Background: Although the surgical release of the sternocleidomastoid muscle (SCM) is required for residual congenital muscular torticollis (CMT), the surgical outcomes between bipolar and unipolar SCM release remained unclear. The purpose of the present study was to assess surgical outcomes after bipolar and unipolar release of SCM in adolescent/adult patients with neglected CMT. Methods: Twenty-one consecutive adolescent/adult patients with neglected CMT who underwent surgical treatment were enrolled. Clinical and radiographic outcomes were evaluated at preoperative and final follow-up. Results: The bipolar release of SCM was performed in 3 patients (B group; males, n = 1, females, n = 2) and the unipolar release of SCM in 18 patients (U group; males, n = 6, females, n = 12). The mean age at surgery was 40.0 ± 17.0 years in Group B, and that was 32.3 ± 13.1 years in Group U (p = 0.47). The mean follow-up period was 16.0 ± 5.7 months in Group B and 10.4 ± 7.6 months in Group U (p = 0.22). Cervicomandibular angle correction rates were comparable at 75.4 ± 2.4% for the B group and 73.1 ± 11.7% for the U group (p = 0.62). There was no significant difference in clinical outcome according to the modified Cheng and Tang score between the two groups (p = 0.89). No major complications arose, although one patient exhibited a transient neurological deficit of the greater auricular nerve, and one patient developed a hematoma in the B group. Conclusions: The unipolar SCM release appeared to be a non-inferiority and less invasive procedure, minimizing surgical scars and avoiding potential auricular nerve damage in adolescent/adult patients with neglected CMT.

Background/Objectives: PhenoAge utilizes biochemical biomarkers to differentiate mortality risk in persons of the same chronological age. However, the details of the relationship between PhenoAge and lumbar spinal stenosis (LSS) remain unclear. We investigated the association between lumbar spinal stenosis (LSS) and biological age quantified by PhenoAge and PhenoAge acceleration (PhenoAgeAccel), comparing surgically treated patients with age- and BMI-matched controls. Methods: This study included 208 LSS patients who underwent surgery. The patients were categorized into four subgroups based on gender and age (≥70 years) at the time of surgery. Demographic data, blood biomarkers, body composition measurements, and Phenotypic age acceleration (PhenoAgeAccel), which was assessed by calculating the residuals from regressing PhenoAge on chronological age were compared among the groups. We also compared control groups matched for age and body mass index (BMI) for each of the four groups using medical examination data. Results: The mean age was 70.2 ± 9.3 years and the mean PhenoAgeAccel was −5.7 ± 6.5 years in the LSS group. PhenoAgeAccel was significantly lower in the control group (−8.5 ± 3.7 years) than in the LSS group, especially in young male (LSS: −2.9 ± 6.7, Control: −7.0 ± 2.8 years), old male (−4.8 ± 4.4, −6.7 ± 4.0 years), and old female (−6.9 ± 5.9, −10.8 ± 3.2 years) subgroups. In the correlation coefficient between PhenoAgeAccel and BMI, there were weak positive correlations (CC: 0.08–0.31) across all subgroups in the control group, whereas there was a weak negative correlation (CC: −0.29) in the old female subgroup in the LSS group. Conclusions: The impact of LSS on PhenoAgeAccel varied by age and gender, and the adverse effect of LSS could be particularly pronounced in elderly women with low BMIs.

Corrective spine surgery for spinal deformities, such as adolescent idiopathic scoliosis (AIS) and adult spinal deformity (ASD), aims to enhance the quality of life by addressing physical impairments. However, the extent of patient satisfaction after surgery, which includes pain management, functional recovery, and psychological contentment, exhibits considerable variation across different cultural and geographical landscapes. This review describes the influence of cultural and regional disparities on postoperative satisfaction in AIS and ASD surgery with a particular emphasis on the disparities between the US and Japan. This review underscores the intricate relationship between surgical outcomes and patient-reported satisfaction metrics. The investigation reveals significant contrasts in patient satisfaction and clinical results between these 2 countries, attributed to divergent cultural expectations, lifestyle adaptations, and perceptions of bodily image. These distinctions are crucial for healthcare professionals to recognize, as they necessitate a culturally nuanced approach to patient care. This comparative review not only enhances the understanding of patient experiences across cultures but also provides valuable guidance for physicians in customizing their strategies to align with the varied expectations of their patients, thereby improving postoperative satisfaction and overall quality of life. This review emphasizes the necessity of a tailored and culturally sensitive approach to managing spinal deformities, underscoring the need to factor in cultural and regional elements to enhance patient satisfaction and surgical outcomes.

Background/Objectives: Teriparatide, a recombinant form of parathyroid hormone used for the treatment of osteoporosis, has also been investigated in patients undergoing spinal fusion surgery. The aim of this study was to evaluate the association between perioperative teriparatide use and postoperative complications after spinal fusion surgery through a meta-analysis of randomized controlled trials (RCTs) and observational studies. Methods: Systematic searches were conducted across PubMed, EMBASE, Cochrane Library, and Scopus for RCTs and observational studies that compared surgical outcomes in spinal instrumentation procedures with and without teriparatide. The primary pooled outcome was proximal junctional kyphosis (PJK). Secondary outcomes were radiographic nonunion, mechanical complications, reoperation rate, and incidence of new vertebral fractures. Meta-analyses were performed using Mantel–Haenszel models. Results: A total of 20 studies comprising 2543 patients with degenerative lumbar disease, adult spinal deformity, or osteoporotic vertebral fracture were included. Perioperative teriparatide use was associated with a lower incidence of PJK (Risk Ratio [RR] 0.40, 95% confidence interval [CI] 0.22–0.75, p = 0.004) and radiographic nonunion both on a per-patient basis (RR 0.66, 95% CI 0.47–0.93, p = 0.02) and on a per-level basis (RR 0.55, 95% CI 0.37–0.82, p = 0.004). Although there were no statistically significant differences in mechanical complications (RR 0.75, 95% CI 0.54–1.04, p = 0.08), reoperation rate (RR 0.76, 95% CI 0.53–1.08, p = 0.13), and new vertebral fractures (RR 0.60, 95% CI 0.31–1.17, p = 0.13), these outcomes numerically favored teriparatide. Conclusions: Perioperative teriparatide use was associated with lower rates of PJK and radiographic nonunion after spinal fusion surgery. However, the included studies were heterogeneous, and evidence for mechanical complications, reoperation, and new vertebral fractures remains limited.