Background: Intradiscal condoliase injection for lumbar disc herniation (LDH) was developed in Japan in 2018. The treatment is intermediate between conservative therapy and surgery, and its frequency is increasing. Condoliase is limited to a single application over a lifetime, rendering it important to understand the indications and predictors of its effectiveness. This review aimed to summarize published studies and provide appropriate indications and limitations for appropriate patient selection based on existing findings.
Methods: While adhering to PRISMA guidelines, we searched the PubMed, Web of Science, and EMBASE databases to identify articles reporting the clinical outcomes of intradiscal condoliase injection for LDH. Data extraction focused on the effective rate, prognostic factors, and posttreatment imaging changes and was used in the meta-analysis.
Results: Nineteen studies met the inclusion criteria. Our meta-analysis revealed 78% total response, 11% posttreatment surgery, and 42% posttreatment Pfirrmann-classification-grade progression rates. Posttreatment intervertebral disc degeneration was potentially associated with an improved response rate and disc regeneration one year posttreatment, especially in young patients. The Regimen for patients aged <20 and >70 years should be carefully selected, including those with a disease duration of >1 year, recurrent LDH, small-sized LDH, vertebral instability, and inadequate duration (<3 months) of conservative therapy.
Conclusions: Although long-term outcomes and imaging changes must be evaluated owing to the heterogeneity of previous studies, intradiscal condoliase injection is a minimally invasive and cost-effective treatment option for patients with LDH. Treatment indications should be determined after carefully evaluating evidence from previous conservative and surgical treatments.
{"title":"Indication and Limitation of Intradiscal Condoliase Injection for Patients with Lumbar Disc Herniation: Literature Review and Meta-Analysis.","authors":"Hideaki Nakajima, Shuji Watanabe, Kazuya Honjoh, Arisa Kubota, Akihiko Matsumine","doi":"10.22603/ssrr.2023-0294","DOIUrl":"10.22603/ssrr.2023-0294","url":null,"abstract":"<p><strong>Background: </strong>Intradiscal condoliase injection for lumbar disc herniation (LDH) was developed in Japan in 2018. The treatment is intermediate between conservative therapy and surgery, and its frequency is increasing. Condoliase is limited to a single application over a lifetime, rendering it important to understand the indications and predictors of its effectiveness. This review aimed to summarize published studies and provide appropriate indications and limitations for appropriate patient selection based on existing findings.</p><p><strong>Methods: </strong>While adhering to PRISMA guidelines, we searched the PubMed, Web of Science, and EMBASE databases to identify articles reporting the clinical outcomes of intradiscal condoliase injection for LDH. Data extraction focused on the effective rate, prognostic factors, and posttreatment imaging changes and was used in the meta-analysis.</p><p><strong>Results: </strong>Nineteen studies met the inclusion criteria. Our meta-analysis revealed 78% total response, 11% posttreatment surgery, and 42% posttreatment Pfirrmann-classification-grade progression rates. Posttreatment intervertebral disc degeneration was potentially associated with an improved response rate and disc regeneration one year posttreatment, especially in young patients. The Regimen for patients aged <20 and >70 years should be carefully selected, including those with a disease duration of >1 year, recurrent LDH, small-sized LDH, vertebral instability, and inadequate duration (<3 months) of conservative therapy.</p><p><strong>Conclusions: </strong>Although long-term outcomes and imaging changes must be evaluated owing to the heterogeneity of previous studies, intradiscal condoliase injection is a minimally invasive and cost-effective treatment option for patients with LDH. Treatment indications should be determined after carefully evaluating evidence from previous conservative and surgical treatments.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917458","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}
Lumbar interbody fusion (LIF) is a surgical procedure for treating lumbar spinal stenosis and deformities. It removes a spinal disc and insert a cage or bone graft to promote solid fusion. Extensive research on LIF has been supported by numerous animal studies, which are being developed to enhance fusion rates and reduce the complications associated with the procedure. In particular, the anterior approach is significant in LIF research and regenerative medicine studies concerning intervertebral discs, as it utilizes the disc and the entire vertebral body. Several animal models have been used for anterior LIF (ALIF), each with distinct characteristics. However, a comprehensive review of ALIF models in different animals is currently lacking. Medium-sized and large animals, such as dogs and sheep, have been employed as ALIF models because of their suitable spine size for surgery. Conversely, small animals, such as rats, are rarely employed as ALIF models because of anatomical challenges. However, recent advancements in surgical implants and techniques have gradually allowed rats in ALIF models. Ambitious studies utilizing small animal ALIF models will soon be conducted. This review aims to review the advantages and disadvantages of various animal models, commonly used approaches, and bone fusion rate, to provide valuable insights to researchers studying the spine.
