Asian Spine Journal最新文献

{"title":"Bone fusion materials: past, present, and future.","authors":"Young-Hoon Kim, Ki-Won Kim, Kee-Won Rhyu, Jong-Beom Park, Jae-Hyuk Shin, Young-Yul Kim, Jun-Seok Lee, Joong-Hyun Ahn, Ji-Hyun Ryu, Hyung-Youl Park, Sang-Il Kim","doi":"10.31616/asj.2024.0520","DOIUrl":"10.31616/asj.2024.0520","url":null,"abstract":"<p><p>Bone fusion is one of the mainstay managements for degenerative spinal diseases and critical-sized bone defects resulting from trauma, tumors, infection, and nonunion. Bone graft materials are required for promoting bone healing, with autografts historically considered the gold standard due to their osteogenic, osteoinductive, and osteoconductive properties. However, donor site morbidities have led to the development of alternative bone graft substitutes. Currently available alternative options for bone fusion include allografts, ceramics, demineralized bone matrix (DBM), and bone morphogenetic proteins (BMPs). Each material has its advantages and disadvantages. Allografts avoid donor site morbidities but lack osteogenic properties and pose disease transmission risks. DBMs are acid-extracted allografts that have osteoconductive and osteoinductive properties but require combination with autografts because of the lack of evidence for their stand-alone use. BMP-2 has potent osteoinductive properties and is considered an ideal fusion material, but faces unresolved challenges related to optimal dosage and carrier. Synthetic peptides, mimicking the cell-binding domain of type I collagen, facilitate the attachment of osteogenic cells (such as osteoblasts) to the graft material and the production of extracellular matrix, leading to improved bone growth at the fusion site. The development of materials with ideal properties is a research hotspot. Recent advancements in biomaterials, such as hydrogels, nanomaterials, and three-dimensional-printed biomaterials, offer promising future options for bone fusion. This review provides an overview of available bone fusion materials, their advantages and disadvantages, and introduces emerging candidate options for bone fusion.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"490-500"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188038","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":"Inhibitory effect of MLC901 on axonal demyelination in experimental animals undergoing circumferential lumbal stenosis by increasing transforming growth factor-β1 levels.","authors":"Kevin Jonathan Sjukur, Willy Adhimarta, Andi Asadul Islam, Bambang Priyanto, Andriany Qanitha","doi":"10.31616/asj.2024.0364","DOIUrl":"10.31616/asj.2024.0364","url":null,"abstract":"<p><strong>Study design: </strong>Experimental study using circumferential lumbar stenosis (CLS) rat model.</p><p><strong>Purpose: </strong>To investigate the effect of MLC901 administration on transforming growth factor (TGF)-β1 level and the degree of axonal demyelination in the CLS rat model.</p><p><strong>Overview of literature: </strong>CLS is common in older adults, causing neuropathic pain that impairs daily functioning. TGF-β1 plays an essential role in nerve regeneration and reducing axonal demyelination in CLS. MLC901, a traditional therapeutic formula, has shown promise in preclinical studies, including modulating proinflammatory cytokines. While MLC901's effect on serum TGF-β1 levels in the CLS rat model has been explored, its impact on tissue TGF-β1 expression remains understudied.</p><p><strong>Methods: </strong>Rats were randomly allocated into one of six groups: no CLS (baseline), CLS only (pretreatment), short treatment (1 day) with MLC901, short treatment with placebo, longer treatment (7 days) with MLC901, and longer treatment with placebo. The CLS model was induced by laminectomy at the lumbar 5th vertebra, followed by teflon insertion around the dura mater. Serum TGF-β1 levels were measured using enzyme-linked immunosorbent assay. Tissue TGF-β1 expression and the degree of axonal demyelination were assessed by immunohistochemistry and histopathology, respectively.</p><p><strong>Results: </strong>Long treatment MLC901 group had significantly higher serum TGF-β1 levels than the pretreatment group (p<0.001). Long treatment MLC901 group also exhibited the highest TGF-β1 tissue expression among all treatment groups, including the baseline group (p=0.013). Axonal demyelination was lowest in the long treatment MLC901 group, indicated by the highest number of Schwann cells (p<0.001), the fewest inflammatory cells (except versus baseline) (p=0.001), and the fewest vacuoles (except versus baseline) (p=0.015).</p><p><strong>Conclusions: </strong>MLC901 can inhibit axonal demyelination in experimental animals undergoing CLS surgery by upregulating TGF-β1 levels. MLC901 has the potential to be used as an adjuvant therapy in CLS surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"333-345"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975256","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: Rapid bodyweight reduction before lumbar fusion surgery increased postoperative complications.","authors":"Sanjay Rawat, Sarvdeep Dhatt, Vijay Goni, Vishal Kumar, Devendra Chouhan","doi":"10.31616/asj.2020.0611.r1","DOIUrl":"10.31616/asj.2020.0611.