Surgical Techniques – Pubmed Results

CONCLUSIONS: Both posterior-only and combined anterior-posterior fixation show broadly similar neurological, radiological, and functional outcomes in thoracolumbar burst fractures. Posterior-only fixation was associated with perioperative advantages and a lower risk of pulmonary complications. Surgical decision-making should therefore be individualized based on fracture morphology, neurological status, and patient-specific factors, particularly given that most included evidence remains...

CONCLUSION: According to our retrospective study, with vitamin D supplementation, careful patient rotation, and complex intensive care, the rate of thoracic spine fractures in patients with very severe COVID pneumonia can be reduced to below 1%.

The accurate quantification of trunk muscle biomechanics during alpine skiing remains challenging, primarily owing to the inconsistent validation of core muscle activation patterns in existing musculoskeletal models under three-dimensional dynamic conditions. Therefore, we developed a static optimization with summed equilibrium equation (SO-SEE) algorithm for a kinematic-coupled lumbar spine musculoskeletal model and applied it to alpine skiing. The algorithm consolidated individual...

To investigate the impact of cervical paraspinal muscle characteristics on early implant subsidence following single-level anterior cervical corpectomy and fusion (ACCF). A retrospective analysis was conducted on 110 patients who underwent single-level ACCF with titanium implants. The cross-sectional area (CSA) of paraspinal muscles was measured on preoperative magnetic resonance imaging (MRI), and the deep-to-superficial extensor muscle ratio (DSR) was calculated. Sagittal alignment...

Anterior lumbar interbody fusion (ALIF) is widely used for degenerative lumbar disc disease, offering restoration of disc height and sagittal alignment. However, pseudarthrosis remains a relevant complication, and the benefit of supplemental posterior fixation over stand-alone constructs is still debated. To compare the incidence of pseudarthrosis following stand-alone ALIF versus ALIF combined with posterior pedicle screw fixation. A systematic review and meta-analysis were conducted in...

INTRODUCTION: Fighter pilots are exposed to high +Gz forces, helmet-mounted equipment, and extreme head positions that potentially cause cervical spine degeneration and pain. This study aimed to investigate whether individual +Gz exposure, quantified by Fatigue Index (FI), predicts cervical spine degenerative changes and neck pain over a 10-yr follow-up.

CONCLUSION: The adjunctive use of tendon-regulating and bone-setting manipulation on top of conventional rehabilitation is more effective than conventional rehabilitation alone in alleviating pain, improving functional status, and correcting lumbopelvic sagittal imbalance in LDH patients after TLIF surgery.

CONCLUSION: Both manipulations can enlarge the space between the intervertebral disc and the nerve roots, with the complex manipulation demonstrating superior biomechanical decompression effects. This study not only verifies the biomechanical mechanisms of the two Traditional Chinese Medicine manipulations but also provides a reproducible and extensible three-dimensional finite element model for subsequent related clinical and mechanical research, possessing certain promotional value and...

CONCLUSION: Compared with the combination of intravenous TXA and gelatin sponge, the use of intravenous TXA combined with local Surgiflo^(TM) in single-level TLIF significantly reduces postoperative drainage and perioperative blood loss, shortens both operation time and extubation time, without increasing the risk of wound complications or deep vein thrombosis.

CONCLUSION: The use of a self-designed intracorporeal bone graft device for transpedicular autografting combined with osteoinductive materials and pedicle screw fixation effectively restores vertebral height, reconstructs anterior and middle column stability, prevents postoperative correction loss, and preserves spinal mobility in patients with fresh thoracolumbar burst fractures, yielding satisfactory clinical outcomes.

CONCLUSION: For lumbar facet joint disorders, coblation radiofrequency ablation combined with ozone injection demonstrates superior efficacy to monotherapy, providing more effective pain relief, higher excellent/good rates, and excellent safety.

CONCLUSION: Site-specific HU measurement at the posterior endplate is superior to traditional methods for predicting cage subsidence following TLIF. Combining this metric with the VBQ score further enhances predictive efficacy. However, standardized measurement protocols and multicenter validation are still required to confirm these findings and establish their clinical utility.

CONCLUSION: Under strict adherence to indications and preoperative risk assessment, manual reduction combined with anterior surgery effectively relieves facet locking, decompresses the spinal cord, restores spinal stability, and promotes neurological recovery. This combined strategy is a feasible option for selected patients with cervical dislocation and facet locking.