{"title":"Animal Model for Anterior Lumbar Interbody Fusion: A Literature Review.","authors":"Hiromu Yoshizato, Tadatsugu Morimoto, Toshihiro Nonaka, Koji Otani, Takaomi Kobayashi, Takema Nakashima, Hirohito Hirata, Masatsugu Tsukamoto, Masaaki Mawatari","doi":"10.22603/ssrr.2023-0262","DOIUrl":"10.22603/ssrr.2023-0262","url":null,"abstract":"<p><p>Lumbar interbody fusion (LIF) is a surgical procedure for treating lumbar spinal stenosis and deformities. It removes a spinal disc and insert a cage or bone graft to promote solid fusion. Extensive research on LIF has been supported by numerous animal studies, which are being developed to enhance fusion rates and reduce the complications associated with the procedure. In particular, the anterior approach is significant in LIF research and regenerative medicine studies concerning intervertebral discs, as it utilizes the disc and the entire vertebral body. Several animal models have been used for anterior LIF (ALIF), each with distinct characteristics. However, a comprehensive review of ALIF models in different animals is currently lacking. Medium-sized and large animals, such as dogs and sheep, have been employed as ALIF models because of their suitable spine size for surgery. Conversely, small animals, such as rats, are rarely employed as ALIF models because of anatomical challenges. However, recent advancements in surgical implants and techniques have gradually allowed rats in ALIF models. Ambitious studies utilizing small animal ALIF models will soon be conducted. This review aims to review the advantages and disadvantages of various animal models, commonly used approaches, and bone fusion rate, to provide valuable insights to researchers studying the spine.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917452","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}
Introduction: This study aimed to measure the intraocular pressure (IOP) of patients undergoing open surgery in the supine position (control group) and spine surgery in the prone position (spine group) to clarify IOP range and change by posture, determine the risk factors for increased IOP in the prone position, and reduce visual complications after surgery in the prone position.
Methods: A prospective cohort study was conducted in healthy adults (34-83 years of age) with an American Society of Anesthesiologists classification I/II. The spine group was examined for IOP, anterior chamber angle (ACA), and fundus findings the day prior to surgery. On the day of surgery, IOP measurements were taken at fixed time points: immediately after intubation; at 0.5, 1, and 2 h after intubation; at suture closure; and at the end of surgery in the control group. In the spine group, they were taken immediately after intubation; at 0.5, 1, and 2 h after prone position; at suture closure; and immediately and 5 min after returning to the supine position. The risk factors for increased IOP in the prone position were examined.
Results: The control group showed no significant changes in IOP within the normal range (<20 mmHg) during surgery. In the spine group, IOP was higher at each time point than immediately after intubation. IOP increased sharply above the normal range within 1 h after changing from the supine to the prone position and continued to gradually increase until suture closure. IOP decreased 5 min after the patient returned to the supine position. ACA, body mass index, blood loss, time in the prone position, and operative time were not risk factors for increased IOP in the prone position.
Conclusions: Patients were constantly exposed to above-normal IOP during prone spinal surgery. However, neither group reported visual impairment. No risk factors were identified for increased IOP in the prone position.
