Asian Spine Journal最新文献

{"title":"Bone fusion materials: past, present, and future.","authors":"Young-Hoon Kim, Ki-Won Kim, Kee-Won Rhyu, Jong-Beom Park, Jae-Hyuk Shin, Young-Yul Kim, Jun-Seok Lee, Joong-Hyun Ahn, Ji-Hyun Ryu, Hyung-Youl Park, Sang-Il Kim","doi":"10.31616/asj.2024.0520","DOIUrl":"https://doi.org/10.31616/asj.2024.0520","url":null,"abstract":"<p><p>Bone fusion is one of the mainstay managements for degenerative spinal diseases and critical-sized bone defects resulting from trauma, tumors, infection, and nonunion. Bone graft materials are required for promoting bone healing, with autografts historically considered the gold standard due to their osteogenic, osteoinductive, and osteoconductive properties. However, donor site morbidities have led to the development of alternative bone graft substitutes. Currently available alternative options for bone fusion include allografts, ceramics, demineralized bone matrix (DBM), and bone morphogenetic proteins (BMPs). Each material has its advantages and disadvantages. Allografts avoid donor site morbidities but lack osteogenic properties and pose disease transmission risks. DBMs are acid-extracted allografts that have osteoconductive and osteoinductive properties but require combination with autografts because of the lack of evidence for their stand-alone use. BMP-2 has potent osteoinductive properties and is considered an ideal fusion material, but faces unresolved challenges related to optimal dosage and carrier. Synthetic peptides, mimicking the cell-binding domain of type I collagen, facilitate the attachment of osteogenic cells (such as osteoblasts) to the graft material and the production of extracellular matrix, leading to improved bone growth at the fusion site. The development of materials with ideal properties is a research hotspot. Recent advancements in biomaterials, such as hydrogels, nanomaterials, and three-dimensional-printed biomaterials, offer promising future options for bone fusion. This review provides an overview of available bone fusion materials, their advantages and disadvantages, and introduces emerging candidate options for bone fusion.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dystrophinopathy in the paravertebral muscle of adolescent idiopathic scoliosis: a prospective case-control study in China.","authors":"Junyu Li, Danfeng Zheng, Zekun Li, Jiaxi Li, Zexi Yang, Xiang Zhang, Yingshuang Zhang, Miao Yu","doi":"10.31616/asj.2024.0299","DOIUrl":"https://doi.org/10.31616/asj.2024.0299","url":null,"abstract":"<p><strong>Study design: </strong>A prospective case-control study.</p><p><strong>Purpose: </strong>This prospective case-control study aimed to analyze the paravertebral muscle changes in patients with adolescent idiopathic scoliosis (AIS) and determine paravertebral myopathological changes associated with the clinical progression of AIS.</p><p><strong>Overview of literature: </strong>The incidence of AIS is significant globally and worsens before bone maturation, causing a serious effect. Many studies have investigated its causes-such as genetic, epigenetic, and hormonal factors-but more research remains warranted.</p><p><strong>Methods: </strong>This study enrolled 40 patients with AIS, 20 patients with congenital scoliosis (CS), and 20 patients with spinal degenerative disease (SDD). All patients underwent open posterior surgery in our hospital, and a paravertebral muscle (multifidus muscle) biopsy was performed intraoperatively. This study included many indexes that describe muscle, especially dystrophin staining. The above pathological results were compared among the AIS, CS, and SDD groups. The correlation between the Cobb angle and Nash-Moe classification and the above pathological results was analyzed in patients with AIS.</p><p><strong>Results: </strong>Significant reductions in the dystrophin staining of dystrophin-1 (p<0.001), dystrophin-2 (p<0.001), and dystrophin-3 (p<0.001) were observed in the AIS group than in the CS and SDD groups. The higher the Nash-Moe classification in the AIS group, the more significant the loss of dystrophin-2 (p=0.042) in the convex paraspinal muscles. Additionally, a significantly positive correlation was observed between the reductions of dystrophin-2 on the concave side of the AIS group and Cobb angle (p=0.011).</p><p><strong>Conclusions: </strong>Dystrophin protein deficiency in the paraspinal muscles plays a crucial role in AIS formation and progression. The severity of scoliosis in patients with AIS is correlated with the extent of dystrophin loss in the paravertebral muscles. Therefore, dystrophin dysfunction may be relevant to AIS occurrence and development.