JOR Spine最新文献

{"title":"Changes in Midrange and End Range Adjacent Segment Motion 3 Years After One- Or Two-Level Cervical Arthrodesis","authors":"Clarissa M. LeVasseur,&nbsp;Samuel W. Pitcairn,&nbsp;Xinyi Dan,&nbsp;Yan Ma,&nbsp;David O. Okonkwo,&nbsp;Jeremy D. Shaw,&nbsp;William F. Donaldson,&nbsp;Joon Y. Lee,&nbsp;William J. Anderst","doi":"10.1002/jsp2.70224","DOIUrl":"https://doi.org/10.1002/jsp2.70224","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Biomechanical cadaver studies consistently find that cervical arthrodesis leads to increased motion adjacent to the arthrodesis. However, in vivo evidence indicates adjacent segment end range motion does not reliably increase at 1 year after one-level or two-level cervical arthrodesis. Because changes beyond 1 year remain unknown, this study assessed the effects of one- and two-level cervical arthrodesis on adjacent segment motion 3 years after arthrodesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-two patients were tested preoperatively (PRE), 1 year postoperatively (1YR-POST), and 3 years postoperatively (3YR-POST) along with 22 asymptomatic controls, who were tested once. A validated CT model-based tracking technique was used to measure three-dimensional (3D) vertebral motion from biplane radiographs acquired during dynamic flexion-extension and axial rotation of the cervical spine. Adjacent segment intervertebral end range of motion (ROM) and midrange ROM (i.e.<i>,</i> head within 20° of neutral) were compared between one-level and two-level arthrodesis patients and controls after accounting for head ROM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>End range adjacent segment motion tended to increase over time after arthrodesis; however, significant increases were found only after two-level arthrodesis. In contrast, midrange adjacent segment motion increased significantly after one- and two-level arthrodesis and was greater than in corresponding motion segments in controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Midrange adjacent segment motion may be better than end range motion for detecting early mechanical changes after cervical arthrodesis that could contribute to adjacent segment degeneration. In vivo changes in adjacent segment motion are inconsistent across patients up to 3 years after anterior cervical arthrodesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"9 4","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70224","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149205731","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":"Biomechanical, Structural, and Composition Characterization of the Vertebra-Disc Interface","authors":"Neilesh R. Frings,&nbsp;Harrah R. Newman,&nbsp;Faysal M. Haque,&nbsp;Veronica A. Caruso,&nbsp;Dawn M. Elliott,&nbsp;Elise F. Morgan","doi":"10.1002/jsp2.70223","DOIUrl":"https://doi.org/10.1002/jsp2.70223","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The spinal endplate region consists of the cartilage endplate (CEP), bony endplate (BEP), and subchondral trabecular bone (STB). Although this region is often involved in vertebral fractures and disrupted with disc degeneration, the biomechanics of these tissues are incompletely understood. The goal of this study was to characterize the mechanical, structural, and compositional properties of the spinal endplate region across aging and disc degeneration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cadaveric human lumbar spine segments (<i>n</i> = 45) were imaged with magnetic resonance imaging to assess disc degeneration. BEP and STB microstructure were analyzed with micro-computed tomography. BEP specimens were subjected to four-point-bend testing, and CEP specimens to confined compression testing. BEP and STB composition was measured with ash analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Several BEP mechanical properties, including flexural modulus, were associated with structural measures such as bone volume fraction, but showed few correlations to composition. Measures of structure and composition were generally different but correlated between the BEP and STB. Superior and inferior endplates differed from each other in structure but not composition. Apart from the STB microstructure, which became sparser with age in superior endplates, none of the endplate region properties correlated with age or disc degeneration, despite large ranges in values observed for many of these properties, particularly, BEP fracture strain (1%–52% strain).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Structural measures are more reliable indicators of endplate region properties than are compositional measures, age, or disc degeneration. The BEP may play an important, independent role in spine function, due to its range in ductility and limited correspondence in properties to those of neighboring tissues.