Pub Date : 2024-09-01Epub Date: 2024-07-05DOI: 10.1007/s00586-024-08393-5
Xiaoqing Ye, Jiandong Li, Zhitao Shangguan, Zhenyu Wang, Gang Chen, Wenge Liu
Purpose: To assess whether preoperative facet joint parameters in patients with degenerative lumbar spondylolisthesis (DS) are risk factors for cage subsidence (CS) following transforaminal lumbar interbody fusion (TLIF).
Methods: We enrolled 112 patients with L4-5 DS who underwent TLIF and were followed up for > 1 year. Preoperative demographic characteristics, functional areas of paraspinal muscles and psoas major muscles (PS), total functional area relative to vertebral body area, functional cross-sectional area (FCSA) of PS and lumbar spine extensor muscles, normalized FCSA of PS to the vertebral body area (FCSA/VBA), lumbar indentation value, facet joint orientation, facet joint tropism (FT), cross-sectional area of the superior articular process (SAPA), intervertebral height index, vertebral Hounsfield unit (HU) value, lordosis distribution index, t-scores, sagittal plane parameters, visual analog scale (VAS) for low back pain, VAS for leg pain, Oswestry disability index, global alignment and proportion score and European quality of life-5 dimensions (EQ-5D) were assessed.
Results: Postoperative CS showed significant correlations with preoperative FO(L3-4), FT (L3 and L5), SAPA(L3-5), L5-HU, FCSA/VBA(L3-4), Pre- T-score, post-6-month VAS for back pain and EQ-5D scores among other factors. According to ROC curve analysis, the optimal decision points for FO(L3-4), L3-SAPA, FCSA/VBA(L3-4), L5-HU, and Pre- T-score were 35.88°, 43.76°,114.93, 1.73, 1.55, 136, and - 2.49.
Conclusions: This study identified preoperative FO, SAPA, preoperative CT, Pre- T-score and the FCSA/VBA as independent risk factors for CS after TLIF for DS. These risk factors should enable spinal surgeons to closely monitor and prevent the occurrence of CS.
{"title":"Are the facet joint parameters risk factors for cage subsidence after TLIF in patients with lumbar degenerative spondylolisthesis?","authors":"Xiaoqing Ye, Jiandong Li, Zhitao Shangguan, Zhenyu Wang, Gang Chen, Wenge Liu","doi":"10.1007/s00586-024-08393-5","DOIUrl":"10.1007/s00586-024-08393-5","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether preoperative facet joint parameters in patients with degenerative lumbar spondylolisthesis (DS) are risk factors for cage subsidence (CS) following transforaminal lumbar interbody fusion (TLIF).</p><p><strong>Methods: </strong>We enrolled 112 patients with L4-5 DS who underwent TLIF and were followed up for > 1 year. Preoperative demographic characteristics, functional areas of paraspinal muscles and psoas major muscles (PS), total functional area relative to vertebral body area, functional cross-sectional area (FCSA) of PS and lumbar spine extensor muscles, normalized FCSA of PS to the vertebral body area (FCSA/VBA), lumbar indentation value, facet joint orientation, facet joint tropism (FT), cross-sectional area of the superior articular process (SAPA), intervertebral height index, vertebral Hounsfield unit (HU) value, lordosis distribution index, t-scores, sagittal plane parameters, visual analog scale (VAS) for low back pain, VAS for leg pain, Oswestry disability index, global alignment and proportion score and European quality of life-5 dimensions (EQ-5D) were assessed.</p><p><strong>Results: </strong>Postoperative CS showed significant correlations with preoperative FO(L3-4), FT (L3 and L5), SAPA(L3-5), L5-HU, FCSA/VBA(L3-4), Pre- T-score, post-6-month VAS for back pain and EQ-5D scores among other factors. According to ROC curve analysis, the optimal decision points for FO(L3-4), L3-SAPA, FCSA/VBA(L3-4), L5-HU, and Pre- T-score were 35.88°, 43.76°,114.93, 1.73, 1.55, 136, and - 2.49.</p><p><strong>Conclusions: </strong>This study identified preoperative FO, SAPA, preoperative CT, Pre- T-score and the FCSA/VBA as independent risk factors for CS after TLIF for DS. These risk factors should enable spinal surgeons to closely monitor and prevent the occurrence of CS.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534106","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 : 2024-08-30DOI: 10.1007/s00586-024-08460-x
Hazel Denton, Jake M McDonnell, Jack Curran, Kielan Wilson, Hugo Temperley, Gráinne Cunniffe, Seamus Morris, Stacey Darwish, Joseph S Butler
Study design: Narrative Review.
