Journal of Bone and Joint Surgery, American Volume最新文献

{"title":"Beyond the Operating Room: Orthopaedic Advocacy, Identity, and Wider Impact.","authors":"Yogesh S Salphale, Sushrut S Babhulkar, Anuradha Y Salphale","doi":"10.2106/JBJS.26.00935","DOIUrl":"https://doi.org/10.2106/JBJS.26.00935","url":null,"abstract":"<p><p>➢ Orthopaedic identity is traditionally anchored in the operating room, where technical skill, decisive intervention, and operative outcomes remain central to professional validation. Yet orthopaedic surgeons also encounter realities that no implant can fully address: motor vehicle collisions, unsafe work, poverty, delayed access, disability, rehabilitation gaps, and loss of livelihood. We argue that orthopaedic responsibility may, in selected circumstances, extend beyond direct operative care into advocacy, education, systems improvement, disability inclusion, public engagement, and health-policy work.➢ Drawing on examples from global surgery, surgical safety, the Ponseti method, rural fracture-care ethics, and professional identity formation, we examine how surgeons may translate clinical experience into wider public benefit. We propose that nonoperative roles should not be justified by personal fulfillment alone, but by whether they multiply benefit: improving access, safety, training, dignity, public trust, policy, rehabilitation, or community outcomes beyond an individual operative caseload.➢ We also address the tension between the urgent need for operating surgeons and the potential societal benefit of surgeons serving in wider roles. In health systems already constrained by workforce pressures and waiting lists, advocacy beyond the operating room must remain accountable to patients and communities. The key ethical question is whether such work subtracts from surgical capacity or whether it strengthens the conditions under which musculoskeletal care is delivered.➢ Operative service remains foundational to orthopaedic identity. However, if orthopaedic surgery is understood as a moral practice directed toward restoring function, relieving pain, and protecting dignity, its responsibilities cannot be confined entirely within the operating room walls.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of Orthopaedic Trauma Association Members on Firearm Injury Prevention: Results from a 2025 Membership Survey.","authors":"Kehinde S Agoro, Malena Del Olmo","doi":"10.2106/JBJS.25.01650","DOIUrl":"https://doi.org/10.2106/JBJS.25.01650","url":null,"abstract":"<p><strong>Background: </strong>Firearm injury has become an escalating public health crisis in the United States and is now the leading cause of death among children and adolescents who are 1 to 19 years of age. Orthopaedic trauma surgeons frequently manage the complex sequelae of these injuries and are increasingly engaged in prevention advocacy. This study aimed to characterize the perspectives of the Orthopaedic Trauma Association (OTA) members on firearm ownership, injury prevention, and the organization's advocacy role.</p><p><strong>Methods: </strong>An anonymous, cross-sectional, web-based survey was distributed to all 3,721 active OTA members between April 10 and July 7, 2025. The questionnaire, which included 27 numbered items and 7 additional open-ended comment prompts and was adapted from prior surveys by the American College of Surgeons (ACS) and the American Association of Neurological Surgeons (AANS), assessed demographic characteristics, firearm ownership and storage practices, clinical exposure, prior safety training, and views on firearm injury prevention and OTA advocacy. Descriptive statistics were used to summarize responses, which were contextualized within published ACS and AANS findings.</p><p><strong>Results: </strong>A total of 503 respondents (13.5% response rate) completed the survey. Among 412 clinically active respondents, 95.6% (394) reported treating firearm-related injuries. Nearly one-half (47.4%) of respondents owned a firearm, yet 85.3% supported OTA-led, nonpartisan advocacy to reduce firearm injuries, deaths, and disability, comparable with support rates in ACS studies (85.5%) and AANS studies (78.7%). Respondents emphasized firearm safety training, secure storage, and integrating mental health into prevention strategies as priorities. Qualitative responses underscored the importance of evidence-based, nonpartisan engagement sensitive to regional and legal contexts.</p><p><strong>Conclusions: </strong>OTA members broadly endorse firearm injury prevention as a public health priority. With nearly one-half of the respondents to our survey reporting firearm ownership, similar to rates in other surgical specialties, respondents expressed strong support for training, secure storage, and advocacy initiatives, reflecting a balanced, nonpartisan approach to firearm injury prevention. These findings establish a baseline for ongoing OTA-led efforts and align the organization with broader multidisciplinary prevention initiatives.</p><p><strong>Level of evidence: </strong>Prognostic Level V. