Spine – Pubmed Results

CONCLUSION: The MEC(90) of ropivacaine for spinal anesthesia in IELD was 9.474 mg/3 mL, the clinically recommended dose was 9.5 to 10.5 mg/3 mL.

CONCLUSIONS: We hypothesize that the suture-anchor technique is non-inferior to the clip-plate system regarding neurological recovery and laminar stability. By rigorously comparing these techniques, this trial seeks to establish high-level evidence for a surgical strategy that maintains clinical standards while potentially reducing healthcare costs.

CONCLUSION: This case highlights operative considerations when using intravertebral stents in a young adult trauma patient, using cancellous allograft with posterior fixation for immediate stability.

BACKGROUND Although pedicle screw fixation is widely used in lumbar spinal fusion, screw loosening, which is well described in patients with osteoporosis, remains a clinically relevant yet insufficiently investigated problem in individuals without osteoporosis, particularly regarding revision strategies and risk factors for recurrence. This study aimed to identify risk factors for recurrent pedicle screw loosening after revision surgery for lumbar spinal stenosis using bone grafting, cement...

CONCLUSIONS: Among anesthesia residents, adjunctive VR simulator training improves the technical and cognitive performance in neuraxial ultrasound compared with traditional didactic teaching alone.

Background and objectives Minimally invasive spinal techniques aim to reduce tissue trauma while maintaining surgical efficacy. Comparative evidence integrating early biochemical muscle injury markers with long-term clinical and imaging outcomes remains limited. This study evaluated postoperative day 3 biochemical responses, and one-year clinical and MRI-based imaging changes between microsurgical lumbar discectomy (MLD) and percutaneous endoscopic lumbar discectomy (PELD). Methods 192 patients...

We evaluated the clinical outcomes and limitations of anterior and posterior combined surgery with a mini-open corpectomy applying an expandable cage (Xcore®) and percutaneous pedicle screw (PPS) fixation using single-position surgery in the lateral decubitus position in patients aged > 75 years with thoracolumbar vertebral collapse. The cases of 30 consecutive patients who underwent this procedure and had ≥ 1-year follow-up were retrospectively analyzed. The mean operative time was 78.8 min and...

CONCLUSION: The ESPB in single-level lumbar discectomies was associated with a lower NLR, an established indicator of inflammation. Additionally, ESPB provided lower postoperative opioid requirements and pain scores.

Customized 3D-printed cervical orthoses usually offer better fit and support. However, clinical evidence regarding the effectiveness of immobilization and comfort remains limited. This study aims to compare the effectiveness of custom-made cervical orthoses with that of commercially available orthoses in preventing pressure ulcers (PUs), improving immobilization, and providing comfort and ease of use. We measured the risk of PUs associated with six neck postures to assess comfort and...

CONCLUSION: The fusion of spectral ED and VNCa images could show potential in improving the visualization of the ice-ball during bone cryoablation.

CONCLUSION: Women and Medicare/Medicaid patients experience poorer postoperative outcomes, with increased ED visits and readmissions after lumbar fusion surgery. Race did not significantly affect outcomes, although small sample sizes may have limited this analysis.

Background It is unknown whether subclinical emphysema-like changes, quantified at chest CT, are associated with loss of bone mineral density (BMD) in individuals without clinical chronic obstructive pulmonary disease (COPD). Purpose To identify early imaging markers of lung and bone health using deep learning-based imaging analysis in a large multiethnic cohort. Materials and Methods Chest CT scans obtained using the SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS)...

CONCLUSION: The MILD® procedure is a safe and effective treatment for LSS, providing significant and sustained improvements in pain and function, making the technique particularly suitable for patients ineligible for surgery or at higher risk of experiencing complications from it.

CONCLUSIONS: Patients who have HLF-caused LSCS, are unresponsive to conservative treatment, and are poor surgical candidates can undergo mild® safely. This study showed significant improvement in VAS pain scores, walking distance, and standing time at intervals of one month, one-6 months, and 6-12 months.

CONCLUSION: A combination of PKP and PVB can significantly improve the pain relief rate and the quality of life in the early postoperative period of patients with thoracic vertebral fractures and costal pain.

