Latest Spine Surgery research

Top 10 this week

Week of 27 September 2026

1. 1

   Radiotherapy versus observation following surgical resection of WHO grade 2 atypical meningioma (ROAM/EORTC-1308): an international, multicentre, open-label, phase 3, randomised controlled trial

   Lancet (London, England) · Q1 journal · RCT · Evidence level 1 (High) · 25 September 2026

   In this randomized trial of 157 patients after complete tumor removal, recurrence occurred in 14% given radiotherapy and 30% assigned to observation over a median 64 months; 5-year disease-free survival was about 80% versus 64%. Radiation-related serious adverse effects occurred in 8% of treated patients, so preventing recurrence requires weighing possible delayed harms in individual discussions.

2. 2

   Performance of a multi-cancer early detection test in the randomized controlled NHS-Galleri trial

   Nature medicine · Q1 journal · RCT · Evidence level 1 (High) · 22 September 2026

   In the NHS-Galleri trial, the test's sensitivity for all cancers ranged from 27% to 37% across three annual rounds, while 99.5% to 99.6% of people without cancer screened negative. A positive result indicated cancer in 46% to 58% of cases, but the trial did not meet its primary goal of reducing advanced cancer diagnoses; whether screening improves outcomes remains unproven.

3. 3

   Unilateral Versus Bilateral Percutaneous Kyphoplasty for Single-Level Thoracolumbar Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta-Analysis

   Journal of clinical medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 10 September 2026

   Across 11 studies of recent single-level spinal fractures, treatment through one or both sides of the vertebra produced similar pain relief, complication rates and overall clinical outcomes. Bilateral treatment slightly improved some X-ray measures, but the differences were small; study-design inconsistencies and limited randomized evidence leave the best approach dependent on patient anatomy and surgical judgment.

4. 4

   Tenecteplase Before Thrombectomy at 4.5 to 24 Hours for Basilar Artery Occlusion: The ATTENTION LATE Randomized Clinical Trial

   JAMA · Q1 journal · RCT · Evidence level 1 (High) · 23 September 2026

   In this trial of 330 patients with moderate to severe basilar artery blockage treated 4.5 to 24 hours after stroke onset, 30% achieved functional independence with tenecteplase before thrombectomy, exactly the same proportion as with thrombectomy alone. Brain bleeding and mortality were also similar; the result applies to patients treated at stroke centers equipped for thrombectomy.

5. 5

   DNL343 and Disease Progression in Amyotrophic Lateral Sclerosis: A Randomized Clinical Trial

   JAMA network open · Q1 journal · RCT · Evidence level 1 (High) · 1 September 2026

   High-quality evidence in a top journal

6. 6

   Preventing pancreatic fistula following pancreatectomy: meta-analysis of randomized clinical trials

   BJS open · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 4 September 2026

   A meta-analysis of 46 randomized trials found that not placing surgical drains during left-sided pancreatectomy significantly reduced grade B/C pancreatic fistula rates, with high-certainty evidence supporting this approach. Peri-operative somatostatin analogues and corticosteroids also lowered fistula risk, though the steroid data are less certain. Further trials, especially in high-risk patients and combining strategies, are needed.

7. 7

   Intrawound vancomycin for prevention of surgical site infection: meta-analysis of randomized clinical trials

   BJS open · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 4 September 2026

   A meta-analysis of 22 randomized trials involving 8,424 adults found that applying vancomycin directly to the wound lowered the overall infection rate from standard care (about one fewer infection per 82 patients treated) and halved Gram-positive infections. The benefit was modest, did not affect deep or superficial infections, and evidence quality was moderate, suggesting selective rather than routine use.

8. 8

   Endoscopic ultrasound-guided versus percutaneous transhepatic gallbladder drainage in surgically high-risk patients with acute cholecystitis: a systematic review and meta-analysis

   Surgical endoscopy · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 22 September 2026

9. 9

   Direct Oral Anticoagulant Plus Single Versus Dual Antiplatelet Therapy After Carotid Artery Stenting: A Multicenter Propensity-Matched Cohort Study

   Neurosurgery · Q1 journal · RCT · Evidence level 1 (High) · 22 September 2026

   High-quality evidence in a top journal

10. 10

    Prophylactic vs Therapeutic Anticoagulation in Hospitalized Patients With COVID-19: A Randomized Clinical Trial

    JAMA network open · Q1 journal · RCT · Evidence level 1 (High) · 1 September 2026

    In this trial of 139 hospitalized patients, death or a blood clot occurred in 21% given therapeutic-dose anticoagulation and 29% given preventive-dose treatment, a difference that was not statistically significant. Bleeding events were similar, with seven versus six reported; the small trial leaves uncertainty about whether stronger anticoagulation benefits some patients.