Currarino syndrome is a rare condition with an incidence of approximately 1 in 100,000. It is characterised by the triad of a sacral defect, a presacral mass and anal atresia or stenosis, and it is commonly associated with genetic mutations in the MNX1 gene.We report a case of an infant presenting with recurrent right gluteal abscess secondary to an infected sacrococcygeal teratoma, associated with anal stenosis. Extensive workup was performed to investigate for the source of her recurrent...

CONCLUSIONS: Surgimap Spine plan was relatively the most reliable and accurate approach to predict the PSO angle and achieve proper postoperative sagittal alignment for AS patients in comparison to other methods. Predetermined PT using the equation PT = (0.47 × PI - 7.5) and well-defined criteria (SSA > 108°, SPA > 152°, and TPA < 22°) could improve the predictive values.

CONCLUSION: The addition of fracture-level screws to SPSF improved long-term sagittal alignment and maintenance of vertebral height and was associated with less severe postoperative disc degeneration.

CONCLUSION: Intradiscal gentamicin may be effective in reducing the incidence of postoperative discitis following open microdiscectomy.

CONCLUSION: ACDF was associated with substantial pain relief, neurological recovery, and high fusion rates at 12 months with acceptable complication rates.

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Spinal surgery is primarily performed to improve neurological function; compared with intracranial surgery, it is rarely conducted to address life-threatening conditions. As the goal of treatment is functional recovery, postoperative complications must be minimized. Appropriate perioperative management is therefore essential, and includes careful preoperative neurological evaluation; postoperative monitoring of neurological, respiratory, and circulatory status; and early detection and management...

CONCLUSION: Lumbar fusion was associated with a small increase in hip fracture risk, with long constructs conferring substantially higher risk in adults < 65.

To assess a robotic-assisted system versus open manual techniques to: (1) compare pedicle screw accuracy between fellows and attendings with and without robotic assistance, and (2) evaluate executed versus planned trajectory fidelity relative to prior reports. Robotic-assisted spine systems aim to improve the accuracy, reproducibility, and safety of pedicle screw placement. Limited evidence compares outcomes across differing surgeon experience levels. A total of 255 thoracolumbar pedicle screws...

Oblique Lumbar Interbody Fusion (OLIF) is widely used minimally invasive techniques for lumbar degenerative diseases. While neurological complications are recognized, they predominantly affect the ipsilateral lumbar plexus. Contralateral L4 nerve root compression is an exceptionally rare and often overlooked complication, with limited understanding of its biomechanical mechanisms and sparse radiological evidence linking symptoms to specific causes. A 61-year-old female underwent L3/4 and L4/5...

RATIONALE: Chaetomium globosum (C. globosum) is a saprophytic fungus widely distributed in nature, characterized by low clinical pathogenicity but capable of causing severe infections, particularly in immunocompromised hosts or under conducive environmental conditions. Spinal infections attributable to C. globosum are exceedingly rare and often present diagnostic dilemmas due to atypical presentations. This case underscores the importance of considering fungal etiologies in spinal pathologies....

Epidural fibrosis (EF) refers to the non-physiological scar formation at the site where a surgical incision is made to access the spinal canal. This condition often results in functional disability and pain following spinal surgery and is a common and difficult-to-treat contributor to Failed Back Surgery Syndrome (FBSS). This study aimed to investigate the effectiveness of platelet-rich fibrin (PRF) clots, vein grafts, or a combination of both in reducing epidural fibrosis after laminectomy in...

CONCLUSIONS: TF-FESS under local anesthesia appears feasible, with no clinically significant complications observed in this cohort, irrespective of frailty status. Although the dosing thresholds were well-tolerated, they should be interpreted with caution given the study's retrospective nature. Adherence to weight-based dosing and a standardized conscious sedation protocol is associated with a favorable safety profile while preserving real-time neurological feedback. This strategy may minimize...

Entomologically induced bone modification is increasingly recognized in archaeological and palaeontological contexts yet remains rarely documented in forensic casework. We report an indoor forensic case of extensive vertebral destruction most consistent with arboreal nasutitermitine termites, herein reported as Nasutitermes sp. (Isoptera: Termitidae) in Martinique. A largely desiccated human skeleton, discovered in 2025 inside a locked residence, exhibited severe osteolysis of cervical vertebrae...

