Purpose: This study aimed to develop machine-learning algorithms for predicting survival in patients who underwent surgery for spinal metastasis.
Overview of literature: This study develops machine-learning models to predict postoperative survival in spinal metastasis patients, filling the gaps of traditional prognostic systems. Utilizing data from 389 patients, the study highlights XGBoost and CatBoost algorithms̓ effectiveness for 90, 180, and 365-day survival predictions, with preoperative serum albumin as a key predictor. These models offer a promising approach for enhancing clinical decision-making and personalized patient care.
Methods: A registry of patients who underwent surgery (instrumentation, decompression, or fusion) for spinal metastases between 2004 and 2018 was used. The outcome measure was survival at postoperative days 90, 180, and 365. Preoperative variables were used to develop machine-learning algorithms to predict survival chance in each period. The performance of the algorithms was measured using the area under the receiver operating characteristic curve (AUC).
Results: A total of 389 patients were identified, with 90-, 180-, and 365-day mortality rates of 18%, 41%, and 45% postoperatively, respectively. The XGBoost algorithm showed the best performance for predicting 180-day and 365-day survival (AUCs of 0.744 and 0.693, respectively). The CatBoost algorithm demonstrated the best performance for predicting 90-day survival (AUC of 0.758). Serum albumin had the highest positive correlation with survival after surgery.
Conclusions: These machine-learning algorithms showed promising results in predicting survival in patients who underwent spinal palliative surgery for spinal metastasis, which may assist surgeons in choosing appropriate treatment and increasing awareness of mortality-related factors before surgery.
{"title":"Development and internal validation of machine-learning models for predicting survival in patients who underwent surgery for spinal metastases.","authors":"Borriwat Santipas, Kanyakorn Veerakanjana, Piyalitt Ittichaiwong, Piya Chavalparit, Sirichai Wilartratsami, Panya Luksanapruksa","doi":"10.31616/asj.2023.0314","DOIUrl":"10.31616/asj.2023.0314","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Purpose: </strong>This study aimed to develop machine-learning algorithms for predicting survival in patients who underwent surgery for spinal metastasis.</p><p><strong>Overview of literature: </strong>This study develops machine-learning models to predict postoperative survival in spinal metastasis patients, filling the gaps of traditional prognostic systems. Utilizing data from 389 patients, the study highlights XGBoost and CatBoost algorithms̓ effectiveness for 90, 180, and 365-day survival predictions, with preoperative serum albumin as a key predictor. These models offer a promising approach for enhancing clinical decision-making and personalized patient care.</p><p><strong>Methods: </strong>A registry of patients who underwent surgery (instrumentation, decompression, or fusion) for spinal metastases between 2004 and 2018 was used. The outcome measure was survival at postoperative days 90, 180, and 365. Preoperative variables were used to develop machine-learning algorithms to predict survival chance in each period. The performance of the algorithms was measured using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>A total of 389 patients were identified, with 90-, 180-, and 365-day mortality rates of 18%, 41%, and 45% postoperatively, respectively. The XGBoost algorithm showed the best performance for predicting 180-day and 365-day survival (AUCs of 0.744 and 0.693, respectively). The CatBoost algorithm demonstrated the best performance for predicting 90-day survival (AUC of 0.758). Serum albumin had the highest positive correlation with survival after surgery.</p><p><strong>Conclusions: </strong>These machine-learning algorithms showed promising results in predicting survival in patients who underwent spinal palliative surgery for spinal metastasis, which may assist surgeons in choosing appropriate treatment and increasing awareness of mortality-related factors before surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"325-335"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065313","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":"Response to the Letter to the Editor: Comparison of efficacy between transforaminal epidural steroid injection technique without contrast versus with contrast in lumbar radiculopathy: a prospective longitudinal cohort study.","authors":"Waroot Pholsawatchai, Park Manakul, Warisara Lertcheewanan, Koopong Siribumrungwoung, Thongchai Suntharapa, Rattalerk Arunakul","doi":"10.31616/asj.2024.0177.r2","DOIUrl":"10.31616/asj.2024.0177.r2","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"18 3","pages":"485-486"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496956","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 : 2024-06-01Epub Date: 2023-12-26DOI: 10.31616/asj.2023.0407
