Asian Spine Journal最新文献

{"title":"Is \"routine\" magnetic resonance imaging necessary in adolescent idiopathic scoliosis? A retrospective analysis in New Zealand.","authors":"Hasanga Fernando, Euphemia Li, Antony Field, Hamish Deverall, Haemish Crawford, Joseph Frederick Baker","doi":"10.31616/asj.2024.0348","DOIUrl":"https://doi.org/10.31616/asj.2024.0348","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Purpose: </strong>To determine the prevalence of neural axis abnormalities (NAA) in patients with adolescent idiopathic scoliosis (AIS) undergoing deformity corrective surgery and evaluate factors that may predict the presence of underlying NAA in these patients.</p><p><strong>Overview of literature: </strong>There is no clear consensus regarding the use of magnetic resonance imaging (MRI) to screen for potential NAA in patients with AIS. Various clinical and radiographic risk factors predicting underlying NAA have been suggested, but these remain controversial.</p><p><strong>Methods: </strong>This study included 282 patients with presumed AIS who underwent preoperative MRI to exclude NAA between 2010 and 2020 in multiple centers. Spinopelvic parameters, including Cobb angle, thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt, and pelvic incidence, were measured on preoperative and postoperative radiographs. Additional clinical data were gathered on curve characteristics, symptomatic back pain, and abnormal preoperative neurological examinations.</p><p><strong>Results: </strong>The median age was 14 years (range, 11-18 years). The cohort consisted of 49 males (17%), 217 patients (77%) of European ethnicity, 30 (10.6%) Māori, and 7 (2.5%) Pacific Islanders. Twenty-one patients (7.4%) had NAA, of which five required neurosurgical intervention. Among the NAA group, four were diagnosed with Chiari malformations, seven with syringomyelia, and four with both. The presence of NAA did not affect curve reduction with surgery. No significant association was found between NAA and any investigated variable.</p><p><strong>Conclusions: </strong>Routine preoperative MRI is justifiable, as 7.4% of the cohort had NAA, with five patients requiring neurosurgical intervention, thereby altering operative management.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706109","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":"Measures to prevent acute airway obstruction after anterior cervical spine surgery: a retrospective cohort study from Japan and a review of the literature.","authors":"Seiichi Odate, Jitsuhiko Shikata, Kazuaki Morizane","doi":"10.31616/asj.2024.0551","DOIUrl":"https://doi.org/10.31616/asj.2024.0551","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study and literature review.</p><p><strong>Purpose: </strong>We analyzed the clinical characteristics of acute airway obstruction (AAO) after anterior cervical spine surgery (ACSS), evaluated the effectiveness of newly implemented preventive measures, and assessed whether extubation immediately after surgery is practical.</p><p><strong>Overview of literature: </strong>AAO is a rare but potentially fatal complication after ACSS. Recent studies have focused on postoperative management strategies such as prolonged intubation in the intensive care unit; however, the feasibility and safety of immediate extubation have not been studied extensively. This study addressed this critical gap.</p><p><strong>Methods: </strong>We retrospectively reviewed data from patients who underwent ACSS and then immediate extubation according to policy at our institution between April 2006 and January 2019. Patients were categorized into AAO and non-AAO groups according to whether postoperative airway compromise necessitated reintubation or hematoma evacuation. Statistical analyses identified surgery-related risk factors associated with AAO. These findings and a review of the literature prompted the implementation of 10 preventive measures in February 2019. We then analyzed outcomes from 156 subsequent cases of ACSS.</p><p><strong>Results: </strong>AAO occurred in 7 (0.68%) of 1,036 patients. Significant risk factors included the number of fixed disc segments (p =0.031), instrumentation of a more cephalad upper vertebra (p =0.007), and use of a halo vest (p <0.001). Among 156 patients who underwent ACSS after preventive measures were implemented, no cases of AAO were observed, but statistical significance could not be determined because of the limited sample size.</p><p><strong>Conclusions: </strong>We systematically examined AAO prevention strategies and the potential effectiveness of 10 preventive measures. Despite these preventive measures, AAO cannot be prevented entirely; thus, rigorous monitoring after extubation is essential. Although the trend toward prolonged intubation is increasing, our findings suggest that immediate extubation is suitable for most patients.