Spine Journal最新文献

{"title":"Return to Work After Lumbar Endoscopic Spinal Surgery in the United States.","authors":"Peter B Derman, Micheal Raad, Alexander M Satin, Albert Telfeian, John Ogunlade, Conor Dunn, Osama Kashlan, Sanjay Konakondla, Anubhav G Amin, Meng Huang, Imad Khan, Mark Mahan, Christoph P Hofstetter, Mary P Rogers-LaVanne","doi":"10.1016/j.spinee.2025.05.033","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.05.033","url":null,"abstract":"<p><strong>Background context: </strong>Return to work (RTW) after spinal surgery is a crucial postoperative outcome influencing patients' lives. Endoscopic spinal surgery (ESS) is an ultra-minimally invasive technique for the treatment of spinal pathology, and some ESS procedures have been shown to improve RTW dynamics following spinal surgery.</p><p><strong>Purpose: </strong>The aim of this study is to investigate RTW within ninety days following various lumbar ESS procedures in the United States (US) and compare differences in RTW between patient occupational activity levels and ESS procedural types.</p><p><strong>Study design/setting: </strong>Prospectively collected data provided by patients via the SPINEHealthie mobile health application PATIENT SAMPLE: Patients with a status of employed who received lumbar ESS (n=192) OUTCOME MEASURES: Back pain, leg pain, ODI, and return to work after spine surgery METHODS: The SPINEHealthie project dataset was used for this study. The SPINEHealthie project is a multi-center, multi-surgeon prospectively collected dataset for endoscopic spine surgery in which patients utilize a mobile health application to report critical outcome measures. One hundred ninety-two patients met the inclusion criteria for this study. The primary outcome was patient reported time to RTW. Kaplan Meier survival analysis and Cox proportional hazard models were performed to analyze RTW after lumbar ESS.</p><p><strong>Results: </strong>Average age was 52.0 years, and 59.4% of the sample were male. The cumulative incidence in RTW was 83.6% with a median of patients returning to work at or before 16.0 days after any type of lumbar ESS. Patients with labor-intensive occupations returned to work significantly later than patients with sedentary occupations (p=0.014). Surgical procedure was also associated with RTW (p=0.043); a median of patients returned to work at or before 13.0 days after interlaminar discectomy or unilateral decompression, 20.0 days after far lateral approaches for discectomy or decompression, and 40.0 days after interlaminar unilateral laminotomy for bilateral decompression.</p><p><strong>Conclusions: </strong>Patients who received lumbar ESS return to work relatively rapidly compared to the literature on traditional open lumbar procedures. The type of ESS (as dictated by the underlying pathology), as well as patient occupational physical activity requirements impact postoperative RTW.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152238","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":"Deciphering the Role of Glial Cell-Specific Metabolites as Biomarkers in Early Cervical Myelopathy- Insights from in vivo MRS study.","authors":"Karthik Ramachandran, Puspha Bhari Thippeswamy, Ajoy Prasad Shetty, Rishi Mugesh Kanna, Shanmuganathan Rajasekaran","doi":"10.1016/j.spinee.2025.05.031","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.05.031","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Early degenerative cervical myelopathy (DCM) presents a diagnostic dilemma due to its variability in presentation, overlap with other clinical conditions, and lack of specific clinical tests. Although magnetic resonance imaging (MRI) is the preferred imaging modality, its ability to detect early cervical myelopathy remains uncertain due to its inability to detect microstructural changes at an early spondylotic stage. Magnetic Resonance Spectroscopy (MRS) is a novel, non-invasive spinal imaging technique that provides metabolic and biochemical information regarding spinal cord function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aims to determine the diagnostic role of MRS and Diffusion Tensor Imaging (DTI) in patients with DCM. Additionally, we intend to explore the role of MRS metabolites/ratio as molecular biomarkers for the early detection of DCM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Prospective observational study PATIENT SAMPLE: The study includes a sample size of 89 subjects (20 asymptomatic volunteers and 69 patients with different grades of DCM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;Predictability of MRS and DTI in identifying early DCM. The severity of myelopathy was assessed using the modified Japanese Orthopaedic Association (mJOA) score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study populations were classified according to their mJOA scores: Group 1 included asymptomatic volunteers with no clinical features of cervical myelopathy. Group 2 included patients with a score of 15 to 17 (mJOA \"mild\") presenting with early symptoms of myelopathy, like arm pain, hand numbness and