Objectives: The premise of this review is to provide a review of the literature pertaining to studies describing outcomes of surgical cohorts when implementing C1 osteosynthesis for arch fractures with or without transverse atlantal ligamentous (TAL) injury.
Methods: A comprehensive search strategy was implemented across several search engines to identify studies which evaluate the outcomes of C1 osteosynthesis for patients with C1 arch fractures with and without TAL injury.
Results: Ten studies were identified. Parameters reported included osteosynthesis fusion rates, deformity correction, preservation of motion segments, patient reported outcome measures and overall complications. Overall, C1 osteosynthesis showed excellent fusion rates with complications comparable to traditional techniques denoted in literature. Furthermore, the osteosynthesis technique depicted good overall deformity correction and preservation of motion segments, in addition to good patient reported outcomes.
Conclusion: It appears C1 osteosynthesis offers a safe and efficacious alternative option for the surgical treatment of C1 fractures with TAL rupture. It has the potential to reduce deformity, increase ROM, improve PROMs and has complication rates comparable with those of fusion techniques. However more robust prospective evidence is required.
{"title":"Isolated C1 arch fractures: C1-2 fusion vs. C1 osteosynthesis - surgical strategies for potentially unstable injuries.","authors":"Hazel Denton, Jake M McDonnell, Jack Curran, Kielan Wilson, Hugo Temperley, Gráinne Cunniffe, Seamus Morris, Stacey Darwish, Joseph S Butler","doi":"10.1007/s00586-024-08460-x","DOIUrl":"https://doi.org/10.1007/s00586-024-08460-x","url":null,"abstract":"<p><strong>Study design: </strong>Narrative Review.</p><p><strong>Objectives: </strong>The premise of this review is to provide a review of the literature pertaining to studies describing outcomes of surgical cohorts when implementing C1 osteosynthesis for arch fractures with or without transverse atlantal ligamentous (TAL) injury.</p><p><strong>Methods: </strong>A comprehensive search strategy was implemented across several search engines to identify studies which evaluate the outcomes of C1 osteosynthesis for patients with C1 arch fractures with and without TAL injury.</p><p><strong>Results: </strong>Ten studies were identified. Parameters reported included osteosynthesis fusion rates, deformity correction, preservation of motion segments, patient reported outcome measures and overall complications. Overall, C1 osteosynthesis showed excellent fusion rates with complications comparable to traditional techniques denoted in literature. Furthermore, the osteosynthesis technique depicted good overall deformity correction and preservation of motion segments, in addition to good patient reported outcomes.</p><p><strong>Conclusion: </strong>It appears C1 osteosynthesis offers a safe and efficacious alternative option for the surgical treatment of C1 fractures with TAL rupture. It has the potential to reduce deformity, increase ROM, improve PROMs and has complication rates comparable with those of fusion techniques. However more robust prospective evidence is required.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105975","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 : 2024-08-30DOI: 10.1007/s00586-024-08463-8
Fabio Galbusera, Andrea Cina, Dave O'Riordan, Jacopo A Vitale, Markus Loibl, Tamás F Fekete, Frank Kleinstück, Daniel Haschtmann, Anne F Mannion
Purpose: This study aimed to develop machine learning methods to estimate bone mineral density and detect osteopenia/osteoporosis from conventional lumbar MRI (T1-weighted and T2-weighted images) and planar radiography in combination with clinical data and imaging parameters of the acquisition protocol.
Methods: A database of 429 patients subjected to lumbar MRI, radiographs and dual-energy x-ray absorptiometry within 6 months was created from an institutional database. Several machine learning models were trained and tested (373 patients for training, 86 for testing) with the following objectives: (1) direct estimation of the vertebral bone mineral density; (2) classification of T-score lower than - 1 or (3) lower than - 2.5. The models took as inputs either the images or radiomics features derived from them, alone or in combination with metadata (age, sex, body size, vertebral level, parameters of the imaging protocol).
