Objective Spinal fusion surgery is effective for treating various adult spinal deformities. However, spinal fusion surgery is associated with the risk of adjacent segment disease (ASD; 5%–30%), particularly proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). Proximal junctional tethering (PJT) has become a popular technique owing to increasing evidence that it can decrease the rate of PJK or PJF.
Methods A literature search was conducted using PubMed, Embase, and Cochrane Library. Twelve eligible studies were identified. These studies were predominantly retrospective in nature and compared the incidence of PJK or PJF in adults undergoing spinal fusion surgery with or without PJT. Risk of bias was assessed using the Newcastle-Ottawa scale. All outcomes were analyzed using R software (ver. 4.4.1).
Results We included 8 retrospective cohort studies and 3 propensity-score-matched analyses; these studies comprised 1,424 patients. PJT was associated with a significant decrease in the odds of development of PJK (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.27–0.71) and PJF (OR, 0.36; 95% CI, 0.19–0.69) compared with control. Subgroup analysis results revealed no significant difference in ASD rates between geographical locations, between tethering with and without crosslinks, and between specific tethering techniques.
Conclusion PJT significantly reduces the odds of both PJK and PJF in adults undergoing spinal fusion surgery.
Objective Full endoscopic cervical surgery (FECS) is an evolving minimally invasive approach for treating cervical spine disorders. This systematic review synthesizes current evidence on the clinical outcomes and patient perspectives associated with FECS, specifically evaluating its safety, efficacy, and overall patient satisfaction.
Methods A systematic search of the PubMed/MEDLINE, Cochrane Library, Embase, and Web of Science databases was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies published between January 2000 and September 2024 that reported on clinical outcomes or patient perspectives related to FECS were included. Risk of bias was assessed using the ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) tool and the Cochrane Risk of Bias tool. Inclusion criteria encompassed randomized controlled trials, prospective cohort studies, retrospective studies, and observational studies focused on adult populations undergoing FECS for cervical spine surgery.
Results The final synthesis included 30 studies. FECS was associated with significant reductions in both cervical and radicular pain, as well as meaningful functional improvements, measured by standardized clinical scales such as the Neck Disability Index and visual analogue scale. Patient satisfaction rates were consistently high, with most studies reporting satisfaction exceeding 85%. Complication rates were low, primarily involving transient neurological deficits that were typically resolved without the need for further intervention. Nonrandomized studies generally presented a moderate risk of bias due to confounding and selection, whereas randomized controlled trials exhibited a low risk of bias.
Conclusion FECS is a safe and effective minimally invasive surgical option for cervical spine disorders associated with substantial pain relief, functional improvement and high levels of patient satisfaction.
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Objective The ever-growing number of articles related to full-endoscopic spine surgery published in the last few decades presents a challenge which is perplexing and time-consuming in identifying the current research status. The study aims to identify and analyze the most cited works related to full-endoscopic decompression spine surgery, compare the articles published by different publishers and area, and show the current publication status of full-endoscopic research.
Methods Using Bibliometrix, CiteSpace, and VOSviewer, we analyzed the bibliometric data selected from the Web of Science database between 1992 and 2022. Spine has the highest H-index with the most-cited journal in the field of full-endoscopic decompression spine surgery. China ranked as the most productive country, whereas the most cited with high H-index papers came from South Korea. For the author analysis, Yeung AT, Ruetten S, Hoogland T, Ahn Y, Choi G, and Mayer HM were the most impactful authors in the global and local citations. The most productive organization is Wooridul Spine Hospital.
Conclusion The bibliometric study showed a growing trend of research on full-endoscopic decompression spine surgery over the past 30 years. It has demonstrated that there is a significant increase in the number of authors, institutions, and internationally collaborated countries. However, the quality of studies is still low, and the lack of high-quality clinical evidence and the trend of general journal submissions has somewhat affected the quality of endoscopy journals in recent years.
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