi, Takahiro Onoki, Kenichiro Yahata, Toshimi Aizawa","doi":"10.1016/j.spinee.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.02.003","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the potential of using dural deviation in axial T2-weighted MRI to differentiate between Eden type-2 and type-3 spinal dumbbell schwannomas preoperatively.</p><p><strong>Methods: </strong>A retrospective analysis of 43 patients with spinal dumbbell Schwannomas was conducted. Tumors were classified into Eden type-2 or type-3 based on the need for dural incision during surgery. The dural deviation ratio (D-ratio) was measured using axial T2-weighted MRI. Statistical significance and diagnostic accuracy were assessed with Mann-Whitney U test and receiver operating characteristic (ROC) analysis. The authors declare no conflicts of interest and no funding sources for this study.</p><p><strong>Results: </strong>The D-ratio was significantly higher in type-2 tumors (median: 0.904) than in type-3 tumors (median: 0.585) (p < 0.001). ROC analysis showed an AUC of 0.950, with a cut-off value of 0.746, 92.4% sensitivity, and 91.2% specificity.</p><p><strong>Conclusions: </strong>The D-ratio is a reliable indicator for distinguishing between type-2 and type-3 Schwannomas, with a cut-off value of 0.746.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494508","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":"Incidental durotomy should not preclude same-day discharge from lumbar spine surgery.","authors":"Austin C Kaidi, Adin Ehrlich, Tarek Harhash, Tejas Subramanian, Kasra Araghi, Prerana Katiyar, Farah Musharbash, Eric Zhao, Sereen Halayqeh, Tomoyuki Asada, Andrea Pezzi, Atahan Durbas, Adrian Lui, Oliva Tuma, Rujvee Patel, James E Dowdell, Sheeraz A Qureshi, Sravisht Iyer","doi":"10.1016/j.spinee.2025.02.001","DOIUrl":"10.1016/j.spinee.2025.02.001","url":null,"abstract":"<p><strong>Background context: </strong>An incidental durotomy is a common surgical complication that can occur during any spine surgery. Although rarely associated with sequelae requiring intervention, keeping patients who sustained durotomy for overnight observation is a common clinical practice.</p><p><strong>Purpose: </strong>To determine whether patients who sustained incidental durotomy during lumbar spine surgery can be safely discharged on the day of surgery.</p><p><strong>Design: </strong>Retrospective Cohort Study PATIENT SAMPLE: Patients who sustained incidental durotomy during elective lumbar microdiscectomy or decompression OUTCOME MEASURES: Outcome measures included complication rates, reoperation rates, readmission rates, patient reported outcome measures (PROMs) and return to activity metrics.</p><p><strong>Methods: </strong>Over a 7-year study period, 66 patients who sustained an incidental durotomy during elective primary microdiscectomy or decompression were identified. Patients were stratified by their discharge date on either postoperative day (POD) 0 (ambulatory) or POD1-14 (inpatient). A 2-tailed students t-test was utilized to determine if there was a difference in complication rates, PROMs, or return to activity metrics.</p><p><strong>Results: </strong>Among 66 patients who were identified, 18 were discharged on POD0 and 48 were discharged on POD1-14. Among these patients, only 27 (41%) had the durotomy repaired via primary suture repair. The vast majority utilized a combination of a dural patch and dural sealant. Overall, no significant differences were seen in complication rates, reoperation rates, readmission rates, PROMs, or return to activity metrics between the inpatient and ambulatory groups. For patients that required additional interventions for management of the durotomy, none presented within 48 hours of surgery.</p><p><strong>Conclusion: </strong>Patients who sustain incidental durotomy during lumbar decompression/microdiscectomy can be safely discharge on the day of surgery if a watertight seal can be obtained via any repair method.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442560","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":"Response to the letter to the editor regarding “Is orthotic treatment beneficial for fresh osteoporotic vertebral fractures? A propensity score matching study”","authors":"Masayoshi Iwamae MD,&nbsp;Shinji Takahashi MD, PhD,&nbsp;Hidetomi Terai MD, PhD","doi":"10.1016/j.spinee.2024.11.022","DOIUrl":"10.1016/j.spinee.2024.11.022","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 3","pages":"Pages 627-628"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395585","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 “Is orthotic treatment beneficial for fresh osteoporotic vertebral fractures?Apropensity score matching study” by Iwamae et al","authors":"Jixin Chen MD,&nbsp;Qinxin Zhou MM","doi":"10.1016/j.spinee.2024.10.029","DOIUrl":"10.1016/j.spinee.2024.10.029","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 3","pages":"Page 626"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395584","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":"Response