Spine Journal最新文献

{"title":"Optimization of 3D-titanium interbody cage design. Part 1: in vitro biomechanical study of subsidence.","authors":"S Harrison Farber, Alton J Oldham, Luke K O'Neill, Anna G U Sawa, Alexis C Ratliff, Ahmed Doomi, Bernardo de Andrada Pereira, Juan S Uribe, Brian P Kelly, Jay D Turner","doi":"10.1016/j.spinee.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.spinee.2024.12.002","url":null,"abstract":"<p><strong>Background context: </strong>Cage subsidence is a complication of interbody fusion associated with poor clinical outcomes. 3D-printed titanium interbody cages allow for the alteration of features such as stiffness and porosity. However, the influence of these features on subsidence and their biological effects on fusion have not been rigorously evaluated.</p><p><strong>Purpose: </strong>This 2-part study sought to determine how changes in 3D-printed titanium cage parameters affect subsidence using an in vitro bone model (Part 1) and biological fusion using an in vivo sheep model (Part 2).</p><p><strong>Study design: </strong>Biomechanical foam block model.</p><p><strong>Methods: </strong>In Part 1 of this study, 9 implant types were tested (8 per implant type). The implant types included 7 3D-printed titanium interbody cages with various surface areas, porosities, and surface topographies, along with 1 standard polyetherether ketone (PEEK) cage and 1 solid titanium cage. Subsidence testing was performed in a standardized foam block model using 2 different densities of foam. Digital imaging correlation was used to determine the relative vertical displacement of the interbody cage-foam block construct.</p><p><strong>Results: </strong>Subsidence decreased as the surface contact area with the bone model increased (all p≤0.01). Increased porous surface topography increased subsidence, while a nonporous surface significantly decreased subsidence (all p<0.001). Subsidence did not differ based on changes in implant porosity (all p≥0.35) or material property/modulus (all p≥0.19). Subsidence was significantly decreased with the higher density foam (p<0.001). The stiffness of the implant was affected by porosity (all p<0.02) and smooth surface topography (p=0.01) but not by lumen size (all p≥0.15). Stiffness did not differ between porous titanium and PEEK implants (p=0.96), which were both less stiff than solid titanium implants (both p <0.001). Surface area negatively correlated with subsidence (r=-0.786, p=0.012) but was not correlated with stiffness (r=0.560, p=0.12).</p><p><strong>Conclusions: </strong>Implant surface area and surface topography greatly influenced interbody subsidence. Apparent stiffness, implant porosity, and material property did not affect subsidence in this in vitro model. Higher foam density also led to lower subsidence than low-density foam. Biological response in the in vivo setting likely also influences clinical subsidence, which is evaluated in the companion study (Part 2).</p><p><strong>Clinical significance: </strong>This study provides valuable information regarding the new 3D-printed titanium technology. We showed that cage surface area and surface topography were the implant design parameters that had the greatest influence on the development of interbody subsidence. Moreover, bone mineral density was the factor that had the greatest effect on subsidence prevention. These data support patient optimization befor","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856488","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":"\"Pyogenic Spondylodiscitis from Oral Odontogenic Origins: A Frequently Overlooked Entity\".","authors":"Ann-Kathrin Joerger, Miriam Zahn, Carolin Albrecht, Markus Nieberler, Herbert Deppe, Maria Wostrack, Bernhard Meyer","doi":"10.1016/j.spinee.2024.12.019","DOIUrl":"https://doi.org/10.1016/j.spinee.2024.12.019","url":null,"abstract":"<p><strong>Background context: </strong>Primary spondylodiscitis occurs through the hematogenous spread of a pathogen entering the body via a point of entry. The infection's origin often remains unclear. During dental procedures or through minor traumas, oral bacteria can enter the bloodstream and disseminate throughout the body.</p><p><strong>Purpose: </strong>This study's objective was to further investigate the role of odontogenic (i.e., teeth-related) causes of spondylodiscitis, especially in cases where another infective focus could not be identified initially.</p><p><strong>Design: </strong>Retrospective analysis.