{"title":"Increase in Intraoperative Intraocular Pressure in the Prone Position.","authors":"Tamie Takenami, Kazutaka Tanaka, Tomoko Suzuki, Hiromi Hiruma, Tetsuya Ikeda, Kosuke Sugimura","doi":"10.22603/ssrr.2023-0263","DOIUrl":"10.22603/ssrr.2023-0263","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to measure the intraocular pressure (IOP) of patients undergoing open surgery in the supine position (control group) and spine surgery in the prone position (spine group) to clarify IOP range and change by posture, determine the risk factors for increased IOP in the prone position, and reduce visual complications after surgery in the prone position.</p><p><strong>Methods: </strong>A prospective cohort study was conducted in healthy adults (34-83 years of age) with an American Society of Anesthesiologists classification I/II. The spine group was examined for IOP, anterior chamber angle (ACA), and fundus findings the day prior to surgery. On the day of surgery, IOP measurements were taken at fixed time points: immediately after intubation; at 0.5, 1, and 2 h after intubation; at suture closure; and at the end of surgery in the control group. In the spine group, they were taken immediately after intubation; at 0.5, 1, and 2 h after prone position; at suture closure; and immediately and 5 min after returning to the supine position. The risk factors for increased IOP in the prone position were examined.</p><p><strong>Results: </strong>The control group showed no significant changes in IOP within the normal range (<20 mmHg) during surgery. In the spine group, IOP was higher at each time point than immediately after intubation. IOP increased sharply above the normal range within 1 h after changing from the supine to the prone position and continued to gradually increase until suture closure. IOP decreased 5 min after the patient returned to the supine position. ACA, body mass index, blood loss, time in the prone position, and operative time were not risk factors for increased IOP in the prone position.</p><p><strong>Conclusions: </strong>Patients were constantly exposed to above-normal IOP during prone spinal surgery. However, neither group reported visual impairment. No risk factors were identified for increased IOP in the prone position.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917457","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}
Pub Date : 2024-03-11eCollection Date: 2024-07-27DOI: 10.22603/ssrr.2023-0231
Dhiraj V Sonawane, Harshit Dave, Shivaprasad S Kolur, Ajay Chandanwale, Sagar A Jawale, Naved Ahmed F Ansari
Introduction: This study investigates the outcomes of treating neglected unstable Hangman's fractures through a single-stage Anterior Cervical Discectomy and Fusion (ACDF) procedure with tricortical iliac crest bone grafts.
Methods: Five patients with neglected unstable Hangman's fractures, treated at our institution between March 2012 and March 2017, underwent C2-C3 ACDF. Functional outcomes were assessed using the Visual Analog Scale (VAS) score and Neck Disability Index (NDI), and neurological evaluation was done using the American Spinal Injury Association (ASIA) grading system. The radiological assessment included serial plain radiographs and a computed tomography scan at a 12-month follow-up.
Results: Postoperatively, C2-C3 angulation improved significantly, decreasing from 15° to 4.4°, and sagittal translation improved from 4.2 mm to 2 mm. The VAS score improved from 6.4 to 1.4 at 24 months postsurgery. Concurrently, NDI decreased from 70.4% to 14.8%. Fusion occurred in an average of 5.6 months. Neurologically, one patient improved from ASIA grade D to grade E, while the other four retained their grade E status.
Conclusions: A single-stage ACDF with autologous iliac crest bone grafts is an effective surgical option for neglected type II/IIA Hangman's fractures, yielding satisfactory functional and radiological outcomes. This technique significantly corrects anterior translation and angulation, even in neglected cases, with the aid of intraoperative skull traction and plate reduction.
