JOR Spine最新文献

{"title":"Reduced Shear Modulus and Altered Lamellar Morphology of the Outer Annulus Fibrosus in Painful Intervertebral Disc Degeneration Compared With Tissue From Non-Surgical Controls","authors":"Taylor J. Bader,&nbsp;Manmeet Dhiman,&nbsp;Lucas Lo Vercio,&nbsp;Jacques Bouchard,&nbsp;Fred Nicholls,&nbsp;Nathan Evaniew,&nbsp;Bradley Jacobs,&nbsp;Kenneth C. Thomas,&nbsp;Paul Salo,&nbsp;David A. Hart,&nbsp;Neil A. Duncan,&nbsp;Ganesh Swamy","doi":"10.1002/jsp2.70123","DOIUrl":"10.1002/jsp2.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stability of the spine and intervertebral disc (IVD) integrity is enabled by the highly organized fibrocartilaginous annulus fibrosus (AF). The shear properties of the AF are important in maintaining IVD integrity. AF shear mechanics in degenerative disc (DD) remain underexplored, especially in comparing minimally degenerative (non-DD) and symptomatic DD individuals. This study measured tissue mechanical properties (AF simple shear modulus and dynamic shear properties) and examined structure (with optical coherence tomography (OCT)) in surgical DD and non-DD control individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Whole AF tissue samples were collected from non-DD donors (<i>N</i> = 13) and DD surgical individuals (<i>N</i> = 30). Two anterior outer AF (OAF) 5 mm cubes were sectioned from each sample and subjected to shear in two orientations, radial (coronal plane, G1) and circumferential (sagittal plane, G2). Tissues underwent static shear and dynamic shear protocols to a maximum of 10% shear strain. Following mechanical tests, average lamellar thickness was assessed using OCT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Static shear moduli were significantly reduced for DD tissue compared to non-DD in both the radial (G1) (non-DD: 83.0 ± 41.3 kPa, DD: 24.1 ± 23.7 kPa) and the circumferential (G2) (non-DD: 226.2 ± 81.9 kPa, DD: 54.0 ± 40.2 kPa) orientations (<i>p</i> &lt; 0.05). Further dynamic mechanical alterations were detected in hysteresis, phase shift, and dynamic modulus. Shear moduli correlated negatively with lamellar thickness (G1: r_s = −0.63, G2: r_s = −0.71).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There were significant alterations in AF shear moduli and dynamic properties in DD individuals when compared to non-DD controls. Structural correlations highlight the role of the highly organized AF lamellar structure on shear modulus values. These findings suggest that altered AF mechanics may contribute to DD pathology and associated low back pain, warranting further investigation into structural and functional AF changes in symptomatic individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 4","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Resolution 3-Dimensional Micro-CT Imaging of Intervertebral Discs Using a Novel Contrast Agent","authors":"Madison M. Buckles,&nbsp;Abdulkadir Nur,&nbsp;Nada H. Warda,&nbsp;Jacob C. Moncher,&nbsp;Mohammad Yunus Ansari","doi":"10.1002/jsp2.70125","DOIUrl":"10.1002/jsp2.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The nucleus pulposus (NP) in the intervertebral disc (IVD) is the first structure to exhibit degenerative changes during IVD degeneration (IDD). Currently, micro-computed tomography (micro-CT) imaging of the NP is a limiting factor in detecting IDD at an early stage. While contrast-enhanced micro-CT has been investigated, an effective contrast agent for IVD has not been identified. This study investigates potassium iodide (KI) as an effective contrast agent for micro-CT-based IVD visualization across multiple animal models to study IDD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We collected tails and spines from mice, rats, rabbits, sheep, and stained them with KI followed by micro-CT imaging. For IDD, we performed caudal annular needle puncture surgery (NPS) in age and sex-matched mice (<i>n</i> = 10) and stained with KI for imaging with micro-CT. For the aging model, we compared IVDs from old to young mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to unstained IVDs, KI effectively stained and visualized the 3D structure of the NP, exhibiting X-ray attenuation properties comparable to bone. KI contrast staining enabled accurate and reproducible quantification of IVD height and NP volume. The cross-sectional micro-CT images of NPS IVDs were indistinguishable from the histological findings of the same sample and showed similar degenerative changes in the NP. We also found that KI staining is reversible, and the tissue remains compatible with downstream histological processing and immunostaining. Notably, KI successfully stained the NP in decalcified tissue, offering an advantage for NP analysis by removing bone background in micro-CT scans. Additionally, we estimated that up to 15 sagittal sections, each 5 μm thick with 75 μm spacing, would be needed to fully assess IVD degeneration in mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated that KI can be used to positively stain NP in the intact tail or spine and provide qualitative and quantitative data without any adverse effects on the immune/histological processing of the samples.