Asian Spine Journal最新文献

{"title":"Predictive factors for greater than 15° thoracic kyphosis gain following surgery for adolescent idiopathic scoliosis: a retrospective comparative study in Japan.","authors":"Jein Boon Chen, Masato Tanaka, Shinya Arataki, Tadashi Komatsubara, Akiyoshi Miyamoto, Ingrid Frances Dizon Ignacio, Md Mahmudul Hassan, Tomoyoshi Sakaguchi, Koji Uotani","doi":"10.31616/asj.2025.0734","DOIUrl":"https://doi.org/10.31616/asj.2025.0734","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To identify factors predictive of a postoperative gain in thoracic kyphosis (TK) of at least 15° after deformity correction surgery for adolescent idiopathic scoliosis (AIS).</p><p><strong>Overview of literature: </strong>Conventional treatment strategies for AIS have historically emphasized the correction of coronal deformity despite the higher prevalence of sagittal imbalance in AIS compared to those without spinal deformity. However, recent research has brought attention to the importance of sagittal alignment as a significant determinant of quality of life.</p><p><strong>Methods: </strong>We retrospectively reviewed 54 patients (aged ≤20 years) who underwent deformity correction surgery for AIS between 2018 and 2024. Patients were stratified into two cohorts based on the degree of postoperative TK gain: ≥15° or <15°.</p><p><strong>Results: </strong>Both patient groups were comparable in terms of demographic characteristics, including age, sex distribution, height; body mass index, Risser's grade, or follow-up duration (p >0.05). However, those with ≥15° TK gain demonstrated significantly lower preoperative TK (17.7°±9.8° vs. 23.6°±9.9°), greater postoperative change in TK (21.2°±5.4° vs. 6.9°±4.9°, p <0.000), lower preoperative pelvic tilt (10.0°±8.4° vs. 15.6°±7.7°, p =0.014), and significantly higher screw density (74.5%±6.2% vs. 70.3%±5.2%, p =0.006). Other radiological (Cobb angle, apex level, main thoracic curve flexibility, main thoracic curve correction, sagittal vertical axis, lumbar lordosis, and pelvic incidence) and surgical parameters (fusion levels, blood loss, and surgical time) were comparable between groups.</p><p><strong>Conclusions: </strong>Our findings suggest that higher screw density and preoperative sagittal morphology (hypokyphotic thoracic alignment and lower pelvic tilt) influence the degree of TK correction attainable after AIS surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418216","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":"Emerging growth modulation techniques in treatment of adolescent idiopathic scoliosis: a meta-analysis of the outcomes and safety of anterior vertebral body tethering and ApiFix.","authors":"Eduardo Hevia, Jesús Burgos, Vicente García, Hashem Altabbaa, Gonzalo Mariscal, Carlos Barrios","doi":"10.31616/asj.2025.0612","DOIUrl":"https://doi.org/10.31616/asj.2025.0612","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Purpose: </strong>To systematically evaluate the effectiveness and implant failures of anterior vertebral body tethering (AVBT) and ApiFix as treatment options for adolescent idiopathic scoliosis (AIS).</p><p><strong>Overview of literature: </strong>We identified 27 studies involving AVBT in 1,263 patients and five studies involving ApiFix in 167 patients. The main outcomes were curve corrections, modifications in thoracic kyphosis, and alterations in lumbosacral lordosis noted at 1-, 2-, and 3-year follow-up visits. In addition, adverse events, encompassing tether breakage and reoperation rate, were meticulously documented.</p><p><strong>Methods: </strong>We performed a meta-analysis of the studies of adolescents with idiopathic scoliosis treated with AVBT or ApiFix. We used R software to pool data, including mean changes and event rates, and we assessed heterogeneity via the Q statistic and I 2.</p><p><strong>Results: </strong>With AVBT, the main thoracic curve improved from 46.8° to 20.6° over 1 year (53.3% reduction) and from 42.9° to 22.7° over 2 years (47.6% reduction). Thoracolumbar curves reduced by 53.8% at 1 year and by 48% at 2 years. Thoracic kyphosis did not change significantly. Tether breakage occurred in 25% of patients (up to 48% at 3 years), and 7% required reoperation. With ApiFix, at 2-3 years, the main thoracic curve improved from 45.1° to 22.7° (47.2% reduction). The pooled mean change for kyphosis was -10.0° (95% confidence interval, -35.5 to 15.4). Reoperation was necessary in 25% of cases.</p><p><strong>Conclusions: </strong>Neither AVBT nor ApiFix achieved more than 50% curve correction. Some initial corrections were reversed, and we found no consistent evidence of growth modulation or significant sagittal improvement. Complications were substantial: tether breakage occurred in nearly half the patients with AVBT, and 25% of patients with ApiFix required reoperation. These findings raise concerns about the long-term suitability of growth modulation techniques for young patients with AIS.