</p><p><strong>Patient sample: </strong>In a cohort of 340 consecutive patients with primary spondylodiscitis treated at a Level I Spine Center from 01/01/2018 to 12/31/2022, those with oral bacteria in blood cultures or disc tissue samples and available orthopantomograms (OPG, i.e. panoramic X-ray of the teeth) (please define this-general readership will not know what this is) were retrospectively reevaluated for odontogenic origins. Patients with secondary spondylodiscitis from a previous operation (< 3 months) in the same segment were excluded.</p><p><strong>Outcome measures: </strong>Radiological features indicating an infectious dental focus included apical (in the mandible/maxilla?) radiolucency of the tooth, impacted teeth, residual roots, and vertical or cup-shaped bone loss.</p><p><strong>Methods: </strong>Patients' medical records, imaging data, laboratory, microbiological and histopathological findings, and surgical reports were analyzed. The term oral bacteria refers to the whole microbiome of the oral cavity. Periodontal bacteria are bacterial species implicated in periodontal diseases. For further classification, periodontal bacteria were assigned to one of five complexes previously described.</p><p><strong>Results: </strong>The most frequent infective source was (what joints?) an infection of the major joints of the extremeties (14.1%), followed by ulcers of the extremities (10.3%) and urosepsis (10.0%). An odontogenic origin was initially identified in 8.9%. In 33.1% of cases, the source of infection was not found. Oral bacteria were found in 38 cases (13.3%) of 286 (i.e. all cases with a positive pathogen detection) of the 33.1% of cases?. Six of these had an identified focus of the throat, and six had an initially clear dental focus. Of the remaining 26 cases, OPG was available for 14. Re-evaluation of OPG revealed an odontogenic focus in 9 out of 14 cases (64.3%). Two of these cases had a concomitant infective focus, while in 7 cases, initially, no infectious focus was found.</p><p><strong>Conclusion: </strong>An odontogenic origin for spondylodiscitis was more prevalent than initially presumed, particularly in patients where no source was identified at first sight. We therefore recommend a thorough diagnostic dental work-up as a standard procedure for patients with primary spondylodiscitis.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856486","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":"Duraplasty promotes functional recovery by alleviating intraspinal pressure and edema following severe spinal cord compression injury in rabbits: Experimental studies.","authors":"Chaohua Yang, Tao He, Jingjin Ma, Qing Wang, Song Wang, Gaoju Wang, Jin Yang, Zhiyu Chen, Qiaochu Li, Fangbiao Zhan, Changchun Jian, Daxiong Feng, Zhengxue Quan","doi":"10.1016/j.spinee.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.spinee.2024.12.007","url":null,"abstract":"<p><strong>Background: </strong>After acute traumatic spinal cord injury (tSCI), various surgical strategies have been developed to alleviate elevated intraspinal pressure (ISP) and secondary injury.</p><p><strong>Purpose: </strong>Our study aimed to investigate the impacts of duraplasty and laminectomy on edema progression, perfusion and functional outcomes after severe balloon compression SCI.</p><p><strong>Study design: </strong>In vivo animal study.</p><p><strong>Methods: </strong>Closed balloon compression injuries were induced at the T7 level in rabbits using an inflated volume of 50 μl. Laminectomy (1-level laminectomy: 1-laminectomy; 3-level laminectomy: 3-laminectomy) and duraplasty were performed immediately after model generation. ISP was monitored using a SOPHYSA probe at the epicenter within 7 days post-SCI. Edema progression, perfusion and damage severity were evaluated by serial multisequence MRI scans, behavioral and bladder scores within 8 weeks post-SCI. Blood-spinal cord barrier (BSCB) permeability and histopathology were subsequently analyzed.</p><p><strong>Results: </strong>After SCI, ISP was steeply elevated in the control and 1-laminectomy groups, peaking at 33.14±4.91 and 31.71±4.50 mmHg at 48 h post-SCI; whereas in the 3-laminectomy and duraplasty groups, ISP peaked at 29.43±4.04 and 12.14±1.86 mmHg (p<0.0001) at 72 h post-SCI. MRI and function scores showed that duraplasty significantly reduced the intramedullary lesion length (IMLL) and blood flow reduction ratio, and promoted fiber tract sparing and spinal cord functional recovery (p<0.01). Histopathology revealed that duraplasty significantly reduced BSCB permeability, tissue loss and inflammation and promoted axon preservation (p<0.01), while it did not increase early scar formation.