Results: The best-performing models achieved mean absolute errors of 0.15-0.16 g/cm2 for the direct estimation of bone mineral density, and areas under the receiver operating characteristic curve of 0.82 (MRIs) - 0.80 (radiographs) for the classification of T-scores lower than - 1, and 0.80 (MRIs) - 0.65 (radiographs) for T-scores lower than - 2.5.
Conclusions: The models showed good discriminative performances in detecting cases of low bone mineral density, and more limited capabilities for the direct estimation of its value. Being based on routine imaging and readily available data, such models are promising tools to retrospectively analyse existing datasets as well as for the opportunistic investigation of bone disorders.
目的:本研究旨在开发机器学习方法,结合临床数据和采集方案的成像参数,从传统腰椎核磁共振成像(T1 加权和 T2 加权图像)和平面放射摄影中估算骨矿密度并检测骨质疏松/骨质疏松症:从一个机构数据库中创建了一个包含 429 名在 6 个月内接受过腰椎 MRI、X 射线照相和双能 X 射线吸收测量的患者的数据库。对多个机器学习模型进行了训练和测试(373 名患者用于训练,86 名患者用于测试),目标如下:(1)直接估算脊椎骨矿物质密度;(2)对 T 评分低于-1 或(3)低于-2.5 进行分类。这些模型以图像或从图像中提取的放射组学特征为输入,或单独输入,或与元数据(年龄、性别、体型、椎骨水平、成像方案参数)结合输入:表现最好的模型在直接估算骨矿密度方面的平均绝对误差为 0.15-0.16 g/cm2,在 T 值低于-1 的分类中,接收者操作特征曲线下的面积为 0.82(核磁共振成像)-0.80(X 光片),在 T 值低于-2.5 的分类中,接收者操作特征曲线下的面积为 0.80(核磁共振成像)-0.65(X 光片):这些模型在检测低骨矿物质密度病例方面表现出良好的鉴别能力,但在直接估算骨矿物质密度值方面能力有限。这些模型以常规成像和现成数据为基础,是对现有数据集进行回顾性分析以及对骨病进行机会性调查的有前途的工具。
{"title":"Estimating lumbar bone mineral density from conventional MRI and radiographs with deep learning in spine patients.","authors":"Fabio Galbusera, Andrea Cina, Dave O'Riordan, Jacopo A Vitale, Markus Loibl, Tamás F Fekete, Frank Kleinstück, Daniel Haschtmann, Anne F Mannion","doi":"10.1007/s00586-024-08463-8","DOIUrl":"https://doi.org/10.1007/s00586-024-08463-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop machine learning methods to estimate bone mineral density and detect osteopenia/osteoporosis from conventional lumbar MRI (T1-weighted and T2-weighted images) and planar radiography in combination with clinical data and imaging parameters of the acquisition protocol.</p><p><strong>Methods: </strong>A database of 429 patients subjected to lumbar MRI, radiographs and dual-energy x-ray absorptiometry within 6 months was created from an institutional database. Several machine learning models were trained and tested (373 patients for training, 86 for testing) with the following objectives: (1) direct estimation of the vertebral bone mineral density; (2) classification of T-score lower than - 1 or (3) lower than - 2.5. The models took as inputs either the images or radiomics features derived from them, alone or in combination with metadata (age, sex, body size, vertebral level, parameters of the imaging protocol).</p><p><strong>Results: </strong>The best-performing models achieved mean absolute errors of 0.15-0.16 g/cm<sup>2</sup> for the direct estimation of bone mineral density, and areas under the receiver operating characteristic curve of 0.82 (MRIs) - 0.80 (radiographs) for the classification of T-scores lower than - 1, and 0.80 (MRIs) - 0.65 (radiographs) for T-scores lower than - 2.5.</p><p><strong>Conclusions: </strong>The models showed good discriminative performances in detecting cases of low bone mineral density, and more limited capabilities for the direct estimation of its value. Being based on routine imaging and readily available data, such models are promising tools to retrospectively analyse existing datasets as well as for the opportunistic investigation of bone disorders.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105974","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 : 2024-08-30DOI: 10.1007/s00586-024-08454-9
Guanyi Liu, Xuan Wang, Jiawei Zhang, Nanjian Xu, Lu Mao, Jun Qian, Xuyu Liao, Leijie Zhou, Yadan Niu
Purpose: The primary objective of this study is to evaluate and compare the clinical and radiographic outcomes of the combined spinous process-splitting approach with a Wiltse (SPSW) approach, the combined conventional approach with a Wiltse (CW) approach, and the conventional open (CO) approach in unilateral transforaminal lumbar interbody fusion (TLIF).