clumsiness with/ without the symptoms of radiculopathy. Group 3 included patients with mJOA \"moderate\" myelopathy score of 12 to 14, presenting with symptoms like gait instability and a decrease in hand dexterity. Group 4 included patients with mJOA \"severe\" score of less than or equal to 11, presenting with advanced symptoms like walker/wheelchair-dependence, loss of hand dexterity, and bladder disturbances. We then looked at MR Imaging in these symptomatic patients to evaluate stenosis. Single voxel MRS was placed at the C2 level, and DTI parameters were measured at the site of maximum compression. MRI parameters like the compression level, presence of signal hyperintensity, grading of stenosis, and compression ratio were also analysed in T2W MRI images.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 89-study population, 20 asymptomatic volunteers in group 1 and 23 patients each in groups 2, 3 and 4 were included. Among the various parameters, there was a statistically significant difference between the groups for various MRS metabolite ratios, namely NAA/Cr (P= 0.008), Cho/Cr (P=0.025), Cho/NAA (P&lt;0.001), Cr/NAA (P &lt;0.001) and MIn/NAA (P=0.003) as well as DTI parameters namely FA (P= 0.010) and ADC (P=0.011). A significant linear correlation was observed between the severity of myelopathy (mJOA score) and the following parameters: Cho/NAA","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151796","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 “Robotic pedicle screw placement with 3D MRI registration: moving towards radiation free robotic spine surgery” by Altorfer et al","authors":"Yayu Zhao MM ,&nbsp;Wen Lei MM ,&nbsp;Weichao Li MD, PhD","doi":"10.1016/j.spinee.2025.01.041","DOIUrl":"10.1016/j.spinee.2025.01.041","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 6","pages":"Pages 1304-1305"},"PeriodicalIF":4.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098657","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 the Editor “Robotic pedicle screw placement with 3D MRI registration: moving towards radiation free robotic spine surgery”","authors":"Franziska C.S. Altorfer MD ,&nbsp;Darren R. Lebl MD, MBA","doi":"10.1016/j.spinee.2025.02.004","DOIUrl":"10.1016/j.spinee.2025.02.004","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 6","pages":"Pages 1306-1307"},"PeriodicalIF":4.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098658","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":"Corrigendum to \"An in vivo 3-dimensional kinematics study of the cervical vertebrae under physiological loads in patients with cervical spondylosis\" [Spine J (2025) 734-748].","authors":"Yanlong Zhong, Fangming Zhan, Zizhen Zhang, Guoan Li, Shaobai Wang, Zongmiao Wan","doi":"10.1016/j.spinee.2025.04.025","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.04.025","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095510","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":"A Prospective Multicenter Randomized Controlled Trial on Safety and Procedural Competency in SI Joint Fusion Performed by Interventional Pain Physicians Trained by a Spine Surgeon.","authors":"Kingsley R Chin, Erik Spayde, William M Costigan, Soubrata V Raikar, Yeshvant A Navalgund, Paul Pannozzo, Jessen J Mukalel, Steven Siwek, Sachin Narain, Luis Fandos, Paul Ky, Shaun Jackson, Ajay Yeddu, Michael Rock, Randolph Chang, Tian Xia, Abdul Shahid, Vasilios Kountis, Mark H Coleman, Azhar Pasha, Boleslav Kosharskyy, Christine Haddad, Faris Abusharif, Matthew McCarty, Michael D Danko, Justice Otchere, Michael Hunter, Matthias Wiederholz, Abram Burgher, Vito Lore, Angel Walker, Hope Estevez, Chukwunonso C Ilogu, Jason A Seale","doi":"10.1016/j.spinee.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.05.014","url":null,"abstract":"<p><strong>Background context: </strong>Sacroiliac joint (SIJ) fusion was traditionally performed exclusively by spine surgeons using a minimally invasive direct lateral approach. With advancements in technology, SIJ fusion has evolved into percutaneous techniques which have been adopted by interventional pain management (IPM) physicians due to their expertise in interventional techniques. However, this expansion has raised safety concerns among spine surgeons regarding \"practice creep\" and procedural competency gaps. Furthermore, the lack of uniform outpatient credentialing has created an environment where safety oversight may be inconsistent.</p><p><strong>Purpose: </strong>To evaluate and compare the safety and procedural competency of percutaneous posterior-oblique SIJ fusions performed by trained IPM physicians using titanium screws plus a synthetic bioactive glass flowable biologics under direct spine surgeon supervision versus non-spine surgeon supervision.</p><p><strong>Study design/setting: </strong>A prospective multicenter randomized controlled trial conducted across multiple ambulatory surgery centers between 2020 and 2022.</p><p><strong>Patient sample: </strong>276 adult patients (mean age 56.7 years; 72.1% female) scheduled for SIJ fusion.