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Original Articles

Degenerative

Frailty-Muscle Phenotypes Predict Outcomes After Lumbar Fusion in Adults Aged ≥75 Years: A Retrospective Cohort Study
Ma Chao Guo, Xiangyu Li, Shuaikang Wang, Xiaolong Chen, Chao Kong, Yuxi Liu, Shibao Lu
Neurospine 2026;23(2):242-254.   Published online April 30, 2026
DOI: https://doi.org/10.14245/ns.2551838.919

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Frailty-Muscle Phenotypes Predict Outcomes After Lumbar Fusion in Adults Aged ≥75 Years: A Retrospective Cohort Study
Neurospine. 2026;23(2):242-254.   Published online April 30, 2026
DOI: https://doi.org/10.14245/ns.2551838.919
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Frailty-Muscle Phenotypes Predict Outcomes After Lumbar Fusion in Adults Aged ≥75 Years: A Retrospective Cohort Study
Neurospine. 2026;23(2):242-254.   Published online April 30, 2026
DOI: https://doi.org/10.14245/ns.2551838.919
Close
Objective
To evaluate whether combining clinical frailty with magnetic resonance imaging (MRI)-derived posterior paraspinal muscle degeneration identifies perioperative risk phenotypes in adults aged ≥75 years undergoing lumbar fusion.
Methods
We retrospectively studied patients aged ≥75 years undergoing lumbar fusion with preoperative lumbar MRI. Frailty was assessed using the Fried phenotype (frail: score ≥3). Posterior paraspinal muscle degeneration across L1–S1 was quantified using automated segmentation and a composite posterior frailty index (PFI); severe degeneration was defined as the upper quartile of PFI. Patients were classified into 4 frailty×muscle phenotypes. Primary outcomes were any in-hospital complication and prolonged length of stay (LOS ≥16 days).
Results
Among 248 patients, phenotypes A–D (A, nonfrail/nonsevere; B, frail/nonsevere; C, nonfrail/severe; D, frail/severe) comprised 132, 54, 20, and 42 patients, respectively. Any in-hospital complication occurred in 18.2% of phenotype A compared with 50.0%–57.1% in phenotypes B–D (p<0.001). Prolonged LOS (≥16 days; cohort 75th percentile) occurred in 0.8% of phenotype A versus 38.9% (B), 35.0% (C), and 78.6% (D) (p<0.001), corresponding to absolute risk increases of +34.2 to +77.8 percentage points. After adjustment, higher-risk phenotypes remained independently associated with increased odds of any complication and prolonged LOS; however, the prolonged-LOS odds estimates were imprecise due to sparse events in the reference group. Phenotype was not independently associated with 90-day readmission. Pain improvement (ΔVAS [visual analogue scale]) was attenuated in phenotypes B and D, while differences in ΔODI (Oswestry Disability Index) were not statistically significant.
Conclusion
Integrating frailty and MRI-based posterior paraspinal degeneration provides actionable stratification of complication and prolonged LOS risk after lumbar fusion in older adults.

Citations

Citations to this article as recorded by  Crossref logo
  • From the Editor-in-Chief: Featured Articles in the April 2026 Issue
    Inbo Han
    Neurospine.2026; 23(2): 227.     CrossRef
  • A Commentary on “Frailty-Muscle Phenotypes Predict Outcomes After Lumbar Fusion in Adults Aged ≥75 Years: A Retrospective Cohort Study”
    Julie L. Chan, Daniel J. Hoh
    Neurospine.2026; 23(2): 255.     CrossRef
  • 406 View
  • 20 Download
  • 2 Crossref

Cervical Spine

Occipital Bone Erosion Following C1–2 Posterior Fixation: A Comparative Per-Screw Analysis of Tan versus Harms-Goel Techniques
Shigeo Ueda, Nobuaki Naito, Hokuto Yamashita, Jiro Ohara, Atsuhiko Toyoshima, Miyuki Fukuda, Nobuhiro Sasaki, Masayuki Kuroda, Minoru Hoshimaru
Neurospine 2026;23(2):404-410.   Published online April 30, 2026
DOI: https://doi.org/10.14245/ns.2551796.898

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Occipital Bone Erosion Following C1–2 Posterior Fixation: A Comparative Per-Screw Analysis of Tan versus Harms-Goel Techniques
Neurospine. 2026;23(2):404-410.   Published online April 30, 2026
DOI: https://doi.org/10.14245/ns.2551796.898
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Occipital Bone Erosion Following C1–2 Posterior Fixation: A Comparative Per-Screw Analysis of Tan versus Harms-Goel Techniques
Neurospine. 2026;23(2):404-410.   Published online April 30, 2026
DOI: https://doi.org/10.14245/ns.2551796.898
Close
Objective
To investigate the relationship between C1 screw trajectory and occipital bone erosion in C1–2 posterior fixation.
Methods
This retrospective cohort study analyzed 27 patients (54 screws) who underwent C1–2 posterior fixation between March 2018 and March 2023 at a single institution by multiple surgeons. Screws were classified by trajectory: Tan technique (n=39) or Harms-Goel (HG) technique (n=15). Primary outcome was occipital bone erosion; the secondary outcome was breach of inner cortical layer. Per-screw analysis was performed using generalized estimating equations to account for bilateral screw clustering.
Results
Mean follow-up was 48.3 (range, 24–84) months. Occipital bone erosion occurred in 51.3% (20 of 39) of Tan screws versus 6.7% (1 of 15) of HG screws (p<0.001). Breach of inner cortical layer occurred exclusively with the Tan technique (10.3% vs. 0%, p=0.302). In mixed Tan+HG cases (n=3), erosion occurred only on the Tan side (2 of 3 screws) with no erosion on HG side (0 of 3 screws). C1 upper line transgression was a critical risk factor; no erosion occurred in screws that did not exceed this anatomical landmark (adjusted relative risk [RR], 6.82; 95% confidence interval [CI], 2.41–19.31). Additional risk factors included height O–C1 ≤4.5 mm (RR, 3.81; 95% CI, 1.51–6.28) and height O–C1 extension ≤1 mm (RR, 4.86; 95% CI, 2.05–11.53). No patients required reoperation for erosion-related symptoms during follow-up.
Conclusion
Screw trajectory is the primary determinant of occipital bone erosion following C1–2 fixation. The HG technique demonstrated significantly lower erosion rates (6.7% vs. 51.3%). When anatomically feasible, HG technique may be considered to reduce erosion risk.
  • 218 View
  • 14 Download

