Objective This study compared the efficacy of posterior pedicle screw fixation with 5.5-mm rods (PPSF5.5) with anterior corpectomy (AC) for metastatic cervicothoracic junction (CTJ) tumors.
Methods This retrospective analysis included patients with CTJ tumors who underwent PPSF5.5 or AC from January 2000 to December 2023. Data collected included demographics, surgical details, clinical outcomes (visual analogue scale scores for neck or back pain, Spinal Instability Neoplastic Scale score, McCormick scale, Nurick grade, and Eastern Cooperative Oncology Group score), radiologic results (cervical segmental Cobb angle), and surgical complications (instrumentation failure, tumor regrowth, and wound infection).
Results The AC group showed a tendency for short-level fusion. Patients in this group had tumors primarily located near C7 and generally confined to the vertebral body. AC was associated with more significant postoperative kyphotic changes in the index vertebra during follow-up than PPSF5.5. Moreover, AC was associated with a higher incidence of instrumentation failure, necessitating revision surgeries. Conversely, patients in the PPSF5.5 group tended to require revision surgery due to tumor regrowth.
Conclusion For CTJ metastatic tumors, PPSF5.5 provides superior resistance to forward bending and collapse prevention and minimizes instrumentation failure rate compared to AC. Moreover, AC may reduce the risk of tumor recurrence, but this approach is recommended only if the tumor is confined to the vertebral body and located at the upper level of the CTJ.
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The efficacy of 5.5-mm diameter rods combined with cervical pedicle screws for the treatment of challenging spinal disease in cervicothoracic junction: Is it a game-changer? Younggyu Oh, Subum Lee, Sang Hyub Lee, Danbi Park, Chongman Kim, Sun Woo Jang, Jin Hoon Park Medicine.2025; 104(36): e44369. CrossRef
Objective The cervical spine presents challenges in treating metastatic cervical spinal tumors (MCSTs). Although the efficacy of cervical pedicle screw placement (CPS) has been well established, its use in combination with 5.5-mm rods for MCST has not been reported. This study aimed to evaluate the efficacy of CPS combined with 5.5-mm rods in treating MCST and compare it with that of CPS combined with traditional 3.5-mm rods.
Methods This retrospective study analyzed 58 patients with MCST who underwent posterior cervical spinal fusion surgery by a single surgeon between March 2012 and December 2022. Data included demographics, surgical details, imaging results, numerical rating scale score for neck pain, Eastern Cooperative Oncology Group performance status, and Spine Oncology Study Group Outcomes Questionnaire responses.
Results Preoperative Spinal Instability Neoplastic Scores were significantly higher in the 5.5-mm rod group. Greater kyphotic changes in the index vertebra were observed in the 3.5-mm rod group. Neck pain reduction was significantly better in the 5.5-mm rod group.
Conclusion CPS with 5.5-mm rods provides superior biomechanical stability and effectively resists forward bending momentum in posterior MCST fusion surgery. These findings support the use of 5.5-mm rods to enhance surgical outcomes.
Citations
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Anterior Corpectomy Versus Posterior Pedicle Screw Fixation With 5.5-mm Rods for Metastatic Spinal Tumor Located in the Cervicothoracic Junction Sun Woo Jang, Hong Kyung Shin, Sang Ryong Jeon, Sung Woo Roh, Danbi Park, Chongman Kim, Jin Hoon Park Neurospine.2025; 22(2): 603. CrossRef
The efficacy of 5.5-mm diameter rods combined with cervical pedicle screws for the treatment of challenging spinal disease in cervicothoracic junction: Is it a game-changer? Younggyu Oh, Subum Lee, Sang Hyub Lee, Danbi Park, Chongman Kim, Sun Woo Jang, Jin Hoon Park Medicine.2025; 104(36): e44369. CrossRef
Verification, validation, and uncertainty quantification of finite element analysis results for pedicle screw assemblies under ASTM F1717 flexion and extension testing On Sim, Byeong Cheol Jeong, Chiseung Lee Frontiers in Bioengineering and Biotechnology.2025;[Epub] CrossRef
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Objective Romosozumab is increasingly employed to manage osteoporosis. However, no studies have analyzed its effects on recent osteoporotic vertebral compression fractures (OVCFs). Therefore, this study aimed to evaluate the efficacy of romosozumab compared with teriparatide in managing OVCFs.
Methods The electronic medical records of postmenopausal patients with recent OVCFs who were administered romosozumab or teriparatide for one year from March 2018 to August 2022 were retrospectively reviewed. We compared the 2 groups for demographics, radiological outcomes (compression ratio, Cobb angle, and bone mineral density [BMD]), and clinical outcomes (Numerical Rating Scale [NRS] for back pain).
Results Fifty-five patients with OVCFs, 32 patients treated with romosozumab and 23 with teriparatide, were included in this study. The change of BMD (g/cm2) values was significantly higher (p = 0.016) in the romosozumab (0.04 ± 0.06) than in the teriparatide group (0.00 ± 0.08) in the femur total. Furthermore, in subgroup analysis, the change of BMD (g/cm2) values in the lumbar spine was significantly higher (p = 0.016) in the romosozumab (0.12 ± 0.06) than in the teriparatide group (0.07 ± 0.06) in the lumbar spine. The decrease in NRS was significantly higher (p = 0.013) in the romosozumab (6.6 ± 2.0) than in the teriparatide group (5.5 ± 2.1). However, there was no significant difference in radiologic outcomes between the 2 groups.
Conclusion Our findings suggest that romosozumab may be more effective than teriparatide in treating OVCFs in postmenopausal females, particularly in improving BMD and reducing back pain as measured by NRS.
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