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"501-502"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198175","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 density comparison between the normal pedicle trajectory, cortical bone trajectory, and modified cortical bone trajectory using computed tomography: a cross-sectional study.","authors":"Bikash Parajuli, Dipak Shrestha, Kuniyoshi Abumi, Sabik Kayastha, Jagadish Thapa, Sanjay Sharma, Suman Lamichhane, Christian Deininger","doi":"10.31616/asj.2024.0377","DOIUrl":"10.31616/asj.2024.0377","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Purpose: </strong>To compare bone density by computed tomography Hounsfield unit (CTHU) between the original pedicle trajectory (OPT), cortical bone trajectory (CBT), and modified cortical bone trajectory (MCBT).</p><p><strong>Overview of literature: </strong>The significant pullout strength in CBT is believed to be due to increased screw-cortical bone contact; however, it allows for shorter/less-diameter screw placement, and the fixation is limited to the posterior one-third of the vertebral body, compromising the screw anchorage in the anterior vertebra.</p><p><strong>Methods: </strong>Computed tomography transverse sections of the L1-L5 (1,000 vertebrae) of 200 patients were cut into three planes: (1) horizontal to the pedicle, representing the plane for OPT; (2) in the caudocranial plane in the sagittal plane and divergent in the transverse plane representing the CBT; and (3) the caudocranial plane in the sagittal plane and parallel in the transverse plane representing the MCBT. For each trajectory, the CTHU of four points, namely, posterior cortex, mid-pedicle, midbody, and anterior cortex, were compared within the area of screw insertion.</p><p><strong>Results: </strong>The mean CTHUs of OPT, CBT, and MCBT were 354.2±70 HU, 529.9±75 HU, and 457.3±90 HU, respectively (p <0.01). The CTHU of the posterior cortex in MCBT was 65.6% higher than that in OPT and 14.9% lower than that in CBT. A comparable decline in CTHU with age was noted in CBT and MCBT (Pearson's r : -0.20 vs. -0.22; adjusted R 2: 0.040 vs. 0.047). However, a higher decline in CTHU with age was observed in OPT (Pearson's r =-0.38, adjusted R 2=0.14).</p><p><strong>Conclusions: </strong>MCBT has a significantly higher CTHU than OPT. The density in the posterior cortex in MCBT is comparable to that in the CBT trajectory. MCBT appears to be an alternative trajectory for lumbar spine fixation.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"372-379"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539999","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":"Predictors of hospitalization for longer than one day following elective single-level anterior cervical discectomy and fusion: a retrospective case-control database study.","authors":"Sam Han Jiang, James W Nie, Nauman Shaukat Chaudhry, Saavan Patel, Darius Ansari, Ashwin Ganesh, Jeffrey Z Nie, Jaimin Patel, Ankit Indravadan Mehta","doi":"10.31616/asj.2024.0321","DOIUrl":"10.31616/asj.2024.0321","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective case-control study.</p><p><strong>Purpose: </strong>To understand the risk factors for prolonged hospitalization following anterior cervical discectomy and fusion (ACDF) to reduce postoperative complications and better identify optimal candidates for elective ACDF.</p><p><strong>Overview of literature: </strong>Despite the proven safety of ACDF, many patients may experience prolonged postoperative hospitalization.</p><p><strong>Methods: </strong>Data were collected from the American College of Surgeons National Surgical Quality Improvement Program dataset spanning 2017-2019. The primary outcome of interest was the length of stay (LOS). The study population was divided into two cohorts: those with LOS ≤1 day and those with LOS >1 day. Univariate and multivariate analyses were performed to identify predictors of LOS >1 day. Propensity score matching and group comparisons were used to evaluate pre- and post-discharge complication rates between the cohorts.</p><p><strong>Results: </strong>A total of 12,906 patients with ACDF were identified in the database and considered eligible for the study. Of these patients, 69.5% had LOS ≤1 day and 30.5% had LOS >1 day. Factors associated with LOS >1 day included age ≥65 years, female sex, non-White race, American Society of Anesthesiologists classification 3, dependent functional status, and operation length of 120-150 minutes and >150 minutes. Patients with LOS >1 day were more likely to undergo intraoperative or postoperative blood transfusions (0.1% vs. 0.7%, p<0.001), unplanned reoperations (0% vs. 1.7%, p<0.001), and develop pneumonia during hospitalization (0% vs. 0.7%, p<0.001). These patients were also more likely to be readmitted (2.7% vs. 4.3%, p<0.001).</p><p><strong>Conclusions: </strong>Older patients, those with poorer functional status, and those who undergo longer operative times are more likely to experience prolonged postoperative hospitalization. These patients are also at increased risk of complications such as pneumonia, blood transfusions, reoperation, and readmission. Careful patient selection for ACDF is essential to reduce the risk of prolonged hospitalization and associated complications.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"389-398"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540021","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: A new classification of atlas fracture based on computed tomography: reliability, reproducibility, and preliminary clinical significance.","authors":"Everpraise Siangshai, Anmol","doi":"10.31616/asj.2025.0185.r1","DOIUrl":"10.31616/asj.2025.0185.