Deformity

Prevalence and Risk Factors for Postoperative Neurological Complications in Spinal Deformity Surgery: A Systematic Review and Proportional Meta-Analysis
Yam Wa Man, Jedidiah Yui Shing Lui, Chor Yin Lam, Jason Pui Yin Cheung, Prudence Wing Hang Cheung
Neurospine 2025;22(1):243-263.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2449364.682

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Prevalence and Risk Factors for Postoperative Neurological Complications in Spinal Deformity Surgery: A Systematic Review and Proportional Meta-Analysis
Neurospine. 2025;22(1):243-263.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2449364.682
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Prevalence and Risk Factors for Postoperative Neurological Complications in Spinal Deformity Surgery: A Systematic Review and Proportional Meta-Analysis
Neurospine. 2025;22(1):243-263.   Published online March 31, 2025
DOI: https://doi.org/10.14245/ns.2449364.682
Close
Objective
To investigate the incidence of postoperative neurological complications among patients who underwent spinal deformity surgery and to determine the significant risk factors for postoperative neurological complications.
Methods
Six databases PubMed, Web of Science, Scopus, MEDLINE, Embase, and Cochrane Library have been searched to identify observational studies from inception until January 2025. Inclusion criteria were patients aged ≥10 years with postoperative neurological complications after spinal deformity surgery. Stata/MP18.0 was used to conduct the meta-analysis in this review. The summary incidence estimates, proportion with 95% confidence intervals (CIs) and weights were pooled by the random-effects restricted maximum likelihood model.
Results
The search strategy identified 53 articles with 40,958 patients for final review. Overall incidence of postoperative neurological complications was 7% (95% CI, 5.0%–9.0%; p < 0.001; I2 = 98.34%) in which incidence estimates for patients with adult spinal deformity and underwent 3-column spinal osteotomies were 12% (95% CI, 9%–16%; p < 0.001; I2 = 93.17%) and 18% (95% CI, 8%–31%; p < 0.001; I2 = 94.68%) respectively. Preoperative neurological deficit was the risk factor with highest overall odds ratio (OR, 2.86; 95% CI, 1.85–4.41; p = 0.01; I2 = 76.20%), followed by the presence of kyphosis (OR, 1.13; 95% CI, 0.75–1.70; p = 0.02; I2 = 81.80%) and age at surgery (OR, 1.04; 95% CI, 1.01–1.08; p = 0.04; I2 = 68.80%).
Conclusion
Preoperative neurological deficit, the presence of kyphosis and age at surgery were significant risk factors for postoperative neurological complications. Therefore, comprehensive preoperative assessment and surgical planning are crucial to minimize the risk of developing postoperative neurological complications or the deterioration of pre-existing neurologic deficits.

Citations

Citations to this article as recorded by  Crossref logo
  • Is Medicaid status associated with adverse outcomes following posterior spinal fusion for adolescent idiopathic scoliosis? A propensity score–matched nationwide analysis
    Abhiram Dawar, Gnaneswar Chundi, Maansi Chalasani, Amog Mysore, Rohan Singh, Christopher Kozak, Robert DalCortivo, Neil K. Kaushal
    Journal of Pediatric Orthopaedics B.2026;[Epub]     CrossRef
  • Understanding late-onset neurological deficit in severe rigid Scoliosis: A comprehensive review
    Siddharth S. Sethy, Nikhil Goyal, Aakash Jain, Syed Ifthekar, Vibhor Abrol, Pratibha Bhatia
    Journal of Clinical Orthopaedics and Trauma.2025; 70: 103175.     CrossRef
  • A Commentary on “The Contribution of Paraspinal Sarcopenia on Sagittal Imbalance in Degenerative Kyphosis”
    Worawat Limthongkul
    Neurospine.2025; 22(3): 692.     CrossRef
  • Proximal Lower Extremity Weakness Following Pedicle Subtraction Osteotomy in Adult Spinal Deformity: Influence of Correction Level and Clinical Outcomes
    Shinsuke Sato, Yusuke Nakao, Shingo Kumaki, Shigeo Sano
    Cureus.2025;[Epub]     CrossRef
  • Postoperative Experience of Older Adult Patients Who Underwent Lumbar Spine Surgery: A Qualitative Study
    Wonhee Baek, Yujin Suh, Hana Lee
    Journal of Korean Academy of Fundamentals of Nursing.2025; 32(4): 456.     CrossRef
  • 10,678 View
  • 158 Download
  • 1 Web of Science
  • 5 Crossref
Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine
Dong Hun Kim, Jae Taek Hong, Jung Woo Hur, Il Sup Kim, Ho Jin Lee, Jong Beom Lee
Neurospine 2024;21(2):565-574.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2347270.635

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Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine
Neurospine. 2024;21(2):565-574.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2347270.635
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Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine
Neurospine. 2024;21(2):565-574.   Published online June 30, 2024
DOI: https://doi.org/10.14245/ns.2347270.635
Close
Objective
To evaluate C2 muscle preservation effect and the radiological and clinical outcomes after C2 recapping laminoplasty.
Methods
Fourteen consecutive patients who underwent C2 recapping laminoplasty around C1–2 level were enrolled. To evaluate muscle preservation effect, the authors conducted a morphological measurement of extensor muscles between the operated and nonoperated side. Two surgeons measured the cross-sectional area (CSA) of obliquus capitis inferior (OCI) and semispinalis cervicis (SSC) muscle before and after surgery to determine atrophy rates (ARs). Additionally, we examined range of motion (ROM), sagittal vertical axis (SVA), neck visual analogue scale (VAS), Neck Disability Index (NDI), and Japanese Orthopaedic Association (JOA) score to assess potential changes in alignment and consequent clinical outcomes following posterior cervical surgery.
Results
We measured the CSA of OCI and SSC before surgery, and at 6 and 12 months postoperatively. Based on these measurements, the AR of the nonoperated SSC was 0.1% ± 8.5%, the AR of the operated OCI was 2.0% ± 7.2%, and the AR of the nonoperated OCI was -0.7% ± 5.1% at the 12 months after surgery. However, the AR of the operated side’s SSC was 11.2% ± 12.5%, which is a relatively higher value than other measurements. Despite the atrophic change of SSC on the operated side, there were no prominent changes observed in SVA, C0–2 ROM, and C2–7 ROM between preoperative and 12 months postoperative measurements, which were 11.8 ± 10.9 mm, 16.3° ± 5.9°, and 48.7° ± 7.7° preoperatively, and 14.1 ± 11.6 mm, 16.1° ± 7.2°, and 44.0° ± 10.3° at 12 months postoperative, respectively. Improvement was also noted in VAS, NDI, and JOA scores after surgery with JOA recovery rate of 77.3% ± 29.6%.
Conclusion
C2 recapping laminoplasty could be a useful tool for addressing pathologies around the upper cervical spine, potentially mitigating muscle atrophy and reducing postoperative neck pain, while maintaining sagittal alignment and ROM.

