Asian Spine Journal最新文献

{"title":"LIVS Dictionary: reference values for lumbar reference values for lumbar intervertebral spacing in a Chinese population.","authors":"Jianfei Hou, Zhen Ye, Yaru Wang, Kailiang Cheng, Yong Wang, Chao Zhu, Ping Wang, Zhenzhen Cao","doi":"10.31616/asj.2025.0356","DOIUrl":"https://doi.org/10.31616/asj.2025.0356","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective, cross-sectional study.</p><p><strong>Purpose: </strong>Injuries to the lumbar spine may alter the lumbar intervertebral space (LIVS). This study aimed to establish the LIVS Dictionary, a standardized anatomical reference system for LIVS, and to evaluate its ability to detect ligamentous injuries using sex-specific normative data.</p><p><strong>Overview of literature: </strong>This study presents the first computed tomography (CT)-based LIVS Dictionary from 457 asymptomatic subjects. It identifies sex-specific differences, age-linked degeneration patterns, and demonstrates its utility in detecting anterior ligament injuries, particularly among females.</p><p><strong>Methods: </strong>Enhanced whole-abdominal CT scans from 457 asymptomatic adults were retrospectively analyzed to construct the LIVS Dictionary. Seven anatomical regions encompassing 28 LIVS parameters were quantified using 3D Slicer. A validation cohort of 87 patients with five distinct types of lumbar fractures was included. Statistical analyses involved t -tests, Cohen's d, uniform manifold approximation and projection clustering, and Elastic Net receiver operating characteristic (ROC) curve analysis with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Most LIVS parameters were significantly larger in males (25 of 28 parameters, p<0.05), particularly in the anterior regions. Age analysis revealed sex-specific degeneration patterns: males showed progressive LIVS reduction with age, whereas females exhibited localized decline after 80 years. Incidental anatomical variants included lumbarization in 5.25% and sacralization in 1.09% of the healthy cohort. Among fracture types, transverse process fractures produced the greatest LIVS alterations. The Elastic Net model demonstrated excellent predictive performance (area under the ROC curve=0.90; 95% CI, 0.88-0.92; accuracy=0.94).</p><p><strong>Conclusions: </strong>Lumbar spine injuries produce quantifiable alterations in LIVS morphology. The LIVS Dictionary provides a validated framework for identifying these changes and captures sex-, age-, and fracture-related morphological variations with high diagnostic robustness. This framework establishes a foundation for clinical evaluation, biomechanical modeling, and forensic applications related to spinal stability.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621527","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":"Opioid-sparing effect of postoperative continuous intravenous nefopam in multilevel degenerative lumbar spinal fusion: a randomized double-blind placebo-controlled trial.","authors":"Borriwat Santipas, Panya Luksanapruksa, Suwimon Tangwiwat, Piyawadee Rungmongkolsab, Sarunya Poolpol, Sirichai Wilartratsami","doi":"10.31616/asj.2025.0512","DOIUrl":"https://doi.org/10.31616/asj.2025.0512","url":null,"abstract":"<p><strong>Study design: </strong>Prospective, randomized, double-blind, placebo-controlled trial.</p><p><strong>Purpose: </strong>This study aimed to evaluate the analgesic efficacy and safety of postoperative continuous intravenous nefopam infusion in reducing opioid consumption after multilevel degenerative lumbar spinal fusion.</p><p><strong>Overview of literature: </strong>Nefopam is a nonopioid, nonsteroidal analgesic with multimodal mechanisms, comprising serotonin, norepinephrine, and dopamine reuptake inhibition, as well as glutamatergic pathway modulation. Despite its opioid-sparing properties demonstrated in other surgeries, evidence supporting its role in spinal surgery, particularly multilevel fusion, remains limited. This study aimed to investigate the efficacy and safety of intravenous nefopam in reducing opioid consumption after multilevel lumbar spine fusion.</p><p><strong>Methods: </strong>This study randomized 66 patients undergoing decompressive laminectomy and fusion for degenerative lumbar spinal stenosis involving three or more levels to receive either nefopam or a placebo immediately postoperatively. All patients received standardized multimodal analgesia, including intravenous morphine patient-controlled analgesia, acetaminophen, and nonsteroidal anti-inflammatory drugs. The primary outcome includes total morphine consumption at 24 hours. Secondary outcomes include cumulative morphine consumption at 12, 36, and 48 hours, pain scores at rest and during movement, and adverse event incidences.