Asian Spine Journal最新文献

{"title":"Impact of patient-reported allergies and psychiatric history on lumbar interbody fusion outcomes: a retrospective cohort study in the United States.","authors":"Jason Salvato, Evan Florey, Aidan Johnson, Michael Pheasant, Alex Tang, Tan Chen","doi":"10.31616/asj.2025.0692","DOIUrl":"https://doi.org/10.31616/asj.2025.0692","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To determine whether patient-reported allergies (PRAs) are associated with pain, mobility, and functional outcomes following lumbar interbody fusion (LIF).</p><p><strong>Overview of literature: </strong>Prior studies suggest PRAs may correlate with worse postoperative pain, disability, and satisfaction; however, findings are inconsistent, and their impact on LIF outcomes remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 325 adults undergoing elective LIF for degenerative pathology (November 2019-January 2023). Patients were stratified into ≥1 PRA (n=242) and no known allergies (n=83). Demographics, psychiatric history, preoperative opioid use, and allergy type were recorded. Primary outcomes included changes in Patient-reported outcome measures (PROMs; PROMIS overall, physical, and mental health) and Oswestry Disability Index (ODI) from baseline to 1 year. Secondary outcomes included Visual Analog Scale (VAS) and Activity Measure for Post-Acute Care (AMPAC) mobility. Multivariate regression assessed associations with outcomes. Minimal clinically important difference (MCID) thresholds were ODI ≥10 and PROMIS ≥8. Receiver operating characteristic analysis evaluated PRA count as a predictor of MCID.</p><p><strong>Results: </strong>Patients with PRAs were more frequently female (57%; p=0.002) and had higher rates of psychiatric comorbidities (p=0.02). The PRA group demonstrated greater improvement in PROMIS overall (p=0.049) and mental health (p=0.026) scores, with no difference in ODI change. PRA count was not associated with VAS, AMPAC, or MCID attainment. Psychiatric history independently predicted lower odds of achieving MCID for PROMIS physical (odds ratio [OR], 0.52; p=0.048) and ODI (OR, 0.27; p=0.002). PRA count showed poor predictive value for MCID (area under the curve<0.600).</p><p><strong>Conclusions: </strong>PRAs were not associated with worse outcomes after LIF and were linked to greater improvement in PROMIS scores. Psychiatric history, but not allergy count, was a strong predictor of reduced MCID attainment.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760529","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":"Bone quality, biology, and next-generation enhancers for spinal fusion in osteoporosis: a comprehensive narrative review with systematic search methodology.","authors":"Dong-Ju Lim, Joon-Il La","doi":"10.31616/asj.2026.0186","DOIUrl":"https://doi.org/10.31616/asj.2026.0186","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Comprehensive narrative review with systematic search methodology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To consolidate current evidence on the influence of bone quality on spinal fusion outcomes and investigate the efficacy of systemic pharmacotherapies as well as emerging biologic and biomaterial enhancements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Overview of literature: &lt;/strong&gt;Impaired bone quality is common among spinal fusion candidates yet frequently remains underdiagnosed. Conventional dual-energy X-ray absorptiometry (DXA) alone underestimates bone fragility. However, novel assessment modalities, systemic pharmacotherapies, and advanced biologics and biomaterials are emerging to address this gap.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search of PubMed, EMBASE, and the Cochrane Library databases was conducted through September 2025 in accordance with the PRISMA 2020 (Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020) guidelines. Search terms included spinal fusion, osteoporosis, bone quality assessment (DXA, trabecular bone score [TBS], vertebral bone quality), antiosteoporotic medications, exosomes, Nel-like molecule type 1, gene therapy, and three-dimensional-printed scaffolds. Clinical trials, meta-analyses, and key preclinical studies were included. Of the 1,247 records identified, 53 met the inclusion criteria. Due