Asian Spine Journal最新文献

{"title":"Validation of the visual body image classification in adolescent idiopathic scoliosis: a retrospective study.","authors":"Han Sol Kim, Jae Yoon Jeong, Yoon Jae Cho, Tae Sik Goh, Jung Sub Lee","doi":"10.31616/asj.2024.0201","DOIUrl":"10.31616/asj.2024.0201","url":null,"abstract":"<p><strong>Study design: </strong>A prospective study.</p><p><strong>Purpose: </strong>To diagnose scoliosis, a visit to the hospital for radiography is typically necessary. In such cases, children with scoliosis are exposed to radiation, which may place their health at risk. Therefore, we sought to determine whether a classification method based on visual body images obtained through photography can be used to diagnose scoliosis.</p><p><strong>Overview of literature: </strong>Scoliosis can be diagnosed and classified into various types using radiographs. However, no studies have attempted to classify scoliosis based on visual body images.</p><p><strong>Methods: </strong>From January 1, 2019 to December 31, 2022, 136 patients newly diagnosed with Adolescent idiopathic scoliosis and 124 healthy candidates from our institution were enrolled. This study classified body images into five types based on visual confirmation of the positional relationship of the body. The accuracy of this classification method was identified by calculating its sensitivity, specificity, and reproducibility of this classification method within and between observers according to kappa value.</p><p><strong>Results: </strong>Overall, 136 patients and 124 control subjects who visited the Pusan National University Hospital, Busan, Korea were photographed and compared by obtaining back images and X-ray radiographs. The sensitivity and specificity of the classification method showed a satisfactory-to-good degree of accuracy, although the degree varies depending on the visual body image type. The classification methods exhibited good intraobserver reliability (κ=0.855) and moderate interobserver reliability (κ=0.751).</p><p><strong>Conclusions: </strong>Our classification method showed a high degree of sensitivity and specificity (98.1% sensitivity, 98.9% specificity, and 98.4% accuracy) while exhibiting high reproducibility and ease of access. Based on our findings, we believe that our classification method can be used for scoliosis screening.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"829-835"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799308","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":"Traumatic posterior atlantoaxial dislocation without an associated fracture: a PRISMA-compliant case-based systematic review and meta-analysis.","authors":"Mahmoud Fouad Ibrahim, Ahmed Shawky Abdelgawaad, Essam Mohammed El-Morshidy, Amr Hatem, Mohamed El-Meshtawy, Mohammad El-Sharkawi","doi":"10.31616/asj.2024.0331","DOIUrl":"10.31616/asj.2024.0331","url":null,"abstract":"<p><p>Traumatic posterior atlantoaxial dislocation (TPAD) without an associated fracture is a rare and challenging spinal injury. This PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-compliant case-based systematic review and meta-analysis aimed to comprehensively explore TPAD, covering clinical presentation, diagnosis, treatment, and clinical and radiological outcomes. Following the presentation of a case of TPAD without an associated fracture, we conducted a systematic search of electronic databases, including Scopus, PubMed, and Web of Science, from inception through October 2023, without language restrictions. Cases involving dislocations due to congenital anomalies or inflammatory processes were excluded. The search yielded 31 eligible cases of TPAD without an associated fracture. The majority (81%) of the cases were males, with traffic accidents being the leading cause (87%). Notably, 52% of the cases presented without any neurological deficits. Regarding treatment approaches, 23% of the cases were managed through closed reduction alone, 32% required fusion following closed reduction, and 45% underwent open reduction and fusion. A time delay exceeding 7.5 days was associated with a significantly higher risk of closed reduction failure (odds ratio, 56.463; p =0.011). This review identified key management strategies for TRAD without fracture, informed by the available evidence. Optimal management entails prompt closed reduction under C-arm while monitoring neurological status once hemodynamic stability is achieved. Surgical fusion is indicated for cases with magnetic resonance imaging-confirmed transverse ligament rupture or residual instability. If closed reduction fails, open reduction and fusion should be carried out. Posterior C1-C2 screws fixation is the preferred fusion technique, providing high levels of safety and biomechanical stability.