Asian Spine Journal最新文献

{"title":"Efficacy of gabapentin and pregabalin for the treatment of neurogenic claudication in lumbar spinal stenosis: a double-blind randomized placebo-controlled trial.","authors":"Chatupon Chotigavanichaya, Korawish Mekariya, Borriwat Santipas, Sirichai Wilartratsami, Ekkapoj Korwutthikulrangsri, Monchai Ruangchainikom, Panya Luksanapruksa","doi":"10.31616/asj.2025.0096","DOIUrl":"https://doi.org/10.31616/asj.2025.0096","url":null,"abstract":"<p><strong>Study design: </strong>A double-blind randomized placebo-controlled trial.</p><p><strong>Purpose: </strong>To evaluate the efficacy and safety of gabapentin (GBA) and pregabalin (PGB) versus placebo in managing neurogenic intermittent claudication (NIC), functional outcomes, and quality of life in patients with lumbar spinal stenosis (LSS).</p><p><strong>Overview of literature: </strong>GBA and PGB are frequently prescribed for NIC associated with LSS. However, evidence supporting their efficacy, either in comparison with placebo or in direct comparison between the two gabapentinoids in LSS, remains limited.</p><p><strong>Methods: </strong>LSS patients with predominant NIC symptoms for ≥3 months were randomized (1:1:1) to receive GBA (1,800 mg/day), PGB (300 mg/day), or placebo in addition to standard conservative management, including physical therapy and naproxen. GBA and PGB were both titrated to the effective dose over 14 days. The primary outcome was NIC pain measured by Visual Analog Scale (VAS). Secondary outcomes included the Swiss Spinal Stenosis Score (SSS), self-paced shuttle walk test (SPSWT; time to NIC symptoms and walking distance), Euro-QoL Group's 5-Dimension, 5-Level (EQ-5D-5L), and adverse effects. All outcomes were assessed monthly over 4 months.</p><p><strong>Results: </strong>Ninety patients (mean age, 63.14 years; symptoms duration, 19.38 months) were included. All groups demonstrated significant improvements in VAS, SSS, SPSWT, and EQ-5D-5L at 4 months. At 1 and 2 months, PGB showed greater EQ-5D-5L improvement compared to GBA (mean differences: 0.07 [p=0.045] and 0.08 [p=0.001], respectively). No significant differences in other outcomes were observed between groups at any time point. Adverse effects, including dizziness and sedation, were more common in the GBA and PGB groups compared to placebo (p<0.001).</p><p><strong>Conclusions: </strong>GBA and PGB did not demonstrate superior efficacy over placebo in reducing NIC and improving functional outcomes in LSS. Moreover, their use was associated with a higher incidence of adverse effects. These findings suggest limited utility for gabapentinoids as adjunctive treatments for LSS.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940361","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}

{"title":"Superior facet joint violation after lumbar pedicle screw placement: a scoping review of prevalence, biomechanics, and implications for adjacent segment disease.","authors":"Conor McNamee, Jake Michael McDonnell, David Kelly, Harry Marland, Stacey Darwish, Joseph Simon Butler","doi":"10.31616/asj.2025.0143","DOIUrl":"https://doi.org/10.31616/asj.2025.0143","url":null,"abstract":"<p><p>Facet joint violation (FJV) is a known complication of pedicle screw fixation that may contribute to adjacent segment disease (ASD) by altering spinal biomechanics and increasing loading of the cranial facet joints. However, the prevalence, biomechanical effects, and longterm consequences of FJV remain unclear. A scoping review was conducted using the PubMed, Embase, and Scopus databases. Clinical studies reporting the number of FJVs in relation to screws placed during lumbar fusion or assessing the frequency of ASD in patients with FJV were included. Biomechanical studies evaluating segmental kinematics and loading after FJV were also included. Data regarding study characteristics, surgical techniques, FJV rates, severity grading, and outcomes were extracted. Bayesian statistical models were applied for pooled prevalence estimates. Fifty studies met the inclusion criteria (39 clinical and 11 biomechanical studies). The prevalence of FJV varied, with robotic-assisted percutaneous placement associated with the lowest risk (4.79%; 95% credible interval [CrI], 3.88-5.79), and freehand percutaneous placement associated with the highest risk (19.45%; 95% CrI, 18.15-20.73). FJV rates were highest at L2 (14.5%; 95% CrI, 10.4%-19.0%) compared to lower levels. Biomechanical studies indicate that minor FJV may destabilize the superior segment by disrupting the facet capsule, while severe FJV involving full joint traversal might stabilize the segment due to the screw's interaction with both articulating processes. Limited evidence suggests an association between FJV and ASD, though methodological limitations, selection bias, and reporting errors limit conclusions. FJV is common during lumbar fusion, especially with percutaneous screw placement. While biomechanical evidence suggests differing grades of FJV may variably alter segmental stability, its role in ASD development remains uncertain. Given its prevalence, biomechanical implications, and potential mitigation through navigation or robotics, determining whether FJV is a clinically significant driver of ASD is a key research imperative.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940324","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}

