European Spine Journal最新文献

{"title":"Machine learning and neural network algorithms for prediction of C5 palsy after posterior surgery for ossification of posterior longitudinal ligament.","authors":"Dingyu Jiang, Ben Liu, Yuxing Tan, Binbin Ma, Yunqi Wu, Xiyang Wang, Xiongjie Shen, Yilu Zhang, Zheng Liu","doi":"10.1007/s00586-026-09988-w","DOIUrl":"https://doi.org/10.1007/s00586-026-09988-w","url":null,"abstract":"<p><strong>Purpose: </strong>C5 palsy (C5P) is one of the main postoperative complications of ossification of the posterior longitudinal ligament (OPLL). However, an accurate predictive tool for C5P remains to be developed. Forecasting this potentially avoidable consequence preoperatively can improve patient management, shared decision-making, and counseling.</p><p><strong>Methods: </strong>Electronic medical records and radiographic measurements of patients with OPLL who underwent posterior cervical spine surgery between January 1, 2012 and May 1, 2022 were retrospectively collected and analyzed. The data were split into training (80%) and testing (20%) datasets. Two machine learning algorithms and a logistic regression model were trained and optimized using the training dataset, and their performances were assessed using the testing dataset. Important feature screening was conducted to identify the influential factors associated with the dependent variable, and model-based threshold effect analysis was further performed to derive data-driven cutoff values for continuous predictors, and category-specific effects were summarized for discrete variables. Additionally, three advanced neural network models were also preliminarily applied and explored in this study.</p><p><strong>Results: </strong>In terms of predicting the postoperative C5P condition, the model with the best performance was the random forest model, with an AUC value of 0.9273, an accuracy rate of 0.8983, a precision rate of 0.8, a recall rate of 0.6667, and an F1 score of 0.7273. The results of the feature importance of the logistic regression, random forest, and XGBoost models indicated that the spinal canal occupancy rate (SCOR) was the most important predictive factor for postoperative C5P. The variable threshold effect analysis of the random forest model showed that when the SCOR was greater than 46%, there would be a significant risk of C5P.</p><p><strong>Conclusion: </strong>Machine learning models showed good predictive power and provided information about the phenotypes of patients with OPLL most likely to develop C5P after surgical intervention. In general, the utilization of machine learning holds promises as a valuable tool for the management of patients with OPLL.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute neurological deficit following lumbar microdiscectomy: a multiple sclerosis relapse mimicking a surgical complication - a case report and literature review.","authors":"Erhan Toprak, Muhammed Çağrı Görgeç, Duygu Dereli","doi":"10.1007/s00586-026-09984-0","DOIUrl":"https://doi.org/10.1007/s00586-026-09984-0","url":null,"abstract":"<p><strong>Objective: </strong>Acute neurological deficits following lumbar microdiscectomy are most commonly attributed to surgical complications. In this study, we present a case of multiple sclerosis (MS) relapse mimicking a postoperative surgical complication.</p><p><strong>Case: </strong>A 42-year-old female developed acute left lower extremity plegia in the early postoperative period following L4-5 microdiscectomy. Imaging studies and surgical re-exploration revealed no evidence of a compressive pathology. During clinical follow-up, neurological involvement progressed to the upper extremity. Detailed medical history revealed a prior diagnosis of MS and discontinuation of disease-modifying therapy. Due to contraindication to corticosteroid therapy, therapeutic plasma exchange was initiated, resulting in complete neurological recovery within 48 h.</p><p><strong>Conclusion: </strong>In the presence of negative imaging findings and anatomical incongruity, MS relapse should be considered in the differential diagnosis.