| Suzuki A, Daubs MD, Hayashi T, et al. Patterns of cervical disc degeneration: analysis of magnetic resonance imaging of over 1000 symptomatic subjects. Global Spine Journal. 2018;8(3):254-259. doi:10.1177/2 192 568 217 719 436 |
Cross-sectional |
The authors developed a comprehensive grading system and an algorithm for cervical disc degeneration (Table 1).
The grade of cervical disc degeneration was categorized into 4 grades:
• Grade 0 (no degeneration)
• Grade I (mild degeneration)
• Grade II (moderate degeneration)
• Grade III (severe degeneration) |
Yes, kappa statistic |
| Garber S, Bisson E, Schmidt M. Comparison of three-dimensional fluoroscopy versus postoperative computed tomography for the assessment of accurate screw placement after instrumented spine surgery. Global Spine Journal. 2012;2(2):095-098. doi:10.1055/s-0032-1 319 775 |
Retrospective |
The objective of study was to compare images obtained using 3-dimensional fluoroscopy intraoperatively with the images obtained on postoperative CT scan for equivalent visualization of instrumentation placement.
• Rao grading scale was used for assessment of screw placement (Table 1) |
Yes, kappa statistic |
| Dahdaleh N, Khanna R, Menezes A, et al. The application of the revised condyle-C1 interval method to diagnose traumatic atlanto-occipital dissociation in adults. Global Spine Journal. 2016;6(6):529-534. doi:10.1055/s-0035-1 569 058 |
Retrospective |
Modified or revised condyle–C1 interval (CCI) along with other commonly used methodologies were retrospectively applied to patients with atlanto-occipital dislocation (AOD) and to a cohort of 30 patients without AOD.
Continuous measurements from both the AOD and normal cohorts were converted to binary format, that is, diagnostic of AOD: yes, no |
Yes, kappa statistic |
| Malham G, Parker R, Ballok Z, Goss B, Diwan A, Uribe J. Bone scans are reliable for the identification of lumbar disk and facet pathology. Global Spine Journal. 2015;5(1):023-030. doi:10.1055/s-0034-1 394 298 |
Survey |
The objective of the study was to evaluate the reliability of bone single-photon emission computed tomography (SPECT) versus bone SPECT images co-registered with computed tomography (bone SPECT-CT).
Interobserver agreement for identification of any diagnostically relevant uptake in the disk and/or facet joint between L1 and S1 was analyzed. |
Yes, kappa statistic |
| Kulkarni AG, Tapashetti S. Outcomes of discectomy in young adults with large central lumbar disc herniations presenting with predominant leg pain. Global Spine Journal. 2019;10(4):412-418. doi:10.1177/2 192 568 219 856 871 |
Retrospective cohort |
The objective of the study was to evaluate the outcomes of discectomy in young patients with large central lumbar disc herniation (CLDH) presenting with predominant leg pain.
Central disc herniation type was categorized as described by Barlocher et al, which categorizes CLDH into extrusion or sequestration of disc occupying more than 50% of the sagittal intraspinal diameter and contained central herniation occupying less than 50% |
Yes, kappa statistic |
| Willhuber GC, Bendersky M, Cicco FLD, et al. Development of a new therapy-oriented classification of intervertebral vacuum phenomenon with evaluation of intra- and interobserver reliabilities. Global Spine Journal. 2020:219 256 822 091 300. doi:10.1177/2 192 568 220 913 006 |
Diagnostic study |
The objective of this study was to describe a new classification of vacuum phenomenon based on computed tomography scan in order to improve the indications for percutaneous discoplasty.
• Classification system included type 0, type 1, type 2, type 2A, type 2B, type 3, type 3A, type 3B (Table 1) |
Yes, kappa statistic |
| Barkoh K, Ohiorhenuan IE, Lee L, et al. The DOWN questionnaire: a novel screening tool for cervical spondylotic myelopathy. Global Spine Journal. 2019;9(6):607-612. doi:10.1177/2 192 568 218 815 863 |
Case-control |
The authors created the DOWN questionnaire to identify patients with cervical spondylotic myelopathy (CSM) that should be further evaluated both clinically and with advanced imaging.