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 3","pages":"503-504"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537938","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":"Can generative artificial intelligence provide accurate medical advice?: a case of ChatGPT versus Congress of Neurological Surgeons management of acute cervical spine and spinal cord injuries clinical guidelines.","authors":"Michael Saturno, Mateo Restrepo Mejia, Wasil Ahmed, Alexander Yu, Akiro Duey, Bashar Zaidat, Fady Hijji, Jonathan Markowitz, Jun Kim, Samuel Cho","doi":"10.31616/asj.2024.0301","DOIUrl":"10.31616/asj.2024.0301","url":null,"abstract":"<p><strong>Study design: </strong>An experimental study.</p><p><strong>Purpose: </strong>To explore the concordance of ChatGPT responses with established national guidelines for the management of cervical spine and spinal cord injuries.</p><p><strong>Overview of literature: </strong>ChatGPT-4.0 is an artificial intelligence model that can synthesize large volumes of data and may provide surgeons with recommendations for the management of spinal cord injuries. However, no available literature has quantified ChatGPT's capacity to provide accurate recommendations for the management of cervical spine and spinal cord injuries.</p><p><strong>Methods: </strong>Referencing the \"Management of acute cervical spine and spinal cord injuries\" guidelines published by the Congress of Neurological Surgeons (CNS), a total of 36 questions were formulated. Questions were stratified into therapeutic, diagnostic, or clinical assessment categories as seen in the guidelines. Questions were secondarily grouped according to whether the corresponding recommendation contained level I evidence (highest quality) versus only level II/III evidence (moderate and low quality). ChatGPT-4.0 was prompted with each question, and its responses were assessed by two independent reviewers as \"concordant\" or \"nonconcordant\" with the CNS clinical guidelines. \"Nonconcordant\" responses were rationalized into \"insufficient\" and \"contradictory\" categories.</p><p><strong>Results: </strong>In this study, 22/36 (61.1%) of ChatGPT's responses were concordant with the CNS guidelines. ChatGPT's responses aligned with 17/24 (70.8%) therapeutic questions and 4/7 (57.1%) diagnostic questions. ChatGPT's response aligned with only one of the five clinical assessment questions. Notably, the recommendations supported by level I evidence were the least likely to be replicated by ChatGPT. ChatGPT's responses agreed with 80.8% of the recommendations supported exclusively by level II/III evidence.</p><p><strong>Conclusions: </strong>ChatGPT-4 was moderately accurate when generating recommendations that aligned with the clinical guidelines. The model frequently aligned with low evidence and therapeutic recommendations but exhibited inferior performance on topics that contained high-quality evidence or pertained to diagnostic and clinical assessment strategies. Medical practitioners should monitor its usage until further models can be rigorously trained on medical data.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"432-443"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540011","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 sarcopenia on outcomes following vertebral augmentation for osteoporotic vertebral compression fracture: a systematic review and meta-analysis.","authors":"Bao Tu Thai Nguyen, Tan Thanh Nguyen, Yi-Jie Kuo, Yu-Pin Chen","doi":"10.31616/asj.2024.0467","DOIUrl":"10.31616/asj.2024.0467","url":null,"abstract":"<p><p>Vertebral augmentation is a safe and effective treatment for osteoporotic vertebral compression fractures (OVCFs) in elderly patients. The impact of sarcopenia on post-procedure outcomes has been debated. This meta-analysis examined its effect on outcomes following vertebral augmentation in OVCF patients. Several electronic databases were searched until August 2024 for studies that compared patients with and without sarcopenia after kyphoplasty or vertebroplasty for OVCFs. The outcomes of interest were the rates of vertebral refracture and residual back pain (RBP), clinical outcomes, length of hospital stay, and mortality rate. The pooled results are presented as odds ratios (ORs) or mean differences with corresponding 95% confidence intervals (CIs). Fourteen studies involving 2197 patients with OVCF treated with vertebral augmentation were included. Of these patients, 813 had sarcopenia and 1384 did not, with a mean age of 73.06. Patients with sarcopenia exhibited a higher prevalence of refracture than those without sarcopenia (OR, 2.92; 95% CI, 1.34-6.34; p =0.007). Patients without sarcopenia had a 64% lower risk of RBP than those with sarcopenia (OR, 0.36; 95% CI, 0.23-0.56; p <0.001). Additionally, patients with sarcopenia demonstrated worse postoperative clinical outcomes, longer hospital stays, and a significantly higher risk of mortality. Sarcopenia adversely affects patients undergoing vertebral augmentation for OVCFs. Early diagnosis of sarcopenia in patients with OVCF and the adoption of comprehensive management strategies to improve and maintain muscle health are recommended (PROSPERO registry number: CRD42024578202).