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 4","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age and Spinal Level as Predictors of Lumbar Disc Degeneration in Humans and Mice: A Comparative Analysis","authors":"Ravij Mehta,&nbsp;Sarthak Mohanty,&nbsp;Andrew Parker Hallmark,&nbsp;Veeraj Shah,&nbsp;Tom Ross,&nbsp;Eric A. Bogner,&nbsp;Tejbir S. Pannu,&nbsp;Mathieu Bannwarth,&nbsp;Sohrab Virk,&nbsp;Sravisht Iyer,&nbsp;James C. Farmer,&nbsp;Russel C. Huang,&nbsp;Darren R. Lebl,&nbsp;Bernard A. Rawlins,&nbsp;Harvinder S. Sandhu,&nbsp;Han Jo Kim,&nbsp;Matthew E. Cunningham,&nbsp;Sheeraz Qureshi,&nbsp;Todd J. Albert,&nbsp;Chitra L. Dahia","doi":"10.1002/jsp2.70122","DOIUrl":"10.1002/jsp2.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Aging is a major risk factor for IVD degeneration and chronic lower back pain. Comparing degenerative patterns in human and mice, a commonly used pre-clinical model, is crucial for validating it in preclinical mechanistic research. The goal of the study was to compare the effect of age and spine level on degeneration in human and mouse lumbar IVDs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>T2-weighted MRI images of human lumbar spine were graded using the Pfirrmann system. H&amp;E-stained mid-coronal sections of mouse lumbar IVDs were scored using the Melgoza and Chenna system. Age, gender, IVD level, and lumbar IVD degeneration scores, respectively, were used for statistical analysis in each species. Linear regression and one-way ANOVA with post hoc Tukey analysis were used to compare regression slopes and intercepts. Age conversion from mouse to human was performed according to the Jackson Laboratory's outline of mouse age and its human equivalents. Generalized estimating equations (GEE) were used to model continuous degeneration scores, accounting for intra-subject correlation due to multiple IVD levels per subject. Main effects included sex, IVD level (L1–S1), and age, with an interaction term assessing the impact of age across levels. An autoregressive correlation structure was specified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Age significantly correlated with IVD degeneration in humans (<i>p</i> &lt; 0.0001) and mice (<i>p</i> &lt; 0.0002). And the IVD level predicted degeneration in both species (L5–S1 in human, and L6–S1 in mice). Normalizing age and pathology revealed an earlier onset of degeneration in humans than in mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Age and spinal IVD level influence lumbar IVD degeneration in both human and mice with a higher rate of degeneration at the lumbosacral junction in both species. These findings suggest that mice are a suitable model for studying the cellular and molecular basis of IVD degeneration and associated neurological symptoms, with the L6–S1 level being the most relevant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 4","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbopelvic Kinematics During Functional Tasks in a Chronic Low Back Pain Observational Cohort","authors":"Kevin M. Bell,&nbsp;Rachel E. Roos,&nbsp;Zakiy Alfikri,&nbsp;William Anderst,&nbsp;Anna Bailes,&nbsp;William W. Clark,&nbsp;Harold A. Cook,&nbsp;Jessa Darwin,&nbsp;Marit Johnson,&nbsp;Gina P. McKernan,&nbsp;Sebastian Murati,&nbsp;Bambang Parmanto,&nbsp;Nam V. Vo,&nbsp;Leming Zhou,&nbsp;Gwendolyn A. Sowa","doi":"10.1002/jsp2.70117","DOIUrl":"https://doi.org/10.1002/jsp2.70117","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The University of Pittsburgh Mechanistic Research Center, entitled, “Low Back Pain: Biological, Biomechanical, Behavioral Phenotypes (LB&lt;sup&gt;3&lt;/sup&gt;P),” is part of the National Institutes of Health's Helping to End Addiction Long-term Initiative. LB&lt;sup&gt;3&lt;/sup&gt;P conducted a prospective, observational cohort study to identify phenotypes from over 1000 participants with chronic low back pain (cLBP). This article reports findings from multi-level inertial measurement unit (IMU) kinematic data collected during performance-based tests obtained at the in-person LB&lt;sup&gt;3&lt;/sup&gt;P enrollment visit.