Diagonal paraspinal muscle degeneration and osteoporosis were associated with rotatory subluxation in degenerative lumbar scoliosis.

Purpose: This study aimed to investigate the potential association between paraspinal muscle (PSM) degeneration, osteoporosis, and vertebral rotatory subluxation (VRS) in patients with degenerative lumbar scoliosis (DLS).

Methods: This retrospective study analyzed standing anteroposterior radiographs to assess the coronal (Cobb angle, coronal balance distance, and lateral translation) and sagittal parameters (thoracic kyphosis, lumbar lordosis, and sagittal vertical axis). Patients were categorized into rotatory subluxation (RS, lateral translation ≥ 5 mm) and non-RS groups, with the RS group further subdivided into single- and double-level subgroups based on the frequency of RS occurrence.

Fibro-NPC: a pathogenic subtype identified at single-cell resolution with secreted SFRP4 as a biomarker in intervertebral disc degeneration.

Background: Intervertebral disc degeneration (IDD) is a primary cause of low back pain and, in severe cases, can lead to disability. Current treatments for low back pain remain limited in efficacy, underscoring the need for a deeper understanding of the molecular mechanisms driving IDD. The degeneration process is primarily driven by an imbalance in the extracellular matrix, largely due to the senescence of nucleus pulposus cells (NPCs).

Large-Channel Interlaminar Endoscopic Discectomy for Highly Migrated Lumbar Disc Herniation: Effectiveness and Safety.

Purpose: Highly migrated lumbar disc herniation (HM-LDH) presents a significant challenge for surgeons. This study aimed to assess the safety and clinical outcomes of large-channel interlaminar endoscopic discectomy for HM-LDH and compare it to open fenestration discectomy.

Patients And Methods: Patients who underwent large-channel interlaminar endoscopic discectomy (group A) or open fenestration discectomy (group B) for HM-LDH between January 2021 and December 2023 were included.

Effect of pelvic compensation capacity on proximal junctional kyphosis: a stratified analysis of pelvic tilt in adult spinal deformity surgery.

Background: Pelvic compensation, as quantified by the pelvic tilt (PT), has been identified as a crucial compensatory mechanism in patients with adult spinal deformity (ASD). However, it remains uncertain whether PT has important roles in predicting the occurrence of proximal junctional kyphosis (PJK). Therefore, the purpose of this study is to analyze the influence of pelvic compensation, specifically PT, on the development of PJK in ASD patients following the second sacral alar-iliac (S2AI) fixation.

Biomechanical Advantages of Novel Duet Screws Plus Bilateral Satellite Rods Fixation in the Correction Surgery for Adult Spinal Deformity.

Purpose: Adult spinal deformity (ASD) patients undergoing pedicle subtraction osteotomy (PSO) with long fusion to the pelvis have a high risk of rod failure at the PSO level or adjacent areas. This study aimed to investigate the biomechanical advantages of novel duet screws (multiaxial screws with dual heads) plus satellite rods in ASD correction using finite element models and cadaveric specimens.

Methods: A lumbar-pelvis finite element model was constructed, and Von Mises equivalent stress was used to analyze the structural stress under different fixation constructs.

Evaluation of cosmetic shoulder balance in Lenke type 1 and 2 adolescent idiopathic scoliosis across different observational perspectives.

Background: Shoulder imbalance in patients with adolescent idiopathic scoliosis (AIS) contributes to a negative self-image and psychological distress, particularly in those with Lenke type 1 or 2 curves. Although previous studies have emphasized the significance of cosmetic shoulder balance (Sh.B) in informing clinical decisions and evaluating postoperative patient-reported outcomes (PROs), the observational perspective-a crucial factor-has often been overlooked in cosmetic assessment, potentially leading to inaccuracies and inconsistencies in measurements.

Modeling optimal trajectory for tricortical pedicle screw fixation in adult thoracic spine: an imaging study using the three-dimensional reconstruction technique.

Background: Tricortical pedicle screw (TCPS) is a novel method for thoracic fixation to prevent proximal junctional kyphosis in scoliosis correction surgery. However, there is limited reports on the radiographic parameters of TCPS trajectories. Through computational simulation of TCPS placement in thoracic vertebrae utilizing three-dimensional digital modeling, this study sought to elucidate the ideal radiographic trajectory parameters and compare them with the real data from clinical practice, evaluating the technique's feasibility and safety, thereby providing essential radiological reference data for surgical strategy optimization.

Determining the bone mineral density in patients with degenerative lumbar scoliosis: CT hounsfield unit values versus MRI vertebral bone quality scores.

Objective: To compare the performance of T-score, HU values, and VBQ scores in assessing bone mineral density in patients with degenerative lumbar scoliosis (DLS).

Methods: A total of 320 patients were retrospectively reviewed, including 220 with DLS and 100 age-matched patients with lumbar spinal stenosis as the control group. The DLS cohort was stratified into three subgroups based on Cobb angle: mild scoliosis group(10° < Cobb angle ≤ 20°), moderate scoliosis group(20° < Cobb angle ≤ 40°) and severe scoliosis group(Cobb angle > 40°).

