Asian Spine Journal最新文献

{"title":"Impact of cage type on subsidence following anterior cervical discectomy and fusion: a retrospective study.","authors":"Pierce J Ferriter, Suhas K Etigunta, Akiro H Duey, Christopher Gonzalez, Katrina Nietsch, Ashley M Rosenberg, Bashar Zaidat, Avanish Yendluri, Daniel Berman, Junho Song, Jun S Kim, Samuel K Cho","doi":"10.31616/asj.2025.0197","DOIUrl":"https://doi.org/10.31616/asj.2025.0197","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>This study investigated the impact of cage material on subsidence and segmental lordosis following anterior cervical discectomy and fusion (ACDF), comparing polyetheretherketone (PEEK), titanium, and ceramic synthetic cages, as well as structural allografts.</p><p><strong>Overview of literature: </strong>Subsidence following ACDF surgery can negatively impact clinical outcomes. Although extensively studied, the relationship between cage type and subsidence remains unclear due to conflicting data and inconsistent control for confounders, underscoring the need for multivariable analysis to determine material-specific effects.</p><p><strong>Methods: </strong>Retrospective study of 120 patients (223 fusion levels) who underwent ACDF between 2016 and 2021. Spacer types included structural allografts, PEEK, titanium, and ceramic cages. Radiographic measurements of subsidence were obtained from immediate (≤8 weeks) and long-term (≥6 months) postoperative lateral cervical radiographs. Multivariable linear regression was used to assess the association between spacer type and subsidence, adjusting for patient demographics, surgical levels, smoking history, and osteopenia.</p><p><strong>Results: </strong>The mean age of patients was 53.6±10.9 years and 41.7% were male; 47.5% had a smoking history and 20.8% had osteopenia. There were 38 one-level (31.7%), 61 two-level (50.8%), and 21 three-level fusions (17.5%). Spacer distribution included 62 structural allografts (51.7%), 27 PEEK (22.5%), 20 titanium (16.7%), and 11 ceramic (9.2%) cages. On multivariable analysis, PEEK cages were associated with significantly less anterior subsidence (β=-0.972, p <0.001) and posterior subsidence (β=-0.666, p=0.001) compared to allografts, and greater preservation of segmental lordosis (β=1.393, p=0.024). No significant differences in subsidence were found between titanium, ceramic, and allograft spacers.</p><p><strong>Conclusions: </strong>PEEK cages showed reduced subsidence and better preservation of cervical lordosis compared to structural allografts, while titanium and ceramic cages did not differ significantly from structural allografts. These results suggest that PEEK cages may help minimize subsidence-related complications and improve outcomes.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111816","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":"Posterior debridement and corpectomy via removal of the spinal canal's lateral wall approach for infection after vertebral augmentation: a technique note and early outcome.","authors":"Yihang He, Xiaolin Chen, Feng Huang, Guosheng Zhao, Yang Wang, Yu Du, Zhenyong Ke","doi":"10.31616/asj.2025.0105","DOIUrl":"10.31616/asj.2025.0105","url":null,"abstract":"<p><p>This study aimed to preliminarily evaluate the efficacy of posterior debridement and corpectomy via the spinal canal's lateral wall approach (PDC-SCLWA) for spinal infection after vertebral augmentation (SIAVA). The procedure is characterized as \"lateral wall resection for access, anterior lesion removal for debridement, and posterior wall preservation for bone graft fusion.\" This distinguishes it from conventional 360° decompression that involves extensive lamina and facet joint resection. Eight patients who underwent PDC-SCLWA were included. The mean surgical duration was 290.6±59.2 minutes, with an average intraoperative blood loss of 775.0±389.7 mL. Intraoperative dural laceration occurred in two patients. All patients' symptoms were alleviated, and no recurrent infection was observed during follow-up. Seven patients received double titanium meshes, and one received an iliac bone graft. At 3 months postoperatively, the fusion rates of intervertebral bodies and posterolateral laminae were 93.8% (15/16) and 100% (7/7), respectively. SIAVA is a severe postoperative complication, especially in elderly patients with multiple comorbidities. PDC-SCLWA is a safe and effective surgical technique. It provides advantages through posterior wall preservation that minimize spinal cord disruption, maintains mechanical stability, and optimizes the bone graft bed for fusion.