Asian Spine Journal最新文献

{"title":"Endoscopic spine surgery for obesity-related surgical challenges: a systematic review and meta-analysis of current evidence.","authors":"Wongthawat Liawrungrueang, Watcharaporn Cholamjiak, Peem Sarasombath, Yudha Mathan Sakti, Pang Hung Wu, Meng-Huang Wu, Yu-Jen Lu, Lo Cho Yau, Zenya Ito, Sung Tan Cho, Dong-Gune Chang, Kang Taek Lim","doi":"10.31616/asj.2024.0376","DOIUrl":"https://doi.org/10.31616/asj.2024.0376","url":null,"abstract":"<p><p>Obesity presents significant challenges in spinal surgery, including higher rates of perioperative complications, prolonged operative times, and delayed recovery. Traditional open spine surgery often exacerbates these risks, particularly in patients with obesity, because of extensive tissue dissection and larger incisions. Endoscopic spine surgery (ESS) has emerged as a promising minimally invasive alternative, offering advantages such as reduced tissue trauma, minimal blood loss, lower infection rates, and faster recovery. This systematic review and meta-analysis aimed to evaluate the safety, efficacy, and outcomes of ESS techniques, including fully endoscopic and biportal endoscopic lumbar discectomy and decompression, in patients with obesity and lumbar spine pathologies. A comprehensive literature search of the PubMed/Medline, Embase, and Scopus databases yielded 2,975 studies published between 2000 and 2024, of which 10 met the inclusion criteria. The meta-analysis revealed significant improvements in pain relief (Visual Analog Scale) and functional outcomes (Oswestry Disability Index), with comparable results between patients with and without obesity. Patients who are obese experienced longer operative times and have a slightly higher risk of symptom recurrence; however, ESS demonstrated lower rates of wound infections, shorter hospital stays, and faster recovery than traditional surgery. These findings position ESS as a viable and effective option for managing lumbar spine conditions in patients with obesity, addressing obesity-related surgical challenges while maintaining favorable clinical outcomes. However, limitations such as study heterogeneity and the lack of randomized controlled trials highlight the need for further high-quality research to refine ESS techniques and optimize patient care in this high-risk population.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802422","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":"Minimally invasive biportal endoscopic spinal surgery for central canal stenosis in low-grade degenerative lumbar spondylolisthesis: clinical outcomes and implications: a retropective observational study.","authors":"Wongthawat Liawrungrueang, Ho-Jin Lee, Sang Bum Kim, Sang Hyeok Lee, Sang Shin Lee, Ju-Eun Kim","doi":"10.31616/asj.2024.0433","DOIUrl":"https://doi.org/10.31616/asj.2024.0433","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective observational study.</p><p><strong>Purpose: </strong>To assess the clinical and radiological outcomes of unilateral laminotomy for bilateral decompression (ULBD) using biportal endoscopic spinal surgery (BESS) in patients with low-grade degenerative lumbar spondylolisthesis (DLS) and central canal stenosis.</p><p><strong>Overview of literature: </strong>DLS with central canal stenosis frequently requires surgical intervention to alleviate symptoms. Although traditional fusion surgeries are effective, they are associated with risks such as adjacent segment disease and increased postoperative morbidity. BESS presents a minimally invasive alternative that aims to achieve adequate decompression while preserving segmental stability.</p><p><strong>Methods: </strong>A total of 68 patients with symptomatic, low-grade DLS and moderate-to-severe central canal stenosis underwent ULBD using BESS. Patients were followed for at least 2 years. Clinical outcomes were measured using the Visual Analog Scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI), and the modified Macnab criteria for patient satisfaction. Radiological outcomes were assessed on the basis of sagittal translation from dynamic flexion-extension radiographs.</p><p><strong>Results: </strong>The mean VAS score for back pain decreased from 3.8±2.4 preoperatively to 1.9±2.0 at the final follow-up, and the leg pain scores decreased from 6.4±1.8 to 2.3±2.0 (both p<0.05). The ODI score improved significantly from 48.9±15.7 preoperatively to 23.1±17.5 at the final follow-up (p<0.05). According to the modified Macnab criteria, 27.9%, 42.6%, 22.1%, and 7.4% of the patients reported excellent, good, fair, and poor outcomes. Radiological assessments indicated no significant changes in sagittal translation, supporting the preservation of spinal stability.