Spine Journal最新文献

{"title":"Prognostic Outcomes of Spinal Metastasis: Timing of Metastasis Presentation Matters.","authors":"Shan-Lun Tsao, Chang-Wei Tsou, Yu-Ting Pan, Hung-Kuan Yen, Hao-Chen Lin, Jen-Hao Liu, Fon-Yih Tsuang, Ue-Cheung Ho, Wei-Hsin Lin, Ming-Hsiao Hu, Paul Ogink, Olivier Q Groot","doi":"10.1016/j.spinee.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.09.002","url":null,"abstract":"<p><strong>Background context: </strong>Spinal metastasis (SM), though typically associated with late-stage disease, can manifest at any point in the disease process as a synchronous spinal metastasis (SSM) or metachronous spinal metastasis (MSM). The timing of SM presentation can influence the complexity of treatment approaches. Therefore, investigating the clinical and prognostic distinctions between SSM and MSM is vital for enhancing patient management strategies.</p><p><strong>Purpose: </strong>This study investigates the incidence, prognosis, and primary malignancies differences between SSM and MSM, aiming to improve clinical practice through inclusion of both surgical and/or radiotherapy cases.</p><p><strong>Study design/setting: </strong>A retrospective study at a single tertiary care center in Taiwan PATIENT SAMPLE: 4269 patients aged 18 or older who received surgery and/or radiotherapy for image-confirmed spinal metastasis at a tertiary medical center in Taipei from 2010 to 2022 OUTCOME MEASURES: The primary outcome was the incidence of SSM among patients with SM requiring local treatment. Secondary outcomes included survival differences and primary malignancy distributions between SSM and MSM.</p><p><strong>Methods: </strong>SSM was defined as SM diagnosed within 31 days of initial cancer diagnosis; MSM was diagnosed later. Missing data was handled with multiple imputation using chained equations. Prognostic differences were analyzed using univariate and multivariate Cox proportional hazards models, and survival outcomes were compared with Kaplan-Meier and log-rank tests. Differences in primary malignancy types and growth rates were evaluated using Chi-square test or Fisher's exact test.</p><p><strong>Results: </strong>SSM was identified in 19.6% (838/4269) and MSM in 80.4% (3431/4269). SSM patients had a longer median survival than MSM (17.4 months, interquartile ranges [IQR] 5.6-49.0 vs. 7.5 months, IQR 3.0-20.9; p<0.001). Lung cancer was the most common primary malignancy, comprising nearly half of SSM cases. Patients with SSM had a more favorable prognosis than MSM (HR=0.74; p<0.001).</p><p><strong>Conclusion: </strong>One-fifth of the patients were diagnosed with SM before the primary tumor was identified. These SSM patients exhibit distinct clinical and prognostic profiles compared to MSM patients, often showing a survival advantage likely due to their treatment-naïve status and lower tumor burden at time of presentation. These differences suggest that patients with SSM may benefit from tailored treatment approaches, such as more durable surgical stabilization or consideration of higher radiation doses, given their comparatively favorable survival outlook. Future studies should recognize SSM as a unique clinical entity to refine prognostic models and optimize therapeutic approaches.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114773","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 regarding “Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials.”","authors":"W. Evan Rivers DO ,&nbsp;Aaron Conger DO ,&nbsp;Ameet Nagpal MD, MS, MEd, MBA ,&nbsp;Byron J. Schneider MD ,&nbsp;Nathaniel M. Schuster MD ,&nbsp;Joshua D. Rittenberg MD","doi":"10.1016/j.spinee.2025.05.032","DOIUrl":"10.1016/j.spinee.2025.05.032","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 10","pages":"Pages 2353-2354"},"PeriodicalIF":4.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060111","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 “The simple etiology of scoliosis, low back pain, and herniated lumbar disks.” by O'Gara","authors":"David Poulter PT","doi":"10.1016/j.spinee.2025.05.030","DOIUrl":"10.1016/j.spinee.2025.05.030","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 10","pages":"Pages 2351-2352"},"PeriodicalIF":4.