Asian Spine Journal最新文献

{"title":"Comparable 2-year functional outcomes following vertebroplasty for thoracic and lumbar osteoporotic vertebral compression fractures: a retrospective cohort study.","authors":"Yong Ng, Jeremy Tze En Lim, Lei Jiang, Yee Gen Lim, Zhixing Marcus Ling, Chee Cheong Reuben Soh, Christian Hwee Yee Heng","doi":"10.31616/asj.2026.0262","DOIUrl":"10.31616/asj.2026.0262","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To compare short- and medium-term patient-reported outcome measures (PROMs) between thoracic and lumbar percutaneous vertebroplasty (PVP) cohorts for osteoporotic vertebral compression fractures (OVCFs).</p><p><strong>Overview of literature: </strong>PVP is well-established for pain relief in OVCF; however, whether clinical outcomes vary by the anatomical location of the treated vertebrae, remains unclear.</p><p><strong>Methods: </strong>Ninety patients who underwent PVP between January 2010 and August 2022 with complete 2-year PROM follow-up were included and stratified into thoracic (n=33) and lumbar (n=57) cohorts. Outcomes included the Oswestry Disability Index (ODI), North American Spine Society (NASS) Neurogenic Symptom score, Visual Analog Scale (VAS) pain score, and Short Form-36 (SF-36) domains. Between-group comparisons were assessed using Wilcoxon rank-sum tests, and effect sizes were summarized using Cliff's delta. Minimal clinically important difference (MCID) achievement was assessed for ODI, VAS Back Pain, and VAS Leg Pain. Multivariable linear regression examined the independent effect of vertebral region after adjustment for age, sex, race, number of vertebral levels treated, and baseline PROMs, with Benjamini-Hochberg false-discovery-rate (FDR) correction applied for multiple comparisons.</p><p><strong>Results: </strong>The mean age was 76.4±8.5 years, and 83.3% of patients were female. No significant between-group differences were observed in ODI, NASS score, VAS pain score, or any SF-36 domain at 6 months or 2 years (p>0.05). MCID achievement rates for ODI and VAS Back Pain were high and comparable between groups at both follow-up points, exceeding 87%. On adjusted regression, the vertebral region was not an independent predictor of any postoperative PROM after FDR correction.</p><p><strong>Conclusions: </strong>Thoracic and lumbar vertebroplasty yielded comparable 2-year PROMs with no statistically significant differences detected between cohorts. These findings suggest that the vertebral region may not be a major determinant of patient-reported recovery following vertebroplasty for OVCFs. However, residual confounding, attrition, and absent radiographic variables preclude definitive conclusions regarding clinical equivalence.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"717-727"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711177","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: Inquiry regarding lumbosacral transitional vertebrae and sagittal alignment.","authors":"Diril Sabri Kerem, Akcali Ayhan, Ozyigit Elif, Ekinci Safak","doi":"10.31616/asj.2025.0708.r1","DOIUrl":"10.31616/asj.2025.0708.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 4","pages":"817-818"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878915","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":"Latent profile analysis of multidimensional muscle profiles versus traditional sarcopenia metrics for capturing sagittal malalignment in adult spinal deformity: a retrospective study.","authors":"Donghua Huang, Zhan Wang, Mihir Dekhne, Michael Jian-Wen Chen, Annika Bay, Robert N Uzzo, Gabrielle Dykhouse, Atahan Durbas, Andrea Pezzi, Stephane Owusu-Sarpong, Luis Felipe Colon, Kasra Araghi, Quante Singleton, Farah Musharbash, Sereen Halayqeh, Matthew E Cunningham, Han Jo Kim, Francis C Lovecchio","doi":"10.31616/asj.2026.0116","DOIUrl":"10.31616/asj.2026.0116","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>Using latent profile analysis (LPA) to multidimensionally profile trunk muscles, we aimed to identify muscle phenotypes, compare LPA-based classification with sarcopenia definitions for explaining sagittal alignment, and examine malalignment patterns across LPA-derived subtypes.</p><p><strong>Overview of literature: </strong>Paraspinal sarcopenia is closely associated with sagittal malalignment in adult spinal deformity (ASD), but traditional single-muscle or single-metric definitions fail to capture heterogeneous muscle degeneration.</p><p><strong>Methods: </strong>This retrospective cohort study included 145 patients with ASD undergoing long-segment fusion (≥5 levels; upper instrumented vertebra T1-L1) with ≥1-year follow-up. We measured muscle quantity using the psoas vertebral body index (PVBI) and paralumbar vertebral body index (PLVBI), and muscle quality using fatty infiltration (FI) of the psoas and paralumbar (multifidus and erector spinae) muscles. LPA was applied to PVBI, PLVBI, and psoas and paralumbar FI to identify clusters. For comparison, sarcopenia was defined by each metric. We compared LPA with single-metric definitions for predicting sagittal measures and examined clinical, radiographic (pre/ post), and surgical outcomes across LPA subtypes.