• Each patient answered 4 questions encompassing common symptoms associated with CSM. |
Yes, kappa statistic |
| Ono AHDA, Chang VYP, Rodenbeck EM, et al. Assessment of the accuracy of the AO Spine-TL classification for thoracolumbar spine fractures using the AO Surgery Reference mobile app. Global Spine Journal. 2020:219 256 822 090 169. doi:10.1177/2 192 568 220 901 694 |
Cohort |
The authors sought to evaluate the accuracy of the AO Surgery Reference mobile app in the diagnosis and treatment of thoracolumbar fractures as proposed by the AO TL classification. |
Yes, kappa statistic |
| Willhuber GC, Guiroy A, Zamorano J, Astur N, Valacco M. Independent reliability analysis of a new classification for pyogenic spondylodiscitis. Global Spine Journal. 2020:219 256 822 091 909. doi:10.1177/2 192 568 220 919 091 |
Diagnostic |
The authors sought to perform an independent reliability analysis of a new classification system for spondylodiscitis based on magnetic resonance imaging (Table 1). |
Yes, kappa statistic |
| Stoker GE, Buchowski JM, Chen CT, Kim HJ, Park MS, Riew KD. Hypovitaminosis D and cervical disk herniation among adults undergoing spine surgery. Global Spine Journal. 2013;3(4):231-236. doi:10.1055/s-0033-1 354 252 |
Retrospective |
The authors sought to examine the association of vitamin D levels with intervertebral disk disease.
• The C2–T1 disk was evaluation radiographically for degeneration and herniation
• Degeneration was rated on a spectrum from normal structure and signal intensity (grade I) to disk collapse (grade V) and summed per patient |
Yes, kappa statistic |
| Park M, Moon SH, Kim TH, et al. Asymptomatic stenosis in the cervical and thoracic spines of patients with symptomatic lumbar stenosis. Global Spine Journal. 2015;5(5):366-371. doi:10.1055/s-0035-1 549 031 |
Retrospective |
The objective of the study was to investigate the incidence of asymptomatic radiologic cervical and thoracic stenosis in elderly patients with symptomatic lumbar stenosis, to investigate the incidence of concurrent radiologic spinal stenosis in the cervical and thoracic spines, and to identify the radiologic features of cervical stenosis that might predict concurrent thoracic stenosis.
Radiologic parameters between the subgroups of cervical stenosis with and without thoracic stenosis was determined to elucidate the radiologic features of cervical stenosis that might predict concurrent thoracic stenosis. |
Yes, kappa statistic |
| Rajasekaran S, Kanna RM, Schroeder GD, et al. Does the spine surgeon’s experience affect fracture classification, assessment of stability, and treatment plan in thoracolumbar injuries? Global Spine Journal. 2017;7(4):309-316. doi:10.1177/2 192 568 217 699 209 |
Prospective survey |
The authors evaluated how surgeon’s experience affected the reproducibility of fracture classification according to the AOSpine Thoracolumbar Injury Classification System. And also determined the influence of surgeon’s experience on the assessment of stability and on treatment decision-making for different fracture subtypes, based on evaluating conventional radiographs, CT, and MRI. |
Yes, kappa statistic |
| Oshima Y, Kelly M, Song KS, et al. Spinolaminar line test as a screening tool for C1 stenosis. Global Spine Journal. 2016;6(4):370-374. doi:10.1055/s-0035-1 564 418 |
Retrospective cohort |
The objective of the study was to clarify the sensitivity of C3-C2 spinolaminar line test as a screening tool for the stenosis of C1 space available for the cord (SAC).
• SAC of atlas measured
• If ventral lamina of C1 lay ventral to C3-C2 spinolaminar line, spinolaminar test defined as positive indicating the possibility of existence of a relatively narrow SAC of C1.
• Dimensions of the atlas, dens diameter, atlantodental interval (ADI), and C1 SAC measured using CT scans.
