Effect of Preoperative Nutritional Status on Postoperative Clinical Outcomes of Patients with Metastatic Spinal Tumors: Japan Association of Spine Surgeons with Ambition Multicenter Study.

Study Design: A multicenter prospective study.

Objective: To evaluate the effect of preoperative nutritional status, assessed using the Prognostic Nutritional Index (PNI), on clinical outcomes, including survival prognosis, postoperative complications, hospitalization duration, and functional prognosis, in patients with metastatic spinal tumors undergoing surgery.

Summary Of Background Data: Malnutrition is common in patients with cancer and is associated with poor clinical outcomes.

Abnormal Paravertebral Muscle Activity and Cervical Extensor Muscle Condition Affect Dynamic Spinal Balance during Gait in Dropped Head Syndrome.

Introduction: The pathogenesis of dropped head syndrome (DHS) involves factors like fat infiltration of the cervical extensor muscle, cervical degeneration, and sarcopenia, which are typically assessed using conventional imaging. Previous studies have demonstrated cervical and thoracic anterior tilt deterioration during gait in patients with DHS. However, the relationship between dynamic spinal balance and conventional imaging findings has not been investigated.

The significance of adding posterior decompression to spine stabilization in metastatic spinal surgery: a multicenter prospective study.

The usefulness of spine stabilization for treating metastatic spinal tumors with tumor-induced instability has been reported. However, no reports have prospectively evaluated the effectiveness of adding posterior decompression to stabilization surgery for improving symptoms. This multicenter prospective study aimed to determine whether adding posterior decompression to spine stabilization surgery for metastatic spinal tumors affects postoperative outcomes and complications.

Predictive factors for bladder function recovery following cervical OPLL surgery: a comprehensive analysis.

Background Context: Neurogenic bladder dysfunction, a condition affecting both bladder storage and voiding function, remains a primary source of morbidity in patients with cervical ossification of posterior longitudinal ligaments (OPLL). Prognosticating the functional outcomes of bladder function postoperatively in patients with cervical OPLL is crucial for patient counseling, rehabilitation planning, and discharge protocols. However, a validated prediction model for bladder function outcomes is currently unavailable.

Survival days of patients with metastatic spinal tumors of lung cancer requiring surgery: a prospective multicenter study.

Surgery for metastatic spinal tumors has improved postoperative activities of daily living. A few studies reported on prognostic factors assessed in large multicenter prospective studies for metastatic spinal tumors of lung cancer origin. This study aimed to determine preoperative prognostic factors in patients undergoing surgery for metastatic spinal tumors associated with lung cancer.

Three-dimensional gait analysis reveals differences in spinal balance and muscle activity during prolonged walking in patients with dropped head syndrome based on global spinal alignment.

Purpose: No studies have elucidated the dynamic spinal balance in patients with dropped head syndrome (DHS) categorized by global spinal alignment. We investigated the differences in dynamic spinal balance and corresponding muscle activity during prolonged walking in patients with DHS based on their global spinal alignment.

Methods: Three-dimensional gait analysis combined with electromyography was conducted to evaluate kinematic spinal parameters during walking, including the sagittal vertical axis (SVA) in the cervical (C-SVA), thoracic (T-SVA), and lumbar (L-SVA) regions, along with the muscle activity.

Preoperative pars defect length predicts bone union after direct repair for lumbar spondylolysis using the modified smiley face rod technique: a retrospective cohort study.

Study Design: A retrospective cohort study.

Purpose: 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.

Overview Of Literature: Lumbar spondylolysis is a common cause of low back pain in young athletes, often leading to pseudarthrosis that requires surgical intervention.

Incidence and risk factors of dysphagia after cervical laminoplasty.

Dysphagia is a known complication following anterior cervical spine surgery, but it has also been reported after laminoplasty. We sought to determine the incidence of dysphagia following cervical laminoplasty. Prospective, multicenter, observational study of patients who underwent cervical laminoplasty or posterior lumbar spinal surgery between April 2022 and May 2024.

