Journal of Craniovertebral Junction and Spine最新文献

{"title":"Trends in cervical laminoplasty: Medicare projections through 2060.","authors":"Paul G Mastrokostas, Christian Cassar, Mohammed Shah, Sean Inzerillo, Leonidas E Mastrokostas, Jad Bou Monsef, Afshin E Razi, Mitchell K Ng","doi":"10.4103/jcvjs.jcvjs_113_25","DOIUrl":"10.4103/jcvjs.jcvjs_113_25","url":null,"abstract":"<p><strong>Context: </strong>Cervical laminoplasty is a motion-preserving surgical alternative to laminectomy and fusion for multilevel cervical myelopathy. While studies have explored its clinical outcomes, few have assessed national trends or projected future procedural volumes, particularly within the aging Medicare population.</p><p><strong>Aims: </strong>The aim of this study is to analyze historical trends in cervical laminoplasty utilization within the Medicare population and project future procedural volumes through 2060.</p><p><strong>Settings and design: </strong>Retrospective trend analysis using a national database.</p><p><strong>Subjects and methods: </strong>A retrospective analysis was conducted using the Centers for Medicare and Medicaid Services Medicare Part B National Summary database from 2005 to 2022. Laminoplasty procedures were identified using current procedural terminology codes 63050 and 63051. To account for increasing Medicare Advantage enrollment, a correction factor was applied based on Kaiser Family Foundation data.</p><p><strong>Statistical analysis used: </strong>Four forecasting models - log-linear, Poisson, negative binomial regression, and auto-regressive integrated moving average - were evaluated to project future utilization. Model performance was assessed using mean absolute error and root mean square error. The Poisson regression model was selected for its balance of predictive accuracy and reliability.</p><p><strong>Results: </strong>From 2005 to 2022, laminoplasty volume increased 200.7%, from 811 to 2,437 procedures annually. The Poisson model projected an average 5.1% annual growth rate, with procedural volume reaching 15,528 by 2060 (95% confidence interval: 13,992-17,234), representing a 537% increase from 2022 levels.</p><p><strong>Conclusions: </strong>Cervical laminoplasty utilization is projected to increase considerably through 2060. As demand rises, further studies should explore factors influencing growth and assess broader implications for surgical decision-making and policy.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"16 3","pages":"296-300"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted cervical pedicle screw placement using a novel hybrid dilator technique: A clinical series of 565 screws.","authors":"Abhishek Soni, S Vidyadhara, Madhava Pai Kanhangad, T Balamurugan","doi":"10.4103/jcvjs.jcvjs_115_25","DOIUrl":"10.4103/jcvjs.jcvjs_115_25","url":null,"abstract":"<p><strong>Background: </strong>Cervical pedicle screws provide superior biomechanical fixation with pullout strength four times greater than lateral mass screws, but placement is technically demanding with traditional malposition rates of 6.7%-31.6%. Robotic-assisted spine surgery has demonstrated success in thoracolumbar applications, but cervical translation has been hindered by the lack of cervical-specific instrumentation requiring expensive custom instruments.</p><p><strong>Methods: </strong>We developed a hybrid technique combining robotic guidance with standard cervical instrumentation using minimally invasive surgery dilators as an interface. Sixty-five consecutive patients underwent robot-assisted cervical pedicle screw placement with 565 screws across C2-C7 levels using MazorX Stealth robotic system with O-arm navigation. Accuracy was assessed using Gertzbein-Robbins and Neo classification systems with 3-6-month follow-up for complications.</p><p><strong>Results: </strong>The technique achieved 98.76% clinically acceptable accuracy (Gertzbein-Robbins Grade A + B) with 1.24% breach rate. Perfect placement (Grade A) occurred in 95.22% of screws. Vertebral artery protection was excellent with 99.65% showing no foramen breach. Major complications occurred in 1.5% of patients (single vertebral artery injury), with 7.7% experiencing transient C5 weakness that resolved completely. No patients required revision surgery.