- Avoidance of vascular injury during trans-psoas approaches; awareness of venous anatomy on MRI. [Journal Article]
- CONCLUSIONS: The vascular anatomy is readily identified on the pre-operative MRI. Veins considered to be large enough to present a surgical hazard, at levels proximal to the L4-5 disc, have a diameter greater than the exiting nerve root at the same level. Review of the vascular anatomy should be performed during the surgical planning to avoid any potential haemorrhagic complications.
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- Statistical fragility of significant outcomes in spine surgery randomized controlled trials: a systematic review of binary and continuous outcomes. [Review]
- CONCLUSIONS: In recent spine surgery RCTs with statistically significant primary outcomes, findings were often statistically fragile. For binary outcomes, reversal of statistical significance required a change in outcome status for a median of only 4 patients, with more than three-quarters of outcomes having an FI ≤ 5. Continuous outcomes also showed measurable fragility, with reversal requiring reallocation of a median of 12.2 patients. These results suggest that a substantial proportion of statistically significant findings in contemporary spine surgery RCTs may be less robust than conventional P-values alone imply. Fragility analysis may therefore serve as a useful complement to conventional significance testing when interpreting statistically significant findings in spine surgery trials, particularly for clinically important binary endpoints.
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- Prognostic Factors for Neurological Outcome After Surgery for Idiopathic Spinal Cord Herniation: A Systematic Review and Published Individual Patient Data Analysis. [Review]
- CONCLUSIONS: Surgical treatment of ISCH resulted in neurological improvement in a substantial proportion of patients. This IPD analysis identified preoperative neurological impairment and specific anatomical characteristics as factors associated with postoperative recovery, suggesting that advanced neurological deterioration may reduce the probability of functional improvement.These findings should be regarded as exploratory and underscore the need for prospective studies with standardized outcome assessment to refine surgical decision-making in ISCH.
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- Accuracy of general-purpose large language models (LLMS) in interpreting adolescent idiopathic scoliosis radiographs: a comparative study with experienced spine surgeons. [Journal Article]
- CONCLUSIONS: The tested general-purpose LLM versions showed limited reliability for comprehensive AIS radiographic interpretation. Their performance was substantially weaker for Lenke classification, modifiers, and fusion-level-related landmarks than for CA estimation. The findings do not support independent use of these systems for scoliosis measurement, education, or surgical planning. At present, these tools should be regarded as supervised documentation or teaching aids rather than measurement or decision-making systems.
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- Foot drop secondary to lumbar degenerative disease: a scoping review of recovery patterns, predictors, and research gaps. [Review]
- CONCLUSIONS: Shorter symptom duration and greater preoperative strength are the most consistently reported predictors of recovery from FD after lumbar decompression, but the certainty of this evidence is low: the underlying studies are predominantly retrospective and single-predictor in design, use incompatible definitions of both FD and recovery, vary in follow-up, and report an effect estimate with a confidence interval in only 8 of 22 cases. The universal absence of electrodiagnostic testing further means that no included study could exclude a coexisting peripheral entrapment contributing to the deficit. These limitations currently preclude meaningful quantitative pooling of recovery rates. We propose a minimum reporting set intended to make future primary studies mutually poolable, and identify standardized definitions, fixed follow-up windows, and baseline electrodiagnostic assessment as prerequisites for a reliable meta-analysis.
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- Immediate in-brace correction and 1-year radiographic stability after a hybrid textile brace for adolescent idiopathic scoliosis: a retrospective cohort study. [Journal Article]
- CONCLUSIONS: The hybrid textile brace was associated with significant immediate radiographic correction, particularly in flexible curves. Baseline flexibility is informative in anticipating the immediate corrective response, whereas the uncontrolled design precludes conclusions regarding long-term clinical effectiveness.
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- MR spectroscopy in the diagnosis of lumbar discogenic pain. [Journal Article]
- CONCLUSIONS: MRS of lumbar discs may become a viable alternative to PD, as our experience and the technique evolves.