</p><p><strong>Results: </strong>Morphine consumption was significantly lower at 24 hours in the nefopam group compared with placebo (10.44±8.40 mg vs. 20.49±16.60 mg, p =0.013). Reductions persisted at 36 hours (13.44±9.99 mg vs. 28.42±22.54 mg, p=0.009). Pain scores at rest and during movement were similar between groups at all time points (p>0.05). Adverse event rates, including nausea/vomiting (12.1% vs. 9.1%) and tachycardia (12.1% vs. 6.1%), did not significantly differ. No serious complications occurred.</p><p><strong>Conclusions: </strong>In patients undergoing multilevel degenerative lumbar spinal fusion, continuous intravenous nefopam infusion significantly reduced postoperative opioid requirements without worsening adverse events. Nefopam may be a useful opioid-sparing adjunct in multimodal postoperative pain protocols for major spine surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621522","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":"Artificial intelligence-based detection of acute postoperative airway complications following anterior cervical spine surgery: a retrospective imaging evaluation.","authors":"Gil Kimchi, Shachar Shemesh, David Levin, Ran Harel","doi":"10.31616/asj.2025.0403","DOIUrl":"https://doi.org/10.31616/asj.2025.0403","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective imaging evaluation using an artificial intelligence (AI)-generated model.</p><p><strong>Purpose: </strong>To develop novel AI software for early prediction and identification of postoperative airway obstruction based on routine post-operative imaging.</p><p><strong>Overview of literature: </strong>Acute postoperative airway obstruction following anterior cervical spine surgery due to edema or hematoma is rare but potentially life-threatening. No automated system currently exists to detect this complication in its early stages.</p><p><strong>Methods: </strong>All adult patients who underwent anterior cervical fusion between 2012 and 2019 at a single tertiary care center were retrospectively identified. These cases were used to develop an AI model capable of autonomously distinguishing critical airway narrowing from benign postoperative swelling. Image processing and augmentation techniques were applied to establish a segmentation model incorporating three-dimensional reconstructions for computed tomography (CT) scans and pixel analysis for plain radiographs. The Cat- Boost algorithm was harnessed to refine decision trees and generate precise predictions, which were integrated into a graphical user interface for intuitive interaction.</p><p><strong>Results: </strong>A total of 815 anterior cervical fusion procedures were identified; 795 patients met the inclusion criteria. Respiratory complications occurred in 35 patients (4.4%), with 11 (1.3%) caused by airway obstruction. The model achieved a positive predictive value of 0.98, a negative predictive value of 0.90, a sensitivity of 0.91, and a specificity of 0.99.</p><p><strong>Conclusions: </strong>The AI model developed in this study showed strong potential for predicting airway compromise following anterior cervical discectomy and fusion, despite variability between CT and radiographic environments. This tool may facilitate early detection of patients at risk of postoperative airway obstruction and help distinguish benign postoperative changes from complications. Further studies are warranted to validate these initial findings.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621555","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":"A nationwide perspective on ergonomic gaps in spine surgery: modifiable risk factors and gender-based findings.","authors":"Priyambada Kumar, Mehul Sarkar, Mithilesh Nikam","doi":"10.31616/asj.2025.0507","DOIUrl":"https://doi.org/10.31616/asj.2025.0507","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional questionnaire-based study.</p><p><strong>Purpose: </strong>To determine the prevalence, anatomical distribution, and modifiable ergonomic risk factors for work-related musculoskeletal disorders (MSDs) among early-career spine surgeons in India, with an emphasis on gender-based differences.</p><p><strong>Overview of literature: </strong>Although MSDs are a well-recognized occupational hazard for surgeons, a large portion of existing spine surgery literature originates from high-income countries, focuses on low back pain, and lacks targeted evaluation of early-career surgeons in low- and middle-income countries. Consequently, gender-specific ergonomic challenges remain underexplored.