1.A predictive nomogram for selective screening of asymptomatic vertebral fractures: The Vietnam Osteoporosis Study
T. NGUYEN ; Bao T. NGUYEN ; An V. TRAN ; Tan T. NGUYEN ; Long H. NGO ; Tam VO ; Thi H NHUNG THAI ; Linh D. MAI ; Thach S. TRAN ; Tuan V. NGUYEN ; Lan T. HO-PHAM
Osteoporosis and Sarcopenia 2025;11(1):9-14
Objectives:
Vertebral fractures are associated with disability and mortality, but most vertebral fractures are asymptomatic. The present study aimed to determine the incidence of and develop a predictive nomogram for asymptomatic vertebral fractures in Vietnamese adults.
Methods:
This cohort study as a part of the Vietnam Osteoporosis Study involved 168 men and 287 women aged 50 years and older without a clinically diagnosed vertebral fracture. Their spine x-rays were taken at the recruitment and subsequent 2-year visit. Vertebral fractures were ascertained using the Genant’s semiquantitative method. We employed the Bayesian Model Averaging method to search for the optimal model for predicting asymptomatic vertebral fractures. A predictive nomogram was also developed to facilitate risk prediction.
Results:
During a median of 2.38 years of follow-up, 13 men and 16 women developed an asymptomatic vertebral fracture, yielding the overall incidence rate of 28 fractures per 1000 person-years, or 33 fractures/1000 personyears in men and 24 fractures/1000 person-years in women, respectively. Most asymptomatic vertebral fractures were moderate, almost 1.5 times more common than mild fractures. The optimal model for predicting incident asymptomatic vertebral fractures included age, male sex and lower femoral neck T-score. The area under the receiver’s operating characteristic curve was 0.91, with 95% CI ranging from 0.86 to 0.96.
Conclusions
Asymptomatic vertebral fractures were relatively common among adults in Vietnam. A simple model with sex, age and femoral neck T-score is helpful for selective screening of asymptomatic vertebral fractures in Vietnamese individuals.
2.Effectiveness of biportal endoscopic lumbar interbody fusion using the multi-layer bone grafting technique: a retrospective study from Vietnam
Tran Vu Hoang DUONG ; Pham Anh TUAN ; Huynh Van VU ; Chu Van LAM ; Le Tan LINH ; Phan DUY ; Wongthawat LIAWRUNGRUEANG
Asian Spine Journal 2025;19(2):228-241
Methods:
This study included 41 patients with single-level grades 1 or 2 LS from February 2023 to February 2024. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Bridwell fusion grades were evaluated via lumbar spine computed tomography performed 6 months postoperatively.
Results:
Over a mean follow-up period of 10.6 months (range, 7–18 months), significant improvements were observed in VAS scores for low back pain (from 7.8±0.8 to 2.1±1.4) and leg pain (from 8.1±1.3 to 1.9±1.5) as well as ODI scores (from 50.4±15.4 to 14.8±10.5). The cohort consisted of patients with grades 1 (73.2%) and 2 LS (26.8%) at L4–L5 (58.6%), L5–S1 (34.1%), and L3–L4 (7.3%) levels. The mean operation time was 182.8±36.4 minutes, with a mean intraoperative blood loss of 190.5±81.3 mL and a mean hospital stay of 7.2±3.6 days. Successful fusion (Bridwell grades I/II) was achieved in 82.9% of the cases, with a 4.9% incidence of cage subsidence. Minor complications included durotomies in two patients (4.9%), whereas no major complications, such as nerve root injury, hardware-related issues, or postoperative infections, were reported.
Conclusions
The described BE-LIF technique, using HA bone grafts, which are an autologous bone from the preserved IAP, and a TLIF cage, is a viable, safe, and effective option for treating low-grade LS. This approach achieves favorable clinical outcomes and high fusion rates, which provides a cost-effective alternative to advanced surgical implants.