</p><p><strong>Conclusions: </strong>This hybrid technique addresses instrument compatibility barriers in robotic cervical spine surgery by eliminating dependence on custom instruments while maintaining robotic accuracy. The technique demonstrates superior outcomes compared to traditional approaches and facilitates broader robotic cervical surgery adoption. Multi-center validation studies are needed to establish the generalizability.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"16 3","pages":"301-306"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of surgeries on normal match of T1 slope and cervical lordosis in cervical spondylotic myelopathy.","authors":"Tao Liu, Zhongzheng Zhi, Shuiqiang Qiu, Jian Kang, Jinhao Miao, Zhimin He, Zude Liu","doi":"10.4103/jcvjs.jcvjs_84_25","DOIUrl":"10.4103/jcvjs.jcvjs_84_25","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to explore the normal matching changes between T1 slope (T1S) and cervical lordosis (CL) in patients with multilevel cervical spondylotic myelopathy (CSM) after anterior and posterior reconstruction surgeries.</p><p><strong>Materials and methods: </strong>One hundred thirty-four patients diagnosed with multilevel CSM and a normal matching of T1S-CL were enrolled from the medical records spanning 2015-2020. The anterior group comprised 69 patients, and the posterior group included 65 patients. This study retrospectively analyzed perioperative parameters, including clinical parameters of the Japanese Orthopedic Association (JOA) score, Visual Analog Scale (VAS), neck disability index (NDI), and radiologic parameters T1S, CL, C2-7 sagittal vertical axis (SVA), and T1S-CL.</p><p><strong>Results: </strong>Prior to surgery, there were no significant differences in factors between two groups (<i>P</i> > 0.05). Postoperatively, while the JOA scores were similar between groups (<i>P</i> > 0.05), the anterior group showed significantly lower in NDI, VAS, perioperative parameters, and incidences of complications (<i>P</i> < 0.001). Significant changes were observed in each group for T1S, CL, C2-7 SVA and T1S-CL (<i>P</i> < 0.001). Preoperatively, in the anterior group, significant correlations were identified between T1S-CL and T1S, CL, and C2-7 SVA (<i>P</i> < 0.05). In the posterior group, significant correlations were observed between T1S-CL and T1S, CL, and C2-7 SVA (<i>P</i> < 0.05). Following surgery, in the anterior group, the correlations persisted between T1S-CL and T1S, CL, and C2-7 SVA (<i>P</i> < 0.05). In the posterior group, the correlations between T1S-CL and T1S, and CL were not significant (<i>P</i> > 0.05). The comparative analysis of parameter changes between anterior and posterior groups revealed no significant difference in the changes of T1S and C2-7 SVA (<i>P</i> > 0.05), whereas significant differences were observed in the changes of C2-7 lordosis and T1S-CL (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Anterior reconstruction surgeries can improve or optimize the normal matching of T1S-CL, while a mismatching of T1S and CL is more likely to occur after posterior surgery, potentially leading to cervical sagittal malalignment and imbalance in patients with multilevel CSM.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"16 3","pages":"327-334"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lordotic restoration: A comparison of transforaminal lumbar interbody fusion expandable and static cages at the lumbosacral junction.","authors":"Zuhair Mohammed, Sean Taylor, Saurabh Rawall, Francis Cruz, Addison Cimino, Luke Hiatt","doi":"10.4103/jcvjs.jcvjs_142_25","DOIUrl":"10.4103/jcvjs.jcvjs_142_25","url":null,"abstract":"<p><strong>Background: </strong>L5-S1 is a challenging level for achieving fusion, where traditional transforaminal lumbar interbody fusion (TLIF) techniques may fail to maintain disc height and lordosis. Expandable cages, offering in situ expansion, may improve radiographic outcomes. Their use specifically at L5-S1 has not been previously studied.</p><p><strong>Methods: </strong>We retrospectively reviewed patients ≥18 years who underwent TLIF at L5-S1 between January 2015 and September 2023. Patients were grouped by cage type (expandable vs. static). Radiographic data included anterior and posterior disc heights, disc angle, L5-S1, L4-S1, and L1-S1 sagittal lordotic angles, and lumbar distribution index. Measurements were recorded preoperatively and at two postoperative intervals.