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Shoulder Field Anesthesia (SFA) with Interscalene Block (ISB) for Analgesia After Arthroscopic Shoulder Surgery: A Randomized Noninferiority Trial.","authors":"Feras Qawasmi, Tomer Gazit, Assil Mahamid, Muhammad Khatib, Hazem Safadi, Dror Robinson, Laila Yehia, Hamza Murad, Mustafa Yassin","doi":"10.2106/JBJS.26.00153","DOIUrl":"https://doi.org/10.2106/JBJS.26.00153","url":null,"abstract":"<p><strong>Background: </strong>An interscalene brachial plexus block (ISB) is commonly used for analgesia after shoulder surgery but is associated with neurologic and respiratory complications, including hemidiaphragmatic paralysis. Surgeon-performed shoulder field anesthesia (SFA) is a landmark-guided, phrenic nerve-sparing technique that may provide effective analgesia with fewer complications. The purpose of this study was to compare SFA with ISB for pain control after arthroscopic shoulder surgery. We investigated whether SFA would provide noninferior analgesia as measured by cumulative 48-hour postoperative pain scores.</p><p><strong>Methods: </strong>In this randomized trial, patients undergoing arthroscopic shoulder surgery were assigned to SFA or ISB. Postoperative pain was assessed using the numeric rating scale (NRS) at 2, 4, 8, 24, and 48 hours. Patient satisfaction was assessed at 48 hours. Other secondary outcomes included opioid consumption, hospital stay, and block-related complications.</p><p><strong>Results: </strong>Eighty patients (mean age, 47.7 ± 15.7 years; 53 men) completed the study. All patients were classified as White; 80% were of Middle Eastern ethnicity. Baseline characteristics were comparable between the SFA and ISB groups. The primary outcome analysis demonstrated a mean difference in the cumulative 48-hour NRS pain score of -0.824 (ISB - SFA), with a 95% confidence interval of -1.853 to 0.206. The upper limit of the confidence interval remained below the prespecified noninferiority margin of 1.5 NRS points, demonstrating noninferiority of SFA. ISB provided lower pain scores during the early postoperative period (4 to 8 hours), and pain scores converged thereafter. Hospital stay was shorter in the SFA group. Opioid consumption, patient satisfaction, and oxygen desaturation rates were similar between groups. Two cases of Horner syndrome and 1 respiratory event requiring intensive care occurred in the ISB group; none occurred in the SFA group.</p><p><strong>Conclusions: </strong>SFA was noninferior to ISB for the prespecified cumulative 48-hour pain end point. ISB provided superior pain relief during the first 4 to 8 hours, but SFA offered a lung-sparing alternative with similar cumulative opioid requirements and patient satisfaction, fewer clinically apparent block-related complications, and a shorter hospital stay. These findings support a risk-benefit framework to guide individualized analgesic selection.</p><p><strong>Level of evidence: </strong>Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Motion Is For.","authors":"Mohammad Poursalehian, Jad Ismail, Robert A Sershon","doi":"10.2106/JBJS.26.01127","DOIUrl":"https://doi.org/10.2106/JBJS.26.01127","url":null,"abstract":"","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Mechanisms of Osteoarthritis: A Review and Opportunities for Novel Therapeutics.","authors":"Alexander K Meininger, Hasan E Baydoun","doi":"10.2106/JBJS.26.00446","DOIUrl":"https://doi.org/10.2106/JBJS.26.00446","url":null,"abstract":"<p><p>➢ Osteoarthritis (OA) represents a biologically dynamic disease characterized by progressive failure of cartilage homeostasis through interconnected molecular mechanisms. Chondrocytes shift from an anabolic to a catabolic phenotype, marked by increased matrix metalloproteinase activity, while the synthetic capacity of articular cartilage diminishes.➢ Key signaling cascades including NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) and MAPK (mitogen-activated protein kinase) become dysregulated, driving matrix degradation. Declining autophagy impairs cellular quality control while senescent cells accumulate, releasing inflammatory mediators that amplify tissue damage. The immune response extends beyond macrophage polarization to involve adaptive immune cells, including T cell subsets that sustain chronic synovial inflammation.➢ Emerging disease-modifying strategies-including Wnt pathway inhibitors, FGF (fibroblast growth factor) 18 analogs, senolytic agents, gene therapy approaches, and allogeneic MSC (mesenchymal stem cell) implantation-offer the first genuine prospects for altering the natural history of this disease. However, translational challenges remain, as highlighted by mixed results in recent clinical trials.➢ The future of OA management lies in precision molecular orthopaedics: matching patients to targeted therapies on the basis of their predominant disease endotype.