Bone turnover markers in the preoperative assessment of bone quality - A prospective investigation of bone microstructure and advanced glycation endproducts in lumbar fusion patients.

Introduction: Effective tools to evaluate bone quality preoperatively are scarce and the standard method to determine bone quality requires an invasive biopsy. A non-invasive, and preoperatively available method for bone quality assessment would be of clinical value. The purpose of this study is to investigate the associations of bone formation marker, serum bone alkaline phosphatase (BAP), and bone resorption marker, urine collagen cross-linked N-telopeptide (uNTX) to volumetric bone mineral density (vBMD), fluorescent advanced glycation endproducts (fAGEs) and bone microstructure.

The Impact of the COVID-19 Pandemic on Ambulatory Lumbar Spine Decompression Surgery.

Background Only a few studies have examined the impact of the coronavirus disease 2019 pandemic on spine ambulatory surgeries and changes in trends. Therefore, we investigated trends during the pre-pandemic period and three pandemic stages in patients undergoing lumbar decompression procedures in the ambulatory surgery (AMS) setting. Methodology A total of 2,670 adult patients undergoing one- or two-level lumbar decompression surgery were retrospectively reviewed.

Georg Schmorl Prize of the German Spine Society (DWG) 2023: the influence of sarcopenia and paraspinal muscle composition on patient-reported outcomes: a prospective investigation of lumbar spinal fusion patients with 12-month follow-up.

Purpose: This study aimed to investigate the impact of sarcopenia and lumbar paraspinal muscle composition (PMC) on patient-reported outcomes (PROs) after lumbar fusion surgery with 12-month follow-up (12 M-FU).

Methods: A prospective investigation of patients undergoing elective lumbar fusion was conducted. Preoperative MRI-based evaluation of the cross-sectional area (CSA), the functional CSA (fCSA), and the fat infiltration(FI) of the posterior paraspinal muscles (PPM) and the psoas muscle at level L3 was performed.

Correlation between MRI-based spinal muscle parameters and the vertebral bone quality score in lumbar fusion patients.

Introduction: The vertebral bone quality (VBQ) score that is based on non-contrast enhanced T1-weighted MRI was recently introduced as a novel measure of bone quality in the lumbar spine and shown to be a significant predictor of healthy versus osteopenic/osteoporotic bone.

Research Question: This study aimed to assess possible correlations between the VBQ score and the functional cross-sectional area (FCSA) of psoas and lumbar spine extensor muscles.

Material And Methods: Patients who underwent fusion surgery between 2014 and 2017 and had lumbar MRI and CT scans within 6 months prior to surgery were included.

Fat infiltration of the posterior paraspinal muscles is inversely associated with the fat infiltration of the psoas muscle: a potential compensatory mechanism in the lumbar spine.

Background: The function of the paraspinal muscles and especially the psoas muscle in maintaining an upright posture is not fully understood. While usually considered solely as a hip flexor, the psoas muscle and its complex anatomy suggest that the muscle has other functions involved in stabilizing the lumbar spine. The aim of this study is to determine how the psoas muscle and the posterior paraspinal muscles (PPM; erector spinae and multifidus) interact with each other.

Predicting postoperative outcomes in lumbar spinal fusion: development of a machine learning model.

Background Context: Degenerative lumbar spondylolisthesis (DLS) is a prevalent spinal disorder, often requiring surgical intervention. Accurately predicting surgical outcomes is crucial to guide clinical decision-making, but this is challenging due to the multifactorial nature of postoperative results. Traditional risk assessment tools have limitations, and with the advent of machine learning, there is potential to enhance the precision and comprehensiveness of preoperative evaluations.

Association of abdominal aortic calcification and lower back pain in patients with degenerative spondylolisthesis.

Abdominal aortic calcification (AAC) is hypothesized to lead to ischemic pain of the lower back. This retrospective study aims to identify the relationship between AAC and lower back pain (LBP) in patients with degenerative lumbar spondylolisthesis. Lower back pain was assessed preoperatively and 2 years after surgery using the numeric analogue scale.

