Neurospine

Minimally Invasive Spine Surgery

Endoscopic Decompression Combined With Percutaneous Pedicle Screw Fixation for AOSpine A3 or A4 Thoracolumbar Fractures With Neurological Deficits: A Retrospective Cohort Study: Huiming Yang, Junxian Miao, Jiangtao Wang, Dan Han, Yuhang Wang, Liang Yan, Biao Wang, Dingjun Hao; Neurospine 2025;22(2):571-582. Published online April 30, 2025; DOI: https://doi.org/10.14245/ns.2449212.606

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Endoscopic Decompression Combined With Percutaneous Pedicle Screw Fixation for AOSpine A3 or A4 Thoracolumbar Fractures With Neurological Deficits: A Retrospective Cohort Study

Neurospine. 2025;22(2):571-582. Published online April 30, 2025

DOI: https://doi.org/10.14245/ns.2449212.606

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Endoscopic Decompression Combined With Percutaneous Pedicle Screw Fixation for AOSpine A3 or A4 Thoracolumbar Fractures With Neurological Deficits: A Retrospective Cohort Study

Neurospine. 2025;22(2):571-582. Published online April 30, 2025

DOI: https://doi.org/10.14245/ns.2449212.606

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Objective
This study aimed to compare the clinical outcomes of patients with AOSpine A3 or A4 thoracolumbar fractures presenting with neurological deficits treated with endoscopic decompression combined with percutaneous pedicle screws fixation (endoscopic minimally invasive surgery, EMIS) or conventional open surgery (OS).
Methods
Data of patients with AOSpine A3 or A4 thoracolumbar fractures with neurological deficits who were treated with EMIS or OS between June 2019 and July 2021 were extracted from the electronic database. Various clinical outcomes were compared between the 2 cohorts.
Results
Among the 231 patients who were followed up for more than 2 years, 107 were in the EMIS cohort and 124 were in the OS cohort. Compared with the OS cohort, the EMIS cohort had longer operative time (p<0.05), but the intraoperative blood loss, incision length and hospital stay were significantly reduced (p<0.05). At both postoperative and final follow-up assessments, the EMIS cohort demonstrated significantly better visual analogue scale and Oswestry Disability Index outcomes compared to the OS cohort (p<0.05). Both cohorts maintained similar correction of spinal canal erosion rate, percentage of anterior vertebral height and sagittal Cobb angle after surgery and at the last follow-up (p>0.05). According to American Spinal Injury Association classification, the 2 cohorts had similar neurological recovery at the last follow-up (p>0.05).
Conclusion
In comparison to OS, EMIS treatment for AOSpine A3 or A4 thoracolumbar fractures with neurological deficits has shown comparable clinical efficacy while significantly reducing surgical trauma.

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Severe trauma care: advances and future directions in diagnostic and therapeutic techniques and information technology support
Feifei Jin, Shu li, Xuemin Zhang, Wei Huang, Jing Zhou, Zhongdi Liu, Pan Hu, Yanqiu Wu, Zixiao Zhang, Lijun Hou, Xiangjun Bai, Tianbing Wang
Medical Review.2026;[Epub] CrossRef

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Spine and Spinal Cord Tumors DSPN-Neurospine Special Issue

Steroids in the Management of Preoperative Neurological Deficits in Metastatic Spine Disease: Results From the EPOSO Study: Anne L. Versteeg, Lior M. Elkaim, Arjun Sahgal, Laurence D. Rhines, Daniel M. Sciubba, James M. Schuster, Michael G. Fehlings, Aron Lazary, Michelle J. Clarke, Paul M. Arnold, Chetan Bettegowda, Stefano Boriani, Ziya L. Gokaslan, Charles G. Fisher, Michael H. Weber, AO Spine Knowledge Forum Tumor; Neurospine 2022;19(1):43-50. Published online January 30, 2022; DOI: https://doi.org/10.14245/ns.2142768.384

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Steroids in the Management of Preoperative Neurological Deficits in Metastatic Spine Disease: Results From the EPOSO Study

Neurospine. 2022;19(1):43-50. Published online January 30, 2022

DOI: https://doi.org/10.14245/ns.2142768.384

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Steroids in the Management of Preoperative Neurological Deficits in Metastatic Spine Disease: Results From the EPOSO Study

Neurospine. 2022;19(1):43-50. Published online January 30, 2022

DOI: https://doi.org/10.14245/ns.2142768.384

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Objective
Patients presenting with neurological deficit secondary to metastatic epidural spinal cord compression (MESCC) are often treated with surgery in combination with high-dose corticosteroids. Despite steroids being commonly used, the evidence regarding the effect of corticosteroids on patient outcomes is limited. The objective of this study was to describe the effect of corticosteroid use on preoperative neurological function in patients with MESCC.
Methods
Patients who underwent surgery between August 2013 and February 2017 for the treatment of spinal metastases and received steroids to prevent neurologic deficits were included. Data regarding demographics, diagnosis, treatment, neurological function, adverse events, health-related quality of life, and survival were extracted from an international multicenter prospective cohort.
Results
A total of 30 patients treated surgically and receiving steroids at baseline were identified. Patients had a mean age of 58.2 years (standard deviation, 11.2 years) at time of surgery. Preoperatively, 50% of the patients experienced deterioration of neurological function, while in 30% neurological function was stable and 20% improved in neurological function. Lengthier steroid use did not correlate with improved or stabilized neurological function. Postoperative adverse events were observed in 18 patients (60%). Patients that stabilized or improved neurologically after steroid use showed a trend towards improved survival at 3- and 24-month postsurgery.
Conclusion
This study described the effect of steroids on preoperative neurological function in patients with MESCC. Stabilization or improvement of preoperative neurological function occurred in 50% of the patients.