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"889-902"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799307","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":"A magnetic resonance imaging-based morphometric analysis of bilateral L1-L5 oblique lumbar interbody fusion corridor: feasibility of safe surgical approach and influencing factors.","authors":"Archit Goyal, Mayukh Guha, Rajat Mahajan","doi":"10.31616/asj.2024.0193","DOIUrl":"10.31616/asj.2024.0193","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cross-sectional study.</p><p><strong>Purpose: </strong>To investigate the size and local anatomy of the right and the left-sided oblique corridors between L1-L5 levels and identify the potential impact of increasing age and sex on corridor size.</p><p><strong>Overview of literature: </strong>The oblique lumbar interbody fusion (OLIF) was introduced by Silvestre and his colleagues as a solution to the approach-related complications associated with anterior lumbar interbody fusion and lateral lumbar interbody fusion. Limited data were available describing the local anatomy and morphology of this approach.</p><p><strong>Methods: </strong>Imaging data of 300 patients (150 males and 150 females) who underwent 1.5T magnetic resonance imaging (MRI) scans of the lumbar spine at Indian Spinal Injuries Centre, New Delhi, India between January 2023 and January 2024 were retrospectively reviewed. The cohort was stratified into six age groups (21-30, 31-40, 41-50, 51-60, 61-70, and >70 years) with 25 patients in each age group for both sexes. T2 weighted axial MRI images were analyzed from the L1-L5 level at the mid-disc level to calculate the corridor size. The local anatomical differences were recorded.</p><p><strong>Results: </strong>At L1-L2, L2-L3, L3-L4, and L4-L5 levels, the mean corridor sizes in males were 17.48, 15.50, 13.41, and 9.32 mm on the left side, and 11.48, 7.12, 4.34, and 1.64 mm on the right side, respectively. The corresponding mean corridor sizes in females were 10.34, 12.94, 12.64, and 7.22 mm on the left side and 2.66, 3.52, 3.69, and 1.64 mm on the right side, respectively. For both sides, the corridor size was significantly affected by sex, increased with age, and decreased at the lower lumbar disc levels.</p><p><strong>Conclusions: </strong>A left-sided OLIF approach is more feasible for both sexes. The right-sided approach is less likely to be performed effectively.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"757-764"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456892","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":"Can unilateral-transforaminal lumbar interbody fusion replace the traditional transforaminal lumbar interbody fusion procedure for lumbar degenerative disc diseases?: a single center matched case-control mid-term outcome study.","authors":"Sajan Karunakar Hegde, Appaji Krishnamurthy Krishnan, Vigneshwara Badikkillaya, Sharan Talacauvery Achar, Harith Baddula Reddy, Akshyaraj Alagarasan, Rochita Venkataramanan","doi":"10.31616/asj.2024.0230","DOIUrl":"10.31616/asj.2024.0230","url":null,"abstract":"<p><strong>Study design: </strong>Matched case-control study.</p><p><strong>Purpose: </strong>To evaluate the midterm outcomes of unilateral pedicle screw fixation (UPSF) versus bilateral pedicle screw fixation (BPSF) in transforaminal lumbar interbody fusion (TLIF) procedure, ascertain efficacy of UPSF in adequately decompressing contralateral foramen+spinal canal and reducing rate of adjacent segment degeneration (ASD) at 4-8-year follow-up (FU).</p><p><strong>Overview of literature: </strong>Previous meta-analyses found no significant differences between UPSF and BPSF regarding fusion rates, clinical and radiological outcomes; however, few studies have reported higher rates of cage migration/subsidence and pseudoarthrosis in the UPSF. No study has evaluated the impact of UPSF on indirect decompression and ASD.</p><p><strong>Methods: </strong>Retrospective analysis of 319 patients treated with UPSF vs. 331 patients treated with BPSF between 2012 to 2020. Clinical and radiological outcomes were evaluated at 6 months, 1 year, 2 years, and 4 years postoperatively. X-rays were used to assess fusion+ASD and computed tomography scans in doubtful cases. Magnetic resonance imaging was used at last FU to determine cross-sectional area of cord (CSA), foraminal height (FH), and width (FW) restoration.</p><p><strong>Results: </strong>The mean FU duration was 50 months (range, 44-140 months). In UPSF, CSA increased by 2.3 times from preoperative values; FH and FW increased by 25% and 17.5%, respectively, at last FU (p<0.001); fusion rate was 94.3%, comparable to BPSF (similar CSA, FW, FH, 96.4% fusion rate). In UPSF, adjacent disc height remained stable, from preoperative 11.39±2.03 to 10.97±1.93 postoperatively at 4 years and 10.03±1.88 at 8 years. BPSF showed ASD in 14 (4.47%) vs. three patients (1.06%) in UPSF (p<0.04). Complication rates were similar (6.58% UPSF vs. 6.04% BPSF, p>0.05).