Asian Spine Journal最新文献

{"title":"Sarcopenia is associated with degenerative lumbar spondylolisthesis but does not compromise surgical outcomes: a retrospective study in Japan.","authors":"Yosuke Takeichi, Yoshihito Sakai, Tsuyoshi Watanabe, Hiroki Matsui, Ryo Sato, Yui Adachi, Kohei Uomi","doi":"10.31616/asj.2026.0250","DOIUrl":"10.31616/asj.2026.0250","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Purpose: </strong>To comprehensively evaluate skeletal-muscle characteristics in patients with degenerative spondylolisthesis (DS), clarify the association between sarcopenia and DS, and determine the impact of sarcopenia on surgical outcomes.</p><p><strong>Overview of literature: </strong>In lumbar spinal stenosis (LSS), factors such as spinal alignment, facet-joint orientation, and trunk muscle atrophy and fatty degeneration contribute to DS development. However, the role of sarcopenia in surgical outcomes in DS remains unclear.</p><p><strong>Methods: </strong>A cross-sectional analysis of 1,415 patients with LSS and L4-L5 stenosis (mean age 75.2±8.7 years; 703 males and 712 females) was performed to identify factors associated with Meyerding grade I or greater spondylolisthesis using sex-adjusted analysis of covariance and logistic regression. A longitudinal analysis of 373 patients who underwent surgery for LSS (mean age, 72.1±8.8 years; 200 males and 173 females) was conducted using the Asian Working Group for Sarcopenia algorithm to evaluate the effect of sarcopenia on 1-year postoperative outcomes.</p><p><strong>Results: </strong>Logistic regression analysis identified female sex, greater lumbar lordosis, lower skeletal-muscle mass index, smaller lumbar-multifidus (LM) cross-sectional area, smaller facet-joint angle, disc degeneration, smaller L4-L5 dural-sac area, and low flavum-canal ratio as significant variables associated with DS. No significant differences in the surgical outcomes were observed in LSS patients with and without DS, and no significant intergroup differences were noted in limb skeletal-muscle mass. However, both LM and erector spinae exhibited significantly more postoperative decreases in the DS group than in the non-DS group. No significant differences in skeletal-muscle mass change or surgical outcomes were observed according to sarcopenia status among DS patients.</p><p><strong>Conclusions: </strong>Sarcopenia is associated with DS, trunk muscle atrophy, and fatty degeneration. However, surgical treatment of patients with DS and sarcopenia yields favorable clinical outcomes because adequate decompression and stabilization may mitigate the impact of reduced skeletal-muscle mass.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"728-741"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148682819","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":"Osteoporosis and sarcopenia in spine care: from recognition to integrated management.","authors":"Yoshihito Sakai","doi":"10.31616/asj.2026.0403","DOIUrl":"10.31616/asj.2026.0403","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 4","pages":"V-VI"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878994","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: Impact of abscess type on outcomes following posterior fixation for thoracolumbar pyogenic spondylitis: a multicenter retrospective cohort study.","authors":"Jiajun Deng, Yongchun Xiao, Hongsheng Lin","doi":"10.31616/asj.2026.0638.r1","DOIUrl":"10.31616/asj.2026.0638.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 4","pages":"832-833"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878950","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":"Response to the letter to the editor: Impact of abscess type on outcomes following posterior fixation for thoracolumbar pyogenic spondylitis: a multicenter retrospective cohort study.","authors":"Hisanori Gamada, Toru Funayama, Yosuke Ogata, Takane Nakagawa, Takahiro Sunami, Kotaro Sakashita, Shun Okuwaki, Kento Inomata, Kaishi Ogawa, Yosuke Shibao, Hiroshi Kumagai, Katsuya Nagashima, Kengo Fujii, Yosuke Takeuchi, Masaki Tatsumura, Itsuo Shiina, Masafumi Uesugi, Masao Koda","doi":"10.31616/asj.2026.0638.r2","DOIUrl":"10.31616/asj.2026.0638.r2","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 4","pages":"834-835"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879049","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":"Bone quality and biologic enhancers for spinal fusion in osteoporosis: a narrative review.","authors":"Dong-Ju Lim, Joon-Il La","doi":"10.31616/asj.2026.0186","DOIUrl":"10.31616/asj.2026.0186","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Comprehensive narrative review with systematic search methodology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To consolidate current evidence on the influence of bone quality on spinal fusion outcomes and investigate the efficacy of systemic pharmacotherapies as well as emerging biologic and biomaterial enhancements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Overview of literature: &lt;/strong&gt;Impaired bone quality is common among spinal fusion candidates yet frequently remains underdiagnosed. Conventional dual-energy X-ray absorptiometry (DXA) alone underestimates bone fragility. However, novel assessment modalities, systemic pharmacotherapies, and advanced biologics and biomaterials are emerging to address this gap.