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Participants with cLBP were recruited and performed self-paced and fast-paced movements while wearing inertial measurement units (IMUs) placed over T1/T2, T12/L1, L5/S1, and along the right femur. For self-paced tests: axial rotation (AR), lateral bending (LB), and flexion and extension (F/E), participants performed to their maximum range of motion (ROM), and for fast-paced tests: combined rotation/flexion (CRF), AR, LB, flexion, five times sit to stand (5STS), and postural lifting strategy (PLS), participants performed at their maximum speed. ROM, velocity, acceleration, and lumbopelvic rhythm (LPR) were calculated for tests using IMU data. LPR was calculated as the ratio of absolute lumbar to hip movement and was extracted for each motion quartile (0%–25%, 25%–50%, 50%–75%, and 75%–100%) during neutral-to-flexion and neutral-to-extension.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Analysis of sensor data of 954 participants (58.6 ± 16.4 years old; 40% male and 60% female) revealed variable kinematic patterns across spinal and hip regions during isolated and functional movements. Noticeable variations were observed based on movement type, with the trunk region demonstrating predominant mobility during self-paced movements like AR and LB, while the hip region played a critical role in functional tasks (CRF, 5STS, PLS). LPR evaluation indicated that individuals with cLBP typically adopt a hip-dominant movement pattern, with slightly greater lumbar contributions during the initial phase of flexion. Sex and age analyses unveiled females generally exhibit greater ROM and higher velocities compared to males. Younger participants (&lt; 60 years old) show more dynamic movement patterns, except in the hip region during F/E, where older (≥ 60) participants exhibited greater excursion.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study characterized spinal and hip movement in ","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 4","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Computational Pathology to Assess Degenerative Disc Histology","authors":"Richard D. Bell,&nbsp;Evie C. Reddick,&nbsp;David J. Lillyman,&nbsp;Fei San Lee,&nbsp;Rebecca A. Wachs","doi":"10.1002/jsp2.70119","DOIUrl":"https://doi.org/10.1002/jsp2.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Preclinical models of disc degeneration are important tools to discover disease pathology. Histopathology is often used to understand these changes, but analyses remain reliant on pathologists or graders using time-consuming scoring systems. The integration of computational pathology can improve this process by leveraging machine learning (ML) algorithms. Thus, this work aimed to develop a segmentation model to identify seven distinct disc tissues and utilize the segmented tissue areas generated from the model, along with other derived measures, to estimate pathological changes that align with traditional histological scoring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Hematoxylin and eosin-stained motion segment sections were collected from four independent studies. Each study included a disc injury puncture in Sprague Dawley rats. An active learning technique and a trained deep convolutional neural network were used to infer tissue segmentation. The model was then applied to untrained images to infer tissue segmentation, extract geometric and cell count features, and correlate these measurements with histologic scores from a standard scoring system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The segmentation model was highly performant with an Intersection over Union (mIOU) and frequency weighted Intersection over Union (fwIOU) of 0.83 ± 0.04 and 0.94 ± 0.02 in the Test set, respectively. The ML-derived measures correlated well with histologic scores, with absolute ranges from rho = 0.65 to 0.87. Further, these ML-derived measures were altered with disc degeneration with significant differences in NP cell number, NP area ratio, NP/AF border, NP roundness, and AF perimeter. Lastly, our model could measure additional tissue changes not captured through a standard histological scoring system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Herein, we developed the first computational pathology model to phenotype disc degeneration tissue. Our model significantly correlates with traditional histopathology scoring methods, detects subtle differences between groups by directly measuring pathologic features in the images, and increases efficiency by automating the majority of the process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 4","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Side Iatrogenic Pedicle Injury May Trigger an Increased Risk of Contralateral Screw Loosening: An In Silico Study","authors":"Jiexiang Yang,&nbsp;Junjie Chen,&nbsp;Guoyou Wang,&nbsp;Lijunpeng Jia,&nbsp;Yingguang Zhou,&nbsp;Jingchi Li","doi":"10.1002/jsp2.70124","DOIUrl":"https://doi.org/10.1002/jsp2.