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060110","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 'Letter to the Editor regarding, \"Multisociety response to The BMJ publications on interventional spine procedures for chronic back and neck pain,\" by Rittenberg' [The Spine Journal 25 (2025) 1853-1854].","authors":"Xiaoqin Wang, Liang Yao, Stephane Genevay, Gordon H Guyatt, Thomas Agoritsas, Jason W Busse","doi":"10.1016/j.spinee.2025.08.323","DOIUrl":"https://doi.org/10.1016/j.spinee.2025.08.323","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076417","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":"Anterior vs. posterior approaches in the management of multilevel degenerative cervical myelopathy: a systematic review and meta-analysis.","authors":"Omar Kouli, Lana Al-Nusair, Ashish Basnet, Radek Kaiser, Michael Fehlings, Martin Wilby, Nisaharan Srikandarajah","doi":"10.1016/j.spinee.2025.08.336","DOIUrl":"10.1016/j.spinee.2025.08.336","url":null,"abstract":"<p><strong>Background context: </strong>Degenerative cervical myelopathy (DCM) is the commonest cause of spinal cord dysfunction. The optimal surgical approach for multilevel DCM (MDCM) remains debated.</p><p><strong>Purpose: </strong>To assess functional, patient-reported, and surgical-related outcomes of anterior and posterior surgical approaches for MDCM.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Outcome measures: </strong>Primary outcomes included modified Japanese Orthopaedic Association (mJOA), Neck Disability Index (NDI), pain visual analogue scale (VAS), SF-36, and EQ-5D at ≥1-year. Secondary outcomes included length of stay, C5 palsy, reoperation and intraoperative bleeding.</p><p><strong>Methods: </strong>Following the PRISMA guidelines, MEDLINE, Web of Science, and Cochrane databases (inception to November 2024) were accessed to search for studies comparing anterior and posterior approaches in adult patients with MDCM spanning ≥2 levels, including cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL). Meta-extraction was performed independently by multiple reviewers using Covidence. Data were pooled by a random-effects model, with effect sizes reported as mean differences (MDs) and odds ratios (ORs). Mixed-effects meta-regression accounted for baseline variability. Subgroup analyses examined CSM vs. OPLL and follow-up duration (1 vs. ≥2 years).</p><p><strong>Results: </strong>At final follow-up, the anterior approach demonstrated significantly better mJOA (MD 0.42, 95% CI, 0.20 to 0.64), NDI (MD -1.29, -2.41 to -0.17) and VAS (MD -0.60, -1.04 to -0.17), though did not reach minimal clinically important differences (MCIDs). Quality-of-life measures were comparable. Subgroup analysis further supported anterior surgery across CSM and OPLL groups. Early advantages of anterior surgery in NDI and VAS diminished until becoming nonsignificant at ≥2 years. Anterior surgery resulted in shorter length of stay (LOS) (MD -1.41 days, -1.91 to -0.90) and lower odds of C5 palsy (OR 0.37, 0.28-0.49).</p><p><strong>Conclusions: </strong>Both surgical approaches yield comparable long-term outcomes, with anterior surgery demonstrating statistically significant early functional advantages, shorter LOS, and lower odds of C5 palsy. However, these advantages diminish over time, with functional improvements not consistently reaching MCIDs. Given the heterogeneity of DCM, surgical decision-making should be individualized, incorporating patient-specific factors and long-term functional priorities to optimize outcomes.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975851","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":"Robotic Spine surgery: beyond adverse event reports and operative time.","authors":"Vivien Chan, Corey T Walker, David L Skaggs","doi":"10.1016/j.spinee.2025.08.325","DOIUrl":"10.1016/j.spinee.2025.08.325","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976301","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: The hidden cost of robotic spine surgery: Real-world adverse events cause 58-minute delays and undermine economic viability.","authors":"Paul C McAfee, Isador Lieberman","doi":"10.1016/j.spinee.2025.07.035","DOIUrl":"10.1016/j.spinee.2025.07.035","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976256","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":"Posterior reduction and temporary fixation for odontoid fractures: an intermuscular dissection approach versus a midline standard muscle stripping approach.","authors":"Zhenji Xu, Wenqing Wang, Ji Wu, Wenwen Wang, Dongqing Zhu, Qunfeng Guo","doi":"10.1016/j.spinee.2025.08.337","DOIUrl":"10.1016/j.spinee.2025.08.337","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background context: &lt;/strong&gt;Both the intermuscular dissection approach and the midline, standard muscle stripping approach in posterior reduction and temporary fixation (PRTF) technique can effectively avoid the loss of atlantoaxial motion function caused by posterior atlantoaxial fusion. The intermuscular dissection approach demonstrates superior paravertebral muscles integrity preservation. Therefore, we hypothesize that the range of motion (ROM) in rotation of C1-C2 after instrumentation removal would be superior in patients undergoing