</p><p><strong>Conclusions: </strong>BESS with ULBD represents a safe and effective minimally invasive approach for treating low-grade DLS with central canal stenosis. It offers substantial symptom relief and functional improvement without jeopardizing spinal stability, making it a viable alternative to conventional fusion surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802424","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":"Advanced technique of biportal endoscopic transforaminal lumbar interbody fusion for revision surgery: a technical note.","authors":"Young-Il Ko, Jin Young Lee, Hun-Chul Kim, Hyeon Guk Cho, Jeong Woo Park, Sang-Ho Han","doi":"10.31616/asj.2024.0532","DOIUrl":"https://doi.org/10.31616/asj.2024.0532","url":null,"abstract":"<p><p>The application area of biportal endoscopic spine surgery (BESS) is gradually expanding. Compared with conventional fusion surgery, transforaminal interbody fusion (TLIF) using BESS (BESS-TLIF) has the advantages of less bleeding, minimal postoperative pain, and faster recovery. This technical note highlights its application in managing complex conditions such as scar tissue adhesion, altered anatomy, and implant removal, common in reoperations. The method focuses on precise dissection, endoscopic visualization, and careful tissue handling to ensure effective decompression and stabilization. Three representative cases, including reoperations for recurrent disc herniation, adjacent segment disease (ASD) following prior fusion, and ASD with nonunion of the prior fusion site requiring fusion extension, were described. All three cases exhibited clinical improvement following surgery. BESS is an effective and safe method for spinal revision surgery not only in simple decompression surgery but also in cases that required fusion surgery. As BESS is advancing, its role in complex spinal surgeries is expected to expand, potentially setting new standards in minimally invasive spine surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802417","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":"The social media footprint of endoscopic spine surgery: a cross-sectional analysis of content on Twitter/X.","authors":"Alex Kane Miller, Matthew Stewart Easthardt, Christopher Ryan Michel, Daniel Kwangwon Park","doi":"10.31616/asj.2025.0068","DOIUrl":"https://doi.org/10.31616/asj.2025.0068","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional social media content analysis.</p><p><strong>Purpose: </strong>Patients increasingly rely on social media for education and perspectives regarding surgical care. Given the growing interest in endoscopic spine surgery, there is a need to critically evaluate related content available on social media.</p><p><strong>Overview of literature: </strong>While patient and surgeon engagement with spine surgery topics on social media has been explored, no previous study has specifically examined endoscopic spine surgery content on Twitter/X.</p><p><strong>Methods: </strong>The Twitter/X website's user-facing search functionality was used to compile tweets containing hashtags related to endoscopic spine surgery. The search spanned from the website's inception to December 31, 2024. Tweets were categorized by authorship and location. Each tweet was independently analyzed by two reviewers to identify themes and contextual nature (educational vs. promotional).</p><p><strong>Results: </strong>A total of 890 tweets from 199 accounts were analyzed. The majority of content (76.0%) originated from outside the United States. Medical doctors, doctors of osteopathy, and other healthcare providers authored 44.4% of the content. Patient-facing advertisements accounted for 24.5% of tweets. Approximately 22.1% of tweets contained content intended for healthcare professionals already familiar with endoscopic spine surgery, primarily highlighting conference/educational activities, research projects, or noteworthy cases.</p><p><strong>Conclusions: </strong>A growing body of information related to endoscopic spine surgery is available on Twitter/X, though a large portion of this content consists of healthcare providers advertising to potential patients. Future research should prioritize identifying and analyzing patient perspectives on endoscopic spine surgery portrayed on social media platforms.