Asian Spine Journal最新文献

{"title":"Performance and clinical implications of machine learning models for detecting cervical ossification of the posterior longitudinal ligament: a systematic review.","authors":"Wongthawat Liawrungrueang, Sung Tan Cho, Watcharaporn Cholamjiak, Peem Sarasombath, Nattaphon Twinprai, Prin Twinprai, Inbo Han","doi":"10.31616/asj.2024.0452","DOIUrl":"10.31616/asj.2024.0452","url":null,"abstract":"<p><p>Ossification of the posterior longitudinal ligament (OPLL) is a significant spinal condition that can lead to severe neurological deficits. Recent advancements in machine learning (ML) and deep learning (DL) have led to the development of promising tools for the early detection and diagnosis of OPLL. This systematic review evaluated the diagnostic performance of ML and DL models and clinical implications in OPLL detection. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/Medline and Scopus databases were searched for studies published between January 2000 and September 2024. Eligible studies included those utilizing ML or DL models for OPLL detection using imaging data. All studies were assessed for the risk of bias using appropriate tools. The key performance metrics, including accuracy, sensitivity, specificity, and area under the curve (AUC), were analyzed. Eleven studies, comprising a total of 6,031 patients, were included. The ML and DL models demonstrated high diagnostic performance, with accuracy rates ranging from 69.6% to 98.9% and AUC values up to 0.99. Convolutional neural networks and random forest models were the most used approaches. The overall risk of bias was moderate, and concerns were primarily related to participant selection and missing data. In conclusion, ML and DL models show great potential for accurate detection of OPLL, particularly when integrated with imaging techniques. However, to ensure clinical applicability, further research is warranted to validate these findings in more extensive and diverse populations.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"148-159"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999027","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":"History of Western Pacific Orthopedic Association, Western Pacific Orthopedic Association Spine Section, and Asian Spine Journal.","authors":"Myung-Sang Moon","doi":"10.31616/asj.2024.0127","DOIUrl":"10.31616/asj.2024.0127","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 1","pages":"1-2"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555742","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.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.31616/asj.2025.0001.r1","DOIUrl":"10.31616/asj.2025.0001.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 1","pages":"162-163"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555783","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":"Hybrid decompression-based surgical strategy for treating multilevel thoracic ossification of the ligamentum flavum: a retrospective study.","authors":"Cong Nie, Kaiwen Chen, Shenyan Gu, Feizhou Lyu, Jianyuan Jiang, Xinlei Xia, Chaojun Zheng","doi":"10.31616/asj.2024.0366","DOIUrl":"10.31616/asj.2024.0366","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study design was adopted.</p><p><strong>Purpose: </strong>This study investigated the surgical modification of laminectomy, including piecemeal and en bloc resections, and compared this hybrid approach with conventional en bloc laminectomy for treating multilevel thoracic ossification of the ligamentum flavum (TOLF).</p><p><strong>Overview of literature: </strong>En bloc laminectomy is the most commonly used method for managing symptomatic TOLF. However, this approach can easily cause intraoperative spinal cord irritation, dural tear, and cerebrospinal fluid leakage (CFL).</p><p><strong>Methods: </strong>Motor-evoked potentials (MEPs) and somatosensory-evoked potentials (SEPs) were recorded in 48 patients with TOLF (hybrid 20 vs. en bloc 28) during surgery. Patients were categorized based on MEP/SEP improvement, deterioration, or no change, and MEP/SEP improvement rates were measured in the improvement group. Furthermore, all patients were assessed using the Ashworth and modified Japanese Orthopedic Association scores.</p><p><strong>Results: </strong>The incidences of both MEP/SEP improvement (21.4% vs. 25.0%, p=0.772) and deterioration (21.4% vs. 20.0%, p=0.904) were similar between the en bloc and hybrid laminectomy groups, and no difference in preoperative and postoperative clinical assessments was observed between the two groups (p>0.05). In four patients (4/28, 14.3%) undergoing en bloc laminectomy, MEP amplitudes initially increased after OLF removal but gradually decreased. This delayed MEP reduction did not occur in the hybrid laminectomy group. Furthermore, more patients undergoing en bloc laminectomy had CFL than those undergoing hybrid laminectomy (46.4% vs. 15.0%, p=0.023). In the improvement group, the hybrid laminectomy group exhibited higher MEP improvement rates in the bilateral abductor hallucis than the en bloc laminectomy group (left side: 213.4%±35.9% vs. 152.5%±41.0%, p=0.028; right side: 201.2%±32.0% vs. 145.2%±46.3%, p=0.043).</p><p><strong>Conclusions: </strong>Compared with en bloc laminectomy, hybrid laminectomy may be a safe and effective method for treating multilevel TOLF, potentially reducing intraoperative spinal cord irritation and CFL and causing relatively better functional recovery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 1","pages":"74-84"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555714","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":"Minimally invasive transforaminal interbody fusion for high-grade spondylolisthesis: a retrospective study analysis of a tailor-made solution.","authors":"Arvind Gopalrao Kulkarni, Priyambada Kumar, Arvind Umarani, Shankargouda Patil, Sunil Chodavadiya","doi":"10.31616/asj.2024.0378","DOIUrl":"10.31616/asj.2024.0378","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Purpose: </strong>We investigated cantilever reduction and fusion technique in high-grade spondylolisthesis (HGS) with minimally invasive surgery-transforaminal interbody fusion (MIS-TLIF).