Asian Spine Journal最新文献

{"title":"Uniportal endoscopic decompression and debridement for infectious diseases of spine with neurological deficits: a retrospective study in China.","authors":"Hui Lv, Jianhong Zhou, Yuan Guo, Sheng Liao, Hui Chen, Fei Luo, Jianzhong Xu, Zhongrong Zhang, Zehua Zhang","doi":"10.31616/asj.2025.0020","DOIUrl":"10.31616/asj.2025.0020","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Purpose: </strong>To evaluate the clinical efficacy of uniportal endoscopic decompression and debridement (UEDD) in treating infectious diseases of the spine (IDS) with neurological deficits.</p><p><strong>Overview of literature: </strong>IDS patients with neurological deficits often require urgent surgical decompression. However, the efficacy of UEDD in this complex patient population is not well-characterized.</p><p><strong>Methods: </strong>This retrospective study analyzed 32 consecutive IDS patients who underwent UEDD surgery. Clinical features, laboratory data (erythrocyte sedimentation rate and C-reactive protein), and treatment outcomes were analyzed.</p><p><strong>Results: </strong>Definite microorganisms were identified in 27 patients (84.3%), with 24 (88.9%) meeting cure criteria. The cure rate was significantly higher in the detected pathogen group compared to the undetected pathogen group (88.9% vs. 80%; χ²=19.36, p<0.0001). Metagenomic next generation sequencing (mNGS) provided faster diagnosis (41.72±6.81 hours) compared to tissue culture (95.74±35.47 hours, p<0.05). The predominant causative pathogen was Mycobacterium tuberculosis, followed by Staphylococcus aureus. Significant improvements were observed in Visual Analog Scale pain scores, from a mean of 7.9 preoperatively to 1.06 at 1 year postoperatively. The Oswestry Disability Index revealed a similar trend, showing significant improvement (p<0.05).</p><p><strong>Conclusions: </strong>UEDD is a viable alternative to traditional open surgery for managing IDS in high-risk patients. UEDD offers a dual therapeutic-diagnostic advantage during the initial admission phase, enabling simultaneous debridement, neurological decompression, and targeted biopsy in a single intervention. Compared with traditional tissue culture, mNGS enables rapid microbiological diagnosis and extensive pathogen coverage.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"205-216"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802430","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":"Biportal endoscopic non-facetectomy foraminal decompression and discectomy (ligamentum flavum turn-down technique).","authors":"Dae-Young Lee, Han-Bin Jin, Hee Soo Kim, Jun-Bum Lee, Si-Young Park, Seung-Hwan Kook","doi":"10.31616/asj.2025.0069","DOIUrl":"10.31616/asj.2025.0069","url":null,"abstract":"<p><p>This study introduces a novel biportal endoscopic foraminal decompression technique that minimizes bone removal while ensuring safe and effective nerve root decompression. Leveraging the accessory process as a key surgical landmark, this technique enables precise navigation and controlled turn-down of the ligamentum flavum (LF). A key advantage of this technique is its reduced requirement for bone resection, differing from traditional microscopic or uniportal endoscopic surgeries that often necessitate resection of the lateral isthmus or superior articular process. This technique is particularly beneficial for foraminal and extraforaminal herniated nucleus pulposus cases, where bony decompression needs are relatively lower compared to foraminal stenosis. Using the accessory process as a landmark also enhances surgical precision and reduces the risk of nerve root injury, providing a valuable advantage for less experienced surgeons. Despite these advantages, challenges exist, particularly at the L5-S1 level, where the less prominent accessory process and limited workspace due to anatomical constraints can pose difficulties. In cases of severe bony compression, additional bone removal may be necessary to achieve adequate decompression. In conclusion, the Non-facetectomy LF turn-down technique (non-facetectomy foraminal decompression) offers a safe and effective minimally invasive alternative for treating various foraminal pathologies.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"259-266"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802420","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":"O-arm navigation-based transforaminal unilateral biportal endoscopic discectomy for upper lumbar disc herniation: an innovative preliminary study.","authors":"Dong Hyun Lee, Choon Keun Park, Jin-Sung Kim, Jin Sub Hwang, Jin Young Lee, Dong-Geun Lee, Jae-Won Jang, Jun Yong Kim, Yong-Eun Cho, Dong Chan Lee","doi":"10.31616/asj.2025.0072","DOIUrl":"10.31616/asj.2025.0072","url":null,"abstract":"<p><strong>Study design: </strong>Technical case report.