Objective: In the digital age, patients turn to online sources for lumbar spine fusion information, necessitating a careful study of large language models (LLMs) like chat generative pre-trained transformer (ChatGPT) for patient education.Methods: Our study aims to assess the response quality of Open AI (artificial intelligence)’s ChatGPT 3.5 and Google’s Bard to patient questions on lumbar spine fusion surgery. We identified 10 critical questions from 158 frequently asked ones via Google search, which were then presented to both chatbots. Five blinded spine surgeons rated the responses on a 4-point scale from ‘unsatisfactory’ to ‘excellent.’ The clarity and professionalism of the answers were also evaluated using a 5-point Likert scale.Results: In our evaluation of 10 questions across ChatGPT 3.5 and Bard, 97% of responses were rated as excellent or satisfactory. Specifically, ChatGPT had 62% excellent and 32% minimally clarifying responses, with only 6% needing moderate or substantial clarification. Bard’s responses were 66% excellent and 24% minimally clarifying, with 10% requiring more clarification. No significant difference was found in the overall rating distribution between the 2 models. Both struggled with 3 specific questions regarding surgical risks, success rates, and selection of surgical approaches (Q3, Q4, and Q5). Interrater reliability was low for both models (ChatGPT: k = 0.041, p = 0.622; Bard: k = -0.040, p = 0.601). While both scored well on understanding and empathy, Bard received marginally lower ratings in empathy and professionalism.Conclusion: ChatGPT3.5 and Bard effectively answered lumbar spine fusion FAQs, but further training and research are needed to solidify LLMs’ role in medical education and healthcare communication.

Pregnancy induces substantial anatomical, hormonal, and biomechanical changes in the spine and pelvis to accommodate fetal growth and maintain postural adaptation. This narrative review synthesizes peer-reviewed evidence regarding pregnancy-related spinal biomechanics, with a particular focus on low back pain, spinopelvic alignment, sacroiliac joint dysfunction, and potential contributions to degenerative spinal conditions. A systematic search of PubMed, Embase, and Google Scholar was conducted using Boolean operators and relevant terms, yielding 1050 unique records, with 53 peer-reviewed articles ultimately cited. The review reveals that increased lumbar lordosis, ligamentous laxity, altered gait mechanics, and muscular deconditioning elevate mechanical load on the lumbar spine, predisposing up to 56% of pregnant individuals to low back pain. These changes are often associated with sacroiliac joint laxity, anterior pelvic tilt, and multiparity. Long-term risks may include degenerative disc disease and spondylolisthesis. Conservative interventions such as pelvic floor muscle training, prenatal exercise, and surface topography monitoring offer symptom relief and support early rehabilitation, although standardized protocols and longitudinal outcome data remain limited. Pregnancy-related spinal changes are multifactorial and clinically relevant; an interdisciplinary approach involving spinal biomechanics, physical therapy, and obstetric care is critical for optimizing maternal musculoskeletal health.

Aim: The purpose of this study was to elucidate differences in patient perspectives on large language model (LLM) vs. physician-generated responses to frequently asked questions about anterior cervical discectomy and fusion (ACDF) surgery. Methods: This cross-sectional study had three phases: In phase 1, we generated 10 common questions about ACDF surgery using ChatGPT-3.5, ChatGPT-4.0, and Google search. Phase 2 involved obtaining answers to these questions from two spine surgeons, ChatGPT-3.5, and Gemini. In phase 3, we recruited 5 cervical spine surgery patients and 5 age-matched controls to assess the clarity and completeness of the responses. Results: LLM-generated responses were significantly shorter, on average, than physician-generated responses (30.0 +/- 23.5 vs. 153.7 +/- 86.7 words, P < 0.001). Study participants were more likely to rate LLM-generated responses with more positive clarity ratings (H = 6.25, P = 0.012), with no significant difference in completeness ratings (H = 0.695, P = 0.404). On an individual question basis, there were no significant differences in ratings given to LLM vs. physician-generated responses. Compared with age-matched controls, cervical spine surgery patients were more likely to rate physician-generated responses as higher in clarity (H = 6.42, P = 0.011) and completeness (H = 7.65, P = 0.006). Conclusion: Despite a small sample size, our findings indicate that LLMs offer comparable, and occasionally preferred, information in terms of clarity and comprehensiveness of responses to common ACDF questions. It is particularly striking that ratings were similar, considering LLM-generated responses were, on average, 80% shorter than physician responses. Further studies are needed to determine how LLMs can be integrated into spine surgery education in the future.