3.Effectiveness of biportal endoscopic lumbar interbody fusion using the multi-layer bone grafting technique: a retrospective study from Vietnam
Tran Vu Hoang DUONG ; Pham Anh TUAN ; Huynh Van VU ; Chu Van LAM ; Le Tan LINH ; Phan DUY ; Wongthawat LIAWRUNGRUEANG
Asian Spine Journal 2025;19(2):228-241
Methods:
This study included 41 patients with single-level grades 1 or 2 LS from February 2023 to February 2024. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Bridwell fusion grades were evaluated via lumbar spine computed tomography performed 6 months postoperatively.
Results:
Over a mean follow-up period of 10.6 months (range, 7–18 months), significant improvements were observed in VAS scores for low back pain (from 7.8±0.8 to 2.1±1.4) and leg pain (from 8.1±1.3 to 1.9±1.5) as well as ODI scores (from 50.4±15.4 to 14.8±10.5). The cohort consisted of patients with grades 1 (73.2%) and 2 LS (26.8%) at L4–L5 (58.6%), L5–S1 (34.1%), and L3–L4 (7.3%) levels. The mean operation time was 182.8±36.4 minutes, with a mean intraoperative blood loss of 190.5±81.3 mL and a mean hospital stay of 7.2±3.6 days. Successful fusion (Bridwell grades I/II) was achieved in 82.9% of the cases, with a 4.9% incidence of cage subsidence. Minor complications included durotomies in two patients (4.9%), whereas no major complications, such as nerve root injury, hardware-related issues, or postoperative infections, were reported.
Conclusions
The described BE-LIF technique, using HA bone grafts, which are an autologous bone from the preserved IAP, and a TLIF cage, is a viable, safe, and effective option for treating low-grade LS. This approach achieves favorable clinical outcomes and high fusion rates, which provides a cost-effective alternative to advanced surgical implants.
4.A predictive nomogram for selective screening of asymptomatic vertebral fractures: The Vietnam Osteoporosis Study
T. NGUYEN ; Bao T. NGUYEN ; An V. TRAN ; Tan T. NGUYEN ; Long H. NGO ; Tam VO ; Thi H NHUNG THAI ; Linh D. MAI ; Thach S. TRAN ; Tuan V. NGUYEN ; Lan T. HO-PHAM
Osteoporosis and Sarcopenia 2025;11(1):9-14
Objectives:
Vertebral fractures are associated with disability and mortality, but most vertebral fractures are asymptomatic. The present study aimed to determine the incidence of and develop a predictive nomogram for asymptomatic vertebral fractures in Vietnamese adults.
Methods:
This cohort study as a part of the Vietnam Osteoporosis Study involved 168 men and 287 women aged 50 years and older without a clinically diagnosed vertebral fracture. Their spine x-rays were taken at the recruitment and subsequent 2-year visit. Vertebral fractures were ascertained using the Genant’s semiquantitative method. We employed the Bayesian Model Averaging method to search for the optimal model for predicting asymptomatic vertebral fractures. A predictive nomogram was also developed to facilitate risk prediction.
Results:
During a median of 2.38 years of follow-up, 13 men and 16 women developed an asymptomatic vertebral fracture, yielding the overall incidence rate of 28 fractures per 1000 person-years, or 33 fractures/1000 personyears in men and 24 fractures/1000 person-years in women, respectively. Most asymptomatic vertebral fractures were moderate, almost 1.5 times more common than mild fractures. The optimal model for predicting incident asymptomatic vertebral fractures included age, male sex and lower femoral neck T-score. The area under the receiver’s operating characteristic curve was 0.91, with 95% CI ranging from 0.86 to 0.96.
Conclusions
Asymptomatic vertebral fractures were relatively common among adults in Vietnam. A simple model with sex, age and femoral neck T-score is helpful for selective screening of asymptomatic vertebral fractures in Vietnamese individuals.
5.A predictive nomogram for selective screening of asymptomatic vertebral fractures: The Vietnam Osteoporosis Study
T. NGUYEN ; Bao T. NGUYEN ; An V. TRAN ; Tan T. NGUYEN ; Long H. NGO ; Tam VO ; Thi H NHUNG THAI ; Linh D. MAI ; Thach S. TRAN ; Tuan V. NGUYEN ; Lan T. HO-PHAM
Osteoporosis and Sarcopenia 2025;11(1):9-14
Objectives:
Vertebral fractures are associated with disability and mortality, but most vertebral fractures are asymptomatic. The present study aimed to determine the incidence of and develop a predictive nomogram for asymptomatic vertebral fractures in Vietnamese adults.