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- Multifactorial prediction of mechanical complications after lumbar fusion using bone quality and turnover markers. [Journal Article]
- CONCLUSIONS: Preoperative T-score, BMD, and HU values alone showed limited predictive accuracy for mechanical complications after lumbar fusion. However, integrating serum bone turnover markers and surgical factors substantially improved predictive performance. A multifactorial preoperative assessment incorporating bone density, metabolic, and mechanical parameters may better stratify risk and guide surgical planning in patients with poor bone quality.
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- Predictive value of intraoperative bulbocavernosus reflex monitoring for postoperative voiding dysfunction after lumbosacral spine surgery: a systematic review and meta-analysis. [Review]
- CONCLUSIONS: Intraoperative BCR monitoring is feasible and may provide clinically useful predictive information for POVD after lumbosacral spine surgery. Its high specificity and NPV support its use as a part of a multimodal neuromonitoring protocol for assessing sacral pathway integrity. Further prospective studies are needed to validate its predictive performance and standardize monitoring protocols and outcome definitions.
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- Subarachnoid-subarachnoid bypass versus extradural decompression for adhesive syringomyelia: experimental and early clinical evaluation. [Journal Article]
- CONCLUSIONS: In this rat model, S-S bypass produced more favorable structural and functional outcomes than extradural decompression by providing an alternative pathway across the obstructed segment. The preliminary clinical series supports the technical feasibility and short-term safety of the procedure, but its clinical effectiveness requires confirmation in larger controlled studies.
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- Dual-media spinal endoscopy versus unilateral biportal endoscopy for single-level degenerative lumbar spinal stenosis: a comparative study of mid-term outcomes. [Journal Article]
- CONCLUSIONS: Both DMSE and UBE appear to be safe and effective minimally invasive procedures for patients with single-level DLSS, with generally comparable short- to mid-term clinical outcomes. DMSE was associated with lower fluoroscopy frequency but greater facet resection, whereas UBE showed lower early postoperative CK elevation. These findings suggest different perioperative and technical profiles rather than clear overall superiority of either technique.
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- Is time really spine? Early versus delayed surgical decompression in traumatic spinal cord injury: a systematic review and meta-analysis. [Review]
- CONCLUSIONS: Earlier surgical decompression was associated with greater AIS-grade neurological recovery after traumatic spinal cord injury, particularly for improvement of at least two grades. However, most evidence was observational and limited by heterogeneous timing definitions, inconsistent outcome reporting and residual confounding. These findings support timely decompression when medically feasible, but do not establish that surgical timing alone determines neurological recovery.
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- Primary spinal bone sarcomas in Japan: a nationwide comparative analysis of demographic and pathologic features, treatment patterns, and survival. [Journal Article]
- CONCLUSIONS: Primary spinal BS in Japan differs substantially from non-spinal BS in clinical profile, treatment, and prognosis. Histological subtype and disease extent were the strongest independent prognostic factors. These nationwide real-world data offer a benchmark for risk stratification and may inform future treatment strategies for this rare disease.
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- Longitudinal trajectories and determinants of urinary outcomes after spinal ependymoma surgery. [Journal Article]
- CONCLUSIONS: Urinary dysfunction is common after spinal ependymoma surgery but often improves over time. Early indwelling catheter dependency should not be considered a definitive poor prognostic sign, while extent of resection and intraoperative neurophysiological alterations appear to identify patients at increased risk of early postoperative urinary dysfunction.
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- SATB2 promotes osteogenic differentiation of OPLL-derived posterior longitudinal ligament cells via Wnt/β-catenin signaling in association with RUNX2. [Journal Article]Eur Spine J. 2026 Oct 12. [Online ahead of print]ES
- CONCLUSIONS: Our findings support that, in OPLL cells, SATB2 is associated with Wnt/β-catenin-related signaling changes, increased RUNX2 expression, and enhanced osteogenic differentiation. These data extend prior observations from other osteogenic models to an OPLL-relevant cellular context and suggest that SATB2-associated osteogenic signaling may contribute to OPLL pathogenesis. Further studies are required to define the precise mechanism linking SATB2 to DKK1/Wnt regulation and to determine whether these effects are specific to the OPLL disease context.
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