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418219","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":"Responsiveness and minimal clinically important difference of the Brief BESTest 12 months after surgery for lumbar spinal stenosis: a prospective cohort study in Japan.","authors":"Tomoyoshi Sakaguchi, Masato Tanaka, Shinya Arataki, Tadashi Komatsubara, Toshinori Ohmori, Hiroto Inoue, Yosuke Yasuda, Hidemi Fujii, Eri Oikawa, Kayo Utsunomiya","doi":"10.31616/asj.2025.0819","DOIUrl":"https://doi.org/10.31616/asj.2025.0819","url":null,"abstract":"<p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Purpose: </strong>To assess the responsiveness of the Brief Balance Evaluation Systems Test (Brief BESTest) after lumbar spinal stenosis (LSS) surgery and to determine its minimal clinically important difference (MCID).</p><p><strong>Overview of literature: </strong>LSS leads to balance impairment and increased fall risk, even after surgical decompression. Although postoperative balance improves, the specific subsystems that recover and the clinically meaningful magnitude of the change remain unclear.</p><p><strong>Methods: </strong>This prospective study included 197 patients aged ≥60 years who underwent decompression or fusion surgery for LSS. Balance was assessed preoperatively and 12 months postoperatively using the Brief BESTest. Responsiveness was quantified using the standardized response mean (SRM). The MCID was determined using receiver operating characteristic (ROC) analysis with the Global Rating of Change as an anchor. Bootstrap resampling was used to evaluate MCID stability. Patients were classified into moderate or severe groups based on preoperative Brief BESTest scores, using 13 points as the previously identified cutoff for increased fall risk in older adults.</p><p><strong>Results: </strong>The Brief BESTest scores improved significantly in all patients (11.6±5.5 to 14.1±6.2; SRM=0.51). The severe group showed greater responsiveness (SRM=0.64) than the moderate group (SRM=0.38). In the subsystem, the largest improvements were observed in anticipatory postural adjustments and gait stability, whereas stability limits showed little change. ROC analysis identified an MCID of 2 points (area under the curve=0.79), which was consistent across the severity subgroups. Bootstrap validation confirmed the stability of this 2-point MCID.</p><p><strong>Conclusions: </strong>The Brief BESTest showed moderate responsiveness to balance improvements after LSS surgery, with marked gains in anticipatory adjustments and gait stability. The MCID of the Brief BESTest after LSS surgery is 2 points, providing a practical benchmark for postoperative evaluation regardless of preoperative severity.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418237","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":"Comparison between endoscopic lumbar discectomy with and without annulus fibrosus suturing: a systematic review and meta-analysis.","authors":"Rowen Lin, Justin Chung, Evan Dunn, Grace Kim, Kevin Mo, William Fang, Daniel Lee, Don Park, Sohaib Hashmi, Yu-Po Lee, Nitin Bhatia, Hao-Hua Wu","doi":"10.31616/asj.2025.0635","DOIUrl":"https://doi.org/10.31616/asj.2025.0635","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Overview of literature: </strong>Endoscopic lumbar discectomy is a minimally invasive technique used to treat herniations while reducing tissue trauma, incision length, blood loss, and infection. However, such procedures may damage the annulus fibrosus, which increases the risk of reherniation and revision.</p><p><strong>Purpose: </strong>The current study aimed to compare the outcomes of endoscopic lumbar discectomy with and without simultaneous repair of the annulus fibrosus through suturing.</p><p><strong>Methods: </strong>From project initiation on June 2025 to the present, three reviewers conducted a systematic review of studies published in PubMed, Embase, and Cochrane Library databases in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All meta-analyses were conducted using STATA ver. 18.0.</p><p><strong>Results: </strong>A total of nine studies, with 1,192 patients who underwent endoscopic lumbar discectomy for lumbar herniation, were included for analysis. Among the included patients, 514 (43.1%) underwent annulus fibrosus suturing, whereas 678 (56.9%) received only discectomy. The most commonly involved disc segment was L4/L5 with 267 patients (44.5%). Patients who underwent endoscopic lumbar discectomy with annulus fibrosus suturing showed a significant increase in operative time by 8.89 minutes (weighted mean difference [WMD], 8.89 minutes; 95% confidence intervals [CI], 1.01-16.77; p=0.03), had 0.31 times the odds of developing reherniation (odds ratio [OR], 0.31; 95% CI, 0.17-0.55; p=0.00), and had 0.26 times the odds of needing revision surgery (OR, 0.26; 95% CI, 0.10-0.68; p=0.01). No significant difference in intraoperative blood loss and hospital length of stay were observed between the groups. Postoperative and 3-month follow-up Visual Analog Scale (VAS)/Oswestry Disability Index (ODI) scores did not significantly differ between the groups at correlation coefficients r=0.3, 0.5, and 0.7, although the suture group demonstrated a favorable trend in ODI scores (p=0.0681-0.0782).