Prediction of early postoperative complications and transfusion risk after lumbar spinal stenosis surgery in geriatric patients: machine learning approach based on comprehensive geriatric assessment.

Background: Lumbar spinal stenosis is one of the most common surgery-requiring conditions of the spine in the aged population. As elderly patients often present with multiple comorbidities and limited physiological reserve, individualized risk assessment using comprehensive geriatric assessment is crucial for optimizing surgical outcomes.

Methods: Patients 65 years or older who underwent elective surgery for lumbar spinal stenosis between June 2015 and December 2018 were prospectively enrolled, resulting in 261 eligible patients of age 72.

How sagittal alignment changes can affect independent horizontal gaze after neuromuscular scoliosis correction.

Background: When surgical correction for spinal deformity is performed for neuromuscular scoliosis (NMS) patients, sudden changes in sagittal spinal alignment after surgery can cause difficulties in maintaining independent horizontal gaze. Typically, patients with weak neck flexors can experience a loss of head control during neck extension that cannot be restored to a neutral position to allow horizontal gaze. This study aimed to analyze the radiological factors associated with the ability to maintain an independent horizontal gaze following deformity correction surgery in patients with NMS.

Can we predict post-surgical improvement in functional stooping in lumbar spinal stenosis? Insights from oblique lumbar interbody fusion outcomes and radiologic predictors.

Background: Functional stooping, characterized by a forward-flexed lumbar posture in patients with lumbar spinal stenosis (LSS), serves as a compensatory mechanism aimed at alleviating pain by expanding the constricted spinal canal. Surgeons widely use the oblique lateral interbody fusion (OLIF) to treat patients with LSS, restoring segmental lordosis in index surgical level. In some patients with LSS, improvement of global sagittal imbalance occurs after short-level OLIF.

Role of Denosumab in Patients with Intermediate Spinal Instability Neoplastic Score (SINS).

Objectives: The current study aimed to evaluate the effect of denosumab on patients with impending instability due to spinal metastasis, including whether it can improve spinal instability neoplastic score (SINS) and reduce the need for surgical treatment.

Methods: This study retrospectively reviewed patients initially treated non-operatively for metastatic spinal lesions with intermediate SINS (7-12 points) between January 2017 and December 2023 in a single tertiary cancer hospital. Patients were divided into two groups based on the use of denosumab for the intermediate SINS lesion: D-group and N-group.

Deep learning-based prediction of cervical canal stenosis from mid-sagittal T2-weighted MRI.

Objective: This study aims to establish a large degenerative cervical myelopathy cohort and develop deep learning models for predicting cervical canal stenosis from sagittal T2-weighted MRI.

Materials And Methods: Data was collected retrospectively from patients who underwent a cervical spine MRI from January 2007 to December 2022 at a single institution. Ground truth labels for cervical canal stenosis were obtained from sagittal T2-weighted MRI using Kang's grade, a four-level scoring system that classifies stenosis with the degree of subarachnoid space obliteration and cord indentation.

The Efficacy of a Novel Hybrid Brace in the Treatment of Adolescent Idiopathic Scoliosis: A Prospective Case-Series Study.

: Bracing is an effective treatment for preventing curve progression in skeletally immature adolescent idiopathic scoliosis (AIS) patients. A novel hybrid brace has been developed to overcome the limitations of conventional rigid and soft braces. This study aimed to evaluate the clinical efficacy of the novel hybrid brace.

A Multicenter Investigation on the Incidence and Risk Factors of Wound Dehiscence Following Surgical Treatment of Metastatic Spinal Tumors: The Korean Society of Spinal Tumors Multicenter Study (KSST 2023-01).

Wound dehiscence is a common complication in metastatic spinal tumor surgery, but its risk factors remain unclear. This retrospective, multicenter study included patients who underwent surgical treatment for metastatic spinal tumors between 2020 and 2022. Data on patient demographics, primary tumor type, comorbidities, laboratory values, surgical details, and the use of radiation therapy, chemotherapy, and steroids were collected.