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Disc Arthroplasty: Evolution, Evidence, and Future Directions in Motion-Preservation Surgery.","authors":"Matthew T Kim, Seungjun Lee, Graham S Goh, K Daniel Riew","doi":"10.2106/JBJS.26.00323","DOIUrl":"https://doi.org/10.2106/JBJS.26.00323","url":null,"abstract":"<p><p>➢ Cervical disc arthroplasty (CDA) provides clinical outcomes comparable with those of anterior cervical discectomy and fusion (ACDF) for 1-level and 2-level cervical degenerative disc disease (DDD), with durable long-term motion preservation.➢ Although CDA is associated with lower rates of adjacent-segment pathology compared with ACDF, the absolute risk reduction at longer follow-up is modest and methodological heterogeneity across trials limits definitive conclusions.➢ Expanded indications including multilevel (≥3-level) CDA, hybrid constructs, and other situations that were previously considered contraindicated during U.S. Food and Drug Administration (FDA) Investigational Device Exemption (IDE) trials have shown promising short-term to intermediate-term results in more recent studies.➢ As CDA utilization increases, standardized failure reporting and the development of evidence-based revision algorithms are critical to optimize long-term outcomes.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult Cervical Deformity: Contemporary Evaluation, Classification, and Surgical Decision-Making.","authors":"Mihir S Dekhne, Gregory S Kazarian, Han Jo Kim","doi":"10.2106/JBJS.26.00473","DOIUrl":"https://doi.org/10.2106/JBJS.26.00473","url":null,"abstract":"<p><p>➢ Standing full-spine radiographs are mandatory for cervical deformity evaluation; key alignment targets include cervical sagittal vertical axis (cSVA) of ≤40 mm, T1 slope minus cervical lordosis (T1S - CL) of <15°, and a chin-brow vertical angle (CBVA) between -10° and +10° relative to the true vertical. The achievement of these thresholds is independently associated with better patient-reported outcomes, whereas values outside these ranges are associated with worse disability and quality-of-life scores.➢ The Kim-International Spine Study Group (ISSG) morphology-based classification, which identifies 4 patterns (flat neck, focal, cervicothoracic, and coronal or complex) from standing and dynamic extension radiographs, provides a reproducible morphology and flexibility-based framework that informs operative planning and has demonstrated superior interrater and intrarater reliability over prior descriptive systems; final surgical decisions integrate flexibility, neurological status, global alignment, bone quality, and patient-specific factors, and the direct impact of this classification on surgical outcomes requires further prospective validation.➢ Surgical planning is stratified by the intended lower instrumented vertebra (LIV) (Type 1: LIV T2-T4; Type 2: within the cervical spine or cervicothoracic junction; Type 3: extending past the thoracolumbar junction) and by whether the deformity is ankylosed, which determines the need for osteotomy.➢ Overall complication rates exceed 50% in prospective multicenter data; systematic risk mitigation, including neuromonitoring, tranexamic acid, staged approaches, and frailty-based patient selection, is essential for safe outcomes.➢ Despite high complication rates, the surgical correction of cervical deformity yields clinically meaningful improvements in pain and health-related quality of life at 1 year in appropriately selected patients; realistic goal-setting and individualized alignment targets are the keys to durable success.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Lengthen or Revise: Reevaluating Anterior Acetabular Overhang Thresholds in Iliopsoas Impingement After Total Hip Arthroplasty.","authors":"David S Clark, John J Kelly, Sandeep R Yanamala, Emma E Helgeson, Robert T Trousdale, Bruce A Levy, Michael J Taunton, Mario Hevesi","doi":"10.2106/JBJS.26.00011","DOIUrl":"https://doi.org/10.2106/JBJS.26.00011","url":null,"abstract":"<p><strong>Background: </strong>Iliopsoas impingement (IPI) is a known cause of persistent anterior hip pain following total hip arthroplasty (THA). Management of IPI has often relied on an 8-mm anterior acetabular overhang threshold to guide operative treatment, favoring acetabular revision for greater overhang and iliopsoas tenotomy for lesser overhang. These thresholds were initially established on the basis of the outcomes of open tenotomy, and now, with an improved understanding of IPI and the advent of arthroscopic iliopsoas fractional lengthening (IPFL), a review of the 8-mm threshold is warranted.</p><p><strong>Methods: </strong>A retrospective review was performed to identify patients who underwent arthroscopic IPFL following primary THA between 2017 and 2024, with a minimum follow-up of 1 year. Acetabular overhang was measured for all patients using cross-table lateral radiographs, and patients were stratified into <8-mm and ≥8-mm cohorts. Patient-reported outcome measures, reoperations, revisions, and complications were collected and analyzed on the basis of both the classic 8-mm threshold and continuous statistical methods.