</p><p><strong>Results: </strong>LPA explained sagittal alignment better than any single measure and revealed four phenotypes: Mild-Deg (high quantity, low FI; n=49), Mod-Deg (moderate; n=39), Seve-Deg (low quantity, high FI; n=34), and Hete-Deg (low quantity, high paralumbar FI but low psoas FI; n=23). Preoperative deformity progressively worsened from Mild-Deg to Seve-Deg, while Hete-Deg also showed pronounced malalignment. Postoperatively, most metrics were similar across groups. At last follow-up, however, Mod-Deg/Seve-Deg had greater pelvic incidence (PI)-lumbar lordosis (LL), and LL in Seve-Deg trended toward progressive worsening from postoperative to follow-up (PI-LL and T4 pelvic angle).</p><p><strong>Conclusions: </strong>Multidimensional LPA muscle phenotyping outperformed single-metric sarcopenia definitions in explaining sagittal alignment. It also identified a heterogeneous Hete-Deg subtype suggestive of functional compensation despite severe preoperative deformity, whereas Seve-Deg reflected irreversible muscle loss with progressive imbalance.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"627-643"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683283","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":"Diagnostic performance of the vertebral bone quality score for osteoporosis is minimally influenced by lipid parameters in lumbar fusion patients: a retrospective study.","authors":"Fangke Hu, Dapeng Yu, Penghe Li, Dong Zhao, Gang Liu, Feng Jing, Qiang Yang, Chao Chen","doi":"10.31616/asj.2026.0274","DOIUrl":"10.31616/asj.2026.0274","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Purpose: </strong>To evaluate the influence of lipid parameters on vertebral bone quality (VBQ) scores in patients undergoing lumbar fusion surgery.</p><p><strong>Overview of literature: </strong>The MRI-derived VBQ score is a validated tool for assessing osteoporosis in patients undergoing lumbar fusion surgery. However, the effect of lipid parameters on its diagnostic performance remains unclear.</p><p><strong>Methods: </strong>Consecutive patients who underwent lumbar fusion surgery over a 3-year period were retrospectively reviewed. Inclusion required the availability of lumbar T-scores, quantitative computed tomography, magnetic resonance imaging (MRI), and laboratory data obtained within a 1-month interval. Patients were stratified according to lipid levels and clinical characteristics. Correlation analysis and receiver operating characteristic (ROC) curve analysis evaluated the impact of lipid parameters on VBQ 1.5T, VBQ 3.0T, and the calibrated VBQ (C-VBQ) scores, which was developed to improve consistency across different MRI field strengths.</p><p><strong>Results: </strong>This study included 294 patients (mean age, 67.1±6.5 years; 57.8% female; 56.8% with hyperlipidemia). Among the lipid parameters evaluated, only high-density lipoprotein cholesterol (HDLC) demonstrated a modest association with VBQ scores. Correlation analysis demonstrated significant positive correlations between HDLC and both VBQ 1.5T (p =0.003) and C-VBQ (p =0.001). After stratification by HDLC levels, C-VBQ differed significantly between normal and abnormal HDLC groups (p =0.046). Significant differences in VBQ 3.0T and C-VBQ across HDLC quintiles persisted even after T-score adjustment (p =0.037 and p =0.003). ROC analysis revealed minimal influence of lipid parameters or hyperlipidemia on VBQ diagnostic performance.</p><p><strong>Conclusions: </strong>Among lipid parameters, only HDLC was positively associated with VBQ scores; however, this weak association did not significantly compromise the diagnostic performance of VBQ for osteoporosis.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"644-655"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683329","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":"Magnetic resonance imaging-derived vertebral bone quality correlates with computed tomography-derived bone density and paraspinal muscle degeneration: a systematic review and meta-analysis.","authors":"Mohammad Mahdi Aghaei, Armin Babaei, Sadegh Bagherzadeh, Faramarz Roohollahi, Mark Greenberg, Puya Alikhani, Mohsen Rostami","doi":"10.31616/asj.2026.0046","DOIUrl":"10.31616/asj.2026.0046","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Purpose: </strong>To quantitatively synthesize the relationship between magnetic resonance imaging (MRI)-derived vertebral bone quality (VBQ) and computed tomography (CT)-derived Hounsfield units (HU), and paraspinal muscle characteristics.</p><p><strong>Overview of literature: </strong>Osteoporosis and sarcopenia frequently coexist as \"osteosarcopenia,\" representing degeneration of the \"bone-muscle unit.