Sam Yeol Chang, Dong-Ho Kang, Samuel K Cho
This review comprehensively examines the evolution and current state of interbody cage technology for lumbar interbody fusion (LIF). This review highlights the biomechanical and clinical implications of the transition from traditional static cage designs to advanced expandable variants for spinal surgery. The review begins by exploring the early developments in cage materials, highlighting the roles of titanium and polyetheretherketone in the advancement of LIF techniques. This review also discusses the strengths and limitations of these materials, leading to innovations in surface modifications and the introduction of novel materials, such as tantalum, as alternative materials. Advancements in three-dimensional printing and surface modification technologies form a significant part of this review, emphasizing the role of these technologies in enhancing the biomechanical compatibility and osseointegration of interbody cages. In addition, this review explores the increase in biodegradable and composite materials such as polylactic acid and polycaprolactone, addressing their potential to mitigate long-term implant-related complications. A critical evaluation of static and expandable cages is presented, including their respective clinical and radiological outcomes. While static cages have been a mainstay of LIF, expandable cages are noted for their adaptability to the patient's anatomy, reducing complications such as cage subsidence. However, this review highlights the ongoing debate and the lack of conclusive evidence regarding the superiority of either cage type in terms of clinical outcomes. Finally, this review proposes future directions for cage technology, focusing on the integration of bioactive substances and multifunctional coatings and the development of patient-specific implants. These advancements aim to further enhance the efficacy, safety, and personalized approach of spinal fusion surgeries. Moreover, this review offers a nuanced understanding of the evolving landscape of cage technology in LIF and provides insights into current practices and future possibilities in spinal surgery.
{"title":"Innovative Developments in Lumbar Interbody Cage Materials and Design: A Comprehensive Narrative Review.","authors":"Sam Yeol Chang, Dong-Ho Kang, Samuel K Cho","doi":"10.31616/asj.2023.0407","DOIUrl":"10.31616/asj.2023.0407","url":null,"abstract":"<p><p>This review comprehensively examines the evolution and current state of interbody cage technology for lumbar interbody fusion (LIF). This review highlights the biomechanical and clinical implications of the transition from traditional static cage designs to advanced expandable variants for spinal surgery. The review begins by exploring the early developments in cage materials, highlighting the roles of titanium and polyetheretherketone in the advancement of LIF techniques. This review also discusses the strengths and limitations of these materials, leading to innovations in surface modifications and the introduction of novel materials, such as tantalum, as alternative materials. Advancements in three-dimensional printing and surface modification technologies form a significant part of this review, emphasizing the role of these technologies in enhancing the biomechanical compatibility and osseointegration of interbody cages. In addition, this review explores the increase in biodegradable and composite materials such as polylactic acid and polycaprolactone, addressing their potential to mitigate long-term implant-related complications. A critical evaluation of static and expandable cages is presented, including their respective clinical and radiological outcomes. While static cages have been a mainstay of LIF, expandable cages are noted for their adaptability to the patient's anatomy, reducing complications such as cage subsidence. However, this review highlights the ongoing debate and the lack of conclusive evidence regarding the superiority of either cage type in terms of clinical outcomes. Finally, this review proposes future directions for cage technology, focusing on the integration