- Perioperative Anabolic Osteoporosis Pharmacotherapy is Associated with Lower Rates of Proximal Junctional Kyphosis After Adult Spinal Deformity Surgery: A Systematic Review and Meta-Analysis. [Journal Article]Spine (Phila Pa 1976). 2026 Aug 17. [Online ahead of print]S
- CONCLUSIONS: Perioperative anabolic osteoporosis pharmacotherapy is associated with lower rates of proximal junctional kyphosis and reoperation following adult spinal deformity surgery, providing the first pooled evidence that the underlying bone-quality substrate may be pharmacologically modifiable. The certainty of this evidence is low; these findings support incorporating bone health optimization into perioperative planning as a modifiable target and prioritizing randomized trials of specific agents.
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- The Effects of Obesity Among Patients Undergoing Surgery for Degenerative Lumbar Conditions: An Observational Study From the Canadian Spine Outcomes and Research Network (CSORN). [Journal Article]Spine (Phila Pa 1976). 2026 Aug 14. [Online ahead of print]S
- CONCLUSIONS: Patients with obesity were less likely to experience improvement of disability after surgery for degenerative lumbar conditions and severe obesity was particularly associated with greater odds adverse events. These findings inform shared clinical decision-making and suggest that obesity management prior to surgery may be of benefit.
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- Osteoporosis and Mechanical Failure After Long-Segment Fusion for Degenerative Lumbar Scoliosis: A Systematic Review of Direct and Indirect Evidence. [Journal Article]Spine (Phila Pa 1976). 2026 Aug 14. [Online ahead of print]S
- CONCLUSIONS: Most core DLS reports linked lower bone quality to mechanical complications, but retrospective design, probable cohort overlap, measure-dependent null findings, and reporting defects make certainty very low. No pooled DLS-specific magnitude is justified. Effects on final alignment and disability remain unresolved, and perioperative anabolic therapy is promising but not definitive.
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- T4-L1PA Mismatch Predicts Mechanical Revision After Multilevel Fusion to the Upper Lumbar and Lower Thoracic Spine. [Journal Article]Spine (Phila Pa 1976). 2026 Aug 14. [Online ahead of print]S
- CONCLUSIONS: Postoperative T4-L1PA mismatch was the most consistent alignment predictor of mechanical revision over 5 years in thoracolumbar and upper lumbar fusions (UIV T8-L3) to the sacropelvis and remained independently prognostic at 1 year, with most revisions attributable to proximal junctional failure. PI-LL contributed early risk but weakened over time. Combined assessment identified a high-risk subgroup.
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- Impact of Concomitant Hip Osteoarthritis on Pelvic Decompensation, Spinopelvic Alignment, and Surgical Outcomes in Degenerative Lumbar Scoliosis. [Journal Article]Spine (Phila Pa 1976). 2026 Aug 14. [Online ahead of print]S
- CONCLUSIONS: Severe hip OA was associated with pelvic decompensation and reduced hip extension. Patients with severe hip OA had worse baseline sagittal malalignment and inferior PROMs that persisted 2 year following surgery. These findings underscore the importance of evaluating hip OA during preoperative planning for DLS.
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- Prevalence of Lumbar MRI Changes Associated with Nerve Root Compression Among Middle-aged People - A Northern Finland Birth Cohort 1966 Study. [Journal Article]Spine (Phila Pa 1976). 2026 Aug 17. [Online ahead of print]S
- CONCLUSIONS: Lumbar MRI changes associated with nerve root compression were frequent, and their severity was mostly mild in general middle-aged population.
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- Impact of oncological biomarkers and clinical factors on survival outcomes in renal cell carcinoma with spinal metastasis: a retrospective analysis. [Journal Article]J Neurosurg Spine. 2026 Aug 14; :1-11. [Online ahead of print]JN
- CONCLUSIONS: Immunohistochemical biomarkers, particularly CK7, AE1/AE3, CAM5.2, and EGFR, hold significant prognostic value in RCC spinal metastasis and can help stratify patients into high- and low-risk groups. The integration of these biomarkers into tree-based machine learning models provides interpretable data-driven decision tools to support personalized surgical and systemic treatment planning. These findings warrant validation in larger multi-institutional prospective cohorts and further analysis of biomarker interactions.