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802426","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":"Opportunistic screening for osteoporosis using artificial intelligence-based morphometric analysis of chest computed tomography images: a retrospective multicenter study in Russia leveraging the COVID-19 pandemic.","authors":"Alexey Vladimirovich Petraikin, Perry Joseph Pickhardt, Mikhail Gennadevich Belyaev, Zhanna Evgenievna Belaya, Maxim Evgenievich Pisov, Alim Niyazovich Bukharaev, Aleksei Andreevich Zakharov, Nikita Dmitrievich Kudryavtsev, Tatiana Mikhailovna Bobrovskaya, Dmitry Sergeevich Semenov, Ekaterina Sergeevna Akhmad, Zlata Romanovna Artyukova, Liya Ruslanovna Abuladze, Ludmila Arsenevna Nizovtsova, Ivan Andreevich Blokhin, Anton Vyacheslavovich Vladzymyrskyy, Yuriy Aleksandrovich Vasilev","doi":"10.31616/asj.2024.0314","DOIUrl":"https://doi.org/10.31616/asj.2024.0314","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To evaluate the effectiveness of opportunistic osteoporosis screening using an artificial intelligence (AI) algorithm for detecting vertebral compression deformity (VCD >25%) and reduced bone mineral density (BMD) from routine chest computed tomography (CT) scans.</p><p><strong>Overview of literature: </strong>Osteoporosis is an insidious metabolic disease that often remains asymptomatic for a long time, and is typically diagnosed due to the occurrence of complications. An approach for diagnosing osteoporosis based on routine CT examinations, including the use of AI services, is being actively studied.</p><p><strong>Methods: </strong>Patients aged >50 years who underwent chest CT using the standard protocol between 09.06.2021 and 30.06.2021 at four inpatient and three outpatient clinics were retrospectively enrolled. The morphometric AI algorithm detected vertebral compression index and vertebrae density in Hounsfield units (HU). The AI algorithm was calibrated for BMD measurements using a phantom. Osteoporotic BMD was defined according to the American College of Radiology criteria (<80 mg/mL). The presence of vertebral fracture (VF) was verified using semiquantitative and algorithm-based qualitative methods by three radiologists, followed by two experts with 15 and 35 years of experience in the field.</p><p><strong>Results: </strong>CT studies of 1,888 patients (mean age, 66.3 years) were included. The AI algorithm detected VCD in 336 patients (17.8%), with 105 (5.5%) having VF. Low BMD values were detected in 501 patients (26.5%; 31.0% of females, 18.6% of males).</p><p><strong>Conclusions: </strong>We observed high diagnostic accuracy of opportunistic osteoporosis screening using AI algorithms for detecting VF and low BMD. AI-based opportunistic screening of osteoporosis and VF in chest CT scans can facilitate the identification of high-risk cohorts.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555736","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":"Pelvic ring ratio: a novel indicator of comprehensive pelvic alignment assessment.","authors":"Hiroaki Nakashima, Noriaki Kawakami, Sadayuki Ito, Naoki Segi, Jun Ouchida, Ippei Yamauchi, Tokumi Kanemura, Shiro Imagama","doi":"10.31616/asj.2024.0447","DOIUrl":"https://doi.org/10.31616/asj.2024.0447","url":null,"abstract":"<p><strong>Study design: </strong>A cross-sectional study.</p><p><strong>Purpose: </strong>To determine the effectiveness of the pelvic ring ratio as an indicator for assessing pelvic tilt (PT) from the frontal view and explore its correlation with various whole-body sagittal alignment (WBSA) parameters using EOS imaging technology.</p><p><strong>Overview of literature: </strong>Traditional indicators of PT often rely on sagittal plane measurements, which can be challenging in cases of pelvic rotation or obesity. A new indicator such as the pelvic ring ratio could address these challenges and aid in the comprehensive assessment of pelvic alignment.</p><p><strong>Methods: </strong>In total, 104 healthy participants (28 men, 76 women; mean age, 52.8±12.3 years) with no spinal disorders were recruited. Whole-body radiography using the EOS imaging system was performed to obtain sagittal and coronal parameters, including the pelvic ring ratio. Intra- and interobserver variability were assessed using intraclass correlation coefficients (ICCs) based on measurements by three spine surgery specialists. Correlation analyses among the pelvic ring ratio, age, body mass index, and WBSA parameters were conducted, and a multiple linear regression model was developed to predict PT.</p><p><strong>Results: </strong>The mean pelvic ring ratio was 53.3%±11.5%. The intra- and interobserver ICCs were 0.89 and 0.87, respectively, indicating good reliability. The pelvic ring ratio was negatively correlated with age (r =-0.387, p <0.05) and PT (r =-0.598, p <0.05). The regression model revealed that the pelvic ring ratio and sex significantly predicted PT (p <0.05). Women had higher pelvic ring ratio (55.0%±11.3%) than men (48.6%±10.8%).