Challenges and limitations of the existing scoring systems for postoperative outcomes in thoracolumbar pyogenic spondylitis: a multicenter retrospective cohort study.

Purpose: This study aimed to evaluate the predictive ability of existing scoring systems for postoperative outcomes in patients with thoracolumbar pyogenic spondylitis treated with minimally invasive posterior fixation.

Methods: We conducted a multicenter retrospective cohort study of 90 patients with thoracolumbar pyogenic spondylitis treated with minimally invasive posterior fixation between January 2014 and June 2024. We assessed the Brighton spondylodiscitis score (BSDS), spinal instability spondylodiscitis score (SISS), and spinal infection treatment evaluation (SITE) score.

Posterior fixation for pyogenic spondylitis following osteoporotic vertebral fracture: A retrospective study of five challenging cases.

Background: Pyogenic spondylitis following osteoporotic vertebral fracture is rare but serious with a poor clinical outcome. Although posterior fixation is an effective treatment for pyogenic spondylitis, surgical outcomes following osteoporotic vertebral fractures remain largely unreported. We present the outcomes of five challenging cases treated with posterior fixation.

Preventing neurological deterioration after ambulation in posterior decompression and fusion for thoracic ossification of the posterior longitudinal ligament.

PurposeThe objective of this study was to clarify the characteristics of immediate neurological deterioration (ND) after ambulation and its potential preventative measures using multi-rod reinforcement during posterior decompression and fusion (PDF) with instrumentation for thoracic ossification of the posterior longitudinal ligament (T-OPLL).MethodsStudy 1: Fifteen patients with T-OPLL who underwent PDF before 2020 were included. Demographic, radiographic, intraoperative, and postoperative data were compared between the 6 patients with ND and 9 patients without ND after ambulation.

Risk Factors for Early 3-Month Postoperative Mortality in Metastatic Spinal Tumor Surgery: A JASA Multicenter Prospective Study.

Study Design: Prospective multicenter study.

Objective: To investigate risk factors for 3-month postoperative mortality in metastatic spinal tumor surgery, focusing on nutritional biomarkers and prognostic scores alongside clinical indicators.

Summary Of Background Data: Metastatic spinal tumors affect patient morbidity and mortality.

Predicting Postoperative Neurological Outcomes in Metastatic Spinal Tumor Surgery Using Machine Learning.

Study Design: Retrospective analysis of data collected across multiple centers.

Objective: To develop machine learning models for predicting neurological outcomes one month postoperatively in patients with metastatic spinal tumors undergoing surgery, and to identify key factors influencing neurological recovery.

Summary Of Background Data: The increasing prevalence of spinal metastases has led to a growing need for surgical intervention to address mechanical instability and neurological deficits.

Gram-negative rods are associated with prolonged treatment in patients with thoracolumbar pyogenic spondylitis after minimally invasive posterior fixation compared with gram-positive cocci: a multicenter retrospective cohort study.

Background: This study compared patient characteristics, clinical outcomes, and antibiotic durations between patients undergoing posterior fixation for gram-negative rods (GNR) or gram-positive cocci (GPC) thoracolumbar pyogenic spondylitis.

Methods: In this multicenter retrospective cohort study, 53 patients who underwent minimally invasive posterior fixation for thoracolumbar pyogenic spondylitis were categorized into a GPC or GNR group based on the identified causative organisms. Patient characteristics, surgical outcomes, and postoperative infection control were compared between the two groups to identify factors affecting antibiotic duration.

Posterior fixation without debridement for pyogenic spondylodiscitis can promote infection control: initial evaluation of a pyogenic spondylodiscitis posterior fixation rat model.

Purpose: Pyogenic spondylodiscitis is a significant health concern, particularly in older individuals. Minimally invasive surgical techniques, such as posterior fixation, are promising for infection control; however, their mechanisms remain unclear. This study aimed to clarify how posterior fixation promotes infection control in an animal model.