• Spinal cord diameters at C1 and C7 levels and existence of spinal cord compression measured using MRI |
Yes, kappa statistic |
| Grin A, Krylov V, Lvov I, et al. External multicenter study of reliability and reproducibility for lower cervical spine injuries classification systems—part 1: a comparison of morphological schemes. Global Spine Journal. 2019:219 256 821 986 821. doi:10.1177/2 192 568 219 868 218 |
Multicenter observational survey |
The objective of the study was to measure and compare the inter- and intraobserver reliability for the Allen-Fergusson, Harris, Argenson, and AOSpine systems of classification of subaxial cervical spinal injuries, on implementation by neurosurgeons having different levels of experience and working in different clinics. |
Yes, kappa statistic |
| Weber C, Rao V, Gulati S, Kvistad K, Nygaard Ø, Lønne G. Inter- and intraobserver agreement of morphological grading for central lumbar spinal stenosis on magnetic resonance imaging. Global Spine Journal. 2015;5(5):406-410. doi:10.1055/s-0035-1 551 651 |
Validation study |
The objective of the study was to evaluate and validate the inter- and intraobserver agreement of a morphological grading system for central lumbar spinal stenosis on magnetic resonance imaging between neurosurgeons and radiologists.
Grading method (Figure 1) is based on the original publication by Schizas et al (grade A-D) |
Yes, kappa statistic |
| Schroeder G, Kepler C, Koerner J, et al. A worldwide analysis of the reliability and perceived importance of an injury to the posterior ligamentous complex in AO type A fractures. Global Spine Journal. 2015;5(5):378-382. doi:10.1055/s-0035-1 549 034 |
Survey |
The objective of the study was to determine the reliability with which spine surgeons identify a posterior ligamentous complex (PLC) injury in a patient with a compression-type vertebral body fracture (type A). |
Yes, kappa statistic |
| Schell A, Rhee JM, Holbrook J, Lenehan E, Park KY. Assessing foraminal stenosis in the cervical spine: a comparison of three-dimensional computed tomographic surface reconstruction to two-dimensional modalities. Global Spine Journal. 2017;7(3):266-271. doi:10.1177/2 192 568 217 699 190 |
Retrospective radiographic |
The objective of the study was to determine interrater variability in grading cervical foraminal stenosis using 3 different CT imaging modalities: 3D CT surface reconstructions (3DSR), 2D sagittal oblique multiplanar reformations (2D-SOMPR), and conventional 2D axial CT imaging. |
Yes, kappa statistic |
| Morimoto Y, Shigematsu H, Iwata E, et al. Evaluating cervical sagittal alignment in cervical myelopathy: are sitting cervical radiographs and standing whole-spine radiographs equally useful? Global Spine Journal. 2019;9(6):591-597. doi:10.1177/2 192 568 218 811 841 |
Retrospective |
The authors sought to clarify the differences in cervical alignment findings between sitting cervical lateral radiographs and standing whole-spine lateral radiographs with clavicle positioning in cervical spondylotic myelopathy (CSM) patients.
Parameters measured on lateral radiographs included C0-2 angle, C2-7 Cobb and Gore angles, McGregor angle, CGH-C7 angle, T1-slope (Figure 2) |
Yes, intraclass correlation coefficient (ICC) |
| Cheung J, Samartzis D, Cheung P, Cheung K, Luk K. Reliability analysis of the distal radius and ulna classification for assessing skeletal maturity for patients with adolescent idiopathic scoliosis. Global Spine Journal. 2016;6(2):164-168. doi:10.1055/s-0035-1 557 142 |
Prospective radiographic study |
The objective of the study was to test the reliability of the Distal Radius and Ulna Classification (DRU) |
Yes, intraclass correlation (ICC) analysis |
| Faraj SSA, Hennepe NT, van Hooff ML, Pouw M, de Kleuver M, Spruit M. The natural history of progression in adult spinal deformity: a radiographic analysis. Global Spine Journal. 2020;10(3):272-279.doi:10.1177/2 192 568 219 845 659 |
Historical cohort |
The objective of the study was to evaluate the natural history of adult spinal deformity (ASD), and curve progression in the coronal and sagittal planes in a cohort of nonsurgical patients.