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111783","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":"Optimizing lie-to-stand time to avoid orthostatic intolerance during early mobilization after enhanced recovery after surgery program for minimally invasive spine surgery: oblique lateral interbody fusion versus minimally invasive transforaminal lumbar interbody fusion: a prospective cohort study in Thailand.","authors":"Panapol Varakornpipat, Wirinaree Kampitak, Teerachat Tanasansomboon, Wicharn Yingsakmongkol, Worawat Limthongkul, Vit Kotheeranurak, Akaworn Mahatthanatrakul, Weerasak Singhatanadgige","doi":"10.31616/asj.2025.0226","DOIUrl":"https://doi.org/10.31616/asj.2025.0226","url":null,"abstract":"<p><strong>Study design: </strong>Prospective study.</p><p><strong>Purpose: </strong>To evaluate the hemodynamic response to early mobilization following oblique lateral interbody fusion (OLIF) compared to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) with an enhanced recovery after surgery (ERAS) program.</p><p><strong>Overview of literature: </strong>The ERAS program mitigates surgical stress and facilitates early recovery. Orthostatic intolerance (OI) may impede early mobilization after spine surgery. Data on OI after OLIF and MIS-TLIF with an ERAS are limited. This study compares OI incidence and outcomes of these two procedures.</p><p><strong>Methods: </strong>The hemodynamic response to postural changes (supine to sitting and standing) was evaluated preoperatively and at 6, 12, 24, and 48 hours postoperatively in 30 patients who underwent single-level OLIF versus MIS-TLIF within an ERAS protocol. The protocols were evaluated sequentially, beginning with a change from supine to sitting, followed immediately by standing, with the patient remaining in the standing position for 3 minutes for evaluation.</p><p><strong>Results: </strong>This study compared OLIF and MIS-TLIF in 60 patients and found no significant differences in baseline characteristics. The OLIF group demonstrated greater hemodynamic stability within 6 hours after surgery, exhibiting smaller decreases in systolic blood pressure and mean arterial pressure, along with reduced fluid responsiveness compared to the MIS-TLIF group. Both groups of patients exhibited comparable heart rates and cardiac output stabilization over time. Clinically, OLIF resulted in greater postoperative back pain relief, lower blood loss (45±7.31 mL vs. 99.33±14.13 mL), and higher postoperative hemoglobin levels compared to MIS-TILF. Operative time, hospital stay, and complication rates were comparable between the OLIF and MIS-TLIF groups.</p><p><strong>Conclusions: </strong>OLIF was associated with improved hemodynamic parameters within 6 hours postoperatively, less blood loss, and improved pain relief compared to MIS-TLIF, while both procedures demonstrated similar operative times, hospital stays, and no complications.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111807","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":"Efficacy of chemical prophylaxis for venous thromboembolism after degenerative spine surgery: a systematic review and meta-analysis.","authors":"Zahra Ramezani, Seyed Danial Alizadeh, Armin Khavandegar, Mahgol Sadat Hassan Zadeh Tabatabaei, Vali Baigi, Rasoul Masoomi, Vafa Rahimi-Movaghar","doi":"10.31616/asj.2024.0510","DOIUrl":"https://doi.org/10.31616/asj.2024.0510","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to assess the effectiveness of chemical prophylaxis in preventing venous thromboembolism (VTE) and spinal epidural hematoma (SEH) following degenerative spine surgery. The effectiveness of chemical prophylaxis in preventing VTE and SEH following degenerative spine surgery remains controversial, with variability in protocols and a lack of comprehensive, high-quality studies guiding optimal prophylaxis strategies. An electronic search across five databases, including Medline, Embase, Cochrane Library, Scopus, and Web of Science, was performed on February 2, 2024 to identify studies comparing chemical with nonchemical prophylaxis for VTE among degenerative spine surgery patients. Studies reporting on VTE (deep vein thrombosis and pulmonary embolism) and SEH were included. Patients under 18 years of age and those with trauma, tumors, infections, congenital deformities, and adolescent idiopathic scoliosis were excluded. Data on study characteristics, clinical details, and outcomes were collected. Metaanalyses were conducted to compare patients received chemical and non-chemical prophylaxis for VTE. Subgroup analyses according to the type of medication used for the chemical prophylaxis, study design, dosage regimen, and study quality were also performed. A total of 17 studies involving 5,383 patients satisfied our eligibility criteria. No significant difference in VTE incidence was observed between patients receiving chemical and non-chemical prophylaxis (risk ratio, 1.09; 95% confidence interval, 0.82 to 1.46; p=0.988). Subgroup analyses also showed consistent results (p>0.05). SEH incidence was reported in five studies (29.4%) involving five cases, among whom three and two were in the control and chemoprophylaxis groups, respectively. Perioperative chemoprophylaxis may not significantly alter VTE or SEH rates following degenerative spine surgery. This study highlights the need for further high-quality studies to establish better recommendations for VTE prophylaxis after degenerative spine surgeries (PROSPERO registration no., CRD42024585493).