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"9 4","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149099789","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 Deep Learning-Based Multimodal Fusion Model for Predicting Bone Cement Leakage in Percutaneous Kyphoplasty: Development and Validation.","authors":"Tianyi Wang, Yu Xi, Ruiyuan Chen, Xingyu Liu, Dong Liu, Minghui Liang, Tianlang Xie, Baodong Wang, Aobo Wang, Ning Fan, Peng Du, Shuncheng Jiao, Yiling Zhang, Lei Zang","doi":"10.1002/jsp2.70221","DOIUrl":"https://doi.org/10.1002/jsp2.70221","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of intelligent methodologies that effectively integrate multimodal information to predict bone cement leakage (BCL) during percutaneous kyphoplasty (PKP). This study aimed to develop and validate a deep learning (DL)-based multimodal fusion model that incorporates preoperative CT, MRI, and clinical variables to predict BCL subtypes during PKP.</p><p><strong>Methods: </strong>This study included a retrospective internal dataset for model training and validation, a prospective internal dataset, and an external dataset for independent testing. The fusion model incorporated preoperative spinal CT, MRI, and structured clinical baseline data within a two-stage framework. The first stage consisted of target vertebra localization based on vertebral segmentation. The second stage comprised a classification module implemented using a multibranch 3D ResNet-50 network. Performance was compared with image-only models, single-modality models, and spine surgeons using the area under the receiver operating characteristic curve (AUC), the area under the precision-recall curve, and other metrics.</p><p><strong>Results: </strong>The multimodal DL model achieved AUC values ranging from 0.795 to 0.861 in the internal test set and from 0.767 to 0.848 in the external test set for predicting BCL subtypes. Type III leakage demonstrated the highest predictive performance (internal AUC, 0.861; external AUC, 0.848). Overall, the fusion model achieved the highest AUC values and showed superior accuracy and agreement compared with spine surgeons, particularly for Type I (<i>κ</i>: internal, 0.439 vs. 0.030-0.075; external, 0.298 vs. 0.019-0.066) and Type IV leakage (<i>κ</i>: internal, 0.459 vs. 0.133-0.186; external, 0.545 vs. 0.002-0.095).</p><p><strong>Conclusion: </strong>A two-stage multimodal fusion DL framework enables accurate, reliable, and promisingly generalizable prediction of BCL subtypes in PKP, outperforming spine surgeons and supporting individualized preoperative decision-making.</p>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"9 3","pages":"e70221"},"PeriodicalIF":3.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038770","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":"The Effect of Head-Forward Posture on Lower Neck Loads and Dislocation Risk in Head-First Impact: A Computational and Experimental Investigation","authors":"Mario Mongiardini,&nbsp;Duane Cronin,&nbsp;Ryan D. Quarrington","doi":"10.1002/jsp2.70219","DOIUrl":"10.1002/jsp2.70219","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Subaxial cervical facet dislocation (CFD) is a severe neck injury associated with head-first impact (HFI). However, CFD has not been reliably reproduced in experimental or numerical studies, limiting understanding of its underlying mechanics. This study quantified the influence of preimpact head-forward posture on lower-neck sagittal-plane loading associated with CFD during HFI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A detailed finite element head–neck model was enhanced and evaluated against literature data, then used to investigate HFI response at a 2 m/s vertical drop impact velocity. A reposturing procedure achieved graded head-forward eccentricity from 0 to 50 mm in 5 mm increments, reflecting postures observed during anticipatory neck bracing. A matched cadaveric HFI experiment was subsequently performed with 30 mm eccentricity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Simulations demonstrated that eccentricities of 15 mm or more produced an S-shaped neck deformation during impact, as observed in prior experiments that produced CFD, accompanied by marked increases in anterior intervertebral shear and flexion bending at C7/T1. The matched cadaveric experiment produced bilateral C7/T1 dislocation, consistent with the predicted loading and deformation trends. However, complete CFD was not reproduced computationally because current intervertebral soft-tissue failure formulations did not capture the observed failure progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preimpact head-forward eccentricity can substantially increase lower-neck loading and susceptibility to CFD under the inverted-drop conditions studied.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"9 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912248","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":"Alignment Between Large Language Models and Consensus in Endoscopic Spinal Disc Surgery: A Comparative Analysis Against the Neurocore-SENSED","authors":"Abdullah İyigün,&nbsp;Göker Yurdakul,&nbsp;Alper Dünki,&nbsp;Mehmet Ali Yayla","doi":"10.1002/jsp2.70216","DOIUrl":"10.1002/jsp2.70216","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Neurocore-SENSED framework, derived from a three-round modified Delphi process involving 77 international spine surgeons, provides a structured reference standard for reporting in endoscopic spine surgery (ESS) for disc disease. The ability of large language models (LLMs) to reproduce graded levels of expert agreement within a reporting framework has not been examined in ESS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the