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal nerves as landmarks for spinal cord segment delineation: cervical cross-sectional area measurement in healthy subjects.","authors":"Tayssir Boushila, Mouna Sahnoun, Fathi Kallel, Nadia Bouattour, Mariem Damak","doi":"10.1007/s00586-026-09979-x","DOIUrl":"https://doi.org/10.1007/s00586-026-09979-x","url":null,"abstract":"<p><p>Precise measurement of Spinal Cord Cross-Sectional Area (SC-CSA) is crucial for monitoring SC health and diagnosing neurodegenerative diseases. Accurate measurement of SC-CSA is challenging due to several factors such as SC curvature, patient positioning, segmentation methods, and limitations of Magnetic Resonance Imaging (MRI) resolution. Traditional methods that rely on vertebral levels as a reference suffer from inter-subject variability and limited reproducibility. In this study, we propose a novel landmark-based method to define robust anatomical references for standardizing the delineation of SC segment boundaries for SC-CSA measurements. This approach relies on consecutive spinal nerve midpoints (CNMPs) as anatomical references, providing more precise segment delineation and consistent SC-CSA measurements. We validated the effectiveness and robustness of our method using two public datasets of healthy individuals: the first comprises MRI images from different scanners and centers, and the second offers three different head positions for the cervical SC. Experimental results show an intra-subject mean coefficient of variation across head positions of 4.01 ± 2.89% for the proposed CNMP-based landmarks, compared to 4.46 ± 3.10% for vertebral-based landmarks. This demonstrates that the proposed CNMP method can serve as a reliable reference for reducing the variability of CSA measurements compared to the vertebral levels method. Our findings suggest that this approach could potentially aid in the diagnosis of pathological cohorts.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced machine learning model for Cobb angle progression in adolescent idiopathic scoliosis with surface topography: a multicenter, prospective, observational study.","authors":"José María González Ruiz, Judith Salat-Batlle, Macarena Alejandra Rodas Rivas, Judith Sánchez-Raya, Joan Bagó, Joan Masnou, Pamela Andrea Espinoza Poblete, Marco Morillo Armendariz, Susana Núñez-Pereira, Bruna Nichele da Rosa, Zeinab Estaji, Lindsey Westover","doi":"10.1007/s00586-026-09992-0","DOIUrl":"https://doi.org/10.1007/s00586-026-09992-0","url":null,"abstract":"<p><strong>Introduction: </strong>Excessive radiographic exposure in the follow-up of adolescent idiopathic scoliosis (AIS) remains a clinical concern. Surface topography (ST) and angle of trunk rotation (ATR) have shown promise for non-radiographic monitoring, although their ability to detect clinically meaningful Cobb angle changes (> 5°) remains limited. This study aimed to validate a machine learning model for predicting Cobb angle progression using ST parameters and ATR obtained at three and six months.</p><p><strong>Methods: </strong>A prospective observational study was conducted in 43 AIS patients (57 curves) recruited from two centers. Baseline and six-month radiographic Cobb angles were recorded along with ATR and five ST asymmetry parameters (MaxDev, RMS, LatDev, hump volume, asymmetry patch area). A random forest (RF) model was used to predict Cobb angles at 3 and 6 months and then to estimate progression over 6 months (ΔCobb). Outcomes were classified as improvement (ΔCobb < -5°), stabilization (-5° ≤ ΔCobb ≤ + 5°), or progression (ΔCobb > + 5°).</p><p><strong>Results: </strong>The RF model predicted the six-month radiographic Cobb with MAE of 7.03° (three-month input) and 6.91° (six-month input). The progression model integrating both time points achieved an overall accuracy of 80.7%, with detection accuracies of 100% for stabilization, 53.8% for improvement, and 37.5% for progression. Quantitatively, 84.2% of the curves had a progression prediction error of less than 5°.</p><p><strong>Conclusion: </strong>The model accurately identified stabilized cases, suggesting that non-radiographic follow-up combining ST and ATR could reliably detect non-progressive AIS within six months. This approach could potentially reduce up to 80% of unnecessary follow-up radiographs in stable patients.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical relevance among optical, ultrasonic, and radiographic imaging in scoliosis assessment.","authors":"Yiying Zou, Martin Bertsch, Mirko Kaiser, William R Taylor, Vanja Lukovic, Man Sang Wong, Sasa Cukovic","doi":"10.1007/s00586-026-09985-z","DOIUrl":"https://doi.org/10.1007/s00586-026-09985-z","url":null,"abstract":"<p><strong>Purpose: </strong>Although optical (OPI) and ultrasonic imaging (USI) have each been independently investigated as non-invasive alternatives to radiography (Xray) in scoliosis assessment, no study has yet directly compared their clinical performance. This study aimed to evaluate the clinical agreement and validity of OPI and USI, using Xray as the reference standard.