Citations

Citations to this article as recorded by  Crossref logo
  • The Craniopharyngioma Quality of Life (C-QOL) Index: a preliminary disease-specific, patient-centered tool for assessing patient reported outcomes in adult craniopharyngioma patients
    Saket Myneni, Shaan Bhandarkar, Hanan Akbari, Raquel Mayne, A. Karim Ahmed, Foad Kazemi, João Paulo Almeida, Anand V. Germanwala, Andrew S. Venteicher, Nathan T. Zwagerman, Eric W. Wang, Garret Choby, Erin L. McKean, Carl H. Snyderman, Nicholas R. Rowan,
    Journal of Neuro-Oncology.2026;[Epub]     CrossRef
  • Comparison of Two Posterior Minimally Invasive Approaches for Odontoid Fractures: Midline Nuchal Ligament Approach vs. Paramedian Muscle‐Splitting Approach
    Youcai Qiu, Liang Wang, Yijin Wang, Yang Li, Xuhua Lu
    Orthopaedic Surgery.2026; 18(1): 74.     CrossRef
  • Techniques for Cervical Laminoplasty
    Newton Cho, Ankit I. Mehta, Aditya Vedantam, C. Rory Goodwin, Uzondu F. Agochukwu, Lukas Grassner, Aria Nouri, Bizhan Aarabi, Jefferson R. Wilson, Nathan Evaniew
    Global Spine Journal.2026;[Epub]     CrossRef
  • C2-Involving Cervical Ossification of the Posterior Longitudinal Ligament (OPLL): Dome-like Laminoplasty Versus Laminectomy With Fusion
    Jun Jae Shin, Sun Joon Yoo, Se Jun Park, Dong Kyu Kim, Hyun Jun Jang, Bong Ju Moon, Kyung Hyun Kim, Jeong Yoon Park, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim, Joongkyum Shin, Yoon Ha
    Global Spine Journal.2026;[Epub]     CrossRef
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    Saket Myneni, Linda Tang, Hanan Akbari, Raquel Mayne, A. Karim Ahmed, Foad Kazemi, Nicolas Dea, Nathan T. Zwagerman, Shirley Y. Su, Garret Choby, Eric W. Wang, Kristin J. Redmond, Erin L. McKean, Carl H. Snyderman, Nicholas R. Rowan, Debraj Mukherjee
    Journal of Neuro-Oncology.2025; 173(1): 157.     CrossRef
  • The Spinal Chordoma Patient Reported Outcome Survey (spCPROS): a patient-centered, disease-specific tool for assessing quality of life in spinal chordoma patients
    Saket Myneni, Linda Tang, Hanan Akbari, Raquel Mayne, Foad Kazemi, Ruiwen Xiong, Kristin J. Redmond, Mark H. Bilsky, Raphaële Charest-Morin, Daniel G. Tobert, Vikram Chakravarthy, Ganesh M. Shankar, Sheng-Fu L. Lo, John H. Shin, Jean-Paul Wolinsky, Daniel
    Journal of Neuro-Oncology.2025; 175(2): 813.     CrossRef
  • 6,205 View
  • 134 Download
  • 7 Web of Science
  • 6 Crossref

Review Article

Proximal Junctional Failure in Adult Spinal Deformity Surgery: An In-depth Review
Mitsuru Yagi, Kento Yamanouchi, Naruhito Fujita, Haruki Funao, Shigeto Ebata
Neurospine 2023;20(3):876-889.   Published online September 30, 2023
DOI: https://doi.org/10.14245/ns.2346566.283

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Proximal Junctional Failure in Adult Spinal Deformity Surgery: An In-depth Review
Neurospine. 2023;20(3):876-889.   Published online September 30, 2023
DOI: https://doi.org/10.14245/ns.2346566.283
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Proximal Junctional Failure in Adult Spinal Deformity Surgery: An In-depth Review
Neurospine. 2023;20(3):876-889.   Published online September 30, 2023
DOI: https://doi.org/10.14245/ns.2346566.283
Close
Adult spinal deformity (ASD) surgery aims to correct abnormal spinal curvature in adults, leading to improved functionality and reduced pain. However, this surgery is associated with various complications, one of which is proximal junctional failure (PJF). PJF can have a significant impact on a patient’s quality of life, necessitating a comprehensive understanding of its causes and the development of effective management strategies. This review aims to provide an in-depth understanding of PJF in ASD surgery. PJF is a complex complication resulting from a multitude of factors including patient characteristics, surgical techniques, and postoperative management. Age, osteoporosis, overcorrection of sagittal alignment, and poor bone quality are identified as significant risk factors. The clinical implications of PJF are substantial, often requiring revision surgery and causing a considerable decrease in patients’ quality of life. Prevention strategies include careful preoperative planning, appropriate patient selection, and optimization of surgical techniques. Treatment often necessitates a multifaceted approach, including surgical intervention and the management of underlying risk factors. Predictive modeling is an emerging field that may offer a promising avenue for the risk stratification of patients and individualized preventive strategies. A thorough understanding of PJF’s pathogenesis, risk factors, and clinical implications is essential for surgeons involved in ASD surgery. Current preventive measures and treatment strategies aim to mitigate the risk and manage the complications of PJF, but the complication cannot be entirely prevented. Future research should focus on the development of more effective preventive and treatment strategies, and predictive models could be valuable in this pursuit.

