Asian Spine Journal最新文献

{"title":"Long-term follow-up reveals non-utility of nonsurgical management in moderate adolescent idiopathic scoliosis: a comprehensive meta-analysis.","authors":"Eduardo Hevia, Jesús Burgos, Vicente García, María Teresa de Santos Moreno, Ibrahim Khalil, Gonzalo Mariscal, Carlos Barrios","doi":"10.31616/asj.2024.0358","DOIUrl":"10.31616/asj.2024.0358","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to evaluate the outcomes of conservative management of moderate adolescent idiopathic scoliosis (AIS), focusing on long-term curve behavior, surgical rates, patient-reported outcomes, and the influence of follow-up duration. A comprehensive literature search was conducted adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Statistical analyses, using Review Manager, encompassed mean differences, risk ratios, pooled incidences, and random-effects models. Heterogeneity was assessed using the I2 statistic. The outcome measures were radiographic curve progression, percentage of patients with significant (>5°) progression, surgery rates, sagittal profile changes, back pain rates, quality of life scales, and functional outcomes. Thirteen studies involving 1,492 patients with AIS curves within 30°-45°, treated conservatively, with a minimum 10-year follow-up, were included. At 20+ years of follow-up (mean age, 34.5 years), curves worsened by an average of -5.69° (95% confidence interval [CI], -11.66 to 0.29). At 25+ years of follow-up (mean age, 49.8 years), curves worsened by an average of -14.32° (95% CI, -20.14 to -8.50). The incidence of significant progression was 35.68% (95% CI, 22.85 to 48.50). The surgery rate was 14.20% (95% CI, 0.87 to 27.53). Sagittal alignment (thoracic kyphosis and lumbar lordosis) remained within normal ranges at the final follow-up, with no significant changes from baseline. Back pain rate was 63.35% (95% CI, 38.36 to 88.34). These findings highlight the alarming incidence of curve progression and pain in conservatively managed AIS patients. A critical re-evaluation of conservative versus operative indications is imperative to mitigate long-term impacts and improve outcomes for this population.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"638-651"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter to the editor: Computed tomography Hounsfield unit values as a treatment response indicator for spinal metastatic lesions in patients with non-small-cell lung cancer: a retrospective study in Japan.","authors":"Sho Dohzono","doi":"10.31616/asj.2025.0237.r2","DOIUrl":"10.31616/asj.2025.0237.r2","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"677-678"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783324","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":"Effect of the discrepancy between sacral and pelvic obliquity on postoperative disk wedging below the lower instrumented vertebra in patients with Lenke type 5 adolescent idiopathic scoliosis: a retrospective study in Japan.","authors":"Takahito Iga, Satoshi Suzuki, Kazuki Takeda, Toshiki Okubo, Masahiro Ozaki, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.31616/asj.2024.0445","DOIUrl":"10.31616/asj.2024.0445","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To evaluate the effect of discrepancies between sacral and pelvic obliquity on postoperative disk wedging below the lower instrumented vertebra in Lenke type 5 adolescent idiopathic scoliosis (AIS).</p><p><strong>Overview of literature: </strong>Previous studies have not fully explored the effect of discrepancies between sacral and pelvic obliquity on postoperative outcomes in patients with Lenke type 5 AIS.</p><p><strong>Methods: </strong>Data from 35 patients with Lenke type 5 AIS (mean age, 14.7±1.8 years) followed for a minimum of 5 years were retrospectively analyzed. We investigated the effect of sacral coronal obliquity (S angle) and pelvic coronal obliquity (P angle) on postoperative coronal radiographic parameters. The angle between the S and P angles was defined as the sacral and pelvic (SP) angle. The patients were grouped by preoperative SP angle (<5°, n=23; ≥5°, n=12). Pre- and post-operative radiographic parameters were compared to determine whether the preoperative SP angle affected postoperative spinal alignment.</p><p><strong>Results: </strong>The discrepancy between SP obliquity was reduced by correction surgery 5 years postoperatively. The mean lumbar Cobb angle correction rate in the ≥5° group was significantly lower than that in the <5° group (52.1%±17.8% vs. 65.5%±12.7%), and the mean wedge angle below the lower instrumented vertebra (LIV) in the ≥5° group was significantly larger than that in the <5° group (9.0°±2.6° vs. 4.7°±3.4°) 5 years postoperatively. No significant between-group differences were observed in age, Risser grade, thoracic Cobb angle correction rate, LIV-central sacral vertical line (CSVL), and C7-CSVL. The Scoliosis Research Society-22 outcomes were comparable between the two groups.