{"title":"Augmented reality-guided pedicle screw fixation: an experimental study.","authors":"Sang-Min Park, Dongjoon Kim, Jiwon Park, Ho-Joong Kim, Jin S Yeom","doi":"10.31616/asj.2025.0163","DOIUrl":"https://doi.org/10.31616/asj.2025.0163","url":null,"abstract":"<p><strong>Study design: </strong>Cadaveric experimental study.</p><p><strong>Purpose: </strong>To evaluate the feasibility and accuracy of pedicle screw placement using a custom-developed augmented reality-assisted pedicle screw fixation (ARPSF) system in a porcine spine model.</p><p><strong>Overview of literature: </strong>Conventional pedicle screw placement techniques face limitations including potential inaccuracy, radiation exposure, and workflow disruption. Augmented reality technology can overlay virtual surgical planning directly onto the operative field while maintaining the surgeon's focus on the patient.</p><p><strong>Methods: </strong>Five porcine cadaveric lumbar spines were used in this study. A custom-developed head-mounted display system with optical tracking projected three-dimensional reconstructed spine models and planned screw trajectories into the surgeon's field of view. A single experienced spine surgeon placed 50 pedicle screws (4.5 mm diameter). Registration was performed using a point-pair matching technique with fifteen anatomical landmarks. Accuracy was assessed via postoperative computed tomography scan, measuring entry point deviation, trajectory deviation, and angular difference, and evaluated using the Gertzbein-Robbins classification.</p><p><strong>Results: </strong>Of the 50 pedicle screws placed, 47 (94%) achieved grade A accuracy with complete containment within the pedicle. The remaining three screws (6%) were classified as grade B, with minor breaches less than 2 mm. No unsafe placements (grades C-E) occurred. The mean entry point deviation was 0.55 mm (standard deviation [SD]=0.33 mm), and the mean deviation at the screw tip was 0.71 mm (SD=0.32 mm). The mean axial angular deviation was 2.04° (SD=0.58°). The average placement time was 2.2 minutes per screw.</p><p><strong>Conclusions: </strong>The custom-developed ARPSF system demonstrated high accuracy for pedicle screw placement in a porcine model, achieving submillimeter precision and minimal angular deviation. This experimental study shows the potential of augmented reality technology to enhance spine instrumentation precision.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939712","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}

{"title":"Proposal of a new indicator of hip compensation for spinopelvic-hip mismatch: a retrospective study in Japan.","authors":"Ryo Fujita, Kohei Takahashi, Ko Hashimoto, Kazuyoshi Baba, Kenichiro Yahata, Takahiro Onoki, Takashi Aki, Keisuke Ishikawa, Toshimi Aizawa","doi":"10.31616/asj.2024.0475","DOIUrl":"https://doi.org/10.31616/asj.2024.0475","url":null,"abstract":"<p><strong>Study design: </strong>retrospective study.</p><p><strong>Purpose: </strong>This study aimed to develop an indicator of the compensatory capacity of hip joints in response to spinopelvic mismatch using standard radiographs.</p><p><strong>Overview of literature: </strong>EOS imaging has enabled detailed analysis of hip and lower extremity compensation in sagittal malalignment. However, its high cost and limited availability hinder widespread clinical use. Currently, there are no established indicators to assess hip compensation for spinopelvic mismatch using standard radiographs.</p><p><strong>Methods: </strong>A total of 209 patients with osteoporosis and 54 with adult spinal deformities were included. Patients were divided into two groups based on pelvic incidence-lumbar lordosis (PI-LL): <20° and ≥20° groups. The sagittal vertical axis (SVA), thoracic kyphosis, PI, pelvic tilt (PT), LL, sacral slope, and pelvic femoral angle (PFA) were measured. Health-related quality of life (HRQOL) was assessed in 86 patients using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). A new index, PFA-(PI-LL), was defined as spinopelvic-hip mismatch. Correlation coefficients were calculated for each radiographic parameter, and the coefficient of determination (R2) for the relationship of each parameter with SVA was evaluated in both groups. The correlations between SVA, PT, PI-LL, PFA-(PI-LL), and JOABPEQ domain scores were also analyzed.</p><p><strong>Results: </strong>PI-LL correlated with PFA in the PI-LL <20° group (r=0.56, p<0.001) but not in the PI-LL ≥20° group. Among all parameters, PFA-(PI-LL) demonstrated the strongest association with SVA, indicating its superior ability to explain variations in sagittal alignment in both groups and across all patients (all patients, R2=0.77). Significant correlations were observed between the radiographic parameters and JOABPEQ scores across all domains.</p><p><strong>Conclusions: </strong>PFA-(PI-LL), which represented spinopelvic-hip mismatch, was a reliable indicator of hip compensatory function in terms of anterior trunk inclination and HRQOL.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833856","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}