Identification of Atypical Scoliosis Patterns Using X-ray Images Based on Fine-Grained Techniques in Deep Learning.

Study DesignRetrospective diagnostic study.ObjectivesTo develop a fine-grained classification model based on deep learning using X-ray images, to screen for scoliosis, and further to screen for atypical scoliosis patterns associated with Chiari Malformation type I (CMS).MethodsA total of 508 pairs of coronal and sagittal X-ray images from patients with CMS, adolescent idiopathic scoliosis (AIS), and normal controls (NC) were processed through construction of the ResNet-50 model, including the development of ResNet-50 Coronal, ResNet-50 Sagittal, ResNet-50 Dual, ResNet-50 Concat, and ResNet-50 Bilinear models.

Free-hand insertion of S2AI screw: what can we learn from O-arm navigation?

Objective: To characterize the actual entry point and trajectory of the S2AI screw following O-arm navigation from the postoperative CT scans.

Methods: Postoperative CT scans from 66 patients of adult degenerative scoliosis who received S2AI fixation under O-arm navigation were investigated. 3D image processing was applied to analyze and compare two entry points of the S2AI screw: point A was the reference point which was located at 1 mm lateral and 1 mm distal to the S1 dorsal sacral foramen; point B was the actual entry point, and the relative positions of point A and point B were compared with the S1 entry point.

Thiol-ene photoclick hydrogels reinforced with poly(protocatechualdehyde)-coated gallium doped bioactive glass nanoparticles for scarless healing of infected wound.

Complex pathological microenvironment mainly characterized by excessive inflammation, reactive oxygen species (ROS) production, drug-resistant bacterial infection makes wound rapid scarless healing still a major clinical challenge. Inspired by skin composed principally of collagen and mucopolysaccharides, an injectable nanocomposite hydrogel with immunoregulation, antioxidant and antibacterial activity based on allyl glycidyl ether grafted gelatin (Gel-AGE), cysteamine grafted hyaluronic acid (HA-CSA) and poly(protocatechualdehyde)-coated gallium doped bioactive glass (PPA@GaBG) nanoparticles, was designed for treatment of infected wound. The PPA@GaBG/Gel-AGE/HA-CSA (PGBGH) hydrogel can be rapidly formed via thiol-ene photo-click chemistry between Gel-AGE and HA-CSA.

Genome-wide association study reveals as a novel susceptibility gene associated with primary spontaneous pneumothorax in the Chinese Han population.

Background: Primary spontaneous pneumothorax is a rare disease commonly found in young adults with unknown etiology. We aimed to investigate the susceptibility genes and the downstream signaling involved in the development of primary spontaneous pneumothorax.

Methods: We conducted the first large-scale genome-wide association study (GWAS) composed of 2223 patients and 3838 controls.

Pelvic Incidence Changes in Patients with Adult Spinal Deformity Following S2AI Fixation: Is the Hip Joint Involved?

Study Design: Retrospective study.

Objective: To investigate whether the hip joints are involved in PI changes and explore its implications on pre-to-post PI changes.

Summary Of Background Data: Pelvic incidence (PI) is a key parameter in formulating surgical strategies for adult spinal deformity (ASD) patients requiring spinopelvic fixation.

Upregulated CEMIP promotes intervertebral disc degeneration via AP-1-mediated change in chromatin accessibility.

Background: Intervertebral disc degeneration (IDD), a chronic and multifactorial skeletal disorder, is the primary cause of low back pain. It results in reduced disc height and nucleus pulposus hydration due to proteoglycan loss and nucleus pulposus cells (NPCs) dysfunction within a hypoxic microenvironment. Metabolic dysregulation initiates catabolic processes, leading to extracellular matrix (ECM) degradation and compromising disc biomechanical integrity.

How to Apply the Sequential Correction Technique to Treatment of Congenital Cervicothoracic Scoliosis: A Technical Note and Case Series.

Objective: Hemivertebrae in the cervicothoracic junction in the pediatric population are treated conventionally with a two-rod instrumentation pattern. However, the increase in complexity, severity, and immaturity of osseous malformation in the cervicothoracic spine presents additional challenges in construct planning. This study aims to introduce an integrated instrumentation strategy named the sequential correction technique in the treatment of congenital cervicothoracic scoliosis caused by hemivertebra (CTS-HV) and evaluate its feasibility and treatment effects.

Environmental high-risk efflux pumps mediate concurrent enhancement of resistance and virulence in reclaimed water from urban wastewater treatment plants.

With the growing demand for urban water, reclaimed water is a key solution for mitigating shortages. However, wastewater treatment plants (WWTPs) can act as reservoirs for antibiotic resistance genes (ARGs) and virulence factors (VFs), posing environmental and public health risks. This study systematically investigated the distribution and co-selection mechanisms of ARGs and VFs across four treatment stages in five WWTPs in Nanjing over two years, with a focus on high-risk efflux pump-related ARGs.