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706110","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":"Evaluating the feasibility of pinless robot-assisted spine surgery: a prospective study of 750 cases and 3,924 screws in the thoracolumbar spine in India.","authors":"Abhishek Soni, Vidyadhara Srinivasa, Balamurugan Thirugnanam, Madhava Pai Kanhangad, Akhil Xavier Joseph","doi":"10.31616/asj.2025.0066","DOIUrl":"https://doi.org/10.31616/asj.2025.0066","url":null,"abstract":"<p><strong>Study design: </strong>This single-center prospective study compared pin-mounted and pinless robot-assisted techniques for thoracolumbar pedicle screw placement.</p><p><strong>Purpose: </strong>To evaluate the feasibility, accuracy, and safety of a novel pinless technique in comparison to the traditional pin-mounted method in thoracolumbar fusion surgery.</p><p><strong>Overview of literature: </strong>Robot-assisted spine surgery has enhanced the precision of pedicle screw placement and reduced radiation exposure. While conventional pin-mounted techniques are effective, they can lead to hardware-related complications. Emerging evidence indicates that eliminating bone-mounted fixation could streamline the surgical workflow without compromising accuracy or safety.</p><p><strong>Methods: </strong>A total of 750 consecutive patients who underwent robot-assisted thoracolumbar fusion were enrolled. Two groups were defined: 200 cases (890 screws) using the pin-mounted approach and 550 cases (3,034 screws) utilizing the pinless method. All procedures employed intraoperative computed tomography imaging and a standardized protocol with a table-mounted robotic system. Screw accuracy was assessed using the Gertzbein-Robbins grading system, with grades A and B classified as acceptable. Secondary parameters, including operative time, blood loss, and radiation exposure, were also recorded.</p><p><strong>Results: </strong>The pin-mounted group achieved an overall pedicle screw accuracy of 99.55% compared to 99.40% in the pinless group (p >0.05). There were four breaches in the pin-mounted group and 18 breaches in the pinless group, all of which were revised intraoperatively, with no permanent neurovascular injuries or major complications reported. Blood loss and radiation exposure were similar between the groups.</p><p><strong>Conclusions: </strong>The pinless robot-assisted pedicle screw placement technique demonstrates accuracy and safety comparable to the traditional pin-mounted method. By eliminating bone-mounted fixation, this approach simplifies the surgical workflow and reduces hardwarerelated complications, making it an effective alternative for thoracolumbar fusion surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706096","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 pars defect length predicts bone union after direct repair for lumbar spondylolysis using the modified smiley face rod technique: a retrospective cohort study.","authors":"Shotaro Teruya, Shun Okuwaki, Hisanori Gamada, Toru Funayama, Masaki Tatsumura","doi":"10.31616/asj.2025.0090","DOIUrl":"https://doi.org/10.31616/asj.2025.0090","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Purpose: </strong>To determine whether the preoperative pars defect length predicts bone union following the modified smiley face rod (mSFR) technique for lumbar spondylolysis and to identify a threshold for clinical decision-making.</p><p><strong>Overview of literature: </strong>Lumbar spondylolysis is a common cause of low back pain in young athletes, often leading to pseudarthrosis that requires surgical intervention. Various techniques, including mSFR, address pseudarthrosis; however, the effect of preoperative pars defect length on bone union remains unclear.</p><p><strong>Methods: </strong>This study analyzed 75 pars defects in 38 patients treated with mSFR between 2014 and 2022. Pre- and postoperative pars defect lengths were measured using computed tomography (CT). Patients were categorized into bone union and nonunion groups based on CT findings up to 24 months postoperatively. Group comparisons of defect lengths were performed using the Mann-Whitney U test. Logistic regression was used to examine the association between preoperative defect length and nonunion. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal threshold for preoperative defect length.</p><p><strong>Results: </strong>Bone union was achieved in 65 of 75 defects (87%). The preoperative pars defect length was significantly shorter in the bone union group than in the nonunion group (3.0 mm vs. 5.6 mm, p <0.001). A strong correlation was observed between pre- and postoperative pars defect lengths (Spearman's rho=0.76). Logistic regression analysis revealed a significant association between a longer preoperative defect and nonunion (odds ratio, 1.89; 95% confidence interval, 1.29-2.72; p =0.001). ROC analysis revealed a cut-off value of 3.8 mm (sensitivity, 89%; specificity, 75%; area under the curve=0.86).</p><p><strong>Conclusions: </strong>Bone union following the mSFR technique may be influenced by the pars defect length, with larger preoperative defects potentially hindering bone union. The technique is most effective when the preoperative defect length is ≤3.8 mm.