</p><p><strong>Outcome measures: </strong>The primary outcome measures were surgical complications, deviations, and revisions. These were assessed through medical records and radiographs for at least 6 months post operative.</p><p><strong>Methods: </strong>276 patients were in this study and were randomly assigned to Group 1 or Group 2. 66 patients (Group 1; spine surgeon supervised). 67 patients, clinical specialist supervised, plus 143 assigned to sales representatives/independent distributors supervised (Group 2; non-spine surgeon supervised). All primary procedures were performed by 47 IPM physicians who received structured training on the percutaneous posterior-oblique technique by a board-certified orthopedic spine surgeon. Surgical complications, deviations, and revisions were recorded, with follow-up data collected for at least twelve months.</p><p><strong>Results: </strong>A total of 9 complications (3.3%), 4 deviations (1.4%), and 5 revision cases (1.8%) were observed. Group 1 experienced no complications, deviations, or revisions. In Group 2, 9 complications (4.3%) and 4 deviations (1.9%) occurred between the second and fifth operative days. 5 cases were revised (2.4%).</p><p><strong>Conclusions: </strong>Spine surgeon training equipped IPM physicians to safely performed percutaneous posterior-oblique SIJ fusions with titanium screws plus biologics, achieving low complication and revision rates. These findings highlight the importance of incorporating standardized surgeon-led training and certification programs to bridge the competency gap and ensure safe adoption of interventional spine surgery practices by IPM physicians.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095508","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 Effect of L5-S1 Fusion on Global Spine Motion: A Range of Motion Analysis Comparing 2-level TDR Versus Hybrid at L4-S1 in 235 Patients.","authors":"Thierry Marnay, Guillaume Geneste, Gregory Edgard-Rosa, Martin Grau-Ortiz, Caroline Hirsch, Georges Negre","doi":"10.1016/j.spinee.2025.05.029","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.05.029","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background context: &lt;/strong&gt;Lumbar total disc replacement (TDR) is a treatment option with 30 years of experience and extensive publications on clinical results. However, there is sparse literature on mid- and long-term mobility or the difference between L4-S1 two-level TDR and TDR/ALIF hybrid constructs with anterior lumbar interbody fusion (ALIF) at L5-S1 and TDR at L4-L5.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The purpose of this study was to measure and compare key mobility parameters in flexion-extension for both groups. These included motion at L4-L5, participation of pelvis mobility, global lumbar motion, and the effectiveness of overall lumbar flexion-extension. In addition, we looked for potential compensation above and below L5-S1 fusion in the hybrid group versus two-level TDR group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design/setting: &lt;/strong&gt;Retrospective clinical study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient sample: &lt;/strong&gt;We analyzed 235 patients who had surgery between 2003-2013; 170 patients received 2-level TDR (TDR group) and 65 received L4-L5 TDR and L5-S1 ALIF (Hybrid group). The average follow-up was 124 months for TDR group and 97 months for the hybrid group. Baseline demographics and patient-reported preoperative clinical parameters were equivalent in both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;Clinical measures included the following: Oswestry Disability Index (ODI), Visual Analog Scale (VAS) back and leg pain, Satisfaction Index Scores and time of patient return to work after surgery. Complication, reoperation, and revision rates, and perioperative data points were also assessed. Radiographic evaluation included measurement of the following: pelvic parameters (Incidence, Pelvic Tilt, Sacral Slope), L4-L5 and L5-S1 flexion-extension range of motion (ROM), pelvic motion as measured by sacral slope in flexion-extension, and flexion-extension L1 ROM (newly described in the body of manuscript as \"L1 Race\") to show the effect the lumbopelvic complex has on global motion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The radiographic evaluation was performed on pre- and postoperative lateral and dynamic flexion-extension X-rays at the latest follow-up (minimum of 24 months follow-up).