</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"476-489"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539959","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":"Complications and curve progression in EOS patients with extended distraction surgery intervals in growing rod surgery: a retrospective cohort study in China.","authors":"Jianqiang Wang, Haoshuang Geng, Lijin Zhou, Yong Hai","doi":"10.31616/asj.2024.0426","DOIUrl":"10.31616/asj.2024.0426","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective case-control study.</p><p><strong>Purpose: </strong>This study aimed to explore the relationship between the rod-lengthening interval and the incidence of postoperative complications as well as the outcomes in patients with early-onset scoliosis (EOS) undergoing growing rod surgery.</p><p><strong>Overview of literature: </strong>EOS is characterized by a spinal deformity that manifests before the age of 10 years. The growing rod technique allows for spinal curvature correction while preserving spinal growth through periodic lengthening surgeries typically performed every 6 months. However, we found that due to challenges, many patients undergo a 1-year or even longer interval between lengthening surgeries.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 59 patients with EOS who underwent growing rod surgery at our institution between August 2012 and June 2022. We collected radiographic parameters to compare the differences in outcomes and complications between patients who underwent lengthening surgeries at intervals of 12 months versus those with intervals of >12 months.</p><p><strong>Results: </strong>In this study, we found 29 complications in 59 patients. The complication rate was significantly lower in the group with lengthening intervals of 12 months compared with the group with intervals longer than 12 months (35.3% vs. 68%, p <0.05). In addition, patients in the group with intervals of 12 months showed less progression of the main curve, a lower maximum kyphosis angle, and greater increases in height in the fixed segments (d=7.53±3.69 cm, p <0.05). In contrast, patients with lengthening intervals longer than 12 months were more likely to experience sagittal plane imbalance (p <0.05).</p><p><strong>Conclusions: </strong>Lengthening intervals of greater than 12 months have a higher rate of complications and increase the risk of curve progression and spinal imbalance. Increasing the interval time just to minimize the number of surgeries before the final fusion is unwise.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"399-407"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540031","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":"Modified Wiltse approach versus conventional posterior approach for treating single-segment spinal tuberculosis and infections: a retrospective study of 102 cases in Guangxi Province, China.","authors":"Abu Moro, ShiAn Liao, Yue Fan, Yihan Wang, Wenfei Gu, Xinli Zhan, JinSong Yang","doi":"10.31616/asj.2024.0440","DOIUrl":"https://doi.org/10.31616/asj.2024.0440","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Purpose: </strong>To compare the modified Wiltse with the conventional posterior approach for single-segment spinal tuberculosis/infections.</p><p><strong>Overview of literature: </strong>Spinal infections (such as spondylitis, discitis, and spondylodiscitis) are therapeutically challenging owing to their pathophysiological complexities and delayed diagnosis, particularly in developing countries. Despite treatment advancements, challenges persist, which include multidrug resistance and surgery-related complications.</p><p><strong>Methods: </strong>A retrospective analysis of 102 patients who underwent single-segment spinal tuberculosis surgery was conducted to compare patients who underwent surgery using the conventional posterior with those using the modified Wiltse approach. The key parameters analyzed included surgical duration, blood loss, complication rates, intensive care unit stay, deformity correction, and neurological improvement.</p><p><strong>Results: </strong>The modified Wiltse group exhibited lower intraoperative hemorrhage (184.72 mL vs. 365.91 mL, p<0.05) without significant differences in surgery duration and other tested outcomes. Both groups demonstrated significant improvement in thoracic kyphosis over time (p<0.01) and between the groups, with pairwise comparisons showing significant improvement from preoperative to postoperative and from preoperative to follow-up (p<0.01) but not from postoperative to follow-up, demonstrating postoperative kyphotic stability. Significant improvements in lumbar lordosis (p=0.047) and within the groups (p=0.002) were observed over time; however, pairwise comparisons did not reveal significant differences (p >0.05), demonstrating surgical intervention that focused on lordotic stability rather than correction in both groups. Significant neurological improvements were also observed, with the modified Wiltse group demonstrating superior recovery to the conventional posterior group from baseline.</p><p><strong>Conclusions: </strong>The modified Wiltse approach offers a promising alternative to conventional techniques by reducing intraoperative blood loss while maintaining efficacy in deformity correction and neurological recovery. It is a viable option for patients who require reduced invasiveness and blood loss.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198176","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}