</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111796","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":"Important postoperative magnetic resonance imaging findings correlated with clinical outcomes to evaluate adequacy and success of decompression surgery-what radiologists need to know: a systematic review.","authors":"Ifran Saleh, Rahmad Mulyadi, Witantra Dhamar Hutami, Kevin Dilian Suganda","doi":"10.31616/asj.2025.0061","DOIUrl":"https://doi.org/10.31616/asj.2025.0061","url":null,"abstract":"<p><p>This study aimed to systematically review evidence on the magnetic resonance imaging (MRI) findings-particularly postoperative ones-that correlate with the clinical outcomes to assess the adequacy of decompression surgery for degenerative lumbar spinal stenosis (LSS). Few studies have evaluated postoperative MRI findings and their correlation with clinical outcomes following decompression surgery for degenerative LSS. A comprehensive literature search was performed employing search engines. We analyzed postoperative MRI findings to identify those that correlated with clinical outcomes. Our study included 12 articles. Available literature indicated that certain postoperative MRI findings correlated with clinical outcomes and thus reflect the adequacy of decompression surgery. These findings included postoperative dural sac cross-sectional area (DSCA) expansion, amelioration in the grade of stenosis, reversion of nerve root sedimentation sign (SedSign), and absence of redundant nerve roots (RNRs). Postoperative MRI indicators-such as DSCA expansion, improved stenosis grade, SedSign reversal, and absence of RNRs-correlate with clinical improvement and should be actively assessed to evaluate the adequacy of decompression surgery in LSS.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111825","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 to select a treatment method for patients with potentially unstable metastatic vertebrae (spinal instability neoplastic score 7-12): a systematic review.","authors":"Tue Helme Kildegaard, Daniel Sabroe, Miao Wang, Kristian Høy","doi":"10.31616/asj.2025.0078","DOIUrl":"https://doi.org/10.31616/asj.2025.0078","url":null,"abstract":"<p><p>The spinal instability neoplastic score (SINS) is used to evaluate spinal stability in patients with metastatic vertebrae and to guide treatment selection. SINSs of 13-18 indicate instability typically requiring surgery, while SINSs of 1-6 indicate stability and suitability for radiotherapy. However, the optimal approach for patients with SINSs of 7-12 remains unclear. This systematic review aimed to determine the optimal primary treatment for patients with intermediate SINSs (7-12) and potentially unstable metastatic vertebrae. A systematic literature search was conducted in PubMed, Embase, and Scopus, following the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. Twenty-six studies were included in this review (three A-class and 23 B-class). The A-class studies showed better outcomes with surgery±radiotherapy than radiotherapy alone. Two B-class studies indicated that patients with SINSs ≥10 more frequently underwent surgery, and one study found surgery was less effective for SINSs ≤9. Four studies showed good outcomes of surgery. In another study, 30% of patients became unstable after radiotherapy. In four studies, vertebral compression fractures developed in 20%-30% of patients after stereotactic body radiation therapy or stereotactic ablative body radiotherapy. One study showed that SINSs of 7-12 were correlated with radiotherapy failure, while another study found no such association. This systematic review suggests that surgical intervention alone or in combination with radiation may be superior for patients with SINSs of 7-12 and metastatic spinal tumors. The SINS 7-12 category might be divided into subgroups where surgery or radiotherapy is optimal. SINS ≥10 may indicate a need for surgery, and individual SINS components could be predictive. Further research is warranted to obtain more definitive evidence.