Hospitals in the United States often have an abundance of unused medical supplies and equipment while many developing countries are in considerable need of these resources. Many nongovernmental organizations (NGOs) have donated medical equipment to health centers in low-resource settings to rectify this issue; however, studies show many of these donations are not usable by the facilities that receive them. To better serve the partner hospitals of our NGO, Oasis Medical Relief, we investigated the perspectives and insights of Ethiopian healthcare workers (HCWs) on the medical equipment distribution paradigm of the country. Qualitative analysis including semi-structured, open-ended interviews was conducted. Semi-structured interviews (n = six) were conducted with HCWs (four physicians and two hospital administrators) working in hospitals in Addis Ababa and Southern Nations, Nationalities, and Peoples’ Region (SNNPR) of Ethiopia. Interviews were recorded and transcribed. Categorical content analysis was utilized to develop themes. The topical areas addressed by our questions include populations served, prevalence of diseases, laws, and strategies guiding medical equipment distribution, funding and budget for medical equipment, etc. Three themes related to perspectives and insights of HCWs on the current medical equipment distribution paradigm in Ethiopia interviewed include: (1) state of healthcare concerns, (2) medical equipment scarcity, and (3) policy shaping medical distribution paradigm. Pre-donation assessments utilized to understand equipment needs are recognized by the World Health Organization to more effectively address medical equipment/supply. However, to further strengthen such efforts, qualitative interviews with HCWs are a tool that can be utilized to better understand the intricacies of Ethiopia’s complex medical distribution paradigm. This can potentially lead to more effective partnerships between NGOs and their partner hospitals. Furthermore, increasing decentralized methods of procuring medical equipment should be further explored to mitigate issues with national distribution of medical supplies.

Studies report patient race, income, and education influence spinal fusion outcomes; fewer studies, however, examine the influence of provider factors such as exposure to diversity or cultural sensitivity. To examine how providers' experience with diverse patient populations affects spinal fusion outcomes. Retrospective review of 39,680 patients undergoing lumbar and cervical fusions, 2003-2021, in Clinformatics® Data Mart national database. We used the provider patient racial diversity index (pRDI)-a published metric of physician exposure to diverse patients-to divide patients into groups based their provider's category (I, II, III) where patients treated by category III providers had surgeons with the most diverse patient populations. Multivariate regression models on propensity score-matched cohorts examined the association between patient SES and provider category on post-operative outcomes. Black patients had decreased discharge home (OR 0.67; 95% CI 0.54-0.83) compared to white patients. Patients treated by category III providers had increased length of stay (Coeff. 0.62; 95% CI 0.43-0.81), charge (Coeff. 36800; 95% CI 29,200-44,400), and decreased discharge home (OR 0.90; 95% CI 0.83-0.97) compared to patients treated by category I providers. Asian patients treated by category II providers had decreased readmission (OR 0.38; 95% CI 0.14-0.96), and Black patients treated by category III providers had increased discharge home (OR 1.41; 95% CI 1.1-1.9) compared to those treated by category I providers. While our study found two specific instances of improved spine surgery outcomes for minority patients treated by providers serving diverse patient populations, we present mixed findings overall. This study serves as the foundation for future research to better understand how provider pRDI affects outcomes in patients undergoing lumbar and cervical spine surgery.

Study Design.: Cadaveric biomechanical analysis. Objective.: To compare the fatigue resistance and failure behavior of cortical bone trajectory (CBT) and traditional pedicle screw (TPS) constructs in severely destabilized lumbar segments under cyclic flexion-compression loading. Summary of Background Data.: CBT screw fixation is increasingly used for lumbar stabilization and offers theoretical biomechanical advantages over TPS, including higher insertional torque and increased cortical engagement. However, its fatigue behavior in unstable constructs remains poorly characterized, despite clinical reports of early failures following interbody reduction maneuvers. Materials and Methods.: Fourteen lumbar motion segments (L2–L3 and L4–L5) from seven cadaveric spines were randomized to CBT or TPS fixation (n=7 per group) using a paired design. Following subtotal discectomy and bilateral facetectomy, constructs were cyclically loaded (200–750 N, 2 Hz, 50,000 cycles). Segment stiffness, flexion range of motion (ROM), and survival were compared. Bone mineral density (BMD) was quantified via dual-energy x-ray absorptiometry. Results.: In the intact state, CBT and TPS constructs showed no significant differences in stiffness or ROM. After destabilization and instrumentation, CBT constructs demonstrated reduced flexion ROM ( P =0.026), with similar end-range stiffness ( P =0.219). BMD significantly correlated with ROM and stiffness in the destabilized state (ρ=–0.72, P =0.007; ρ=0.65, P =0.014). Three of seven constructs in each group survived cyclic loading. While CBT constructs withstood more cycles on average (19,500±13,026 vs . 5,625±6,419), the difference was not statistically significant ( P =0.710). Conclusions.: In a highly destabilized flexion-compression model, CBT and TPS constructs demonstrated similar fatigue performance. CBT screws offered greater resistance to ROM but no significant advantage in construct stiffness or survival. These results suggest that observed clinical failures of CBT may be attributable to surgical technique or placement sensitivity rather than inferior fatigue behavior.