to the broad thematic scope encompassing bone quality assessment, pharmacological optimization, and emerging biologics/biomaterials, a narrative synthesis was performed. Risk of bias was assessed employing the Cochrane Risk of Bias 2.0 tool for randomized controlled trials (RCTs) and the Newcastle-Ottawa Scale for observational studies. The certainty of evidence for major clinical recommendations was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Comprehensive assessment using TBS and Fracture Risk Assessment Tool identified impaired bone quality in 37.5% of surgical candidates, with vitamin D deficiency or insufficiency present in up to 57%. A network meta-analysis of 13 RCTs found teriparatide as significantly superior to placebo (odds ratio, 3.2; moderate certainty), while teriparatide plus denosumab exhibited the highest efficacy (surface under the cumulative ranking curve [SUCRA]=90.9). Extended teriparatide treatment (&gt;6 months) increased union rates to 87.1%. In preclinical models, mesenchymal stem cell-derived exosomes achieved 83.3% fusion in preclinical models versus 27.3% in controls (very low certainty evidence). Overall risk of bias across included RCTs was low to moderate, while most observational studies were of moderate quality per the Newcastle-Ottawa Scale.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A multimodal approach combining comprehensive bone quality assessment, systemic anabolic optimization (moderate certainty evidence), and targeted novel biologics delivered via advanced biomate","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760481","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":"Long-term outcomes of primary percutaneous endoscopic lumbar discectomy: systematic review and meta-analysis.","authors":"Conor McNamee, David Kelly, Oisin Shannon, Jake Michael McDonnell, Stacey Darwish, Joseph Simon Butler","doi":"10.31616/asj.2025.0572","DOIUrl":"https://doi.org/10.31616/asj.2025.0572","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Objectives: </strong>To evaluate long-term functional, radiological, and surgical outcomes of percutaneous endoscopic lumbar discectomy (PELD).</p><p><strong>Overview of literature: </strong>Early studies suggest that PELD achieves outcomes comparable to those of microdiscectomy with less perioperative morbidity and faster recovery, although technical challenges contribute to a steep learning curve. Long-term data remain sparse, and observational studies are necessary to assess late outcomes.</p><p><strong>Methods: </strong>A systematic search of the PubMed, Embase, and Scopus databases was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies that reported outcomes at ≥5 years after PELD were included. The Visual Analog Scale (VAS) for leg and back pain, Oswestry Disability Index (ODI), Japanese Orthopedic Association score, disc height, range of motion (ROM), complication rates, recurrent herniation, and reoperation rates were assessed. Data were extracted and pooled using random-effects meta-analysis as appropriate. The risk of bias was assessed using the National Institute of Health Quality Assessment Tool.</p><p><strong>Results: </strong>Nine studies including 2,369 patients undergoing transforaminal or interlaminar PELD with a mean follow-up of ≥5 years were analyzed. Pooled functional outcomes at ≥5 years were favorable: VAS (leg) 1.09, VAS (back) 1.18, and ODI 11.98. The proportion of patients with good/excellent results according to the MacNab criteria was 88%. Recurrence and reoperation rates were 6% and 7%, respectively, similar to those reported after microdiscectomy in historical cohorts. Radiological outcomes showed modest disc height reduction and preserved ROM without evidence of long-term instability based on flexion-extension ROM. Most complications were early, transient, and infrequent.</p><p><strong>Conclusions: </strong>PELD may provide sustained symptom relief and low rates of complication, recurrence, and reoperation in long-term follow-up. Late clinical and functional outcomes appear to be favorable. However, the predominance of retrospective data and selective loss to follow-up limits the strength of the conclusions.