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Study Design: Retrospective study Objective: Our purpose was to evaluate spinal rotation measurement by scoliometer or EOS Imagings with reference to that by CT images, and to clarify their applicability in clinical practice. Methods: Patients with adolescent idiopathic scoliosis (AIS) who were indicated for surgery were enrolled and the informed consents were obtained. The angle of trunk rotation (ATR) was measured by the scoliometer. Apical vertebral rotation (AVR) was measured with EOS Imaging and CT images. Paired T tests were used to compare the measurements between ATR or AVR-EOS and AVR-CT. Pearson correlation analysis was performed to explore the relationship between ATR or AVR-EOS and AVR-CT. Then subgroup analysis was performed. Results: Forty-seven consecutive AIS patients with 62 curves were identified. In the whole group, the ATR, as well as AVR-EOS, was significantly smaller than the AVR-CT. Both ATR and AVR-EOS correlated with AVR-CT, although AVR-EOS correlated better. In thoracic group, there was no significant difference between ATR and AVR-CT (P =.236). A significant correlation was found between ATR and AVR-CT(r =.574, P <.001). In TL/L group, no significant difference was noted between AVR-EOS and AVR-CT (P =.414), and a significant correlation was found between AVR-EOS and AVR-CT(r =.824, P <.001). Conclusion: ATR by scoliometer is numerically similar to AVR by CT and may evaluate the spinal rotation more appropriately in thoracic spine. AVR by EOS is numerically similar to AVR by CT and may be more applicable in TL/L spine. Appropriate methods could be selected according to the location of the curve. [ABSTRACT FROM AUTHOR]

Objectives: To compare the clinical and radiographic outcomes of oblique lateral lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion in patients with grade‐1 L4/5 degenerative spondylolisthesis. Methods: Based on the inclusion and exclusion criteria, the comparative analysis included consecutive patients with grade‐1 degenerative spondylolisthesis who underwent oblique LIF (OLIF, n = 36) or minimally invasive transforaminal LIF (MI‐TLIF, n = 45) at the Department of Spine Surgery, Beijing Jishuitan Hospital from January 2016 to August 2017. Patient satisfaction Japanese Orthopaedic Association score, visual analog scale (VAS) scores for back and leg pain, Oswestry disability index (ODI), radiographic outcomes including anterior/posterior disc heights (ADH/PDH), foraminal height (FH), foraminal width (FW), cage subsidence, cage retropulsion, and fusion rate were assessed during a 2‐year follow‐up. Continuous data are presented as mean ± standard deviation and were compared between groups using the independent sample t‐test. Categorical data are presented as n (%) and were compared between groups using the Pearson chi‐squared test or Fisher's exact test. Repetitive measurement and analysis of variance was employed in the analysis of ODI, back pain VAS score, and leg pain VAS score. Statistical significance was defined as p < 0.05. Results: The OLIF and MI‐TLIF groups comprised 36 patients (age, 52.1 ± 7.2 years; 27 women) and 45 patients (age, 48.4 ± 14.4 years; 24 women), respectively. Satisfaction rates at 2 years post procedure exceeded 90% in both groups. The OLIF group had less intraoperative blood loss (140 ± 36 vs 233 ± 62 mL), lower back pain VAS score (2.42 ± 0.81 vs 3.38 ± 0.47), and ODI score (20.47 ± 2.53 vs 27.31 ± 3.71) at 3 months follow‐up (with trends toward lower values at 2 years follow‐up), but higher leg pain VAS scores at all postoperative time points than the MI‐TLIF group (all p < 0.001). ADH, PDH, FD, and FW improved in both groups post‐surgery. At the 2 year follow‐up, the OLIF group had a higher rate of Bridwell grade‐I fusion (100% vs 88.9%, p = 0.046) and lower incidences of cage subsidence (8.33% vs 46.67%, p < 0.001) and retropulsion (0% vs 6.67%, p = 0.046) than the MI‐TLIF group. Conclusions: In patients with grade‐I spondylolisthesis, OLIF was associated with lower blood loss and greater improvements in VAS for back pain and ODI and radiologic outcomes than MI‐TLIF. The OLIF is more suitable for these patients with low back pain as the main symptoms are accompanied by mild or no leg symptoms before operation. [ABSTRACT FROM AUTHOR]