{"title":"Is Anterior Cervical Discectomy and Fusion Sufficient for Neglected Unstable Hangman's Fracture? A Retrospective Case Series of Five Patients.","authors":"Dhiraj V Sonawane, Harshit Dave, Shivaprasad S Kolur, Ajay Chandanwale, Sagar A Jawale, Naved Ahmed F Ansari","doi":"10.22603/ssrr.2023-0231","DOIUrl":"10.22603/ssrr.2023-0231","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates the outcomes of treating neglected unstable Hangman's fractures through a single-stage Anterior Cervical Discectomy and Fusion (ACDF) procedure with tricortical iliac crest bone grafts.</p><p><strong>Methods: </strong>Five patients with neglected unstable Hangman's fractures, treated at our institution between March 2012 and March 2017, underwent C2-C3 ACDF. Functional outcomes were assessed using the Visual Analog Scale (VAS) score and Neck Disability Index (NDI), and neurological evaluation was done using the American Spinal Injury Association (ASIA) grading system. The radiological assessment included serial plain radiographs and a computed tomography scan at a 12-month follow-up.</p><p><strong>Results: </strong>Postoperatively, C2-C3 angulation improved significantly, decreasing from 15° to 4.4°, and sagittal translation improved from 4.2 mm to 2 mm. The VAS score improved from 6.4 to 1.4 at 24 months postsurgery. Concurrently, NDI decreased from 70.4% to 14.8%. Fusion occurred in an average of 5.6 months. Neurologically, one patient improved from ASIA grade D to grade E, while the other four retained their grade E status.</p><p><strong>Conclusions: </strong>A single-stage ACDF with autologous iliac crest bone grafts is an effective surgical option for neglected type II/IIA Hangman's fractures, yielding satisfactory functional and radiological outcomes. This technique significantly corrects anterior translation and angulation, even in neglected cases, with the aid of intraoperative skull traction and plate reduction.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917473","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 Concerning \"Clinical Outcomes of Condoliase Injection Therapy for Lateral Lumbar Disc Herniation\" by Kagami et al.","authors":"Hatato Ito, Tadatsugu Morimoto, Tomohito Yoshihara, Masatsugu Tsukamoto, Takaomi Kobayashi, Masaaki Mawatari","doi":"10.22603/ssrr.2023-0247","DOIUrl":"10.22603/ssrr.2023-0247","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311806","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 Case of an Iatrogenic Pseudomeningocele after Thoracic Spinal Cord Tumor Surgery with a Long-Term Follow-Up.","authors":"Kanichiro Wada, Gentaro Kumagai, Youshiro Nitobe, Kotaro Aburakawa, Toru Asari, Yasuyuki Ishibashi","doi":"10.22603/ssrr.2023-0242","DOIUrl":"10.22603/ssrr.2023-0242","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917472","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":"Reply to \"Letter to the Editor Concerning 'Clinical Outcomes of Condoliase Injection Therapy for Lateral Lumbar Disc Herniation' by Kagami et al.\"","authors":"Yujiro Kagami, Hiroaki Nakashima, Naoki Segi, Ryuichi Shinjo, Shiro Imagama","doi":"10.22603/ssrr.2024-0001","DOIUrl":"10.22603/ssrr.2024-0001","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312731","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}
Introduction: This study aimed to compare the outcomes of corrective fusion for adult spinal deformity (ASD) in older people using two different sagittal correction goals: the conventional formula of "pelvic incidence (PI)-lumbar lordosis (LL) mismatch <10°" and an undercorrection strategy based on the range of 10°≤PI-LL≤20°.
Methods: A total of 102 consecutive patients (11 male and 91 female patients; mean age, 72.0 years) aged above 65 years with scoliosis >20° or LL<20° who had undergone long-segment fusion from the lower thoracic spine to the pelvis for ASD and had been followed-up for a minimum of two years at our institution since March 2013 were included in this retrospective study. After excluding patients with PI-LL≤-10° on postoperative standing radiographs, the remaining patients were divided into two groups: 31 patients with 10°≤PI-LL≤20° (U group) and 63 patients with -10°
Results: The incidence of proximal junctional kyphosis and mechanical failure was not significantly different between the groups (p=0.659 and 1.000, respectively). After excluding patients who underwent reoperation due to mechanical failure, there were no differences in the Oswestry Disability Index (ODI) and each domain of the Visual Analog Scale score, Scoliosis Research Society-22r patient questionnaire (SRS-22r), or the short form 36 health survey questionnaire at the final observation between the U (n=27) and M (n=57) groups. In addition, the non-inferiority and equivalence of the U group to the M group were demonstrated in all domains of the SRS-22r and ODI. Furthermore, the superiority of the U group was demonstrated by the functional domain of SRS-22r.
Conclusions: For the sagittal correction goal in corrective fusion surgery for ASD in the elderly, strict adherence to "PI-LL mismatch <10°" is not necessary and "PI-LL≤20°" may be acceptable.