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Screw loosening is a frequently reported complication following pedicle screw fixation, resulting in various adverse outcomes. The primary trigger for screw loosening is biomechanical deterioration. Iatrogenic injury to the pedicle is a commonly observed scenario. This alteration can lead to an increased risk of pedicle screw loosening. Bilateral pedicle screws distribute load during the patient's daily activities and can be regarded as an integrated structure from a biomechanical perspective. Consequently, biomechanical interactions are prevalent between the two sides of the pedicle screws. This study aimed to determine whether unilateral pedicle injury influences contralateral screw loosening by deteriorating the local biomechanical environment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The numerical model of the L5 vertebral body, developed in our previous studies, was employed in this investigation. Bilateral pedicle screws were inserted following the standard trajectory. Simulations of both half and complete ventral and dorsal side pedicle injuries were performed on the right-side pedicle. Stress and strain values of the screw trajectory, along with screw displacement values on the contralateral side, were recorded to assess the potential risk of screw loosening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to the model without pedicle injury, models with pedicle injuries exhibited higher interfacial stress and strain, as well as greater screw displacement. This effect was particularly pronounced when the pedicle on the side of torque restriction (e.g., caudal side pedicle injury under the flexion loading condition) was considered. Furthermore, unilateral iatrogenic injury to the pedicle can trigger multi-degree-of-freedom coupled motion under a single-direction torque.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Single-side iatrogenic pedicle injury can lead to multi-degree-of-freedom coupled motion of the screw-fixed vertebral body, and biomechanical deterioration of the contralateral screw trajectory, thereby increasing the risk of contralateral pedicle screw loosening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 4","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile Health (mHealth) for Chronic Low Back Pain Assessment: Design, Development, and Usability Evaluation","authors":"Zakiy F. Alfikri,&nbsp;Marit E. Johnson,&nbsp;Brad E. Dicianno,&nbsp;Carol M. Greco,&nbsp;Bambang Parmanto,&nbsp;Sara R. Piva,&nbsp;Rachel E. Roos,&nbsp;Andi Saptono,&nbsp;Gwendolyn A. Sowa,&nbsp;Leming Zhou,&nbsp;Kevin M. Bell","doi":"10.1002/jsp2.70118","DOIUrl":"https://doi.org/10.1002/jsp2.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic low back pain (cLBP) requires precise phenotyping for tailored treatments. This study introduces a mobile health (mHealth) system for cLBP assessment, aiming to collect extensive biomechanical and behavioral data from in-clinic and seven-day at-home assessments from 1000 individuals with cLBP to accommodate accurate phenotyping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a user-centered design approach, an integrated mHealth system was developed, comprising two mobile applications: a clinician-facing in-clinic app and a participant-facing at-home app. The in-clinic app aids physical therapists in conducting in-clinic assessments, while the at-home app allows cLBP patients to manage and submit responses to ecological momentary assessments (EMA). Usability evaluations were conducted using the mHealth App Usability Questionnaire (MAUQ) and qualitative open-ended questions asking about ease of use, learnability, overall impression and satisfaction, and reflective questions. Scores from MAUQ were summarized using median and interquartile range (IQR). The usability results were used to iteratively refine the system's design and functionality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three physical therapists and 337 out of 522 cLBP patients participated in the usability evaluations. The evaluations demonstrated positive feedback for both apps. For the in-clinic app, the first iteration median MAUQ score was 6 (IQR 1) and the second iteration median MAUQ score was also 6 (IQR 2). For the at-home app, the median MAUQ scores were consistently high across five iterations (median score of 7 (IQR 1) for all iterations). These scores indicated good usability, meaning they were easy to use, efficient, and satisfying. Iterative modifications based on the feedback focused on enhancing navigation consistency, responsiveness, and user interface, resulting in overall improved usability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The in-clinic app