Methods: The clinical outcomes were assessed, and intraoperative data and complications were collected. Numeric Rating Scale (NRS) scores for low back pain and leg pain, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores for evaluating functions of the lumbar spine and health-related quality of life, and the modified MacNab standard for assessing satisfaction were analyzed. Radiographic outcomes included disc space height, segmental lordosis, interbody fusion assessment, and the rate of muscle atrophy of the multifidus and the erector spinae muscles.
Results: Among the three groups, the SPSW group exhibited the shortest operation and drain retention time, lowest intraoperative blood loss, and minimal postoperative blood loss. Notably, the SPSW group displayed the highest level of social life function based on the JOABPEQ, and the highest level of patient satisfaction according to the modified MacNab Criteria, along with the lowest rate of muscle atrophy.
Conclusion: All the SPSW, CW, and CO approach TLIF procedures achieved overall satisfactory effects of decompression and fusion for lumbar degenerative diseases. The SPSW approach procedure appears to be associated with the smallest surgical trauma and highest satisfaction because of reducing iatrogenic injury of the paraspinal muscles.
{"title":"Comparison of clinical and radiographic outcomes in unilateral transforaminal lumbar interbody fusion: a retrospective analysis of three surgical approaches.","authors":"Guanyi Liu, Xuan Wang, Jiawei Zhang, Nanjian Xu, Lu Mao, Jun Qian, Xuyu Liao, Leijie Zhou, Yadan Niu","doi":"10.1007/s00586-024-08454-9","DOIUrl":"https://doi.org/10.1007/s00586-024-08454-9","url":null,"abstract":"<p><strong>Purpose: </strong>The primary objective of this study is to evaluate and compare the clinical and radiographic outcomes of the combined spinous process-splitting approach with a Wiltse (SPSW) approach, the combined conventional approach with a Wiltse (CW) approach, and the conventional open (CO) approach in unilateral transforaminal lumbar interbody fusion (TLIF).</p><p><strong>Methods: </strong>The clinical outcomes were assessed, and intraoperative data and complications were collected. Numeric Rating Scale (NRS) scores for low back pain and leg pain, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores for evaluating functions of the lumbar spine and health-related quality of life, and the modified MacNab standard for assessing satisfaction were analyzed. Radiographic outcomes included disc space height, segmental lordosis, interbody fusion assessment, and the rate of muscle atrophy of the multifidus and the erector spinae muscles.</p><p><strong>Results: </strong>Among the three groups, the SPSW group exhibited the shortest operation and drain retention time, lowest intraoperative blood loss, and minimal postoperative blood loss. Notably, the SPSW group displayed the highest level of social life function based on the JOABPEQ, and the highest level of patient satisfaction according to the modified MacNab Criteria, along with the lowest rate of muscle atrophy.</p><p><strong>Conclusion: </strong>All the SPSW, CW, and CO approach TLIF procedures achieved overall satisfactory effects of decompression and fusion for lumbar degenerative diseases. The SPSW approach procedure appears to be associated with the smallest surgical trauma and highest satisfaction because of reducing iatrogenic injury of the paraspinal muscles.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105973","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 : 2024-08-29DOI: 10.1007/s00586-024-08464-7
I Gusti Lanang Ngurah Agung Artha Wiguna, Yosi Kristian, Maria Florencia Deslivia, Rudi Limantara, David Cahyadi, Ivan Alexander Liando, Hendra Aryudi Hamzah, Kevin Kusuman, Dominicus Dimitri, Maria Anastasia, I Ketut Suyasa
Study design: Cross-sectional Database Study.