</p><p><strong>Methods: </strong>A nationwide, cross-sectional online survey was conducted (January-June 2025) among spine surgeons with <10 years of independent practice experience. The questionnaire assessed the demographics, operative workload, ergonomic practices, equipment use, and MSD symptoms over the past 12 months. Associations were evaluated using χ2 or Fisher's exact tests, as appropriate, and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) derived from multivariable exact logistic regression.</p><p><strong>Results: </strong>A total of 764 surgeons (mean age, 35.4±4.5 years; 19.6% women) participated. MSD prevalence was 83.9%, with 96.1% of symptomatic surgeons reporting neck discomfort. All women reported MSD, whereas only 80.0% of men did so (p<0.001). Microscope use was significantly associated with neck discomfort (aOR, 1.65; 95% CI, 1.14-2.39; p=0.009), whereas loupe use was not. Consistent table height adjustment was associated with markedly decreased MSD prevalence (72.8% vs. approximately 100%; aOR, 0.21; 95% CI, 0.05-0.88; p=0.03). Only 6.7% of the respondents reported preoperative ergonomic planning, despite frequent assistant-surgeon height mismatch (63.8%).</p><p><strong>Conclusions: </strong>This nationwide survey of young spine surgeons in India revealed an unprecedented neck-dominant MSD pattern, universal MSD prevalence among female surgeons, and a strong protective effect of consistent table height adjustment. These findings underscore the urgent need for targeted ergonomic training, visualization tool optimization, and integration of ergonomic planning into surgical workflows.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608068","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":"Acute spinal cord injury: contemporary management and novel therapies.","authors":"Han-Dong Lee, Nam-Su Chung, Hee-Woong Chung, Jong Min Baik, Dong Sub Im, Hae-Dong Jang","doi":"10.31616/asj.2025.0878","DOIUrl":"https://doi.org/10.31616/asj.2025.0878","url":null,"abstract":"<p><p>Acute spinal cord injury (SCI) remains a life-threatening condition associated with substantial morbidity, mortality, and long-term disability. Despite the advances in trauma systems, surgical techniques, and critical care, the optimal management strategies for acute SCI continue to improve, and clinical practice remains heterogeneous across institutions. The pathophysiology of acute SCI involves an irreversible primary mechanical insult, followed by a dynamic secondary injury cascade characterized by ischemia, inflammation, excitotoxicity, and apoptotic cell death. Early neurological assessments using standardized clinical scales, along with advanced imaging, particularly magnetic resonance imaging, play a crucial role in injury characterization, prognostication, and treatment planning. The contemporary acute management of this condition focuses on the prevention of secondary injury through hemodynamic optimization, early stabilization, and timely surgical decompression. Growing evidence has supported early decompressive surgery, particularly within 24 hours after injury, to improve neurological outcomes. However, the optimal timing, surgical strategy, and patient selection process remain areas of ongoing debate. Pharmacologic neuroprotection, including high-dose methylprednisolone, has become increasingly controversial, while novel agents such as riluzole and minocycline have shown promising but inconclusive results in clinical trials. Beyond conventional management, novel therapeutic approaches-including cell-based therapies, biologics targeting neuroregeneration, neuromodulation, and advanced rehabilitation technologies-have been actively investigated. In parallel, advances in artificial intelligence and predictive modeling are beginning to influence early prognostication and individualized treatment strategies. This review aimed to synthesize current evidence regarding the assessment and management of acute SCI, highlight key controversies, and discuss novel therapies that may shape future clinical practice.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608052","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":"Comparative analysis of MRI-based VBQ score and CT-based HU with DEXA-based T-score in assessing BMD in degenerative spine.","authors":"N Arul Kumaran, Karthik Ramachandran, Nivendiran Kuppusamy, Pushpa Bhari Thippeswamy, Ajoy Prasad Shetty, Rishi Mugesh Kanna, Shanmuganathan Rajasekaran","doi":"10.31616/asj.2025.0546","DOIUrl":"10.31616/asj.2025.0546","url":null,"abstract":"<p><strong>Study design: </strong>Observational study.</p><p><strong>Purpose: </strong>This study aimed to investigate the diagnostic performance of computed tomography (CT)-derived Hounsfield units (HU) and magnetic resonance imaging (MRI)-based Vertebral Bone Quality (VBQ) scores by comparing them with dual-energy X-ray absorptiometry (DEXA) T-scores in patients with degenerative spine.