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- What predicts prolonged length of stay after surgery for cervical spondylotic myelopathy? A QOD CSM study. [Journal Article]J Neurosurg Spine. 2026 Aug 14; :1-10. [Online ahead of print]JN
- CONCLUSIONS: In this large cohort of patients operated on for CSM, prior shoulder surgery, greater number of levels fused, and diabetes were significant positive predictors of prolonged LOS, while anterior approach surgery, radicular motor deficit, and higher baseline mJOA scores were predictive of a shorter inpatient stay. Patients with prior shoulder surgery and those with radicular motor deficit may represent distinct and clinically important subgroups within the broader CSM population. Machine learning models demonstrated excellent performance for predicting prolonged LOS from purely preoperative variables. The findings of this study may help enhance preoperative counseling, perioperative care, and resource utilization for CSM surgery.
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- Risk factors for mechanical failure involving the cervicothoracic junction following posterior cervical instrumentation. [Journal Article]J Neurosurg Spine. 2026 Aug 14; :1-8. [Online ahead of print]JN
- CONCLUSIONS: In the largest single-institution experience to date, this study identified construct-specific factors, including the UIV, LIV, and C7 pedicle screw placement, as independent predictors of mechanical failure in patients undergoing PCDF with constructs ending at or beyond the CTJ.
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- The utility of the Risk Assessment and Prediction Tool in predicting discharge disposition, length of stay, and readmissions in patients undergoing transforaminal lumbar interbody fusion. [Journal Article]J Neurosurg Spine. 2026 Aug 14; :1-7. [Online ahead of print]JN
- CONCLUSIONS: In patients undergoing TLIF, higher preoperative RAPT scores were associated with greater odds of home discharge and shorter LOS. RAPT may serve as a practical preoperative tool to support discharge planning and resource allocation in spine surgery.
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- Response to the Letter Regarding "Influence of Preoperative Mental Health on Surgical and Clinical Outcomes in Degenerative Cervical Myelopathy": A Multicenter Prospective Cohort Study. [Journal Article]Spine (Phila Pa 1976). 2026 Aug 13. [Online ahead of print]S
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- Proximal Junctional Failure After Adult Spinal Deformity Surgery: A Systematic Review and Meta-analysis of Predictive Risk Factors. [Journal Article]Spine (Phila Pa 1976). 2026 Aug 13. [Online ahead of print]S
- CONCLUSIONS: PJF after ASD surgery reflects the interaction between sagittal misalignment, correction strategy, and junctional structural capacity. Continuous bone quality measures, particularly opportunistic Hounsfield unit assessment, show potential for risk stratification and may inform targeted preventive strategies in biologically vulnerable patients, pending prospective validation.
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- Declining Reimbursement, Shifting Surgical Workforce, and Geographic Disparities in Lumbar Laminectomy: A Medicare Analysis, 2013-2023. [Journal Article]Spine (Phila Pa 1976). 2026 Aug 12. [Online ahead of print]S
- CONCLUSIONS: Lumbar laminectomy utilization and surgeon reimbursement declined substantially among Medicare FFS beneficiaries from 2013 to 2023 and geographic disparities in utilization persisted throughout the study period. These findings highlight ongoing workforce and access concerns in lumbar spine surgery. However, these findings reflect trends specific to the fee-for-service Medicare population and should not be interpreted as a decline in lumbar decompression access across all Medicare beneficiaries, given the concurrent expansion of Medicare Advantage enrollment during the study period.
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- Letter to the Editor Regarding "Bone Health Medication Following Low Energy Thoracic and Lumbar Fractures". [Journal Article]Spine (Phila Pa 1976). 2026 Aug 12. [Online ahead of print]S
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- Impact of Preoperative Intramedullary T2 Signal Intensity Changes on Surgical Outcomes in Cervical Spondylotic Myelopathy: A Multicenter Prospective Study. [Journal Article]Spine (Phila Pa 1976). 2026 Aug 12. [Online ahead of print]S
- CONCLUSIONS: Preoperative intramedullary T2 SI was associated with greater preoperative upper extremity pain/numbness, and with a greater preoperative C2-7 angle. However, after adjustment for confounders, the binary presence of intramedullary T2 SI was not statistically significantly associated with worse 2-year neurological, functional, or patient-reported outcomes.
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