Objective: While the American Spinal Injury Association (ASIA) Impairment Scale is the standard for assessing spinal cord injuries (SCI), it has limitations due to subjectivity and impracticality. Advances in machine learning (ML) and image recognition have spurred research into their use for outcome prediction. This study aims to analyze deep learning techniques for identifying and classifying cervical SCI severity from MRI scans.
Methods: The study included patients with traumatic and nontraumatic cervical SCI admitted from 2019 to 2022. MRI images were labeled by two senior resident physicians. A deep convolutional neural network was trained using axial and sagittal cervical MRI images from the dataset. Model performance was assessed using Dice Score and IoU to measure segmentation accuracy by comparing predicted and ground truth masks. Classification accuracy was evaluated with the F1 Score, balancing false positives and negatives.
Result: In the axial spinal cord segmentation, we achieved a Dice score of 0.94 for and IoU score of 0.89. In the sagittal spinal cord segmentation, we obtained Dice score up to 0.9201 and IoU scores up to 0.8541. The model for axial image score classification gave a satisfactory result with an F1 score of 0.72 and AUC of 0.79.
Conclusion: Our models successfully identified cervical SCI on T2-weighted MR images with satisfactory performance. Further research is needed to develop more advanced models for predicting patient outcomes in SCI cases.
{"title":"A deep learning approach for cervical cord injury severity determination through axial and sagittal magnetic resonance imaging segmentation and classification.","authors":"I Gusti Lanang Ngurah Agung Artha Wiguna, Yosi Kristian, Maria Florencia Deslivia, Rudi Limantara, David Cahyadi, Ivan Alexander Liando, Hendra Aryudi Hamzah, Kevin Kusuman, Dominicus Dimitri, Maria Anastasia, I Ketut Suyasa","doi":"10.1007/s00586-024-08464-7","DOIUrl":"https://doi.org/10.1007/s00586-024-08464-7","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional Database Study.</p><p><strong>Objective: </strong>While the American Spinal Injury Association (ASIA) Impairment Scale is the standard for assessing spinal cord injuries (SCI), it has limitations due to subjectivity and impracticality. Advances in machine learning (ML) and image recognition have spurred research into their use for outcome prediction. This study aims to analyze deep learning techniques for identifying and classifying cervical SCI severity from MRI scans.</p><p><strong>Methods: </strong>The study included patients with traumatic and nontraumatic cervical SCI admitted from 2019 to 2022. MRI images were labeled by two senior resident physicians. A deep convolutional neural network was trained using axial and sagittal cervical MRI images from the dataset. Model performance was assessed using Dice Score and IoU to measure segmentation accuracy by comparing predicted and ground truth masks. Classification accuracy was evaluated with the F1 Score, balancing false positives and negatives.</p><p><strong>Result: </strong>In the axial spinal cord segmentation, we achieved a Dice score of 0.94 for and IoU score of 0.89. In the sagittal spinal cord segmentation, we obtained Dice score up to 0.9201 and IoU scores up to 0.8541. The model for axial image score classification gave a satisfactory result with an F1 score of 0.72 and AUC of 0.79.</p><p><strong>Conclusion: </strong>Our models successfully identified cervical SCI on T2-weighted MR images with satisfactory performance. Further research is needed to develop more advanced models for predicting patient outcomes in SCI cases.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092589","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 : 2024-08-29DOI: 10.1007/s00586-024-08468-3
Edmond Lou
{"title":"Answer to the Letter to the Editor of F. Xiao, et al. concerning \"Reliability and accuracy of scoliotic parameters on using a wireless handheld 3D ultrasound for children with adolescent idiopathic scoliosis: a pilot study\" by Nguyen TNN, et al. (Eur Spine J [2024]; doi:10.1007/s00586-024-08445-w).","authors":"Edmond Lou","doi":"10.1007/s00586-024-08468-3","DOIUrl":"https://doi.org/10.1007/s00586-024-08468-3","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092590","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}
Purpose: This study aimed to quantify and evaluate morphology of intervertebral space between neighboring cervical units using radiographic imaging indices, to help spine surgeons when performing anterior cervical discectomy and fusion (ACDF) surgery on the Chinese population.
