Spine Journal最新文献

{"title":"Response to letter to the Editor regarding “Risk factors of domino osteoporotic vertebral fractures is severe paraspinal muscle fatty degeneration”","authors":"Tomoyuki Kusukawa PhD , Keishi Maruo PhD , Masakazu Toi PhD , Tetsuto Yamaura MD , Masaru Hatano MD , Kazuma Nagao PhD , Hayato Oishi MD , Yutaka Horinouchi MD , Fumihiro Arizumi PhD , Kazuya Kishima PhD , Toshiya Tachibana PhD","doi":"10.1016/j.spinee.2024.12.020","DOIUrl":"10.1016/j.spinee.2024.12.020","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 4","pages":"Pages 845-846"},"PeriodicalIF":4.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642235","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 importance of social work in chronic low back pain management: recommendations for future research” by Zhu et al","authors":"Zhongxing Liu PhD , Mengzhe Tian MD , Lincheng Duan PhD","doi":"10.1016/j.spinee.2024.12.005","DOIUrl":"10.1016/j.spinee.2024.12.005","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 4","pages":"Pages 857-858"},"PeriodicalIF":4.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641765","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 “Do patients with lumbar spinal stenosis benefit from decompression of levels with adjacent moderate stenosis? A prospective cohort study from the NORDSTEN study”","authors":"Sara Tronstad MD , Erland Hermansen MD, PhD","doi":"10.1016/j.spinee.2024.12.015","DOIUrl":"10.1016/j.spinee.2024.12.015","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 4","pages":"Page 848"},"PeriodicalIF":4.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641710","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 “Isolated decompression for degenerative spondylolisthesis is less costly than fusion even with high revision rates” by Kaidi et al","authors":"Francisco Kovacs MD, PhD , Jesús Seco-Calvo MD, PhD","doi":"10.1016/j.spinee.2024.10.031","DOIUrl":"10.1016/j.spinee.2024.10.031","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 4","pages":"Page 849"},"PeriodicalIF":4.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641711","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 “Isolated decompression for degenerative spondylolisthesis is less costly than fusion even with high revision rates”","authors":"Austin C. Kaidi MD, MSc, Jerry Y. Du MD, Tejas Subramanian BE, Troy Amen MD, MBA, Tomoyuki Asada MD, Sheeraz A. Qureshi MD, MBA, Sravisht Iyer MD","doi":"10.1016/j.spinee.2024.12.009","DOIUrl":"10.1016/j.spinee.2024.12.009","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 4","pages":"Pages 850-851"},"PeriodicalIF":4.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641712","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 “Do patients with lumbar spinal stenosis benefit from decompression of levels with adjacent moderate stenosis? A prospective cohort study from the NORDSTEN study” by Tronstad et al","authors":"Francisco Kovacs MD, PhD , Estanislao Arana MD, MHE, PhD","doi":"10.1016/j.spinee.2024.08.032","DOIUrl":"10.1016/j.spinee.2024.08.032","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 4","pages":"Page 847"},"PeriodicalIF":4.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642236","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 “Risk factors of domino osteoporotic vertebral fractures is severe paraspinal muscle fatty degeneration”, by Kusukawa et al","authors":"Wei-Zhen Tang MD, Xue-Bing Chen MD, Tai-Hang Liu PhD","doi":"10.1016/j.spinee.2024.10.030","DOIUrl":"10.1016/j.spinee.2024.10.030","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 4","pages":"Pages 843-844"},"PeriodicalIF":4.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642237","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":"Appropriate Use Criteria for Osteoporotic Compression Fractures.","authors":"Charles Cho, Jeffrey Hills, Paul Anderson, Thiru Annaswamy, R Carter Cassidy, Chad Craig, Russell DeMicco, John Easa, Scott Kreiner, Daniel Mazanec, John O'Toole, George Rappard, Robert Ravinsky, Andrew Schoenfeld, John Shin, Greg Whitcomb, Charles Reitman","doi":"10.1016/j.spinee.2025.02.007","DOIUrl":"10.1016/j.spinee.2025.02.007","url":null,"abstract":"<p><strong>Background context: </strong>There is a lack of consensus regarding optimal indications for treatment of patients with osteoporotic vertebral fractures. An opportunity exists to improve outcomes if these indications can be clarified.