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760466","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":"Spinopelvic alignment in asymptomatic adults: a global meta-analysis quantifying heterogeneity and proposing a functional parameter hierarchy.","authors":"Yanis Shavlovskiy, Vladimir Nikolenko","doi":"10.31616/asj.2025.0532","DOIUrl":"https://doi.org/10.31616/asj.2025.0532","url":null,"abstract":"<p><strong>Study design: </strong>Meta-analysis.</p><p><strong>Purpose: </strong>This PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-compliant meta-analysis aimed to quantify global variation in spinopelvic parameters among asymptomatic adults, distinguish population-invariant from adaptive components, and propose a clinically relevant parameter hierarchy.</p><p><strong>Overview of literature: </strong>High variability in sagittal spinal alignment is well established. However, a meta-analysis employing standardized methodology to quantify the heterogeneity and stratify findings by geographic region has not been conducted.</p><p><strong>Methods: </strong>This systematic review identified 140 studies reporting 15 types of radiographic measurements in healthy 18-60-year-old individuals (n=1,229-15,251 subjects) from PubMed, Academia, and ResearchGate up to June 2025. The National Institutes of Health Quality Assessment Tool was used to assess the risk of bias. Parameters were regional spine curvatures, pelvic parameters, and global alignment measures. Random-effects models generated pooled estimates with 95% prediction intervals (95% pelvic incidence [PI]). Meta-regression was performed for geographic subgroup comparison.</p><p><strong>Results: </strong>All parameters demonstrated substantial heterogeneity (I2, 72%-98%), irreducible by demographic stratification. Pelvic tilt (PT) exhibited consistently low variability across populations (95% PI <5°). Bicoxofemoral axis-referenced angles-including T1 and T9 PT (T1PT and T9PT), and T1 pelvic angle (TPA)-demonstrated low variability in the available cohorts (95% PI <5°), indicating potential stability, but require further validation. The regional spine curvatures-including cervical lordosis, thoracic kyphosis, and lumbar lordosis- varied widely (95% PI >10°). PT was uniquely conserved across geographic subgroups (Δ<1°, p =0.58), with sacral slope (SS) and PI demonstrating population-specific adaptations. Major limitations include the high heterogeneity of data, measurement variability across the included studies, and the low number of included studies reporting T1PT, T9PT, and TPA.</p><p><strong>Conclusions: </strong>We propose a functional hierarchy of spinopelvic parameters based on their observed heterogeneity-from stable \"core\" to variable \"adaptive\" components. Future research is warranted to validate the potential population-invariance of currently underreported bicoxofemoral axis-referenced parameters and to evaluate whether correction strategies focused on these stable elements improve surgical outcomes.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760545","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":"Unilateral hemilaminectomy for intradural spinal tumors: a 10-year retrospective cohort study.","authors":"Mehmet Alpay Çal, Selçuk Göçmen, Muhittin Emre Altunrende, Serdar Kahraman","doi":"10.31616/asj.2025.0787","DOIUrl":"https://doi.org/10.31616/asj.2025.0787","url":null,"abstract":"<p><strong>Study design: </strong>Single-center retrospective cohort study.</p><p><strong>Purpose: </strong>To evaluate tumor control, neurological recovery, perioperative morbidity, and long-term biomechanical stability of unilateral hemilaminectomy (UH) for adult intradural spinal tumors.</p><p><strong>Overview of literature: </strong>Total laminectomy disrupts stabilizing posterior elements and may necessitate instrumentation for deformity. UH preserves the contralateral posterior complex, offering comparable resection rates, reduced perioperative morbidity, and shorter hospitalization. However, most studies on UH involve small, methodologically heterogeneous samples, with limited long-term data on neurological recovery and mechanical stability without fusion.