Methods: The background and imaging parameters of the subjects were assessed. Cervical lateral radiographs were employed to measure the intervertebral height (IH), intervertebral height index (IHI), and segmental lordosis (SL). Endplate parameters measurements were conducted on sagittal T2-weighted magnetic resonance imaging (MRI), including endplate sagittal diameter (ESD), and endplate concavity depth (ECD). All individuals were divided into three age groups: individuals aged 20-35 were in group A, individuals aged 36-50 were in group B, and individuals aged over 50 were in group C. A comparison of the variables was conducted among the three groups. Additionally, these radiographic parameters were also compared between males and females.
Results: A total of 102 individuals were included in this study. IH was greater at C6/7 than those at other segmental levels (p < 0.001). The largest SL values were found at C6/7, while the least were found at C3/4. The superior ESD (ESDs) and ECD (ECDs) of the intervertebral space were significantly greater than those of the inferior endplates (p < 0.05). The ESD and ECD values were the largest at C6/7, while the least at C3/4. Additionally, age and gender had an influence on several parameters. IH was significantly lower in group A compared to group B (p < 0.05) and group C (p < 0.05) from C3/4 level to C6/7 level. ECDs were lower in group A compared to group B (p < 0.05) and group C (p < 0.05) at each level. IH and ESD in males were generally significantly greater than those in females at all levels (p < 0.05).
Conclusion: The current study found that C6/7 had the greatest IH, SL, ESD, and ECD values in asymptomatic Chinese. SL gradually increased from C3/4 to C6/7 levels. IH and ECD were significantly associated with age. Males had greater IH and ESD values than females. These findings provide baseline information for planning for selection of anterior screws and intervertebral implants.
目的:本研究旨在利用影像学指标对相邻颈椎单位之间的椎间隙形态进行量化和评估,以帮助脊柱外科医生在中国人群中开展颈椎椎间盘切除和融合术(ACDF)前路手术:方法:评估受试者的背景和影像学参数。采用颈椎侧位片测量椎间高度(IH)、椎间高度指数(IHI)和节段前凸(SL)。通过矢状位 T2 加权磁共振成像(MRI)测量终板参数,包括终板矢状位直径(ESD)和终板凹陷深度(ECD)。所有患者被分为三个年龄组:20-35 岁为 A 组,36-50 岁为 B 组,50 岁以上为 C 组。此外,还对男性和女性的这些放射学参数进行了比较:结果:共有 102 人参与了这项研究。与其他节段水平相比,C6/7 的 IH 更大(P本研究发现,在无症状的中国人中,C6/7 的 IH、SL、ESD 和 ECD 值最大。SL从C3/4到C6/7水平逐渐增加。IH和ESD与年龄明显相关。男性的 IH 值和 ESD 值高于女性。这些发现为选择前路螺钉和椎间植入物的计划提供了基础信息。
{"title":"Sagittal morphometry of intervertebral spaces in subaxial cervical region of asymptomatic Chinese.","authors":"Huihong Shi, Song Liu, Wenjun Hu, Jianan Chen, Yanbo Chen, Youxi Lin, Nianchun Liao, Dongsheng Huang, Wenjie Gao, Anjing Liang","doi":"10.1007/s00586-024-08462-9","DOIUrl":"https://doi.org/10.1007/s00586-024-08462-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to quantify and evaluate morphology of intervertebral space between neighboring cervical units using radiographic imaging indices, to help spine surgeons when performing anterior cervical discectomy and fusion (ACDF) surgery on the Chinese population.</p><p><strong>Methods: </strong>The background and imaging parameters of the subjects were assessed. Cervical lateral radiographs were employed to measure the intervertebral height (IH), intervertebral height index (IHI), and segmental lordosis (SL). Endplate parameters measurements were conducted on sagittal T2-weighted magnetic resonance imaging (MRI), including endplate sagittal diameter (ESD), and endplate concavity depth (ECD). All individuals were divided into three age groups: individuals aged 20-35 were in group A, individuals aged 36-50 were in group B, and individuals aged over 50 were in group C. A comparison of the variables was conducted among the three groups. Additionally, these radiographic parameters were also compared between males and females.</p><p><strong>Results: </strong>A total of 102 individuals were included in this study. IH was greater at C6/7 than those at other segmental levels (p < 0.001). The largest SL values were found at C6/7, while the least were found at C3/4. The superior ESD (ESDs) and ECD (ECDs) of the intervertebral space were significantly greater than those of the inferior endplates (p < 0.05). The ESD and ECD values were the largest at C6/7, while the least at C3/4. Additionally, age and gender had an influence on several parameters. IH was significantly lower in group A compared to group B (p < 0.05) and group C (p < 0.05) from C3/4 level to C6/7 level. ECDs were lower in group A compared to group B (p < 0.05) and group C (p < 0.05) at each level. IH and ESD in males were generally significantly greater than those in females at all levels (p < 0.05).</p><p><strong>Conclusion: </strong>The current study found that C6/7 had the greatest IH, SL, ESD, and ECD values in asymptomatic Chinese. SL gradually increased from C3/4 to C6/7 levels. IH and ECD were significantly associated with age. Males had greater IH and ESD values than females. These findings provide baseline information for planning for selection of anterior screws and intervertebral implants.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092592","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 : 2024-08-29DOI: 10.1007/s00586-024-08472-7