{"title":"Biportal endoscopic versus conventional open spine surgery for lumbar degenerative disease: a systematic review and meta‑analysis.","authors":"Alexander Yu, Mark Kurapatti, Ryan Hoang, Charu Jain, Gray William Ricca, Junho Song, Joshua Lee, Daniel Berman, Samuel Kang-Wook Cho","doi":"10.31616/asj.2025.0063","DOIUrl":"https://doi.org/10.31616/asj.2025.0063","url":null,"abstract":"<p><p>This study was the first comprehensive systematic review and meta-analysis to compare clinical outcomes between conventional open surgery and biportal endoscopy for decompression and fusion of lumbar degenerative disease. Although conventional open spine surgery has been the standard approach for decades, biportal endoscopy has gained attention as a minimally invasive alternative with potential surgical outcome benefits. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we performed a systematic review and meta-analysis including eight comparative studies on open and biportal endoscopic spine surgery. A comprehensive search of PubMed, Embase, and Scopus identified studies that reported outcomes, such as the Oswestry Disability Index (ODI), Visual Analog Scale (VAS) scores for back and leg pain, complication rates, operative time, and hospital stay. Data were analyzed using a random effects model to evaluate the effect size between the two approaches. We analyzed 414 open and 383 biportal endoscopic lumbar surgical procedures. The open group had a mean age of 61.0 years and comprised 42.0% men, whereas the biportal group had a mean age of 59.8 years and comprised 46.7% men. Compared with open spine surgery, biportal surgery was associated with a significantly longer operative time but shorter length of hospital stay and similar preoperative VAS scores, ODI score, and postoperative outcomes at <1 month and >1 year. Fusion subgroup analysis showed significantly lower VAS score for back pain with biportal surgery than with open surgery, but the other measures were comparable. Despite its longer operative time, biportal endoscopy led to shorter hospital stay and similar long-term pain and disability outcomes, compared with open spine surgery. Given the significant improvement in short-term leg pain relief after fusion procedures, biportal endoscopic spine surgery is a potential minimally invasive alternative to open surgery that warrants further study.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833853","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}

{"title":"Radiological outcomes of static and expandable cage placement in minimally invasive oblique lumbar interbody fusion: a retrospective study.","authors":"Margaret Patricia Calder Seaton, Brian Robert Hirshman, Timothy Yushin Kim, Martin Huy Pham","doi":"10.31616/asj.2025.0032","DOIUrl":"https://doi.org/10.31616/asj.2025.0032","url":null,"abstract":"<p><strong>Study design: </strong>A single surgeon, retrospective case series.</p><p><strong>Purpose: </strong>This study aimed to compare the radiological outcomes after using expandable versus static cages in oblique lumbar interbody fusion (OLIF).</p><p><strong>Overview of literature: </strong>OLIF enables access to the spine while avoiding the anterior vessels and psoas muscles via a retroperitoneal corridor. Static cages have been used in this approach; however, they present with limitations, including repeated trialing, resulting in endplate violation and implant subsidence.</p><p><strong>Methods: </strong>Patients who underwent OLIF (n=86) were divided into expandable (n=39) and static cage (n=47) groups. Radiographic data were then analyzed preoperatively and postoperatively, including immediate, 3 months, and the most recent follow-up.</p><p><strong>Results: </strong>Cage type predicted the incidence of subsidence, with expandable cages associated with 4.00 and 2.43 fewer instances of subsidence compared with static cages at the postoperative and most recent time points (p<0.05). Cage type was a significant predictor of the change in height in both the posterior disk and foraminal height (FH) models. Expandable cages were associated with improved posterior disk height (DH) expansion at all three time points (1.24 mm, 0.88 mm, and 1.85 mm, respectively; p<0.01), and with larger FH increases at the 3 months postoperatively and most recent follow-up (1.12 mm, 0.40 mm, and 1.28 mm, respectively; p=0.096, 0.016, and 0.030). The expandable cage type was associated with improvement (3.46°, 3.12°, and 3.36°; p<0.01, 0.05, and 0.08, respectively) at the postoperative and 3-month time points when predicting the change in segmental lordosis. No statistically significant differences were found between the groups in disk angle and lumbar lordosis measurements or baseline demographics.</p><p><strong>Conclusions: </strong>The results of this study indicate that both static and expandable cages result in radiographic improvement in posterior DH, segmental lordosis, and FH when used in OLIF. Expandable cages may demonstrate certain advantages over static cages due to lower implant subsidence instances and the greater posterior disk and FH expansion, thereby providing preliminary evidence to support the superiority of expandable cages in OLIF procedures.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833857","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}