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search of PubMed, EMBASE, and the Cochrane Library databases was conducted through September 2025 in accordance with the PRISMA 2020 (Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020) guidelines. Search terms included spinal fusion, osteoporosis, bone quality assessment (DXA, trabecular bone score [TBS], vertebral bone quality), antiosteoporotic medications, exosomes, Nel-like molecule type 1, gene therapy, and three-dimensional-printed scaffolds. Clinical trials, meta-analyses, and key preclinical studies were included. Of the 1,247 records identified, 53 met the inclusion criteria. Due to the broad thematic scope encompassing bone quality assessment, pharmacological optimization, and emerging biologics/biomaterials, a narrative synthesis was performed. Risk of bias was assessed employing the Cochrane Risk of Bias 2.0 tool for randomized controlled trials (RCTs) and the Newcastle-Ottawa Scale for observational studies. The certainty of evidence for major clinical recommendations was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Comprehensive assessment using TBS and Fracture Risk Assessment Tool identified impaired bone quality in 37.5% of surgical candidates, with vitamin D deficiency or insufficiency present in up to 57%. A network meta-analysis of 13 RCTs found teriparatide as significantly superior to placebo (odds ratio, 3.2; moderate certainty), while teriparatide plus denosumab exhibited the highest efficacy (surface under the cumulative ranking curve [SUCRA]=90.9). Extended teriparatide treatment (&gt;6 months) increased union rates to 87.1%. In preclinical models, mesenchymal stem cell-derived exosomes achieved 83.3% fusion in preclinical models versus 27.3% in controls (very low certainty evidence). Overall risk of bias across included RCTs was low to moderate, while most observational studies were of moderate quality per the Newcastle-Ottawa Scale.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A multimodal approach combining comprehensive bone quality assessment, systemic anabolic optimization (moderate certainty evidence), and targeted novel biologics delivered via advanced biomate","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"754-767"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760481","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":"Response to the letter to the editor: Risk factors for cage subsidence following anterior-posterior spinal fixation in osteoporotic vertebral fractures: a multicenter retrospective study.","authors":"Yuki Kinoshita, Shinji Takahashi, Hiroyuki Yasuda, Masaki Terakawa, Sadahiko Konishi, Minori Kato, Hiromitsu Toyoda, Akinobu Suzuki, Koji Tamai, Akito Yabu, Yuta Sawada, Masayoshi Iwamae, Yuki Okamura, Yuto Kobayashi, Masato Uematsu, Hiroshi Taniwaki, Hiroaki Nakamura, Hidetomi Terai","doi":"10.31616/asj.2026.0686.r2","DOIUrl":"10.31616/asj.2026.0686.r2","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 4","pages":"825-826"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878997","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: Risk factors for cage subsidence following anterior-posterior spinal fixation in osteoporotic vertebral fractures: a multicenter retrospective study.","authors":"Sharath Raj, Saloni Rani Kumar","doi":"10.31616/asj.2026.0686.r1","DOIUrl":"10.31616/asj.2026.0686.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 4","pages":"823-824"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879067","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":"Beyond bone mineral density: expanding therapeutic targets for precision spine surgery.","authors":"Takashi Kaito","doi":"10.31616/asj.2026.0401","DOIUrl":"10.31616/asj.2026.0401","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 4","pages":"I-II"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878887","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":"When alignment is necessary but not sufficient: muscle phenotype, the bone-muscle unit, and the next iteration of adult spinal deformity planning.","authors":"Dong-Ju Lim","doi":"10.31616/asj.2026.0402","DOIUrl":"10.31616/asj.2026.0402","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 4","pages":"III-IV"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879041","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":"Differential association of psoas and paraspinal muscle volumes with appendicular lean mass index: AI-derived lumbar computed tomography three-dimensional volumetric indices in older Korean Women: an observational study.","authors":"Eun Chae Lee, Jang Hyuk Cho, Dong Gyu Lee","doi":"10.31616/asj.2026.0213","DOIUrl":"10.31616/asj.2026.0213","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cross-sectional study.</p><p><strong>Purpose: </strong>To investigate the relationship between sarcopenia-related markers and artificial intelligence (AI)-derived three-dimensional (3D) volumetric indices of lumbar muscles.</p><p><strong>Overview of literature: </strong>Sarcopenia is characterized by loss of skeletal muscle mass and physical function. Although appendicular skeletal muscle mass (ASM) is widely used for sarcopenia assessment, reliable evaluation of lumbar paraspinal muscles remains limited. AIbased 3D volumetric analysis may provide a reproducible approach for muscle assessment.</p><p><strong>Methods: </strong>This single-center retrospective cross-sectional study included 58 women aged ≥65 years who underwent lumbar computed tomography and sarcopenia assessment. AI-derived 3D volumetric analysis was performed using TotalSegmentator implemented in 3D Slicer. Volumetric indices were calculated as muscle volume (cm3) divided by height3 (m3). Associations between volumetric indices and ASM measured by dual-energy X-ray absorptiometry were evaluated using Pearson correlation and multivariable linear regression analyses.</p><p><strong>Results: </strong>Among the 58 participants, 25 were classified as having sarcopenia. Appendicular skeletal muscle mass index (ASMI) was not significantly associated with paraspinal muscle volume indices. In contrast, the iliopsoas muscle volume index showed a significant positive correlation with ASMI (r=0.424, p<0.001). No significant differences in AI-derived 3D lumbar muscle volumetric indices were observed between sarcopenic and non-sarcopenic groups.</p><p><strong>Conclusions: </strong>Paraspinal muscle volume indices were not significantly associated with ASMI, whereas iliopsoas muscle volume indices showed a significant association. These findings suggest that the iliopsoas muscle may better reflect systemic skeletal muscle mass than paraspinal muscles in older women.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"668-675"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197290","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}