</p><p><strong>Purpose: </strong>To present a novel navigation-assisted transforaminal unilateral biportal endoscopy (UBE) lumbar discectomy technique for managing upper lumbar disc herniation.</p><p><strong>Overview of literature: </strong>Upper lumbar disc herniation is significantly less common than lower lumbar disc herniation, accounting for only 1%-2% of cases. However, treatment is more challenging and is associated with worse outcomes. Anatomical differences between the upper and lower lumbar spine complicate the standard interlaminar approach using UBE, making it insufficient for complete removal of herniated discs. Integrating endoscopic spine surgery with intraoperative navigation provides three-dimensional computer-reconstructed visual data, thereby enhancing the feasibility of the technique.</p><p><strong>Methods: </strong>The UBE approach targeted the ventral part of the superior articular process in the transforaminal UBE setup, specifically for upper lumbar disc herniation, with an approach angle of approximately 30º on the axial plane. Intraoperative navigation was employed to improve puncture accuracy for this relatively unfamiliar surgical technique. Navigation-assisted transforaminal UBE lumbar discectomy was performed on four patients presenting with back or leg discomfort due to disc herniation at the L1-L2 or L2-L3 levels.</p><p><strong>Results: </strong>All patients experienced symptom relief and were discharged on postoperative day 2.</p><p><strong>Conclusions: </strong>Transforaminal UBE lumbar discectomy is a viable therapeutic option for upper lumbar paracentral disc herniation, which is typically associated with poor prognosis. Integrating navigation integration into this novel approach enhances precision and safety.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"194-204"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802425","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":"Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey.","authors":"Bilal Bahadır Akbulut, Elif Ezgi Çenberlitaş, Mustafa Serdar Bölük, Taşkın Yurtseven, Hüseyin Biçeroğlu","doi":"10.31616/asj.2025.0050","DOIUrl":"10.31616/asj.2025.0050","url":null,"abstract":"<p><strong>Study design: </strong>Expanding upon established surgical simulation methods, we developed a fused deposition modeling three-dimensional (3D)-printed model of the C1-T1 vertebra for posterior cervical foraminotomy training that features silicone-based neural elements, polyurethane foam-based ligaments, and polyethylene terephthalate glycol vertebrae.</p><p><strong>Purpose: </strong>This study evaluated the effectiveness of a cost-efficient 3D-printed training model designed to help neurosurgical residents acquire fundamental skills in endoscopic posterior cervical foraminotomy while addressing the technique's challenging learning curve and limited training resources.</p><p><strong>Overview of literature: </strong>Only a few studies have investigated the efficacy of such a model.</p><p><strong>Methods: </strong>Eight neurosurgery residents each with over 2 years of training completed four training sessions on two randomly assigned cervical spine levels using the newly developed 3D-printed model. A simple plumbing endoscope was used for real-time surgical visualization.</p><p><strong>Results: </strong>Among the 64 completed surgical levels, left-sided procedures showed significantly higher insufficient decompression rates than did right-sided procedures (25.0% vs. 3.6%, p=0.002). However, no significant difference in overall complication rates was observed between sides (p=0.073). Surgical parameters remained consistent across sides, with no significant differences in operative duration. Brunner-Langer analysis revealed substantial improvements in operative duration (mean duration decrease from 21:42±2:15 to 6:33±0:42 minutes, p=0.004) and total complications (mean decrease from 2.1±0.8 to 0.4±0.5, p=0.007) across sessions. Although fluoroscopy timing showed marginal improvement (mean duration decrease from 2:12±1:15 to 0:55±0:23 minutes, p=0.057), the number of fluoroscopic images tended to decrease.</p><p><strong>Conclusions: </strong>Our findings suggest that this novel 3D-printed cervical spine model could be a viable, low-cost option for neurosurgical training programs aiming to help residents develop essential endoscopic skills in a controlled setting. Facilitating early proficiency in posterior cervical foraminotomy can serve as a valuable intermediate step before transitioning to cadaveric models and clinical practice.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"183-193"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802421","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: Validation of the visual body image classification in adolescent idiopathic scoliosis: a retrospective study.","authors":"Anmol Mall, Reema Rasotra","doi":"10.31616/asj.2025.0026.r1","DOIUrl":"10.31616/asj.2025.0026.