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging of the lumbar spine: can we reach a consensus and have norms? A plea to colleagues in radiology India.","authors":"Arvind G Kulkarni, Abhijeet D Wadi, Shankargouda R Patil, Meet K Shah, Ponnam Ragha Midhun, Sunil S Chodavadiya","doi":"10.31616/asj.2024.0389","DOIUrl":"https://doi.org/10.31616/asj.2024.0389","url":null,"abstract":"<p><strong>Study design: </strong>An analytical study.</p><p><strong>Purpose: </strong>To analyze the inadequacies of magnetic resonance imaging (MRI) films provided by diagnostic centers, leading to questionable and inconclusive diagnoses.</p><p><strong>Overview of literature: </strong>No literature is currently available on this subject.</p><p><strong>Methods: </strong>Lumbosacral MRI films of patients who visited the outpatient department between January 2023 and March 31, 2024, were evaluated to check for technical inadequacies.</p><p><strong>Results: </strong>A total of 1,150 lumbar MRI sets from 100 MRI centers were examined. Thirty-five percent did not include T1 axial images, and 8% did not include T1 sagittal images. Thirty-eight percent did not specify the sagittal image sequencing (right-to-left or left-to-right). Eighty-five percent of the sagittal images were profiled from right to left, and 15% were profiled from left to right. Macnab's recommendation was not followed in 970 sets. The axial sectioning of the scout films was nonparallel to the examined segment in 350 sets. The sacroiliac joint was not screened in 40% of the sets. The number of plates provided ranged from two to six films.</p><p><strong>Conclusions: </strong>Based on the results obtained, we strongly recommend that radiologists form structured guidelines to be followed by MRI centers to ensure uniformity, address inadequacies, and minimize the chance of errors in diagnosis and subsequent treatment.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcome of vertebroplasty alone versus short-segment posterior instrumentation with vertebroplasty in osteoporotic vertebral fracture: a propensity-score-matched analysis.","authors":"Borriwat Santipas, Nath Adulkasem, Korawish Mekariya, Ekkapoj Korwutthikulrangsri, Monchai Ruangchainikom, Werasak Sutipornplalangkul","doi":"10.31616/asj.2024.0231","DOIUrl":"https://doi.org/10.31616/asj.2024.0231","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study with propensity-score-matched analysis.</p><p><strong>Purpose: </strong>To compare the efficacy of vertebroplasty (VP) versus short-segment posterior instrumentation (SS) with VP in patients with osteoporotic vertebral fractures (OVFs).</p><p><strong>Overview of literature: </strong>OVFs significantly affect the aging population, causing pain, reduced mobility, and increased dependence. Treatment guidelines vary, and a consensus on the most effective approach remains unclear. To the best of our knowledge, no previous report focused on the efficacy comparison of VP alone versus SS with VP.</p><p><strong>Methods: </strong>The study included patients with OVFs undergoing VP with or without SS from 2017 to 2021. Baseline demographic and patient-reported outcome scores, including Oswestry Disability Index (ODI) and European Quality-of-Life-5 Dimensions (EQ-5D), were collected preoperatively and 1 year postoperatively. Radiographic outcomes, including Cobb angle, sagittal angle reduction, and kyphotic progression, were assessed. Perioperative data were gathered. Propensity-score matching was conducted to compare both groups after adjusting for baseline characteristics.</p><p><strong>Results: </strong>This study included 60 patients. The subsequent analyses included 19 patients in both the SS+VP group and the VP groups after matching patient cohorts across various covariates. The SS+VP group demonstrated better ODI (30.38±17.12 vs. 49.68±19.43, p=0.0025) and EQ-5D scores (0.80±0.19 vs. 0.6±0.31, p=0.0018) at 1 year postoperative. Sagittal angle correction was higher in the SS+VP group (10.63°±6.34° vs. 5.74°±5.91°, p=0.0188). The SS+VP group exhibited higher blood loss and longer operative time. Perioperative complications, kyphotic progression, adjacent fractures, and reoperation rates were similar between the two groups.</p><p><strong>Conclusions: </strong>SS with VP generated superior patient-reported outcomes and sagittal angle correction for OVFs when evaluated one year postoperatively compared to VP alone. Perioperative complications, kyphotic progression, adjacent fractures, and reoperation rates were similar despite increased blood loss and extended operative time.