Asian Spine Journal最新文献

{"title":"Lumbar spinal stenosis: current concept of management.","authors":"Ji-Won Kwon, Kyung-Soo Suk, Seong-Hwan Moon, Si-Young Park, Namhoo Kim, Sub-Ri Park, Jae-Won Shin, Hak-Sun Kim, Byung Ho Lee","doi":"10.31616/asj.2025.0198","DOIUrl":"https://doi.org/10.31616/asj.2025.0198","url":null,"abstract":"<p><p>Lumbar spinal stenosis (LSS) is a common degenerative spinal condition where spinal canal narrowing causes symptoms such as neurogenic claudication, radiculopathy, and lower back pain. While non-operative and surgical approaches yield similar long-term outcomes, surgical intervention-particularly decompression-can provide earlier symptom relief, functional recovery, and fall prevention in selected patients with refractory symptoms. Recent advancements in surgical technologies and image guidance have brought about a paradigm shift in LSS management. Biportal endoscopic spine surgery (BESS) has gained global traction as a minimally invasive alternative to traditional decompression methods, offering superior visualization, less soft tissue damage, shorter hospital stays, and faster recovery. High-quality studies, including randomized controlled trials, have shown promising outcomes for this technique. Furthermore, the integration of navigation systems, robot-assisted instrumentation, and artificial intelligence (AI)-driven diagnostics and surgical planning tools is transforming spinal surgery by enhancing precision in preoperative evaluation and intraoperative execution. These innovations enable accurate targeting, reduce complications, and improve reproducibility across diverse surgical settings. This review provides an updated overview of LSS, covering its pathophysiology, clinical assessment, diagnosis, and treatment. Special emphasis is placed on the growing role of BESS and the transformative impact of digital technologies such as navigation, robotics, and AI in the evolving landscape of spinal stenosis care.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282244","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":"Letter to the Editor: Rapid bodyweight reduction before lumbar fusion surgery increased postoperative complications.","authors":"Sanjay Rawat, Sarvdeep Dhatt, Vijay Goni, Vishal Kumar, Devendra Chouhan","doi":"10.31616/asj.2020.0611.r1","DOIUrl":"https://doi.org/10.31616/asj.2020.0611.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198175","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":"Modified Wiltse approach versus conventional posterior approach for treating single-segment spinal tuberculosis and infections: a retrospective study of 102 cases in Guangxi Province, China.","authors":"Abu Moro, ShiAn Liao, Yue Fan, Yihan Wang, Wenfei Gu, Xinli Zhan, JinSong Yang","doi":"10.31616/asj.2024.0440","DOIUrl":"https://doi.org/10.31616/asj.2024.0440","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Purpose: </strong>To compare the modified Wiltse with the conventional posterior approach for single-segment spinal tuberculosis/infections.</p><p><strong>Overview of literature: </strong>Spinal infections (such as spondylitis, discitis, and spondylodiscitis) are therapeutically challenging owing to their pathophysiological complexities and delayed diagnosis, particularly in developing countries. Despite treatment advancements, challenges persist, which include multidrug resistance and surgery-related complications.</p><p><strong>Methods: </strong>A retrospective analysis of 102 patients who underwent single-segment spinal tuberculosis surgery was conducted to compare patients who underwent surgery using the conventional posterior with those using the modified Wiltse approach. The key parameters analyzed included surgical duration, blood loss, complication rates, intensive care unit stay, deformity correction, and neurological improvement.</p><p><strong>Results: </strong>The modified Wiltse group exhibited lower intraoperative hemorrhage (184.72 mL vs. 365.91 mL, p<0.05) without significant differences in surgery duration and other tested outcomes. Both groups demonstrated significant improvement in thoracic kyphosis over time (p<0.01) and between the groups, with pairwise comparisons showing significant improvement from preoperative to postoperative and from preoperative to follow-up (p<0.01) but not from postoperative to follow-up, demonstrating postoperative kyphotic stability. Significant improvements in lumbar lordosis (p=0.047) and within the groups (p=0.002) were observed over time; however, pairwise comparisons did not reveal significant differences (p >0.05), demonstrating surgical intervention that focused on lordotic stability rather than correction in both groups. Significant neurological improvements were also observed, with the modified Wiltse group demonstrating superior recovery to the conventional posterior group from baseline.