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;When L5-S1 is fused, there is no compensation from pelvic motion to overcome the loss of mobility. TDR group shows a pelvi-femoral ROM (defined as sacral slope in extension minus sacral slope in flexion) gain of 16.77°, vs a gain of only 6.11° in the Hybrid group. L5-S1 fusion also reduces L4-L5 TDR mobility in the Hybrid group compared to the 2-level TDR group and decreases flexion compared to baseline. There is a mean reduction in lumbar (L1-S1) ROM of 1.53° in Hybrid group versus 20.02° gain in TDR group. L1 Race also reflects the superiority of 2-level TDR vs hybrid with a gain of 32.58° in TDR vs 4.68° in Hybrid, demonstrating that reduced global motion is principally due to the loss of L5-S1 influence on motion above and below. ODI, VAS ba","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086907","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":"TBRG4 regulates ubiquitination of Beclin1 and participates in autophagy pathway to inhibit intervertebral disc degeneration.","authors":"Xilong Cui, Feng Zhang, Di Cui, Wei Zhang, Hao Wu, Xi Chen, Haiyang Yu","doi":"10.1016/j.spinee.2025.05.018","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.05.018","url":null,"abstract":"<p><strong>Background: </strong>IDD is commonly observed in symptomatic spinal disorders and is associated with mitochondrial dysfunction and NPC apoptosis. Current therapeutic targets remain theoretical, highlighting the need to explore alternative molecular targets.</p><p><strong>Purpose: </strong>To investigate the role of TBRG4 in regulating mitochondrial function, autophagy, and apoptosis in IDD, and to evaluate its therapeutic potential.</p><p><strong>Study design/settings: </strong>This study combines molecular and cellular biology techniques with an in vivo rat model of IDD.</p><p><strong>Methods: </strong>Human NPCs were isolated and characterized from IDD patients and controls. TBRG4 expression was modulated using plasmid transfection. Autophagy, apoptosis, and mitochondrial function were assessed using immunofluorescence, Western blot, and flow cytometry. Co-immunoprecipitation and mass spectrometry identified TBRG4-interacting proteins. A rat IDD model evaluated TBRG4's therapeutic effects in vivo.</p><p><strong>Results: </strong>TBRG4 expression was significantly downregulated in degenerated NPCs. TBRG4 knockdown exacerbated mitochondrial dysfunction, increased apoptosis via the BCL2/C-caspase3 pathway, and inhibited autophagy. Mechanistically, TBRG4 interacted with Beclin1 and reduced its ubiquitination, thereby promoting autophagy. Overexpression of TBRG4 in NPCs restored mitochondrial function and suppressed apoptosis. In a rat IDD model, TBRG4 overexpression alleviated disc degeneration, as evidenced by MRI, histological analysis, and decreased Pfirmmann grading.</p><p><strong>Conclusions: </strong>TBRG4 plays a crucial protective role in IDD by promoting autophagy and maintaining mitochondrial homeostasis. It interacts with Beclin1 to enhance autophagy by reducing ubiquitination. TBRG4 shows potential as a novel therapeutic target for IDD.</p><p><strong>Clinical significance: </strong>TBRG4-based therapies may represent a promising strategy to mitigate IDD progression, improve NPC survival, and restore disc function. Future research should focus on the development of TBRG4 activators and large-scale clinical validation.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086903","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":"Spinal Cord Status Assessment and Early Interventional Personalized Rehabilitation after Endoscopic Surgery for Cervical Compressive Myelopathy: A Randomized Trial.","authors":"Yiwei Ding, Fengtong Lou, Rui Cao, Zhengcao Lu, Guangnan Yang, Qiang Jiang, Mei Shuai, Yuxian Zhong","doi":"10.1016/j.spinee.2025.05.024","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.05.024","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background context: &lt;/strong&gt;Cervical compressive myelopathy (CCM), frequently arising from spinal degeneration, results in significant motor and sensory deficits. Currently, there is a lack of precise prognostic evaluation methods following decompression surgery for CCM, which hinders the optimization of personalized rehabilitation therapy. However, the combination of intraoperative endoscopic visualization of dural sac compression morphology and electrophysiological functional assessment holds promise in addressing this gap.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To determine whether a personalized rehabilitation strategy, informed by intraoperative endoscopic and electrophysiological assessments, enhances postoperative functional outcomes in CCM patients compared to traditional rehabilitation after canal decompression surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design/setting: &lt;/strong&gt;PROSPECTIVE SINGLE-CENTER RANDOMIZED CONTROLLED STUDY, TRIAL REGISTRATION: ChiCTR2400081458.