of bioactive substances and multifunctional coatings and the development of patient-specific implants. These advancements aim to further enhance the efficacy, safety, and personalized approach of spinal fusion surgeries. Moreover, this review offers a nuanced understanding of the evolving landscape of cage technology in LIF and provides insights into current practices and future possibilities in spinal surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"444-457"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139037398","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":"Response to the Letter to the Editor: Lumbar transforaminal injection of steroids versus platelet-rich plasma for prolapse lumbar intervertebral disc with radiculopathy: a randomized double-blind controlled pilot study.","authors":"Anuj Gupta, Harvinder Singh Chhabra, Vishwajeet Singh, Daram Nagarjuna","doi":"10.31616/asj.2024.0109.r2","DOIUrl":"10.31616/asj.2024.0109.r2","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"18 3","pages":"489-490"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496957","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}
The purpose of this narrative review was to comprehensively elaborate the various components of artificial intelligence (AI), their applications in spine surgery, practical concerns, and future directions. Over the years, spine surgery has been continuously transformed in various aspects, including diagnostic strategies, surgical approaches, procedures, and instrumentation, to provide better-quality patient care. Surgeons have also augmented their surgical expertise with rapidly growing technological advancements. AI is an advancing field that has the potential to revolutionize many aspects of spine surgery. We performed a comprehensive narrative review of the various aspects of AI and machine learning in spine surgery. To elaborate on the current role of AI in spine surgery, a review of the literature was performed using PubMed and Google Scholar databases for articles published in English in the last 20 years. The initial search using the keywords "artificial intelligence" AND "spine," "machine learning" AND "spine," and "deep learning" AND "spine" extracted a total of 78, 60, and 37 articles and 11,500, 4,610, and 2,270 articles on PubMed and Google Scholar. After the initial screening and exclusion of unrelated articles, duplicates, and non-English articles, 405 articles were identified. After the second stage of screening, 93 articles were included in the review. Studies have shown that AI can be used to analyze patient data and provide personalized treatment recommendations in spine care. It also provides valuable insights for planning surgeries and assisting with precise surgical maneuvers and decisionmaking during the procedures. As more data become available and with further advancements, AI is likely to improve patient outcomes.
{"title":"Artificial intelligence: a new cutting-edge tool in spine surgery.","authors":"Guna Pratheep Kalanjiyam, Thiyagarajan Chandramohan, Muthu Raman, Haritha Kalyanasundaram","doi":"10.31616/asj.2023.0382","DOIUrl":"10.31616/asj.2023.0382","url":null,"abstract":"<p><p>The purpose of this narrative review was to comprehensively elaborate the various components of artificial intelligence (AI), their applications in spine surgery, practical concerns, and future directions. Over the years, spine surgery has been continuously transformed in various aspects, including diagnostic strategies, surgical approaches, procedures, and instrumentation, to provide better-quality patient care. Surgeons have also augmented their surgical expertise with rapidly growing technological advancements. AI is an advancing field that has the potential to revolutionize many aspects of spine surgery. We performed a comprehensive narrative review of the various aspects of AI and machine learning in spine surgery. To elaborate on the current role of AI in spine surgery, a review of the literature was performed using PubMed and Google Scholar databases for articles published in English in the last 20 years. The initial search using the keywords \"artificial intelligence\" AND \"spine,\" \"machine learning\" AND \"spine,\" and \"deep learning\" AND \"spine\" extracted a total of 78, 60, and 37 articles and 11,500, 4,610, and 2,270 articles on PubMed and Google Scholar. After the initial screening and exclusion of unrelated articles, duplicates, and non-English articles, 405 articles were identified. After the second stage of screening, 93 articles were included in the review. Studies have shown that AI can be used to analyze patient data and provide personalized treatment recommendations in spine care. It also provides valuable insights for planning surgeries and assisting with precise surgical maneuvers and decisionmaking during the procedures. As more data become available and with further advancements, AI is likely to improve patient outcomes.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"458-471"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449474","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 : 2024-06-01Epub Date: 2024-06-26DOI: 10.31616/asj.2024.0177.r1
