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This study aimed to perform a comparative analysis of postoperative results between lumbar degenerative spondylolisthesis (LDS) treated with oblique lateral interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) from the Chiba spine surgery registry database. Sixty-five patients who underwent single-level OLIF (O group) for LDS with ≥ 3 years’ follow-up were retrospectively reviewed. The control group comprised 78 patients who underwent single-level TLIF (T group). The analyzed variables included global alignment, radiological parameters of fused segments, asymptomatic and symptomatic ASD incidence, clinical outcomes at 3 years postoperatively using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire data, visual analogue scale scores for low back pain, lower extremity pain, and lower extremity numbness. There was no significant change in global alignment between the two groups. The rate of improvement in anterior intervertebral disc height was not significantly different between the groups at 1-month postoperatively. However, at the final evaluation, the anterior intervertebral disc height and incidence of asymptomatic ASD were significantly higher in the O group. There was no significant difference in symptomatic ASD, reoperation cases, or clinical results between groups. Thus, single-level OLIF can maintain the corrected disc height, but as it has no effect on global alignment, its benefit is limited.

Introduction: Mirogabalin should be equivalent to pregabalin, but with fewer incidences of adverse drug reactions (ADRs). To verify these benefits in actual clinical trials, our study investigated the frequency of ADRs and mirogabalin's analgesic effects during treatment of peripheral neuropathic pain.Methods: This study included 74 patients with lower limb pain. We surveyed patient reports of ADRs during the followup period as the primary endpoint and examined the visual analog scale (VAS) reported for lower limb pain as the secondary endpoint (before administration, and two and four weeks after administration).Results: The occurrence of ADR was 27.0%, like the frequency of ADRs in the clinical trials for other disorders. However, the discontinuation rate of administration was 10.8%, which was significantly lower than the frequency of ADR occurrences. When the analgesic effect was assessed, a significant decrease in the temporal change of VAS for lower limb pain was observed before administration, and two and four weeks after administration.Conclusions: In this study, the occurrence of ADRs reported by the patients was like the frequency of ADRs reported in the clinical trials for other disorders. When assessing the analgesic effect, the temporal change of VAS for lower limb pain was found to decrease significantly before administration, and two and four weeks after administration.

This study investigated the effect of romosozumab on bone union in a rat posterolateral lumbar fixation model. Posterolateral lumbar fixation was performed on 8‐week‐old male Sprague Dawley rats (n = 20). For bone grafting, autogenous bone (40 mg) was harvested from the spinous processes of the 10th thoracic vertebra until the 2nd lumbar vertebra and implanted between the intervertebral joints and transverse processes of the 4th and 5th lumbar vertebrae on both sides. Rats were matched by body weight and equally divided into two groups: R group (Evenity®, 25 mg/kg) and control (C) group (saline). Subcutaneous injections were administered twice a week until 8 weeks after surgery. Computed tomography was performed at surgery and week 8 after surgery. The area and percentage of bone trabeculae in the total area of bone fusion were calculated. Statistical analysis was performed using an unpaired t test (p < 0.05). We found that the R group rats had significantly higher mean bone union rate and volume than did the C group rats at all time courses starting week 4 after surgery. The R group had significantly higher increase rates than did the C group at weeks 4 and 6 after surgery. The percentage of bone trabeculae area in the R group was approximately 1.7 times larger than that in the C group. Thus, we demonstrated that romosozumab administration has stimulatory effects on bony outgrowth at bone graft sites. We attribute this to the modeling effect of romosozumab.

Study Design. A retrospective analysis of magnetic resonance imaging (MRI).Objective. The study aimed to evaluate the performance of a convolutional neural network (CNN) to differentiate spinal pyogenic spondylitis from Modic change on MRI. We compared the performance of CNN to that of four clinicians. Summary of Background Data. Discrimination between pyogenic spondylitis and spinal Modic change is crucial in clinical practice. CNN deep-learning approaches for medical imaging are being increasingly utilized. Methods. We retrospectively reviewed MRIs from pyogenic spondylitis and spinal Modic change patients. There were 50 patients per group. Sagittal T1-weighted (T1WI), sagittal T2-weighted (T2WI), and short TI inversion recovery (STIR) MRIs were used for CNN training and validation. The deep learning framework Tensorflow was used to construct the CNN architecture. To evaluate CNN performance, we plotted the receiver operating characteristic curve and calculated the area under the curve. We compared the accuracy, sensitivity, and specificity of CNN diagnosis to that of a radiologist, spine surgeon, and two orthopedic surgeons.Results. The CNN-based area under the curves of the receiver operating characteristic curve from the T1WI, T2WI, and STIR were 0.95, 0.94, and 0.95, respectively. The accuracy of the CNN was significantly greater than that of the four clinicians on T1WI and STIR (P < 0.05), and better than a radiologist and one orthopedic surgeon on the T2WI (P < 0.05). The sensitivity was significantly better than that of the four clincians on T1WI and STIR (P < 0.05), and better than a radiologist and one orthopedic surgeon on the T2WI (P < 0.05). The specificity was significantly better than one orthopedic surgeon on T1WI and T2WI (P < 0.05) and better than both orthopedic surgeons on STIR (P < 0.05). Conclusion. We differentiated between Modic changes and pyogenic spondylitis using a CNN that interprets MRI. The performance of the CNN was comparable to, or better than, that of the four clinicians.