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient sample: &lt;/strong&gt;78 patients underwent spinal decompression surgery at The Sixth Medical Center of Chinese PLA General Hospital. The inclusion criteria included a diagnosis of CCM due to spondylosis or ossification of the longitudinal ligament. Participants were excluded if they had prior spinal surgeries or comorbidities unrelated to CCM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;The primary outcome was the Japanese Orthopaedic Association (JOA) score, assessing spinal function. Secondary outcomes included the Neck Disability Index (NDI), Visual Analogue Scale (VAS) for pain, and three-dimensional gait analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study was a double-blind randomized controlled trial comparing two postoperative rehabilitation strategies for patients with CCM following endoscopic spinal decompression surgery. After surgery, patients were randomly assigned to two groups. The experimental group received personalized rehabilitation based on real-time intraoperative spinal cord status assessments, using a combination of endoscopic visualization and electrophysiological grading. Interventions included lower limb exoskeleton-assisted walking and targeted motor function training. The control group received conventional standard rehabilitation treatment. Both groups were assessed using the JOA, NDI, and VAS scores before rehabilitation, 1 month, 3 months, and 12 months after the start of rehabilitation. Additionally, gait analysis (including stride frequency, gait velocity, and stride length) was performed before and 3 months after the start of rehabilitation to evaluate the clinical rehabilitation outcomes in both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both groups showed significant improvements in JOA, NDI, VAS scores, and gait tests during the postoperative rehabilitation process. The experimental group demonstrated a more substantial increase in the primary outcome measure, the JOA score (12MO: 4.79±0.74 vs 3.53±0.93, P &lt; 0.05). Additionally, the ","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081434","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":"Risk of ossification of posterior longitudinal ligament (OPLL) volume progression following laminoplasty.","authors":"Qu Ruomu, Qin Siyuan, Wang Ben, Zhao Yanbin, Pan Shengfa, Chen Xin, Liu Zhongjun, Jiang Liang, Lang Ning, Zhou Feifei","doi":"10.1016/j.spinee.2025.05.028","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.05.028","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background context: &lt;/strong&gt;Progression of ossification of posterior longitudinal ligament (OPLL) after laminoplasty (LP) can lead to recurrent compression of the spinal cord, neurological progression, and possibly revision surgery. Continuity of OPLL across segments, termed true continuous segments (TCS), has been previously found to help maintaining lordosis after LP. However, the impact of TCS on post-LP OPLL volume progression remains unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aimed to investigate the influence of TCS in post-LP OPLL volume progression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Retrospective cohort study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient sample: &lt;/strong&gt;Patients who underwent LP during 2006-2017 and had preoperative computed tomography (CT) and a minimum five year CT follow-ups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;Progression of OPLL volume as measured on CT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Preoperative CT images were assessed, dividing patients into TCS and non-TCS groups. The demographics, preoperative segments of OPLL were recorded. As per the previously described classification, TCS was recorded as I (continuous type OPLL on disc space spanning the upper and lower adjacent vertebral bodies for more than half of their height without any bony crack regardless of bridge formation between vertebral bodies), II (OPLL adherent to both upper and lower adjacent vertebral bodies by bridging) or III (obvious interbody auto-fusion), and the TCS II and III were defined as true bridging segments (TBS). The number of disc levels which have a TCS was documented as the TCS counts. OPLL volume was calculated by manually segmenting images using 3D slicers (Figure 2). OPLL annual volume progression rate (AVPR) was calculated by the volume change of OPLL divided by follow-up period. An AVPR greater than 5% was defined as OPLL progression. The AVPR of both groups were compared. Multivariable logistic analysis was conducted to account for confounders.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 56 patients (33 males and 23 females) were included in this study, with a mean age of 53.2±8.7. The average CT follow-up durations were 95.1±33.8 months. The preoperative OPLL segments of non-TCS and TCS groups were 2.9±1.0 and 4.4±1.3 (p&lt;0.001) and the preoperative volume of non-TCS and TCS groups were 986.3±603.7 and 3512.1±1909.8mm&lt;sup&gt;3&lt;/sup&gt; (p&lt;0.001), respectively. At final follow-up, the AVPR of non-TCS and TCS groups were 12.7%±18.2% and 5.9%±4.7% (p=0.393), respectively. Nineteen (54.3%) patients in the non-TCS group and 10 (47.6%) patients in the TCS group showed OPLL progression (p=0.632). Correlation analysis revealed that the TCS Type I counts did not present significant correlation with AVPR, while preoperative CL (p=0.021), TBS counts (p=0.029) and age (p=0.001) significantly negatively correlated with AVPR. Multivariable logistics analysis results revealed that more TBS counts (OR=0.095, p=0.026) and higher age (OR=0.894, p=0.0","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037187","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}