Eun Kyung Khil
{"title":"Response to Editorial Comments on 'Neurosarcoidosis involving cervical nerve root with unusual MRI findings: a case report and systematic literature review'.","authors":"Eun Kyung Khil","doi":"10.1007/s00586-024-08472-7","DOIUrl":"https://doi.org/10.1007/s00586-024-08472-7","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092591","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 : 2024-08-29DOI: 10.1007/s00586-024-08452-x
Dae-Woong Ham, Jeuk Lee, GilWon Choi, Byung-Taek Kwon, Kwang-Sup Song
Purpose: This study examined the predictive value of the gluteal muscle index (GMI) for diagnosing sarcopenia in patients with degenerative lumbar disease (DLD), highlighting the need for effective diagnostic markers in this population.
Methods: This prospective observational study included 202 elderly patients scheduled for lumbar spine surgery. Muscle indices for psoas, paraspinal, and gluteal muscles were measured using multiaxial computed tomography. Sarcopenia was diagnosed per the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Statistical analysis comprised univariate and multivariate logistic regression to identify predictors of sarcopenia.
Results: Of patients, 77% were diagnosed with sarcopenia. The GMI and psoas muscle index (PMI) were identified as significant predictors of sarcopenia in the univariate analysis. Multivariate analysis confirmed their predictive value, with higher indices correlating with a reduced risk of sarcopenia (GMI odds ratio [OR] = 0.95, 95% confidence interval [CI] = 0.92-0.97; PMI OR = 0.95, 95% CI = 0.92-0.98, both P < .001).
Conclusion: The GMI serves as a reliable predictor of sarcopenia in elderly patients undergoing lumbar spine surgery for DLD, suggesting a significant role of gluteal muscles in diagnosing sarcopenia. Incorporating GMI into clinical assessments is critical to better manage and diagnose sarcopenia in this population.
{"title":"The cross-sectional area of gluteal muscle on multiaxial CT scan as a predictor for diagnosing sarcopenia in patients with degenerative lumbar disease.","authors":"Dae-Woong Ham, Jeuk Lee, GilWon Choi, Byung-Taek Kwon, Kwang-Sup Song","doi":"10.1007/s00586-024-08452-x","DOIUrl":"https://doi.org/10.1007/s00586-024-08452-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined the predictive value of the gluteal muscle index (GMI) for diagnosing sarcopenia in patients with degenerative lumbar disease (DLD), highlighting the need for effective diagnostic markers in this population.</p><p><strong>Methods: </strong>This prospective observational study included 202 elderly patients scheduled for lumbar spine surgery. Muscle indices for psoas, paraspinal, and gluteal muscles were measured using multiaxial computed tomography. Sarcopenia was diagnosed per the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Statistical analysis comprised univariate and multivariate logistic regression to identify predictors of sarcopenia.</p><p><strong>Results: </strong>Of patients, 77% were diagnosed with sarcopenia. The GMI and psoas muscle index (PMI) were identified as significant predictors of sarcopenia in the univariate analysis. Multivariate analysis confirmed their predictive value, with higher indices correlating with a reduced risk of sarcopenia (GMI odds ratio [OR] = 0.95, 95% confidence interval [CI] = 0.92-0.97; PMI OR = 0.95, 95% CI = 0.92-0.98, both P < .001).</p><p><strong>Conclusion: </strong>The GMI serves as a reliable predictor of sarcopenia in elderly patients undergoing lumbar spine surgery for DLD, suggesting a significant role of gluteal muscles in diagnosing sarcopenia. Incorporating GMI into clinical assessments is critical to better manage and diagnose sarcopenia in this population.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092593","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 : 2024-08-28DOI: 10.1007/s00586-024-08425-0
Daniel Haschtmann, Christian Brand, Tamas F Fekete, Dezsö Jeszenszky, Frank S Kleinstück, Raluca Reitmeir, François Porchet, Laura Zimmermann, Markus Loibl, Anne F Mannion
Introduction: Low-grade isthmic and degenerative spondylolisthesis (DS) of the lumbar spine are distinct pathologies but both can be treated with lumbar decompression with fusion. In a very large cohort, we compared patient-reported outcome in relation to the pathology and chief complaint at baseline.