</p><p><strong>Conclusions: </strong>The modified Wiltse approach offers a promising alternative to conventional techniques by reducing intraoperative blood loss while maintaining efficacy in deformity correction and neurological recovery. It is a viable option for patients who require reduced invasiveness and blood loss.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198176","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":"Preliminary clinical study of outpatient anterior cervical discectomy and fusion in Chinese Han patients: a retrospective analysis.","authors":"Lun Luo, Zhizhong Chen, Jun Dai, Xushen Zhao, Zhentao Zhou, Min Zhang, Xiaozhong Zhou","doi":"10.31616/asj.2024.0341","DOIUrl":"https://doi.org/10.31616/asj.2024.0341","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective analysis.</p><p><strong>Purpose: </strong>To investigate the safety, clinical efficacy, and health economic benefits of anterior cervical discectomy and fusion (ACDF) among Chinese Han patients in an outpatient setting.</p><p><strong>Overview of literature: </strong>For years, ACDF has been conducted in an outpatient setting in Western countries. However, studies addressing whether this type of surgery carries the same level of safety and clinical efficacy for Chinese Han patients are scarce.</p><p><strong>Methods: </strong>A retrospective analysis was conducted based on the clinical data of Han patients who underwent ACDF between January 2022 and May 2024. A total of 84 patients were included, and 1:1 propensity score matching was employed between 42 patients who underwent outpatient ACDF and 42 who underwent inpatient ACDF before evaluating the safety and clinical efficacy.</p><p><strong>Results: </strong>The mean follow-up period was 3.9 months (range, 1-12 months). The fibrinogen and activated partial thromboplastin time of the outpatient and inpatient groups were comparable, which were different from the data of Caucasians in the literature. No significant differences in adverse events within 30 days following the surgery were found between the outpatient (28.6%) and inpatient (33.3%) groups. No significant differences in the Japanese Orthopaedic Association score and Neck Disability Index were noted between the two groups 1 month before and after the surgery. The readmission rates were low in the outpatient group 30 days after surgery (2.4%).</p><p><strong>Conclusions: </strong>Consistent with the Caucasian and Black, one- to two-level ACDF conducted on Chinese Han patients in an outpatient setting demonstrated comparable safety and clinical effectiveness to routine inpatient settings.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198177","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":"Associations between preoperative opioids, posthospitalization discharge disposition, and long-term opioid prescribing after spine surgery: a population-based cohort study.","authors":"Savannah Rose Whitfield, Andrew Charles Hanson, Erica Bellamkonda, Maria Mendoza De La Garza, Xander Schmidt, William Michael Hooten, Nafisseh Sirjani Warner","doi":"10.31616/asj.2024.0414","DOIUrl":"https://doi.org/10.31616/asj.2024.0414","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Purpose: </strong>To evaluate the association between preoperative opioid use and discharge disposition following major spine surgery and between discharge disposition and opioid availability through 1 year postoperatively.</p><p><strong>Overview of literature: </strong>Preoperative opioid use is prevalent in spine surgery and is associated with larger postoperative opioid consumption, longer hospitalizations, increased healthcare expenses, and greater risk of surgical revision. However, whether preoperative opioid use is associated with discharge disposition following major spine surgery, which may serve as an indicator of postoperative functional recovery, remains unclear.</p><p><strong>Methods: </strong>This retrospective population-based cohort study incorporated comprehensive prescription opioid information for 2223 adults (age ≥18 years) undergoing spine surgery in Olmsted County, Minnesota, between January 1, 2005, and December 31, 2016. Multivariable models were employed to assess the relationships among preoperative opioid exposures, postoperative opioid exposures, and discharge disposition (home, inpatient rehabilitation facility [IRF], and skilled nursing facility [SNF]).