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance and clinical implications of machine learning models for detecting cervical ossification of the posterior longitudinal ligament: a systematic review.","authors":"Wongthawat Liawrungrueang, Sung Tan Cho, Watcharaporn Cholamjiak, Peem Sarasombath, Nattaphon Twinprai, Prin Twinprai, Inbo Han","doi":"10.31616/asj.2024.0452","DOIUrl":"https://doi.org/10.31616/asj.2024.0452","url":null,"abstract":"<p><p>Ossification of the posterior longitudinal ligament (OPLL) is a significant spinal condition that can lead to severe neurological deficits. Recent advancements in machine learning (ML) and deep learning (DL) have led to the development of promising tools for the early detection and diagnosis of OPLL. This systematic review evaluated the diagnostic performance of ML and DL models and clinical implications in OPLL detection. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/Medline and Scopus databases were searched for studies published between January 2000 and September 2024. Eligible studies included those utilizing ML or DL models for OPLL detection using imaging data. All studies were assessed for the risk of bias using appropriate tools. The key performance metrics, including accuracy, sensitivity, specificity, and area under the curve (AUC), were analyzed. Eleven studies, comprising a total of 6,031 patients, were included. The ML and DL models demonstrated high diagnostic performance, with accuracy rates ranging from 69.6% to 98.9% and AUC values up to 0.99. Convolutional neural networks and random forest models were the most used approaches. The overall risk of bias was moderate, and concerns were primarily related to participant selection and missing data. In conclusion, ML and DL models show great potential for accurate detection of OPLL, particularly when integrated with imaging techniques. However, to ensure clinical applicability, further research is warranted to validate these findings in more extensive and diverse populations.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atlantodentoplasty using the anterior retropharyngeal approach for treating irreducible atlantoaxial dislocation with atlantodental bony obstruction: a retrospective study.","authors":"Jia Shao, Yun Peng Han, Yan Zheng Gao, Kun Gao, Ke Zheng Mao, Xiu Ru Zhang","doi":"10.31616/asj.2024.0362","DOIUrl":"https://doi.org/10.31616/asj.2024.0362","url":null,"abstract":"<p><strong>Study design: </strong>This was a retrospective study.</p><p><strong>Purpose: </strong>The current study aimed to investigate the clinical efficacy of atlantodentoplasty using the anterior retropharyngeal approach against irreducible atlantoaxial dislocation with atlantodental bony obstruction.</p><p><strong>Overview of literature: </strong>In cases of atlantoaxial dislocation with atlantodental bony obstruction, owing to the presence of an osteogenic mass between the atlas and odontoid process, reduction is challenging to complete using the posterior approach. Transoral odontoidectomy is technically demanding and is associated with several risks.</p><p><strong>Methods: </strong>The clinical data of 26 patients diagnosed with irreducible atlantoaxial dislocation complicated by atlantodental bony obstruction were analyzed retrospectively. All patients underwent anterior retropharyngeal atlantodentoplasty, followed by posterior occipitocervical fusion. Details including surgical duration and blood loss volume were recorded. Radiographic data such as the anterior atlantodental interval, O-C2 angle, space available for the cord, clivus-canal angle, and cervical medullary angle, and clinical data including the Japanese Orthopedic Association (JOA) score were assessed. The fusion time of the grafted bone and the development of complications were examined.</p><p><strong>Results: </strong>In patients undergoing anterior retropharyngeal atlantodentoplasty, the surgical duration and blood loss volume were 120.1±16.4 minutes and 100.6±33.5 mL, respectively. The anterior atlantodental interval decreased significantly after the surgery (p <0.001). The O-C2 angle, space available for the cord, clivus-canal angle, and cervical medullary angle increased significantly after the surgery (p <0.001). The JOA score during the latest follow-up significantly increased compared with that before the surgery (p <0.001). The improvement rate of the JOA score was 80.8%±18.1%. The fusion time of the grafted bone was 3-8 months, with an average of 5.7±1.5 months. In total, 11 patients presented with postoperative dysphagia and three with irritating cough. However, none of them exhibited other major complications.</p><p><strong>Conclusions: </strong>Anterior retropharyngeal atlantodentoplasty can anatomically reduce the atlantoaxial joint with a satisfactory clinical outcome in patients with irreducible atlantoaxial dislocation with atlantodental bony obstruction.