to letter to editor regarding “Foot pressure transfers are altered in lumbar radiculopathy but reversible after surgery: a prospective, pedobarography study”","authors":"Rishi M. Kanna MS, MRCS, FNB","doi":"10.1016/j.spinee.2024.10.023","DOIUrl":"10.1016/j.spinee.2024.10.023","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 3","pages":"Pages 624-625"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395583","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 editor regarding “Foot pressure transfers are altered in lumbar radiculopathy but reversible after surgery: a prospective, pedobarography study” by Kanna et al","authors":"Ch Raja Bhaskar Venkata SriMadhusudan MBBS,&nbsp;Aman Verma MBBS, MS,&nbsp;Pankaj Kandwal MBBS, MS","doi":"10.1016/j.spinee.2024.09.034","DOIUrl":"10.1016/j.spinee.2024.09.034","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 3","pages":"Pages 622-623"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395588","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 editor regarding “Immediate versus delayed venous thromboembolism prophylaxis following spine surgery: increased rate of unplanned reoperation for postoperative hematoma with immediate prophylaxis” by Lambrechts et al","authors":"Parshwanath Bondarde MBBS ,&nbsp;Akash Jain MS ,&nbsp;Pankaj Kandwal MS ,&nbsp;Kaustubh Ahuja MS","doi":"10.1016/j.spinee.2024.10.025","DOIUrl":"10.1016/j.spinee.2024.10.025","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 3","pages":"Pages 620-621"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395587","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":"Are paraspinal muscle morphology and composition associated with lumbar spinal stenosis? A systematic review.","authors":"Aliyu Lawan, Zakari Crites Videman, Anna Belay, Shaima Behery, Suzan Ibrahim, Tiana Ulrich, Kishanthiny Varatharaja, Michele C Battié","doi":"10.1016/j.spinee.2025.01.027","DOIUrl":"10.1016/j.spinee.2025.01.027","url":null,"abstract":"<p><strong>Background: </strong>There has been increasing interest in associations between paraspinal muscle phenotypes and common spinal disorders, including lumbar spinal stenosis (LSS). However, the relation of paraspinal muscle morphology and composition with LSS is unclear.</p><p><strong>Objectives: </strong>To provide a systematic overview and synthesis of current evidence on the association of paraspinal muscle morphology and composition with LSS presence, pain and disability or function.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Methods: </strong>Relevant studies were identified from a search of EMBASE, PubMed, SPORTDiscuss, Cinahl, Web of Science and PEDro. Relevant studies were selected, data were extracted, and risk of bias was assessed by 2 independent reviewers prior to conducting a narrative synthesis to summarize evidence using GRADE considerations. The study protocol was prospectively registered (Prospero: CRD42021246492).</p><p><strong>Results: </strong>Of 33 studies included in the review, multifidus (n=22) was most frequently studied, followed by psoas (n=10). Fatty infiltration (20 studies), CSA (n=11) and relative CSA (n=10) were the most studied paraspinal phenotypes. Most studies (n=31) had low risk of bias, with selection and confounding bias (n=13) most common. High variability in approaches used to measure muscle morphology and composition and LSS disability and pain, and variable control of confounding factors, created challenges in synthesizing findings. The only association identified for which there was moderate certainty of evidence was between increased multifidus fatty infiltration and the presence of LSS (4 of 6 studies). All other associations studied with high or moderate strength of evidence demonstrated no association, including no association between multifidus fatty infiltration and pain severity (8 studies), multifidus CSA and LSS disability (7 studies), psoas morphology and LSS anatomical severity (4 studies), or psoas composition and LSS pain severity (4 studies) for which there was high certainty. There was moderate certainty of no association between multifidus morphology and LSS pain severity (5 of 7 studies), and erector spinae morphology and pain severity (3 studies), and erector spinae composition and LSS pain severity (3 studies) and function (3 studies). Other associations remain more unclear.</p><p><strong>Conclusion: </strong>Largely consistent results suggest multifidus fatty infiltration is associated with the presence of LSS. However, other specific associations examined with high or moderate certainty of evidence demonstrated no association, and others remain largely undetermined. Although interest has grown in paraspinal muscle morphology and composition for improved phenotyping, prognosis and treatment of common spinal disorders, the clinical utility of paraspinal muscle imaging in LSS remains unclear.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374943","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}