</p><p><strong>Overview of literature: </strong>Most publications that describe minimally invasive surgeries for HGS, especially grade 4 or 5 listhesis, utilized a combined anterior and posterior approach. To the best of our knowledge, a detailed report that provides specific technical nuances for optimal use of a posterior-only approach utilizing MIS-TLIF is greatly lacking.</p><p><strong>Methods: </strong>This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS- TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years.</p><p><strong>Results: </strong>This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years.</p><p><strong>Conclusions: </strong>MIS-TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 1","pages":"10-20"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555784","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":"Which subtypes of degenerative lumbar spondylolisthesis are suitable for oblique lumbar interbody fusion? A retrospective study in China based on the clinical and radiographic degenerative spondylolisthesis classification.","authors":"Xianghe Wang, Hongwei Wang, Xiaosheng Ma, Xinlei Xia, Feizhou Lyu, Haocheng Xu, Hongli Wang","doi":"10.31616/asj.2024.0310","DOIUrl":"10.31616/asj.2024.0310","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Purpose: </strong>To evaluate the radiological characteristics of degenerative lumbar spondylolisthesis (DS) and analyze the suitability of oblique lumbar interbody fusion (OLIF) for different DS subtypes.</p><p><strong>Overview of literature: </strong>OLIF has gained distinction for its minimal invasiveness and quicker recovery. Despite its promising effectiveness in treating DS, variations in patient characteristics necessitate precise surgical technique selection. The clinical and radiographic degenerative spondylolisthesis (CARDS) classification aids in identifying suitable DS subtypes.</p><p><strong>Methods: </strong>From March 2020 to March 2023, 100 inpatients with DS were classified into groups A, B, C, and D based on the CARDS classification system. Preoperative radiological data were analyzed to measure the severity of central canal stenosis, facet joint arthropathy, intervertebral disc herniation, and spinal epidural lipomatosis, osteophyte formation, range of motion (ROM), and computed tomography value of the vertebral bodies. The radiological characteristics and clinical contraindications for OLIF were compared among the groups.</p><p><strong>Results: </strong>Of the 100 patients, 51% had clinical contraindications for OLIF, which included 85%, 25%, 62.5%, and 20% of patients in groups A, B, C, and D, respectively. Compared with group B, group A demonstrated greater severity of central canal stenosis, whereas group C showed a higher degree of facet joint arthropathy. More patients in groups A and C had severe central canal stenosis. Regarding the ROM results, group A had segmental stiffness, whereas group D presented relatively unstable slip segments.</p><p><strong>Conclusions: </strong>Patients with different DS subtypes have varied radiological characteristics. Groups B and D are suitable candidates for OLIF. Most patients in group A are unsuitable for OLIF because of bony hyperplasia, severe spinal stenosis, and segmental stiffness.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 1","pages":"112-120"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555785","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":"Functional outcomes of microdiscectomy in Bertolotti syndrome: the relationship between lumbosacral transitional vertebrae and lumbar disc herniation: a prospective study in Greece.","authors":"Stylianos Kapetanakis, Krikor Gkoumousian, Nikolaos Gkantsinikoudis, Constantinos Chaniotakis","doi":"10.31616/asj.2024.0213","DOIUrl":"10.31616/asj.2024.0213","url":null,"abstract":"<p><strong>Study design: </strong>The lumbosacral transitional vertebrae (LSTV) in patients with Bertolotti syndrome (BS) cause alterations in the biomechanics of the lumbosacral junction. These entities have been associated with secondary conditions, such as lumbar disc herniation (LDH).</p><p><strong>Purpose: </strong>To investigate the clinical outcomes of microdiscectomy in patients with symptomatic LDH and BS.</p><p><strong>Overview of literature: </strong>There is limited data in the literature on the functional outcomes of patients with LSTV who undergo microdiscectomy.</p><p><strong>Methods: </strong>This study enrolled 308 patients diagnosed with LDH and concurrent LSTV. All patients underwent microdiscectomy. Clinical evaluation was performed preoperatively and at distinct follow-up intervals of 1, 3, 6, and 12 months, and 2 and 5 years postoperatively. Assessment included clinical examination and implementation of the well-established, patient-reported outcome measures Visual Analog Scale (VAS) and Short-Form 36 (SF-36) Medical Health Survey Questionnaire for Health-Related Quality of Life (HRQoL) analysis. Furthermore, the anatomical relationship between LSTV and LDH was also studied.</p><p><strong>Results: </strong>The SF-36 indices and VAS score were statistically significantly ameliorated within the follow-up period. Maximum improvement was noted at 3 months, with further minimal improvement after 6 months, and stabilization of indices until the end of followup. Castellvi type IB was the most frequent LSTV type. The adjacent level (L4-L5) just above the LSTV was the most affected with an incidence of 72.1%. In the subgroups of Castellvi type IA, IIA, and IIIA, the LDH side was ipsilateral with the LSTV in 38.3% of patients. In this study, all patients underwent microdiscectomy and demonstrated favorable clinical outcomes (functional recovery and pain relief) and notable amelioration of HRQoL.