Radiographic factors measured included direction of scoliosis, curve magnitude, Cobb angle, thoracic kyphosis, lumbar lordosis, pelvic tilt, pelvic incidence, sacral slope, pelvic incidence minus lumbar lordosis
• and position of the intercrest line. |
Yes, intraclass correlation (ICC) |
| Maheswaran A, Aiyer SN, Farouk O, et al. Assessment of interobserver variability for CT scan–based evaluation of posterior ligament complex injury in thoracolumbar fractures: an international multicenter pilot study. Global Spine Journal. 2020;10(2):118-129.doi:10.1177/2 192 568 219 839 414 |
Pilot study |
The objective of the study was to determine the interobserver variability and the feasibility of CT based parameters to assess posterior ligament complex (PLC) injury compared with MRI when used in a multicenter setting. |
Yes, intraclass correlation (ICC) |
| Grin A, Krylov V, Lvov I, et al. External multicenter study of reliability and reproducibility for lower cervical spine injuries classification systems—part 2: an analysis of the subaxial cervical spine injury classification and cervical spine injury severity score scale. Global Spine Journal. 2019:219 256 821 989 654. doi:10.1177/2 192 568 219 896 546 |
Observational |
The authors sough to quantify and compare inter- and intraobserver reliability of the subaxial cervical spine injury classification (SLIC) and the cervical spine injury severity score (CSISS) |
Yes, intraclass correlation coefficient (ICC) and kappa statistic |
| Fox S, Spiess M, Hnenny L, Fourney DR. Spinal Instability Neoplastic Score (SINS): reliability among spine fellows and resident physicians in orthopedic surgery and neurosurgery. Global Spine Journal. 2017;7(8):744-748. doi:10.1177/2 192 568 217 697 691 |
Reliability analysis |
The authors sought to determine the reliability of the Spinal Instability Neoplastic Score among spine residents and fellows, and its role as an educational tool. |
Yes, intraclass correlation coefficient (ICC) and kappa statistic |
| Gupta A, Upadhyaya S, Yeung CM, et al. Does size matter? An analysis of the effect of lumbar disc herniation size on the success of nonoperative treatment. Global Spine Journal. 2019:219 256 821 988 082. doi:10.1177/2 192 568 219 880 822 |
Retrospective study |
Authors examined whether the size of a lumbar disc herniation (LDH) is predictive of the need for surgical intervention within 2 years after obtaining an initial MRI scan
Following measurements were made for a given disc herniation:
• The anterior-posterior length of both the canal and the herniated disc
• The average width of the disc within the canal
• The total canal area
• The total disc area |
Yes, Cronbach’s alpha and intraclass correlation coefficient (ICC) |
| Horsting P, Pavlov P, Jacobs W, Obradov-Rajic M, de Kleuver M. Good functional outcome and adjacent segment disc quality 10 years after single-level anterior lumbar interbody fusion with posterior fixation. Global Spine Journal. 2012;2(1):021-026. doi:10.1055/s-0032-1 307 264 |
Prospective cohort |
The authors sought to analyze long-term functional outcome and to determine the rate of adjacent segment degeneration (ASD) 10 years after ALIF with additional posterior fixation
• Scoring of adjacent segment disease was based on Pfirrmann grade of discs, grade of facet joint degeneration, modic changes (Table 2) |
No |
| Obradov M, Bénard MR, Janssen MMA, Anderson PG, Heesterbeek PJC, Spruit M. Kinematic magnetic resonance imaging assessment of the degenerative cervical spine: changes after anterior decompression and cage fusion. Global Spine Journal. 2016;6(7):673-678. doi:10.1055/s-0036-1 579 551 |
Prospective cohort |
The objective of the study was to measure adjacent segment pathology, cervical curvature, and ROM of individual segments of the cervical spine using kinematic MRI before and 24 months after monosegmental cage fusion.