extent to which three contemporary LLMs align with the Neurocore-SENSED consensus and whether they discriminate between items of differing consensus level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In January 2026, each of the 166 framework items with published item-level endorsement data was submitted once to GPT-5.2, Gemini 3 Pro, and Claude Sonnet 4.6, in independent sessions with web retrieval disabled. Models selected one of five ordered response options directly. Alignment was assessed by Spearman correlation with panel endorsement and by four measures of categorical agreement, each with bootstrap 95% confidence intervals. Separate protocols examined response stability, response format, and prior exposure to the consensus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All three models correlated significantly with panel endorsement. Gemini 3 Pro aligned most closely (<i>r</i>_<i>s</i> = 0.709, 95% CI 0.627–0.776), exceeding Claude Sonnet 4.6 (<i>r</i>_<i>s</i> = 0.622; <i>p</i> = 0.009) and GPT-5.2 (<i>r</i>_<i>s</i> = 0.565; <i>p</i> &lt; 0.001), which did not differ. Categorical agreement was limited and equivalent across models, with observed agreement of 0.506–0.518 and overlapping confidence intervals for all marginal-robust statistics. Between 81.3% and 95.8% of responses fell in the top two categories, and discordance was almost entirely unidirectional: 31 items were endorsed by every model but by fewer than half the panel, against one item in the opposite direction. Weighted kappa was not interpretable in this setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Current LLMs reproduce the broad rank ordering of expert endorsement in ESS reporting but cannot reliably distinguish endorsed from contested propositions, principally because of a positive response bias.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"9 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897111","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":"My Love Story With HIFs in the Disc: A Journey to the Humboldt Research Award","authors":"Makarand V. Risbud","doi":"10.1002/jsp2.70218","DOIUrl":"10.1002/jsp2.70218","url":null,"abstract":"<p>The intervertebral disc is a prime example of tissue adaptation to metabolic and mechanical extremes. As the largest avascular organ in the human body, the disc and the central nucleus pulposus (NP) endure constant compressive loading while sustaining a hypoxic, relatively acidic, and hyperosmotic microenvironment that would be inhospitable to most cell types. Over the past two decades, work from my laboratory has revealed extraordinary details of this type of adaptation, that hypoxia-inducible factors (HIFs), particularly HIF-1α, serve as master regulators of NP cell survival, metabolism, and matrix homeostasis. This review chronicles the scientific and personal journey that began with a single unexpected observation: the normoxic stabilization of HIF-1α in NP cells. That finding grew into a substantial understanding of oxygen-independent HIF regulation and biology in the disc. Through sustained collaborations with Irving Shapiro and other colleagues and a succession of talented trainees, we demonstrated that HIF-1α is indispensable for disc development and homeostasis. In contrast, HIF-2α plays a distinct, largely opposing role, promoting matrix catabolism and fibrosis. Our work has revealed the molecular architecture underlying the disc's adaptation to avascularity, encompassing HIF-dependent regulation of glycolytic enzymes, glucose transporters, carbonic anhydrases CA9 and CA12, monocarboxylate transporter 4 (MCT4), and BNIP3-mediated mitophagy, and has opened promising therapeutic avenues for disc regeneration. Recently, we discovered that NP-derived lactate exported via MCT4 is actively imported primarily by vertebral endplate cells, and, to a lesser extent, by annulus fibrosus cells via MCT1, where it serves dual roles as a TCA metabolite and an epigenetic regulator through lactylation. This review celebrates the intellectual journey, the collaborative spirit that sustained it, and the honor of the Alexander von Humboldt Research Award, while providing a synthesis of HIF biology in the intervertebral disc spanning the discovery of oxygen by Priestley 1774 to the 2019 Nobel Prize and beyond.</p>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"9 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887612","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":"Assessment of Vertebral Body Bone Quality in Adolescent Idiopathic Scoliosis (AIS) Using Micro-CT, qBEI, and Nanoindentation—A Case Study","authors":"Natalia M. Castoldi,&nbsp;Edmund Pickering,&nbsp;Jiaqiu Wang,&nbsp;Madge Martin,&nbsp;James Roberts,&nbsp;Jurgis Ruza,&nbsp;Laure Stickel,&nbsp;Geoffrey N. Askin,&nbsp;Robert D. Labrom,&nbsp;Maree T. Izatt,&nbsp;Davide Fontanarosa,&nbsp;J. Paige Little,&nbsp;Peter Pivonka","doi":"10.1002/jsp2.70217","DOIUrl":"10.1002/jsp2.70217","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adolescent idiopathic scoliosis (AIS) is the most common three-dimensional spinal deformity, predominantly affecting females aged 10–16 years. Although no single etiological factor has been definitively identified, alterations in bone quality and biomechanical