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085026","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":"Correlation between postoperative shoulder imbalance and distal adding-on and distal junctional kyphosis in Lenke type 2 adolescent idiopathic scoliosis: a retospective study.","authors":"Norihiro Isogai, Satoshi Suzuki, Nao Otomo, Yohei Takahashi, Masahiro Ozaki, Toshiki Okubo, Osahiko Tsuji, Narihito Nagoshi, Mitsuru Yagi, Masaya Nakamura, Morio Matsumoto, Kota Watanabe","doi":"10.31616/asj.2025.0120","DOIUrl":"https://doi.org/10.31616/asj.2025.0120","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Purpose: </strong>This study aimed to evaluate the correlation between postoperative shoulder imbalance (PSI) and distal junctional kyphosis (DJK) in patients with Lenke type 2 adolescent idiopathic scoliosis (AIS).</p><p><strong>Overview of literature: </strong>Despite reports on several risk factors of postoperative radiographical complications, including PSI, distal adding-on (DA), and DJK in patients with AIS, the correlation between PSI and DJK has not been thoroughly examined.</p><p><strong>Methods: </strong>This study included 62 patients with Lenke type 2 AIS who underwent posterior correction and fusion surgeries. The patients were categorized into the PSI and non-PSI groups based on their radiographic shoulder height 2 years after surgery. Radiographic parameters, lower end vertebra (LEV), lower instrumented vertebra (LIV), sagittal stable vertebra (SSV), postoperative DA and DJK, and Scoliosis Research Society 22 scores were compared between the two groups using unpaired t -tests or Pearson's chi-square tests.</p><p><strong>Results: </strong>Twenty-eight patients in the PSI group and 34 in the non-PSI group were evaluated. Three patients had DA in the PSI group and 10 with DA and four with DJK in the non-PSI group. LIV-LEV was higher in the PSI group than in the non-PSI group. Although the LIV-SSV was not significantly different between the two groups, among the three patients with DJK, two had LIV-SSV of -3, one had -1, and one had 0. No significant differences in other examinations were noted between the two groups.</p><p><strong>Conclusions: </strong>Although more proximal LIV selection might lead to stable DA and DJK, the LIV selection should not be extended distally to prevent DA and DJK because favorable shoulder balance and clinical outcome can still be achieved.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084976","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":"Spine surgery for metastatic spine cancer in the era of advanced radiation therapy.","authors":"Sehan Park, Dong-Ho Lee, Chang Ju Hwang, Jae Hwan Cho","doi":"10.31616/asj.2025.0042","DOIUrl":"https://doi.org/10.31616/asj.2025.0042","url":null,"abstract":"<p><p>Metastatic spine cancer (MSC), a common complication of advanced malignancies, poses significant challenges due to pain, neurological deficits, and mechanical instability. While radiation therapy is a cornerstone of treatment, the role of spine surgery is evolving, fueled by advances in surgical techniques and radiation modalities such as stereotactic body radiation therapy (SBRT). This review examines the evolving role of spine surgery in MSC management, focusing on separation surgery, surgical innovations, and future directions. The treatment paradigm for MSC shifted with the advent of SBRT, which delivers high-dose precision radiation, improving local control even in radioresistant tumors. This advancement enabled the adoption of separation surgery, a technique aimed at creating a safe margin between the tumor and neural structures without extensive tumor resection, followed by SBRT to achieve tumor regression. Separation surgery reduces morbidity, shortens operative times, and achieves comparable local control rates to traditional corpectomy procedures. Innovations like minimally invasive surgery, stereotactic navigation, and cement-augmented instrumentation have improved surgical safety and outcomes. Emerging technologies, such as machine learning for predictive modeling and augmented reality for surgical navigation, hold potential for improving decision-making and procedural accuracy. Spine surgery remains integral to MSC treatment, especially for high-grade metastatic epidural spinal cord compression and mechanical instability. Integrating advanced technologies and multidisciplinary collaboration is key to optimizing patient outcomes. Comprehensive, patient-centered strategies addressing both oncological and mechanical aspects can improve survival and quality of life for patients with MSC.