</p><p><strong>Conclusions: </strong>The pelvic ring ratio is a reliable and valuable indicator for PT assessment from the frontal view. It exhibits significant correlations with age and certain WBSA parameters, showing potential to improving the diagnostic accuracy and treatment planning for patients with spinal and hip disorders.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540010","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 radiographic predictive factors for the favorable outcome of lumbar epidural steroid injection in lumbosacral radiculopathy: a prospective analytical study from Thailand.","authors":"Pornpan Chalermkitpanit, Wicharn Yingsakmongkol, Weerasak Singhatanadgige, Teerachat Tanasansomboon, Patt Pannangpetch, Sittisak Honsawek","doi":"10.31616/asj.2024.0412","DOIUrl":"https://doi.org/10.31616/asj.2024.0412","url":null,"abstract":"<p><strong>Study design: </strong>A prospective analytic study.</p><p><strong>Purpose: </strong>To investigate the clinical factors and magnetic resonance imaging (MRI) findings that can predict a favorable outcome following transforaminal epidural steroid injection (TFESI) in patients with lumbosacral radiculopathy.</p><p><strong>Overview of literature: </strong>The efficacy of lumbar epidural steroid injection varies, and no clinical parameters have been established to predict a favorable response to TFESI reliably.</p><p><strong>Methods: </strong>In total, 120 patients diagnosed with lumbosacral radiculopathy underwent TFESI. At each index spinal level, 5.0 mg of a dexamethasone mixture in 2.0% lidocaine and 0.5% bupivacaine was injected. At the 2-week follow-up, a favorable response to TFESI was defined as pain reduction upon movement of >50.0%. Pain manifestation and MRI findings were evaluated.</p><p><strong>Results: </strong>A favorable response was observed in 60.8% of the patients 2 weeks post-TFESI. In the multivariate analysis, patients with mild central canal stenosis had 4.8 times higher odds of a favorable response to TFESI than those with severe central canal stenosis (adjusted odds ratio, 4.8; 95% confidence interval [CI], 1.2-18.8; p =0.023). Favorable responders experienced a notable 29-week period of pain reduction (95% CI, 10.3-47.8), along with a significantly lower incidence of surgery at 12 months (13.7%) (p <0.01). The mean pain score differences of 3.5 out of 10 observed 2 weeks and 1 month post-TFESI represented the optimal sensitivity and specificity in forecasting favorable responder status.</p><p><strong>Conclusions: </strong>A pain reduction of 3.5 out of 10 within 1 month is considered a clinical benchmark for predicting long-term positive outcomes after TFESI. The presence of severe central canal stenosis is significantly associated with an unfavorable response to TFESI.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540018","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 comprehensive review of risk factors and prevention strategies: how to minimize mechanical complications in corrective surgery for adult spinal deformity.","authors":"Jin-Sung Park, Hyun-Jun Kim, Se-Jun Park, Dong-Ho Kang, Chong-Suh Lee","doi":"10.31616/asj.2024.0505","DOIUrl":"https://doi.org/10.31616/asj.2024.0505","url":null,"abstract":"<p><p>Adult spinal deformity (ASD) surgery aims to correct abnormal spinal alignment in both the sagittal and coronal planes to alleviate pain and improve functional activities of daily living. Despite the advancements in surgical techniques that have led to better clinical outcomes, postoperative mechanical complications remain. These complications include instrumentation failure, with proximal junctional kyphosis (PJK), proximal junctional failure (PJF), and rod fractures (RFs) being the most common. Such complications deteriorate clinical outcomes and often require revision surgery, which can be more burdensome for surgeons and patients, than index surgery. Thus, the risk factors for mechanical complications must be identified, and effective preventive strategies established. Therefore, this study aimed to review the risk factors for mechanical complications, focusing on PJK, PJF, and RF, and explore prevention strategies for these complications in ASD surgery, drawing upon recent literature.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539995","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":"More postoperative complications and revision surgery after occipitocervical fusion than after atlantoaxial fusion: a retrospective multicenter cohort study.","authors":"Koji Uotani, Angel Oscar Paz Flores, Masato Tanaka, Shashank J Ekade, Shinya Arataki, Tadashi Komatsubara, Yoshiaki Oda, Kensuke Shinohara, Toshifumi Ozaki","doi":"10.31616/asj.2024.0374","DOIUrl":"https://doi.org/10.31616/asj.2024.0374","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective multicenter cohort study.