</p><p><strong>Methods: </strong>Adult patients (≥18 years) undergoing UH for intradural spinal tumors (2015-2025) were retrospectively identified from a prospectively maintained database. Pediatric patients and those with extradural tumors were excluded. Primary endpoints were the extent of resection (gross total resection [GTR] vs. subtotal resection [STR]) and biomechanical stability (segmental instability or delayed fusion). Secondary outcomes included operative time, blood loss, length of stay, transfusion, postoperative complications, and unplanned reoperation. Neurological function (American Spinal Injury Association Impairment Scale [AIS] C/D vs. AIS E) was analyzed using Fisher's exact and McNemar tests. A focused literature review summarized comparative evidence on UH versus total laminectomy.</p><p><strong>Results: </strong>Of the 405 UH procedures screened, 136 adult intradural tumors met the criteria (108 extramedullary; 28 intramedullary). The average operative time, blood loss, and hospital stay were 91.0±13.5 minutes, 58.5±16.6 mL, and 3.97±1.05 days, respectively. One patient developed postoperative complications (cerebrospinal fluid leak requiring duraplasty); no transfusions or instrumented fusion were required. GTR was achieved in 95.6% cases; six intramedullary astrocytomas underwent STR followed by stereotactic radiotherapy. Neurological status improved significantly in extramedullary tumors (p<0.001), and no radiographic recurrence or delayed fusion occurred during follow-up.</p><p><strong>Conclusions: </strong>UH allows high resection rates, neurological improvement, low morbidity, and durable mechanical stability in intradural tumors, supporting its use as a tissue-preserving alternative to wider posterior exposure.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760475","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":"How statistically fragile are randomized controlled trial outcomes of balloon kyphoplasty for vertebral compression fractures?","authors":"Alexander Yu, Kareem Samir Mohamed, Mark Kurapatti, Junho Song, Jonathan James Huang, Prabhjot Singh, Yazan Alasadi, Abhijeet Grewal, Om Nephade, Nikan Namiri, John Corvi, Jun Kim, Samuel Kang-Wook Cho","doi":"10.31616/asj.2025.0282","DOIUrl":"https://doi.org/10.31616/asj.2025.0282","url":null,"abstract":"<p><p>Randomized controlled trials (RCTs) are essential for guiding the treatment of vertebral compression fractures with kyphoplasty, yet the statistical robustness of their findings has not been thoroughly evaluated. This systematic review assessed the fragility of dichotomous outcomes in kyphoplasty RCTs using the fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ). A comprehensive search of PubMed, Embase, and MEDLINE identified eligible RCTs, yielding 282 dichotomous outcomes for analysis. The overall median FI was 4 (interquartile range [IQR], 4-5), corresponding to a median FQ of 0.020 (IQR, 0.013-0.040). Statistically significant outcomes (n=18) demonstrated greater fragility, with a median FI of 2 (IQR, 1-4) and FQ of 0.015 (IQR, 0.011-0.029), compared with nonsignificant outcomes (n=264; FI, 5 [IQR, 4-5]; FQ, 0.020 [IQR, 0.013-0.041]). Subgroup analyses revealed that pain and complication outcomes had median FIs of 4 and 5, respectively, with FQs ranging from 0.016 to 0.025. Cement leakage outcomes were the most fragile (FI, 4; FQ, 0.048). More than half of the analyzed outcomes involved a greater number of patients lost to follow-up than their corresponding FI, underscoring the need for cautious interpretation of kyphoplasty trial results and supporting the inclusion of fragility metrics in future trial reporting to better inform clinical decision-making.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643784","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 and radiological outcomes of biportal endoscopic posterior cervical foraminotomy: a single-center retrospective cohort study with 1-year follow-up.","authors":"Tran Vu Hoang Duong, Pham Anh Tuan, Phan Quang Son, Le Tan Bao, Phan Dinh Thanh, Wongthawat Liawrungrueang","doi":"10.31616/asj.2025.0626","DOIUrl":"https://doi.org/10.31616/asj.2025.0626","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective single-center cohort study.</p><p><strong>Purpose: </strong>To evaluate 1-year clinical and radiological outcomes of biportal endoscopic posterior cervical foraminotomy (BE-PCF) in cervical spondylotic radiculopathy (CSR).