Purpose: Discrepancies between clinical and imaging findings complicate accurate diagnoses of spinal levels in lumbar disorders. Extreme variations in the 12th rib length may be associated with cranial or caudal shifts of the lumbosacral plexus; however, the anatomical basis remains speculative because of limited in vivo visualization. This study assessed whether the conus medullaris position and L4 morphology-particularly the branch to the lumbosacral trunk (LST)-can be visualized using magnetic resonance imaging (MRI) and their correlations with the 12th rib length and symptom deviation.
Methods: This study included 127 patients who underwent lumbar disc herniation surgery and 25 cadaveric specimens. MRI and radiography were used to measure the conus medullaris level, LST branch visibility, and 12th rib length. Cadaveric dissections evaluated the LST branch thickness and its association with the rib length and plexus position.
Results: Patients with symptoms of caudal shift had shorter 12th ribs, a more cranially located conus medullaris, and more frequent visibility of the LST branch using MRI (all p < 0.001). LST branches visible with MRI were linked to shorter ribs and higher conus levels. The conus position positively correlated with the rib length (r = 0.36). A cadaveric analysis revealed a strong inverse correlation between the rib length and LST branch thickness (r = -0.86).
Conclusion: The 12th rib length, conus medullaris level, and L4 morphology reflect cranial-caudal shifts in neural structures and symptoms. These anatomical markers may be clinically useful predictors of level-specific symptoms and support more accurate surgical planning.
{"title":"12th rib length and L4 branch morphology predict cranio-caudal symptom discrepancies in lumbar disorders: clinical and cadaveric study.","authors":"Juri Teramoto, Hidetoshi Nojiri, Hidaka Anetai, Yukoh Ohara, Koichiro Ichimura, Muneaki Ishijima","doi":"10.1007/s00586-026-09814-3","DOIUrl":"https://doi.org/10.1007/s00586-026-09814-3","url":null,"abstract":"<p><strong>Purpose: </strong>Discrepancies between clinical and imaging findings complicate accurate diagnoses of spinal levels in lumbar disorders. Extreme variations in the 12th rib length may be associated with cranial or caudal shifts of the lumbosacral plexus; however, the anatomical basis remains speculative because of limited in vivo visualization. This study assessed whether the conus medullaris position and L4 morphology-particularly the branch to the lumbosacral trunk (LST)-can be visualized using magnetic resonance imaging (MRI) and their correlations with the 12th rib length and symptom deviation.</p><p><strong>Methods: </strong>This study included 127 patients who underwent lumbar disc herniation surgery and 25 cadaveric specimens. MRI and radiography were used to measure the conus medullaris level, LST branch visibility, and 12th rib length. Cadaveric dissections evaluated the LST branch thickness and its association with the rib length and plexus position.</p><p><strong>Results: </strong>Patients with symptoms of caudal shift had shorter 12th ribs, a more cranially located conus medullaris, and more frequent visibility of the LST branch using MRI (all p < 0.001). LST branches visible with MRI were linked to shorter ribs and higher conus levels. The conus position positively correlated with the rib length (r = 0.36). A cadaveric analysis revealed a strong inverse correlation between the rib length and LST branch thickness (r = -0.86).</p><p><strong>Conclusion: </strong>The 12th rib length, conus medullaris level, and L4 morphology reflect cranial-caudal shifts in neural structures and symptoms. These anatomical markers may be clinically useful predictors of level-specific symptoms and support more accurate surgical planning.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of a multimodal radiomics-based model for predicting recurrent fracture risk after PVP.","authors":"Muhan Liu, Xiaoning Yang, Yingshan Ding, Zheyi Xiao","doi":"10.1007/s00586-026-09762-y","DOIUrl":"https://doi.org/10.1007/s00586-026-09762-y","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aimed to assess the diagnostic utility of optically pumped magnetometer-based magnetoencephalography (OPM-MEG) in patients with cervical spondylotic myelopathy (CSM).
Methods: A total of 31 CSM patients and 32 healthy volunteers were enrolled. Somatosensory-evoked magnetic fields (SEFs) were recorded using OPM-MEG. Clinical evaluations included the Japanese Orthopaedic Association (JOA) scale and the Short Form-36 (SF-36) health survey. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis.
Results: Compared with healthy controls, CSM patients demonstrated decreased α power in the occipital region, and increased γ power in the occipital, temporal, and frontal regions. Significant differences in phase locking value (PLV) were observed in the α band between the occipital-frontal regions. The latency of the maximum SEF was 49.66 ± 5.51 ms in healthy controls and 58.63 ± 7.73 ms in CSM patients. ROC analysis for SEF latency yielded an area under the curve of 0.844, with a cutoff value of 55.0 ms, sensitivity of 77.4%, and specificity of 81.3%.
Conclusion: MEG may a helpful tool in the functional assessment of the neurological deficits in CSM, and shows potential as an useful method for clinical diagnosis and functional evaluation of this condition.