</p><p><strong>Conclusions: </strong>Duraplasty may alleviate secondary SCI and promote functional recovery. This neuroprotective mechanism may be related to reduced ISP and increased perfusion, resulting in reduced edema, BSCB permeability and inflammation and increased nerve fiber tract preservation.</p><p><strong>Clinical significance: </strong>Duraplasty may promote functional recovery following severe tSCI patients, but further investigations are needed.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840110","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 Impact of Symptom Duration on Postoperative Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis.","authors":"Joseph E Nassar, Manjot Singh, Ashley Knebel, Alejandro Perez-Albela, Michael J Farias, Mohammad Daher, Bryce Basques, Bassel G Diebo, Alan H Daniels","doi":"10.1016/j.spinee.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.spinee.2024.12.012","url":null,"abstract":"<p><strong>Background and context: </strong>The optimal timing at which patients should undergo Anterior Cervical Discectomy and Fusion (ACDF) surgery to achieve the best outcomes has not been determined. Given that patients may experience delays in care and that insurance companies often require a minimum of six weeks of conservative treatment before surgery, it is essential to determine the impact of symptom duration on outcomes following ACDF.</p><p><strong>Purpose: </strong>To evaluate the impact of symptom duration on outcomes following ACDF surgery.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>Medline, Embase and Cochrane Library were searched from inception through July 2^nd, 2024 in accordance with the PRISMA guidelines. Data on Neck Disability Index (NDI), Visual Analogue Scale (VAS) for neck and arm pain, and Short Form-12 (SF-12) physical and mental component scores were extracted. Subgroup analyses were performed to compare the outcomes at 6-months, 12-months and 24-months cutoff time points. Mean differences with 95%CI were used for continuous data.</p><p><strong>Results: </strong>Nine studies comprising 1,511 patients (48.64% female) with a mean age of 50.56±9.88 years were included in this study. All patients achieved improvements in NDI, VAS, and SF-12 following ACDF. The amount of improvement decreased as symptom duration increased with patients experiencing greater than 24 months of symptoms experiencing statistically significantly less improvement in NDI (8.70 vs. 18.93, p=0.03), VAS Neck (1.95 vs. 3.33, p=0.003), and VAS Arm (1.74 vs. 3.72, p<0.001) in comparison to patients with less than 24 months of symptoms. There were no statistically significant differences in outcomes at the 6 and 12 months cut off points between cohorts.</p><p><strong>Conclusion: </strong>Longer symptom duration is associated with worse outcomes compared to shorter symptom duration with statistically significant differences observed at the 24-month cutoff for NDI, VAS Arm, and VAS Neck scores. Patients with greater than 24 months of symptoms also failed to achieve clinically significant improvement in neck pain postoperatively. Given the lasting impact of disability and pain on patients, more studies should assess the impact of symptom duration on postoperative outcomes and at even shorter cut-off points.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840113","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":"Complementary Effects of Postoperative Delirium and Frailty on 30-Day Outcomes in Spine Surgery.","authors":"Nithin K Gupta, Stefan T Prvulovic, Sina Zoghi, Hikmat R Chmait, Michael M Covell, Cameron J Sabet, Daniel T DeGenova, Marc D Moisi, Meic H Schmidt, Christian A Bowers","doi":"10.1016/j.spinee.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.spinee.2024.12.017","url":null,"abstract":"<p><strong>Background context: </strong>With an increasingly older population, the number of frail patients requiring surgical management for degenerative spine diseases is rapidly increasing. Older patients are at increased risk of developing post-operative delirium (POD), which increases the odds of postoperative morbidity and mortality in spine surgery patients. Therefore, frail spine surgery patients may be at greater risk of developing POD and subsequent adverse outcomes.</p><p><strong>Purpose: </strong>To understand the relationship between frailty and POD in spine surgery patients, and the effect of POD on non-fatal and fatal adverse outcomes in frail patients.</p><p><strong>Study design/setting: </strong>Retrospective cohort study utilizing data from the 2021 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database.