Validation of the Korean Version of the 24-Item Early-Onset Scoliosis Questionnaire: A Multicenter Study from the Korean Research Society of Spinal Deformity.

Background: A 24-item early-onset scoliosis questionnaire (EOSQ-24) has been developed as a valid tool for assessing the physical and emotional function of patients with early-onset scoliosis (EOS). Previous studies that conducted transcultural adaptation of the original EOSQ-24 into other languages have demonstrated the high reliability of the questionnaire. However, a Korean version of the EOSQ-24 is not available, limiting optimal patient assessment in this nation.

Automated measurement of pelvic parameters using convolutional neural network in complex spinal deformities: overcoming challenges in coronal deformity cases.

Background Context: Accurate and consistent measurement of sagittal alignment is challenging, particularly in patients with severe coronal deformities, including degenerative lumbar scoliosis (DLS).

Purpose: This study aimed to develop and validate an artificial intelligence (AI)-based system for automating the measurement of key sagittal parameters, including lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope, with a focus on its applicability across a wide range of deformities, including severe coronal deformities, such as DLS.

Design: Retrospective observational study.

Multidisciplinary Digital Therapeutics for Chronic Low Back Pain Versus In-Person Therapeutic Exercise with Education: A Randomized Controlled Pilot Study.

Chronic lower back pain (CLBP) is a global health issue leading to significant disability and socioeconomic burden. Traditional treatments, including exercise and cognitive behavioral therapy (CBT), are often limited by physical and temporal constraints. This study aimed to evaluate the efficacy of multidisciplinary digital therapeutics (MORA Cure LBP) compared to conventional treatments.

Current issues in the treatment of adolescent idiopathic scoliosis: a comprehensive narrative review.

Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of unknown etiology that commonly affects adolescents, imposing significant socioeconomic burdens. Effective management necessitates a comprehensive approach that takes into account multiple factors, including growth potential and psychological issues. Despite significant advancements in AIS management, several questions regarding optimal treatment strategies persist.

Posterior aggressive debulking versus minimal decompression surgery in patients with metastatic spinal cord compression: propensity-score-matching analysis from a multicenter study cohort.

Objective: The goal of this study was to evaluate the comparative outcomes of aggressive debulking (AD) and minimal decompression (MD) surgeries for metastatic spinal cord compression based on surgical burden, functional improvement, and symptomatic local recurrence (SLR).

Methods: In this retrospective analysis from 2 tertiary hospitals, the authors assessed patients with metastatic spinal cord compression treated via AD and MD surgeries between 2010 and 2022. The evaluation included patient demographics, Eastern Cooperative Oncology Group performance status (ECOG-PS), primary tumor type, modified Tokuhashi scores, surgical burden, and SLR.

Effects of the Severity of Stenosis on Clinical Outcomes of Indirect Decompression Using Oblique Lumbar Interbody Fusion.

No consensus has been reached regarding the efficacy of indirect decompression through oblique lumbar interbody fusion (OLIF) in severe lumbar spinal stenosis (LSS). This study investigated the impact of preoperative magnetic resonance imaging (MRI)-based grading of central and foraminal stenosis on OLIF outcomes in LSS patients and identified risk factors for postoperative clinical dissatisfaction. We retrospectively reviewed LSS patients who underwent OLIF with a minimum 1-year follow-up.

Different Neurogenic Bladders in Patients with Cervical and Thoracic Myelopathy: Direct Comparison from a Prospective Case Series.

: This study aimed to identify the unique characteristics of neurogenic bladders and associated symptoms in patients with cervical or thoracic myelopathy using clinical surveys and urodynamic studies (UDSs). : Patients with degenerative cervical (DCM) or thoracic (DTM) myelopathy and lower urinary tract symptoms (LUTSs) scheduled for decompressive surgery were prospectively enrolled. A UDS was performed one day preceding surgery to evaluate the preoperative urological function.