Citations

Citations to this article as recorded by  Crossref logo
  • Relative influence of paraspinal muscularity and underlying bone quality on proximal junctional kyphosis and failure mode in patients undergoing thoracolumbar instrumented fusion
    Zach Pennington, Anthony L. Mikula, Abdelrahman Hamouda, Derrick Obiri-Yeboah, Michael L. Martini, Andrew J. Grossbach, Gabriella L. Paganucci, Ahmad N. Nassr, Brett A. Freedman, Arjun Sebastian, Jeremy L. Fogelson, Benjamin D. Elder
    Clinical Neurology and Neurosurgery.2026; 261: 109286.     CrossRef
  • Differential Risk Factors for Proximal Junctional Kyphosis Between T8-T10 and T11-L1 Upper Instrumented Vertebrae in Adult Spinal Deformity
    Se-Jun Park, Jin-Sung Park, Dong-Ho Kang, Chong-Suh Lee
    Neurosurgery.2026;[Epub]     CrossRef
  • Neurologic deficits due to proximal junctional kyphosis after adult spinal deformity surgery: how often do they happen and do they improve?
    Hani Chanbour, Alan R. Tang, Harsh Jain, Alexander T. Lyons, Soren Jonzzon, Iyan Younus, Steven G. Roth, Amir M. Abtahi, Byron F. Stephens, Scott L. Zuckerman
    Spine Deformity.2026;[Epub]     CrossRef
  • Association between lumbar lordosis and proximal junctional failure following adult spinal deformity surgery: a systematic review and meta-analysis
    Abdullah M. Alharran, AbdulMuhsen AlQallaf, Mohammad Mohammad, Mohammad Salem Alajmi, Mohammad Alkaak, Salem Y. Alenezi, Fahad Mohammad, Ahmad Al Ahmad, Nizar Algarni, Yousef Marwan
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    Sung Tan Cho, Jae Hwan Cho, Dong-Ho Lee, Chang Ju Hwang, Sehan Park, Jin Hwan Kim, Wongthawat Liawrungrueang
    Global Spine Journal.2026;[Epub]     CrossRef
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    Léonard Chatelain, Abbas Dib, Louise Ponchelet, Emmanuelle Ferrero
    Orthopaedics & Traumatology: Surgery & Research.2025; 111(1): 104065.     CrossRef
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    Niall Buckley, Ashel C. Dsouza, Lee A. Tan
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    Aleksey E. Shulga, Mikhail S. Korolev, Sergey P. Ivzhenko, Daniil M. Puchinyan, Vladimir S. Tolkachev, Stanislav D. Shuvalov
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    HyungSub Jin, Kyung-Soo Suk, Byung Ho Lee, Si Young Park, Hak-Sun Kim, Seong-Hwan Moon, Sub-Ri Park, Namhoo Kim, Jae Won Shin, Ji-Won Kwon
    Neurospine.2025; 22(4): 1012.     CrossRef
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    David P. Falk, Ravi Agrawal, Bijan Dehghani, Rohit Bhan, Sachin Gupta, Munish C. Gupta
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    Umesh S. Metkar, W. Jacob Lavelle, Kylan Larsen, Ram Haddas, William F. Lavelle
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    Léonard Chatelain, Abbas Dib, Louise Ponchelet, Emmanuelle Ferrero
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    Keishi Maruo, Fumihiro Arizumi, Tomoyuki Kusukawa, Masakazu Toi, Masaru Hatano, Tetsuto Yamaura, Kazuya Kishima, Toshiya Tachibana
    Asian Spine Journal.2024; 18(4): 532.     CrossRef
  • Proximal Junctional Degeneration and Failure Modes
    Riza M. Cetik, Steven D. Glassman, John R. Dimar, Mitchell J. Campbell, Mladen Djurasovic, Charles H. Crawford, Jeffrey L. Gum, R. Kirk Owens, Kathryn J. McCarthy, Leah Y. Carreon
    Spine.2024; 49(21): 1465.     CrossRef
  • Application of Transverse Process Hooks at Distal Thoracic Vertebrae in Uppermost Vertebral Instrumentation for Adult Spinal Deformity Surgery: Special Focus on Delayed-Onset Neurologic Deficits
    Sun-Joon Yoo, Hyun-Jun Jang, Bong Ju Moon, Jeong-Yoon Park, Sung Uk Kuh, Dong-Kyu Chin, Keun-Su Kim, Jun Jae Shin, Yoon Ha, Kyung-Hyun Kim
    Neurospine.2024; 21(4): 1219.     CrossRef
  • Risk Factors, Biomechanics, and Prevention Strategies for Proximal Junctional Failure in Adult Spinal Deformity Surgery – A Commentary on “Proximal Junctional Failure Development Despite Achieving Ideal Sagittal Correction According to Age-Adjusted Alignm
    Lee A. Tan
    Neurospine.2024; 21(4): 1094.     CrossRef
  • Proximal Junctional Failure Development Despite Achieving Ideal Sagittal Correction According to Age-Adjusted Alignment Target in Patients With Adult Spinal Deformity: Risk Factor Analysis of 196 Cases Undergoing Low Thoracic to Pelvic Fusion
    Se-Jun Park, Jin-Sung Park, Dong-Ho Kang, Minwook Kang, Kyunghun Jung, Chong-Suh Lee
    Neurospine.2024; 21(4): 1080.     CrossRef
  • 12,324 View
  • 579 Download
  • 25 Web of Science
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Original Article

Complication Rates and Utilization Trends of 3-Level Posterior Column Osteotomy Compared to Single-Level Pedicle Subtraction Osteotomy
Emily S. Mills, Kevin Mertz, Ethan Faye, Jennifer A. Bell, Andy T. Ton, Jeffrey C. Wang, Ram K. Alluri, Raymond J. Hah
Neurospine 2023;20(2):662-668.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2346222.111

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Complication Rates and Utilization Trends of 3-Level Posterior Column Osteotomy Compared to Single-Level Pedicle Subtraction Osteotomy
Neurospine. 2023;20(2):662-668.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2346222.111
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Complication Rates and Utilization Trends of 3-Level Posterior Column Osteotomy Compared to Single-Level Pedicle Subtraction Osteotomy
Neurospine. 2023;20(2):662-668.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2346222.111
Close
Objective
The objective of this study is to assess differences in complication profiles between 3-level posterior column osteotomy (PCO) and single-level pedicle subtraction osteotomy (PSO) as both are reported to provide similar degrees of sagittal correction.
Methods
The PearlDiver database was queried retrospectively using International Classification of Disease, 9th and 10th edition and Current Procedural Terminology codes to identify patients who underwent PCO or PSO for degenerative spine disease. Patients under age 18 or with history of spinal malignancy, infection, or trauma were excluded. Patients were separated into 2 cohorts, 3-level PCO or single-level PSO, matched at a 1:1 ratio based on age, sex, Elixhauser comorbidity index, and number of fused posterior segments. Thirtyday systemic and procedure-related complications were compared.
Results
Matching resulted in 631 patients for each cohort. PCO patients had decreased odds of respiratory (odds ratio [OR], 0.58; 95% confidence interval [CI], 0.43–0.82; p = 0.001) and renal complications (OR, 0.59; 95% CI, 0.40–0.88; p = 0.009) compared to PSO patients. There was no significant difference in cardiac complications, sepsis, pressure ulcer, dural tear, delirium, neurologic injuries, postoperative hematoma, postoperative anemia, or overall complications.
Conclusion
Patients who undergo 3-level PCO have decreased respiratory and renal complications compared to single-level PSO. No differences were found in the other complications studied. Considering both procedures achieve similar sagittal correction, surgeons should be aware that 3-level PCO offers an improved safety profile compared to single-level PSO.