PRTF through the intermuscular dissection approach compared to the muscle stripping approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The primary objective of this study was to evaluate the treatment efficacy of PRTF for odontoid fractures, with a secondary comparative analysis of the intermuscular dissection approach versus the muscle stripping approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;A retrospective study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient samples: &lt;/strong&gt;From January 2020 to June 2022, clinical data of 58 patients with acute odontoid fractures who underwent PRTF technique were retrospectively reviewed from the hospital's internal database. The cohort comprised two matched groups: 29 patients treated with the intermuscular dissection approach PRTF technique and 29 patients treated with the muscle stripping approach PRTF technique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;The degree of paravertebral tissue edema in the short-term postoperatively was assessed using the edema coefficient. The operative time, intraoperative blood loss, postoperative paravertebral tissue edema, pain, and supplementary use of narcotics were recorded and compared between the two groups. Fracture healing was evaluated using computed tomography and three-dimensional reconstruction. Instrumentation was removed after fracture healing, and the outcome assessments included American Spinal Injury Association scoring grade, Visual Analog Scale Score for Neck Pain, and Neck Disability Index. Dynamic rotational computed tomography examination of the C1-C2 was performed to compare the ROM in rotation of C1-C2 between the two groups at 3 months after instrumentation removal.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 58 cases with odontoid fractures who underwent PRTF technique were reviewed. The patients' general information, clinical outcomes, and radiographic outcomes were collected. Subsequently, to test our hypothesis, the patients were divided into two groups based on the different techniques of surgical exposure. Clinical data were analyzed between the two groups for differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 58 patients were included in the study, with a mean age of 46.9±12.0 years old. Fracture healing was achieved in all patients in this study, and all patients in this study chose to remove the instrumentation after fracture healing. All patients returned to their preoperative work. There were no significant differences be","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976258","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":"Novel risk calculator predicting long-term survival in pediatric versus adult patients diagnosed with spinal low-grade glioma: a nationwide analysis.","authors":"Abdul Karim Ghaith, Xinlan Yang, Abdel-Hameed Al-Mistarehi, Taha Khalilullah, F N U Ruchika, Joshua Weinberg, Meghana Bhimreddy, Arjun K Menta, Khaled Zeitoun, Chase Foster, David Xu, Nicholas Theodore, Daniel Lubelski","doi":"10.1016/j.spinee.2025.08.335","DOIUrl":"10.1016/j.spinee.2025.08.335","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background context: &lt;/strong&gt;Spinal low-grade gliomas (SLGGs) are rare, slow-growing central nervous system tumors affecting both pediatric and adult populations. Due to their rarity, their prognosis and optimal treatment strategies remain poorly defined, necessitating further investigation into age-related differences in outcomes and risk factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aims to evaluate differences in treatment modalities and clinical outcomes between pediatric and adult SLGG patients. Additionally, it seeks to identify risk factors for long-term survival using predictive modeling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A retrospective cohort study using data from the National Cancer Database (NCDB) was conducted. Patients were stratified into pediatric (≤21 years) and adult (&gt;21 years) groups for comparative analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient sample: &lt;/strong&gt;A total of 884 patients diagnosed with SLGGs (grades I and II) were included: Pediatric patients (≤21 years): 294 (33.3%) and adult patients (&gt;21 years): 590 (66.7%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;The primary outcome was overall survival (OS), analyzed using Kaplan-Meier survival curves and the Log-rank test. Predictive modeling was used to identify significant risk factors associated with mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with SLGGs (grades I and II) were identified from the National Cancer Database (NCDB) and categorized into pediatric (≤21 years) and adult (&gt;21 