</p><p><strong>Patient sample: </strong>Patients aged ≥75 years undergoing spine surgery screened for POD, with a total sample size of 4,195 patients.</p><p><strong>Outcome measures: </strong>Primary outcomes were postoperative delirium (POD), 30-day mortality, and non-fatal adverse outcomes.</p><p><strong>Methods: </strong>Frailty was measured using the Risk Analysis Index (RAI) with tiered cutoffs indicating increasing frailty. Statistical methods included multivariable logistic regression and mediation analysis to evaluate the relationships between RAI, postoperative delirium, and 30-day mortality.</p><p><strong>Results: </strong>Out of 4,195 spine surgery patients aged ≥75 years screened for POD, 353 (8.4%) exhibited POD. POD patients had significantly higher RAI scores relative to those without POD (p < 0.001). Multivariable analysis demonstrated that increasing frailty predicted POD (p < 0.001). In patients with POD, there were increased odds of mortality and all non-fatal adverse outcomes within 30 days (p < 0.001). A complementary mediation effect of POD on frailty's contribution to 30-day mortality was observed (p < 0.001).</p><p><strong>Conclusion: </strong>POD and increasing preoperative frailty RAI scores were independent predictors of mortality and morbidity in older spine surgery patients. POD has a significant synergistic contribution to the adverse effects of frailty following spine surgery. The RAI may be used to identify frail patients at risk of developing POD to enable optimal surgical candidate selection and provide opportunities for risk mitigation, such as prehabilitation and/or specialized perioperative care teams for frail patients.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824745","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 Impact of Obesity on Postoperative and Perioperative Outcomes in Lumbar Spine Surgery, a Systematic Review and Meta Analysis.","authors":"Ebubechi Adindu, Devender Singh, Matthew Geck, John Stokes, TruumeesEeric","doi":"10.1016/j.spinee.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.spinee.2024.12.006","url":null,"abstract":"<p><strong>Background context: </strong>Obesity is increasingly prevalent globally and is associated with various health issues, including spine-related disorders. Previous studies have shown mixed results regarding the impact of obesity on spine surgery outcomes.</p><p><strong>Purpose: </strong>This meta-analysis aims to evaluate the effects of obesity on perioperative and post-operative outcomes in spine surgery patients.</p><p><strong>Study design/setting: </strong>We performed a systematic review and meta-analysis of prospective and retrospective studies comparing outcomes between obese and non-obese spine surgery patients.</p><p><strong>Patient sample: </strong>The meta-analysis included 35,639 patients, of which 9,369 were obese (BMI ≥ 30 kg/m²) and 26,270 were non-obese (BMI < 30 kg/m²).</p><p><strong>Outcome measures: </strong>Primary outcomes included patient-reported outcome measures (PROMs) such as the Oswestry Disability Index (ODI) and the Visual Analog Scale (VAS) for leg and back pain. Secondary outcomes involved perioperative measures like estimated blood loss (EBL), operative time, and length of stay (LOS), as well as complication and reoperation rates.</p><p><strong>Methods: </strong>Following PRISMA guidelines, four databases were searched for relevant studies. The quality of included studies was assessed using the Cochrane Risk of Bias tool. Mean differences were used to quantify the differences in PROMs and perioperative outcomes. Odds ratios were used to analyze differences in complication rates.</p><p><strong>Results: </strong>Obese patients had similar PROMs compared to non-obese patients, with differences not exceeding the minimal clinically important difference (MCID). However, obese patients experienced longer operative times, greater EBL, and extended hospital stays. They also had higher rates of postoperative complications such as dural tears, infections, and reoperations.</p><p><strong>Conclusions: </strong>While obesity is associated with certain perioperative challenges, the postoperative recovery in terms of pain and disability appears comparable between obese and non-obese patients. Spine surgeons should be aware of the increased perioperative risks but can reassure obese patients of similar long-term outcomes post-surgery.