</p><p><strong>Methods: </strong>Radiographic Cobb angle served as the gold standard for clinical evaluation of two non-invasive methods. The OPI-angle was derived from spine models fitted to digitised surface data based on structured-light, while USI-angle was measured from images acquired using an ultrasonic system. All scans were performed in the same upright posture. For analysis, 14 participants with suspected scoliosis completed all three assessments (Xray, OPI, USI) for direct three-way comparison. Additionally, 29 participants underwent Xray and OPI, and 25 underwent Xray and USI, enabling respective pairwise comparisons with the radiographic Cobb angle. The correlation, agreement, and measurement error were evaluated, with subgroup analyses based on spinal region, curve severity, and apical vertebral rotation (AVR) level.</p><p><strong>Results: </strong>Both non-invasive methods showed strong correlations with the radiographic Cobb angle (OPI: r = 0.873, 95% CI: 0.734-0.938; USI: r = 0.902, 95% CI: 0.791-0.953), with mean absolute differences (MADs) of 4.3° and 4.2°, respectively. The correlation between OPI- and USI-angles was r = 0.795 (95% CI: 0.590-0.898). Subgroup analyses revealed stronger correlations in the thoracic compared to the lumbar region for both methods. USI-angle showed a smaller MAD in mild than in moderate curves (4.3° vs. 7.1°). Optimal performance for both methods was observed at 5-10° AVR (OPI: MAD = 3.9°, r = 0.846; USI: MAD = 5.2°, r = 0.835).</p><p><strong>Conclusions: </strong>Both OPI and USI demonstrated strong agreement with radiographic measurements in scoliosis assessment, supporting their potential as useful non-invasive tools for clinical screening and monitoring applications. Additional validation with larger sample sizes, different severities, and various body mass index levels is required to further improve their clinical efficacy and applicability.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a nomogram for differential diagnosis of pyogenic spondylitis and tuberculous spondylitis in China: a multicenter retrospective study.","authors":"Liang Xu, Enuo Dai, Lulu Shi, Yongrui Yang, Wenkai Ruan, Jianlong Li, Rongpan Dang, Huigang An, Wentao Zhao, Yingxin Zhao, Zhaofei Li, Chenggui Zhang, Chenguang Jia, Zhongji Wang, Qile Gao, Ningkui Niu, Shangsheng Xu, Rui Bao, Zhigang Huang, Zhaopeng Li, Xiaogang Guan, Shengping Hu, Hongdong Tan","doi":"10.1007/s00586-026-09908-y","DOIUrl":"https://doi.org/10.1007/s00586-026-09908-y","url":null,"abstract":"<p><strong>Background: </strong>Pyogenic spondylitis (PS) and tuberculous spondylitis (TS) present with significant clinical overlap, posing a major diagnostic challenge. We aimed to develop and validate an imaging-based nomogram integrating CT and MRI features to accurately differentiate PS from TS.</p><p><strong>Method: </strong>We conducted a multicenter retrospective study including 539 patients with spinal infections (251 PS, 288 TS) diagnosed between June 2021 and May 2025. Patients were divided into training (n = 427) and external validation (n = 112) cohorts. Imaging features were screened using univariate logistic regression. The least absolute shrinkage and selection operator (LASSO) regression was then applied to select the optimal predictive feature subset and mitigate overfitting. A multivariate logistic regression model based on these features constructed the nomogram. We evaluated diagnostic performance using the area under receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA). Internal validation employed 500 bootstrap resamples; external validation used an independent cohort.</p><p><strong>Results: </strong>The training cohort comprised 187 (43.8%) PS and 240 (56.2%) TS patients; the external validation cohort had 64 (57.1%) PS and 48 (42.9%) TS patients. LASSO regression identified five key predictors: vertebral involvement pattern (continuous vs. skip/non-continuous), vertebral body T2-weighted signal intensity (hyperintense vs. heterogeneous), MRI abscess wall characteristics (thick/irregular vs. thin/smooth), CT bone destruction type (osteolytic vs. fragmentary), and CT sagittal bone destruction degree (< 1/3 vs. > 2/3). The AUCs of the nomograms for the training and external validation cohorts were 0.908 (95% confidence interval: 0.880-0.936) and 0.899 (95% confidence interval: 0.842-0.955), respectively. Calibration curves showed the optimal concordance between predicted results and the actual observations. DCA indicated that the substantial clinical net benefit across threshold probabilities.