Impact of the Spinal Instability Neoplastic Score on Postoperative Prognosis in Patients with Metastatic Cancer of the Cervical Spine.

Although the Spinal Instability Neoplastic Score (SINS) is widely utilized to evaluate spinal instability, its prognostic value for survival in patients with cervical spinal metastases remains unclear. This study investigated the association between the SINS and survival outcomes in patients with metastatic cervical spine cancer. This retrospective cohort study included 106 patients who underwent surgery for metastatic cervical spine cancer at a single institution between 1995 and 2023.

Proximal Junctional Failure Development Despite Achieving Ideal Sagittal Correction According to Age-Adjusted Alignment Target in Patients With Adult Spinal Deformity: Risk Factor Analysis of 196 Cases Undergoing Low Thoracic to Pelvic Fusion.

Objective: To identify the risk factors for proximal junctional failure (PJF) after adult spinal deformity (ASD) surgery despite ideal sagittal correction according to age-adjusted alignment target.

Methods: The study included patients who underwent low thoracic to pelvic fusion for ASD and obtained ideal correction according to age-adjusted pelvic incidence minus lumbar lordosis. PJF was defined either radiographically as a proximal junctional angle (PJA) of >28° plus a difference in PJA of >22° or clinically as revision surgery for proximal junctional complications.

Postsurgical outcomes differ according to baseline sagittal alignment status even in patients achieving adequate correction relative to age-adjusted alignment target for adult spinal deformity.

Background Context: Baseline severities of sagittal malalignment and degrees of pelvic compensation may affect postsurgical outcomes differently after adult spinal deformity (ASD) surgery, even if the patients achieved optimal correction of sagittal malalignment.

Purpose: To investigate whether postsurgical outcomes vary according to baseline sagittal alignment and pelvic compensation status in patients achieving adequate correction relative to age-adjusted alignment target in ASD surgery.

Study Design/setting: Retrospective study PATIENT SAMPLE: Patients who underwent ≥ 5-level fusion to the pelvis for ASD; achieved matched correction relative to age-adjusted pelvic incidence (PI)-lumbar lordosis (LL); and completed ≥ 2-year follow-up.

Multidisciplinary Digital Therapeutics for Chronic Low Back Pain Versus In-Person Therapeutic Exercise with Education: A Randomized Controlled Pilot Study.

Chronic lower back pain (CLBP) is a global health issue leading to significant disability and socioeconomic burden. Traditional treatments, including exercise and cognitive behavioral therapy (CBT), are often limited by physical and temporal constraints. This study aimed to evaluate the efficacy of multidisciplinary digital therapeutics (MORA Cure LBP) compared to conventional treatments.

Incidence and Risk Factors of Recurrent Proximal Junctional Failure in Adult Spinal Deformity Surgery.

Study Design: Retrospective cohort study.

Objectives: This study aimed to examine the incidence and risk factors for recurrent proximal junctional failure (R-PJF) in adult spinal deformity (ASD) surgery.

Methods: Among 482 patients receiving ≥ five-level fusion to the pelvis for ASD, 60 patients who underwent fusion extension surgery for PJF were included in the study cohort.

The Incidence and Risk Factors of Symptomatic Local Recurrence Following Surgical Treatment for Spinal Metastasis with Involvement of All Three Columns: Focusing on the Extent of Tumor Removal.

Backgroud: Although symptomatic local recurrence (SLR) of spinal metastasis is relatively common after aggressive surgery, there have been few studies on SLR according to the extent of tumor removal. This study aimed to evaluate the incidence of SLR after surgery in spinal metastasis and analyze the risk factors of SLR.

Methods: This study included patients with spinal metastasis to all 3 vertebral columns.

Anterior column realignment better restores sagittal alignment but carries higher risk of mechanical failures than lateral lumbar interbody fusion in patients with degenerative sagittal imbalance.

Background Of Context: Anterior column realignment (ACR), a modified lateral lumbar interbody fusion (LLIF), is an emerging, less invasive technique that allows greater lordosis correction by releasing anterior longitudinal ligament. However, long-term results have been poorly documented with regard to mechanical failure, such as proximal junctional kyphosis (PJK) and rod fracture (RF), and clinical outcomes.

Purpose: To compare the outcomes, primarily mechanical failure, in patients with degenerative sagittal imbalance (DSI) treated with ACR versus LLIF alone.

Survival and Prognostic Factors After Surgery in Single Spinal Metastasis: Comparison of Isolated-Single Spinal Metastasis and Single Spinal Metastasis With Other Metastasis.

Study Design: Retrospective cohort study.

Objectives: This study aimed to evaluate the survival period in patients with a single spinal metastasis (SSM), subsequently comparing those with isolated-single spinal metastasis (I-SSM) and single spinal metastasis with other metastasis (O-SSM) after surgery, and to identify prognostic factors affecting their survival.

Methods: A total of 135 patients were included, with 24 patients in the I-SSM group and 111 in the O-SSM group.

Posterior aggressive debulking versus minimal decompression surgery in patients with metastatic spinal cord compression: propensity-score-matching analysis from a multicenter study cohort.