</p><p><strong>Results: </strong>A total of 2,223 adults were included with the following preoperative opioid availability: none (778 [35.0%]), short term (1,118 [50.3%]), episodic (227 [10.2%]), and long term (100 [4.5%]). Discharge dispositions were home (1,984 [89.2%]), IRF (94 [4.2%]), and SNF (145 [6.5%]). Compared with patients with no preoperative opioid availability, those with short-term or episodic opioid availability are less likely to be discharged to an IRF (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.36-0.87; p=0.010). Patients with long-term opioid availability had significantly increased odds of SNF discharge (OR, 2.93; 95% CI, 1.39-6.17; p=0.005). At 1-year follow-up, patients discharged to IRF had an increased likelihood of long-term postoperative opioid availability compared with those discharged home (OR, 12.49; 95% CI, 4.84-32.24; p<0.001).</p><p><strong>Conclusions: </strong>Preoperative opioid prescribing was associated with post-hospitalization discharge disposition, which in turn was associated with opioid prescribing patterns 1 year postoperatively. Assessing opioid prescribing trends preoperatively may guide discussions regarding anticipated discharge disposition following spine surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198173","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":"Role of preoperative Hounsfield units in predicting subsidence after anterior cervical discectomy and fusion in the United States: a retrospective analysis including osteopenia diagnosis.","authors":"Wasil Ahmed, Akiro Duey, Rami Rajjoub, Timothy Hoang, Bashar Zaidat, Zachary Milestone, Jiwoo Park, Christopher Gonzalez, Pierce Jr Ferriter, Junho Song, Jun Kim, Samuel Cho","doi":"10.31616/asj.2024.0214","DOIUrl":"https://doi.org/10.31616/asj.2024.0214","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Purpose: </strong>This study aimed to investigate the relationship among osteopenia, bone density, and subsidence following anterior cervical discectomy and fusion (ACDF).</p><p><strong>Overview of literature: </strong>Subsidence following ACDF procedures can lead to worse clinical outcomes. Although studies have linked osteopenia to cage subsidence, no consensus has been established on the relationship between bone density and subsidence.</p><p><strong>Methods: </strong>Patients undergoing ACDF between 2016 and 2021 were included and assigned to the osteopenia cohort based on chart review and dual-energy X-ray absorptiometry scan results. Bone density at each vertebral level of the cervical fusion was assessed by measuring Hounsfield units from preoperative computed tomography (CT) scans, and disk height changes were assessed using immediate postoperative (<6 weeks) and final follow-up (>5 months) radiographs. Subsidence was quantified by the difference between the long-term and immediate postoperative anterior and posterior disk heights. A t-test was performed to evaluate the effect of prior osteopenia diagnosis on segmental subsidence. Multivariable analysis, accounting for age, sex, smoking status, and cage type, further investigated the relationship between Hounsfield units and subsidence.</p><p><strong>Results: </strong>Among the 131 patients (244 levels fused), no significant associations were found between osteopenia diagnosis and anterior (p=0.926) or posterior (p=0.918) subsidence. Preoperative CT measurements for 28 patients (54 fused levels) revealed no correlations between subsidence and Hounsfield units at the vertebral levels above and below the fusion. Of the 54 levels with preoperative CT scans, 22 patients (41%) were diagnosed with osteopenia. Osteopenia did not correlate with Hounsfield units using the endplate (superior, p=0.735; inferior, p=0.693), full vertebrae (superior, p=0.686; inferior, p=0.735), or elliptical (superior, p=0.501; inferior, p=0.465) methods.</p><p><strong>Conclusions: </strong>The results did not reveal the relationship between either the prior diagnosis of osteopenia or Hounsfield units and subsidence. These results highlight the multifactorial nature of postoperative subsidence, and osteopenia or Hounsfield units cannot be used alone to determine the subsidence risk.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198178","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":"Effect of rehabilitation timing on the functional, vocational, and psychological outcomes in patients with paraplegia secondary to traumatic spinal cord injury: a retrospective cohort study.","authors":"R Dinesh Iyer, Pranavakumar Palaninathan, Prashasth Belludi Suresh, Vignesh Gunasekaran, Sathiyamoorthi Periyaswamy, Ajoy Prasad Shetty, K S Sri Vijayanand, Rishi Mugesh Kanna, Rajasekaran Shanmuganathan","doi":"10.31616/asj.2024.0132","DOIUrl":"https://doi.org/10.31616/asj.2024.0132","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Purpose: </strong>To study the effect of rehabilitation timing on the functional, psychological, and vocational outcomes of patients with paraplegia secondary to traumatic spinal cord injury (SCI).</p><p><strong>Overview of literature: </strong>Rehabilitation of patients with SCI is vital for preventing secondary complications and early reintegration into society. However, only few studies have investigated the effects of early rehabilitation.