CONCLUSION: Severe fatty infiltration of cervical extensor muscles is associated with poorer neurological recovery, prolonged hospitalization, and sagittal imbalance after laminoplasty in elderly CSM patients. Preoperative MRI-based muscle quality assessment may improve risk stratification and guide surgical planning and postoperative rehabilitation.

CONCLUSION: This meta-analysis concluded that physical exercise improves pain-related outcomes in adult patients. Notably, the forest plot demonstrated a significant mean difference. These findings suggest that physical exercise is associated with a better prognosis in the treatment of lumbar disc herniation.

Lumbar disk herniation (LDH) is a common cause of low back pain and radiculopathy in athletes, particularly in contact sports. The unique biomechanical demands on the athlete's spine and the pressure for expedited return-to-play (RTP) create distinct challenges in management. This review summarizes the epidemiology, biomechanics, pathophysiology, clinical presentation, diagnosis, treatment options, return-to-play considerations, and outcomes of LDH in athletic populations. Lumbar disk herniation...

With recent advancements and growing literature on the treatment of cervical spine disease in athlete populations, there are new paradigms for treatment, either operatively or nonoperatively, to optimize return to play (RTP) and outcomes while minimizing complications. Although conservative management is effective in many cases, high-level athletes with persistent symptoms may benefit from early surgical intervention. Anterior cervical discectomy and fusion and cervical disc arthroplasty (CDA)...

CONCLUSION: Patients with concurrent ARM and SA represent a high-risk group for long-term bowel and bladder dysfunction, and many require structured bowel and/or bladder management. These findings support anticipatory counselling and multidisciplinary follow-up.

Background and Objectives: Spondylodiscitis is a severe spinal infection associated with substantial mortality. Standard diagnostic imaging is often limited to the symptomatic spinal segment, which may fail to detect infection foci in other spinal regions. The prevalence and prognostic significance of multifocal spondylodiscitis remain insufficiently characterized. Materials and Methods: A retrospective single-center cohort study was conducted at the University Medical Center Mannheim, Germany....

Intervertebral disc degeneration (IDD) is a fundamental pathological basis of low back pain, yet its pathogenic mechanisms remain incompletely understood. Infection by low-virulence anaerobic bacteria has recently been recognized as a potential etiological factor. In this study, Cutibacterium acnes (C. acnes) was detected in 13.7% of degenerated intervertebral disc (IVD) tissues, and its presence was significantly associated with younger patients and Modic changes. In vitro experiments...

Interbody fusion cages are widely used to restore spinal stability, yet conventional designs often exhibit mechanical mismatch and limited biological integration. Functionally graded spinal cages incorporate spatial variations in composition and structure to better align mechanical properties with the surrounding bone environment. Although these designs have been extensively studied from an engineering perspective, their biological implications remain less clearly defined. This review examines...

Many people suffer from cervical disc herniation, which significantly affects the lives of individuals, causing chronic pain and functional limitations. This paper presents the development and evaluation of an AI-powered inflatable neck collar designed to provide personalized and adaptive support for individuals experiencing neck pain, particularly those with disc herniations. The system seamlessly integrates motion sensors, a robust AI model trained on a dataset of MRI scans, and a...

CONCLUSION: Our findings demonstrate that radiomics derived from routine non-contrast CT, leveraging deep learning for automated bone compartment segmentation, offers a superior and practical tool for Early identification of high-risk individuals for thoracolumbar OVFs. This approach provides valuable, complementary information beyond vBMD, potentially enhancing clinical decision-making and reducing the burden of osteoporosis.

Lumbar degenerative diseases, primarily caused by pathological tissues compressing spinal nerves, typically necessitate surgical intervention-specifically lumbar nerve decompression-to alleviate pain. Although the anterior decompression approach demonstrates notable advantages, such as reduced bleeding and shorter postoperative hospitalization stays, compared with the conventional posterior approach, patients may still experience incomplete decompression because of various instrumental...

Body mass index (BMI) influences bone metabolism; however, its impact on romosozumab treatment response remains unclear. We investigated whether BMI independently predicts bone mineral density (BMD) response to romosozumab and re-examined the role of the outcome metric (absolute vs. percentage change) in generating the apparent BMI signal. This retrospective study analyzed 304 patients (97.4% female, mean age 76.8 years) with high-risk osteoporosis who completed 12-month romosozumab treatment...