Methods:
This cohort study as a part of the Vietnam Osteoporosis Study involved 168 men and 287 women aged 50 years and older without a clinically diagnosed vertebral fracture. Their spine x-rays were taken at the recruitment and subsequent 2-year visit. Vertebral fractures were ascertained using the Genant’s semiquantitative method. We employed the Bayesian Model Averaging method to search for the optimal model for predicting asymptomatic vertebral fractures. A predictive nomogram was also developed to facilitate risk prediction.
Results:
During a median of 2.38 years of follow-up, 13 men and 16 women developed an asymptomatic vertebral fracture, yielding the overall incidence rate of 28 fractures per 1000 person-years, or 33 fractures/1000 personyears in men and 24 fractures/1000 person-years in women, respectively. Most asymptomatic vertebral fractures were moderate, almost 1.5 times more common than mild fractures. The optimal model for predicting incident asymptomatic vertebral fractures included age, male sex and lower femoral neck T-score. The area under the receiver’s operating characteristic curve was 0.91, with 95% CI ranging from 0.86 to 0.96.
Conclusions
Asymptomatic vertebral fractures were relatively common among adults in Vietnam. A simple model with sex, age and femoral neck T-score is helpful for selective screening of asymptomatic vertebral fractures in Vietnamese individuals.
6.A predictive nomogram for selective screening of asymptomatic vertebral fractures: The Vietnam Osteoporosis Study
T. NGUYEN ; Bao T. NGUYEN ; An V. TRAN ; Tan T. NGUYEN ; Long H. NGO ; Tam VO ; Thi H NHUNG THAI ; Linh D. MAI ; Thach S. TRAN ; Tuan V. NGUYEN ; Lan T. HO-PHAM
Osteoporosis and Sarcopenia 2025;11(1):9-14
Objectives:
Vertebral fractures are associated with disability and mortality, but most vertebral fractures are asymptomatic. The present study aimed to determine the incidence of and develop a predictive nomogram for asymptomatic vertebral fractures in Vietnamese adults.
Methods:
This cohort study as a part of the Vietnam Osteoporosis Study involved 168 men and 287 women aged 50 years and older without a clinically diagnosed vertebral fracture. Their spine x-rays were taken at the recruitment and subsequent 2-year visit. Vertebral fractures were ascertained using the Genant’s semiquantitative method. We employed the Bayesian Model Averaging method to search for the optimal model for predicting asymptomatic vertebral fractures. A predictive nomogram was also developed to facilitate risk prediction.
Results:
During a median of 2.38 years of follow-up, 13 men and 16 women developed an asymptomatic vertebral fracture, yielding the overall incidence rate of 28 fractures per 1000 person-years, or 33 fractures/1000 personyears in men and 24 fractures/1000 person-years in women, respectively. Most asymptomatic vertebral fractures were moderate, almost 1.5 times more common than mild fractures. The optimal model for predicting incident asymptomatic vertebral fractures included age, male sex and lower femoral neck T-score. The area under the receiver’s operating characteristic curve was 0.91, with 95% CI ranging from 0.86 to 0.96.
Conclusions
Asymptomatic vertebral fractures were relatively common among adults in Vietnam. A simple model with sex, age and femoral neck T-score is helpful for selective screening of asymptomatic vertebral fractures in Vietnamese individuals.
7.Effectiveness of biportal endoscopic lumbar interbody fusion using the multi-layer bone grafting technique: a retrospective study from Vietnam
Tran Vu Hoang DUONG ; Pham Anh TUAN ; Huynh Van VU ; Chu Van LAM ; Le Tan LINH ; Phan DUY ; Wongthawat LIAWRUNGRUEANG
Asian Spine Journal 2025;19(2):228-241
Methods:
This study included 41 patients with single-level grades 1 or 2 LS from February 2023 to February 2024. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Bridwell fusion grades were evaluated via lumbar spine computed tomography performed 6 months postoperatively.