</p><p><strong>Conclusions: </strong>UPSF-TLIF is comparable to BPSF in terms of patient-reported clinical outcomes, fusion rates, and complication rates while being superior in terms of lesser ASD. UPSF enables radiologically and clinically significant contralateral indirect neural foraminal decompression and canal decompression without disturbing the contralateral side anatomy, unlike BPSF.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"18 6","pages":"846-855"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943438","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":"Current trends in intraoperative neurophysiological monitoring among Asia-Pacific countries: an Asia-Pacific Spine Society survey.","authors":"Hideki Shigematsu, Akimasa Yasuda, Ronald Tangente, Chris Yin Wei Chan, Ajoy Prasad Shetty, Jason Pui Yin Cheung, Yong Hai, Daisuke Sakai, Kyu-Jung Cho, Chih-Wei Chen, Gabriel Liu, I Gusti Lanang Ngurah Agung Artha Wiguna, Brian Hsu, Mun Keong Kwan","doi":"10.31616/asj.2024.0273","DOIUrl":"10.31616/asj.2024.0273","url":null,"abstract":"<p><strong>Study design: </strong>A prospective web-based survey.</p><p><strong>Purpose: </strong>Although intraoperative neurophysiological monitoring (IONM) is critical in spine surgery, its usage is largely based on the surgeon's discretion, and studies on its usage trends in Asia-Pacific countries are lacking. This study aimed to examine current trends in IONM usage in Asia-Pacific countries.</p><p><strong>Overview of literature: </strong>IONM is an important tool for minimizing neurological complications and detecting spinal cord injuries after spine surgery. IONM can be performed using several modalities, such as transcranial electrical stimulation-muscle evoked potentials (Tc-MEP) and somatosensory evoked potentials (SEP).</p><p><strong>Methods: </strong>Spine surgeons of the Asia-Pacific Spine Society were asked to respond to a web-based survey on IONM. The questionnaire covered various aspects of IONM, including its common modality, Tc-MEP details, necessities for consistent use, and recommended modalities in major spine surgeries and representative surgical procedures.</p><p><strong>Results: </strong>Responses were received from 193 of 626 spine surgeons. Among these respondents, 177 used IONM routinely. Among these 177 respondents, 17 mainly used SEP, whereas the majority favored Tc-MEPs. Although a >50% decrease is the commonly used alarm point in Tc-MEP, half of the Tc-MEP users had no protocols planned for such scenarios. Moreover, half of the Tc-MEP users experienced complications, with bite injuries being the most common. Most respondents strongly recommended IONM in deformity surgery for pediatric and adult populations and tumor resection surgery for intramedullary spinal cord tumors. Conversely, IONM was the least recommended in lumbar spinal canal stenosis surgery.</p><p><strong>Conclusions: </strong>Spine surgeons in Asia-Pacific countries favored IONM use, indicating widespread routine utilization. Tc-MEP was the predominant modality for IONM, followed by SEPs.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"18 6","pages":"813-821"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942661","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":"Optimising deformity correction: a retrospective comparative analysis of two techniques in high magnitude curves in adolescent idiopathic scoliosis.","authors":"Arvind Gopalrao Kulkarni, Priyambada Kumar, Thonangi Yeshwanth, Sharvari Gunjotikar, Praveen Goparaju, Yogesh Madhavrao Adbalwad, Aditya Raghavendra Sai Siva Chadalavada, Arvind Umarani, Shankargouda Patil","doi":"10.31616/asj.2024.0332","DOIUrl":"10.31616/asj.2024.0332","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective comparative study.</p><p><strong>Purpose: </strong>To validate the hypothesis that a combination of multilevel Ponte osteotomy (PO) with intraoperative traction (IOT) results in a better correction than IOT alone in high-magnitude curves in adolescent idiopathic scoliosis (AIS) and does not possess an attributable risk of neurological injury.</p><p><strong>Overview of literature: </strong>On a comprehensive review of the literature, the choice of technique adopted for curves between 65° and 100° remains controversial with no major consensus favoring one technique over the other.