Unexpected Neurological Deterioration Following Occipitocervical Fusion Surgery: A Case Report.

Occipitocervical posterior decompression and fusion (O-C fusion) surgery is occasionally required for treating high cervical myelopathy due to atlantoaxial subluxation. The advance of the instrumentation systems has led to favorable clinical outcomes following O-C fusion surgery. However, the rate of perioperative complications in O-C fusion surgery is relatively high, including instrumentation failure, respiratory complications, and dysphagia.

Utilization of SURGIFLO® Hemostatic Matrix Reduces Intraoperative Blood Loss During Posterior Instrumented Thoracolumbar Spinal Surgery for Patients With Adult Spinal Deformity.

Background Massive blood loss is a major complication of posterior instrumented thoracolumbar surgery for adult spinal deformities. The use of flowable and absorbable hemostatic products, such as SURGIFLO Hemostatic Matrix (SURGIFLO; ETHICON, Inc., Raritan, NJ, US), has become feasible for spinal surgery.

A deep learning-based prediction model for prognosis of cervical spine injury: a Japanese multicenter survey.

Purpose: Cervical spine injuries in the elderly (defined as individuals aged 65 years and older) are increasing, often resulting from falls and minor trauma. Prognosis varies widely, influenced by multiple factors. This study aimed to develop a deep-learning-based predictive model for post-injury outcomes.

Impact of hypertension in diabetes on surgical outcomes after cervical laminoplasty - a retrospective, multi-institutional study of 1002 patients.

Purpose: This study aimed to elucidate the association between comorbid hypertension (HT) and diabetes mellitus (DM) (HT in DM) and clinical outcomes after cervical laminoplasty.

Methods: This retrospective multi-institutional study enrolled patients who underwent laminoplasty between 2008 and 2017. The primary outcome was the recovery rate of JOA score.

Efficacy and Limitations of Continuous Local Antibiotic Perfusion in Treating Surgical Site Infections Following Instrumented Spinal Surgery: A Retrospective Multicenter Study.

Introduction: Surgical site infection (SSI) is one of the most serious postoperative complications following instrumented spinal surgery. We previously reported the potential of continuous local antibiotic perfusion (CLAP) to retain implants for patients with SSI following instrumented spinal surgery. We conducted a retrospective multicenter study to elucidate the efficacy and limitations of CLAP for patients with SSI following instrumented spinal surgery.

Comparison of Disc Degeneration between Pyogenic Spondylitis and Noninfected Lumbar Spondylosis: A Multicenter Retrospective Study with Propensity Score Matching.

Introduction: Disc degeneration is a risk factor of pyogenic spondylitis. However, its degree in patients with pyogenic spondylitis is unknown. This study aimed to determine differences in disc degeneration between patients with pyogenic spondylitis and those with noninfectious lumbar spondylosis.

Is Intraoperative Blood Loss Volume in Elderly Cervical Spine Injury Surgery Greater in Patients with Ankylosis? A Multicenter Survey.

Introduction: Preoperative estimations of blood loss are important when planning surgery for cervical spine injuries in older adults. The association between ankylosis and blood loss in perioperative management is of particular interest. This multicenter database review aimed to evaluate the impact of ankylosis on surgical blood loss volume in elderly patients with cervical spine injury.

Short Fixation Using Upward/Downward Penetrating Endplate Screws and Percutaneous Vertebral Augmentation for Unstable Osteoporotic Vertebral Fractures.

Introduction: Percutaneous vertebral augmentation techniques, such as balloon kyphoplasty (BKP) and vertebral body stenting (VBS), are commonly used for surgical intervention in osteoporotic vertebral fractures (OVFs). However, markedly unstable OVF cases require additional fixation procedures, prompting the exploration of combined percutaneous vertebral augmentation and posterior fixation. A novel surgical approach involving percutaneous vertebral augmentation with upward penetrating endplate screws (PES) and downward PES, complemented by a short fusion of one above one below, was developed.