Results:
Over a mean follow-up period of 10.6 months (range, 7–18 months), significant improvements were observed in VAS scores for low back pain (from 7.8±0.8 to 2.1±1.4) and leg pain (from 8.1±1.3 to 1.9±1.5) as well as ODI scores (from 50.4±15.4 to 14.8±10.5). The cohort consisted of patients with grades 1 (73.2%) and 2 LS (26.8%) at L4–L5 (58.6%), L5–S1 (34.1%), and L3–L4 (7.3%) levels. The mean operation time was 182.8±36.4 minutes, with a mean intraoperative blood loss of 190.5±81.3 mL and a mean hospital stay of 7.2±3.6 days. Successful fusion (Bridwell grades I/II) was achieved in 82.9% of the cases, with a 4.9% incidence of cage subsidence. Minor complications included durotomies in two patients (4.9%), whereas no major complications, such as nerve root injury, hardware-related issues, or postoperative infections, were reported.
Conclusions
The described BE-LIF technique, using HA bone grafts, which are an autologous bone from the preserved IAP, and a TLIF cage, is a viable, safe, and effective option for treating low-grade LS. This approach achieves favorable clinical outcomes and high fusion rates, which provides a cost-effective alternative to advanced surgical implants.
8.A predictive nomogram for selective screening of asymptomatic vertebral fractures: The Vietnam Osteoporosis Study
T. NGUYEN ; Bao T. NGUYEN ; An V. TRAN ; Tan T. NGUYEN ; Long H. NGO ; Tam VO ; Thi H NHUNG THAI ; Linh D. MAI ; Thach S. TRAN ; Tuan V. NGUYEN ; Lan T. HO-PHAM
Osteoporosis and Sarcopenia 2025;11(1):9-14
Objectives:
Vertebral fractures are associated with disability and mortality, but most vertebral fractures are asymptomatic. The present study aimed to determine the incidence of and develop a predictive nomogram for asymptomatic vertebral fractures in Vietnamese adults.
Methods:
This cohort study as a part of the Vietnam Osteoporosis Study involved 168 men and 287 women aged 50 years and older without a clinically diagnosed vertebral fracture. Their spine x-rays were taken at the recruitment and subsequent 2-year visit. Vertebral fractures were ascertained using the Genant’s semiquantitative method. We employed the Bayesian Model Averaging method to search for the optimal model for predicting asymptomatic vertebral fractures. A predictive nomogram was also developed to facilitate risk prediction.
Results:
During a median of 2.38 years of follow-up, 13 men and 16 women developed an asymptomatic vertebral fracture, yielding the overall incidence rate of 28 fractures per 1000 person-years, or 33 fractures/1000 personyears in men and 24 fractures/1000 person-years in women, respectively. Most asymptomatic vertebral fractures were moderate, almost 1.5 times more common than mild fractures. The optimal model for predicting incident asymptomatic vertebral fractures included age, male sex and lower femoral neck T-score. The area under the receiver’s operating characteristic curve was 0.91, with 95% CI ranging from 0.86 to 0.96.
Conclusions
Asymptomatic vertebral fractures were relatively common among adults in Vietnam. A simple model with sex, age and femoral neck T-score is helpful for selective screening of asymptomatic vertebral fractures in Vietnamese individuals.
9.Comprehensive characterization of genomic features and clinical outcomes following targeted therapy and secondary cytoreductive surgery in OCCC: a single center experience
Silvana Talisa WIJAYA ; Natalie YL NGOI ; Jerold WZ LOH ; Tuan Zea TAN ; Diana LIM ; Irfan Sagir KHAN ; Yee Liang THIAN ; Alexa LAI ; Bertrand WL ANG ; Pearl TONG ; Joseph NG ; Jeffrey JH LOW ; Arunachalam ILANCHERAN ; Siew Eng LIM ; Yi Wan LIM ; David SP TAN
Journal of Gynecologic Oncology 2024;35(5):e69-
Objective:
Ovarian clear cell carcinoma (OCCC) is associated with chemoresistance. Limited data exists regarding the efficacy of targeted therapies such as immune checkpoint inhibitors (ICI) and bevacizumab, and the role of secondary cytoreductive surgery (SCS).