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473948","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":"Iliac screw failures compromise long-term radiographic and clinical outcomes of adult spinal deformity surgery without impeding fusion at the lumbosacral junction: a retrospective study in Korea.","authors":"Se-Jun Park, Kyunghun Jung, Jin-Sung Park, Dong-Ho Kang, Minwook Kang, Chong-Suh Lee","doi":"10.31616/asj.2025.0006","DOIUrl":"https://doi.org/10.31616/asj.2025.0006","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Purpose: </strong>To investigate the effects of iliac screw failure (ISF) on L5-S1 fusion and long-term radiographic and clinical outcomes in adult spinal deformity (ASD) surgery.</p><p><strong>Overview of literature: </strong>Iliac fixation is crucial for long-segmental fusion in ASD surgery to prevent mechanical failure at the lumbosacral junction. Despite numerous studies on ISF, its impact on surgical outcomes remains unclear.</p><p><strong>Methods: </strong>We included 192 patients (mean age, 69.2 years; mean follow-up, 57.8 months) who underwent ≥5-level fusion with interbody fusion at L5-S1 and pelvic fixation using bilateral iliac screws between 2014 and 2022. Patients were categorized into no-ISF and ISF groups. Fusion status at L5-S1 was evaluated using computed tomography (CT) images at 2 years postoperatively. Mechanical failures (evaluated in terms of rod fractures and related revision surgery), radiographic outcomes, and clinical outcomes were compared between the groups.</p><p><strong>Results: </strong>ISFs developed in 66 patients (34.4%) by 13.4 months post-surgery on average. At 2-year CT follow-up, no significant differences in fusion grades were observed between the two groups. ISF rates did not differ according to mechanical failure development in terms of rod fracture at L5-S1 (p =0.273) or at ≥L4-5 (p =0.432), or revision surgery at L5-S1 (p =0.144) or at ≥L4-5 (p =0.886). However, at the final follow-up, sagittal parameters, including pelvic incidence, were significantly worse in the ISF group than in the no-ISF group. The final clinical outcomes were also poorer in the ISF group.</p><p><strong>Conclusions: </strong>ISF occurred in over one-third of patients after long-segment fusion. While ISF did not adversely affect radiographic and clinical fusion achievement at the lumbosacral junction, it was associated with inferior long-term radiographic and clinical outcomes.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473945","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 3-kilogram weight-lifting flexion radiograph: a new diagnostic method for segmental sagittal lumbar instability: a cross-sectional study.","authors":"Koopong Siribumrungwong, Warunyoo Suttikadsanee, Waroot Pholsawatchai, Sorrawich Singhatanadgige, Thongchai Suntharapa","doi":"10.31616/asj.2025.0065","DOIUrl":"https://doi.org/10.31616/asj.2025.0065","url":null,"abstract":"<p><strong>Study design: </strong>A cross-sectional study.</p><p><strong>Purpose: </strong>To evaluate the diagnostic performance of a novel 3-kg weight-lifting flexion radiograph for detecting lumbar instability.</p><p><strong>Overview of literature: </strong>Conventional flexion-extension radiographs have limited sensitivity for detecting lumbar instability, while magnetic resonance imaging (MRI) is a reliable standard. This study compares the performance of a novel weight-lifting radiograph to conventional flexion radiographs, using MRI as the reference standard.</p><p><strong>Methods: </strong>Forty-six patients with a diagnosis of lumbar instability were enrolled. Participants underwent lateral flexion, lateral extension, and 3-kg weight-lifting flexion lumbosacral spine radiographs. MRI was also performed on all participants. Diagnostic parameters, including sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and likelihood ratios, were calculated for each lumbar level. Reliability was assessed using intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>The 3-kg weight-lifting flexion radiograph showed higher sensitivity for detecting spinal instability at the L3/4 and L4/5 levels (88% vs. 36% and 83.3% vs. 44.44%, respectively) but lower specificity (61.9% vs. 76.19% and 70% vs. 80%, respectively) compared to the conventional flexion radiograph. McNemar tests revealed no significant differences between the 3-kg weight-lifting flexion radiograph and MRI at these levels (p >0.05). Reliability assessments demonstrated excellent intra- and interobserver agreement (ICC ≥0.99). Furthermore, this technique was safe, with no adverse effects reported.</p><p><strong>Conclusions: </strong>The 3-kg weight-lifting flexion radiograph enhances diagnostic sensitivity and accuracy for lumbar instability, particularly at the L3/4 and L4/5 levels, offering a reliable screening alternative.