</p><p><strong>Conclusion: </strong>The developed nomogram is capable of accurately distinguishing between PS and TS, thereby aiding clinicians in making informed decisions promptly upon obtaining relevant data.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From plastic spine hypothesis to decision-grade evidence: building a translational exposome framework for spine research.","authors":"M Vijayasimha, M Srikanth, Vanshika Verma","doi":"10.1007/s00586-026-09990-2","DOIUrl":"https://doi.org/10.1007/s00586-026-09990-2","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minor endplate damage as an initiator of systemic biomechanical disruption of the lumbar disc: a finite element analysis of the 'mechanical tipping point' in disc failure.","authors":"Shanmuganathan Rajasekaran, Davidson Jebaseelan, Gnanaprakash Gurusamy, Karthik Banurekha Devaraj, Balaji Harinathan, Narayan Yoganandan","doi":"10.1007/s00586-026-09983-1","DOIUrl":"https://doi.org/10.1007/s00586-026-09983-1","url":null,"abstract":"<p><strong>Background: </strong>Vertebral end plates (EP) are essential for disc homeostasis due to their dual role of structural load distributor and a nutritional interface. Focal EP defects are frequently observed clinically, but their true biomechanical significance in vivo is unknown. Finite Element (FE) analysis offers a unique opportunity to simulate specific anatomical changes and can quantify the consequences of the mechanical disruption.</p><p><strong>Methods: </strong>We employed a validated FE Model of L4-L5 functional unit and investigated the effects of physiological compression and pure moments on models simulating: (1) Healthy discs with intact EP, (2) Four EP defect models, and (3) Graded anatomical EP damage based on Integrated Total Endplate Score (I-TEPS). Stress distribution on cartilage end plate (CEP), bony end plate (BEP), annulus fibrosus (AF), nucleus pulposus (NP), and subchondral bone was documented.</p><p><strong>Results: </strong>In the intact healthy model, stress was uniformly distributed without focal concentrations. In contrast, all EP defect models demonstrated significant, non-linear stress elevation across the motion segment. Incremental analysis based on I-TEPS revealed a 'mechanical tipping point' phenomenon: stresses remained relatively stable until score three but increased sharply once the score reached four, coinciding with the onset of BEP involvement.</p><p><strong>Conclusion: </strong>Focal EP defects, irrespective of their location, cause stress extensions beyond the defect zone, causing cascading mechanical disruption of the disc environment. Combined CEP and BEP defects (I-TEPS ≥ 4) represent synergistic mechanical failure, characterized by abnormal NP pressure, annular tension, and subchondral bone stress. These findings demonstrate that EP integrity is one of the primary determinants of segmental spine stability.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative management of antithrombotic therapy in elderly patients undergoing elective ACDF: implementation and outcomes of a standardized institutional protocol.","authors":"Giuseppe Corazzelli, Davide De Los Rios, Gennaro De Rosa, Francesco Fiore, Sergio Corvino, Settimio Leonetti, Francesco Ricciardi, Paolo Di Russo, Nicola Gorgoglione, Valentina Pizzuti, Alessandro D'Elia, Marco Santilli, Fulvio Aloj, Antonio Bocchetti, Raffaele de Falco, Plinio Cirillo, Sergio Paolini, Vincenzo Esposito, Gualtiero Innocenzi","doi":"10.1007/s00586-026-09977-z","DOIUrl":"https://doi.org/10.1007/s00586-026-09977-z","url":null,"abstract":"<p><strong>Objective: </strong>Perioperative management of chronic antithrombotic therapy in elderly patients undergoing elective anterior cervical discectomy and fusion (ACDF) remains poorly standardized. This study evaluated the safety and feasibility of an institutional protocol based on temporary substitution rather than interruption of preexisting antithrombotic regimens.