Objective: The goal of this study was to evaluate the comparative outcomes of aggressive debulking (AD) and minimal decompression (MD) surgeries for metastatic spinal cord compression based on surgical burden, functional improvement, and symptomatic local recurrence (SLR).

Methods: In this retrospective analysis from 2 tertiary hospitals, the authors assessed patients with metastatic spinal cord compression treated via AD and MD surgeries between 2010 and 2022. The evaluation included patient demographics, Eastern Cooperative Oncology Group performance status (ECOG-PS), primary tumor type, modified Tokuhashi scores, surgical burden, and SLR.

Validation of Sagittal age-adjusted Score in Predicting Proximal Junctional Kyphosis/Failure and Clinical Outcomes Following Adult Spinal Deformity Surgery.

Study Design: Retrospective study.

Objectives: To validate the sagittal age-adjusted score (SAAS) in predicting proximal junctional kyphosis/failure (PJK/F) and good clinical outcomes following adult spinal deformity (ASD) surgery.

Summary Of Background Data: SAAS is a relatively new assessment system that incorporates age-adjusted sagittal parameters of pelvic incidence (PI) - lumbar lordosis (LL), pelvic tilt (PT), and T1 pelvic angle (TPA) to predict the PJK/F.

Effects of the Severity of Stenosis on Clinical Outcomes of Indirect Decompression Using Oblique Lumbar Interbody Fusion.

No consensus has been reached regarding the efficacy of indirect decompression through oblique lumbar interbody fusion (OLIF) in severe lumbar spinal stenosis (LSS). This study investigated the impact of preoperative magnetic resonance imaging (MRI)-based grading of central and foraminal stenosis on OLIF outcomes in LSS patients and identified risk factors for postoperative clinical dissatisfaction. We retrospectively reviewed LSS patients who underwent OLIF with a minimum 1-year follow-up.

Risk Factors for Recurrent Proximal Junctional Failure Following Adult Spinal Deformity Surgery: Analysis of 60 Patients Undergoing Fusion Extension Surgery for Proximal Junctional Failure.

Background: Despite numerous studies identifying risk factors for proximal junctional failure (PJF), risk factors for recurrent PJF (R-PJF) are still not well established. Therefore, we aimed to identify the risk factors for R-PJF following adult spinal deformity (ASD) surgery.

Methods: Among 479 patients who underwent ≥5-level fusion surgery for ASD, the focus was on those who experienced R-PJF at any time or did not experience R-PJF during a follow-up duration of ≥1 year.

Incidence and Risk Factors for Mechanical Failure After Anterior Column Realignment in Adult Spinal Deformity Surgery.

Study Design: Retrospective study.

Objectives: To investigate the incidence and risk factors of mechanical failure (MF) following anterior column realignment (ACR) in patients with severe degenerative sagittal imbalance (DSI).

Summary Of Background Data: Considering the biomechanical properties of the procedure, ACR may increase the risk of MF, including proximal junctional kyphosis (PJK) and rod fracture (RF).

Surgical Interventions Following Radiotherapy in Spinal Metastases with Intermediate Instability: A Risk Factor Analysis: The Korean Society of Spinal Tumor Multicenter Study (KSST 2022-02).

Background: One important determinant in choosing a treatment modality is spinal instability. Clear management guidelines are suggested for stable and unstable spinal metastatic lesions, but lesions in the intermediate instability category (SINS [spinal instability neoplastic score] score of 7-12) remain a clinical dilemma. This study aims to analyze the risk factors necessitating surgical intervention after radiotherapy (RT) in patients with those lesions.

The Optimal Lowest Instrumented Vertebra to Prevent the Distal Adding-On Phenomenon in Patients Undergoing Selective Thoracic Fusion for Adolescent Idiopathic Scoliosis with Lenke Type 1A and 1B Curves: Comparison of Nine Selection Criteria.

: There is no solid consensus regarding which lowest instrumented vertebra (LIV) selection criterion is best to prevent distal adding-on (DA) after adolescent idiopathic scoliosis (AIS) surgery. This study aims to search out the LIV selection criteria in the literature and to compare the ability of each LIV selection criterion to prevent DA in patients with AIS. : Patients who underwent thoracic fusion for AIS of Lenke type 1A or 1B were included in this study.

Are Surgical Outcomes Different According to Baseline Balance Status in Elderly Patients with Degenerative Sagittal Imbalance?

Study Design: Retrospective study.

Objective: We sought to compare surgical outcomes according to baseline balance statuses in elderly patients with degenerative sagittal imbalance (DSI).

Summary Of Background: Although optimal sagittal correction has been emphasized for good surgical outcomes, the effect of the state of preoperative balance on surgical outcome has been adequately described at present.

Hook Fixation at Uppermost Instrumented Vertebra +1 Reduced Proximal Junctional Failure in Adult Patients With Spinal Deformity Having Achieved Optimal Deformity Correction by Sagittal Age-Adjusted Score.

Background And Objectives: Appropriate correction relative to the age-adjusted sagittal alignment target reduces the proximal junctional failure (PJF) risk. Nonetheless, a considerable number of patients suffer from PJF despite optimal correction. The aim of this study was to identify the risk factors of PJF that occurs despite optimal correction relative to the sagittal age-adjusted score (SAAS) in adult spinal deformity surgery.