</p><p><strong>Methods: </strong>Patients with paraplegia secondary to traumatic SCI (T2-L2) who underwent rehabilitation at our SCI Rehabilitation Center between January 2018 and December 2022 and who were followed up for at least 12 months were included. Patients were divided into three groups based on the rehabilitation timing after SCI: group 1 (early, within 2 weeks); group 2 (subacute, 2-6 weeks); and group 3 (delayed, >6 weeks). The three groups were compared in terms of functional outcomes, psychological status, and socioeconomic status after injury.</p><p><strong>Results: </strong>A total of 70 patients (62 men and eight women) were included; 30 were in group 1, 18 were in group 2, and 22 were in group 3. Compared with groups 1 and 2, group 3 showed the lowest improvement in mean±standard deviation (SD) Functional Independence Measure score (67.6±14.03 vs. 64.9±8.92 vs. 44.4±12.2, respectively; p<0.05) and significantly higher number of patients with severe (n=10) and extreme depression with suicidal tendency (n=4), with a mean±SD Beck Depression Inventory score of 32.6±8.4. The proportion of unemployed persons was significantly lower in groups 1 and 2 (30% and 27.7%, respectively) than in group 3 (72.2%, 16 of 22).</p><p><strong>Conclusions: </strong>Among patients with paraplegia, rehabilitation within 6 weeks after SCI significantly improved their functional outcomes and psychological well-being and increased their chances of employment and reintegration into society.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198174","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":"Effectiveness of intradiscal steroid injection for spinal stenosis: a retrospective cohort study in South Korea.","authors":"Jin Hwan Kim, Sung Tan Cho, Byung Jik Kim, Su Whi Chae, Wongthawat Liawrungrueang","doi":"10.31616/asj.2024.0513","DOIUrl":"https://doi.org/10.31616/asj.2024.0513","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Purpose: </strong>This study aimed to evaluate the efficacy of intradiscal steroid injection (ISI) in managing patients with spinal stenosis.</p><p><strong>Overview of literature: </strong>ISI has shown effectiveness in relieving lower back pain in patients with degenerative disc disease. However, its potential utility in managing the symptoms of spinal stenosis remains unexplored.</p><p><strong>Methods: </strong>This study included 260 patients with spinal stenosis who complained of lower back pain and radiating pain in the lower extremities. During the ISI, a mixture of 1 mL of dexamethasone 5 mg and 1 mL of ropivacaine 0.2% was administered. Pain levels were assessed at weeks 2 and 6 after ISI using the Visual Analog Scale (VAS) for back and leg pain. Patients requiring surgery within a year because of persistent or worsening symptoms were analyzed, and pain score changes between the surgical and nonsurgical groups were compared.</p><p><strong>Results: </strong>ISI significantly reduced the initial back pain VAS score (8.85) and leg pain VAS score (8.91) at weeks 2 (back pain=4.58; p<0.001, leg pain=4.42; p<0.001) and 6 (back pain=4.79; p<0.001, leg pain=4.70; p<0.001). A total of 228 patients (87.7%) showed improvement of initial symptoms without the need for surgery 1 year after ISI. The surgical and nonsurgical groups showed improvement in leg and back pain VAS scores 2 weeks after ISI. However, in the surgical group, a significant trend was noted toward worsening back and leg pain VAS score at week 6 after ISI.</p><p><strong>Conclusions: </strong>ISI effectively provided temporary pain relief for patients with lumbar spinal stenosis. The majority of patients, up to 1 year later, only necessitate conservative management of their symptoms and do not require surgery. In particular, if the improvement in pain persists up to 6 weeks after the ISI, surgical intervention may be delayed in favor of more conservative treatments.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967902","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":"Characteristics of the positional and morphological parameters of sagittal spine alignment in a cohort of 623 healthy individuals aged >50 years in China.","authors":"Wei Wang, Zheng Wang, Dongfan Wang, Chengxin Liu, Weiguo Zhu, Fumin Pan, Sitao Zhang, Xiaolong Chen, Yu Wang, Shibao Lu","doi":"10.31616/asj.2024.0466","DOIUrl":"https://doi.org/10.31616/asj.2024.0466","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective radiologic study.</p><p><strong>Purpose: </strong>To investigate the spinopelvic positional and morphological parameters of the sagittal spinal alignment in a healthy population from the community.