</p><p><strong>Purpose: </strong>We sought to determine whether occipitocervical (OC) fusion is followed by more postoperative complications and revision surgery than is atlantoaxial (AA) fusion. We aim to compare postoperative complications and revision surgery associated with OC fusion and AA fusion.</p><p><strong>Overview of literature: </strong>OC and AA fusion are established techniques for restoring upper cervical stability. However, the outcomes of the two methods have not been compared.</p><p><strong>Methods: </strong>This study included 90 patients who underwent upper spinal fusion surgery for mechanical instability, performed by three surgeons in two hospitals from 2011 to 2023; OC fusion was indicated for irreducible AA subluxation, os odontoideum, and severe upper C1 fracture. Of the patients, 38 (mean age, 58.7 years) underwent OC fusion, and 52 (mean age, 62.8 years) underwent AA fusion. To evaluate surgical outcomes, we documented surgical time, intraoperative blood loss, postoperative complications, and the rate of revision surgery. Radiographs were obtained to identify screw malposition, rod breakage, and nonunion. To compare the outcomes of the two techniques, we used the Mann-Whitney U test for continuous variables and the chi-square or Fisher's exact test for dichotomous variables.</p><p><strong>Results: </strong>OC fusion took significantly longer (175.4 minutes) than AA fusion (150.7 minutes, p=0.020) and had a higher complication rate (39.5% vs. 11.5%, p <0.0001). The reoperation rate was 23.7% (9/38) after OC fusion and 3.8% (2/52) after AA fusion; the difference was statistically significant (p=0.0073). Average amounts of blood loss were 224 mL during OC fusion and 224 mL during AA fusion; the difference was not significant (p=0.947).</p><p><strong>Conclusions: </strong>Although OC fusion is indispensable for certain conditions, particularly basilar invagination, it entails more risk than dose AA fusion; the choice of technique thus warrants careful consideration.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540003","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":"Decompression and fusion for lumbar degenerative spondylolisthesis is associated with higher early morbidity rates and risk of perioperative complications compared with decompression alone: a retrospective study in the United States.","authors":"Abhinav Sharma, Paramveer Birring, Nischal Acharya, Manaav Mehta, Nicole Liu Goldenhersh, Michael Steinhaus, Hao-Hua Wu, Sohaib Hashmi, Don Young Park, Yu-Po Lee, Nitin Bhatia","doi":"10.31616/asj.2024.0279","DOIUrl":"https://doi.org/10.31616/asj.2024.0279","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Purpose: </strong>To assess differences in 30-day morbidity and mortality and postoperative complications between two surgical treatment options.</p><p><strong>Overview of literature: </strong>The choice of decompression with fusion or decompression alone for the management of degenerative spondylolisthesis (DS) is controversial.</p><p><strong>Methods: </strong>The American College of Surgeons National Quality Improvement Program database was queried for laminectomy or laminotomy with and without fusion from 2015 to 2020. The estimated 30-day mortality and morbidity, 30-day complications, and American Society of Anesthesiologist (ASA) classification were evaluated through chi-square and analysis of variance tests, with the results further stratified according to the ASA classification.</p><p><strong>Results: </strong>Of the 4,120 patients, 2,384 (58%) underwent a laminectomy or laminotomy without fusion and 1,736 (42%) underwent a laminectomy or laminotomy with fusion. Patients undergoing decompression with fusion had higher mean mortality (estimated probability 0.0034 vs. 0.0027, p<0.001), mean morbidity (estimated probability 0.053 vs. 0.048, p<0.001), mean length of stay (3.62±3.4 days vs. 3.15±4.3 days, p<0.001), and bleeding risk necessitating transfusion (9.5% vs. 7.6%, p =0.038). There was a higher rate of overall 30-day postoperative complications associated with an increasing ASA score for both cohorts.</p><p><strong>Conclusions: </strong>Decompression with fusion was associated with higher estimated mortality, morbidity, and 30-day complications. Decompression alone is an appealing treatment option for lumbar DS, particularly for patients with higher ASA scores and those at higher risk.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540035","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}