{"title":"Spinopelvic Parameters in the Elderly: Does Inadequate Correction Portend Worse Outcomes?","authors":"Masanari Takami, Shunji Tsutsui, Keiji Nagata, Hiroshi Iwasaki, Akihito Minamide, Yasutsugu Yukawa, Motohiro Okada, Ryo Taiji, Shizumasa Murata, Takuhei Kozaki, Hiroshi Hashizume, Hiroshi Yamada","doi":"10.22603/ssrr.2023-0206","DOIUrl":"10.22603/ssrr.2023-0206","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to compare the outcomes of corrective fusion for adult spinal deformity (ASD) in older people using two different sagittal correction goals: the conventional formula of \"pelvic incidence (PI)-lumbar lordosis (LL) mismatch <10°\" and an undercorrection strategy based on the range of 10°≤PI-LL≤20°.</p><p><strong>Methods: </strong>A total of 102 consecutive patients (11 male and 91 female patients; mean age, 72.0 years) aged above 65 years with scoliosis >20° or LL<20° who had undergone long-segment fusion from the lower thoracic spine to the pelvis for ASD and had been followed-up for a minimum of two years at our institution since March 2013 were included in this retrospective study. After excluding patients with PI-LL≤-10° on postoperative standing radiographs, the remaining patients were divided into two groups: 31 patients with 10°≤PI-LL≤20° (U group) and 63 patients with -10°<PI-LL<10° (M group). Radiological and clinical outcomes were compared between the groups.</p><p><strong>Results: </strong>The incidence of proximal junctional kyphosis and mechanical failure was not significantly different between the groups (p=0.659 and 1.000, respectively). After excluding patients who underwent reoperation due to mechanical failure, there were no differences in the Oswestry Disability Index (ODI) and each domain of the Visual Analog Scale score, Scoliosis Research Society-22r patient questionnaire (SRS-22r), or the short form 36 health survey questionnaire at the final observation between the U (n=27) and M (n=57) groups. In addition, the non-inferiority and equivalence of the U group to the M group were demonstrated in all domains of the SRS-22r and ODI. Furthermore, the superiority of the U group was demonstrated by the functional domain of SRS-22r.</p><p><strong>Conclusions: </strong>For the sagittal correction goal in corrective fusion surgery for ASD in the elderly, strict adherence to \"PI-LL mismatch <10°\" is not necessary and \"PI-LL≤20°\" may be acceptable.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917476","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":"Treating Severe Cervical Deformity in Neurofibromatosis 1 with a Posterior Fibula Graft from Occiput to Thoracic Spine: A Case Report.","authors":"Bungo Otsuki, Shunsuke Fujibayashi, Takashi Noguchi, Takayoshi Shimizu, Shuichi Matsuda","doi":"10.22603/ssrr.2023-0316","DOIUrl":"10.22603/ssrr.2023-0316","url":null,"abstract":"","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917478","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}
Introduction: The association between postoperative patient-reported outcomes (PROs) and patient satisfaction remains poorly defined in patients undergoing surgery for thoracic myelopathy. This study aimed to investigate PROs and patient satisfaction following surgical intervention for thoracic myelopathy.
Methods: A prospective cohort of 133 patients who underwent surgery for thoracic myelopathy at 13 hospitals between April 2017 and August 2021 was enrolled. Patient demographics and perioperative complications were recorded. PROs were assessed using questionnaires administered preoperatively and 1 year postoperatively, including the EuroQol-5 dimension, physical and mental component summaries of the 12-item Short-Form Health Survey, Oswestry Disability Index, and numerical rating scales for low back, lower extremity, and plantar pain. Patients were categorized into two groups: satisfied (very satisfied, satisfied, and slightly satisfied) and dissatisfied (neither satisfied nor dissatisfied, slightly dissatisfied, dissatisfied, and very dissatisfied).