Citations

Citations to this article as recorded by  Crossref logo
  • Neurological Complications Following Anterior Lumbar Interbody Fusion (ALIF): A Systematic Review
    Takeshi Fujii, Rakesh Kumar, Jihun Cha, Aiyush Bansal, Rafael Garcia de Oliveira, Philip K. Louie, Venu M. Nemani, Jean-Christophe Leveque, Rajiv K. Sethi
    Global Spine Journal.2026; 16(1): 734.     CrossRef
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    Negin Safari Dehnavi, Faramarz Roohollahi, Sadegh Bagherzadeh, P. Mitchell Johansen, Gersham Rainone, Natalie J. Bales, Anjali Pradhan, Mohsen Rostami, Puya Alikhani
    Operative Neurosurgery.2026;[Epub]     CrossRef
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    Jake Carbone, Amit Ratanpal, Anthony K. Chiu, Rohan I. Suresh, Bradley Anderson, Bibhas Amatya, Amil Sahai, Brian Shear, Alexander Ruditsky, Sennay Ghenbot, Louis J. Bivona, Julio J. Jauregui, Daniel L. Cavanaugh, Eugene Y. Koh, Steven C. Ludwig
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    Luigi Aurelio Nasto, Seyed Hirbod Mousavi Nasab, Angelo Sieczak, Alessandro Cattolico, Paolo Ulisse, Enrico Pola
    European Spine Journal.2024; 33(7): 2787.     CrossRef
  • Pedicle Subtraction Osteotomies for Surgical Correction of Fixed Sagittal Imbalance: A Meta-Analysis and Systematic Review
    Pratheek S. Makineni, Mohamed E. El-Abtah, Joshua R. Porto, Michael P. Steinmetz, Edward C. Benzel
    Neurosurgery.2024; 95(6): 1223.     CrossRef
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    Anna Martin, Jamal Zahir, Nathan Smith, Oluwatodimu Raji, David Nelles, Dimitriy Kondrashov
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  • 154 Download
  • 7 Web of Science
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Review Article

CSRS Special Issue

Surgical Strategies and Perioperative Considerations for Cervical Deformity With Cerebral Palsy: A Comprehensive Review of the Literature
Hyung Cheol Kim, Sung Han Oh, Jae Keun Oh, Yoon Ha
Neurospine 2022;19(4):868-875.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2244956.478

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Surgical Strategies and Perioperative Considerations for Cervical Deformity With Cerebral Palsy: A Comprehensive Review of the Literature
Neurospine. 2022;19(4):868-875.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2244956.478
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Surgical Strategies and Perioperative Considerations for Cervical Deformity With Cerebral Palsy: A Comprehensive Review of the Literature
Neurospine. 2022;19(4):868-875.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2244956.478
Close
The complex nature of the cervical spine makes surgical intervention challenging when treating cervical deformity in patients with cerebral palsy (CDCP). However, few studies have investigated the unique characteristics of cerebral palsy that create the need for surgery, the most effective surgical strategies, and the possible perioperative complications. The intended benefit and the potential risk of postoperative complications must be considered when deciding to operate for CDCP. Because the approach and correction strategy depend on the type of cervical deformity, as well as the patient’s comorbidities and functional status, a customized strategy is needed. Perioperatively, botulinum toxin injections and muscle division techniques can help control excessive involuntary movements and improve the spinal fusion success rate. Surgical intervention for CDCP requires a multidisciplinary approach, and the information presented in this article is intended to help in the perioperative management and surgical treatment of CDCP.

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  • Predictive Factors for Postoperative Outcomes of Cervical Spondylotic Myelopathy in Individuals With Cerebral Palsy
    Su Ji Lee, Jihye Hwang, Min Gyu Kang, Minjae Cho, Yoon Ha, Sung-Rae Cho
    Global Spine Journal.2026; 16(1): 75.     CrossRef
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    Mark Katsma, Haiqing Liu, Xiaoyu Pan, Kyle J. Ryan, David P. Roye, Henry G. Chambers, Rachel Byrne, Heakyung Kim, Raffi Najarian, Justin Ramsey, Sruthi Thomas
    Journal of Pediatric Rehabilitation Medicine.2024; 17(1): 19.     CrossRef
  • 6,610 View
  • 191 Download
  • 2 Web of Science
  • 2 Crossref

Case Report: Technical Note

The Technical Feasibility of Unilateral Biportal Endoscopic Decompression for The Unpredicted Complication Following Minimally Invasive Transforaminal Lumbar Interbody Fusion: Case Report
Kwang-Ryeol Kim, Jeong-Yoon Park
Neurospine 2020;17(Suppl 1):S154-S159.   Published online July 31, 2020
DOI: https://doi.org/10.14245/ns.2040174.087

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The Technical Feasibility of Unilateral Biportal Endoscopic Decompression for The Unpredicted Complication Following Minimally Invasive Transforaminal Lumbar Interbody Fusion: Case Report
Neurospine. 2020;17(Suppl 1):S154-S159.   Published online July 31, 2020
DOI: https://doi.org/10.14245/ns.2040174.087
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The Technical Feasibility of Unilateral Biportal Endoscopic Decompression for The Unpredicted Complication Following Minimally Invasive Transforaminal Lumbar Interbody Fusion: Case Report
Neurospine. 2020;17(Suppl 1):S154-S159.   Published online July 31, 2020
DOI: https://doi.org/10.14245/ns.2040174.087
Close
Minimally invasive techniques for transforaminal lumbar interbody fusion (MIS-TLIF) are advantageous because they allow for sufficient surgical exposure and fewer complications through a smaller incision than conventional TLIF. It could be difficult to maintain minimally invasive spine surgery following the unexpected complications after MIS-TLIF. Because MIS-TLIF is usually done via a paramedian small incision with posterior fusion using screws and rods, visualization of the surgical field is limited, and it is difficult to directly assess the neural structure without removing instrumentation. Unilateral biportal endoscopic decompression (UBE) is a rapidly growing surgical method using two 1-cm incisions that are 2 to 3 cm apart. We would like to suggest UBE as an option for immediate reoperation after MIS-TLIF because it has the advantages of targeting pathologic regions and a wide field of visualization through small wounds. The operation is independent of the existing incision from MIS-TLIF, enabling immediate revision surgery without the removal of the screws and rods. UBE has the advantages of targeting specific surgical regions and providing a wide visualization of the operation field through small incisions. UBE can be very useful for discectomy or decompression surgery as well as in immediate reoperation after MIS-TLIF.