</p><p><strong>Overview of literature: </strong>CSR is commonly managed with anterior cervical discectomy and fusion, cervical disc replacement, or posterior cervical foraminotomy. However, these approaches may lead to fusion-related complications, prosthesis degeneration, or posterior tension band disruption. Minimally invasive techniques, such as biportal endoscopic spine surgery, aim to reduce tissue damage while maintaining effective decompression. Long-term outcome data for BE-PCF remain limited.</p><p><strong>Methods: </strong>Twenty-one patients (31 levels) who underwent BE-PCF (June 2023-December 2024) were retrospectively analyzed. Clinical outcomes included Visual Analog Scale (VAS) scores for neck and arm pain and Neck Disability Index (NDI) at baseline, discharge, 6 months, and 1 year. Radiological outcomes were assessed using dynamic radiographs (C2C7 and segmental range of motion [ROM]) and computed tomography (CT) at 6 months, evaluating facet resection, foraminal diameter, and approach angle.</p><p><strong>Results: </strong>Mean follow-up was 14.8±6.7 months. VAS and NDI improved significantly (p<0.001). Neck pain decreased from 6.9±1.1 to 2.5±0.7, arm pain from 8.1±0.7 to 2.0±0.6, and NDI from 30.8±3.6 to 12.2±1.6. Cervical ROM was preserved (C2C7: 40.5°±10.1° vs. 40.5°±10.3°, p=0.99; segmental: 13.1°±4.4° vs. 13.8°±5.7°, p=0.18). CT demonstrated significant foraminal enlargement (mid-foraminal: 4.2±0.8 to 6.5±1.0 mm; distal: 3.7±1.1 to 4.8±1.0 mm; both p<0.001). Mean facet resection was 34.6%±7.7%, with no case exceeding 50%. Complications included transient C5 palsy (4.7%) and one wrong-level surgery (3.2%).</p><p><strong>Conclusions: </strong>BE-PCF is a safe and effective minimally invasive option for CSR, providing significant clinical improvement, preserved cervical motion, and adequate decompression with low complication rates at 1 year.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632097","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":"Predictors of failed closed reduction in subaxial cervical dislocations with interlocked facets: a retrospective cohort study.","authors":"Akio Kawamoto, Takashi Kageyama, Tadashi Yahata, Yasuhisa Ueda, Hokuto Morii, Koichi Inokuchi, Makoto Sawano","doi":"10.31616/asj.2025.0647","DOIUrl":"https://doi.org/10.31616/asj.2025.0647","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study at a tertiary trauma center.</p><p><strong>Purpose: </strong>To identify morphological predictors of failed closed reduction in subaxial cervical dislocation with interlocked facets, focusing on a dichotomized compression-extension (CE) versus non-CE classification, and to assess the association of vertebral artery injury (VAI) with reducibility.</p><p><strong>Overview of literature: </strong>Closed cranial traction is rapid and minimally invasive, yet certain morphologies resist reduction. Prior studies proposed various predictors, but few directly compared CE with non-CE injuries or evaluated VAI.</p><p><strong>Methods: </strong>We analyzed 111 dislocation events in 110 patients treated from 2017 to 2025. All underwent standardized cranial traction. Predictors of success included CE versus non-CE morphology, facet fracture, bilateral dislocation, age, level, American Spinal Injury Association Impairment Scale (ASIA) grade, and time-to-reduction (≤6 hours, 6-12 hours, 12-24 hours, >24 hours). The primary outcome was failure of a closed reduction requiring an open reduction. Logistic regression analyses were performed. VAI was examined as an exploratory factor.</p><p><strong>Results: </strong>Closed reduction failed in 34 events (30.6%). CE morphology (p<0.001) and facet fracture (p=0.001) were independently associated with failure. Younger age and C7 dislocation were significant only in univariate analyses. Bilateral dislocation, ASIA grade, and time-to-reduction were not predictive. VAI was slightly more frequent in the success group (p=0.069) but showed no independent association.</p><p><strong>Conclusions: </strong>A simplified CE-non-CE classification and facet fracture strongly predict irreducibility. VAI is not independently associated with success. Early computed tomography-based identification of CE and facet fracture should guide timely planning for open reduction and stabilization.