Based on the theory of ″Qu-Zhi-Bu-Yi″, this study aimed to investigate the optimal compatibility ratio of Angelicae Pubescentis Radix and Taxilli Herba for preventing and treating pressure-induced human nucleus pulposus(NP) cell apoptosis, and to elucidate the mechanisms. A human NP cell apoptosis model was established using abnormal mechanical pressure at 1.0 MPa. The concentration ratios of quercetin, osthole, and columbianadin were screened by the orthogonal experimental design. Cell...

Accurate vertebrae detection with precise keypoint localization is essential for medical image analysis and clinical applications, such as spinal alignment assessment. This study presents a controlled, task-driven comparison of four pose-based deep learning models for vertebrae detection and keypoint estimation: YOLOv8n-Pose, YOLOv11n-Pose, and Detectron2 (Keypoint R-CNN) with ResNet-50 and ResNet-101 backbones. A single-class vertebrae dataset with bounding box annotations and four anatomically...

CONCLUSION: Within our short-to-medium-term observation period, PELD-LA delivered clinical efficacy comparable to GA-based endoscopic procedures for octogenarians, while significantly reducing perioperative complications and accelerating recovery. Crucially, we do not assert that PELD-LA is universally superior; rather, we emphasize the importance of tailored patient selection. For frail patients with limited physiological reserve, PELD-LA serves as a physiologically rational strategy, balancing...

Cervical spine reconstruction is essential following en bloc tumor resections, particularly in defects exceeding four centimeters. Traditional mechanical solutions or non-vascularized grafts are often suboptimal, with complications such as non-union, infections, and instability. The vascularized osteoadipofascial fibular flap offers a durable alternative with structural and biological benefits. We present the case of a 55-year-old woman with an 8-month history of cervicobrachialgia and left...

An 8-year-old neutered male Australian Shepherd was presented for evaluation of acute lumbosacral pain and reluctance to walk. Magnetic resonance imaging (MRI) of the lumbar spine revealed a well-demarcated, extradural-extramedullary left lateralized mass extending from L6 to L7 vertebrae, displacing and compressing the conus medullaris and the cauda equina, including the left sciatic nerve roots. The mass was T1-weighted hypointense, T2-weighted, and STIR homogeneously hyperintense, with...

Cervical dysphagia is an uncommon but clinically significant cause of chronic swallowing difficulty that is frequently overlooked during routine otolaryngologic and gastrointestinal evaluations. Degenerative cervical spine conditions, such as cervical spondylosis and anterior longitudinal ligament calcification, may compress the esophagus and impair swallowing function. The primary goal of this protocol is to provide a standardized, diagnostic, and management workflow for identifying cervical...

CONCLUSIONS: For adults with lumbar degenerative disease who underwent lumbar surgery, exercise, especially supervised programs, improved trunk extension endurance in the immediate term. Psychologically informed rehabilitation and prehabilitation increased physical activity levels in the intermediate term, while physical activity advice showed no benefit. Findings are limited by low certainty of evidence and high risk of bias.

Atlantoaxial rotatory subluxation (AARS) represents a significant cause of acute torticollis in children involving rotational displacement of C1 on C2. Unlike common idiopathic torticollis, AARS represents a true subluxation that frequently necessitates reduction by an experienced provider to restore alignment. Here, we present the case of a child who developed AARS after falling out of bed. A CT scan confirmed acute C1-C2 rotatory subluxation. The patient was successfully treated with closed...

CONCLUSION: The clinical efficacy of PPECD and microscope-assisted ACDF are both satisfactory. The findings suggest comparable short-term clinical improvement between the two groups. Both ACDF and PPECD resulted in significant improvement in clinical outcomes at 12 months postoperatively. While perioperative metrics favored PPECD, the findings suggest comparable short-term clinical improvement between the two groups.

CONCLUSION: Experimentally induced acute pain exerted no detectable effect on lumbar movement control. Across analyses, performance remained stable, indicating short-term robustness to transient nociceptive input.

Isolated hypoglossal nerve injury is an infrequent occurrence in clinical and forensic traumatology practice. Its etiology includes trauma, malignancy, vascular events, autoimmune diseases, and complications of surgical procedures. Clinical manifestations resulting from nerve damage may present early or be delayed. We present the case of a 44-year-old woman who sustained a fracture of the third cervical vertebra following a traffic accident. An anterior approach was employed for instrumentation...