Stage of degeneration, grade of spinal stenosis, and change in cervical curvature was measured before and after mono-segmental cage fusion
Stage of degenerative disease
• “Degenerative cascade,” MRI based classification, consists of 3 stages (I, II, III)
Spinal stenosis
• Classification of Muhle et al, consists of 4 grades (0-3)
Cervical curvature
• Guigui et al and by Batzdorf and Batzdorff, consists of type 0-3 |
No |
| Abraham E, Manson N, McKeon M. The incidence of adjacent segment breakdown in polysegmental thoracolumbar fusions of three or more levels with minimum 5-year follow-up. Global Spine Journal. 2014;4(2):083-088. doi:10.1055/s-0034-1 370 693 |
Retrospective cohort |
The objective of the study was to identify the incidence of adjacent segment pathology (ASP) after thoracolumbar fusion of 3 or more levels, the risk factors for the development of ASP
Radiographs exhibiting no adjacent segment pathology were distinguished from radiographs demonstrating findings such as degenerative disk disease, listhesis, instability, stenosis, and/or deformity
• The primary outcome measure was defined as the presence or absence of ASP upon radiographic analysis (Figure 1) |
No |
| Bakhsh W, Saleh A, Yokogawa N, Gruber J, Rubery PT, Mesfin A. Cervical ossification of the posterior longitudinal ligament: a computed tomography–based epidemiological study of 2917 patients. Global Spine Journal. 2019;9(8):820-825. doi:10.1177/2 192 568 219 833 658 |
Retrospective cohort |
The objective of the study was to evaluate prevalence of cervical ossification of the posterior longitudinal ligament (OPLL)
• Authors identified and classified OPLL into localized, segmental, continuous, or mixed type via CT scan (Figure 1a and b) |
No |
| Ramadorai U, Hire J, DeVine J. Magnetic resonance imaging of the cervical, thoracic, and lumbar spine in children: spinal incidental findings in pediatric patients. Global Spine Journal. 2014;4(4):223-228. doi:10.1055/s-0034-1 387 179 |
Retrospective case series |
The objective of the study was to determine the rate of spinal incidental findings in asymptomatic pediatric patients, as well as the rate of negative findings in symptomatic patients.
Measured data were coded as follows:
• A +/+ patient was one who presented with a complaint of neck or back pain and a positive MRI
• A −/− patient was one who was completely asymptomatic and had a normal MRI
• A +/− patient was one who presented with pain and had a negative MRI
• A −/+ patient was one without symptoms and a positive MRI |
No |
| Lee S, Jahng TA, Kim HJ. Adverse effect of trauma on neurologic recovery for patients with cervical ossification of the posterior longitudinal ligament. Global Spine Journal. 2015;05(02):124-129. doi:10.1055/s-0034-1 397 340 |
Retrospective study |
The objective of the study was to determine the influence of trauma on the neurologic course in patients who have undergone surgery for cervical posterior longitudinal ligament ossification (OPLL)
• Japanese Orthopedic Association (JOA) score and the Nurick scale were used to assess the degree of cervical myelopathy (Figure 1a and b)
• Cervical angle and cervical range of motion at C2-C7 were calculated by Cobb’s method (Table 3)
• The type of OPLL was classified as segmental, continuous, mixed, or other type (Table 3)
• The space available for the spinal cord (SAC) was measured on midsagittal the CT images. The presence and length associated with the high signal intensity were evaluated on the patients’ initial MRIs (Table 3). |
No |
| Raasck K, Khoury J, Aoude A, et al. The effect of thoracolumbar pedicle isthmus on pedicle screw accuracy. Global Spine Journal. 2019;10(4):393-398.doi:10.1177/2 192 568 219 850 143 |
Retrospective analysis |
The authors of the study aimed to investigate the inverse correlation between pedicle screw breach incidence and vertebral isthmus width.
• The accuracy of each pedicle screw was objectively evaluated by comparing preoperative CT scan with a postoperative CT scan
• The extent of the breach major or minor, was noted.
• A minor breach was defined as a screw that extended less than 2 mm beyond the pedicular cortex, while a major breach was defined as a screw extending over 2 mm. |
No |
| Jeon CH, Lee HD, Chung NS. Does mechanical bowel preparation ameliorate surgical performance in anterior lumbar interbody fusion? Global Spine Journal. 2019;9(7):692-696. doi:10.1177/2 192 568 218 825 249 |
Retrospective case-control |
The objective of the study was to investigate whether mechanical bowel preparation (MBP) improves surgical performance and decrease operative complications in anterior lumbar interbody fusion (ALIF)
Immediately postoperatively, the operating surgeon completed a self-administered questionnaire assessing the easiness of each surgical procedure on a 4-point Likert-type scale (1 = excellent, 2 = good, 3 = fair, 4 = poor).
• The questionnaires involved peritoneal mobilization during the retroperitoneal approach, surgical field exposure for ALIF, and performance of interbody fusion procedure.