\" MRI-derived VBQ is an emerging opportunistic imaging biomarker; however, its physiological validity relative to CT-derived HU and paraspinal muscle degeneration remains ill-defined.</p><p><strong>Methods: </strong>A systematic review and meta-analysis (according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines) was conducted to explore relevant literature reporting quantitative associations between VBQ, HU, and paraspinal muscle metrics in the PubMed, Embase, Scopus, and Web of Science databases up to December 9, 2025. Reported correlation coefficients were pooled using random-effects models with Fisher's Z transformation. An exploratory regression synthesis was performed using reconstructed individual participant data.</p><p><strong>Results: </strong>We included 24 studies with 4,447 patients. VBQ demonstrated a moderate inverse correlation with CT-derived HU (pooled r=-0.55; 95% confidence interval [CI], -0.65 to -0.43; findings consistent across cervical and lumbar regions), a small negative association with paraspinal muscle cross-sectional area (r=-0.19), but a strong positive association with muscle fat infiltration (r=0.63). In contrast, HU was positively associated with muscle size and negatively associated with fat infiltration. Reconstructed data yielded an exploratory translation model: HU=-50.9×VBQ+378.</p><p><strong>Conclusions: </strong>VBQ correlates robustly with CT-derived bone density and paraspinal myosteatosis, supporting its role as an imaging marker of the bone-muscle unit in the spine. While CT-derived HU remains essential for absolute bone assessment, VBQ offers a radiation-free, opportunistic tool for identifying patients with compromised musculoskeletal integrity (PROSPERO registration number: CRD420251238599).</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"782-794"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197312","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":"Inter-observer reliability of osteoporotic fracture classification across imaging modalities for thoracolumbar osteoporotic fractures.","authors":"Teresa Kalantari, Alvaro Zamarron, Ana Royuela, Victor Bello, Mohamed M Aly, Raquel Gutiérrez-González","doi":"10.31616/asj.2026.0369","DOIUrl":"10.31616/asj.2026.0369","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective single-center cohort study.</p><p><strong>Purpose: </strong>To investigate the inter- and intra-observer reliability of the osteoporotic fracture (OF) classification across different imaging protocols and levels of surgical experience in a large, consecutive cohort of patients with thoracolumbar osteoporotic vertebral fractures (OVFs).</p><p><strong>Overview of literature: </strong>The OF classification provides a standardized morphological assessment of OVFs. Previous studies reported variable agreement (κ=0.49-0.63), and the influence of imaging modality and observer experience on reliability remains debated.</p><p><strong>Methods: </strong>Patients aged ≥50 years with acute thoracolumbar OVFs diagnosed between 2017 and 2021 were included. Three neurosurgeons (two seniors, one junior) independently assessed fracture morphology using complete Picture Archiving and Communication System studies. Inter-observer agreement was evaluated with Fleiss's kappa and intra-observer agreement with Cohen's kappa from repeated assessments by one senior observer. Subgroup analyses used imaging protocol and observer experience.</p><p><strong>Results: </strong>A total of 482 patients were included. The most common fracture types were OF 2 (43.2%), OF 4 (29.9%), and OF 3 (25.1%). Inter-observer agreement was substantial (κ=0.789; 95% confidence interval [CI], 0.75-0.83), whereas intra-observer agreement for a single senior rater was almost perfect (κ=0.917; 95% CI, 0.88-0.95). Substantial agreement was achieved across all imaging protocols (κ=0.773-0.824), although the magnetic resonance imaging (MRI)+X-ray subgroup (n=17) was underpowered. Among adequately powered subgroups, combined computed tomography (CT) and MRI provided the highest inter-observer consistency, particularly for OF 2 and OF 3 fractures, whereas CT alone was sufficient for OF 4 fractures. OF 1 (n=4) and OF 5 (n=5) cases were considered illustrative only. No significant differences were observed based on observer experience.</p><p><strong>Conclusions: </strong>The OF classification demonstrates substantial to almost perfect reliability across imaging protocols. Combined CT and MRI assessment improved agreement for intermediate fracture types in adequately powered subgroups, supporting their complementary use in clinical practice.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"707-716"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683280","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":"Impact of preoperative prognostic nutritional index on postoperative in-hospital falls after surgery for cervical myelopathy: a retrospective cohort study in Japan.","authors":"Takuya Furuichi, Kazunori Nakaniwa, Masaki Terakawa, Daiki Yamamoto, Yuta Sawada, Seiji Okada, Takashi Kaito","doi":"10.31616/asj.2026.0451","DOIUrl":"10.31616/asj.2026.0451","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To investigate the association between preoperative nutritional status and postoperative in-hospital falls in patients undergoing surgery for cervical myelopathy.