Association Between Osteoarthritis Burden and Intervertebral Disk Degeneration in Patients Undergoing Lumbar Spine Surgery for Degenerative Lumbar Spondylolisthesis.

Study Design: A retrospective analysis of prospectively collected data.

Objective: To assess the association between intervertebral disk degeneration and hip and knee osteoarthritis (OA) in patients with degenerative lumbar spondylolisthesis.

Background: The co-occurrence of hip OA and degenerative spinal pathologies was first described as the "hip-spine syndrome" and has also been observed in knee OA.

Examining the Role of Paraspinal Musculature in Postoperative Disability After Lumbar Fusion Surgery for Degenerative Spondylolisthesis.

Study Design: Retrospective analysis of prospectively enrolled patients.

Objective: To evaluate the relationship between paraspinal muscle (PM) atrophy and Oswestry Disability Index (ODI) improvement after spinal fusion surgery for degenerative lumbar spondylolisthesis.

Background: Atrophy of the PM is linked to multiple spinal conditions, sagittal malalignment, and increased postoperative complications.

Relationship between lumbar spinal stenosis and axial muscle wasting.

Background Context: Although the effect of lumbar spinal stenosis (LSS) on the lower extremities is well documented, limited research exists on the effect of spinal stenosis on the posterior paraspinal musculature (PPM). Similar to neurogenic claudication, moderate to severe spinal canal compression can also interfere with the innervation of the PPM, which may result in atrophy and increased fatty infiltration (FI).

Purpose: This study aims to assess the association between LSS and atrophy of the PPM.

Understanding the Interplay Between Paraspinal Muscle Atrophy and Lumbar Endplate Degeneration: A 3-Year Longitudinal Study.

Study Design: Retrospective analysis of longitudinal data.

Objective: To assess the association between the paraspinal musculature (PM) and lumbar endplate degeneration.

Background: The PM is essential for spinal stability, while the vertebral endplate is pivotal for nutrient transport and force distribution.

Abdominal aortic calcification is independently associated with lumbar endplate degeneration.

Background: Abdominal aortic calcification (AAC) is associated with lower back pain, reduced bone mineral density of the spine. Vascular changes could also affect the already sparsely perfused intervertebral endplate and intervertebral disc.

Methods: Lumbar MRIs and lateral radiographs of patients with lower back pain were retrospectively analyzed.

Abdominal aortic calcification assessed on standard lateral lumbar radiographs as a screening tool for impaired bone status in spine surgery.

Purpose: The aim of this study was to determine whether the presence of abdominal aortic calcification (AAC) can predict patient bone status, represented by volumetric bone mineral density (vBMD) assessed with quantitative computed tomography (QCT).

Methods: Patients undergoing lumbar fusion surgery at a tertiary care center between 2014 and 2021, with a preoperative lumbar CT-scan and lateral lumbar radiographs were retrospectively reviewed. A semi-quantitative measurement method for AAC (AAC 4, 8 and 24) was performed.

Changes of the posterior paraspinal and psoas muscle in patients with low back pain: a 3-year longitudinal study.

Purpose: This study aimed to investigate the changes of the posterior paraspinal muscles (PPM) and psoas muscle in patients with low back pain (LBP) over time.

Methods: Patients with LBP who had a repeat lumbar MRI with a minimum of 3-years apart at a tertiary referral center were analyzed. MRI-based quantitative assessments of the PPM and the psoas muscle were conducted for the baseline and follow-up MRI.

Decision-making Algorithm for the Surgical Treatment of Degenerative Lumbar Spondylolisthesis of L4/L5.

Study Design: A retrospective analysis of prospectively collected data.

Objective: To report the decision-making process for decompression alone (DA) and decompression and fusion (DF) at a tertiary orthopedic center and compare the operative outcomes between both groups.

Background: Controversy exists around the optimal operative treatment for DLS, either with DF or DA.

Frailty Stratification Using the Modified 5-Item Frailty Index: Significant Variation within Frailty Patients in Spine Surgery.

