Medical Literature Digest

This 10-year population-based cohort included 132 subaxial cervical spine fractures in 127 patients with ankylosing spondylitis (median age 70; 88% male), most from low-energy falls; 94% were AO type B or C and 20% had cervical spinal cord injury. Primary management was surgical in 67% and conservative in 33% (14% of conservatively managed patients required delayed surgery); revision surgery occurred in 9% and 90-day mortality was 16%, which was associated with older age, higher ASA class, and in-hospital pneumonia but not with cord injury or treatment modality.

In a nationwide time-varying cohort of 1,620,585 individuals aged ≥50 (2010–2022), degenerative spine disease (SPINE_DX) and spinal fusion (SPINE_FUSION) were modeled as exposures and compared with controls for incident hip osteoarthritis (HOA) and progression to total hip arthroplasty (THA). Both SPINE_DX (HR 1.66, 95% CI 1.64–1.68) and SPINE_FUSION (HR 1.22, 95% CI 1.19–1.25) were associated with increased HOA incidence, and among those with HOA progression to THA was higher with SPINE_FUSION (HR 2.32, 95% CI 2.06–2.62) and SPINE_DX (HR 1.51, 95% CI 1.41–1.62); results were consistent after inverse probability weighting.

A meta-analysis of 17 randomized trials (n=2238) comparing full endoscopic discectomy (FED) versus microscopic discectomy (MSD) for adult lumbar disc herniation found comparable leg pain trajectories and similar operative time and length of stay. FED was associated with small improvements in 1-year back pain and 2-year ODI, reduced blood loss and faster return-to-work, and lower wound-related complications (infection, poor healing, hematoma) but greater radiation exposure; risk of bias was low-to-moderate and the authors judged the certainty of evidence moderate.