Rekib Sacaklidir
{"title":"Letter to the Editor: Comparison of efficacy between transforaminal epidural steroid injection technique without contrast versus with contrast in lumbar radiculopathy: a prospective longitudinal cohort study.","authors":"Rekib Sacaklidir","doi":"10.31616/asj.2024.0177.r1","DOIUrl":"10.31616/asj.2024.0177.r1","url":null,"abstract":"","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"18 3","pages":"483-484"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496954","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}
Koichi Murata, B. Otsuki, Takayoshi Shimizu, Takashi Sono, S. Fujibayashi, Shuichi Matsuda
Study Design A retrospective observational study. Purpose This study aimed to determine an accurate and convenient screening method for predicting proximal junctional fractures (PJFr) following surgery for adult spinal deformity (ASD) using computed tomography (CT)-based measurement of Hounsfield units (HUs). Overview of Literature CT-based measurement of HUs is an alternative tool for assessing bone mineral density. However, the optimal method for predicting adjacent vertebral fractures following spinal fusion using HUs remains unclear. Methods This retrospective observational study included 42 patients who underwent reconstructive surgery for ASD. Elliptical regions of interest (ROIs) on the axial section and rectangular ROIs on the sagittal section were placed at the upper instrumented vertebrae (UIV), UIV+1, and UIV+2. In addition, the HU value of the L2 vertebra was used as the representative. Results PJFr occurred in 28.6% of patients within 2 years following surgery. The HU values obtained from the axial sections of L2, UIV, UIV+1, and UIV+2 were not significantly associated with the incidence of PJFr within 2 years, except for the ROI set in the lower region of the L2 vertebra. However, the HU value of the anterior third of the UIV in the sagittal section was significantly lower in the PJFr group than in the nonPJFr group (87.0 vs. 160.3, p =0.001). A UIV HU value of <100 was associated with a higher incidence of PJFr than an HU vaue of >100 (p <0.05). Conclusions Measurements of HU in the anterior one-third of the UIV in the sagittal section demonstrated predictive ability for PJFr following ASD surgery. A UIV HU value of <100 emerged as a risk factor for PJFr.
研究设计回顾性观察研究目的本研究旨在确定一种准确、便捷的筛查方法,利用基于计算机断层扫描(CT)的霍斯菲尔德单位(HUs)测量方法预测成人脊柱畸形(ASD)手术后的近端交界处骨折(PJFr).文献综述基于计算机断层扫描的 HUs 测量方法是评估骨矿密度的一种替代工具。然而,使用 HUs 预测脊柱融合术后邻近椎体骨折的最佳方法仍不明确。方法这项回顾性观察研究纳入了 42 名接受 ASD 重建手术的患者。轴切面上的椭圆形感兴趣区(ROI)和矢状切面上的矩形感兴趣区分别位于上器械椎体(UIV)、UIV+1 和 UIV+2。此外,还以 L2 椎体的 HU 值为代表。从 L2、UIV、UIV+1 和 UIV+2 轴切面获得的 HU 值与 2 年内 PJFr 的发生率无显著相关性,但 L2 椎体下部区域的 ROI 值除外。然而,PJFr 组 UIV 前三分之一矢状切面的 HU 值明显低于非 PJFr 组(87.0 vs. 160.3,p =0.001)。结论矢状切面 UIV 前三分之一处的 HU 测量结果显示了 ASD 手术后对 PJFr 的预测能力。UIV HU 值小于 100 是 PJFr 的风险因素。
{"title":"Sagittal Section Hounsfield Units of the Upper Instrumented Vertebrae as a Predictor of Proximal Junctional Vertebral Fractures Following Adult Spinal Deformity Surgery.","authors":"Koichi Murata, B. Otsuki, Takayoshi Shimizu, Takashi Sono, S. Fujibayashi, Shuichi Matsuda","doi":"10.31616/asj.2023.0339","DOIUrl":"https://doi.org/10.31616/asj.2023.0339","url":null,"abstract":"Study Design\u0000A retrospective observational study.\u0000\u0000\u0000Purpose\u0000This study aimed to determine an accurate and convenient screening method for predicting proximal junctional fractures (PJFr) following surgery for adult spinal deformity (ASD) using computed tomography (CT)-based measurement of Hounsfield units (HUs).\u0000\u0000\u0000Overview of Literature\u0000CT-based measurement of HUs is an alternative tool for assessing bone mineral density. However, the optimal method for predicting adjacent vertebral fractures following spinal fusion using HUs remains unclear.