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  • Learning Curve of Unilateral Biportal Endoscopy in Spinal Stenosis: A Neuromonitoring-Assisted Analysis
    Ali Gulec, Ebubekir Eravsar, Sadettin Ciftci, Selim Safali, Ali Özdemir, Fatih Durgut, Bahattin Kerem Aydin
    Global Spine Journal.2026; 16(1): 707.     CrossRef
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    Qing-Lin Luo, Xiao-Xing Wang, Xin-Zhi Li, Wei Huang, Bo Li
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    Kai-Uwe Lewandrowski, Álvaro Dowling, Choll Kim, Brian Kwon, John Ongulade, Kenyu Ito, Paulo Sergio Terxeira de Carvalho, Morgan P. Lorio
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    Kwang-Ryeol Kim, Jong Un Lee, Dae-Hyun Kim
    World Neurosurgery.2025; 195: 123594.     CrossRef
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    Yi Rong, Kaixuan Wang, Yalan Pan, Tianchi Zhang, Yong Ma, Lining Wang, Yang Guo, Si Chen, Yang Shao, Tingchen Zhu, Shixiang Wu, Zhen Hua, Jianwei Wang, Hao Yu
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    Yi Rong, Hao Yu, Zhen Hua, Jian-feng Chen, Jian-wei Wang
    European Spine Journal.2025; 34(9): 3876.     CrossRef
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    Journal of Orthopaedic Surgery and Research.2025;[Epub]     CrossRef
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    Alhareth Maaya, Jin Hwa Eum
    Cureus.2025;[Epub]     CrossRef
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    John Choi, Keyur Akbari, Juan Amaya, James Rizkalla
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    Brian Zhaojie Chin, Jung Hahn Yong, Eugene Wang, Seth Ian Sim, Shuxun Lin, Pang Hung Wu, Hwee Weng Dennis Hey
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    Liwen Feng, Junbo Liang, Naiguo Wang, Qingyu Zhang
    Therapeutics and Clinical Risk Management.2024; Volume 20: 249.     CrossRef
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    Bin Wang, Peng He, Xiowei Liu, Zhengfang Wu, Bin Xu
    Orthopaedic Surgery.2023; 15(1): 3.     CrossRef
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    Chang Il Ju, Seung Myung Lee
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    Jae-Young So, Jeong-Yoon Park
    Journal of Minimally Invasive Spine Surgery and Technique.2023; 8(Suppl 1): S29.     CrossRef
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    Sang Yoon Lee, Dong Ah Shin, Seong Yi, Yoon Ha, Keung Nyun Kim, Chang Kyu Lee
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  • 22 Web of Science
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Review Article

Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications
Jeffery Head, George Rymarczuk, Geoffrey Stricsek, Lohit Velagapudi, Christopher Maulucci, Christian Hoelscher, James Harrop
Neurospine 2019;16(3):517-529.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938222.111

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Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications
Neurospine. 2019;16(3):517-529.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938222.111
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Ossification of the Posterior Longitudinal Ligament: Surgical Approaches and Associated Complications
Neurospine. 2019;16(3):517-529.   Published online September 30, 2019
DOI: https://doi.org/10.14245/ns.1938222.111
Close
Ossification of the posterior longitudinal ligament (OPLL) is a rare but potentially devastating cause of degenerative cervical myelopathy (DCM). Decompressive surgery is the standard of care for OPLL and can be achieved through anterior, posterior, or combined approaches to the cervical spine. Surgical correction of OPLL via any approach is associated with higher rates of complications and the presence of OPLL is considered a significant risk factor for perioperative complications in DCM surgeries. Potential complications include dural tear (DT) and subsequent cerebrospinal fluid leak, C5 palsy, hematoma, hardware failure, surgical site infections, and other neurological deficits. Anterior approaches are technically more demanding and associated with higher rates of DT but offer greater access to ventral OPLL pathology. Posterior approaches are associated with lower rates of complications but may allow for continued disease progression. Therefore, the decision to pursue either an anterior or posterior approach to surgical decompression may be critically influenced by complications associated with each procedure. The authors critically review anterior and posterior approaches to surgical decompression of OPLL with particular focus on the complications associated with each approach. We also review the recent work in developing new surgical treatments for OPLL that aim to reduce complication incidence.

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    Cureus.2022;[Epub]     CrossRef
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Clinical Article

Comparison of Radiologic Outcomes of Different Methods in Single-Level Anterior Cervical Discectomy and Fusion
O Ik Kwon, Dong Wuk Son, Sang Weon Lee, Geun Sung Song
Korean J Spine 2016;13(3):91-96.   Published online September 30, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.3.91

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Comparison of Radiologic Outcomes of Different Methods in Single-Level Anterior Cervical Discectomy and Fusion
Korean J Spine. 2016;13(3):91-96.   Published online September 30, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.3.91
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Comparison of Radiologic Outcomes of Different Methods in Single-Level Anterior Cervical Discectomy and Fusion
Korean J Spine. 2016;13(3):91-96.   Published online September 30, 2016
DOI: https://doi.org/10.14245/kjs.2016.13.3.91
Close
Objective

Anterior cervical discectomy and fusion (ACDF) is a choice of surgical procedure for cervical degenerative diseases associated with radiculopathy or myelopathy. However, the patients undergoing ACDF still have problems. The purpose of the present study is to evaluate the radiologic results of 3 different methods in single-level ACDF.

Methods

We conducted a retrospective collection of radiological data from January 2011 to December 2014. A total of 67 patients were included in this study. The patients were divided into 3 groups by operation procedure: using stand-alone cage (group cage, n=20); polyether-ether-ketone (PEEK)-titanium combined anchored cage (group AC, n=21); and anterior cervical cage-plate (group CP, n=26). Global cervical lordosis (C2-C7 Cobb angle), fused segment height, fusion rate, and cervical range of motion (ROM) were measured and analyzed at serial preoperative, postoperative, 6-month, and final 1-year follow-up.