</p><p><strong>Methods: </strong>Twenty-four patients with AIS (Cobb >65°) underwent surgery at a single center between January 2014 and December 2021. The first 10 patients underwent surgery using only IOT (T group), whereas the subsequent 14 patients underwent surgery with a combination of IOT and PO (TP group).</p><p><strong>Results: </strong>The mean preoperative Cobb angles in the T and TP groups were 89.35°±6.05° and 92.32°±9.28°, respectively (p=0.59). The mean flexibility index (FI) of the T and TP groups were 0.31±0.016 and 0.36±0.03, respectively (p=0.41). The mean postoperative Cobb angle in the T and TP groups were 40.25°±5.95° and 19.1°±3.20°, respectively (p=0.041). Apical vertebral rotation improved from mean grade 3.2 (2-4) to grade 2.6 (1-3) in the T group and from mean grade 3.6 (2-4) to mean grade 1.8 (1-3) in the TP group. Postoperatively, the mean thoracic kyphosis was 13.84°±2.10° and 21.02°±1.68° in T and TP groups (p=0.044). Transient signal-loss intraoperatively was noted in two patients, one in each group. No episodes of postoperative neurological deficits were reported. No incidences of pseudarthrosis/implant-related complications were reported at the end of 2 years in either group.</p><p><strong>Conclusions: </strong>IOT and PO complement one another and can be safely combined without an attributable risk of neurological injury.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"18 6","pages":"794-802"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942949","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":"Normative values of non-radiological surface measurement of the lumbar lordosis curvature in the standing position and its association with age, sex, and body mass index: a cross-sectional study of 2,500 healthy individuals from Iran.","authors":"Reza Rajabi, Magdalena Plandowska, Mohammad Bayattork","doi":"10.31616/asj.2024.0317","DOIUrl":"10.31616/asj.2024.0317","url":null,"abstract":"<p><strong>Study design: </strong>A cross-sectional study.</p><p><strong>Purpose: </strong>This study aimed to define the normal values of the lumbar lordosis curve (LLC) and investigate its association with sex, age, and body mass index (BMI).</p><p><strong>Overview of literature: </strong>The importance of the human spine's sagittal alignment, particularly in the lumbar region, has been argued from the physiological and pathophysiological points of view. The LLC size is an important predictor of lumbar pathologies. Lumbar curvature misalignment, particularly increased lumbar lordosis or hypolordosis, can, in the long term, lead to spinal instability and development of disorders such as low back pain and spondylolisthesis Therefore, knowledge about the normal LLC value and its association with age, sex, and BMI, appears crucial.</p><p><strong>Methods: </strong>The study recruited 2,497 asymptomatic volunteers (1,264 women and 1,233 men) aged 5-85 years. Participants were assigned to different groups based on their sex, age, and BMI. The LLC was measured using a Flexicurve.</p><p><strong>Results: </strong>Normal LLC values were established for different sexes, age, and BMI groups. Overall, normal LLC ranges from 10.2° to 74.9° with a mean of 42.34°±13° (male, 38.57°±11.44°; female, 46°±13.38°). LLC was generally higher by 7.5° in women than in men. A significant three-way interaction of sex, age, and BMI with LLC was found. The association of age and BMI with LLC was also significant.</p><p><strong>Conclusions: </strong>Our results can be used as a reference by physicians, healthcare, etc., when the LLC values in different ages and sexes are measured noninvasively. In other words, this information can be used as reference when determining whether the obtained LLC is within the normal range.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"836-845"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715087","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 potential role of synthetic computed tomography in spinal surgery: generation, applications, and implications for future clinical practice.","authors":"Shreya Sankar, Jake Michael McDonnell, Stacey Darwish, Joseph Simon Butler","doi":"10.31616/asj.2024.0197","DOIUrl":"10.31616/asj.2024.0197","url":null,"abstract":"<p><p>Computed tomography (CT) is widely used for the diagnosis and surgical treatment of spinal pathologies, particularly for pedicle screw placement. However, CT's limitations, notably radiation exposure, necessitate the development of alternative imaging techniques. Synthetic CT (sCT), which generates CT-like images from existing magnetic resonance imaging (MRI) scans, offers a promising alternative to reduce radiation exposure. This study examines the emerging role of sCT in spinal surgery, focusing on usability, efficiency, and potential impact on surgical outcomes. This qualitative literature review evaluated various sCT generation methods, encompassing