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822800","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":"Management of Severe Pyogenic Spinal Infections: The 2SICK Study by the EANS Spine Section.","authors":"Andreas Kramer, Santhosh G Thavarajasingam, Jonathan Neuhoff, Felipa Lange, Hariharan Subbiah Ponniah, Sara Lener, Claudius Thomé, Felix C Stengel, Gregor Fischer, Isabel C Hostettler, Martin N Stienen, Maxim Jemna, Konstantinos Gousias, Aleksandra Nedeljkovic, Danica Grujicic, Zarko Nedeljkovic, Jasmina Poluga, Ralph T Schär, Wiktor Urbanski, Carla Sousa, Carlos Daniel Oliveira Casimiro, Helena Harmer, Barbara Ladisich, Matthias Matt, Matthias Simon, Delin Pai, Christian Doenitz, Lorenzo Mongardi, Giorgio Lofrese, Melanie Buchta, Lukas Grassner, Pavel Trávníček, Tomáš Hosszú, Maarten Wissels, Sven Bamps, Waeel Hamouda, Flavio Panico, Diego Garbossa, Marcello Barbato, Manlio Barbarisi, Tobias Pantel, Jens Gempt, Tharaka Sai Kasula, Sohum Desai, Julius Mautin Vitowanu, Bekir Rovčanin, Ibrahim Omerhodzic, Andreas K Demetriades, Benjamin Davies, Ehab Shiban, Florian Ringel","doi":"10.1016/j.spinee.2024.12.018","DOIUrl":"https://doi.org/10.1016/j.spinee.2024.12.018","url":null,"abstract":"<p><strong>Background context: </strong>Spondylodiscitis management presents significant clinical challenges, particularly in critically ill patients, where the risks and benefits of surgical intervention must be carefully balanced. The optimal timing of surgery in this context remains a subject of debate.</p><p><strong>Purpose: </strong>This study aims to evaluate the effectiveness of early surgery versus delayed surgery or conservative management in critically ill patients with de novo pyogenic spondylodiscitis.</p><p><strong>Study design/setting: </strong>This is an international, multicenter retrospective cohort study involving 24 centers, primarily in Europe.</p><p><strong>Patient sample: </strong>The study included 192 critically ill patients (65.63% male) with a median age of 69 years, all severely affected by pyogenic spondylodiscitis characterized by an initial CRP level >200 mg/l or the presence of two out of four Systemic Inflammatory Response Syndrome criteria upon admission.</p><p><strong>Outcome measures: </strong>The primary outcome was 30-day mortality. Secondary outcomes included length of ICU stay, length of hospital stay, and relapse rates of spondylodiscitis.</p><p><strong>Methods: </strong>Patients were divided into three groups: early surgery (within three days of admission), delayed surgery (after three days of admission), and conservative therapy. Propensity score matching and multivariate regression analyses were performed to adjust for baseline differences and assess the impact of treatment modalities on mortality and other clinical outcomes.</p><p><strong>Results: </strong>Delayed surgery was associated with significantly lower 30-day mortality (4.05%) compared to early surgery (27.85%) and conservative therapy (27.78%) (p<0.001). Delayed surgery also resulted in shorter hospital stays (42.76 days) compared to conservative therapy (55.53 days) and early surgery (26.33 days) (p<0.001), and shorter ICU stays (4.52 days) compared to conservative therapy (16.48 days) and early surgery (7.92 days) (p<0.001). The optimal window for surgery, minimizing mortality, was identified as ten to fourteen days post-admission (p=0.02). Risk factors for increased mortality included age (p<0.05), multiple organ failure (p<0.05), and vertebral body destruction (p<0.05), whereas delayed surgery (p<0.05) and the presence of an epidural abscess were associated with reduced mortality (p<0.05).</p><p><strong>Conclusions: </strong>Delayed surgery, optimally between 10 to 14 days post-admission, was associated with lower mortality in critically ill spondylodiscitis patients. These findings highlight the potential benefits of considering surgical timing to improve patient outcomes.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822796","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 concerning \"What are the risk factors for a second osteoporotic vertebral compression fracture?\" by Sang Hoon Hwang, et al. (Spine J. 2023; 23(11):1586-1592.","authors":"Dongdong Cao, Jixin Chen, Weijie Yu","doi":"10.1016/j.spinee.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.spinee.2024.12.013","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819755","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":"Laboratory Parameters as Diagnostic Indicators in Venous Hypertensive Myelopathy.","authors":"Yinqing Wang, Shuangshuang Liu, Hongjun Hao, Chengbin Yang, Tianqi Tu, Yuxiang Fan, Zihao Song, Kun Yang, Hongqi Zhang, Haifeng Li, Yongjie Ma","doi":"10.1016/j.spinee.