Fat beyond muscle: Assessing epimuscular fat of the lumbar spine and its association with vertebral level, demographics, BMI, and low back pain.

Introduction: Epimuscular fat (EF) has rarely been studied in the context of low back pain (LBP).

Research Question: This study aims to assess the presence and extent of EF in the lumbar muscles and its association with vertebral level in patients with low back disorders and to explore correlations between EF, demographics, BMI, and LBP.

Material And Methods: T2 axial MRIs from L1 to L5 were manually segmented to analyze the cross-sectional area (CSA) of EF (mm), and fat infiltration (FI,%) of 40 patients (23 females, 17 males; mean age:65.

Methodological considerations in calculating the minimal clinically important change score for the core outcome measures index (COMI): insights from a large single-centre spine surgery registry.

Introduction: The Minimal Clinically Important Change (MCIC) is used in conjunction with Patient-Reported Outcome Measures (PROMs) to determine the clinical relevance of changes in health status. MCIC measures a change within the same person or group over time. This study aims to evaluate the variability in computing MCIC for the Core Outcome Measure Index (COMI) using different methods.

Long-Term Loss of Alignment Following ASD Surgery in the Absence of Mechanical Complications: Aging Spine?

Study Design: Retrospective analysis of a prospective multicenter Adult Spinal Deformity (ASD) registry.

Objective: Assess whether spinal alignment deteriorates post-surgery in absence of mechanical complications and evaluate the long-term outcomes of ASD surgery over a five-year period.

Summary Of Background Data: ASD is prevalent among older adults, leading to significant pain and disability.

Estimating lumbar bone mineral density from conventional MRI and radiographs with deep learning in spine patients.

Purpose: This study aimed to develop machine learning methods to estimate bone mineral density and detect osteopenia/osteoporosis from conventional lumbar MRI (T1-weighted and T2-weighted images) and planar radiography in combination with clinical data and imaging parameters of the acquisition protocol.

Methods: A database of 429 patients subjected to lumbar MRI, radiographs and dual-energy x-ray absorptiometry within 6 months was created from an institutional database. Several machine learning models were trained and tested (373 patients for training, 86 for testing) with the following objectives: (1) direct estimation of the vertebral bone mineral density; (2) classification of T-score lower than - 1 or (3) lower than - 2.

Patient-reported outcome of lumbar decompression with instrumented fusion for low-grade spondylolisthesis: influence of pathology and baseline symptoms.

Introduction: Low-grade isthmic and degenerative spondylolisthesis (DS) of the lumbar spine are distinct pathologies but both can be treated with lumbar decompression with fusion. In a very large cohort, we compared patient-reported outcome in relation to the pathology and chief complaint at baseline.

Methods: This was a retrospective analysis using the EUROSPINE Spine Tango Registry.

Proximal junctional kyphosis after adult spinal deformity operated patients with long fusion to the pelvis. Does the type of proximal anchor matter?

Purpose: To assess, in a large population of Adult Spinal Deformity (ASD) patients, the true interest of varying the upper anchors as a protective measure against Proximal Junctional Kyphosis (PJK), by analyzing and comparing 2 groups of patients defined according to their proximal construct. Another objective of the study is to look for any other factors, radiological or clinical, that would affect the occurrence of the proximal failure.

Methods: Retrospective review of a prospective ASD database collected from 5 centers.

The use of the Core Yellow Flags Index for the assessment of psychosocial distress in patients undergoing surgery of the cervical spine.

Background: Psychosocial distress (the presence of yellow flags) has been linked to poor outcomes in spine surgery. The Core Yellow Flags Index (CYFI), a short instrument assessing the 4 main yellow flags, was developed for use in patients undergoing lumbar spine surgery. This study evaluated its ability to predict outcome in patients undergoing cervical spine surgery.

Which sagittal plane assessment method is most predictive of complications after adult spinal deformity surgery?

Purpose: Different methods of sagittal alignment assessment compete for predicting adverse events after adult spinal deformity (ASD) surgery. We wanted to study which method provides greater benefit.

Methods: Retrospective study of 391 patients operated for ASD, with > 6 instrumented levels, fused to the pelvis, and 2 years of follow-up.

What factors are associated with a better restoration of pelvic version after adult spinal deformity surgery?