</p><p><strong>Conclusions: </strong>Among the patients who underwent lumbar endoscopic discectomy, those who received annulus fibrosus suturing demonstrated significantly increased operative time but decreased reherniation and reoperation rates compared to those who did not received annulus fibrosus suturing. No significant difference in length of stay or blood loss were observed between the two groups. Conflicting results were noted for VAS and ODI scores, with patients receiving annulus fibrosus suturing generally showing better ODI outcomes but worse VAS scores.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197380","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":"Preoperative coronal magnetic resonance imaging: a critical evaluation of the Kambin's triangle for the transforaminal lumbar interbody fusion procedure.","authors":"Koopong Siribumrungwong, Bunyaporn Wuttiworawanit, Punnawit Pinitchanon, Chanon Chiarnpattanodom, Thongchai Suntharapa","doi":"10.31616/asj.2025.0570","DOIUrl":"https://doi.org/10.31616/asj.2025.0570","url":null,"abstract":"<p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Purpose: </strong>To evaluate the accuracy and reliability of coronal versus axial magnetic resonance imaging (MRI) measurements of Kambin's triangle, using intraoperative findings as the reference standard, in transforaminal lumbar interbody fusion (TLIF).</p><p><strong>Overview of literature: </strong>Previous studies on large cages or extreme TLIF have proposed methods, using axial view MRI, for preoperative measurement of Kambin's triangle. However, the accuracy and reliability of these methods have not been evaluated, which can be particularly challenging in cases of severe stenosis.</p><p><strong>Methods: </strong>A prospective study was conducted in patients undergoing TLIF surgery. Demographic data and surgical approach details were collected. Coronal and axial MRI measurements of the width of Kambin's triangle were obtained at the upper and lower endplates on the operative side. Intraoperative measurements of the corridor were obtained. The relationship between MRI measurements and these intraoperative measurements was analyzed.</p><p><strong>Results: </strong>Among 60 patients, coronal MRI measurement of the width of Kambin̓s triangle at both endplates demonstrated a strong correlation with intraoperative distances. In contrast, axial MRI showed a weak correlation at the upper endplate and a moderate correlation for the lower endplate. The mean absolute error was significantly lower with coronal MRI compared to axial MRI for both the upper (0.70±0.61 mm vs. 2.69±2.90 mm, p<0.001) and lower endplates (1.00±0.98 mm vs. 5.53±4.58 mm, p<0.001). Inter- and intra-observer reliability were also higher for coronal MRI.</p><p><strong>Conclusions: </strong>The study result indicates that coronal MRI measurements of Kambin's triangle are more accurate and reliable than axial measurements. The high reliability of coronal MRI for preoperative assessments in patients undergoing TLIF facilitates improved surgical planning and more appropriate interbody selection.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197333","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":"The top-down driver: a comprehensive review of cervical alignment as the final frontier for global spinal sagittal balance and its practical application in deformity correction.","authors":"Seok Woo Kim, Tae-Hwan Kim, Seok-In Jang, Bong-Su Mun, Hendra Tjong, Seung-Yeon Jeong","doi":"10.31616/asj.2026.0221","DOIUrl":"https://doi.org/10.31616/asj.2026.0221","url":null,"abstract":"<p><p>The cervical spine is a complex, dynamic structure characterized by an expansive range of motion and biological priority for maintaining horizontal gaze. Unlike the rigid thoracolumbar segments, the cervical spine often develops compensatory hyperlordosis in response to global sagittal malalignment. However, aggressive surgical correction of the thoracolumbar axis can paradoxically reduce this compensation, potentially inducing iatrogenic kyphosis. This review synthesizes these dynamics through a \"top-down driver\" framework, shifting away from traditional pelvic-centric models. By analyzing longitudinal data from asymptomatic