properties have been proposed as contributing factors to AIS development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed a surgical protocol to obtain trabecular bone biopsies from the apex vertebra during anterior corrective surgery for AIS. Multimodal analysis was performed on samples from eight AIS participants (14.8 ± 1.5 years), including microstructural assessment via micro-computed tomography (micro-CT), bone mineral density distribution (BMDD) via quantitative backscattered electron imaging (qBEI), and mechanical characterization via nanoindentation. Correlations with major curve angle, apical wedge angle, and Risser grade were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean trabecular bone volume fraction (BV/TV) was 0.146 ± 0.029, comparable to values reported in healthy populations. Mean trabecular thickness (Tb.Th) was 0.146 ± 0.011 mm, suggesting slightly thicker trabeculae than typically reported in healthy young cohorts. BMDD analysis revealed CaPeak values of 23.34 ± 1.02 wt% Ca, and greater CaWidth values (4.26 ± 0.33 wt% Ca) compared to healthy adolescent and adult reference data. CaPeak was significantly negatively correlated with apical wedge angle, indicating lower mineralization with increasing vertebral wedging. Nanoindentation showed a negative association between reduced modulus (13.37 ± 2.5 GPa) and apical wedge angle, with hardness values of 0.412 ± 0.079 GPa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings provide novel insights into vertebral trabecular bone alterations in AIS and their association with deformity severity. To our knowledge, this is the first study to integrate micro-CT, qBEI, and nanoindentation analyses in AIS vertebral biopsies, revealing structural, compositional, and mechanical differences that may contribute to the pathogenesis and progression of AIS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"9 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880371","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":"Are Ceramic Cages an Option for Lumbar Interbody Fusion? A Comparative Biomechanical Numerical Study","authors":"Davide Ninarello,&nbsp;Luigi La Barbera","doi":"10.1002/jsp2.70215","DOIUrl":"10.1002/jsp2.70215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The treatment of severe disc pathologies through lumbar interbody fusion (LIF) involves the insertion of an interbody cage into the degenerated disc space, together with a supporting fixation system. Conventional cage materials, such as Ti6Al4V and PEEK, present several limitations, most notably their non-biodegradability, increasing the risk of cage migration and long-term subsidence (up to 40% incidence). Bioceramics may represent an option while addressing the issue of biodegradability. This study preliminarily investigates the applicability of a commercial bioceramic as an interbody cage material for LIF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>First, an intact L4-L5 functional spine unit (FSU) was validated under both pure moments and combined loading conditions. Subsequently, all surgical steps of the LIF procedure were simulated, followed by postoperative physiological loading to compare the mechanical performance of the ceramic device with standard titanium cages. Two surgical techniques, posterior-LIF (PLIF) and eXtreme-LIF (XLIF), were analyzed. Each simulation assessed the mechanical strength of the interbody cage, the posterior fixation, and the vertebral bone, together with the FSU kinematic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The intact model accurately predicted literature-reported kinematics and intradiscal pressure, and the LIF model reproduced forces on titanium cages consistent with in vitro measurements on human specimens. Both XLIF and PLIF procedures resulted in significant kinematic stabilization of the FSU, with &gt; 70% reduction in range of motion. For PLIF, ceramic cages sustained applied loads with no predicted failure, while XLIF showed minimal interface failure (&lt; 0.6%). Compared with titanium, ceramic cages significantly reduced adjacent vertebral strain, lowering the subsidence risk, without overloading the posterior fixation system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present study supports the potential of bioceramics as viable materials for interbody cage applications in LIF procedures. Experimental tests and clinical validation should be accompanied to further cage design optimization to enhance the safety margins of this novel bioceramic device and ensure proper clinical effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"9 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874172","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 Novel Gelatin Hydrogel-Based Drug-Delivery System Promotes Antimicrobial Efficacy in a Pyogenic Spondylodiscitis Rat Model","authors":"Kunihiko Miyazaki,&nbsp;Yutaro Kanda,&nbsp;Takashi Yurube,&nbsp;Yoshiki Takeoka,&nbsp;Takeru Tsujimoto,&nbsp;Hiroki Ohnishi,&nbsp;Tomoya Matsuo,&nbsp;Masao Ryu,&nbsp;Naotoshi Kumagai,&nbsp;Kohei Kuroshima,&nbsp;Yoshiaki Hiranaka,&nbsp;Yasuhiko Tabata,&nbsp;Ryosuke Kuroda,&nbsp;Kenichiro Kakutani","doi":"10.1002/jsp2.70213","DOIUrl":"10.1002/jsp2.70213","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Spondylodiscitis/spondylitis