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical spondylotic myelopathy and radiculopathy: a stepwise approach and comparative analysis of surgical outcomes: a narrative review of recent literature.","authors":"Min-Woo Kim, Ye-Soo Park, Chang-Nam Kang, Sung Hoon Choi","doi":"10.31616/asj.2024.0465","DOIUrl":"https://doi.org/10.31616/asj.2024.0465","url":null,"abstract":"<p><p>Selecting the optimal surgical treatment for multilevel cervical spondylotic myelopathy and radiculopathy significantly affects symptom improvement, postoperative prognosis, and quality of life. Proper patient selection and precise surgical execution are crucial for achieving successful outcomes, considering the favorable natural course of cervical radiculopathy. Several factors must be considered, including the number of affected segments, spinal alignment, kyphosis degree, stiffness, and surgeon expertise, when determining the surgical approach for cervical spondylotic myelopathy. An anterior approach is commonly used in cases that involve fewer than three segments with mild kyphosis, whereas posterior laminoplasty or anterior cervical discectomy and fusion (ACDF) are effective for cases with more than three segments with maintained lordosis. Both the degree of stiffness and spinal cord compression need to be considered for cases with kyphotic deformity. ACDF may be suitable when anterior structures are the primary source of compression and mild kyphosis is present. The decision between laminoplasty or laminectomy and fusion depends on the kyphosis degree for multilevel compression with kyphosis. An evaluation of cervical rigidity is required for severe kyphosis, and posterior laminectomy and fusion may be effective for flexible kyphosis, whereas a staged posterior-anterior-posterior approach may be required for rigid kyphosis to address both deformity and neural compression. This review summarizes recent research and presents illustrative cases of optimal surgical decision-making for various cervical spondylotic radiculopathy and myelopathy presentations.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography Hounsfield unit values as a treatment response indicator for spinal metastatic lesions in patients with non-small-cell lung cancer: a retrospective study in Japan.","authors":"Hiroshi Taniwaki, Sho Dohzono, Ryuichi Sasaoka, Kiyohito Takamatsu, Masatoshi Hoshino, Hiroaki Nakamura","doi":"10.31616/asj.2024.0334","DOIUrl":"https://doi.org/10.31616/asj.2024.0334","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Purpose: </strong>This study aimed to determine the impact of increased Hounsfield unit (HU) values for metastatic spinal lesions measured via computed tomography on the overall survival of patients with non-small-cell lung cancer (NSCLC) and identify factors associated with increased HU values in metastatic spinal lesions.</p><p><strong>Overview of literature: </strong>Previous studies have underscored the utility of the HU as a marker of treatment response in metastatic bone lesions. However, no prior studies have explored the relationship between HU changes in response to treatment and overall survival in patients with NSCLC.</p><p><strong>Methods: </strong>This study included a total of 85 patients between 2016 and 2021. Nonsurgical treatments were provided by the respiratory medicine department. HU values for metastatic spinal lesions were evaluated upon diagnosis of spinal metastasis (baseline) and at 3, 6, and 12 months thereafter. Patients were then divided into two groups based on the median HU increase from baseline to 3 months. Overall survival was assessed using the Kaplan-Meier method.</p><p><strong>Results: </strong>Based on the median change in HU value (124), 42 and 43 patients were categorized into the HU responder and non-responder groups, respectively. The median overall survival was significantly longer in the HU responder group than in the HU non-responder group (13.7 months vs. 6.4 months, p <0.001). Multiple linear regression analysis revealed that the use of antiresorptive agents and molecularly targeted therapies were factors significantly associated with an increase in HU.</p><p><strong>Conclusions: </strong>An increase in HU values for metastatic spinal lesions after 3 months of treatment was correlated with a significantly longer overall survival in patients with NSCLC. Thus, HU measurements may not only serve as an easy and quantitative approach for evaluating treatment response in metastatic spinal lesions but also predict overall survival.