Asian cohorts and surgical registries, we evaluated the interplay between C2 slope, T1 slope (T1S), T1S cervical lordosis (T1S-CL), chin brow vertical angle, and integrated measures, such as the cervical-thoracolumbar pelvic angle (CTPA) and TPA. To restore economic balance, the surgeon must move beyond segmental correction and manage the integrated hierarchy of the spinal axis. Master regulators (C2 slope and T1S) dictate the primary axis, whereas secondary responders (T1S-CL mismatch and CTPA) represent the \"biomechanical tax\" paid by the body. Ultimately, recognizing the cervical spine as the \"top-down driver\" is essential for successful deformity management. Utilizing the proposed five-step clinical algorithm could allow surgeons to prioritize master regulators, such as C2 slope and T1S-CL mismatch, ensuring more physiologically harmonious global restoration.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197371","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":"Thoracolumbar spine surgery in the post-pandemic era: a national retrospective analysis of thrombotic complications, vaccination status, and prior hospitalization with COVID-19.","authors":"Serena Liu, Anthony Kohler Chiu, Rohan Iyer Suresh, Hershil Patel, Sandeep Bains, Brian Shear, Alex Ruditsky, Leah Henry, Jeremy Dubin, Amil Sahai, Hans Prakash, Idris Amin, Louis Joseph Bivona, Julio Jose Jauregui, Eugene Young Koh, Steven Charles Ludwig, Daniel Lee Cavanaugh","doi":"10.31616/asj.2025.0245","DOIUrl":"10.31616/asj.2025.0245","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To compare thrombotic complication rates in thoracolumbar spine surgery patients before and after the coronavirus disease 2019 (COVID-19) pandemic.</p><p><strong>Overview of literature: </strong>Thrombotic complications are a major cause of postoperative morbidity and mortality in spine surgery. Both COVID-19 infection and vaccination have been linked to hypercoagulability. However, data on pre- versus post-pandemic thrombotic risk in spine surgery are limited, and the influence of infection severity or vaccination status has not been examined.</p><p><strong>Methods: </strong>Adult patients (≥18 years) undergoing primary thoracolumbar decompression with or without fusion were identified, excluding trauma and neoplastic cases. Patients were divided into \"pre-COVID\" and \"post-COVID\" cohorts. Outcomes included 90-day rates of postoperative deep venous thrombosis (DVT), pulmonary embolism (PE), myocardial infarction (MI), and cerebrovascular accident (CVA). Cohorts were compared using Pearson's chi-square tests, and multivariable regression adjusted for demographics and comorbidities.</p><p><strong>Results: </strong>A total of 784,498 patients were included. Post-COVID, rates of DVT (1.4% vs. 1.3%; risk ratio [RR], 1.11; p <0.001), PE (0.9% vs. 0.8%; RR, 1.14; p <0.001, and CVA (0.8% vs. 0.7%; RR, 1.17; p <0.001) were higher. Multivariable analysis demonstrated a 7% increase in odds of VTE post-COVID (odds ratios [OR], 1.07; p =0.002). Unvaccinated patients had a 6% higher odds of VTE (OR, 1.06; p =0.006), whereas vaccinated patients showed a nonsignificant increase (OR, 1.16; p =0.109). Patients with prior COVID-19 hospitalization had approximately double the odds of VTE (OR, 2.03; p =0.011).</p><p><strong>Conclusions: </strong>Thrombotic complications modestly increased after the COVID-19 pandemic. Vaccination status showed no clear association, while prior hospitalization for COVID-19 was the strongest predictor of postoperative thrombotic risk.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"475-485"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of abscess type on outcomes following posterior fixation for thoracolumbar pyogenic spondylitis: a multicenter retrospective cohort study.","authors":"Hisanori Gamada, Toru Funayama, Yosuke Ogata, Takane Nakagawa, Takahiro Sunami, Kotaro Sakashita, Shun Okuwaki, Kento Inomata, Kaishi Ogawa, Yosuke Shibao, Hiroshi Kumagai, Katsuya Nagashima, Kengo Fujii, Yosuke Takeuchi, Masaki Tatsumura, Itsuo Shiina, Masafumi Uesugi, Masao Koda","doi":"10.31616/asj.2025.0366","DOIUrl":"10.31616/asj.2025.0366","url":null,"abstract":"<p><strong>Study design: </strong>Multicenter retrospective cohort study.</p><p><strong>Purpose: </strong>To evaluate the impact of abscess presence and type on treatment duration and clinical outcomes in patients undergoing minimally invasive posterior fixation for thoracolumbar pyogenic spondylitis.</p><p><strong>Overview of literature: </strong>Surgical management is increasingly favored for pyogenic spondylitis. Abscesses, particularly epidural and iliopsoas, have been linked to poorer prognoses, and empyema, though uncommon, tends to be particularly severe. However, the effect of specific abscess types on surgical outcomes remains unclear.