</p><p><strong>Overview of literature: </strong>Despine surgery, accurate bone mineral density (BMD) assessment is crucial for surgical planning and postoperative outcomes. DEXA remains the standard method for assessing osteoporosis; however, its accuracy is reduced in degenerative spinal conditions due to artefactual interference.</p><p><strong>Methods: </strong>This study included patients who underwent lumbar spine MRI, CT, and DEXA scans within a 3-month interval. Vertebral and cerebrospinal fluid signal intensities were used to calculate VBQ scores from T1-weighted sagittal MRI. CT HU values were measured from L1 to L4 vertebrae in axial, sagittal, and coronal planes. DEXA T-scores of the spine and femur were employed as reference standards.</p><p><strong>Results: </strong>In a cohort of 104 patients (mean age, 59.9±11.9 years; 46 males and 58 females), CT HU values exhibited strong positive correlations (r=0.745 spine, 0.680 femur), whereas VBQ scores demonstrated a negative correlation with DEXA T-scores (r=-0.727 spine, -0.783 femur). Optimal thresholds include CT HU values and VBQ scores of ≤163 and ≥2.2 for osteopenia and ≤105 and ≥2.6 for osteoporosis, respectively. CT HU values and VBQ scores were inversely correlated (r=-0.869). Among 25 patients with osteoporotic vertebral compression fractures, DEXA misclassified eight cases, whereas HU and VBQ correctly identified osteoporosis in 21 and 23 patients, respectively.</p><p><strong>Conclusions: </strong>VBQ scores and CT HU values are reliable alternative markers for BMD assessment in the degenerative spine. These modalities provide practical alternatives to DEXA, particularly when DEXA is unavailable or confounded, and can improve opportunistic screening and preoperative planning.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608082","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":"Impact of lumbar spinal canal stenosis on paravertebral muscle condition: an observational study in Japan.","authors":"Jusei Kunimoto, Takahito Iga, Kazuki Takeda, Toshiki Okubo, Satoshi Suzuki, Masahiro Ozaki, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.31616/asj.2025.0381","DOIUrl":"https://doi.org/10.31616/asj.2025.0381","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To examine the impact of lumbar canal stenosis (LSS) severity on paraspinal muscles in patients undergoing surgery.</p><p><strong>Overview of literature: </strong>LSS commonly causes back pain, leg pain, and sensory disturbances, and severe cases may result in muscle weakness. Dysfunction of the lumbar paraspinal muscles is linked to low back pain, and lower extremities muscle weakness is common in severe LSS. However, few studies have investigated the condition of paraspinal muscles in LSS patients. This study aimed to clarify the relationship between LSS severity and paraspinal muscle degeneration by comparing muscle area and fat content in surgical LSS cases.</p><p><strong>Methods: </strong>Seventy-eight patients with LSS (51 males, 27 females) who underwent posterior decompression or decompression with fusion were included. On preoperative T2-weighted magnetic resonance imaging, total muscle cross-sectional area, muscle cross-sectional area (MCSA), fat cross-sectional area, and fat percentage (FP) were measured for the multifidus, longissimus, and psoas muscles. Patients were categorized by stenosis count (single or multiple) and anatomical level (above L3/4, below L4/5, or extensive).</p><p><strong>Results: </strong>The MCSA of the multifidus and longissimus muscles was significantly smaller in the multiple stenosis group than in the single stenosis group (56.5±2.1 cm2 vs. 51.0±1.5 cm2, p=0.0384). FP was significantly higher in the multiple stenosis group (multifidus: 25.5%±1.4% vs. 30.3%±1.0%, p=0.0081; longissimus: 14.3%±0.9% vs. 17.2%±0.7%, p=0.0123) across all levels. No significant differences in MCSA were observed among different anatomical levels.</p><p><strong>Conclusions: </strong>An increased number of stenotic levels were associated with significant paraspinal muscle atrophy and fat infiltration, whereas the anatomical stenosis level showed minimal impact on muscle condition. Stenosis severity, rather than its location, may primarily contribute to paraspinal muscle degeneration in LSS patients.