Methods: This was a retrospective analysis using the EUROSPINE Spine Tango Registry. We included 582 patients (age 60 ± 15 years; 65% female), divided into four groups based on two variables: type of spondylolisthesis and chief pain complaint (leg pain (LP) versus back pain). Patients completed the COMI preoperatively and up to 5 years follow-up (FU), and rated global treatment outcome (GTO). Regression models were used to predict COMI-scores at FU. Pain scores and satisfaction ratings were analysed.
Results: All patients experienced pronounced reductions in COMI scores. Relative to the other groups, the DS-LP group showed between 5% and 11% greater COMI score reduction (p < 0.01 up to 2 years' FU). This group also performed best with respect to pain outcomes and satisfaction. Long-term GTO was 93% at the 5 year FU, compared with between 82% and 86% in the other groups.
Conclusion: Regardless of the type of spondylolisthesis, all groups experienced an improvement in COMI score after surgery. Patients with DS and LP as their chief complaint appear to benefit more than other patients. These results are the first to show that the type of the spondylolisthesis and its chief complaint have an impact on surgical outcome. They will be informative for the consent process prior to surgery and can be used to build predictive models for individual outcome.
{"title":"Patient-reported outcome of lumbar decompression with instrumented fusion for low-grade spondylolisthesis: influence of pathology and baseline symptoms.","authors":"Daniel Haschtmann, Christian Brand, Tamas F Fekete, Dezsö Jeszenszky, Frank S Kleinstück, Raluca Reitmeir, François Porchet, Laura Zimmermann, Markus Loibl, Anne F Mannion","doi":"10.1007/s00586-024-08425-0","DOIUrl":"https://doi.org/10.1007/s00586-024-08425-0","url":null,"abstract":"<p><strong>Introduction: </strong>Low-grade isthmic and degenerative spondylolisthesis (DS) of the lumbar spine are distinct pathologies but both can be treated with lumbar decompression with fusion. In a very large cohort, we compared patient-reported outcome in relation to the pathology and chief complaint at baseline.</p><p><strong>Methods: </strong>This was a retrospective analysis using the EUROSPINE Spine Tango Registry. We included 582 patients (age 60 ± 15 years; 65% female), divided into four groups based on two variables: type of spondylolisthesis and chief pain complaint (leg pain (LP) versus back pain). Patients completed the COMI preoperatively and up to 5 years follow-up (FU), and rated global treatment outcome (GTO). Regression models were used to predict COMI-scores at FU. Pain scores and satisfaction ratings were analysed.</p><p><strong>Results: </strong>All patients experienced pronounced reductions in COMI scores. Relative to the other groups, the DS-LP group showed between 5% and 11% greater COMI score reduction (p < 0.01 up to 2 years' FU). This group also performed best with respect to pain outcomes and satisfaction. Long-term GTO was 93% at the 5 year FU, compared with between 82% and 86% in the other groups.</p><p><strong>Conclusion: </strong>Regardless of the type of spondylolisthesis, all groups experienced an improvement in COMI score after surgery. Patients with DS and LP as their chief complaint appear to benefit more than other patients. These results are the first to show that the type of the spondylolisthesis and its chief complaint have an impact on surgical outcome. They will be informative for the consent process prior to surgery and can be used to build predictive models for individual outcome.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079882","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}