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473949","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":"Lumbar spinal stenosis: current concept of management.","authors":"Ji-Won Kwon, Kyung-Soo Suk, Seong-Hwan Moon, Si-Young Park, Namhoo Kim, Sub-Ri Park, Jae-Won Shin, Hak-Sun Kim, Byung Ho Lee","doi":"10.31616/asj.2025.0198","DOIUrl":"https://doi.org/10.31616/asj.2025.0198","url":null,"abstract":"<p><p>Lumbar spinal stenosis (LSS) is a common degenerative spinal condition where spinal canal narrowing causes symptoms such as neurogenic claudication, radiculopathy, and lower back pain. While non-operative and surgical approaches yield similar long-term outcomes, surgical intervention-particularly decompression-can provide earlier symptom relief, functional recovery, and fall prevention in selected patients with refractory symptoms. Recent advancements in surgical technologies and image guidance have brought about a paradigm shift in LSS management. Biportal endoscopic spine surgery (BESS) has gained global traction as a minimally invasive alternative to traditional decompression methods, offering superior visualization, less soft tissue damage, shorter hospital stays, and faster recovery. High-quality studies, including randomized controlled trials, have shown promising outcomes for this technique. Furthermore, the integration of navigation systems, robot-assisted instrumentation, and artificial intelligence (AI)-driven diagnostics and surgical planning tools is transforming spinal surgery by enhancing precision in preoperative evaluation and intraoperative execution. These innovations enable accurate targeting, reduce complications, and improve reproducibility across diverse surgical settings. This review provides an updated overview of LSS, covering its pathophysiology, clinical assessment, diagnosis, and treatment. Special emphasis is placed on the growing role of BESS and the transformative impact of digital technologies such as navigation, robotics, and AI in the evolving landscape of spinal stenosis care.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282244","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":"Opportunistic screening for osteoporosis using artificial intelligence-based morphometric analysis of chest computed tomography images: a retrospective multi-center study in Russia leveraging the COVID-19 pandemic.","authors":"Alexey Vladimirovich Petraikin, Perry Joseph Pickhardt, Mikhail Gennadevich Belyaev, Zhanna Evgenievna Belaya, Maxim Evgenievich Pisov, Alim Niyazovich Bukharaev, Aleksei Andreevich Zakharov, Nikita Dmitrievich Kudryavtsev, Tatiana Mikhailovna Bobrovskaya, Dmitry Sergeevich Semenov, Ekaterina Sergeevna Akhmad, Zlata Romanovna Artyukova, Liya Ruslanovna Abuladze, Ludmila Arsenevna Nizovtsova, Ivan Andreevich Blokhin, Anton Vyacheslavovich Vladzymyrskyy, Yuriy Aleksandrovich Vasilev","doi":"10.31616/asj.2024.0314","DOIUrl":"10.31616/asj.2024.0314","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Purpose: </strong>To evaluate the effectiveness of opportunistic osteoporosis screening using an artificial intelligence (AI) algorithm for detecting vertebral compression deformity (VCD >25%) and reduced bone mineral density (BMD) from routine chest computed tomography (CT) scans.</p><p><strong>Overview of literature: </strong>Osteoporosis is an insidious metabolic disease that often remains asymptomatic for a long time, and is typically diagnosed due to the occurrence of complications. An approach for diagnosing osteoporosis based on routine CT examinations, including the use of AI services, is being actively studied.</p><p><strong>Methods: </strong>Patients aged >50 years who underwent chest CT using the standard protocol between 09.06.2021 and 30.06.2021 at four inpatient and three outpatient clinics were retrospectively enrolled. The morphometric AI algorithm detected vertebral compression index and vertebrae density in Hounsfield units (HU). The AI algorithm was calibrated for BMD measurements using a phantom. Osteoporotic BMD was defined according to the American College of Radiology criteria (<80 mg/mL). The presence of vertebral fracture (VF) was verified using semiquantitative and algorithm-based qualitative methods by three radiologists, followed by two experts with 15 and 35 years of experience in the field.</p><p><strong>Results: </strong>CT studies of 1,888 patients (mean age, 66.3 years) were included. The AI algorithm detected VCD in 336 patients (17.8%), with 105 (5.5%) having VF. Low BMD values were detected in 501 patients (26.5%; 31.0% of females, 18.6% of males).</p><p><strong>Conclusions: </strong>We observed high diagnostic accuracy of opportunistic osteoporosis screening using AI algorithms for detecting VF and low BMD. AI-based opportunistic screening of osteoporosis and VF in chest CT scans can facilitate the identification of high-risk cohorts.