Predicting adequate segmental lordosis correction in lumbar spinal stenosis patients undergoing oblique lumbar interbody fusion: a focus on the discontinuous segment.

Purpose: To identify the factors associated with a correction of the segmental angle (SA) with a total change greater than 10° in each level following minimally invasive oblique lumbar interbody fusion (MIS-OLIF).

Methods: Patients with lumbar spinal stenosis who underwent single- or two-level MIS-OLIF were reviewed. Segments with adequate correction of the SA >10° after MIS-OLIF in immediate postoperative radiograph were categorized as discontinuous segments (D segments), whereas those without such improvement were assigned as continuous segments (C segments).

Innovative Developments in Lumbar Interbody Cage Materials and Design: A Comprehensive Narrative Review.

This review comprehensively examines the evolution and current state of interbody cage technology for lumbar interbody fusion (LIF). This review highlights the biomechanical and clinical implications of the transition from traditional static cage designs to advanced expandable variants for spinal surgery. The review begins by exploring the early developments in cage materials, highlighting the roles of titanium and polyetheretherketone in the advancement of LIF techniques.

The Fate of Pre-Existing L5-S1 Degeneration following Oblique Lumbar Interbody Fusion of L4-L5 and Above.

Background: Previous studies have identified various risk factors for adjacent segment disease (ASD) at the L5-S1 level after fusion surgery, including preoperative sagittal imbalance, longer fusion, and preoperative disc degeneration. However, only a few studies have explored the risk factors for ASD at the L5-S1 level after oblique lumbar interbody fusion (OLIF) at the L4-L5 level and above. This study aimed to identify the risk factors for symptomatic ASD at the L5-S1 level in patients with pre-existing degeneration after OLIF at L4-L5 and above.

Efficacy of Total En Bloc Spondylectomy versus Stereotactic Ablative Radiotherapy for Single Spinal Metastasis.

To compare total en bloc spondylectomy (TES) with stereotactic ablative radiotherapy (SABR) for single spinal metastasis, we undertook a single center retrospective study. We identified patients who had undergone TES or SABR for a single spinal metastasis between 2000 and 2019. Medical records and images were reviewed for patient and tumor characteristics, and oncologic outcomes.

Midterm Outcomes of Muscle-Preserving Posterior Lumbar Decompression via Sagittal Splitting of the Spinous Process: Minimum 5-Year Follow-up.

Background: To overcome several disadvantages of conventional laminectomy for degenerative lumbar spinal stenosis (DLSS), several types of minimally invasive surgery have been developed. The purpose of the present study was to report the clinical and radiological mid-term outcomes of spinous process-splitting decompression (SPSD) for DLSS.

Methods: Seventy-three consecutive patients underwent SPSD between September 2014 and March 2016.

The Use of High-Density Pedicle Screw Construct with Direct Vertebral Derotation of the Lowest Instrumented Vertebra in Selective Thoracic Fusion for Adolescent Idiopathic Scoliosis: Comparison of Two Surgical Strategies.

Study Design: This study was a retrospective case series.

Purpose: This study was designed to determine whether direct vertebral rotation (DVR) of the lowest instrumented vertebra (LIV) using a high-density (HD) construct can reduce fusion segments without increasing adverse outcomes in selective thoracic fusion (STF) for adolescent idiopathic scoliosis (AIS).

Overview Of Literature: LIV DVR is used to maximize spontaneous lumbar curve correction and reduce adverse outcomes during STF for AIS.

Anterior Cervical Discectomy and Fusion Using -Derived Recombinant Human Bone Morphogenetic Protein-2: A Pilot Study.

Background: Recombinant human bone morphogenetic protein-2 (BMP-2) is an osteoinductive growth factor widely used in orthopedic surgery; it is also known to be associated with postoperative airway compromise or dysphagia when applied to anterior cervical discectomy and fusion (ACDF). However, there have been no reports on ACDF using -derived BMP-2 (E.BMP-2) with hydroxyapatite (HA).