</p><p><strong>Conclusions: </strong>The ≥5° group exhibited a larger wedge angle below the LIV and lower lumbar Cobb angle correction rate than the <5° group 5 years postoperatively. Preoperative discrepancies between SP obliquity should be considered when planning corrective surgery for patients with Lenke type 5 AIS.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"527-534"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967399","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":"Comparison of surgical outcomes between unilateral biportal endoscopic technique and open microdiscectomy in patients with single-level lumbar disc herniation: a single-center retrospective study in China.","authors":"Tianyao Ke, Qiulin He, Qiying Wang, Long Li, Changgui Shi, Jiaxue Zeng, Qing Li","doi":"10.31616/asj.2024.0002","DOIUrl":"10.31616/asj.2024.0002","url":null,"abstract":"<p><strong>Study design: </strong>Single-center retrospective cohort analysis.</p><p><strong>Purpose: </strong>To compare surgical outcomes between the unilateral biportal endoscopic (UBE) and open microdiscectomy for the treatment of single-level lumbar disc herniation (LDH).</p><p><strong>Overview of literature: </strong>Open microdiscectomy remains the gold standard for LDH, while UBE has emerged as a minimally invasive alternative. However, comparative evidence on efficacy, safety, and recovery profiles remains limited.</p><p><strong>Methods: </strong>This was a single-center retrospective analysis of 46 patients with single-level LDH who underwent either the UBE surgery (n=22) or open microdiscectomy (n=24) between January 2020 and December 2022. Demographic information, perioperative data, and radiographic measurements were reviewed. Pain intensity, patient satisfaction, and quality of life were assessed using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) at 1-week, 3-month, and 12-month follow-ups.</p><p><strong>Results: </strong>The mean operative time in the UBE group (86.1±11.4 minutes) was significantly longer than in the open microdiscectomy group (72.3±8.0 minutes, p=0.032). UBE was associated with significantly lower estimated blood loss (54.1±13.7 mL vs. 92.5±11.6 mL, p=0.001) and shorter hospital stay (3.7±1.2 days vs. 6.6±1.4 days, p=0.001). The mean VAS score for back pain at 1 week was significantly better in the UBE group (1.88±0.60 vs. 3.59±0.72, p=0.004). However, both surgical techniques showed similar long-term results regarding disc height, disc angle changes, and patient-reported outcomes.</p><p><strong>Conclusions: </strong>Despite the longer operative time, UBE is associated with reduced estimated blood loss and shorter hospital stays, offering a minimally invasive alternative with early postoperative pain relief. Conversely, open microdiscectomy, the conventional treatment approach, demonstrates comparable efficacy in long-term clinical outcomes despite its more invasive nature. Both methods show similar rates of complications and recurrent disc herniation. UBE is a viable alternative to open microdiscectomy, depending on individual patient considerations and surgical preferences.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"600-608"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961511","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":"Clinical outcomes of posterior cervical fusion in the setting of increasing age and medical complexity: an American national database analysis from 2012 to 2022.","authors":"Ryan Le, Ryan Hoang, Joshua Lee, Noah Makaio Ross, Joe Morrissey, Oluwaseun Awosanya, Michael Oh, Hansen Bow, Yu-Po Lee, Nitin Bhatia","doi":"10.31616/asj.2024.0342","DOIUrl":"10.31616/asj.2024.0342","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>This study aimed to investigate trends in postoperative complications for posterior cervical fusions from 2012 to 2022.</p><p><strong>Overview of literature: </strong>Previous studies analyzing the longitudinal outcomes of posterior cervical fusion from 2003 to 2013 have demonstrated relatively improved postoperative outcomes despite the increasing volume, complexity, and age of the patient population. However, few studies have evaluated these outcomes since 2013.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients undergoing posterior cervical fusion between 2006 and 2022. Patients aged >18 years with current procedural terminology code 22600 for posterior cervical fusion were included. Patient demographics and comorbidities were recorded, including age, race, body mass index, diabetes mellitus, and hypertension. Annual 30-day complication rates were reported, including wound infection, readmission, reoperation, length of stay, intraoperative blood transfusions, and mortality.</p><p><strong>Results: </strong>In total, 25,537 patients undergoing posterior cervical fusion from 2012 to 2022 were included. Variations in the rates of urinary tract infection, deep vein thrombosis, sepsis, reoperation, and mortality were not significant. Wound infection rates increased from 2.4% in 2012 to 4.0% in 2022 (p=0.003). Pneumonia rates increased from 1.2% in 2012 to 1.6% in 2022 (p=0.011). Intraoperative blood transfusion rates decreased consistently from 5.6% in 2012 to 2.8% in 2022 (p<0.001). Readmission rates increased from 6.4% in 2012 to 6.7% in 2022 (p<0.001). The average length of stay decreased from 4.18 days in 2012 to 3.97 days in 2019, before increasing between 2020 and 2022 to 4.17 days in 2022.