CONCLUSION: The effects of preoperative physiotherapy, compared with usual care, on pain, disability, and hospitalisation among patients with DDLS, are minimal. However, the risk of bias of the included studies and the certainty of evidence, based on the GRADE approach, were very low. Future high-quality, low-bias trials are needed to clarify its effectiveness and identify patient subgroups that may benefit the most.

RATIONALE: Percutaneous endoscopic lumbar discectomy is widely performed under general anesthesia. Acute intracranial hypertension caused by massive cerebrospinal fluid loading via an unrecognized dural tear is an under-reported, potentially fatal complication that may be masked by anesthesia.

CONCLUSION: TTCP demonstrated promising biomechanical and biophysiological properties for vertebral augmentation. However, its use in infected sites and in the presence of metabolic bone disorders may be limited. Further clinical studies are required to validate its long-term efficacy.

CONCLUSION: OLIF combined with interspinous fixation, particularly ISFS + LSF, provides a favorable biomechanical profile by enhancing segmental stability and reducing implant-related stress concentrations, while preserving adjacent segment kinematics. ISFS + LSF may serve as a less invasive alternative to BPSF, offering balanced stability and load sharing. ISFS alone is suitable for flexion-dominant loading environments, whereas BPSF remains the most robust option for multiplanar stability at...

CONCLUSION: Resistance to reforming immobilisation practice is unlikely to yield to evidence translation alone. Effective change requires explicit engagement with the evolutionary, historical, linguistic, and cognitive determinants of cervical injury fear, alongside the evidential case for gentle patient handling.

A branchial cleft cyst (BCC) is a neck mass, present from birth, caused by incomplete development of the branchial arches during fetal development. It commonly presents as a solitary, painless mass in the neck of a child or young adult. We present a case of a large intramedullary BCC in a patient with Klippel-Feil syndrome (KFS). A male in his 60s presented with long-lasting neck pain and fast-progressing paraparesis. MRI showed a large intramedullary cystic tumour in the cervicothoracic spine...

CONCLUSIONS: Compared with open surgery, UBE-ULBD demonstrated superior perioperative outcomes, greater early decompression, and improved early Macnab efficacy in patients with severe LSS, supporting its potential as a minimally invasive treatment option.

CONCLUSIONS: Posterior approaches-particularly the PSARP-type-provide safe, effective, and functionally favorable alternatives to anterior surgery for ASM, offering optimal exposure, precise dural closure, superior cosmetic outcomes with minimal morbidity. The anterior route should be reserved for large or high-lying lesions. Further multicenter studies with longer follow-up are warranted.

CONCLUSION: In this paediatric cohort, vertebral body dimensions were more strongly associated with age than spinal canal dimensions. Ethnicity was associated with modest differences in cervical spine morphology, particularly transverse vertebral body diameter. These findings suggest cervical spine development is multifactorial and may have implications for trauma assessment and spinal cord injury risk evaluation in adolescents. Further studies incorporating anthropometric and sex-specific...

Objective: To compare the clinical outcomes of modified full-endoscopic foraminotomy versus conventional foraminotomy in the treatment of lumbar foraminal stenosis. Methods: A retrospective analysis was conducted on the clinical data of patients who underwent uniportal full-endoscopic foraminotomy for foraminal stenosis at Beijing Friendship Hospital between January 2022 and December 2023. The patients were divided into two groups based on whether sublaminar resection of the superior vertebral...

Objective: To investigate the differences in imaging and clinical efficacy between simple decompression and short-segment internal fixation in the treatment of patients with degenerative scoliosis accompanied by lumbar spinal stenosis with a coronal Cobb angle<20°. Methods: A retrospective analysis was conducted on 80 patients diagnosed with degenerative scoliosis complicated by coronal deformity who were admitted to the Department of Spinal Surgery, Tianjin Union Medical Center, between January...

Low back pain is common in road cyclists and has been associated with prolonged lumbar flexion during cycling. The flexion-relaxation (FR) phenomenon reflects neuromuscular control of the lumbar spine, but its response to prolonged cycling under physiologically individualized conditions remains unclear. Thirty-one pain-free road cyclists completed a laboratory protocol in which exercise intensity was prescribed at 50% of the range between the first and second ventilatory thresholds (VT1 and...