• Operative time, EBL, and occurrence of any intraoperative complication were also compared between patients with MBP and without MBP (Table 2). |
No |
| Lee HQ, Kow CY, Ng JS, et al. Correlation of anterior interbody graft choice with patient-reported outcomes in cervical spine trauma. Global Spine Journal. 2019;9(7):735-742. doi:10.1177/2 192 568 219 828 720 |
Ambispective observational cohort |
The objective of the study was to evaluate outcomes of anterior cervical stabilization surgery using a synthetic cage in comparison with iliac crest bone graft (ICBG) following cervical spine trauma.
Radiographic evidence of postoperative interbody fusion and stability was assessed 6 months post-surgery independently by 2 investigators (HL and CK). |
No |
| Kawasaki Y, Seichi A, Zhang L, Tani S, Kimura A. Dynamic changes of cauda equina motion before and after decompressive laminectomy for lumbar spinal stenosis with redundant nerve roots: cauda equina activation sign. Global Spine Journal. 2019;9(6):619-623. doi:10.1177/2 192 568 218 821 344 |
Cross-sectional observational study |
The objective of the study was to define a criterion for achieving successful decompression of lumbar spinal stenosis (LSS) using intraoperative ultrasonography (IOUS) and to investigate the pathogenesis of redundant nerve roots (RNRs) based on the ultrasonographic findings.
• Cauda equina motion was stratified into one of 3 types
• The severity of spinal stenosis was assessed using grading system (A-D) proposed by Schizas et al. |
No |
| Kanna RM, Shetty AP, Rajasekaran S. Predictors of successful outcomes of selective nerve root blocks for acute lumbar disc herniation. Global Spine Journal. 2019;9(5):473-479. doi:10.1177/2 192 568 218 800 050 |
Prospective observational cohort |
The objective of the study was to determine the factors that would predict successful outcomes in patients undergoing selective nerve root block (SNRB)
Radiographic parameters included:
• Level of disc prolapse
• Position of disc in the axial T2 image
• Type of disc herniation
• Pfirrmann’s grade of the affected disc
• Presence of lumbosacral transitional vertebra at the level of the disc herniation
Classification of nerve block radiculogram into 4 types:
• “Arm,” “arrow,” “linear,” and “splash” |
No |
| Kawaguchi Y, Kitajima I, Nakano M, et al. Increase of the serum FGF-23 in ossification of the posterior longitudinal ligament. Global Spine Journal. 2019;9(5):492-498. doi:10.1177/2 192 568 218 801 015 |
Case-control |
The objective of the study was to determine the possible pathogenesis of ossification of the posterior longitudinal ligament (OPLL) in regard to the serum concentration of fibroblast growth factor 23 (FGF-23)
• The diagnosis of OPLL was made radiographically
• The total ossification index (the OS index) was used as an indicator for the severity of spinal ligament ossification
• Progression of ossification was evaluated radiographically |
No |
| Matsumoto T, Okuda S, Nagamoto Y, Sugiura T, Takahashi Y, Iwasaki M. Effects of concomitant decompression adjacent to a posterior lumbar interbody fusion segment on clinical and radiologic outcomes: comparative analysis 5 years after surgery. Global Spine Journal. 2019;9(5):505-511. doi:10.1177/2 192 568 218 803 324 |
Retrospective cohort |
The objective of the study was to examine the effects of concomitant decompression adjacent to the PLIF segment on the clinical and radiological outcomes 5 years after surgery.
• The extent of the concomitant posterior decompression at L3/4 was determined by preoperative myelography
• Disc height, vertebral slippage, range of motion (ROM) of the disc angle, posterior opening angle, segmental lordotic angle, the presence of the intradiscal vacuum phenomenon (IVP) at the L3/4 level, and lumbar lordosis at L1-S were measured on lateral radiograph (Figure 1A) |
No |
| Oitment C, Kwok D, Steyn C. Calcified thoracic disc herniations in the elderly: revisiting the laminectomy for single level disease. Global Spine Journal. 2019;9(5):527-531. doi:10.1177/2 192 568 218 806 274 |
Retrospective case series |
The authors examined a series of myelopathic elderly patients with calcified thoracic disc herniations who received a noninstrumented laminectomy without decompression of the disc space and hypothesize that patients who are medically unfit for extensive surgery or have significant medical comorbidities precluding them from direct decompression may benefit from a laminectomy without decompression of the disc space.