</p><p><strong>Overview of literature: </strong>In-hospital falls are common adverse events among surgical patients; however, the association between preoperative nutritional indices and postoperative in-hospital falls in patients undergoing spinal surgery for cervical myelopathy remains unclear.</p><p><strong>Methods: </strong>We retrospectively reviewed clinical, laboratory, and surgical data of 649 patients who underwent surgery for cervical myelopathy at a single institution. Additionally, preoperative nutritional indices were assessed using the prognostic nutritional index (PNI), geriatric nutritional risk index, and controlling nutritional status score. Multivariable logistic regression and Cox proportional hazards regression analyses were performed to identify fall-related independent risk factors. Kaplan-Meier analysis was used to compare fall-free probability during hospitalization according to the PNI category.</p><p><strong>Results: </strong>Among 649 patients, 48 (7.4%) experienced postoperative in-hospital falls. Patients who experienced falls had significantly lower nutritional status. PNI showed the strongest association with falls among the evaluated nutritional indices (odds ratio [OR], 0.91; p <0.001) and the highest predictive performance, although its discriminatory ability was modest (area under the curve=0.687). A PNI value of <50 (OR, 3.74; p =0.001) and cerebrovascular disease (OR, 5.22; p <0.001) were identified as independent risk factors of falls; this was confirmed in the Cox analysis (PNI <50: hazard ratio [HR], 3.11; p =0.008; cerebrovascular disease: HR, 4.82; p <0.001).</p><p><strong>Conclusions: </strong>Preoperative PNI is a practical laboratory-based marker for identifying patients at high risk of postoperative falls, with low preoperative PNI (<50) associated with an increased risk of postoperative in-hospital falls in patients undergoing surgery for cervical myelopathy.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"698-706"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683299","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":"Diagnostic decision-making, vertebral augmentation, and osteoporosis therapy in vertebral compression fractures: a narrative review.","authors":"Garcia Annette Findlay, Mark Ehioghae, Lancelot Benn, Alejandro Perez Albela, Theodore Quan, Bryce Alexander Basques, Aviram M Giladi, Kevin Yoon, Jonathan Paul Japa, Abdi Khalif, Addisu Mesfin","doi":"10.31616/asj.2026.0108","DOIUrl":"10.31616/asj.2026.0108","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Vertebral compression fractures (VCFs) represent the most prevalent osteoporotic fracture and constitute a growing cause of morbidity, mortality, and healthcare utilization worldwide. Although often considered benign, VCFs are associated with chronic pain, progressive spinal deformity, functional impairment, decreased pulmonary capacity, and increased short- and long-term mortality, especially in older adults. Despite their high prevalence, key challenges persist regarding appropriate diagnostic evaluation, optimal treatment selection, and integration of osteoporosis management following fracture. This narrative review consolidates current evidence on the epidemiology, pathophysiology, diagnostic evaluation, management strategies, and public health implications of VCFs, with a focus on emerging spine-focused care models. VCFs predominantly result from compromised vertebral strength secondary to osteoporosis-related deterioration of trabecular microarchitecture, although traumatic and pathologic etiologies should also be considered. Diagnosis involves careful clinical assessment combined with imaging, with magnetic resonance imaging serving as a key modality for distinguishing acute fractures from chronic deformities or malignancy. Despite advances in diagnostic techniques, VCFs remain underrecognized and undertreated, contributing to avoidable disability and recurrent fractures. This narrative review synthesizes contemporary evidence, highlighting practical considerations for clinical decisionmaking in VCF care. Particular emphasis is placed on differentiating acute symptomatic fractures from chronic deformities or pathologic collapse, identifying patients most likely to benefit from vertebral augmentation, and defining surgical indications in the setting of neurologic compromise, instability, or progressive deformity. Conservative management, incorporating analgesia, early mobilization, and rehabilitation, remains the first-line approach for most stable fractures. Vertebroplasty and balloon kyphoplasty may provide short-term pain relief in carefully selected patients with persistent symptoms. However, the long-term