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Indications for Nonsurgical Treatment of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations: Nikolay Peev, Mehmet Zileli, Salman Sharif, Shahswar Arif, Zarina Brady; Neurospine 2021;18(4):713-724. Published online December 31, 2021; DOI: https://doi.org/10.14245/ns.2142390.195

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Indications for Nonsurgical Treatment of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Neurospine. 2021;18(4):713-724. Published online December 31, 2021

DOI: https://doi.org/10.14245/ns.2142390.195

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Indications for Nonsurgical Treatment of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Neurospine. 2021;18(4):713-724. Published online December 31, 2021

DOI: https://doi.org/10.14245/ns.2142390.195

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Thoracolumbar spine is the most injured spinal region in blunt trauma. Literature on the indications for nonoperative treatment of thoracolumbar fractures is conflicting. The purpose of this systematic review is to clarify the indications for nonsurgical treatment of thoracolumbar fractures. We conducted a systematic literature search between 2010 to 2020 on PubMed/MEDLINE, and Cochrane Central. Up-to-date literature on the indications for nonoperative treatment of thoracolumbar fractures was reviewed to reach an agreement in a consensus meeting of WFNS (World Federation of Neurosurgical Societies) Spine Committee. The statements were voted and reached a positive or negative consensus using the Delphi method. For all of the questions discussed, the literature search yielded 1,264 studies, from which 54 articles were selected for full-text review. Nine studies (4 trials, and 5 retrospective) evaluating 759 participants with thoracolumbar fractures who underwent nonoperative/surgery were included. Although, compression type and stable burst fractures can be managed conservatively, if there is major vertebral body damage, kyphotic angulation, neurological deficit, spinal canal compromise, surgery may be indicated. AO type B, C fractures are preferably treated surgically. Future research is necessary to tackle the relative paucity of evidence pertaining to patients with thoracolumbar fractures.

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Spontaneous Spinal Epidural Hematoma: A Retrospective Study on Prognostic Factors and Review of the Literature: Mark Fedor, Eric S. Kim, Kai Ding, J. Paul Muizelaar, Kee D. Kim; Korean J Spine 2011;8(4):272-282. Published online December 31, 2011; DOI: https://doi.org/10.14245/kjs.2011.8.4.272

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Spontaneous Spinal Epidural Hematoma: A Retrospective Study on Prognostic Factors and Review of the Literature

Korean J Spine. 2011;8(4):272-282. Published online December 31, 2011

DOI: https://doi.org/10.14245/kjs.2011.8.4.272

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Spontaneous Spinal Epidural Hematoma: A Retrospective Study on Prognostic Factors and Review of the Literature

Korean J Spine. 2011;8(4):272-282. Published online December 31, 2011

DOI: https://doi.org/10.14245/kjs.2011.8.4.272

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Objectives

The spontaneous spinal epidural hematoma (SSEH) is a rare clinical entity. Patients typically present with sudden onset back pain followed by neurological deficits.

Methods

Diagnosis of SSEH is usually made with MRI and standard treatment is surgical evacuation. In 1996, Groen published the most comprehensive review on the SSEH in which he analyzed 333 cases. We review 104 cases of SSEH presented in the English literature since the last major review and add three of our own cases, for a total of 107 cases.

Results

Our patients presented with back pain and neurologic deficits. Two made excellent functional recovery with prompt surgical decompression while one continued to have significant deficits despite evacuation. Better postoperative outcome was associated with less initial neurological dysfunction, shorter time to operation from symptom onset and male patients.

Conclusion

We discuss the etiology of SSEH and report current trends in diagnosis, treatment, and outcome.

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Spine Fractures in Patients with Ankylosing Spondylitis : Three Cases Report.: Tae Sik Park, Weon Heo, Dong Youl Rhee, Hwa Seung Park, Jun Sook Song, Se Heun Joung; Korean J Spine 2009;6(2):81-85.

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Spine Fractures in Patients with Ankylosing Spondylitis : Three Cases Report.

Korean J Spine. 2009;6(2):81-85.

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Spine Fractures in Patients with Ankylosing Spondylitis : Three Cases Report.

Korean J Spine. 2009;6(2):81-85.

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Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease. Pathologic changes occurred in patients with AS result in a weakened vertebral column with increased susceptibility to fractures, even though a trivial injury. Fractures usually tends to involve the lower cervical spine, but rarely, they are also occurred in thoracolumbar spine. We present our experiences of three cases of spinal fracture in patients with AS, cervical, thoracic, and lumbar spine, with a review of literatures.

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