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the first study to conduct a holistic assessment in an attempt to delineate the impact of LSTV presence on the postoperative HRQoL of these individuals.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 1","pages":"94-101"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555739","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":"Atlantodentoplasty using the anterior retropharyngeal approach for treating irreducible atlantoaxial dislocation with atlantodental bony obstruction: a retrospective study.","authors":"Jia Shao, Yun Peng Han, Yan Zheng Gao, Kun Gao, Ke Zheng Mao, Xiu Ru Zhang","doi":"10.31616/asj.2024.0362","DOIUrl":"10.31616/asj.2024.0362","url":null,"abstract":"<p><strong>Study design: </strong>This was a retrospective study.</p><p><strong>Purpose: </strong>The current study aimed to investigate the clinical efficacy of atlantodentoplasty using the anterior retropharyngeal approach against irreducible atlantoaxial dislocation with atlantodental bony obstruction.</p><p><strong>Overview of literature: </strong>In cases of atlantoaxial dislocation with atlantodental bony obstruction, owing to the presence of an osteogenic mass between the atlas and odontoid process, reduction is challenging to complete using the posterior approach. Transoral odontoidectomy is technically demanding and is associated with several risks.</p><p><strong>Methods: </strong>The clinical data of 26 patients diagnosed with irreducible atlantoaxial dislocation complicated by atlantodental bony obstruction were analyzed retrospectively. All patients underwent anterior retropharyngeal atlantodentoplasty, followed by posterior occipitocervical fusion. Details including surgical duration and blood loss volume were recorded. Radiographic data such as the anterior atlantodental interval, O-C2 angle, space available for the cord, clivus-canal angle, and cervical medullary angle, and clinical data including the Japanese Orthopedic Association (JOA) score were assessed. The fusion time of the grafted bone and the development of complications were examined.</p><p><strong>Results: </strong>In patients undergoing anterior retropharyngeal atlantodentoplasty, the surgical duration and blood loss volume were 120.1±16.4 minutes and 100.6±33.5 mL, respectively. The anterior atlantodental interval decreased significantly after the surgery (p <0.001). The O-C2 angle, space available for the cord, clivus-canal angle, and cervical medullary angle increased significantly after the surgery (p <0.001). The JOA score during the latest follow-up significantly increased compared with that before the surgery (p <0.001). The improvement rate of the JOA score was 80.8%±18.1%. The fusion time of the grafted bone was 3-8 months, with an average of 5.7±1.5 months. In total, 11 patients presented with postoperative dysphagia and three with irritating cough. However, none of them exhibited other major complications.</p><p><strong>Conclusions: </strong>Anterior retropharyngeal atlantodentoplasty can anatomically reduce the atlantoaxial joint with a satisfactory clinical outcome in patients with irreducible atlantoaxial dislocation with atlantodental bony obstruction.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"54-63"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999014","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":"Cervical spondylotic myelopathy and radiculopathy: a stepwise approach and comparative analysis of surgical outcomes: a narrative review of recent literature.","authors":"Min-Woo Kim, Ye-Soo Park, Chang-Nam Kang, Sung Hoon Choi","doi":"10.31616/asj.2024.0465","DOIUrl":"10.31616/asj.2024.0465","url":null,"abstract":"<p><p>Selecting the optimal surgical treatment for multilevel cervical spondylotic myelopathy and radiculopathy significantly affects symptom improvement, postoperative prognosis, and quality of life. Proper patient selection and precise surgical execution are crucial for achieving successful outcomes, considering the favorable natural course of cervical radiculopathy. Several factors must be considered, including the number of affected segments, spinal alignment, kyphosis degree, stiffness, and surgeon expertise, when determining the surgical approach for cervical spondylotic myelopathy. An anterior approach is commonly used in cases that involve fewer than three segments with mild kyphosis, whereas posterior laminoplasty or anterior cervical discectomy and fusion (ACDF) are effective for cases with more than three segments with maintained lordosis. Both the degree of stiffness and spinal cord compression need to be considered for cases with kyphotic deformity. ACDF may be suitable when anterior structures are the primary source of compression and mild kyphosis is present. The decision between laminoplasty or laminectomy and fusion depends on the kyphosis degree for multilevel compression with kyphosis. An evaluation of cervical rigidity is required for severe kyphosis, and posterior laminectomy and fusion may be effective for flexible kyphosis, whereas a staged posterior-anterior-posterior approach may be required for rigid kyphosis to address both deformity and neural compression. This review summarizes recent research and presents illustrative cases of optimal surgical decision-making for various cervical spondylotic radiculopathy and myelopathy presentations.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"121-132"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999042","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: Factors related to surgical site infection in spinal instrumentation surgery: a retrospective study in Japan.","authors":"Xiangji Liu, Hao Wu","doi":"10.31616/asj.2025.0029.r1","DOIUrl":"10.31616/asj.2025.0029.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"19 1","pages":"164-165"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555719","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}