Methods:
We retrospectively analyzed genomic features and treatment outcomes of 172 OCCC patients treated at our institution from January 2000 to May 2022. Next-generation sequencing (NGS) was performed where sufficient archival tissue was available.
Results:
64.0% of patients were diagnosed at an early stage, and 36.0% at an advanced stage.Patients with advanced/relapsed OCCC who received platinum-based chemotherapy plus bevacizumab followed by maintenance bevacizumab had a median first-line progressionfree survival (PFS) of 12.2 months, compared with 9.3 months for chemotherapy alone (hazard ratio=0.69; 95% confidence interval [CI]=0.33, 1.45). In 27 patients who received an ICI, the overall response rate was 18.5% and median duration of response was 7.4 months (95% CI=6.5, 8.3). In 17 carefully selected patients with fewer than 3 sites of relapse, median PFS was 35 months (95% CI=0, 73.5) and median overall survival was 96.8 months (95% CI=44.6, 149.0) after SCS. NGS on 58 tumors revealed common mutations in ARID1A (48.3%), PIK3CA (46.6%), and KRAS (20.7%). Pathogenic alterations in PIK3CA, FGFR2, and NBN were associated with worse survival outcomes. Median tumor mutational burden was 3.78 (range, 0–16). All 26 patients with available loss of heterozygosity (LOH) scores had LOH <16%.
Conclusion
Our study demonstrates encouraging outcomes with bevacizumab and ICI, and SCS in select relapsed OCCC patients. Prospective trials are warranted.
10.Comprehensive characterization of genomic features and clinical outcomes following targeted therapy and secondary cytoreductive surgery in OCCC: a single center experience
Silvana Talisa WIJAYA ; Natalie YL NGOI ; Jerold WZ LOH ; Tuan Zea TAN ; Diana LIM ; Irfan Sagir KHAN ; Yee Liang THIAN ; Alexa LAI ; Bertrand WL ANG ; Pearl TONG ; Joseph NG ; Jeffrey JH LOW ; Arunachalam ILANCHERAN ; Siew Eng LIM ; Yi Wan LIM ; David SP TAN
Journal of Gynecologic Oncology 2024;35(5):e69-
Objective:
Ovarian clear cell carcinoma (OCCC) is associated with chemoresistance. Limited data exists regarding the efficacy of targeted therapies such as immune checkpoint inhibitors (ICI) and bevacizumab, and the role of secondary cytoreductive surgery (SCS).
Methods:
We retrospectively analyzed genomic features and treatment outcomes of 172 OCCC patients treated at our institution from January 2000 to May 2022. Next-generation sequencing (NGS) was performed where sufficient archival tissue was available.
Results:
64.0% of patients were diagnosed at an early stage, and 36.0% at an advanced stage.Patients with advanced/relapsed OCCC who received platinum-based chemotherapy plus bevacizumab followed by maintenance bevacizumab had a median first-line progressionfree survival (PFS) of 12.2 months, compared with 9.3 months for chemotherapy alone (hazard ratio=0.69; 95% confidence interval [CI]=0.33, 1.45). In 27 patients who received an ICI, the overall response rate was 18.5% and median duration of response was 7.4 months (95% CI=6.5, 8.3). In 17 carefully selected patients with fewer than 3 sites of relapse, median PFS was 35 months (95% CI=0, 73.5) and median overall survival was 96.8 months (95% CI=44.6, 149.0) after SCS. NGS on 58 tumors revealed common mutations in ARID1A (48.3%), PIK3CA (46.6%), and KRAS (20.7%). Pathogenic alterations in PIK3CA, FGFR2, and NBN were associated with worse survival outcomes. Median tumor mutational burden was 3.78 (range, 0–16). All 26 patients with available loss of heterozygosity (LOH) scores had LOH <16%.
Conclusion
Our study demonstrates encouraging outcomes with bevacizumab and ICI, and SCS in select relapsed OCCC patients. Prospective trials are warranted.

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