Objective: Unilateral biportal endoscopic discectomy (UBE) is an emerging and minimally invasive surgeryfor lumbar spinal degenerative disease. However, the efficacy, safety and the radiological changes of dural sac and paraspinal muscle of UBE compared with the conventional percutaneous transforaminal endoscopic discectomy (PTED) remains to be determined. The purpose of the study was to comprehensively compare the clinical efficacy between UBE and PTED in the surgical treatment of lumbar spinal degenerative disease., Methods: The clinical and radiological data of patients who underwent single-segment endoscopic surgery for lumbar spinal degenerative disease in our hospital from January 2021 to June 2022 were collected in the retrospective study. The visual analogue score (VAS) for back and leg pain, Oswestry disability index (ODI) before and 3, 6, and 12 months postoperative, changes of the cross-sectional area of the dural sac area and paraspinal muscles on axial T2-weighted MRI, operation time, intraoperative complications, MacNab criteria for evaluating efficacy at 12 months postoperatively, and recurrence rate of symptoms within 12 months were compared between patients undergoing PTED and UBE surgeries., Results: A total of 142 patients were included. Among them 74 patients underwent PTED surgery, and 68 patients underwent UBE surgery. No statistically significant differences were identified between the groups in demographic variables. The average VAS and ODI scores in both groups showed significant improvement during the follow-up but without statistically significant difference between the groups. The average operation time in the PTED group was 74.82 ± 19.49 min shorter than the 81.36 ± 21.37 min in the UBE group, exhibiting no statistically significant difference. Although the incidence of complications and recurrence was lower in the UBE group (4.05% vs. 1.47%, p = 0.354; 4.05% vs. 1.47%, p = 0.354, respectively), these differences did not reach statistical significance. The dural sac area in the PTED group increased byan average of 43.16 ± 14.62 cm 2 , and it was 68.53 ± 16.42 cm 2 in the UBE group. Despite the dural sac area increased in both groups, the UBE group had a statistically significant greater improvement than the PTED group (p = 0.000). The area of the paraspinal muscle in the UBE group was significantly greater postoperatively (34.54 ± 2.75 cm 2 vs. 36.22 ± 2.96 cm 2 , p = 0.001) and significantly less than in the PTED group at 12 months postoperatively (31.17 ± 2.59 cm 2 vs. 29.46 ± 3.11 cm 2 , p = 0.001)., Conclusion: Both PTED and UBE surgeries can achieve satisfactory improvement in symptoms and function for patients with lumbar spinal degenerative disease and can be well-maintained as a first-line minimally invasive treatment. However, the UBE technique can achieve a better decompression area to restore the normal shape of the dural sac but may lead to greater paraspinal muscle damage and atrophy., (© 2025 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Objective: To analyze the causes of back pain after vertebroplasty or kyphoplasty., Methods: 1 863 patients with back pain who underwent vertebroplasty or kyphoplasty from Jan. 2004 to Dec. 2014 in Department of Spine Surgery, Beijing Jishuitan Hospital, were followed up for least 3 months after surgery with their back pain evaluated by VAS scores. Related information including preoperative, operative and postoperative factors was gathered. The VAS at last follow-up over 5 or the symptom relief less than 50% was considered as non-relieved, the correlations between the symptom relief and potential influencing factors were analyzed by the Spearman correlation., Results: Symptom relief was only correlated with postoperative complications (P<0.001). The back pain in 283 cases (15.2%) had not been relieved. Among them, 87 cases got fractures in other vertebrae (adjacent vertebrae in 67 cases, non-adjacent vertebrae in 20 cases); 3 cases got nonunion in the operated vertebrae; 1 case got postoperative infection; 6 cases got misdiagnosis and the other 186 cases had no known causes for the unrelieved pain., Conclusions: Postoperative back pain after vertebroplasty or kyphoplasty may have variable causes, and some of which have not been entirely understood. If the symptoms are not alleviated or even aggravate after active symptomatic treatment and anti-osteoporotic therapy, underlying causes such as re-fracture, nonunion, infection, pathologic fracture should be sought out.