</p><p><strong>Methods: </strong>We retrospectively analyzed 189 consecutive patients aged ≥ 65 years who underwent elective ACDF between 2019 and 2023. Patients were stratified according to their chronic antithrombotic regimen. Group A included patients with no prior antithrombotic therapy, who received standard postoperative prophylaxis with enoxaparin after drain removal. Group B comprised patients on primary prevention therapy, whose home regimen was discontinued 7 days before surgery and replaced with bridging low-molecular-weight heparin (enoxaparin 40 mg daily) until 15 days postoperatively. Group C included patients on secondary prevention therapy, who suspended their regimen 7 days preoperatively and received low-dose aspirin (100 mg daily) from the preoperative week through postoperative day 15 before resuming their chronic therapy. Primary outcomes were hemoglobin decrease, operative time, and length of stay, while secondary outcomes included complications (Clavien-Dindo classification) and early functional recovery (mJOA, ODI). Non-inferiority analyses using the TOST procedure evaluated whether perioperative outcomes remained within predefined a priori clinical margins across groups.</p><p><strong>Results: </strong>Baseline characteristics and surgical parameters were comparable among groups. No major hemorrhagic or thromboembolic events occurred. Perioperative parameters and minor complications (Clavien-Dindo I-II) were similar across all groups. Functional improvement at 3 months was consistent (p > 0.3).</p><p><strong>Conclusion: </strong>This substitution-based perioperative protocol proved feasible and clinically safe in elderly ACDF patients. Although underpowered to detect rare events, these findings support prospective studies aimed at further investigating the adoption of standardized replacement strategies in this growing surgical population.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HumanMoveNet: a dynamic 3D spine reconstruction framework for low back pain screening and rehabilitation assessment.","authors":"Tao Huang, Zhiyuan Xia, Jason P Y Cheung, Yong Hai, Xihe Kuang, Teng Zhang","doi":"10.1007/s00586-026-09898-x","DOIUrl":"https://doi.org/10.1007/s00586-026-09898-x","url":null,"abstract":"<p><strong>Objectives: </strong>Low back pain (LBP) is a leading cause of disability worldwide, yet current clinical assessments rely heavily on subjective reports and static imaging, providing limited objective quantification of spinal dynamic function. This study aims to develop and evaluate HumanMoveNet, a novel digital framework that reconstructs a temporally consistent 3D human model with precise spinal curvature from monocular visual data to enable objective LBP screening and rehabilitation assessment.</p><p><strong>Methods: </strong>The proposed hybrid framework integrates static anatomical reconstruction, dynamic pose estimation, and temporal smoothing. From a human gait video, a 3D reconstruction network first generates a static human model with personalized spinal morphology. The gait video is then processed via optimized 2D pose estimation and parametric model regression to obtain frame-by-frame 3D human meshes. Graph convolutional and long short-term memory networks are employed to ensure temporal motion continuity. Finally, the static spine is fused with the dynamic pose sequence to create a \"dynamic spine,\" from which key biomechanical parameters-lumbar range of motion (ROM), pelvic tilt range, and spinal symmetry index-are extracted.</p><p><strong>Results: </strong>Validation on 146 subjects demonstrated superior reconstruction performance, achieving a 5.6% improvement (18.85 vs 17.85) in Peak Signal-to-Noise Ratio (PSNR), a 28.4% reduction in Hausdorff Distance (2.1126 mm vs 2.9505 mm), and a 5.1% increase in Intersection over Union (IoU) (0.4122 vs 0.3921) compared with state-of-the-art methods. Analysis of spinal curvature variation showed [Formula: see text] values of [Formula: see text] in females and [Formula: see text] in males, with no significant gender difference ([Formula: see text]). Gender-specific analysis further revealed that females had greater pelvic mobility ([Formula: see text] vs [Formula: see text], [Formula: see text]) and lumbar ROM ([Formula: see text] vs [Formula: see text], [Formula: see text]).</p><p><strong>Conclusions: </strong>HumanMoveNet provides a precise, label-free solution for assessing spinal dynamic function using conventional visual data. By combining high-fidelity spinal anatomy with dynamic motion analysis, it effectively captures LBP-related movement alterations, and shows strong potential for community-based screening, rehabilitation evaluation, and personalized care.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}