Serum alkaline phosphatase/creatinine ratio serving as a screening tool for low lumbar bone mineral density in patients with degenerative lumbar scoliosis.

Purpose: (1) To figure out a simple and effective indicator that could assist in the assessment of bone mineral density (BMD) based on big data and (2) to verify its predictive value for low BMD among patients with degenerative lumbar scoliosis (DLS).

Methods: A total of 6,167 participants from the National Health and Nutrition Examination Survey (NHANES) database (2009-2010, 2013-2014, 2017-2018) and 166 patients who were diagnosed with DLS and hospitalized in our center between June 2019 and April 2023 were enrolled in the study. Cases were divided into two groups based on whether the T-score was below - 1.

O-Arm Navigated MIS-TLIF Avoids Violation and Delays Degeneration of the Supradjacent Facet Joint.

Objective: O-arm navigated MIS-TLIF is one of the novel surgical techniques for treating lumbar spondylolisthesis, but there still lacks enough evidence regarding intraoperative facet joint violation (FJV) and postoperative facet joint degeneration (FJD). This study aimed to compare clinical outcomes, accuracy of screw placement, and supradjacent FJV between the O-arm navigated MIS-TLIF group (NavMIS-TLIF group) and the open-TLIF group for the treatment of low-grade lumbar spondylolisthesis, and further, to investigate the risk factors influencing FJD.

Methods: We retrospectively reviewed a cohort of patients with low-grade lumbar spondylolisthesis who had received O-Arm navigated MIS-TLIF or open TLIF from May 2018 to May 2023.

Does Vertebral Cement Augmentation Reduce Postoperative Proximal Junction Complications in Spinal Deformity Corrective Surgery: A Systematic Review and Meta-analysis.

Objective: To assess the effectiveness of vertebral cement augmentation (VCA) at upper instrumented vertebra (UIV) and UIV+1 in preventing proximal junction complications in correction surgery for adult spinal deformity patients.

Methods: A literature search was conducted on Web of Science, PubMed, and Cochrane Library databases for comparative studies published before December 30th, 2024. Two reviewers independently screened eligible articles based on the inclusion and exclusion criteria, assessed study quality with Newcastle-Ottawa scale, and extracted data like study characteristics, surgical details, primary and secondary outcomes.

Baicalin alleviates intervertebral disc degeneration by inhibiting the p38 MAPK signaling pathway.

Background: Intervertebral disc degeneration (IVDD) represents a prevalent degenerative pathology of the spinal, primarily precipitated by inflammatory processes and the deterioration of extracellular matrix (ECM). Baicalin has an effective anti-inflammatory effect on degenerative diseases. In addition, the P38 mitogen-activated protein kinase (MAPK) signaling pathway plays a crucial role in the pathogenesis of IVDD.

Unraveling the PANoptosis Landscape in Osteosarcoma: A Single-Cell Sequencing and Machine Learning Approach to Prognostic Modeling and Tumor Microenvironment Analysis.

Osteosarcoma (OS) is a highly aggressive bone malignancy prevalent in children and adolescents, characterized by poor prognosis and limited therapeutic options. The tumor microenvironment (TME) and cell death mechanisms such as PANoptosis-comprising pyroptosis, apoptosis, and necroptosis-play critical roles in tumor progression and immune evasion. This study is aimed at exploring the PANoptosis landscape in OS using single-cell RNA sequencing (scRNA-seq) and at developing a robust prognostic model using machine learning algorithms.

Tri-cortical pedicle screw fixation in the most cranial instrumented segment to prevent proximal junctional kyphosis.

Background Context: Proximal junctional kyphosis (PJK) is a common complication of deformity correction for degenerative kyphoscoliosis (DKS) with an incidence between 20% and 40%. Multiple techniques have been proposed to prevent PJK, however, the clinical efficacy of these techniques remains unclear. Here, we investigate the influence of thoracic tri-cortical pedicle screw (TPS) in the most cranial instrumented segment on PJK.

Determining the risk factors for postoperative mechanical complication in degenerative scoliosis: a machine learning approach based on musculoskeletal metrics.

Objective: To determine the risk factors for mechanical complications (MC) following corrective surgery for degenerative scoliosis through a machine learning (ML) algorithm.

Methods: Patients with degenerative scoliosis who received corrective surgery were enrolled. A total of 213 cases were ultimately included and randomized into the training set (70%) and test set (30%) to develop the machine learning-based algorithm.

Proteome analysis reveals paraspinal muscle fiber type changes in patients with degenerative lumbar scoliosis.

Background Context: Degenerative lumbar scoliosis (DLS) is a common aging-related spinal deformity. Paraspinal muscle degeneration is highly correlated with the rapid progression of DLS. However, understanding of the role of the praspinal muscle degeneration is limited because of a lack of histologic and molecular evidence.