Results

Successful bone fusion was achieved in all patients at the final follow-up examination; however, the loss of disc height over 3 mm at the surgical level was observed in 6 patients in group cage. Groups AC and CP yielded significantly better outcomes than group cage in fused segment height and cervical ROM(p=0.01 and p=0.02, respectively). Furthermore, group AC had similar radiologic outcomes to those of group CP.

Conclusion

The PEEK-titanium combined anchored cage may be a good alternative procedure in terms of reducing complications induced by plate after ACDF.

Citations

Citations to this article as recorded by  Crossref logo
  • Single-Level Anterior Cervical Discectomy and Interbody Fusion: A Comparison between Porous Tantalum and Polyetheretherketone Cages
    Edoardo Mazzucchi, Giuseppe La Rocca, Andrea Perna, Fabrizio Pignotti, Gianluca Galieri, Vincenzo De Santis, Pierluigi Rinaldi, Francesco Ciro Tamburrelli, Giovanni Sabatino
    Journal of Personalized Medicine.2022; 12(6): 986.     CrossRef
  • Comparison of the effectiveness and safety of bioactive glass ceramic to allograft bone for anterior cervical discectomy and fusion with anterior plate fixation
    Hyung Cheol Kim, Jae Keun Oh, Du Su Kim, Jeffrey S. Roh, Tae Woo Kim, Seong Bae An, Hyeong Seok Jeon, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Do Heum Yoon, Yoon Ha
    Neurosurgical Review.2020; 43(5): 1423.     CrossRef
  • Radiological and Clinical Outcomes of Anterior Cervical Discectomy and Fusion in Older Patients: A Comparative Analysis of Young-Old Patients (Ages 65–74 Years) and Middle-Old Patients (Over 75 Years)
    Chi Hyung Lee, Dong Wuk Son, Su Hun Lee, Jun Seok Lee, Soon Ki Sung, Sang Weon Lee, Geun Sung Song
    Neurospine.2020; 17(1): 156.     CrossRef
  • Cost-Effectiveness Analysis of Cervical Anterior Fusion and Cervical Artificial Disc Replacement in the Korean Medical System
    Hyosang Lee, Ui Chul Kim, Jae Keun Oh, Taehyun Kim, Sohee Park, Yoon Ha
    Journal of Korean Neurosurgical Society.2019; 62(1): 83.     CrossRef
  • Comparison of Adjacent Segment Degeneration, Cervical Alignment, and Clinical Outcomes After One- and Multilevel Anterior Cervical Discectomy and Fusion
    Jun Jae Shin
    Neurospine.2019; 16(3): 589.     CrossRef
  • 10,588 View
  • 186 Download
  • 5 Crossref

Case Report

Delayed Pharyngeal Extrusion of an Anterior Odontoid Screw
Eun Jung Lee, Jun Won Jang, Seung Ho Choi, Seung Chul Rhim
Korean J Spine 2012;9(3):289-292.   Published online September 30, 2012
DOI: https://doi.org/10.14245/kjs.2012.9.3.289

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Delayed Pharyngeal Extrusion of an Anterior Odontoid Screw
Korean J Spine. 2012;9(3):289-292.   Published online September 30, 2012
DOI: https://doi.org/10.14245/kjs.2012.9.3.289
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Delayed Pharyngeal Extrusion of an Anterior Odontoid Screw
Korean J Spine. 2012;9(3):289-292.   Published online September 30, 2012
DOI: https://doi.org/10.14245/kjs.2012.9.3.289
Close

A 27-year-old woman with a type II odontoid fracture was treated by anterior odontoid screw fixation. Radiographic union at the fracture site was obtained 3 months after surgery. Nearly 3 years after surgery, she presented at a local Ear, Nose, and Throat (ENT) clinic with a 2-month history of dysphagia. Laryngoscopy identified the head of the odontoid lag screw. Plain radiography showed that the head of the screw had migrated into the pharyngeal soft tissue. The atlantoaxial joint was stable, and computed tomography (CT) scans confirmed odontoid fracture fusion. The screw was found to be movable during endoscopy. The screw could be removed by using a transpharyngeal endoscopic approach under general anesthesia. The failure of the screw was considered to be due in part to malpositioning of the screw and in part to local infection. A transoropharyngeal endoscopic approach to remove the loose anterior odontoid screw was feasible.

Citations

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  • Medullabeteiligung bei einer Schraubenosteosynthese einer Densfraktur Typ II nach Anderson und D’Alonzo – eine forensisch-funktionelle Frakturanalyse
    K.-S. Saternus, E. Hoffmann, G. Kernbach-Wighton
    Rechtsmedizin.2024; 34(3): 196.     CrossRef
  • Early Extrusion of an Anterior Odontoid Screw: A Case Report
    Herika Negri Brito, Marcelo Porto Sousa, Lucca B Palavani, Jamal McClendon
    Cureus.2024;[Epub]     CrossRef
  • Full‐Endoscopic Anterior Odontoid Screw Fixation: A Novel Surgical Technique
    Vit Kotheeranurak, Phattareeya Pholprajug, Khanathip Jitpakdee, Pritsanai Pruttikul, Roongrath Chitragran, Weerasak Singhatanadgige, Worawat Limthongkul, Wicharn Yingsakmongkol, Jin‐Sung Kim
    Orthopaedic Surgery.2022; 14(5): 990.     CrossRef
  • Transoral Removal of an Extruded Odontoid Screw Causing Dysphagia and Dysphonia
    Alisa Zhukhovitskaya, Arya N. Shamie, Dinesh Chhetri
    The Laryngoscope.2021; 131(5): 1078.     CrossRef
  • Screw Malposition: Are There Long-term Repercussions to Malposition of Pedicle Screws?
    Terry D. Amaral, Sayyida Hasan, Jesse Galina, Vishal Sarwahi
    Journal of Pediatric Orthopaedics.2021; 41(Suppl 1): S80.     CrossRef
  • Pharyngeal perforation: A rare complication of occipitocervical injury
    Alberto Vandenbulcke, Giulia Cossu, Juan Barges Coll
    Surgical Neurology International.2021; 12: 308.     CrossRef
  • Delayed Pharyngeal Migration of a Mandibular Fixation Screw 30 Years After Orthognathic Surgery
    Esther Cheng, Edward Schaefer, Steven Charous
    Journal of Oral and Maxillofacial Surgery.2019; 77(3): 640.e1.     CrossRef
  • Postoperative intracranial migration of a C2 odontoid screw: A case report and literature review
    Ankush Chandra, Seong-Jin Moon, Blake Walker, Emre Yilmaz, Marc Moisi, Robert Johnson
    Surgical Neurology International.2019; 10: 173.     CrossRef
  • Placement of a single anterior odontoid screw for type II odontoid fractures in a setting with limited resources
    Ahmed Hamdy Ashry, Hashem Mohamed Aboul-Ela
    The Egyptian Journal of Neurology, Psychiatry and Neurosurgery.2019;[Epub]     CrossRef
  • Migration of spinal pedicle screw with aerodigestive perforation and subsequent device expectoration
    Miguel M. Leiva-Juarez, Yitzchok Greenberg, Charles La Punzina
    International Journal of Surgery Case Reports.2018; 46(C): 6.     CrossRef
  • Passage of an Anterior Odontoid Screw through Gastrointestinal Tract
    L. Leitner, C. I. Brückmann, M. M. Gilg, G. Bratschitsch, P. Sadoghi, A. Leithner, R. Radl
    Case Reports in Medicine.2017; 2017: 1.     CrossRef
  • Advantages of Direct Insertion of a Straight Probe Without a Guide Tube During Anterior Odontoid Screw Fixation of Odontoid Fractures
    Jin Hoon Park, Dong-Ho Kang, Moon Kyu Lee, Byoungwoo Yoo, Sang Ku Jung, Soo-Hyun Hwang, Jeoung Hee Kim, Sunkyu Oh, Eun Jung Lee, Sang Ryong Jeon, Sung Woo Roh, Seung Chul Rhim
    SPINE.2016; 41(9): E541.     CrossRef
  • Anterior Screw Fixation of Anteriorly Displaced Type III Odontoid Fracture Corrected by Transoral Digital Manipulation
    Do-sung Lee
    Korean Journal of Spine.2013; 10(2): 101.     CrossRef
  • 9,853 View
  • 73 Download
  • 13 Crossref