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.spinee.2024.12.008","url":null,"abstract":"<p><strong>Background context: </strong>Venous hypertension is a rare cause of myelopathy that can be misdiagnosed as myelitis and be worsened by glucocorticosteroids.</p><p><strong>Purpose: </strong>This study is aims to identify a fluid biomarker with diagnostic value in Venous Hypertensive Myelopathy (VHM).</p><p><strong>Study design: </strong>a retrospective diagnostic study PATIENT SAMPLE: The patients diagnosed as having myelopathy between December 2020 and June 2022 were divided into a VHM group (n=71) and an inflammatory myelopathy (IM) group (n=123). A non-inflammatory neurological disorders (NIND) group (n=53) was also acquired as baseline control.</p><p><strong>Outcome measures: </strong>The primary outcome was the diagnostic accuracy of the fluid biomarkers in the VHM and IM groups.</p><p><strong>Methods: </strong>The albumin, immunoglobulins, oligoclonal bands, neuron-specific enolase, myelin basic protein, and S100β were measured in their cerebrospinal fluid (CSF) and paired serum samples. Potential diagnostic biomarkers were screened through univariate and collinearity analyses. The diagnostic performance of these biomarkers was assessed by plotting the receiver-operating characteristic curves. Additionally, the predictive value of clinical factors and biomarkers for diagnosis was evaluated using multivariable logistic regression analysis.</p><p><strong>Results: </strong>The quantitative and normalized CSF-S100β values were significantly lower in the VHM group (P<.05). Analysis of receiver-operating characteristic curves adjusted for age and sex showed that the normalized CSF-S100β discriminated between VHM and IM (area under the curve (AUC) 0.884, 95% confidence interval [CI] 0.817-0.938). Particularly, it performed well in the AUC for normalized CSF-S100β (AUC 0.9400, 95% CI 0.8621-1.000) when oligoclonal bands and flow-void sign were negative.</p><p><strong>Conclusions: </strong>The normalized CSF-S100β can differentiate between VHM and IM.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819690","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 rare variation of CCDC40 plays a role in the development of idiopathic scoliosis possibly via dysfunction of cilia motility.","authors":"Leilei Xu, Zhenhua Feng, Zhicheng Dai, Yong Qiu, Zhichong Wu, Zezhang Zhu","doi":"10.1016/j.spinee.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.spinee.2024.12.011","url":null,"abstract":"<p><strong>Background context: </strong>Motile cilia dysfunction was reported to lead to scoliosis-like phenotypes in zebrafish models. There is still a lack of population-based study supporting the role of cilia motility associated genes in the etiology of idiopathic scoliosis (IS).</p><p><strong>Purpose: </strong>To investigate the molecular mechanism underlying the relationship between cilia motility associated genes and the development of adolescent idiopathic scoliosis (AIS).</p><p><strong>Study design: </strong>Population-based genetic study METHODS: A cohort of 56 female AIS patients and 30 age-matched non-scoliotic controls were included for tissue expression analysis. 28 patients with lower CCDC40 expression were selected for the exon sequencing. The novel variation was replicated in an independent cohort of 1326 AIS patients and 954 healthy controls. Exogenous versions of WT or mutant human CCDC40 mRNAs were expressed in zebrafish and the phenotype of body axis curvature was observed RESULTS: CCDC40 was found significantly down-expressed in AIS patients as compared with the non-scoliotic controls. A novel coding variant rs185157579 (c.1459G>A) was found significantly associated with AIS, with the mutant allele A adding to the risk of AIS by 2.44 folds. Zebrafish embryo injected with CCDC40 mRNAs containing mutant c.1459G>A presented significantly higher incidence of scoliosis-like phenotype than the wild group.</p><p><strong>Conclusions: </strong>The mutation c.1459G>A in the exon 10 of CCDC40 may lead to body axis curvature of zebrafish by impacting mRNA expression. The underlying molecular mechanism is worthy of further investigation.</p><p><strong>Clinical significance: </strong>Our findings shed a new light on the etiopathogenesis of AIS. The downstream signaling of CCDC40 may be candidate for potential drug targets to prevent the development of AIS. Moreover, the novel variation can be used as a genetic marker of polygenic risk score predicting the risk of AIS.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814665","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}