Asian Spine Journal最新文献

{"title":"Opportunistic screening for osteoporosis using artificial intelligence-based morphometric analysis of chest computed tomography images: a retrospective multi-center 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":"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":"355-371"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555736","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":"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":"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":"380-388"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540010","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":"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":"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":"422-431"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540018","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":"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":"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":"463-475"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539995","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":"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":"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":"444-451"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540003","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":"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":"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":"346-354"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540035","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":"Estimation of proximal junctional failure and associated risk factors in adult spine deformity surgery: an observational study from a single institution.","authors":"Vishwajeet Singh, Marcelo Oppermann, Nathan Evaniew, Alexandra Soroceanu, Fred Nicholls, Bradley Jacobs, Kenneth Thomas, Ganesh Swamy","doi":"10.31616/asj.2024.0405","DOIUrl":"10.31616/asj.2024.0405","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective observational cohort study.</p><p><strong>Purpose: </strong>To estimate the proximal junctional failure (PJF) rate and identify associated factors.</p><p><strong>Overview of literature: </strong>Proximal junctional pathologies are challenging and common complications of adult spine deformity (ASD) surgery. However, the PJF rate was not accurately defined within the ASD cohort. A correct estimate of PJF incidence and associated factors will inform clinicians on reoperation risk and prevention strategies.</p><p><strong>Methods: </strong>This retrospective observational study included patients with degenerative or adult idiopathic thoracolumbar deformity, extended instrumentation, sacropelvic fixation, and more than 2 years of follow-up. Patients with post-traumatic or iatrogenic sagittal malalignment were excluded. Demographic and operative data were obtained from the electronic medical records. Preoperative and followup scoliosis radiographs were reviewed to calculate the spinal alignment parameters. Patients were categorized into the PJF and non- PJF groups using the modified Hart-ISSG criteria, and their demographic, surgical, and radiographic parameters were compared using descriptive statistics. Multivariable logistic regression models were fitted to estimate the association measures of PJF occurrence, and their odds ratios (ORs) were reported with corresponding 95% confidence intervals (CI).</p><p><strong>Results: </strong>Of the eligible 157 patients who underwent surgery between 2011 and 2018, 130 were included. The mean age was 64.6±8 years, and 73% of the patients were female. Moreover, 42 (32%) and 88 patients (68%) were allocated to the PJF and non-PJF groups, respectively. The mean change in the proximal junctional angle (△PJA) in the PJF group was 26°±8.2°, and 33 patients (79%) had a final PJA >20°, 4 (10%) had an additional upper instrumented vertebra (UIV)/UIV+1 fracture, and 5 (12%) had an additional screw dislodgement or fixation failure. Postoperative changes in PJA (OR, 1.23; 95% CI, 1.12-1.37; p <0.001), thoracic kyphosis (TK; OR, 1.06; 95% CI, 1.02-1.11; p =0.004), and the use of a proximal tether (OR, 0.22; 95% CI, 0.04-0.82; p =0.03) were associated with PJF.</p><p><strong>Conclusions: </strong>In this study, the PJF rate was 32%, of which 67% of the patients underwent reoperation. Postoperative PJA and TK changes and the use of proximal tethers were significantly associated with PJF.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"452-462"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539992","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":"Evaluating the effect of early balloon kyphoplasty on adjacent vertebral fracture risk in osteoporotic vertebral fracture management: a retrospective study.","authors":"Masatoshi Yamamoto, Koji Ohta, Daisuke Hirano, Maki Noguchi, Shuhei Ayukawa, Keigo Shirasaki, Kenya Ishizu, Tetsuya Watanabe, Keiichiro Iida","doi":"10.31616/asj.2024.0494","DOIUrl":"10.31616/asj.2024.0494","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To evaluate whether the timing of balloon kyphoplasty (BKP) affects the risk of adjacent vertebral fractures (AVFs) in the management of osteoporotic vertebral fractures.