</p><p><strong>Overview of literature: </strong>The existing parameters for spinal alignment based on the Cobb angle are the primary reference values for evaluating spinal alignment and pelvic morphology. However, they do not fully capture the comprehensive characteristics of sagittal spine alignment. More attention should be given to identifying the specific characteristics of sagittal spinal alignment by focusing on the positions of the kyphotic and lordotic apices.</p><p><strong>Methods: </strong>Among 1,250 volunteers, 623 consecutive normal community volunteers aged >50 years were recruited and underwent standing postural X-ray. A customized computer application analyzed the sagittal morphological and positional parameters, examining their normal distributions and correlations.</p><p><strong>Results: </strong>The correlation between the adjacent morphological and positional parameters was strong between the distal cervical and proximal lumbar spine. In the vertical direction, a significant association was found between the location of the thoracic kyphosis (TK) to lumbar lordosis (LL) transition point (TL point) and both the upper apex of TK (T-apex) (r=0.52) and lower apex of LL (L-apex) (r=0.64). In the horizontal direction, a moderate correlation was found between the thoracic apex offset to the femoral axis (TF) and the lumbar apex offset to the femoral axis (LF) (R2=0.314), whereas LF demonstrated a strong correlation with adjacent overhang (R2=0.685). Close correlations were observed among the morphological and positional parameters. The sacral slope exhibited significant correlations with two parameters related to the lumbar region: L-apex (r=-0.60) and LF (r=0.51).</p><p><strong>Conclusions: </strong>This study found strong correlations between spinopelvic morphology and position, which is crucial for understanding sagittal alignment. Adjacent positional parameters showed significant compliance within the sagittal spine plane from the distal cervical to proximal lumbar regions, suggesting the necessity for additional research on its clinical relevance in spinal disease surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964894","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":"Effect of the discrepancy between sacral and pelvic obliquity on postoperative disk wedging below the lower instrumented vertebra in patients with Lenke type 5 adolescent idiopathic scoliosis: a retrospective study in Japan.","authors":"Takahito Iga, Satoshi Suzuki, Kazuki Takeda, Toshiki Okubo, Masahiro Ozaki, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.31616/asj.2024.0445","DOIUrl":"https://doi.org/10.31616/asj.2024.0445","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To evaluate the effect of discrepancies between sacral and pelvic obliquity on postoperative disk wedging below the lower instrumented vertebra in Lenke type 5 adolescent idiopathic scoliosis (AIS).</p><p><strong>Overview of literature: </strong>Previous studies have not fully explored the effect of discrepancies between sacral and pelvic obliquity on postoperative outcomes in patients with Lenke type 5 AIS.</p><p><strong>Methods: </strong>Data from 35 patients with Lenke type 5 AIS (mean age, 14.7±1.8 years) followed for a minimum of 5 years were retrospectively analyzed. We investigated the effect of sacral coronal obliquity (S angle) and pelvic coronal obliquity (P angle) on postoperative coronal radiographic parameters. The angle between the S and P angles was defined as the sacral and pelvic (SP) angle. The patients were grouped by preoperative SP angle (<5°, n=23; ≥5°, n=12). Pre- and post-operative radiographic parameters were compared to determine whether the preoperative SP angle affected postoperative spinal alignment.</p><p><strong>Results: </strong>The discrepancy between SP obliquity was reduced by correction surgery 5 years postoperatively. The mean lumbar Cobb angle correction rate in the ≥5° group was significantly lower than that in the <5° group (52.1%±17.8% vs. 65.5%±12.7%), and the mean wedge angle below the lower instrumented vertebra (LIV) in the ≥5° group was significantly larger than that in the <5° group (9.0°±2.6° vs. 4.7°±3.4°) 5 years postoperatively. No significant between-group differences were observed in age, Risser grade, thoracic Cobb angle correction rate, LIV-central sacral vertical line (CSVL), and C7-CSVL. The Scoliosis Research Society-22 outcomes were comparable between the two groups.</p><p><strong>Conclusions: </strong>The ≥5° group exhibited a larger wedge angle below the LIV and lower lumbar Cobb angle correction rate than the <5° group 5 years postoperatively. Preoperative discrepancies between SP obliquity should be considered when planning corrective surgery for patients with Lenke type 5 AIS.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967399","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}