\u0000\u0000\u0000Methods\u0000This retrospective observational study included 42 patients who underwent reconstructive surgery for ASD. Elliptical regions of interest (ROIs) on the axial section and rectangular ROIs on the sagittal section were placed at the upper instrumented vertebrae (UIV), UIV+1, and UIV+2. In addition, the HU value of the L2 vertebra was used as the representative.\u0000\u0000\u0000Results\u0000PJFr occurred in 28.6% of patients within 2 years following surgery. The HU values obtained from the axial sections of L2, UIV, UIV+1, and UIV+2 were not significantly associated with the incidence of PJFr within 2 years, except for the ROI set in the lower region of the L2 vertebra. However, the HU value of the anterior third of the UIV in the sagittal section was significantly lower in the PJFr group than in the nonPJFr group (87.0 vs. 160.3, p =0.001). A UIV HU value of <100 was associated with a higher incidence of PJFr than an HU vaue of >100 (p <0.05).\u0000\u0000\u0000Conclusions\u0000Measurements of HU in the anterior one-third of the UIV in the sagittal section demonstrated predictive ability for PJFr following ASD surgery. A UIV HU value of <100 emerged as a risk factor for PJFr.","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"61 18","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140666821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Study Design A retrospective, cross-sectional study was conducted to analyze the implications of asymmetric baseball movements on the incidence of spondylolysis. Purpose This study aimed to evaluate the relationship between asymmetric movements and the laterality of spondylolysis. Overview of Literature Baseball, characterized by its asymmetric throwing and batting, may disproportionately stress one side. Lumbar spondylolysis is a frequent cause of lower back pain in young athletes, particularly those involved in activities with consistent unilateral rotations such as baseball. However, whether a link exists between the laterality in spondylolysis and the dominant throwing/ batting side or whether disparities exist between pitchers and fielders remains unclear. Methods The study included 85 players. Participants were divided into two groups: pitchers and fielders. The association between the laterality of spondylolysis and the throwing/batting side in the overall cohort and between the two groups was evaluated. Results Among pitchers, 16 lesions appeared on the throwing side and 32 on the nonthrowing side (p =0.029). For fielders, no notable difference was observed between the two sides (p =0.363). Furthermore, batting preference did not influence the laterality of spondylolysis in either group. Conclusions Adolescent baseball players, particularly pitchers, exhibited a higher incidence of lumbar spondylolysis on the side opposite their throwing arm. The findings of this study highlight the significant effect of asymmetrical sporting activities on the development of spondylolysis, to which pitchers are particularly susceptible.
{"title":"Characteristics of Lumbar Spondylolysis in Adolescent Baseball Players: Relationship between the Laterality of Lumbar Spondylolysis and the Throwing or Batting Side.","authors":"Shotaro Teruya, T. Funayama, Masaki Tatsumura, Hisanori Gamada, Shun Okuwaki, Takeo Mammoto, Atsushi Hirano, Masashi Yamazaki","doi":"10.31616/asj.2023.0360","DOIUrl":"https://doi.org/10.31616/asj.2023.0360","url":null,"abstract":"Study Design\u0000A retrospective, cross-sectional study was conducted to analyze the implications of asymmetric baseball movements on the incidence of spondylolysis.\u0000\u0000\u0000Purpose\u0000This study aimed to evaluate the relationship between asymmetric movements and the laterality of spondylolysis.\u0000\u0000\u0000Overview of Literature\u0000Baseball, characterized by its asymmetric throwing and batting, may disproportionately stress one side. Lumbar spondylolysis is a frequent cause of lower back pain in young athletes, particularly those involved in activities with consistent unilateral rotations such as baseball. However, whether a link exists between the laterality in spondylolysis and the dominant throwing/ batting side or whether disparities exist between pitchers and fielders remains unclear.\u0000\u0000\u0000Methods\u0000The study included 85 players. Participants were divided into two groups: pitchers and fielders. The association between the laterality of spondylolysis and the throwing/batting side in the overall cohort and between the two groups was evaluated.\u0000\u0000\u0000Results\u0000Among pitchers, 16 lesions appeared on the throwing side and 32 on the nonthrowing side (p =0.029). For fielders, no notable difference was observed between the two sides (p =0.363). Furthermore, batting preference did not influence the laterality of spondylolysis in either group.