</p><p><strong>Overview of literature: </strong>Osteoporotic vertebral fractures are usually managed conservatively; however, complications such as nonunion, neurologic deficits, and high-grade kyphosis can arise. BKP, a minimally invasive procedure for pain relief, has been associated with AVF risk. Although meta-analyses suggest no significant difference in AVF rates between BKP and conservative treatment, retrospective studies report higher AVF rates after BKP. Many of these cases involve patients resistant to conservative treatment, which implies that differences in the incidence of AVF may be influenced by the delay before performing BKP.</p><p><strong>Methods: </strong>We retrospectively analyzed 189 patients who underwent BKP between 2012 and 2023, excluding those with pathological fractures. The incidence of AVF was assessed at 3 months after BKP. Risk factors, including age, sex, fracture site, prior vertebral fractures, bone mineral density, kyphosis angle, endplate damage, signal changes in the fractured vertebral body on magnetic resonance imaging, vertebral instability, and timing of BKP, were evaluated.</p><p><strong>Results: </strong>The overall incidence of AVFs was 29%. The AVF rate was 21% in patients treated with BKP within 30 days, as compared with 32% in those treated later; however, this difference was not statistically significant (p =0.15). Multivariate analysis identified vertebral instability as the only significant risk factor for AVF (odds ratio, 2.73; p =0.01), whereas the timing of BKP showed no significant association with AVF risk.</p><p><strong>Conclusions: </strong>Early BKP does not significantly reduce the risk of AVF. The findings suggest that the management of osteoporotic vertebral fractures should focus on vertebral stability rather than intervention timing.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"408-414"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539953","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":"To Zoom or not to Zoom? A retrospective comparative study to assess the validity of video versus face-to-face consultations and examinations for diagnosing lower back pain in Wales.","authors":"Megan Havard, Ronan McKeogh, Abi Goodier, Gemma Johns, Sashin Ahuja","doi":"10.31616/asj.2024.0344","DOIUrl":"10.31616/asj.2024.0344","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective comparative study.</p><p><strong>Purpose: </strong>To evaluate the accuracy of examination findings and diagnoses established after initial spinal consultations for low back pain conducted virtually in comparison with face-to-face (F2F) consultations.</p><p><strong>Overview of literature: </strong>The COVID-19 (coronavirus disease 2019) pandemic required a shift from F2F to virtual consultations in healthcare, with documented benefits such as reduced costs, CO2 emissions, and time. However, the diagnostic accuracy of telemedicine for conditions requiring physical examinations, such as low back pain, remains underexplored. Although studies have highlighted the feasibility and high satisfaction of virtual spinal assessments, they have not thoroughly investigated their diagnostic accuracy.</p><p><strong>Methods: </strong>This study included 154 new patients with degenerative lumbar spine problems who were assessed via virtual consultations (VCs) (n=77) or F2F (n=77) by a single orthopedic spinal surgeon between May 2020 and January 2021. Patients were matched by age and sex, and examinations followed the \"telemedicine musculoskeletal examination\" protocol by the Mayo Clinic. Diagnostic changes from initial to definitive diagnoses were recorded and compared between the two groups.</p><p><strong>Results: </strong>The diagnostic accuracy of VCs was comparable with that of F2F examinations, with no significant difference in the rate of diagnostic changes between the groups (p=0.814 for any change; p=0.405 for more significant changes). Motor deficits were the only examination component with significant false-positive rates in the VC group (p=0.023).</p><p><strong>Conclusions: </strong>The study findings indicate that the initial spinal VCs and examinations are effective, safe, and beneficial in the evaluation of low back pain, providing the same diagnostic accuracy as initial F2F consultations. All erroneous motor deficit findings were false positive, which means that no serious pathology was missed during the initial VC evaluation. Future research should focus on refining virtual examination techniques, particularly for assessing motor deficits.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"415-421"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540057","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 editor: Evaluating the effect of early balloon kyphoplasty on adjacent vertebral fracture risk in osteoporotic vertebral fracture management: a retrospective study.","authors":"Pravallika Ambati, Bishlesh","doi":"10.31616/asj.2025.0225.r1","DOIUrl":"10.31616/asj.2025.0225.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 3","pages":"505-506"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537939","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}