was successfully used by physical therapists for the assessments of 1000 cLBP patients, receiving positive feedback. Similarly, 989 cLBP patients used the at-home app to complete and submit their EMA, finding it easier to comply with the assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 4","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertebral Growth Modulation Through Periosteal Resection and Fixed Length Deformity Overcorrection: Computational and In Vivo Pilot Study","authors":"Matthew A. Halanski,&nbsp;Cameron Jeffers,&nbsp;Yousuf Abubakr,&nbsp;Minhao Zhou,&nbsp;Brittney Kokinos,&nbsp;Max Twedt,&nbsp;David Bennett,&nbsp;Susan Hamman,&nbsp;Thomas Crenshaw,&nbsp;Grace D. O'Connell,&nbsp;Hani Haider","doi":"10.1002/jsp2.70121","DOIUrl":"https://doi.org/10.1002/jsp2.70121","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Vertebral body tethering (VBT) is a fusionless surgical technique for correcting spinal deformities through asymmetric growth inhibition. Standard VBT often relies on intraoperative overcorrection with an anterior center of rotation, which may decrease disc height and inhibit vertebral growth. Strategies that promote, rather than inhibit, growth could expand the vertebral growth modulation toolkit.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Determine how the center of rotation location during overcorrection influences vertebral growth, and to evaluate the feasibility of growth-promoting techniques, including anterior vertebral periosteal transection and a novel uniplanar, unidirectional, length-stable posterior implant.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Validated finite element model (FEM) simulated anterior versus posterior centers of rotation, assessing effects on disc height, physeal stress, and sagittal vertebral growth. Six swine underwent anterior periosteal transection, with growth rates measured against adjacent vertebrae. In a kyphotic swine model, a posterior fixed-length implant was applied across the most kyphotic disc space, shifting the center of rotation posteriorly; growth modulation was compared to non-operative controls.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Study Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Computational analysis and large animal study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;FEM predicted that a posterior (convex) center of rotation increased disc height, redistributed physeal stress to promote growth, and improved deformity correction, whereas an anterior center of rotation decreased disc height and inhibited growth. Periosteal transection did not accelerate vertebral growth (170 ± 19 μm/day control vs. 155 ± 25 μm/day treated; &lt;i&gt;p&lt;/i&gt; = 0.054). In contrast, the posterior implant achieved overcorrection and induced corrective % appositional metaphyseal growth modulation (+24% ± 10% vs. −11% ± 13% in controls; &lt;i&gt;p&lt;/i&gt; = 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Periosteal resection/transection did not reliably enhance vertebral growth. Shifting the corrective center of rotation posteriorly using a fixed-length, uniplanar device preserved disc height and promoted corrective growth.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 ","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 4","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Five Animal Models for Acute Intervertebral Disc Herniation Research","authors":"Thomas D. Slater,&nbsp;Beatrice Gagliostri,&nbsp;Matthew J. Kibble,&nbsp;Nazli S. Tümer,&nbsp;Peter A. Cripton,&nbsp;Nicolas Newell","doi":"10.1002/jsp2.70116","DOIUrl":"https://doi.org/10.1002/jsp2.70116","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Study Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Microstructural investigation of mechanical load induced acute disc herniation on five animal models.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To compare how spinal discs in different animal models herniate under a standardized complex compressive load.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Summary of Background Data&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Animal models in disc herniation research offer reduced degeneration-associated variability, lower cost, and greater availability compared to human specimens. However, there is limited consensus regarding which species is best suited for modeling human herniation, making a comprehensive comparison of species-specific herniation mechanisms necessary.