</p><p><strong>Methods: </strong>This study included 92 patients who underwent minimally invasive posterior fixation across 10 centers between 2014 and 2024. Patients were classified into an abscess group (epidural, iliopsoas, empyema, or other) and a non-abscess group. Clinical outcomes, including total duration of intravenous antibiotics and unplanned additional surgeries, were compared. Subgroup and regression analyses were conducted to assess the impact of specific abscess type.</p><p><strong>Results: </strong>Abscesses were present in 65 patients (71%): epidural (n=51), iliopsoas (n=38), and empyema (n=3), with some overlap. Compared with the non-abscess group (n=27; 29%), there were no significant differences in antibiotic duration or rates of unplanned additional surgery. However, iliopsoas abscess was associated with longer antibiotic duration (8.1 weeks vs. 6.6 weeks, p =0.044), while all empyema cases required additional surgery for poor infection control (p =0.000). Regression analysis identified iliopsoas abscess and age ≥65 years as independent predictors of prolonged antibiotic use, whereas epidural abscess was associated with shorter antibiotic duration.</p><p><strong>Conclusions: </strong>Iliopsoas abscesses were associated with longer antibiotic courses, while empyema was linked to poor infection control and a higher likelihood of additional surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"455-465"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145905509","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 preoperative nutritional status on 30-day outcomes after elective lumbar laminectomy for lumbar stenosis: a population-based cohort analysis.","authors":"Taylor Furst, Aman Singh, Prasanth Romiyo, Tyler Schmidt","doi":"10.31616/asj.2025.0264","DOIUrl":"10.31616/asj.2025.0264","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To compare rates of 30-day reoperation (RTOR), readmission, overall postoperative complication, non-home discharge, and length of stay (LOS); and investigate individual postoperative complication rates among patients with preoperative normoalbuminemia versus hypoalbuminemia.</p><p><strong>Overview of literature: </strong>Evidence continues to accumulate associating poor preoperative nutritional status with inferior surgical outcomes in spinal deformity and oncology. These spinal subspecialities frequently require instrumentation and significant tissue disruption. However, the relationship between preoperative nutrition and shorter, less invasive spinal decompression remains poorly assessed.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Project database was queried to identify adult patients (>18 years) who underwent elective lumbar laminectomy for lumbar stenosis between 2015 and 2022. Univariate comparison and multivariate logistic regression analyses were conducted.</p><p><strong>Results: </strong>This study identified 9,593 cases. Among primary outcomes, patients with hypoalbuminemia reported more 30-day readmission (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.17-1.2.82; p =0.008) and non-home discharge rates (OR, 2.08; 95% CI, 1.57-2.76; p <0.001) as well as longer LOS (3.7±4.5 days vs. 1.9±2.4 days, p <0.0005) in both univariate and multivariate analyses, whereas they demonstrated higher RTOR (5.3% vs. 2.7%, p =0.003) and postoperative complication rates (19.0% vs. 5.8%, p <0.001) in only univariate analysis compared with those having normoalbuminemia. Among secondary outcomes, patients with hypoalbuminemia reported statistically more wound and pulmonary complications in univariate analysis; however, they had higher risks of only venous thrombosis requiring anticoagulation and stroke in multivariate analysis.</p><p><strong>Conclusions: </strong>Preoperative hypoalbuminemia is associated with higher rates of 30-day readmission, non-home discharge, and postoperative complications, as well as longer LOS after elective open lumbar laminectomy. These data indicate the importance of preoperative nutritional optimization even in shorter, more routine spinal surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"486-497"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547576","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: Effect of mechanical bowel preparation with antibiotics and probiotics on postoperative ileus in patients undergoing posterior lumbar spine surgeries: a randomized controlled trial.","authors":"Mantu Jain, Tanmoy Halder, Shahnawaz Khan, Pankaj Kumar, Arunkumar Sekar, Gurudip Das, Chinmaya Dash, Sujit Kumar Tripathy","doi":"10.31616/asj.2026.0051.r2","DOIUrl":"10.31616/asj.2026.0051.r2","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"20 3","pages":"617-618"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374044","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}