is an intractable disease requiring long-term intravenous antibiotics administration. However, drug delivery is greatly restricted because of the avascular nature in the intervertebral disc, which not only delays recovery but increases antimicrobial resistance and osteomyelitis. The purpose of this study is to elucidate the efficacy of gelatin hydrogel microsphere incorporating cefazolin (GM-CEZ) using a rat spondylodiscitis model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>First, GM-CEZ was characterized by in vitro degradability, sustainability, and antimicrobial effects. Second, its efficacy in vivo was evaluated using a rat spondylodiscitis model of bioluminescent methicillin-susceptible <i>Staphylococcus aureus</i>. Antimicrobial effects were monitored using an in vivo imaging system and blood tests. Residual bone volume was evaluated using micro-computed tomography. Immunohistology for angiogenesis-related CD31 and smooth muscle actin was also performed. Third, in vivo safety was evaluated using a rat intervertebral disc injection model with blood tests for systemic safety and TUNEL staining for local safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In vitro, CEZ was gradually released with GM degradation and antimicrobial effects increased proportionally to the degradation. In vivo, single topical injection of GM-CEZ (1 mg GM, 250 μg/kg CEZ, 100 μL collagen) significantly reduced the amount of bacteria with fewer white blood cells 7 days after treatment and bone destruction 28 days after treatment, compared to local administration of CEZ (250 μg/kg) and systemic administration of CEZ (25 mg/kg/day for 28 days) (all, <i>p</i> &lt; 0.05). Immunopositivity was significantly higher in rats with local GM-CEZ administration than those with local CEZ and systemic CEZ administration (all, <i>p</i> &lt; 0.05), indicating greater tissue reformation. In vivo safety experiments demonstrated no significant myelotoxicity, nephrotoxicity, and local cytotoxicity of GM-CEZ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The local administration of GM-CEZ using a fraction of the systemic CEZ dose achieved enhanced antimicrobial effects without systemic and local toxicity, suggesting its potential as a promising treatment strategy for pyogenic spondylodiscitis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"9 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874168","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":"Growth Plate Morphogens as Potential Modulators of Cellular Tissue Remodeling by Annulus Fibrosus Cells","authors":"K. Stradovnik-Poikilidis,&nbsp;M. Teunissen,&nbsp;F. M. Riemers,&nbsp;M. van Doeselaar,&nbsp;J. Foolen,&nbsp;F. Abinzano,&nbsp;M. A. Tryfonidou,&nbsp;S. J. P. Callens,&nbsp;K. Ito","doi":"10.1002/jsp2.70212","DOIUrl":"https://doi.org/10.1002/jsp2.70212","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adolescent Idiopathic Scoliosis (AIS) is a spinal deformity of unknown etiology that begins in the intervertebral disc and emerges during pubertal growth. In the vertebral growth plate, adjacent to the disc, powerful growth plate morphogens (GPMs) modulate this growth. We evaluated whether GPMs can also alter the capacity of annulus fibrosus (AF) disc cells to proliferate and/or remodel their extracellular matrix (ECM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>AF cell responsiveness to seven GPMs was screened in monolayer culture by RT-qPCR for downstream signaling markers. GPMs and concentrations eliciting significant transcriptional responses were selected for deeper analysis. Bulk RNA sequencing (RNA-seq) was conducted on AF cells cultured in a 2.5D environment to preserve their native elongated phenotype. Differentially expressed genes (DEGs) were identified and subjected to Gene Ontology enrichment, focusing on ECM remodeling and cell-proliferation processes. Transcriptomic findings were corroborated by assessments of cell proliferation (DNA content), sulfated glycosaminoglycan (sGAG) levels, and matrix metalloproteinase (MMP) activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>BMP-2, TGF-β1, and FGF-2 significantly altered AF cell expression of downstream target genes, whereas Ihh, PTHrP, Wnt-1, and FGF-18 did not. IGF-1 induced modest, dose-dependent gene expression changes that were not replicated by RNA-seq. BMP-2 and TGF-β1 upregulated genes associated with anabolic ECM remodeling. BMP-2 promoted a cartilage-like ECM with increased expression of type II-associated collagens, aggrecan, and hyaluronan synthesis. TGF-β1 promoted type I collagen-associated genes, collagen cross-linking, and myofibroblast activation. In contrast, FGF-2 activated transcriptional programs related to cell-cycle progression, collagen degradation, and increased GAG turnover. Functionally, we observed higher DNA content under BMP-2 and TGF-β1 stimulation and higher sGAG levels under BMP-2, TGF-β1, and FGF-2 treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BMP-2, TGF-β1, and FGF-2 can modulate AF cell behavior, influencing tissue remodeling and implicating their involvement in disc wedging during AIS onset.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"9 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148785051","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}