</p><p><strong>Results: </strong>We evaluated 86 hips undergoing IPFL. There were 83 patients (30 men and 53 women), with a mean age of 63.0 ± 11.2 years; with regard to race, 80 patients were White, 1 patient was Black or African American, and 2 patients listed other race or chose not to disclose. The acetabular overhang was <8 mm for 67 hips and ≥8 mm for 19 hips. The mean follow-up was 2.5 ± 1.6 years (range, 1 to 7.5 years). When comparing patients with <8-mm and ≥8-mm acetabular overhang, we observed no significant differences (p > 0.06) in the preoperative and postoperative visual analog scale (VAS) pain scores, modified Harris hip score, Single Assessment Numeric Evaluation (SANE) score, Tegner activity level, subjective groin pain improvement, subjective hip flexion strength improvement, and overall satisfaction. Reoperation (2.9% compared with 10.5%; p = 0.210) and acetabular revision rates (1.5% compared with 5%; p = 0.387) were not significantly different between the <8-mm and ≥8-mm overhang groups.</p><p><strong>Conclusions: </strong>Arthroscopic IPFL provided satisfactory outcomes for patients with IPI, independent of the magnitude of acetabular overhang. IPFL should be considered for first-line surgical management of IPI refractory to nonoperative management, even in the setting of substantial acetabular overhang, given positive outcomes and low rates of subsequent acetabular revision.</p><p><strong>Level of evidence: </strong>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Management Strategies for Osteochondral Lesions of the Talus: A Contemporary Treatment Algorithm.","authors":"Jared Rubin, Alexander Tham, Paloma Gauthier, Christopher D Murawski, Richard D Ferkel, John G Kennedy","doi":"10.2106/JBJS.25.01591","DOIUrl":"https://doi.org/10.2106/JBJS.25.01591","url":null,"abstract":"<p><p>➢ Osteochondral lesions of the talus (OLT) are common injuries that remain difficult to treat because of the challenge of restoring durable hyaline cartilage. Surgical outcomes are influenced by lesion size and morphology, cartilage integrity, subchondral bone involvement, and ankle stability, all of which should be considered when evaluating operative strategies.➢ Fragment fixation preserves the native osteochondral unit in lesions with a viable fragment and is primarily indicated in acute OLT. Lift-drill-fill-fix is utilized in selected chronic lesions with a salvageable fragment and compromised subchondral bone, allowing restoration of the lesion bed and stable fixation.➢ Bone marrow stimulation techniques, including microfracture, antegrade drilling, and retrograde drilling, have demonstrated improvements in pain and functional outcomes in small and contained lesions, although the long-term durability of fibrocartilaginous repair tissue remains variable.➢ Replacement procedures such as autologous osteochondral transplantation and osteochondral allograft transplantation restore the osteochondral unit and have demonstrated favorable outcomes in larger or structurally complex lesions. Cell-based and matrix-assisted cartilage restoration strategies, such as autologous chondrocyte implantation, matrix-induced autologous chondrocyte implantation, and autologous matrix-induced chondrogenesis, have demonstrated improvements in clinical outcomes and cartilage repair in selected patients with OLT.➢ Emerging restorative approaches such as scaffold-based cartilage repair, osteoperiostic autografting techniques, and biologic adjuncts including concentrated bone marrow aspirate, platelet-rich plasma, and hyaluronic acid have demonstrated promising early clinical results, although current evidence remains limited.➢ Salvage procedures, including bulk allograft transplantation, metallic resurfacing, hemiarthroplasty, and arthrodesis, may be considered for extensive lesions or after failure of prior surgical management, although outcomes remain variable, with high complication and failure rates.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sagittal Alignment in Cervical Spine Fusion: Principles, Parameters, and Surgical Implications.","authors":"Bryce A Basques, Puru Sadh, Jinseong Kim, Bassel G Diebo, Alan H Daniels","doi":"10.2106/JBJS.26.00362","DOIUrl":"https://doi.org/10.2106/JBJS.26.00362","url":null,"abstract":"<p><p>➢ Cervical sagittal alignment is associated with patient-reported outcomes, with higher T1 slope-cervical lordosis mismatch and greater C2-C7 sagittal vertical axis correlating with greater disability and worse health-related quality of life.➢ Cervical alignment must be interpreted alongside global sagittal balance, as cervical posture interacts with thoracic and spinopelvic alignment and compensatory mechanisms.➢ Both anterior and posterior cervical fusion can influence sagittal alignment, but optimal outcomes depend on alignment-conscious planning tailored to deformity morphology and spinal flexibility.➢ Preserving or restoring physiologic cervical alignment reduces the risk of postoperative imbalance and adjacent-segment disease, supporting alignment-guided surgical decision-making.</p>","PeriodicalId":15273,"journal":{"name":"Journal of Bone and Joint Surgery, American Volume","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}