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084995","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":"Risk factors for screw loosening following lumbar interbody fusion surgery in degenerative lumbar disease: a systematic review and meta-analysis.","authors":"Bryan Gervais de Liyis, Made Dwinanda Prabawa Mahardana, Tjokorda Istri Putri Mahadewi, Tjokorda Gde Bagus Mahadewa","doi":"10.31616/asj.2025.0142","DOIUrl":"https://doi.org/10.31616/asj.2025.0142","url":null,"abstract":"<p><p>Screw loosening (SL) is a common complication following lumbar interbody fusion (LIF), particularly for degenerative lumbar disease. This study investigated the risk factors for SL following LIF for degenerative lumbar disease and examined the clinical relevance of SL. A PROSPERO-registered systematic search was conducted in the ScienceDirect, PubMed, Google Scholar, Epistemonikos, and Cochrane databases to identify longitudinal studies up to October 2024. Degenerative lumbar diseases included stenosis, spondylolisthesis, and disc herniation. Assessed risk factors were Cobb angle, lumbar lordosis (LL) angle, screw length, fixation to the sacrum, fused levels, and Hounsfield units (HU). Twenty-two studies involving 3,689 participants (56%±5% female; mean age, 61.95±9.55 years) and 17,722 lumbar screws were analyzed. Overall, 10%±2% of screws exhibited loosening in 29%±5% of patients, with 5%±2% undergoing revision surgery. Patients with SL (SL group) and those without SL (non-SL group) had similar sex distribution, body mass index, and comorbidities. The SL group had higher Visual Analog Scale scores for back pain (mean difference [MD], 0.75; 95% confidence interval [CI], 0.42-1.07; p<0.001) and Oswestry Disability Index scores (MD, 3.34; 95% CI, 0.49-6.20; p=0.02), indicating the clinical relevance of SL. The SL group exhibited significantly higher Cobb angle (MD, 2.42; 95% CI, 0.36-4.49; p=0.02), lower LL angle (MD, -3.67; 95% CI, -6.33 to -1.01; p=0.01), and shorter screw length (MD, -1.62; 95% CI, -2.78 to -0.45; p=0.01). Fixation to the sacrum, increased fused levels, and decreased HU were significant risk factors. The area under the curve for HU was 0.80 (0.77-0.84), with a sensitivity of 0.74 (0.67-0.81) and specificity of 0.76 (0.66-0.84), underscoring notable prognostic value. Patients with SL exhibited higher Cobb angles, lower LL angles, and shorter screws. Fixation to sacrum, increased fused levels, and decreased HU were significant risk factors for SL (PROSPERO ID: CRD42024563780).</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085060","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":"Resection of the posterior longitudinal ligament in anterior cervical decompression surgery: a retrospective study of the clinical and radiographic outcomes in Thailand.","authors":"Nattawut Niljianskul, Padungcharn Nivatpumin","doi":"10.31616/asj.2025.0134","DOIUrl":"10.31616/asj.2025.0134","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Purpose: </strong>To compare clinical and radiographic outcomes of patients undergoing anterior cervical decompression surgery with and without resecting the posterior longitudinal ligament (PLL).</p><p><strong>Overview of literature: </strong>Resection of the PLL during anterior cervical decompression surgery is still a controversial topic among spine surgeons.</p><p><strong>Methods: </strong>All patients undergoing anterior cervical decompression surgery from October 2018 to December 2023 were included in this cohort. The PLL was preserved in patients with cervical spondylosis with only axial neck pain, cervical spine injuries with an intact PLL and intervertebral disc, PLL ossification with double layer signs on magnetic resonance imaging studies, and cervical spine metastasis. Clinical outcomes were used to evaluate the visual analog scale for neck pain and a modified Japanese Orthopedic Association score. Radiographs were used to evaluate the device-level Cobb angle (CA), segmental CA, global CA, and sagittal vertical axis, and they were compared with postoperative measurements at 1 year.</p><p><strong>Results: </strong>A total of 102 patients underwent surgical intervention. In 36 patients, PLL was preserved. The retractor time was shorter in the non-PLL resection group and was statistically significant (p=0.046). The non-PLL resection group had fewer complications, but this was not statistically significant (p=0.787). Both clinical and radiographic outcomes were improved after surgery, and there were no statistically significant outcome differences between the resection and non-resection groups.</p><p><strong>Conclusions: </strong>Resecting the PLL in patients undergoing anterior cervical spine surgery may prolong retractor time and could potentially result in postoperative complications. However, it does not significantly affect radiographic outcomes regarding cervical spine alignment compared to patients where the PLL was not cut.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085036","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}