</p><p><strong>Results: </strong>A total of 43 patients were analyzed (15 expandable, 28 static). At baseline, the expandable group had greater posterior disc height (5.03 mm vs. 3.06 mm, <i>P</i> < 0.001). At first follow-up, expandable cages showed higher anterior disc height (18.86 mm vs. 11.80 mm, <i>P</i> < 0.001), posterior disc height (7.80 mm vs. 5.30 mm, <i>P</i> < 0.001), and disc angle (16.27° vs. 11.82°, <i>P</i> = 0.040). From preoperative to final follow-up, expandable cages had greater gains in anterior disc height (9.22 mm vs. 3.27 mm, <i>P</i> < 0.001), disc angle (7.84° vs. 0.24°, <i>P</i> = 0.002), and L5-S1 lordosis (7.03° vs. 0.81°, <i>P</i> = 0.012).</p><p><strong>Conclusions: </strong>Expandable TLIF cages at L5-S1 offer significantly improved radiographic correction over static cages, addressing key limitations of traditional posterior approaches.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"16 3","pages":"335-342"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of posterior odontoid tilt: Think scoliosis.","authors":"Neel Raja, Elias Petrou, Sonal Saran, Hasaam Uldin, Morgan Jones, Fahid Rasul, Kapil Shirodkar, Shashank Chapala, Rajesh Botchu","doi":"10.4103/jcvjs.jcvjs_89_25","DOIUrl":"10.4103/jcvjs.jcvjs_89_25","url":null,"abstract":"<p><strong>Objective: </strong>The odontoid process is an important anatomical structure providing a balance of mobility and stability at the craniocervical junction, with structural and biomechanical associations, and morphology that can be quantified with various measurements. The odontoid tilt angle is a measurement that must be accurately performed and can guide further investigations.</p><p><strong>Materials and methods: </strong>Retrospective analysis of 100 cervical spinal magnetic resonance imaging was performed on patients investigated for neck pain, with a known history of scoliosis, and compared with 50 control patients. Posterior odontoid tilt and Cobb angles were measured by a musculoskeletal radiology fellow and a fellowship-trained musculoskeletal radiologist with more than 10 years of experience, with descriptive statistics then performed on the measurements.</p><p><strong>Results: </strong>One hundred and thirty-two patients met the inclusion criteria, across both the scoliosis and control groups. 9 (18%) patients from the control group demonstrated posterior odontoid tilt, compared with 35 (43%) of patients in the scoliosis group. A range of scoliosis curve morphologies were demonstrated: 62 thoracolumbar, 10 thoracic, 9 lumbar, and 1 cervicothoracic, with average Cobb angles of 24.3°, 26.9°, 23.4, and 54°, respectively. There was good interobserver agreement for both measurements and a statistically significant difference in the posterior odontoid tilt measurements between groups (99% confidence interval, <i>P</i> = 0.0064).</p><p><strong>Conclusion: </strong>We recommend opportunistically assessing for the posterior odontoid tilt (Leaning odontoid tower of BRUMES (Botchu; Raja Rasul; Uldin; Morgan;Elias; Sonal, Shashank, Shirodkar). In cases with a posterior tilt angle >5°, we recommend whole spine imaging to assess for scoliosis in the thoracolumbar spine.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"16 3","pages":"278-283"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atlantoaxial rotatory subluxation in Eagle's syndrome: Is the styloid process protective?","authors":"Mehmet Seçer, Müge Elif Yaşın, Hakan Özçelik","doi":"10.4103/jcvjs.jcvjs_98_24","DOIUrl":"10.4103/jcvjs.jcvjs_98_24","url":null,"abstract":"<p><p>A styloid process >3 cm is known as Eagle's syndrome (ES). This syndrome can lead to neurovascular symptoms. Traumatic atlantoaxial rotatory subluxation (AARS) is very rare in adults. We diagnosed AARS in a patient with ES after high-energy trauma. Posterior C1-2 stabilization was performed under traction. We wanted to discuss the mechanism of AARS in ES based on this case.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"16 3","pages":"360-362"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing precision and safety in lumbar fusion: A comparative study of navigation-assisted versus standard MIS-TLIF for single level fusion.","authors":"Srikant Balasubramaniam, K Jignesh Joshi, K Devendra Tyagi, D Trimurti Nadkarni, R Aijaz Surve","doi":"10.4103/jcvjs.jcvjs_129_25","DOIUrl":"10.4103/jcvjs.jcvjs_129_25","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is commonly used to treat lumbar spine pathologies such as degenerative disc disease and spondylolisthesis. Despite its advantages, standard MIS-TLIF has limitations, including restricted visualization, radiation exposure, and technical challenges. Navigation-assisted modified MIS-TLIF has been developed to enhance precision and safety. This study compares the clinical and radiological outcomes of navigation-assisted modified MIS-TLIF versus standard MIS-TLIF.