{"title":"Magnetoencephalography changes in cervical spondylotic myelopathy: a study of resting-state and somatosensory evoked magnetic fields.","authors":"Geng Zhao, Zhuang Miao, Lianlei Wang, Junyuan Sun, Tianyu Gao, Fulong Wang, Shiqiang Zheng, Xu Zhang, Xinyu Liu","doi":"10.1007/s00586-026-09773-9","DOIUrl":"https://doi.org/10.1007/s00586-026-09773-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the diagnostic utility of optically pumped magnetometer-based magnetoencephalography (OPM-MEG) in patients with cervical spondylotic myelopathy (CSM).</p><p><strong>Methods: </strong>A total of 31 CSM patients and 32 healthy volunteers were enrolled. Somatosensory-evoked magnetic fields (SEFs) were recorded using OPM-MEG. Clinical evaluations included the Japanese Orthopaedic Association (JOA) scale and the Short Form-36 (SF-36) health survey. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Compared with healthy controls, CSM patients demonstrated decreased α power in the occipital region, and increased γ power in the occipital, temporal, and frontal regions. Significant differences in phase locking value (PLV) were observed in the α band between the occipital-frontal regions. The latency of the maximum SEF was 49.66 ± 5.51 ms in healthy controls and 58.63 ± 7.73 ms in CSM patients. ROC analysis for SEF latency yielded an area under the curve of 0.844, with a cutoff value of 55.0 ms, sensitivity of 77.4%, and specificity of 81.3%.</p><p><strong>Conclusion: </strong>MEG may a helpful tool in the functional assessment of the neurological deficits in CSM, and shows potential as an useful method for clinical diagnosis and functional evaluation of this condition.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-14DOI: 10.1007/s00586-026-09812-5
Nabil Alassaf, Anne Tabard-Fougère, Romain Dayer
{"title":"Direct vertebral rotation in idiopathic scoliosis: a systematic review and meta-analysis.","authors":"Nabil Alassaf, Anne Tabard-Fougère, Romain Dayer","doi":"10.1007/s00586-026-09812-5","DOIUrl":"https://doi.org/10.1007/s00586-026-09812-5","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction: A modified bone cement pusher for percutaneous vertebroplasty combined with multi-target negative pressure rotary-cutting technique in puncture biopsy for bone tumors.","authors":"Zhengyong Tao, Zongqiang Yang, Xiaobin Ma, Jiandang Shi, NingKui Niu","doi":"10.1007/s00586-026-09771-x","DOIUrl":"https://doi.org/10.1007/s00586-026-09771-x","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-14DOI: 10.1007/s00586-026-09816-1
Peter Florian Richter, Tobias Pitzen, Christian Liebsch, Hans-Joachim Wilke, Michael Ruf
{"title":"Preoperative C2-tilt as a potential indicator of postoperative trunk shift correction in congenital cervical/cervicothoracic scoliosis.","authors":"Peter Florian Richter, Tobias Pitzen, Christian Liebsch, Hans-Joachim Wilke, Michael Ruf","doi":"10.1007/s00586-026-09816-1","DOIUrl":"https://doi.org/10.1007/s00586-026-09816-1","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-14DOI: 10.1007/s00586-026-09825-0
Mario Taravilla-Loma, Víctor Rodríguez-Domínguez, Javier Giner García, María Luisa Gandía-González, Miguel de Pedro Abascal, Alberto Isla Guerrero, Javier Melchor Duart-Clemente
{"title":"Letter to the Editor concerning \"Protection of the ligamentum flavum reduces epidural fibrosis formation in endoscopic lumbar discectomy\" by Merter et al. (European Spine Journal).","authors":"Mario Taravilla-Loma, Víctor Rodríguez-Domínguez, Javier Giner García, María Luisa Gandía-González, Miguel de Pedro Abascal, Alberto Isla Guerrero, Javier Melchor Duart-Clemente","doi":"10.1007/s00586-026-09825-0","DOIUrl":"https://doi.org/10.1007/s00586-026-09825-0","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-13DOI: 10.1007/s00586-026-09799-z
Joshua Samaniego, Arnold Yl Wong, Karin Wuertz-Kozak, Hans-Joachim Wilke, Nathan Lee, John O'Toole, Jiri Dvorak, Robin Pourzal, Dino Samartzis
{"title":"The \"plastic spine\" phenotype and the spine exposome: emerging links between micro- and nanoplastics and spinal disorders.","authors":"Joshua Samaniego, Arnold Yl Wong, Karin Wuertz-Kozak, Hans-Joachim Wilke, Nathan Lee, John O'Toole, Jiri Dvorak, Robin Pourzal, Dino Samartzis","doi":"10.1007/s00586-026-09799-z","DOIUrl":"https://doi.org/10.1007/s00586-026-09799-z","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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