benefits of augmentation and optimal patient selection criteria remain under investigation. Treatment options range from conservative measures-including analgesia, bracing, mobilization, rehabilitation, and osteoporosis-directed pharmacotherapy-to minimally invasive vertebral augmentation procedures such as vertebroplasty and balloon kyphoplasty. Vertebral augmentation may provide short-term improvements in pain and function in appropriately selected patients, although its long-term benefits and optimal indications remain under investigation. Surgical decompression and stabilization are reserved for patients with neurological compromise, instability, or progressive deformity. From a public health perspective, deficiencies in osteoporosis screening, delayed diagnosis, and disparities in treatment access continue to affect diverse","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"768-781"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705258","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: Can intraoperative T1 tilt predict postoperative shoulder imbalance in patients with Lenke 2 adolescent idiopathic scoliosis?: a retrospective study in Japan.","authors":"Yuki Kinoshita, Yusuke Hori, Masaki Kawamura, Takashi Namikawa, Masatoshi Hoshino, Akira Matsumura","doi":"10.31616/asj.2026.0677.r2","DOIUrl":"10.31616/asj.2026.0677.r2","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 4","pages":"821-822"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879051","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":"Extent of intramedullary short tau inversion recovery signal change predicts traumatic cervical spinal cord injury outcomes in surgically treated older adults: a multicenter study in Japan.","authors":"Takashi Takizawa, Shota Ikegami, Masashi Uehara, Hiroki Oba, Noriaki Yokogawa, Takeshi Sasagawa, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Toru Funayama, Fumihiko Eto, Akihiro Yamaji, Kota Watanabe, Satoshi Nori, Kazuki Takeda, Takeo Furuya, Atsushi Yunde, Hideaki Nakajima, Tomohiro Yamada, Tomohiko Hasegawa, Yoshinori Terashima, Ryosuke Hirota, Hidenori Suzuki, Yasuaki Imajo, Hitoshi Tonomura, Munehiro Sakata, Ko Hashimoto, Yoshito Onoda, Kenichi Kawaguchi, Yohei Haruta, Nobuyuki Suzuki, Kenji Kato, Hiroshi Uei, Hirokatsu Sawada, Kazuo Nakanishi, Hidetomi Terai, Koji Tamai, Akiyoshi Kuroda, Gen Inoue, Takashi Yurube, Yuji Kakiuchi, Katsuhito Kiyasu, Hiroyuki Tominaga, Yoichi Iizuka, Eiji Takasawa, Koji Akeda, Norihiko Takegami, Haruki Funao, Yasushi Oshima, Takashi Kaito, Daisuke Sakai, Toshitaka Yoshii, Tetsuro Ohba, Bungo Otsuki, Shoji Seki, Masashi Miyazaki, Masayuki Ishihara, Seiji Okada, Shiro Imagama, Satoshi Kato","doi":"10.31616/asj.2025.0748","DOIUrl":"https://doi.org/10.31616/asj.2025.0748","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective multicenter study.</p><p><strong>Purpose: </strong>To determine whether the extent of intramedullary hyperintensity on initial fat-suppressed short tau inversion recovery (STIR) magnetic resonance imaging (MRI) predicts neurological outcomes in elderly patients with traumatic cervical spinal cord injury (CSCI) undergoing surgery.</p><p><strong>Overview of literature: </strong>Prognostic stratification in elderly patients with CSCI remains challenging because neurological recovery varies widely. Studies focusing exclusively on surgical populations evaluating imaging predictors-particularly STIR signal changes-are limited.</p><p><strong>Methods: </strong>We retrospectively reviewed patients aged ≥65 years with traumatic CSCI treated at 33 institutions. All patients underwent surgery. Based on initial STIR MRI findings, patients were categorized as H0 (no intramedullary signal change), H1 (single-level change), or H2 (multilevel change). Neurological status was evaluated using the American Spinal Injury Association Impairment Scale (AIS) at injury and final follow-up. A good outcome was defined as AIS grade D/E at follow-up without deterioration or improvement of ≥1 AIS grade. A poor outcome was defined as AIS grade C or worse without improvement. After excluding cases with missing data, inverse probability of treatment weighting (IPTW) was applied for multivariate adjustment in 622 patients (H0=132, H1=350, H2=140).</p><p><strong>Results: </strong>Good outcomes were observed in 92% of H0, 80% of H1, and 68% of H2. Compared with H0, both H1 and H2 were independently associated with higher odds of poor outcomes (IPTW-adjusted odds ratio: 2.4 for H1 vs. H0 and 3.2 for H2 vs. H0).</p><p><strong>Conclusions: </strong>In surgically treated elderly patients with traumatic CSCI, the presence of intramedullary STIR hyperintensity at presentation-particularly across multiple levels-was strongly associated with poorer neurological recovery. The extent of STIR signal change may aid initial risk stratification and clinical decision-making.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410163","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}