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic surgery for multilevel spinal stenosis: a comprehensive meta-analysis and subgroup analysis of uniportal and biportal approaches.","authors":"Manuel González-Murillo, Juan Castro-Toral, César Bonome-González, Juan Álvarez de Mon-Montoliú","doi":"10.31616/asj.2024.0171","DOIUrl":"https://doi.org/10.31616/asj.2024.0171","url":null,"abstract":"<p><p>Minimally invasive spine surgery (MIS) has shown promising results, and endoscopic spine surgery has emerged as a less invasive approach. Although studies have examined the effectiveness of endoscopic surgery for spinal stenosis, no meta-analyses have focused on multilevel cases. This meta-analysis aimed to evaluate the efficacy and safety of uniportal and biportal endoscopy in patients with multilevel spinal stenosis. The patient, intervention, comparison, outcomes, and study criteria were established to guide study selection. Four databases were searched. The outcome measures included patient-reported outcome measures (PROMs), radiological and analytical data, complications, surgery time, length of hospital stay, and blood loss. Review Manager ver. 5.4 software (RevMan; Cochrane, UK) was used for the analysis. Heterogeneity was assessed using the chi-square and I2 tests. Ten studies (n=686) were included. PROMs showed significant improvements in Visual Analog Scale (VAS) scores for back pain (mean difference [MD], 4.07; 95% confidence intervals [CI], 3.72-4.42), leg pain (MD, 5.49; 95% CI, 5.17-5.80), and Oswestry Disability Index (MD, 35.97; 95% CI, 32.46-39.47). MacNab scale results were as follows: excellent (55.37%), good (34.93%), fair (7.58%), and poor (4.06%). C-reactive protein levels did not change significantly; however, hemoglobin levels decreased postoperatively (MD, 1.28; 95% CI, 0.91-1.65). Complications included dural tears (5.46%), hematoma (4.30%), incomplete decompression (3.12%), root injury (2.90%), reoperations/revisions (2.22%), conversion to open or microscopic surgery (1.97%), and transfusions (8.50%). Analysis by levels showed worse VAS leg pain in studies analyzing >30% multilevel stenosis (MD, 4.99; 95% CI, 4.47-5.51 vs. MD, 5.82; 95% CI, 5.63-6.01). Uniportal and biportal endoscopy had similar outcomes, except for a higher incidence of dural tears on biportal endoscopy (uniportal, 3.33%; biportal, 7.05%). This meta-analysis supports endoscopy as an effective and safe option for multilevel lumbar stenoses. It improves long-term pain and functionality, with no significant radiological changes or postoperative inflammation. Complications are few; however, dural tears are more common in biportal endoscopy. Higher multilevel stenosis rates were associated with increased leg pain and a lower likelihood of achieving incomplete decompression.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforaminal interbody debridement and fusion with antibiotic-impregnated bone graft to treat pyogenic discitis and vertebral osteomyelitis: a comparative study in Asian population.","authors":"Chao-Chien Chang, Hsiao-Kang Chang, Meng-Ling Lu, Adam Wegner, Re-Wen Wu, Tsung-Cheng Yin","doi":"10.31616/asj.2024.0388","DOIUrl":"https://doi.org/10.31616/asj.2024.0388","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Purpose: </strong>To evaluate whether using antibiotic-impregnated bone graft (AIBG) enhances infection control and shortens the postoperative course of pyogenic discitis and vertebral osteomyelitis (PDVO).</p><p><strong>Overview of literature: </strong>Surgical treatment of PDVO is indicated for neurological deficit, instability, unknown pathogen, or poorly controlled infection. The posterior-only approach is effective but requires 4-6 weeks of antibiotic treatment postoperatively. We hypothesized that AIBG used in an all-posterior approach could enhance infection control and shorten the postoperative course of PDVO.</p><p><strong>Methods: </strong>Thirty patients with PDVO of the lumbar or thoracic spine treated with transforaminal interbody debridement and fusion (TIDF) with AIBG between March 2014 and May 2022 were reviewed (AIBG group). For comparative analysis, 28 PDVO patients who underwent TIDF without AIBG between January 2009 and June 2011 were enrolled (non-AIBG group). The minimum follow-up duration was 2 years. Clinical characteristics and surgical indications were comparable in the two groups. C-reactive protein (CRP) levels and the postoperative antibiotics course were compared between the two groups.</p><p><strong>Results: </strong>Surgical treatment for PDVO resulted in clinical improvement and adequate infection control. Despite the shorter postoperative intravenous antibiotic duration (mean: 19.0 days vs. 39.8 days), the AIBG group had significantly lower CRP levels at postoperative 4 and 6 weeks. The mean Visual Analog Scale pain scores improved from 7.3 preoperatively to 2.2 at 6 weeks postoperatively. The average angle correction at the last follow-up was 7.9°.</p><p><strong>Conclusions: </strong>TIDF with AIBG for PDVO can achieve local infection control with a faster reduction in CRP levels, leading to a shorter antibiotic duration.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}