traditional atlas-based and bulk-density models, as well as advanced convolutional neural network (CNN) architectures, including U-net, V-net, and generative adversarial network models. The review assessed sCT accuracy and clinical feasibility across different medical disciplines, particularly oncology and surgery, with potential applications in orthopedic, neurosurgical, and spinal surgery. sCT has shown significant promise across various medical disciplines. CNN-based techniques enable rapid and accurate generation of sCT from MRI scans, rendering clinical use feasible. sCT has been used to identify pathologies and monitor disease progression, suggesting that MRI alone may suffice for diagnosis and planning in the future. In spinal surgery, sCTs are particularly useful in visualizing key anatomical features like vertebral dimensions and spinal canal diameter. However, challenges persist, especially in visualizing complex structures and larger spinal regions, like the lumbar spine. Additional limitations include inaccuracies stemming from surgical implants and image variability. The application of sCT technology in spinal surgery holds great promise, improving diagnostics, planning, and treatment outcomes. Although further research is required to improve its precision, it offers a viable alternative to traditional CT in many clinical contexts, with the potential for broader application as the technology matures.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"18 6","pages":"913-922"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943205","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: enhancing perioperative care for elderly spinal surgery patients.","authors":"Hina Vaish","doi":"10.31616/asj.2024.0500.r1","DOIUrl":"https://doi.org/10.31616/asj.2024.0500.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"18 6","pages":"925-926"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962068","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":"Perioperative complications in patients aged ≥85 years undergoing spinal surgery: a retrospective comparative study of pre-old and old patients in Japan.","authors":"Takahiro Mui, Hideki Shigematsu, Masaki Ikejiri, Sachiko Kawasaki, Yasuhito Tanaka","doi":"10.31616/asj.2024.0215","DOIUrl":"10.31616/asj.2024.0215","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective comparative study.</p><p><strong>Purpose: </strong>To compare the characteristics of perioperative complications in patients aged ≥85 years with those of younger patients undergoing similar spine surgery and examine factors associated with perioperative complications and clinical outcomes among patients aged ≥85 years.</p><p><strong>Overview of literature: </strong>The risk factors for perioperative complications and their effect on outcomes in patients aged ≥85 years remain unclear. Furthermore, no study has compared younger patients with similar surgeries and condition with those aged ≥85 years.</p><p><strong>Methods: </strong>The study included patients aged ≥65 years who underwent spinal surgeries. The patients aged ≥85, 75-84, and 65-74 years were categorized into the super-old, old, and pre-old groups, respectively. The differences in perioperative age-related complications were compared among the three groups while matching for surgical procedures and general conditions (study 1). Furthermore, preoperative and intraoperative factors were examined for perioperative complications in the super-old group (study 2). Complications were categorized into surgical site and systemic complications.</p><p><strong>Results: </strong>The analysis included 44 patients from each group. In study 1, the total complication rates were 40.9%, 25%, and 18.2% of the super-old, old, and pre-old groups, respectively. Differences in complication rates were observed between the super-old and pre-old groups (p=0.011). In study 2, 58 patients from the super-old group were analyzed. Surgical site complications were significantly associated with longer surgical duration (p=0.02) and more estimated blood loss (p=0.003). Systemic complications were significantly associated with previous cerebrovascular disease (p=0.014), preoperative motor deficit (p=0.023), and emergency case (p=0.006) and negatively associated with diabetes mellitus (p=0.048).</p><p><strong>Conclusions: </strong>Perioperative complications increased with advancing age in the super-old, old, and pre-old groups. The complication type is associated with specific background factors; therefore, determining them may help prevent perioperative complications.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"856-866"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456915","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}