</p><p><strong>Materials and methods: </strong>This retrospective study included 66 patients who underwent lumbar fusion surgery between April 2020 and March 2023. Patients were divided into two groups: 30 underwent navigation-assisted modified MIS-TLIF and 36 underwent standard MIS-TLIF. Inclusion criteria included chronic low back pain due to lumbar degenerative conditions unresponsive to conservative management and single level pathology. Parameters evaluated included operative time, blood loss, hospital stay, complication rate, screw placement accuracy, fusion status (Bridwell grading), and functional outcomes assessed using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS).</p><p><strong>Results: </strong>The navigation-assisted group demonstrated lower blood loss, shorter hospital stays, and fewer complications. Pedicle screw placement accuracy was higher (96.7% vs. 88.9%). Fusion rates were comparable (Grade 1 fusion: 93.3% vs. 88.9%). Both groups showed significant improvement in ODI and VAS scores over 1 year. Final ODI and VAS scores were slightly better in the standard MIS-TLIF group but not statistically significant.</p><p><strong>Conclusion: </strong>Navigation-assisted modified MIS-TLIF offers improved accuracy, reduced complications, and enhanced perioperative outcomes as compared to standard MIS-TLIF, while achieving similar long-term clinical and radiological results.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"16 3","pages":"259-265"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and treatment of facet syndrome in patients with lumbar spinal stenosis managed with posterior lumbar vertebral spinal stabilization FFX^® facet cages.","authors":"Omar Houari, Mehdi Ben Ammar, Jihad Mortada, Federico Bolognini, Mariano Musacchio, Ariel Lebedenski, Robin Srour","doi":"10.4103/jcvjs.jcvjs_11_25","DOIUrl":"10.4103/jcvjs.jcvjs_11_25","url":null,"abstract":"<p><strong>Background: </strong>Facet joint degeneration represents a common source of low back pain and contributes to the development of lumbar spinal stenosis (LSS). We sought to identify the prevalence of facet syndrome in patients with LSS planned to undergo decompression and placement of facet cages (FFX^® device, SC Medica) and the relationship of medial branch block (MBB) test results with postoperative visual analog scale (VAS) pain scores.</p><p><strong>Materials and methods: </strong>LSS patients undergoing decompression and placement of facet cages performed for a period of 1 year were included. Patients who did not undergo an MBB test prior to surgery were excluded.</p><p><strong>Results: </strong>A total of 22 patients met the inclusion criteria for the study. The mean age was 69.4 ± 12.9 years with a majority of patients (63.6%) being female. Sixteen of the 22 (73%) patients had a positive MBB test. VAS scores were similar at baseline between the MBB positive and negative subgroups. The improvement in postoperative VAS back scores compared to baseline was greater for patients with a positive block test compared to those with a negative test (-4.7 vs. -1.8, respectively). As expected with the decompression part of the procedure, the improvement of VAS leg scores was similar for patients with positive and negative block tests compared to baseline.</p><p><strong>Conclusion: </strong>The present study documents the high prevalence of facet syndrome in patients with LSS and the clinical benefits associated with the use of facet fusion cages to reduce facet-generated back pain.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"16 3","pages":"343-348"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of cage position, radiographic parameters, and hounsfield units on subsidence rate after one to three level anterior cervical discectomy and fusion.","authors":"Jarod Olson, Jonathan F Dalton, Omar H Tarawneh, Rajkishen Narayanan, Alec Giakas, Rachel Huang, Joydeep Baidya, Robert J Oris, Joshua Mathew, William A Green, Nicholas B Pohl, Anthony LaBarbiera, Benjamin Crain, Nathaniel Pineda, Joseph Rajasekaran, Gordon Hua, Mark F Kurd, Jeffrey Rihn, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher Kepler, Gregory Schroeder","doi":"10.4103/jcvjs.jcvjs_119_25","DOIUrl":"10.4103/jcvjs.jcvjs_119_25","url":null,"abstract":"<p><strong>Study design: </strong>The study design was a retrospective cohort.