• Calcification was determined preoperatively via CT or intraoperatively
• ASIA scores were determined by reviewing clinical notes |
No |
| Kanna RM, Raja DC, Shetty AP, Rajasekaran S. Thoracolumbar fracture dislocations without spinal cord injury: classification and principles of management. Global Spine Journal. 2019:219 256 821 989 056. doi:10.1177/2 192 568 219 890 568 |
Retrospective cohort |
The authors describe a case series of patients with thoracolumbar fracture dislocation (TLFD) without cord injury and describe the different injury mechanisms, radiological subtypes, and principles of management.
• Thoracic and lumbar fractures were classified based on the direction of translation into 4 types: coronal translation (type 1), sagittal translation (type 2), combined translation—antero (type 3a), and combined translation—retro (type 3b) |
No |
| Camino Willhuber G, Elizondo C, Slullitel P. Analysis of postoperative complications in spinal surgery, hospital length of stay, and unplanned readmission: application of Dindo-Clavien classification to spine surgery. Global Spine Journal. 2019;9(3):279-286. doi:10.1177/2 192 568 218 792 053 |
Retrospective study |
The authors sought to assess the 90-day postoperative complication rate following spinal surgeries by applying the Dindo-Clavien classification system (complication grade) as well as to analyze the unplanned readmission rate and total hospitalization LOS in patients with and without complications (Table 1) |
No |
| Acosta FL, Mehta VA, Arakelyan A, et al. A novel lumbar motion segment classification to predict changes in segmental sagittal alignment after lateral interbody fixation. Global Spine Journal. 2017;7(7):642-647. doi:10.1177/2 192 568 217 723 925 |
Retrospective cohort |
The authors sought to describe a novel facet-based motion segment classification system that significantly predicted postoperative segmental lordosis after lateral lumbar interbody fusion
• Each facet was assigned a facet grade (min = 0, max = 2), and the sum of the bilateral facet grades was the final motion segment grade (MSG; min = 0, max = 4) (Table 1) |
No |
| Matsumura A, Hoshi M, Takami M, Tashiro T, Nakamura H. Radiation therapy without surgery for spinal metastases: clinical outcome and prognostic factors analysis for pain control. Global Spine Journal. 2012;2(3):137-141. doi:10.1055/s-0032-1 326 948 |
Retrospective case-control |
The objective of the study was to assess the clinical outcome of radiation therapy (RT) for spinal metastases in a retrospective case control study and to identify prognostic factors for pain control in patients with spinal metastases treated with RT.
• Pain grades were assessed using a drug grading level based on World Health Organization (WHO) standards.
• Drug grading using the WHO scale was as follows: 0, no drug; 1, nonsteroidal anti-inflammatory drugs; 2, weak opioid; 3, strong opioid (Table 1)
• Authors used Tokuhashi’s Evaluation System for the Prognosis of Metastatic Spine Tumor (Table 2) |
No |
| Nakazawa T, Inoue G, Imura T, et al. Radiographic and clinical outcomes from the use of S2 alar screws in surgery for adult spinal deformity. Global Spine Journal. 2018;8(7):668-675. doi:10.1177/2 192 568 218 762 378 |
Retrospective |
The objective of the study was to investigate the clinical and radiographic outcomes to evaluate the efficacy of S2 alar screws in surgery for correction of adult spinal deformity (ASD)
• X-ray and CT reviewed by 2 radiologists to determine instrumentation and fusion-related radiographic outcomes (Tables 2 and 3) |
No |
| Kraus M, Weiskopf J, Dreyhaupt J, Krischak G, Gebhard F. Computer-aided surgery does not increase the accuracy of dorsal pedicle screw placement in the thoracic and lumbar spine: a retrospective analysis of 2,003 pedicle screws in a level I trauma center. Global Spine Journal. 2015;5(2):093-101. doi:10.1055/s-0034-1 396 430 |
Retrospective observational |
The authors sought to assess the placement accuracy and potentially influencing factors of 3-dimensionally navigated versus conventionally inserted pedicle screws.