{"title":"Spinal ankylosis and sex-specific predisposing factors in type II odontoid fractures: a comparison with sub-axial fractures.","authors":"Ryo Fujita, Aman Singh, Marcus Björklund, Paul Gerdhem, Anna MacDowall","doi":"10.31616/asj.2025.0089","DOIUrl":"10.31616/asj.2025.0089","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>We assessed the predisposition to type II odontoid fractures (T2OFs) in elderly people by comparing patients who had T2OFs with those who had sub-axial fractures.</p><p><strong>Overview of literature: </strong>T2OFs are common among elderly people; osteoporosis and degenerative changes in the upper cervical spine are major risk factors. However, the role of spinal ankylosis remains unclear.</p><p><strong>Methods: </strong>We analyzed data from 45 patients with T2OFs and 79 with sub-axial fractures, all aged ≥75 years. Hounsfield unit (HU) values at C2-C4, the prevalence of ankylosis, and degenerative changes were assessed via computed tomography. We performed sex-specific analysis and logistic regression to identify factors associated with T2OF. In addition, we used the Swedish Fracture Registry (SFR) to analyze the prevalence of spinal ankylosis among Swedish patients with T2OFs and sub-axial fractures.</p><p><strong>Results: </strong>Among patients with T2OFs, in comparison with those with sub-axial fractures, spinal ankylosis was less prevalent (2.2% vs. 31.6%, p<0.001), HU values were lower (p<0.05), atlanto-occipital degeneration was less prevalent (p=0.009), and facet joint degeneration was more prevalent (p=0.03). Logistic regression revealed that atlanto-occipital degeneration (odds ratio, 0.33; p=0.02) and spinal ankylosis (odds ratio, 0.06; p=0.01) were negative predictors of T2OF. Sex-specific analysis revealed that HU values were lower for women with T2OFs (p<0.05) and ankylosis was less prevalent among men with T2OFs (p<0.001) than among sex-matched patients with subaxial fractures. The SFR confirmed that ankylosis was less prevalent among patients with T2OFs (3.3%) than among those with sub-axial fractures (28.3%, p<0.0001).</p><p><strong>Conclusions: </strong>Spinal ankylosis and atlanto-occipital degeneration are significant risk factors for T2OF. According to sex-specific analysis, spinal ankylosis was less prevalent among men with T2OFs than among those with sub-axial fractures, whereas C2-C4 HU values were significantly lower in among women with T2OFs.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833859","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}