Introduction: Poor restoration of pelvic version after adult spinal deformity (ASD) surgery is associated with an increased risk of mechanical complications and worse quality of life. We studied the factors linked to the improvement of postoperative pelvic version.

Materials And Methods: This is a retrospective analysis of a prospective multicenter ASD database.

Comparing image normalization techniques in an end-to-end model for automated modic changes classification from MRI images.

Introduction: Modic Changes (MCs) are MRI alterations in spine vertebrae's signal intensity. This study introduces an end-to-end model to automatically detect and classify MCs in lumbar MRIs. The model's two-step process involves locating intervertebral regions and then categorizing MC types (MC0, MC1, MC2) using paired T1-and T2-weighted images.

A decade of experience in over 300 surgically treated spine patients with long-term oral anticoagulation: a propensity score matched cohort study.

Purpose: The aim of this study was to investigate the risks and outcomes of patients with long-term oral anticoagulation (OAC) undergoing spine surgery.

Methods: All patients on long-term OAC who underwent spine surgery between 01/2005 and 06/2015 were included. Data were prospectively collected within our in-house Spine Surgery registry and retrospectively supplemented with patient chart and administrative database information.

Influence of smoking on patient-reported outcome measures (PROMs) in patients undergoing surgery for adult spinal deformity: a propensity score-matched analysis.

Purpose: The purpose of this study was to determine the isolated influence of smoking in patient-reported outcome measures (PROMs) for adult spinal deformity (ASD) surgery excluding known tobacco-related complications.

Methods: Retrospective analysis of a prospective multicenter ASD database. Patients operated on ASD with 2 year post-operative follow-up were included.

Sagittal alignment of diverse mechanical complications following adult spinal deformity surgery.

Purpose: To compare the sagittal alignment of patients with diverse mechanical complications (MCs) following adult spinal deformity (ASD) surgery with that of patients without MCs.

Methods: A total of 371 patients who underwent ASD surgery were enrolled. The sagittal spinopelvic parameters were measured preoperatively and at the 6-month and last follow-up, and the global alignment and proportion (GAP) score was calculated.

Rod Angulation Relationship with Thoracic Kyphosis after Adolescent Idiopathic Scoliosis Posterior Instrumentation.

Introduction: Surgery to correct spinal deformities in scoliosis involves the use of contoured rods to reshape the spine and correct its curvatures. It is crucial to bend these rods appropriately to achieve the best possible correction. However, there is limited research on how the rod bending process relates to spinal shape in adolescent idiopathic scoliosis surgery.

Cost Benefit of Implementation of Risk Stratification Models for Adult Spinal Deformity Surgery.

Study Design/setting: Retrospective cohort study.

Objective: Assess the extent to which defined risk factors of adverse events are drivers of cost-utility in spinal deformity (ASD) surgery.

Methods: ASD patients with 2-year (2Y) data were included.

Patient-reported outcomes 1 and 2 years after transforaminal thoracic interbody fusion (TTIF).

Study Design: Retrospective Cohort Study with prospectively collected data.

Purpose: Transforaminal interbody fusion was initially designed for the lumbar spine. A similar approach was later introduced for the thoracic spine (TTIF).

Automatic Calculation of Cervical Spine Parameters Using Deep Learning: Development and Validation on an External Dataset.

Study Design: Retrospective data analysis.

Objectives: This study aims to develop a deep learning model for the automatic calculation of some important spine parameters from lateral cervical radiographs.

Methods: We collected two datasets from two different institutions.

Fixed coronal malalignment (CM) in the lumbar spine independently impacts disability in adult spinal deformity (ASD) patients when considering the obeid-CM (O-CM) classification.

Background: Postoperative flatback has been described in detail for sagittal plane considerations over the past 2 decades, and its correlations with disability are now accepted. Fixed Coronal Malalignment (CM) has been less described, and some authors report no significant association with the clinical outcome. The O-CM classification analyses CM and incorporates specific modifiers for each curve type.

Relationship between pelvic incidence-adjusted relative spinopelvic parameters, global sagittal alignment and lower extremity compensations.

Purpose: In response to sagittal malalignment, compensatory spinal and lower extremity mechanisms are recruited. Thoracolumbar realignment surgery has been shown to yield reciprocal changes in these compensations. Thus, whole-body radiographic assessment has come to the fore.