• Position of the screw was determined regarding the distance to the medial and lateral bone margin of the pedicle and the position of the tip of the screw in the vertebral body
• Perforations of the pedicle were differentiated in 3 grades: grade 0, accurate (no breach of the compact tissue); grade 1, perforation less than 2 mm; grade 2, perforation of 2 mm or more. |
No |
| Gruenberg M, Mereles ME, Willhuber GOC, Valacco M, Petracchi MG, Solá CA. Usefulness of Tokuhashi score in survival prediction of patients operated for vertebral metastatic disease. Global Spine Journal. 2017;7(3):260-265. doi:10.1177/2 192 568 217 699 186 |
Retrospective |
The objective of the study was to evaluate the usefulness of Tokuhashi scoring (TS) system by comparing the predicted and real survival times and analyze the survival time according to the type of tumor (Table 1).
• Preoperative TS was performed in all and patients were classified into 3 groups according to TS; group 1 (TS 0-8), group 2 (TS 9-11), and group 3 (TS 12-15).
• Imaging of the spine was assessed to define the number of metastases, location, and presence of cord or root compression |
No |
| Lafage R, Beyer G, Schwab F, et al. Risk factor analysis for proximal junctional kyphosis after adult spinal deformity surgery: a new simple scoring system to identify high-risk patients. Global Spine Journal. 2019:219 256 821 988 235. doi:10.1177/2 192 568 219 882 350 |
Retrospective |
The authors sough to develop a scoring system to estimate proximal junctional kyphosis (PJK) risk (Figure 2) |
No |
| Elder B, Sankey E, Goodwin C, et al. Surgical outcomes in patients with high spinal instability neoplasm score secondary to spinal giant cell tumors. Global Spine Journal. 2016;6(1):021-028. doi:10.1055/s-0035-1 555 657 |
Retrospective |
The authors sought to describe the surgical outcomes in patients with high preoperative Spinal Instability Neoplastic Score (SINS) secondary to spinal giant cell tumors (GCT).
• Frankel classification was used to determine patients’ preoperative functional status, and the SINS was used to evaluate the degree of spinal instability.
• Tumor location, preoperative tumor volume, Enneking classification, and evidence of pathologic vertebral body fracture also obtained. |
No |
| Shah K, Kothari M, Nene A. Role of frailty scoring in the assessment of perioperative mortality in surgical management of tuberculous spondylodiscitis in the elderly. Global Spine Journal. 2018;8(7):698-702. doi:10.1177/2 192 568 218 764 905 |
Retrospective |
The objective of the study was to examine the usefulness of frailty scoring in elderly patients undergoing surgery for spinal tuberculosis.
• Modified frailty score (MFS) was calculated for each patient and was used to predict 30 day mortality (Table 1).
• Other parameters recorded were American Society of Anesthesiologists (ASA) grade, operative time, blood loss, length of hospital stay, intensive care unit (ICU) stay and preoperative neurological deficit using Frankel system (Table 3). |
No |
| Sciubba D, Jain A, Kebaish KM, et al. Development of a preoperative adult spinal deformity comorbidity score that correlates with common quality and value metrics: length of stay, major complications, and patient-reported outcomes. Global Spine Journal. 2019:219 256 821 989 495. doi:10.1177/2 192 568 219 894 951 |
Retrospective |
The authors developed a novel comorbidity score specific to patients with adult spinal deformity (ASD) based on their preoperative health state and investigated whether it was associated with major complications, length of hospital stay, and self-reported outcomes after ASD surgery (Table 4). |
No |
| Kato M, Namikawa T, Matsumura A, Konishi S, Nakamura H. Radiographic risk factors of reoperation following minimally invasive decompression for lumbar canal stenosis associated with degenerative scoliosis and spondylolisthesis. Global Spine Journal. 2017;7(6):498-505. doi:10.1177/2 192 568 217 699 192 |
Prospective cohort |
The objective of the study was to evaluate the appropriateness of microsurgical bilateral decompression via a unilateral approach (MBDU) for degenerative lumbar scoliosis (DLS) or degenerative spondylolisthesis (DS).
• Clinical indications for MBDU were leg pain and/or leg numbness inducing intermittent claudication
• The radiological indications were lumbar spinal stenosis, DLS with a Cobb’s angle ≥10° or ≤20°, and DS with Meyerding grade ≤1 and posterior opening ≤5° during anterior flexion of the affected intervertebral level
• Patients were divided into 3 groups according to their diagnosis |
No |