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"355-371"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555736","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":"Pelvic ring ratio: a novel indicator of comprehensive pelvic alignment assessment.","authors":"Hiroaki Nakashima, Noriaki Kawakami, Sadayuki Ito, Naoki Segi, Jun Ouchida, Ippei Yamauchi, Tokumi Kanemura, Shiro Imagama","doi":"10.31616/asj.2024.0447","DOIUrl":"10.31616/asj.2024.0447","url":null,"abstract":"<p><strong>Study design: </strong>A cross-sectional study.</p><p><strong>Purpose: </strong>To determine the effectiveness of the pelvic ring ratio as an indicator for assessing pelvic tilt (PT) from the frontal view and explore its correlation with various whole-body sagittal alignment (WBSA) parameters using EOS imaging technology.</p><p><strong>Overview of literature: </strong>Traditional indicators of PT often rely on sagittal plane measurements, which can be challenging in cases of pelvic rotation or obesity. A new indicator such as the pelvic ring ratio could address these challenges and aid in the comprehensive assessment of pelvic alignment.</p><p><strong>Methods: </strong>In total, 104 healthy participants (28 men, 76 women; mean age, 52.8±12.3 years) with no spinal disorders were recruited. Whole-body radiography using the EOS imaging system was performed to obtain sagittal and coronal parameters, including the pelvic ring ratio. Intra- and interobserver variability were assessed using intraclass correlation coefficients (ICCs) based on measurements by three spine surgery specialists. Correlation analyses among the pelvic ring ratio, age, body mass index, and WBSA parameters were conducted, and a multiple linear regression model was developed to predict PT.</p><p><strong>Results: </strong>The mean pelvic ring ratio was 53.3%±11.5%. The intra- and interobserver ICCs were 0.89 and 0.87, respectively, indicating good reliability. The pelvic ring ratio was negatively correlated with age (r =-0.387, p <0.05) and PT (r =-0.598, p <0.05). The regression model revealed that the pelvic ring ratio and sex significantly predicted PT (p <0.05). Women had higher pelvic ring ratio (55.0%±11.3%) than men (48.6%±10.8%).</p><p><strong>Conclusions: </strong>The pelvic ring ratio is a reliable and valuable indicator for PT assessment from the frontal view. It exhibits significant correlations with age and certain WBSA parameters, showing potential to improving the diagnostic accuracy and treatment planning for patients with spinal and hip disorders.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"380-388"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540010","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 and radiographic predictive factors for the favorable outcome of lumbar epidural steroid injection in lumbosacral radiculopathy: a prospective analytical study from Thailand.","authors":"Pornpan Chalermkitpanit, Wicharn Yingsakmongkol, Weerasak Singhatanadgige, Teerachat Tanasansomboon, Patt Pannangpetch, Sittisak Honsawek","doi":"10.31616/asj.2024.0412","DOIUrl":"10.31616/asj.2024.0412","url":null,"abstract":"<p><strong>Study design: </strong>A prospective analytic study.</p><p><strong>Purpose: </strong>To investigate the clinical factors and magnetic resonance imaging (MRI) findings that can predict a favorable outcome following transforaminal epidural steroid injection (TFESI) in patients with lumbosacral radiculopathy.</p><p><strong>Overview of literature: </strong>The efficacy of lumbar epidural steroid injection varies, and no clinical parameters have been established to predict a favorable response to TFESI reliably.</p><p><strong>Methods: </strong>In total, 120 patients diagnosed with lumbosacral radiculopathy underwent TFESI. At each index spinal level, 5.0 mg of a dexamethasone mixture in 2.0% lidocaine and 0.5% bupivacaine was injected. At the 2-week follow-up, a favorable response to TFESI was defined as pain reduction upon movement of >50.0%. Pain manifestation and MRI findings were evaluated.</p><p><strong>Results: </strong>A favorable response was observed in 60.8% of the patients 2 weeks post-TFESI. In the multivariate analysis, patients with mild central canal stenosis had 4.8 times higher odds of a favorable response to TFESI than those with severe central canal stenosis (adjusted odds ratio, 4.8; 95% confidence interval [CI], 1.2-18.8; p =0.023). Favorable responders experienced a notable 29-week period of pain reduction (95% CI, 10.3-47.8), along with a significantly lower incidence of surgery at 12 months (13.7%) (p <0.01). The mean pain score differences of 3.5 out of 10 observed 2 weeks and 1 month post-TFESI represented the optimal sensitivity and specificity in forecasting favorable responder status.</p><p><strong>Conclusions: </strong>A pain reduction of 3.5 out of 10 within 1 month is considered a clinical benchmark for predicting long-term positive outcomes after TFESI. The presence of severe central canal stenosis is significantly associated with an unfavorable response to TFESI.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"422-431"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540018","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}