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632158","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":"Insights into posterior cervical biportal endoscopic spine surgery outcomes in radiculopathy: a systematic review and meta-analysis.","authors":"Bryan Gervais de Liyis, Stevanus Christian Surya, Sulaiman Liyis, Tjokorda Istri Putri Mahadewi, Amal Rizky, Yunus Kuntawi Aji, Fadhil Panyalai, Tjokorda Gde Bagus Mahadewa","doi":"10.31616/asj.2025.0392","DOIUrl":"https://doi.org/10.31616/asj.2025.0392","url":null,"abstract":"<p><strong>Background: </strong>Posterior cervical biportal endoscopic spine surgery (PCBESS), which enables selective decompression through two ipsilateral portals, has emerged as a minimally invasive option for treating cervical radiculopathy secondary to foraminal stenosis and/or disc herniation. This study aimed to assess the efficacy and safety of PCBESS in cervical radiculopathy.</p><p><strong>Methods: </strong>A systematic search of the ScienceDirect, PubMed, Google Scholar, and Cochrane databases was conducted to identify longitudinal studies published up to September 2025. Data on patient demographics, perioperative clinical parameters, and complication rates were extracted. Meta-analyses were performed using random-effects models in STATA software.</p><p><strong>Results: </strong>Fourteen studies comprising 712 patients (62.5% male; mean age, 54.78±1.7 years) were included. The mean operative time was 85.88±32.46 minutes, mean blood loss was 84.89±27.81 mL, and mean hospital stay was 4.45±1.33 days. The overall surgical success rate was 91%±7% (MacNab \"excellent-good\"), with a 3%±2% reoperation rate. Significant improvements were observed in Visual Analog Scale (VAS) pain scores (mean differences [MD], -4.77; 95% confidence intervals [CI], -6.07 to -3.47; p<0.001), Neck Disability Index scores (MD, -27.07; 95% CI, -32.83 to -21.30; p<0.001), and segmental range of motion (MD, 0.55; 95% CI, 0.27-0.84; p<0.001). The overall complication rate was 7%±3%, most commonly dural tears, epidural hematomas, and transient paralysis. Multi-level PCBESS exhibited a higher complication rate than single-level PCBESS (18%±10% vs. 4%±2%, p<0.001). Outcomes were comparable to those of uniportal endoscopic surgery.</p><p><strong>Conclusions: </strong>PCBESS is a safe and effective treatment option for cervical radiculopathy, offering significant pain and functional improvement, low reoperation and complication rates, and outcomes comparable to uniportal endoscopic surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632113","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":"Comparison of Korean questionnaires for lumbar spinal stenosis: a prospective study.","authors":"Il-Soo Eun, Hak Sang Kim, Han Sol Kim, Yoon Jae Cho, Tae Sik Goh, Jung Sub Lee","doi":"10.31616/asj.2025.0591","DOIUrl":"https://doi.org/10.31616/asj.2025.0591","url":null,"abstract":"<p><strong>Study design: </strong>A prospective study.</p><p><strong>Purpose: </strong>To determine the results of two lumbar spinal stenosis (LSS) questionnaires examined for validity in Korean by comparing them with quality of life scores.</p><p><strong>Overview of literature: </strong>Although both LSS questionnaires have been investigated, comparative studies involving both are scarce.</p><p><strong>Methods: </strong>Patients with LSS completed the Korean version of the Fukushima Lumbar Spinal Stenosis Scale (K-FLS), the Korean version of the Zurich Claudication Questionnaire (K-ZCQ), the Korean version of the Oswestry Disability Index (K-ODI), and the Visual Analog Scale (VAS) for back and leg pain. To validate K-FLS and K-ZCQ, we evaluated their correlation with K-ODI and VAS using Spearman's rank correlation analysis.</p><p><strong>Results: </strong>Of 140 patients enrolled, 123 completed the reliability assessment (test-retest). Both questionnaires demonstrated significant correlations with K-ODI and VAS. However, K-FLS exhibited stronger correlations with K-ODI and VAS than with K-ZCQ. In the responsiveness analysis (n=27), K-FLS demonstrated a larger effect size than any subscale of K-ZCQ.</p><p><strong>Conclusions: </strong>K-FLS showed superiority in correlation with K-ODI and VAS and had higher responsiveness than K-ZCQ in LSS.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632115","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}