Background: Frailty status has been associated with higher rates of complications after spine surgery. However, frailty patients constitute a heterogeneous group based on the combinations of comorbidities. The objective of this study is to compare the combinations of variables that compose the modified 5-factor frailty index score (mFI-5) based on the number of comorbidities in terms of complications, reoperation, readmission, and mortality after spine surgery.

Abdominal aortic calcification is independently associated with increased atrophy and fatty infiltration of the lumbar paraspinal muscles: a retrospective cross-sectional study.

Background: Aortic abdominal calcification (AAC) is associated with spine-related conditions, such as lower back pain and reduced bone mineral density. Similar to peripheral vascular disease, AAC possibly reduces blood flow to the lumbar posterior paraspinal muscles (PPM) which may lead to atrophy and increased fatty infiltration.

Methods: Imaging of patients with lower back pain was analyzed.

The anatomical positioning change of retroperitoneal organs in prone and lateral position: an assessment for single-prone position lateral lumbar surgery.

Purpose: There are reports that performing lateral lumbar interbody fusion (LLIF) in a prone, single position (single-prone LLIF) can be done safely in the prone position because the retroperitoneal organs reflect anteriorly with gravity. However, only a few study has investigated the safety of single-prone LLIF and retroperitoneal organ positioning in the prone position. We aimed to investigate the positioning of retroperitoneal organs in the prone position and evaluate the safety of single-prone LLIF surgery.

Bone microstructure and volumetric bone mineral density in patients with global sagittal malalignment.

Purpose: Sagittal spinal malalignment often leads to surgical realignment, which is associated with major complications. Low bone mineral density (BMD) and impaired bone microstructure are risk factors for instrumentation failure. This study aims to demonstrate differences in volumetric BMD and bone microstructure between normal and pathological sagittal alignment and to determine the relationships among vBMD, microstructure, sagittal spinal and spinopelvic alignment.

The Utilization of Intraoperative Neurophysiological Monitoring for Lumbar Decompression and Fusion Surgery in New York State.

Study Design: Retrospective database analysis.

Objective: To elucidate trends in the utilization of intraoperative neurophysiological monitoring (IONM) during elective lumbar surgery procedures and to investigate the association between the use of IONM and surgical outcomes.

Background: The routine use of IONM in elective lumbar spine procedures has recently been called into question due to longer operative time, higher cost, and other substitute advanced technologies.

Osteosarcopenia in the Spine Beyond Bone Mineral Density: Association Between Paraspinal Muscle Impairment and Advanced Glycation Endproducts.

Study Design: Prospective cross-sectional study.

Objective: To determine if an accumulation of advanced glycation endproducts (AGEs) is associated with impaired paraspinal muscle composition.

Background: Impaired bone integrity and muscle function are described as osteosarcopenia.

Association of Frailty and Preoperative Hypoalbuminemia with the Risk of Complications, Readmission, and Mortality After Spine Surgery.

Background: Frailty status and hypoalbuminemia have been associated with higher rates of complications after spine surgery. However, the combination of both conditions has not been fully analyzed. The objective of this study was to assess the effect of frailty and hypoalbuminemia on the risk of complications after spine surgery.

Bone collagen quality in lumbar fusion patients: the association between volumetric bone mineral density and advanced glycation endproducts.

Purpose: The sole determination of volumetric bone mineral density (vBMD) is insufficient to evaluate overall bone integrity. The accumulation of advanced glycation endproducts (AGEs) stiffens and embrittles collagen fibers. Despite the important role of AGEs in bone aging, the relationship between AGEs and vBMD is poorly understood.

Risk Factors for Ambulatory Surgery Conversion to Extended Stay Among Patients Undergoing One-level or Two-level Posterior Lumbar Decompression.

Study Design: A retrospective observational study.

Objective: The objective of this study was to investigate the factors associated with the conversion of patient status from ambulatory surgery (AMS) to observation service (OS) (<48 h) or inpatient (>48 h).

Summary Of Background Data: AMS is becoming increasingly common in the United States because it is associated with a similar quality of care compared with inpatient surgery, significant costs reduction, and patients' desire to recuperate at home.