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Materials and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A standardized shear and compressive load, designed to herniate intervertebral discs, was applied to isolated discs of five cadaveric animal models (&lt;i&gt;n&lt;/i&gt; = 30, 6 specimens per group): bovine tail, bovine lumbar, ovine lumbar, porcine lumbar, and porcine cervical. The segments were flexed (7°), and a shear-compressive load was applied at a crosshead displacement rate of 40 mm min&lt;sup&gt;−1&lt;/sup&gt;, until a force drop, or a displacement limit was reached (~80% of disc height). Microstructural analysis was undertaken to identify failure modes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Clinically relevant herniation features were observed in all models—including endplate and annulus fibrosus (AF) tearing, AF delamination, vertebral body (VB) fracture, nucleus pulposus (NP) extrusion into VB, and radial NP movement. Bovine lumbar, porcine cervical, and porcine lumbar segments exhibited high rates of radial NP movement (84%, 100%, and 67%, respectively), with ovine lumbar discs displaying VB fracture (84%) and NP extrusions into the VB (67%). Bovine tail discs showed minimal damage but were characterized by sequential lamellar AF tears (67%).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Porcine cervical, bovine lumbar, and porcine lumbar discs are suitable for annulus-failure herniation research, although porcine cervical discs may be the most appropriate due to exhibiting the highest rate of relevant damages. Ovine lumbar discs are relevant for studying endplate junction failure herniations, and bovine tail discs are appropriate for implant-related studies.&lt;/p&gt;\u0000 &lt;/se","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Biopsychosocial Impact of Chronic Low Back Pain in Workers Through Artificial Intelligence-Driven Phenotyping","authors":"Paolo Giaccone,&nbsp;Elisabetta de Rinaldis,&nbsp;Federico D'Antoni,&nbsp;Fabrizio Russo,&nbsp;Luca Ambrosio,&nbsp;Giorgia Petrucci,&nbsp;Mario Merone,&nbsp;Leandro Pecchia,&nbsp;Sergio Iavicoli,&nbsp;Gianluca Vadalà,&nbsp;Rocco Papalia,&nbsp;Vincenzo Denaro","doi":"10.1002/jsp2.70110","DOIUrl":"10.1002/jsp2.70110","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Study Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Cross-sectional retrospective cohort study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Chronic low back pain (cLBP) is a major cause of disability worldwide, significantly affecting return to work (RTW). This study aimed to assess the biopsychosocial factors influencing occupational functioning in workers with cLBP using artificial intelligence (AI) data-driven patient phenotyping.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Data of workers affected by cLBP were collected through a comprehensive assessment of demographic, clinical, and occupational factors. Hierarchical clustering was employed to identify distinct phenotypes based on patient-reported outcome measures (PROMs), including the Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Work Ability Index (WAI), Nordic score, and Patient Health Questionnaire-2 (PHQ-2). Independent &lt;i&gt;t&lt;/i&gt; tests and Mann–Whitney &lt;i&gt;U&lt;/i&gt; tests were used for phenotype profiling, distinguishing between continuous and categorical responses, respectively, to assess the most discriminative queries and highlight the most significantly different features (&lt;i&gt;p&lt;/i&gt; &lt; 0.05).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 304 patients were included in the analysis. The AI-driven phenotyping approach identified two distinct clusters, representing 51% (Cluster 1) and 49% (Cluster 2) of the dataset. Compared to Cluster 1, Cluster 2 exhibited significantly higher absenteeism (17.00 vs. 5.22 days, &lt;i&gt;p &lt;&lt;/i&gt; 0.05), lower WAI (33.34 &lt;i&gt;±&lt;/i&gt; 6.84 vs. 38.96 &lt;i&gt;±&lt;/i&gt; 4.31, &lt;i&gt;p &lt;&lt;/i&gt; 0.05), worse pain-related outcomes in terms of higher VAS (5.98 &lt;i&gt;±&lt;/i&gt; 2.06 vs. 4.48 &lt;i&gt;±&lt;/i&gt; 2.48, &lt;i&gt;p &lt;&lt;/i&gt; 0.05) and ODI (33.52 &lt;i&gt;±&lt;/i&gt; 16.56 vs. 20.08 &lt;i&gt;±&lt;/i&gt; 13.59, &lt;i&gt;p &lt;&lt;/i&gt; 0.05), more frequent occupational exposure to manual handling of loads (84% vs. 16%) and higher psychological distress assessed through PHQ-2 (70% vs. 30%).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our study identified the most relevant PROMs differentiating between cLBP clusters of patients, emphasizing different levels of absenteeism and pain-related outcomes.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;These findings contributed to unravel the data-driven AI potential in suggesting personalized interventions targeting specific biopsychosocial profiles, which may improve clinical outcomes and occupational functioning in workers with cLBP, ultimately enhancing their overall well-bei","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}