Clinical Article

Comparative Analysis of Adjacent Levels of Degeneration and Clinical Outcomes Between Conventional Pedicle Screws and Percutaneous Pedicle Screws in Treatment of Degenerative Disease at L3-5; A Preliminary Report
Tae Kyoo Lim, Sang Gu Lee, Chan Woo Park, Woo Kyung Kim, Seong Son, Keun Lee
Korean J Spine 2012;9(2):66-73.   Published online June 30, 2012
DOI: https://doi.org/10.14245/kjs.2012.9.2.66

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Comparative Analysis of Adjacent Levels of Degeneration and Clinical Outcomes Between Conventional Pedicle Screws and Percutaneous Pedicle Screws in Treatment of Degenerative Disease at L3-5; A Preliminary Report
Korean J Spine. 2012;9(2):66-73.   Published online June 30, 2012
DOI: https://doi.org/10.14245/kjs.2012.9.2.66
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Comparative Analysis of Adjacent Levels of Degeneration and Clinical Outcomes Between Conventional Pedicle Screws and Percutaneous Pedicle Screws in Treatment of Degenerative Disease at L3-5; A Preliminary Report
Korean J Spine. 2012;9(2):66-73.   Published online June 30, 2012
DOI: https://doi.org/10.14245/kjs.2012.9.2.66
Close
Objective

This study was conducted to compare radiologic changes and clinical outcomes in adjacent level of percutaneous pedicle screws with those of conventional (open) pedicle screws.

Methods

From January 2007 to December 2009, 51 patients underwent L3-5 decompression and spinal fusion. Percutaneous pedicle screws were used in 22 patients, and open pedicle screws were used in the remaining patients. For estimation of instability, we performed measurements of change in the lordotic and adjacent segment angles. A retrospective evaluation of the patients' data and several assessment scales was conducted for determination of clinical outcomes.

Results

The radiological examinations revealed no significant differences, except the L2-3 sagittal angle change. The upper adjacent level angle change in the open group was larger than that in the percutaneous group. In the percutaneous group, the sagittal angle changed from 9.7±3.0° to 11.25±3.6° during the follow-up periods, and in the open group, the sagittal angle changed from 10.8±4.1° to 13.6±4.5°. Radiological instability was observed in 5 patients (17%) in the open group and in 2 patients (9%) in the percutaneous group. Both groups showed similar clinical outcomes.

Conclusion

We suggest that open screws have a greater tendency to cause degenerative change in the upper segment than percutaneous screws. This may be because percutaneous screw fixation causes minimal injury to supporting structures and preserves adjacent facet joints.

Citations

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  • Development of End-to-End Artificial Intelligence Models for Surgical Planning in Transforaminal Lumbar Interbody Fusion
    Anh Tuan Bui, Hieu Le, Tung Thanh Hoang, Giam Minh Trinh, Hao-Chiang Shao, Pei-I Tsai, Kuan-Jen Chen, Kevin Li-Chun Hsieh, E-Wen Huang, Ching-Chi Hsu, Mathew Mathew, Ching-Yu Lee, Po-Yao Wang, Tsung-Jen Huang, Meng-Huang Wu
    Bioengineering.2024; 11(2): 164.     CrossRef
  • Comparative Analysis of ABM/P-15, Bone Morphogenic Protein and Demineralized Bone Matrix after Instrumented Lumbar Interbody Fusion
    Ashwin Sathe, Sang-Ho Lee, Shin-Jae Kim, Sang Soo Eun, Yong Soo Choi, Shih-min Lee, Ju-Wan Seuk, Yoon Sun Lee, Sang-Ha Shin, Junseok Bae
    Journal of Korean Neurosurgical Society.2022; 65(6): 825.     CrossRef
  • Revision Surgery for Short Segment Fusion Influences Postoperative Low Back Pain and Lower Extremity Pain: A Retrospective Single-Center Study of Patient-Based Evaluation
    Takashi Hirai, Toshitaka Yoshii, Hiroyuki Inose, Tsuyoshi Yamada, Masato Yuasa, Shuta Ushio, Satoru Egawa, Keigo Hirai, Atsushi Okawa
    Spine Surgery and Related Research.2018; 2(3): 215.     CrossRef
  • Paraspinal Muscle Sparing Versus Percutaneous Screw Fixation: A Comparative Enzyme Study of Tissue Injury during the Treatment of L4-L5 Spondylolisthesis
    Dong Am Park, Seok Won Kim, Sung Myung Lee, Chang Il Ju, Chong Gue Kim, Suk Jung Jang
    Korean Journal of Spine.2012; 9(4): 321.     CrossRef
  • 9,869 View
  • 77 Download
  • 4 Crossref
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NS : Neurospine
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