\u0000\u0000\u0000Conclusions\u0000Adolescent baseball players, particularly pitchers, exhibited a higher incidence of lumbar spondylolysis on the side opposite their throwing arm. The findings of this study highlight the significant effect of asymmetrical sporting activities on the development of spondylolysis, to which pitchers are particularly susceptible.","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"139 34","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140668427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Majid Rezvani, Ali Ahmadvand, Taravat Yazdanian, P. Azimi, Navid Askariardehjani
Study Design This was a retrospective study. Purpose This study aimed to assess the value of the Spinal Infection Treatment Evaluation (SITE) score, Brighton Spondylodiscitis Score (BSDS), and Pola classification to predict the need for surgical intervention in patients with spondylodiscitis. Overview of Literature Spondylodiscitis is a rare disease, and the prediction of its outcome is crucial in the decision-making process. Methods All case records were assessed to extract information on the American Spinal Injury Association (ASIA), Visual Analog Scale (VAS), and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores before and after surgery. The SITE score, Pola classification, and BSDS were recorded. The receiver-operating characteristic (ROC) curve analysis and the area under the curve (AUC) were applied to estimate the predictive ability of the scoring systems. Patients' satisfaction with surgery outcomes was evaluated using the VAS, ASIA, JOABPEQ, and Likert scale for quality-of-life evaluation. Results In all 148 patients, case records were reviewed. The mean±standard deviation age of the patients was 54.6±14.7 years. Of these, 112 patients underwent surgery. The AUC scores were 0.86, 0.81, and 0.73 for the SITE score, BSDS, and Pola classification, respectively. In the comparison of the AUC of ROC curves, SITE score vs. BSDS showed a significantly greater AUC, 0.13 (Z =2.1, p =0.037); SITE score vs. Pola classification, 0.05 (Z =0.82, p =0.412); and Pola classification vs. BSDS, 0.08 (Z =1.22, p =0.219). The optimal cutoff score was 8.5 (sensitivity, 80.6%; specificity, 81.2%) for the SITE score and 9.5 (sensitivity, 52.8%; specificity, 83.0%) for the BSDS in the decision to surgery. VAS back pain and JOABPEQ subscales showed a significant difference when compared with preoperative scores. According to ASIA grading, none of the patients experienced neurological deterioration. Overall, patients' satisfaction was observed. Conclusions The findings suggest that the SITE score is a useful measure and helps clinicians make clinically sound decisions in patients with spondylodiscitis.
{"title":"Value of Spinal Infection Treatment Evaluation Score, Pola Classification, and Brighton Spondylodiscitis Score from Decision to Surgery in Patients with Spondylodiscitis: A Receiver-Operating Characteristic Curve Analysis.","authors":"Majid Rezvani, Ali Ahmadvand, Taravat Yazdanian, P. Azimi, Navid Askariardehjani","doi":"10.31616/asj.2023.0317","DOIUrl":"https://doi.org/10.31616/asj.2023.0317","url":null,"abstract":"Study Design\u0000This was a retrospective study.\u0000\u0000\u0000Purpose\u0000This study aimed to assess the value of the Spinal Infection Treatment Evaluation (SITE) score, Brighton Spondylodiscitis Score (BSDS), and Pola classification to predict the need for surgical intervention in patients with spondylodiscitis.\u0000\u0000\u0000Overview of Literature\u0000Spondylodiscitis is a rare disease, and the prediction of its outcome is crucial in the decision-making process.\u0000\u0000\u0000Methods\u0000All case records were assessed to extract information on the American Spinal Injury Association (ASIA), Visual Analog Scale (VAS), and Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores before and after surgery. The SITE score, Pola classification, and BSDS were recorded. The receiver-operating characteristic (ROC) curve analysis and the area under the curve (AUC) were applied to estimate the predictive ability of the scoring systems. Patients' satisfaction with surgery outcomes was evaluated using the VAS, ASIA, JOABPEQ, and Likert scale for quality-of-life evaluation.