years) groups. Demographic, tumor, and treatment characteristics were compared using univariate analysis. Overall survival (OS) was assessed using Kaplan-Meier survival curves and the Log-rank test. Multivariate Cox proportional hazards modeling was performed to identify independent predictors of mortality. Three machine learning models were applied to predict mortality risk, with performance evaluated using the Area Under the Curve (AUC) and Concordance index (C-index). SHapley Additive exPlanations (SHAP) analysis was used to interpret feature importance in the best-performing model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Pediatric patients presented with larger tumors on average but had significantly better OS than adults (long-term mortality: 8.2% vs. 36.8%, p&lt;.001). Surgical resection, including gross total resection (GTR) and subtotal resection (STR), was associated with improved OS in both age groups (p=.0015). Adults were more likely to receive radiation therapy (47.8% vs. 19.1%, p&lt;.001), while pediatric patients more frequently received chemotherapy (18.4% vs. 11.7%, p=.007); however, both treatments were associated with poorer OS (p&lt;.0001). Multivariate Cox regression identified pediatric age (HR=0.26, p&lt;.001) and surgery alone (HR=0.43, p&lt;.001) as protective factors against mortality. The Random Survival Forest model demonstrated the highest predictive performance (AUC=0.74, C-index=0.71), identifying high comorbidity scores, radiation alone, and greater travel distance as key ","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976296","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":"Passive neck stiffness and range of motion for males and females from early to late adulthood.","authors":"Mingyue Liu, Ryan D Quarrington, William S P Robertson, Baptiste Sandoz, Claire F Jones","doi":"10.1016/j.spinee.2025.08.331","DOIUrl":"10.1016/j.spinee.2025.08.331","url":null,"abstract":"<p><strong>Background context: </strong>Understanding human passive neck range of motion (ROM) and stiffness, and their association with age and sex, can be beneficial for clinical assessment, and surrogate and computational modelling.</p><p><strong>Purpose: </strong>To assess passive head-neck ROM and stiffness, and to investigate association with age and sex, in flexion, extension, left and right lateral bending, and axial rotation.</p><p><strong>Study design/setting: </strong>In-vivo human participant testing.</p><p><strong>Methods: </strong>Eighty participants aged 20 to 79 years (nearly even distribution), who self-reported no history of significant health conditions and with no neck pain, were recruited. Two custom apparatus were used to support participants in relaxed lying. Their head was rotated to maximum ROM; applied moment and head-torso motion were recorded. Muscle activation was monitored in real-time to ensure electromyographic signals from agonist muscles remained below a passive threshold. Stiffness was determined from the moment-angle data within each of three zones, with zone boundaries delineated to maximize moment-angle linearity within each zone. The age and sex effects on passive stiffness and ROM were assessed using generalized linear models for flexion and extension, and linear mixed models for lateral bending and axial rotation.</p><p><strong>Results: </strong>Passive neck ROM decreased by 0.2° per year of age in lateral bending and axial rotation for males and females, and extension ROM for males was 5.8° lower than for females. Passive stiffness in lateral bending (zone 1 and 2: 0.9 and 3.5 Nmm/°/year; zone 3: 3%), axial rotation (zone 1 and 2: 1%; zone 3 for males and females: 1.9 and 0.9 Nmm/°/year) and some zones in extension (zone 2: 0.8 Nmm/°/year; males in zone 3: 2.7 Nmm/°/year) increased with age, and males had higher stiffness than females in lateral bending (zone 1 and 2: 22.3 and 43.9 Nmm/°; zone 3: 35%) and axial rotation (zone 1 and 2: 49% and 35%).</p><p><strong>Conclusions: </strong>Passive neck ROM decreased with age in lateral bending and axial rotation, while passive neck stiffness tended to increase with age in all motions but flexion. Extension ROM was higher for females, and lateral bending and axial rotation stiffness at lower angles were higher for males.</p><p><strong>Clinical significance: </strong>The neck ROM, stiffness, and moment-angle corridors developed in this study provide benchmarks for clinical assessment of cervical spine function, and can assist the development of surrogate and computational models incorporating minimal muscle activation, for injury simulation and clinical skill training.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976326","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}