CONCLUSIONS: In older patients with mCRC, early post-chemotherapy skeletal muscle loss-particularly at the L3 level-showed the strongest prognostic association with severe toxicity and mortality. GNRI provided complementary prognostic information as a marker of baseline immunonutritional reserve. Although T12-derived measurements were correlated with L3-derived values, systematic bias suggests that they should not be interpreted interchangeably for longitudinal risk stratification.

CONCLUSION: This study highlights the association between cervical pain and reduced mobility among drivers, particularly motorbike drivers. Although causality cannot be determined, the findings support ergonomic interventions and driver education to promote better postures and musculoskeletal health.

CONCLUSION: Expanding the lamina formation range in UBE spine surgery can lead to reduced stability in flexion and left rotation activities at L (5), S (1), increasing the mechanical load on the intervertebral disc and facet joints. Clinically, under the premise of achieving adequate decompression, prioritizing a forming range corresponding to the lower transverse width partition (25%-50%) may better balance decompression efficacy with biomechanical stability of the L (5), S (1) segment, thereby...

CONCLUSION: In comparison to simple lumbar discectomy, endoscopic lumbar discectomy with annular suturing for LDH not only yields comparable short-term effectiveness but also significantly mitigates the postoperative intervertebral disc height collapse, preserves spinal stability, and decelerates the progression of disc degeneration.

CONCLUSION: The incidence of SFJF following posterior internal fixation for lumbar burst fractures is high, with most fusion processes occurring within the first 6 months after operation. Segmental motion function decreases significantly with increasing fusion grade. Incorporating SFJF assessment into the decision-making process for implant removal in these patients is recommended.

Ultrasound enables radiation-free longitudinal monitoring of scoliosis, but rib shadowing and speckle noise often obscure vertebral structures. Current deep-learning methods present results in terms of localisation accuracy, without directly measuring anatomical completeness. We introduce a vertebra-level completeness model that includes a YOLO-based detection framework and an explicit representation of completeness, the Vertebra Presence Matrix (VPM). The VPM provides visibility into detections...

CONCLUSION: Consistency between the surgeon's dominant hand side and the surgical approach side significantly improves core endoscopic operational efficiency and surgical fluency in UBE lumbar discectomy, without compromising clinical efficacy or safety. It is suggested that this matching factor should be prioritized in surgical scheduling and beginner training to optimize the operative experience and shorten the learning curve.

Enterococcus cecorum has become a significant pathogen of broilers and broiler breeders worldwide, and there are few effective prevention, treatment, or control measures. Improved, preferably nonantibiotic tools are needed to control the disease. Two pen trials were conducted to assess the effectiveness of a day-of-age probiotic and a continuous direct fed microbial (DFM) in preventing colonization of the spleen and free thoracic vertebra after challenge with pathogenic E. cecorum in commercial...

In ovo vaccination is an effective method of immunization that allows protection early in the life of the chick but requires precision during the administration. This present report describes an occurrence of cervical vertebral malformations in broiler chicks that coincide with mechanical failure of an in ovo vaccination system, in the absence of other detected infectious, nutritional, or toxic etiologies. Cervical scoliosis was observed in 2%-8% of chicks at hatch or within days post hatch in...

Objective. Generalisation of synthetic CT (sCT) generation to diagnostic MRI data in the spine faces many challenges, particularly when aiming at accurate visualisation of pathologies for orthopaedic treatment management. In this study we assessed the effect of potential confounding factors on the performance of sCT generation from diagnostic MR images.Approach. Paired spinal diagnostic MR and CT scans from two centres (51 patients) were collected retrospectively, spanning multiple spinal...

Subacute post-traumatic ascending myelopathy (SPAM) is a rare but devastating complication of spinal cord injury (SCI). It is character-ized by progressive neurological deterioration extending several segments above the primary lesion within days to weeks after trauma. The underlying pathophysiology remains uncertain, and treatment strategies are not standardized. A 38-year-old man sustained trau-matic C6-7 spondylolisthesis with bilateral facet dislocation following a motorcycle accident....

Standalone cervical laminectomy is frequently performed in elderly patients with degenerative cervical myelopathy (DCM), yet practical prognostic determinants remain limited. We examined whether the preoperative T1 slope minus cervical lordosis (T1S-CL) predicts 2-year clinical outcomes and yields clinically useful decision thresholds. In this retrospective cohort of elderly DCM patients who underwent multilevel standalone laminectomy with a minimum 2-year follow-up, outcomes were assessed using...