Background and Objectives: Minimally invasive cervical spine surgery (MIS-CSS) relies heavily on intraoperative fluoroscopic imaging, raising concerns about radiation exposure to patients and surgical staff. Unlike lumbar MIS, cervical-specific radiation exposure has not been systematically reviewed, despite distinct anatomical considerations, including proximity to the thyroid gland and lens of the eye. This review aims to quantify intraoperative radiation exposure during MIS cervical spine...

Background and Objectives: Adolescent idiopathic scoliosis (AIS) may influence pelvic orientation and lower-limb alignment; however, data on coronal lower-limb alignment after completion of spinal treatment remain limited. This study aimed to evaluate lower-limb radiographic alignment in AIS patients after spinal treatment and to determine whether these parameters differ according to main curve location. Materials and Methods: In this retrospective study, 70 AIS patients treated surgically (n =...

Coccygodynia may arise from traumatic or nontraumatic causes and can become refractory to conservative treatments, for which coccygectomy may be required. Providing effective anesthesia for this procedure can be challenging. These case reports describe the use of an ultrasound-guided sacral multifidus plane block (SMPB) as the primary anesthetic technique for coccygectomy in two patients with chronic coccygodynia. SMPB provided adequate surgical conditions and postoperative analgesia without...

CONCLUSIONS: QCT-derived vBMD provides a phantom-calibrated, protocol-standardized metric for preoperative risk stratification of cage subsidence after OLIF.

In response to the challenges of insufficient precision and limited safety associated with traditional techniques in the diagnosis and treatment of complex spinal diseases, intelligent technologies-represented by 3D visualization, additive manufacturing (3D printing), surgical navigation and robotics, artificial intelligence, and telemedicine-are driving spine surgery into a new era of precision and personalized treatment. However, there is currently a lack of standardized protocols or...

CONCLUSION: Cervical spine complications following a diagnosis of CD may necessitate opioid therapy, nerve blocks, ablative procedures, and/or surgical interventions. In contrast to prior reports from the predominantly pre-BoNT era, which estimated complication rates of approximately 30%, our cohort, well managed with BoNT therapy, demonstrated a considerably lower risk of cervical spine complications (5.3%). These findings suggest that early initiation of BoNT therapy, by effectively...

Intervertebral disc degeneration (IDD) is characterized by the abnormal synthesis of extracellular matrix (ECM) proteins, increased inflammatory cytokines, and upregulated degradative enzymes. According to the Traditional Chinese Medicine (TCM) concept, the degenerative disease of the intervertebral disc falls under the heading of "stagnation syndrome." Bu-Shen-Huo-Xue-Fang (BSHXF) is commonly applied to the treatment of IDD. In the present study, IDD models were established in rats, and...

CONCLUSION: CDS associated with LMMC and tethered cord represents a rare but clinically significant subset. Even in neurologically intact patients, radiological confirmation of tethering may justify early surgical intervention to prevent future neurological deterioration. Careful radiological assessment and multidisciplinary coordination are essential to optimize long-term functional outcomes.

Pedicle screw fixation is the gold standard for thoracic spine stabilization, but its accuracy is critical due to neurological and vascular complication risks. Robotic-assisted techniques show promise in improving accuracy and reducing radiation, but thoracic-specific evidence is limited. This prospective multicentric observational cohort study involves 6 high-volume centers. 100 adult patients (18-65 years) undergoing robot-assisted thoracic pedicle screw fixation will be recruited. The...

This study aims to evaluate the efficacy of percutaneous vertebroplasty in treating compression fractures of the thoracolumbar spine in elderly patients and to analyze factors influencing the improvement of postoperative kyphotic deformity. A retrospective review was conducted of 106 patients treated with percutaneous cement injection at our hospital from January to December 2024. Preoperative and 3-month postoperative measurements included anterior/mid-height ratio of the injured vertebra,...

To investigate whether specific morphological parameters of the cervical vertebral lamina and spinous processes are associated with cervical spondylosis (CS) in a northeast Chinese population. This retrospective observational study reviewed cervical computed tomography images acquired between August 2022 and August 2025. Patients were divided into a CS group and a control group according to clinical diagnosis. Seven parameters from C3 to C7 were measured: lamina length, lamina width (LW),...