</p><p><strong>Objective: </strong>The objective of the study was to validate the relationship between Hounsfield units (HU) and subsidence, including multilevel anterior cervical discectomy and fusion (ACDF). Cage/graft subsidence commonly occurs after ACDF. Prior work on 1-level ACDF found increased subsidence rates in patients with lower HUs.</p><p><strong>Materials and methods: </strong>Adults who underwent 1-3 level ACDF at a tertiary center and had preoperative computed tomography scans were included (2018-2022). HUs were assessed ~5 mm caudal to the superior endplate. Six-month postoperative radiographs were evaluated for cage/graft positioning, screw loosening, and subsidence. Receiver operating characteristic curves and area under the curve (AUC) assessed the predictive value of segmental/minimum/maximum HU for screw loosening and/or subsidence.</p><p><strong>Results: </strong>Forty-two patients (82 levels) were included - demographics were similar among patients with versus without subsidence at any level. Average HU, segmental HU, segmental HU above and below 343.7 HU, minimum HU, and maximum HU were similar between patients with versus without subsidence at any level. Among the HU measurements, the maximum AUC was 0.554 (95% confidence interval 0.421-0.687) for screw loosening as predicted by minimum HU with a cutoff of 313 HU. Subsidence was more associated with middle positioning compared to anterior (28.0% vs. 10.5%, <i>P</i> = 0.046).</p><p><strong>Conclusions: </strong>Contrary to prior literature, this study found no association and minimal predictive ability of segmental, minimum, or maximum HU values and subsidence or screw loosening after 1-3 level ACDF. Middle positioning was associated with cage/graft subsidence. This suggests that central positioning of the cage/graft is a risk factor for subsidence, potentially due to softer cancellous bone centrally.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"16 3","pages":"349-355"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical disc arthroplasty in Australia: An epidemiological study.","authors":"Matthew Dowsett, Adam R George, Zac Dragan, Christopha J Knee, Brahman S Sivakumar, Ryan J Campbell, Michael Symes","doi":"10.4103/jcvjs.jcvjs_138_25","DOIUrl":"10.4103/jcvjs.jcvjs_138_25","url":null,"abstract":"<p><strong>Introduction: </strong>Favorable clinical outcomes have been reported for cervical disc arthroplasty (CDA), particularly in preserving motion and reducing adjacent segment disease compared with anterior cervical discectomy and fusion. However, evidence on the uptake of CDA in clinical practice remains limited. This study aimed to analyze Australian population trends in CDA over the past 6 years.</p><p><strong>Methods: </strong>The 6-year incidence of CDA in adult patients from 2019 to 2024 was analyzed using the Medicare Benefits Schedule (MBS) database. Data were stratified by sex and year, with population adjustments to account for demographic changes over the study period.</p><p><strong>Results: </strong>A total of 4216 CDA procedures were performed in Australia under the MBS over the 6-year period. The annual mean case volume was 702.7 cases. Procedure volumes remained relatively stable from 2019 to 2021, with a reduction in case numbers thereafter. The highest concentration of procedures occurred in the 35-54 (62.28%) age group (<i>P</i> < 0.001). The distribution across sex was similar, with 2147 cases (50.93%) in males and 2069 cases (49.07%) in females.</p><p><strong>Conclusions: </strong>Although there is growing evidence supporting the safety and efficacy of CDA, its utilization in Australia has remained stable over the past 6 years, with the highest uptake among young to middle-aged patients. Further analysis of utilization trends may help identify factors influencing adoption and guide future surgical practice.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"16 3","pages":"356-359"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}