</p><p><strong>Purpose: </strong>The purpose of the North American Spine Society (NASS) Appropriate Use Criteria (AUC) was to determine the appropriate (i.e. reasonable) multidisciplinary treatment recommendations for patients with osteoporotic vertebral fractures across a spectrum of more common clinical scenarios.</p><p><strong>Study design: </strong>A Modified Delphi process.</p><p><strong>Patient sample: </strong>Modified consensus based guideline OUTCOME MEASURES: Final rating for treatment recommendations as either \"Appropriate\", \"Uncertain\", or \"Rarely Appropriate\" based on the median final rating among the raters.</p><p><strong>Methods: </strong>The methodology was based on the AUC development process established by the Research AND Development (RAND) Corporation. The topic of osteoporotic vertebral compression fracture was selected by NASS for its Clinical Practice Guideline development (CPG). In conjunction, the AUC committee determined key modifiers and adapted the standard definitions developed by the CPG with minimal modifications. A literature search and evidence analysis performed by the CPG were reviewed by the AUC work group. A separate multidisciplinary rating group was assembled. Clinical scenarios were generated based on a matrix of the modifiers, to rate the appropriateness of medical management, cement augmentation, or surgery. Based on the literature, provider experience, and group discussion, each scenario was scored on a nine-point scale on two separate occasions: once without discussion and again following discussion of the initial responses. The median rating for each scenario and level of agreement was then used to determine final indications as rarely appropriate with agreement (1 - 3), uncertain or disagreement (4-6), or appropriate with agreement (7-9). Consensus was not mandatory.</p><p><strong>Results: </strong>Medical management was appropriate across all scenarios. Cement augmentation was rarely appropriate in 60% of scenarios and uncertain or disagreement in 35% of scenarios. In the 5% of scenarios rated as appropriate with agreement for cement augmentation, high pain scores, acute duration, and simple fracture pattern were always present. Surgery was appropriate in 35% of scenarios and strongly influenced by instability and stenosis with neurological findings. Surgery was rarely appropriate in 18%, and uncertain or disagreement in 47% of scenarios.</p><p><strong>Conclusions: </strong>Multidisciplinary appropriate treatment criteria for osteoporotic vertebral fractures were generated based on the RAND methodology. This document provides comprehensive evidence-based recommendations for evaluation and treatment of osteoporotic vertebral fractures. The document in its entire","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574404","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 double-edged sword of generative AI: surpassing an expert or a deceptive \"false friend\"?","authors":"Franziska C S Altorfer, Michael J Kelly, Fedan Avrumova, Varun Rohatgi, Jiaqi Zhu, Christopher M Bono, Darren R Lebl","doi":"10.1016/j.spinee.2025.02.010","DOIUrl":"10.1016/j.spinee.2025.02.010","url":null,"abstract":"<p><strong>Background context: </strong>Generative artificial intelligence (AI), ChatGPT being the most popular example, has been extensively assessed for its capability to respond to medical questions, such as queries in spine treatment approaches or technological advances. However, it often lacks scientific foundation or fabricates inauthentic references, also known as AI hallucinations.</p><p><strong>Purpose: </strong>To develop an understanding of the scientific basis of generative AI tools by studying the authenticity of references and reliability in comparison to the alignment of responses of evidence-based guidelines.</p><p><strong>Study design: </strong>Comparative study.</p><p><strong>Methods: </strong>Thirty-three previously published North American Spine Society (NASS) guideline questions were posed as prompts to 2 freely available generative AI tools (Tools I and II). The responses were scored for correctness compared with the published NASS guideline responses using a 5-point \"alignment score.\" Furthermore, all cited references were evaluated for authenticity, source type, year of publication, and inclusion in the scientific guidelines.