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"324-325"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802423","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":"Editorial comment for the special issue on endoscopic spine surgery.","authors":"Dae-Jung Choi","doi":"10.31616/asj.2025.0330","DOIUrl":"https://doi.org/10.31616/asj.2025.0330","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 2","pages":"IV-VI"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975699","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":"Editorial comment for the special issue on endoscopic spine surgery.","authors":"Meng-Huang Wu","doi":"10.31616/asj.2025.0408","DOIUrl":"https://doi.org/10.31616/asj.2025.0408","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 2","pages":"VIII"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960132","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":"The need for long-term studies to validate endoscopic surgery.","authors":"Ju Eun Kim","doi":"10.31616/asj.2025.0402","DOIUrl":"https://doi.org/10.31616/asj.2025.0402","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 2","pages":"I-II"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960584","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":"Effectiveness of biportal endoscopic lumbar interbody fusion using the multi-layer bone grafting technique: a retrospective study from Vietnam.","authors":"Tran Vu Hoang Duong, Pham Anh Tuan, Huynh Van Vu, Chu Van Lam, Le Tan Linh, Phan Duy, Wongthawat Liawrungrueang","doi":"10.31616/asj.2024.0522","DOIUrl":"https://doi.org/10.31616/asj.2024.0522","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Purpose: </strong>This study aimed to describe the surgical technique of biportal endoscopic (BE) lumbar interbody fusion (LIF) using a multi-layer bone grafting method and to investigate its clinical effectiveness in treating patients with grade I or II lumbar spondylolisthesis (LS).</p><p><strong>Overview of literature: </strong>Previous studies have described BE-LIF; however, these reports predominantly originate from advanced centers in developed countries, using sophisticated implants such as dual transforaminal LIF (TLIF), oblique LIF, or titanium cages. In contrast, the described method utilizes hydroxyapatite (HA) bone grafts and autologous bone obtained from the preserved inferior articular process (IAP), combined with a single conventional TLIF cage, which provides a cost-effective alternative.</p><p><strong>Methods: </strong>This study included 41 patients with single-level grades 1 or 2 LS from February 2023 to February 2024. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Bridwell fusion grades were evaluated via lumbar spine computed tomography performed 6 months postoperatively.</p><p><strong>Results: </strong>Over a mean follow-up period of 10.6 months (range, 7-18 months), significant improvements were observed in VAS scores for low back pain (from 7.8±0.8 to 2.1±1.4) and leg pain (from 8.1±1.3 to 1.9±1.5) as well as ODI scores (from 50.4±15.4 to 14.8±10.5). The cohort consisted of patients with grades 1 (73.2%) and 2 LS (26.8%) at L4-L5 (58.6%), L5-S1 (34.1%), and L3-L4 (7.3%) levels. The mean operation time was 182.8±36.4 minutes, with a mean intraoperative blood loss of 190.5±81.3 mL and a mean hospital stay of 7.2±3.6 days. Successful fusion (Bridwell grades I/II) was achieved in 82.9% of the cases, with a 4.9% incidence of cage subsidence. Minor complications included durotomies in two patients (4.9%), whereas no major complications, such as nerve root injury, hardware-related issues, or postoperative infections, were reported.</p><p><strong>Conclusions: </strong>The described BE-LIF technique, using HA bone grafts, which are an autologous bone from the preserved IAP, and a TLIF cage, is a viable, safe, and effective option for treating low-grade LS. This approach achieves favorable clinical outcomes and high fusion rates, which provides a cost-effective alternative to advanced surgical implants.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 2","pages":"228-241"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960459","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: Effect of core stabilization exercises on cervical sagittal balance parameters in patients with forward head posture: a randomized controlled trial in Egypt.","authors":"Ishika, Zaki Anwer","doi":"10.31616/asj.2025.0130.r1","DOIUrl":"https://doi.org/10.31616/asj.2025.0130.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 2","pages":"326-327"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964585","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}