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608115","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":"Recent advances in robotic-assisted laminectomy in spine surgery: a narrative review.","authors":"Tarun Mattikalli, Konstantinos Margetis, James D Lin, Jeremy Steinberger","doi":"10.31616/asj.2025.0260","DOIUrl":"10.31616/asj.2025.0260","url":null,"abstract":"<p><p>Robotic-assisted laminectomy (RAL) is an emerging technique in spine surgery that can potentially improve precision, safety, and efficiency. While robotic-assisted pedicle screw placement is well established, RAL remains in early stages with varied methodologies and primarily pre-clinical validation. This narrative review evaluates current evidence on RAL, focusing on bone cutting tools, resection strategies, state recognition techniques for real-time identification of bone type and surgical endpoints, and clinical applications to inform future advancements. A comprehensive literature search was conducted using PubMed, Embase, and Cochrane databases with relevant keywords and operators to maximize sensitivity. Twenty-seven studies met predefined inclusion and exclusion criteria. Evaluated cutting tools included burrs, drills, and ultrasonic osteotomes. Burrs and drills provided superior state recognition feedback, while ultrasonic devices offered better force control and reduced thermal damage. Cyclic dorsal-ventral drilling was found to be superior to layer-by-layer resection for ultrasonic cutting. The only clinical study of RAL in a human patient is a case report demonstrating robotic-guided, surgeon-operated laminar bone removal. While RAL shows promise in improving surgical accuracy, the lack of in vivo data and standardized methodology remains a key barrier to clinical adoption. Future research should prioritize comparative evaluation of cutting modalities, clinical validation in human subjects, and long-term outcome studies to support the broader integration of RAL into spine surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"388-398"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548119","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":"Letter to the editor: Interpreting meta-analyses of biportal endoscopic decompression for lumbar spinal stenosis.","authors":"Audai H Abudayeh, Iakiv Fishchenko","doi":"10.31616/asj.2026.0074.r1","DOIUrl":"10.31616/asj.2026.0074.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 2","pages":"407-408"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832908","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":"Methodological evaluation of dual-energy X-ray absorptiometry for Cobb angle measurement in females with idiopathic scoliosis: a reliability and validity study in Thailand.","authors":"Tunyalux Wannakon, Kanogwan Dimu, Achareeyapon Autsriya, Apiwich Apiwongngam, Patraporn Sitilertpisan, Montree Tungjai, Nuanlaor Thawinchai","doi":"10.31616/asj.2025.0291","DOIUrl":"10.31616/asj.2025.0291","url":null,"abstract":"<p><strong>Study design: </strong>Comparative study.</p><p><strong>Purpose: </strong>To evaluate the concurrent validity, test-retest reliability, and inter-rater reliability of Cobb measurement in the coronal plane via dual-energy X-ray absorptiometry (DEXA) images and plain radiographs in female patients with idiopathic scoliosis (IS).</p><p><strong>Overview of literature: </strong>IS, which affects primarily females, is commonly monitored at least biannually with spine radiographs according to the Cobb method. DEXA is a safer imaging method because it involves less radiation exposure. Although DEXA has potential for assessing spinal alignment, its validity and reliability in measuring Cobb angles require further verification.</p><p><strong>Methods: </strong>A repeated-measures design was used to evaluate the test-retest reliability of measuring spinal alignment with DEXA. Eighty-six women aged 18-20 years with a diagnosis of IS, who had undergone spinal radiography within the previous 3 months, underwent two DEXA scans (DEXA1 and DEXA2) 1 week apart. Cobb angles were measured on radiographs, DEXA1, and DEXA2 by two independent assessors. Intraclass correlation coefficients (ICCs) were calculated to assess test-retest reliability and inter-rater reliability. Concurrent validity was examined using Pearson's correlation coefficients between Cobb angles obtained from radiographs and those from DEXA1 and DEXA2 images.</p><p><strong>Results: </strong>Cobb angle measurements from DEXA images had excellent test-retest and nter-rater reliability (ICC>0.90) and very strong concurrent validity with radiographs (r >0.90, p <0.001). The mean difference in Cobb angles between radiographs and DEXA images ranged from 2.37° to 2.91°, whereby the curves were less severe on DEXA images.</p><p><strong>Conclusions: </strong>DEXA has consistent reliability and validity for evaluating spinal alignment and is potentially useful in monitoring curve progression in young populations.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"323-332"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548056","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}