</p><p><strong>Results: </strong>Both tools' responses to guideline questions achieved an overall score of 3.5±1.1, which is considered acceptable to be equivalent to the guideline. Both tools generated 254 references to support their responses, of which 76.0% (n=193) were authentic and 24.0% (n=61) were fabricated. From these, authentic references were: peer-reviewed scientific research papers (147, 76.2%), guidelines (16, 8.3%), educational websites (9, 4.7%), books (9, 4.7%), a government website (1, 0.5%), insurance websites (6, 3.1%) and newspaper websites (5, 2.6%). Claude referenced significantly more authentic peer-reviewed scientific papers (Claude: n=111, 91.0%; Gemini: n=36, 50.7%; p<.001). The year of publication amongst all references ranged from 1988-2023, with significantly older references provided by Claude (Claude: 2008±6; Gemini: 2014±6; p<.001). Lastly, significantly more references provided by Claude were also referenced in the published NASS guidelines (Claude: n=27, 24.3%; Gemini: n=1, 2.8%; p=.04).</p><p><strong>Conclusions: </strong>Both generative AI tools provided responses that had acceptable alignment with NASS evidence-based guideline recommendations and offered references, though nearly a quarter of the references were inauthentic or nonscientific sources. This deficiency of legitimate scientific references does not meet standards for clinical implementation. Considering this limitation, caution should be exercised when applying the output of generative AI tools to clinical applications.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574406","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 cost-effectiveness of physical therapy versus laminectomy for lumbar spinal stenosis: a Markov decision analysis.","authors":"Prashant V Rajan, Joshua Eisenberg, Stephen Selverian, Richard Wawrose, Sangwook Tim Yoon","doi":"10.1016/j.spinee.2025.02.008","DOIUrl":"10.1016/j.spinee.2025.02.008","url":null,"abstract":"<p><strong>Background context: </strong>Physical therapy is often utilized as a nonoperative modality for the treatment of lumbar stenosis, oftentimes a prerequisite for insurance approval for surgery.</p><p><strong>Purpose: </strong>The goal of our study was to evaluate the relative cost-effectiveness of physical therapy as compared to a hospital-based or inpatient single-level lumbar laminectomy from the outset for lumbar stenosis.</p><p><strong>Study design/setting: </strong>Cost-effectiveness analysis, Markov model simulation.</p><p><strong>Patient sample: </strong>We developed a Markov model to analyze the baseline case: a 55-year-old patient with symptomatic lumbar stenosis undergoing physical therapy versus lumbar laminectomy from outset.</p><p><strong>Outcome measures: </strong>Model outcome measures were total quality-adjusted life years (QALYs) and costs, organized into incremental cost-effectiveness ratios (ICERs). ICERs were evaluated against willingness-to-pay thresholds (WTP) of $50,000 and $100,000.</p><p><strong>Methods: </strong>Transition probabilities were derived from the literature. Univariate and bivariate sensitivity analyses were performed as well as a probabilistic analysis varying several sensitive variables over distributions through 10,000 different simulations. Both health-care payer and societal perspectives were included.</p><p><strong>Results: </strong>From health-care payer perspective, laminectomy from outset produced higher QALYs (12.11 vs. 11.87) at lower total cost ($15,735 vs. $16,877) and was thus the dominant treatment. From societal perspective, physical therapy generated lower costs ($32,007) compared to laminectomy ($32,368). With an ICER of $1,485 per QALY for laminectomy which was below the WTP thresholds. The results were not sensitive to the procedural costs of laminectomy and physical therapy. In probabilistic sensitivity analysis, virtually all iterations found laminectomy from outset to be cost-effective over physical therapy across all WTP thresholds.</p><p><strong>Conclusions: </strong>Our cost-effectiveness analysis showed laminectomy to be the preferred treatment strategy from the outset for symptomatic lumbar stenosis from both healthcare payer and societal perspectives. These findings highlight the need for further study into the effectiveness and cost-efficiency of physical therapy to validate these model-based findings and explore ways to optimize the management of lumbar stenosis.</p>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544080","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}