</p><p><strong>Conclusions: </strong>Rates of comorbidities including age, diabetes mellitus, and hypertension have increased among patients undergoing posterior cervical fusion between 2012 and 2022, whereas complication rates have remained relatively similar. The length of stay has shortened despite the higher medical complexity of the patients who underwent surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"583-589"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473942","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 rehabilitation timing on the functional, vocational, and psychological outcomes in patients with paraplegia secondary to traumatic spinal cord injury: a retrospective cohort study.","authors":"Shashi Prakash Sharm, Anmol Bhatia, Mahima Guleria","doi":"10.31616/asj.2025.0361.r1","DOIUrl":"10.31616/asj.2025.0361.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"681-682"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783320","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: Comprehensive spinal tuberculosis score: a clinical guide for the management of thoracolumbar spinal tuberculosis.","authors":"Sanjay Singh Rawat, Pulkesh Singh, Gaurav Kumar Upadhyaya, Mithilesh Ranjan, Ajay Kumar Shukla","doi":"10.31616/asj.2024.0123.r1","DOIUrl":"10.31616/asj.2024.0123.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"673-674"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783322","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":"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":"571-582"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198176","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 impact of fixed segment length on the surgical outcomes of single-segment lumbar burst fractures: shorter segments are more prone to the formation of local stable osteophytes: a retrospective observational study.","authors":"Haoliang Chen, Wen Peng, Xiangyang Liu, Bin Liu","doi":"10.31616/asj.2024.0477","DOIUrl":"10.31616/asj.2024.0477","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Purpose: </strong>This study investigated the impact of long-segment and short-segment pedicle screw fixation on degeneration indicators, particularly stable osteophytes, in the treatment of single-segment lumbar burst fractures.</p><p><strong>Overview of literature: </strong>Current research mainly focuses on clinical indicators such as operation time, Visual Analog Scale (VAS) pain scores, and imaging indicators like the Cobb angle correction rate. However, there is a paucity of research on the indicators of intervertebral disc degeneration at fixed segments (such as bone spur formation, vacuum phenomenon in the disc, and Modic changes). As the health status of the intervertebral disc is closely related to spinal stability, this study provides a comprehensive evaluation of the efficacy of two surgical techniques, providing a more precise basis for clinical treatment.</p><p><strong>Methods: </strong>This was a retrospective analysis of a cohort of 64 patients with single-segment lumbar burst fractures. Among them, 38 patients underwent posterior long-segment pedicle screw-rod fixation (long-segment group), while 26 cases received posterior shortsegment pedicle screw fixation (short-segment group). Changes in degeneration indicators within the fixation area, including osteophyte formation, intervertebral disc vacuum sign, and intervertebral height, were examined.</p><p><strong>Results: </strong>All 64 patients completed surgery and were followed up for at least 24 months. At the final follow-up at 24 months, the shortsegment fixation group exhibited a higher osteophyte formation score than the long-segment fixation group. However, no significant between-group differences were observed in the incidence of intervertebral disc vacuum sign or intervertebral height loss rate.</p><p><strong>Conclusions: </strong>After a 2-year follow-up, the short-segment fixation group demonstrated a similar intervertebral height loss rate and intervertebral disc vacuum sign incidence compared to the long-segment fixation group, but a higher rate of stable osteophyte formation.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"516-526"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473950","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: Computed tomography Hounsfield unit values as a treatment response indicator for spinal metastatic lesions in patients with non-small-cell lung cancer: a retrospective study in Japan.","authors":"Mohammad Haris Ali, Syed Mohib Ullah, Meer Hassan Lucky, Javed Iqbal","doi":"10.31616/asj.2025.0237.r1","DOIUrl":"10.31616/asj.2025.0237.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"675-676"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783318","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}