\u0000\u0000\u0000Results\u0000In all 148 patients, case records were reviewed. The mean±standard deviation age of the patients was 54.6±14.7 years. Of these, 112 patients underwent surgery. The AUC scores were 0.86, 0.81, and 0.73 for the SITE score, BSDS, and Pola classification, respectively. In the comparison of the AUC of ROC curves, SITE score vs. BSDS showed a significantly greater AUC, 0.13 (Z =2.1, p =0.037); SITE score vs. Pola classification, 0.05 (Z =0.82, p =0.412); and Pola classification vs. BSDS, 0.08 (Z =1.22, p =0.219). The optimal cutoff score was 8.5 (sensitivity, 80.6%; specificity, 81.2%) for the SITE score and 9.5 (sensitivity, 52.8%; specificity, 83.0%) for the BSDS in the decision to surgery. VAS back pain and JOABPEQ subscales showed a significant difference when compared with preoperative scores. According to ASIA grading, none of the patients experienced neurological deterioration. Overall, patients' satisfaction was observed.\u0000\u0000\u0000Conclusions\u0000The findings suggest that the SITE score is a useful measure and helps clinicians make clinically sound decisions in patients with spondylodiscitis.","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"139 49","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140668721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Ifthekar, Ju-Wan Seuk, Ui Dong Hwang, Hyung-Chang Lee, Sang-Ho Lee, J. Bae
This retrospective case series of prospective data aims to describe the transaxillary approach for the treatment of upper thoracic spine pathology. Various surgical techniques and approaches have been reported across the literature to address upper thoracic spine pathology, including the cervicothoracic approach, anterior transsternal approach, posterolateral approach, supraclavicular approach, and lateral parascapular approaches. These techniques are invasive. A minimally invasive, less morbid, and direct access approach to the pathology of the upper thoracic spine has not been reported in the literature. Patients with pathology affecting the first thoracic vertebra up to the sixth thoracic vertebra were classified into the upper thoracic spine group. Patients with pathology below the sixth thoracic vertebra were excluded. Patients not having a minimum follow-up of 12 months were also excluded. The study analyzed 18 patients. The mean preoperative modified Japanese Orthopedic Association score was 7.2±1.44, which improved to 10.16±1.2 (p<0.05). The majority (14/18) of the patients had an excellent outcome. Three patients had good outcomes, and one patient had a fair outcome. Five cases of intraoperative dural leak were recorded, and one patient had postoperative neurological deficit. The transaxillary approach is a safe, viable, muscle-sparing, and minimally invasive approach for ventral pathologies of the upper thoracic spine.
{"title":"The Transaxillary Approach as a Direct Route in the Management of Upper Thoracic Spine Pathology: A Technical Note with Case Series.","authors":"S. Ifthekar, Ju-Wan Seuk, Ui Dong Hwang, Hyung-Chang Lee, Sang-Ho Lee, J. Bae","doi":"10.31616/asj.2023.0175","DOIUrl":"https://doi.org/10.31616/asj.2023.0175","url":null,"abstract":"This retrospective case series of prospective data aims to describe the transaxillary approach for the treatment of upper thoracic spine pathology. Various surgical techniques and approaches have been reported across the literature to address upper thoracic spine pathology, including the cervicothoracic approach, anterior transsternal approach, posterolateral approach, supraclavicular approach, and lateral parascapular approaches. These techniques are invasive. A minimally invasive, less morbid, and direct access approach to the pathology of the upper thoracic spine has not been reported in the literature. Patients with pathology affecting the first thoracic vertebra up to the sixth thoracic vertebra were classified into the upper thoracic spine group. Patients with pathology below the sixth thoracic vertebra were excluded. Patients not having a minimum follow-up of 12 months were also excluded. The study analyzed 18 patients. The mean preoperative modified Japanese Orthopedic Association score was 7.2±1.44, which improved to 10.16±1.2 (p<0.05). The majority (14/18) of the patients had an excellent outcome. Three patients had good outcomes, and one patient had a fair outcome. Five cases of intraoperative dural leak were recorded, and one patient had postoperative neurological deficit. The transaxillary approach is a safe, viable, muscle-sparing, and minimally invasive approach for ventral pathologies of the upper thoracic spine.","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":"23 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140665736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}