{"title":"Increasing public interest in lumbar decompression and fusion surgery in the United States: higher search volumes in the Northeast region from 2015 to 2024.","authors":"Paul G Mastrokostas, Leonidas E Mastrokostas, Ahmed K Emara, Ian J Wellington, Elizabeth Ginalis, John K Houten, Amrit S Khalsa, Ahmed Saleh, Jad Bou Monsef, Afshin E Razi, Mitchell K Ng","doi":"10.31616/asj.2025.0133","DOIUrl":"https://doi.org/10.31616/asj.2025.0133","url":null,"abstract":"<p><strong>Study design: </strong>A cross-sectional study.</p><p><strong>Purpose: </strong>This study aimed to investigate temporal patterns, seasonal variations, and geographic differences in the US public interest in lumbar decompression and fusion surgery.</p><p><strong>Overview of literature: </strong>The number of lumbar decompression and fusion surgery procedures for various surgical indications has significantly increased in the United States over the past few decades. As the prevalence of these procedures increases, patients are increasingly seeking online information on these procedures.</p><p><strong>Methods: </strong>This study analyzed US public interest in lumbar decompression and fusion surgery using Google Trends data from January 1, 2015 to December 31, 2024. The relative search volume (RSV) was used to measure public interest. Temporal trends were assessed using linear regression analysis, whereas seasonal and geographic variations were evaluated using analysis of variance and Tukey's post hoc tests. Statistical significance was set at p<0.05.</p><p><strong>Results: </strong>Public interest in lumbar decompression and fusion surgery showed a statistically significant upward trend from 2015 to 2024 (p<0.05), with R2 ranging from 0.0141 to 0.6748 across search terms. Monthly analysis revealed that the average search volume was highest in October (78.8%) and lowest in December (68.7%). No significant differences were observed among seasons (p=0.102). Geographically, the highest mean RSV was in the Northeast (43.3%), followed by the West (19.5%), Midwest (12.6%), South (11.1%), and Southwest (10.2%), with significant differences among these regions (p<0.001).</p><p><strong>Conclusions: </strong>Public interest in lumbar decompression and fusion surgery has shown a consistent and statistically significant upward trend over the past decade. Although seasonal variation was not significant, notable geographic differences in search volume were observed, with the northeast showing the highest level of interest. These findings highlighted regional disparities in public engagement and may serve as a basis for future healthcare resource planning and patient education strategies.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833854","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}

{"title":"Recovery patterns from C5 palsy after anterior cervical decompression and fusion, posterior cervical decompression and fusion, and laminoplasty for degenerative cervical myelopathy: systematic review and meta-analysis of 748 C5 palsy cases.","authors":"Vibhu Krishnan Viswanathan, Guna Pratheep Kalanchiam, Akilan Chinnappan, Sathish Muthu","doi":"10.31616/asj.2025.0012","DOIUrl":"https://doi.org/10.31616/asj.2025.0012","url":null,"abstract":"<p><p>Despite the favorable postoperative prognosis of C5 palsy (C5P), a certain proportion of these patients have less satisfactory outcomes. The current systematic review and meta-analysis thus aimed to comprehensively evaluate existing literature and identify the onset, recovery patterns, and outcomes of C5P following diverse surgical approaches. Five different databases (Google Scholar, Embase, PubMed, Web of Science, and Cochrane Library) were thoroughly searched for relevant literature on October 15, 2024. Studies reporting on incidences of C5P following surgery for degenerative cervical conditions with recovery data published until 2024 were scrutinized. Narrative or systematic reviews, opinions, letters to the editor, and manuscripts published in non-English languages were excluded. A total of 30 articles involving 8,116 patients who underwent undergoing surgery for degenerative cervical myelopathy with 748 reported C5P cases were included for analysis. The overall time to palsy reported in the included studies was 3 days (95% confidence interval [CI], 2.56-3.60). Palsy occurred earliest with anterior cervical decompression and fusion (ACDF) at 2 days (95% CI, 0.35-4.54), followed by laminoplasty (LP) at 3.2 days (95% CI, 2.02-4.34) and posterior cervical decompression and fusion (PCDF) at 3.6 days (95% CI, 2.81-4.37). Patients with palsy showed improved recovery with time. At the 1-year follow-up, the reported recovery rates were 100%, 52.9%, and 50% for ACDF, LP, and PCDF, respectively. C5P demonstrated a delayed presentation, with mean onset of 3 days after surgery, which can range from 2 days for ACDF to 3.6 days for PDCF. Recovery improved progressively with time and varied for different surgical procedures, with ACDF showing the best recovery and PDCF for cervical myelopathy showing the poorest recovery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833858","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}

{"title":"O-arm navigation-guided unilateral biportal endoscopic lumbar interbody fusion using a lateral lumbar interbody fusion cage.","authors":"Min Gyu Kang, Yun Seong Cho, Ji Young Jang, Jung Hoon Kang, Nhat Duy Nguyen, Dong Ah Shin, Seong Yi, Yoon Ha, Keung Nyun Kim, Chang Kyu Lee","doi":"10.31616/asj.2025.0015","DOIUrl":"https://doi.org/10.31616/asj.2025.0015","url":null,"abstract":"<p><p>Unilateral biportal endoscopic surgery has received attention in the field of minimally invasive spinal surgery because of its various advantages, including minimized musculoligamentous injury, low postoperative pain, and faster recovery, compared with conventional open spinal surgery. Navigation system advancements have improved the precision of instrument placement and cage positioning, thereby facilitating the insertion of larger cages in the unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF). In this study, we demonstrated the safety and efficacy of lateral lumbar interbody fusion cage insertion in UBE-TLIF with the assistance of O-arm navigation.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833855","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}