Results: The mean age of the patients was 66.5 years, comprising 87 men and 46 women. The most common diagnoses were ossification of the ligamentum flavum (48.8%) and thoracic spondylotic myelopathy (26.3%). Seventy-four (55.6%) and 59 (44.3%) patients underwent decompression surgery and underwent decompression with fusion, respectively. Eight patients required reoperation due to postoperative surgical site infection, hematoma, and insufficient decompression in four, three, and one patient. Ninety (67.7%) patients completed both the preoperative and postoperative PRO questionnaires, all of which demonstrated significant improvement. Among them, 58 (64.4%) and 32 (35.6%) reported satisfaction and dissatisfaction with their treatment, respectively. The satisfied group showed superior improvement in PROs than the dissatisfied group, although there were no significant differences in complication rates between the two groups.
Conclusions: The 64.4% satisfaction rate observed in patients undergoing surgery for thoracic myelopathy was lower than that reported in previous studies on cervical or lumbar spine surgery. The dissatisfied group exhibited significantly poorer quality of life (QOL) and higher pain scores than the satisfied group.
{"title":"Patient-Reported Outcomes and Patient Satisfaction Following Surgery for Thoracic Myelopathy.","authors":"Yusuke Ito, Nozomu Ohtomo, Hideki Nakamoto, So Kato, Yuki Taniguchi, Hiroyasu Kodama, Yusuke Sato, Naohiro Kawamura, Juichi Tonosu, Akiro Higashikawa, Fumiko Saiki, Yujiro Takeshita, Masato Anno, Masayoshi Fukushima, Masaaki Iizuka, Satoshi Baba, Takashi Ono, Naohiro Tachibana, Nobuhiro Hara, Naoki Okamoto, Seiichi Azuma, Ryuji Sakamoto, Hiroki Iwai, Masahito Oshina, Shurei Sugita, Shima Hirai, Yukimasa Yamato, Kazuhiro Masuda, Sakae Tanaka, Yasushi Oshima","doi":"10.22603/ssrr.2023-0279","DOIUrl":"10.22603/ssrr.2023-0279","url":null,"abstract":"<p><strong>Introduction: </strong>The association between postoperative patient-reported outcomes (PROs) and patient satisfaction remains poorly defined in patients undergoing surgery for thoracic myelopathy. This study aimed to investigate PROs and patient satisfaction following surgical intervention for thoracic myelopathy.</p><p><strong>Methods: </strong>A prospective cohort of 133 patients who underwent surgery for thoracic myelopathy at 13 hospitals between April 2017 and August 2021 was enrolled. Patient demographics and perioperative complications were recorded. PROs were assessed using questionnaires administered preoperatively and 1 year postoperatively, including the EuroQol-5 dimension, physical and mental component summaries of the 12-item Short-Form Health Survey, Oswestry Disability Index, and numerical rating scales for low back, lower extremity, and plantar pain. Patients were categorized into two groups: satisfied (very satisfied, satisfied, and slightly satisfied) and dissatisfied (neither satisfied nor dissatisfied, slightly dissatisfied, dissatisfied, and very dissatisfied).</p><p><strong>Results: </strong>The mean age of the patients was 66.5 years, comprising 87 men and 46 women. The most common diagnoses were ossification of the ligamentum flavum (48.8%) and thoracic spondylotic myelopathy (26.3%). Seventy-four (55.6%) and 59 (44.3%) patients underwent decompression surgery and underwent decompression with fusion, respectively. Eight patients required reoperation due to postoperative surgical site infection, hematoma, and insufficient decompression in four, three, and one patient. Ninety (67.7%) patients completed both the preoperative and postoperative PRO questionnaires, all of which demonstrated significant improvement. Among them, 58 (64.4%) and 32 (35.6%) reported satisfaction and dissatisfaction with their treatment, respectively. The satisfied group showed superior improvement in PROs than the dissatisfied group, although there were no significant differences in complication rates between the two groups.</p><p><strong>Conclusions: </strong>The 64.4% satisfaction rate observed in patients undergoing surgery for thoracic myelopathy was lower than that reported in previous studies on cervical or lumbar spine surgery. The dissatisfied group exhibited significantly poorer quality of life (QOL) and higher pain scores than the satisfied group.</p>","PeriodicalId":22253,"journal":{"name":"Spine Surgery and Related Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917474","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}