Methods: This RCT included 60 patients (30 in control and 30 in intervention) between 18 and 80 years old, scheduled for elective single or double-level lumbar spine surgeries through the posterior approach. Intervention group (MBP) received PEGLEC, tablet Metronidazole 400 mg twice daily (BD), tablet Cefuroxime 500 mg BD, and probiotic (Bacillus clausii ) on pre-operation day, whereas the control (non-MBP) had no specific bowel preparation but received only a placebo. Outcome parameters included time to first flatus, bowel sound, and first defecation, which were compared between the two groups. Results: Demographic data such as age, sex, body mass index, level of surgery, and intraoperative data such as duration of surgery and blood loss were similar without significant differences. The time to first flatus, bowel sounds, and first defecation was not statistically significant, but POI was seen in 6.67% of patients, all belonging to the MBP group. No correlation observed between the duration of the ileus and the intraoperative blood loss and duration of surgery. Conclusions Bowel preparation may not be necessary for patients undergoing posterior lumbar spine surgery involving a maximum of two levels.

Robotic-assisted laminectomy (RAL) is an emerging technique in spine surgery that can potentially improve precision, safety, and efficiency. While robotic-assisted pedicle screw placement is well established, RAL remains in early stages with varied methodologies and primarily pre-clinical validation. This narrative review evaluates current evidence on RAL, focusing on bone cutting tools, resection strategies, state recognition techniques for real-time identification of bone type and surgical endpoints, and clinical applications to inform future advancements. A comprehensive literature search was conducted using PubMed, Embase, and Cochrane databases with relevant keywords and operators to maximize sensitivity. Twenty-seven studies met predefined inclusion and exclusion criteria. Evaluated cutting tools included burrs, drills, and ultrasonic osteotomes. Burrs and drills provided superior state recognition feedback, while ultrasonic devices offered better force control and reduced thermal damage. Cyclic dorsal–ventral drilling was found to be superior to layer-by-layer resection for ultrasonic cutting. The only clinical study of RAL in a human patient is a case report demonstrating robotic-guided, surgeon-operated laminar bone removal. While RAL shows promise in improving surgical accuracy, the lack of in vivo data and standardized methodology remains a key barrier to clinical adoption. Future research should prioritize comparative evaluation of cutting modalities, clinical validation in human subjects, and long-term outcome studies to support the broader integration of RAL into spine surgery.

Methods: Forty-three pain-free controls and 43 patients with chronic NSLBP were enrolled. Using non-invasive techniques, synchronized lumbar spine motion and erector spinae (ES) EMG activity were recorded during standardized trunk flexion-extension cycles. Results: Several variables differed significantly between the two groups. Logistic regression identified two variables with significant odds ratios for the presence of chronic NSLBP: time spent with the spine flexed beyond 90% of its maximum range (odds ratio, 0.92; 95% confidence interval, 0.86–0.99) and the ES relaxation ratio (odds ratio, 1.08; 95% confidence interval, 1.04–1.13). Conclusions Individuals with and without chronic NSLBP exhibit distinct spinal motion and ES activity patterns during trunk flexionextension. These differences—specifically the time of maximum lumbar flexion and the relaxation ratio—can be objectively and easily measured. Their assessment may offer valuable clinical utility for the diagnosis and follow-up of NSLBP patients.

Methods: A repeated-measures design was used to evaluate the test–retest reliability of measuring spinal alignment with DEXA. Eighty-six women aged 18–20 years with a diagnosis of IS, who had undergone spinal radiography within the previous 3 months, underwent two DEXA scans (DEXA1 and DEXA2) 1 week apart. Cobb angles were measured on radiographs, DEXA1, and DEXA2 by two independent assessors. Intraclass correlation coefficients (ICCs) were calculated to assess test–retest reliability and inter-rater reliability. Concurrent validity was examined using Pearson’s correlation coefficients between Cobb angles obtained from radiographs and those from DEXA1 and DEXA2 images. Results: Cobb angle measurements from DEXA images had excellent test–retest and nter-rater reliability (ICC>0.90) and very strong concurrent validity with radiographs (r >0.90, p <0.001). The mean difference in Cobb angles between radiographs and DEXA images ranged from 2.37° to 2.91°, whereby the curves were less severe on DEXA images. Conclusions DEXA has consistent reliability and validity for evaluating spinal alignment and is potentially useful in monitoring curve progression in young populations.

Methods: Lateral radiographs were obtained from 100 healthy adults in standing and seated postures at 25°, 35°, and 45° recline angles. Spinal parameters (cervical lordosis, thoracic kyphosis, thoracolumbar kyphosis, lumbar lordosis, sacral slope, pelvic tilt, and T1 spinopelvic inclination) and seat belt metrics (X-value, Z-value, and lap belt angle) were measured. Multivariate regression was used to assess associations with sex, age, height, and body mass index (BMI). Results: Reclining reduced cervical/lumbar lordosis and sacral slope, while thoracic kyphosis and pelvic tilt increased. Higher BMI was associated with a cranially shifted and more horizontal lap belt. Taller individuals showed greater T1 spinopelvic inclination and pelvic parameters. Females exhibited more pronounced thoracic kyphosis and pelvic retroversion across reclining angles. Conclusions Car seat recline significantly alters spinal alignment and seat belt positioning, with changes influenced by age, height, and BMI. These findings support ergonomic improvements in seat design and may inform surgical planning for ASD.

Methods: This study included 138 patients who underwent PLIF, with a mean age of 67 years and a follow-up period of 12 months. At 12 months postoperatively, lumbar computed tomography (CT) was performed to assess SL, and patients were categorized into SL and nonloosening (NL) groups accordingly. A propensity score-matched model was used to adjust for age, sex, and body mass index (BMI). Propensity score matching was performed to compare outcomes between the SL and NL groups. Results: Among the 138 patients, 29 (21%) developed SL following PLIF. Preliminary analysis revealed that the patients in the SL group were older and exhibited decreased femoral neck bone mineral density, preoperative pelvic retroversion, poor whole spine alignment, and lesser improvement in HRQOL compared with the NL group. Using propensity score matching, 22 patients were selected from each group (mean age, 72 years) (C-statistic=0.78). The propensity score-matched analysis demonstrated significant differences in the preoperative pelvic tilt (25.9° vs. 17.8°, p=0.010) between the matched SL and NL groups. Furthermore, the Oswestry Disability Index scores indicated poorer improvements in the matched SL group than in the matched NL group at 9 months postoperatively (p=0.025). Conclusions After matching, pre- and postoperative pelvic retroversion were significantly associated with SL. Patients with SL experienced significantly poorer improvement in HRQOL at 9 months postoperatively. Therefore, implementing strategies for preventing SL may enhance early postoperative HRQOL.