Journal of Orthopaedic Surgery and Research最新文献

{"title":"The impact of halo-pelvic traction on deformity correction and bone mineral density in patients with severe spine deformity.","authors":"Bin Zheng, Deng Zhao, Panfeng Yu, Zhenqi Zhu, Haiying Liu, Yan Liang","doi":"10.1186/s13018-025-06211-2","DOIUrl":"https://doi.org/10.1186/s13018-025-06211-2","url":null,"abstract":"<p><strong>Background: </strong>Severe spinal deformities require surgical intervention, with preoperative traction commonly used to improve spinal flexibility and surgical safety. However, the impact of traction on bone mineral density (BMD) and its relationship with correction outcomes remains poorly understood.</p><p><strong>Methods: </strong>This retrospective study analyzed patients with severe spinal deformities who underwent halo-pelvic traction before surgical correction. Key parameters including Cobb angle, thoracic kyphosis (TK), height, and BMD were measured before and after traction. Paired t-tests and Pearson correlation analysis were performed to assess treatment effects and relationships between variables.</p><p><strong>Results: </strong>Twenty-six patients (10 males, 16 females; mean age 25.31 ± 7.52 years) underwent traction for an average of 3.88 ± 1.31 months. Traction significantly improved spinal parameters: Cobb angle decreased by 37.56 ± 7.45° (P < 0.001), thoracic kyphosis reduced by 35.72 ± 13.32° (P < 0.001), and height increased by 10.2 ± 3.36 cm (P < 0.001). However, BMD decreased significantly by 17.90 ± 15.58 (P < 0.001). Correlation analysis revealed strong positive correlations between BMD loss and Cobb angle correction(r = 0.730) and Thoracic kyphosis correction(r = 0.683), indicating greater correction was associated with more pronounced BMD reduction.</p><p><strong>Conclusion: </strong>While preoperative traction effectively corrects severe spinal deformities and improves flexibility, it significantly decreases BMD. The strong correlation between correction effectiveness and bone loss highlights the need for careful monitoring of bone quality during traction, especially in high-risk patients. Further research is needed to optimize traction protocols and prevent bone loss.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"791"},"PeriodicalIF":2.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958048","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":"Management of Dupuytren disease of the little finger.","authors":"Melinda Moscovici, Valerio Pace, Fabrizio Marzano, Francesco Bronzini, Giacomo Placella, Dario Perugia, Nicola Maffulli, Filippo Migliorini, Riccardo Maria Lanzetti","doi":"10.1186/s13018-025-06176-2","DOIUrl":"https://doi.org/10.1186/s13018-025-06176-2","url":null,"abstract":"<p><strong>Background: </strong>The surgical management of Dupuytren disease (DD) is associated with a high rate of complications. Recurrences are relatively common and may result in permanent disability, particularly when the little finger (LF) is involved. This study aims to provide both objective and subjective information, along with professionals' experiences.</p><p><strong>Methods: </strong>A questionnaire survey, comprising both open and closed questions, was distributed to hand surgeons, physiotherapists, and occupational therapists engaged in the management of DD across five continents. The involvement and role of the LF in DD were extensively highlighted and emphasised. Only consistent answers were included. A total of 588 questionnaires were completed.</p><p><strong>Results: </strong>50% (n = 294) of the answers were from hand surgeons, 24% (n = 141) from physiotherapists and 26% (n = 153) from occupational therapists. 76.5% (n = 153) of the healthcare professionals (HCP) agreed that: \"The LF does not necessarily benefit from good results. Rehabilitation, just like surgery, can be delicate and difficult.\". Different agreements were found between surgeons and occupational therapists (p = 0.007) and among surgeons, depending on their surgical experience (p = 0.008). No significant differences were seen between surgeons and physiotherapists.</p><p><strong>Conclusions: </strong>The LF in Dupuytren's disease requires special attention during surgery and rehabilitation. All healthcare professionals (HCPs) should invest in patient education to ensure early referral and optimal adherence to treatments. Further high-quality research is warranted to achieve a definitive consensus on optimal treatment and rehabilitation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"789"},"PeriodicalIF":2.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957891","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":"LncRNA LINC01123-mediated impaired fracture healing through miR-134-5p/XIAP axis.","authors":"Song Zhou, ZeWen Zheng, ChuanKai Zhang, Liang Hao, Qiang Chen, Ke Sun, Min Cai","doi":"10.1186/s13018-025-06167-3","DOIUrl":"https://doi.org/10.1186/s13018-025-06167-3","url":null,"abstract":"<p><strong>Background: </strong>The prolonged recovery and heightened discomfort associated with delayed fracture healing present substantial clinical challenges. Investigations into lncRNA-mediated pathways may provide novel biological targets for enhancing osseous regeneration and improving clinical outcomes.</p><p><strong>Aim: </strong>The focus of this study is to elucidate the role and molecular mechanism of lncRNA LINC01123 (LINC01123) dysregulation in the osteogenic differentiation of osteoblasts.</p><p><strong>Methods: </strong>Real-time quantitative polymerase chain reaction (RT-qPCR) determined LINC01123, miR-134-5p and XIAP levels in samples, alongside an assessment of osteogenic marker mRNA expression. The targeting relationships were verified by luciferase activity assay. The biological behavioural competence of the cells was assessed by cell counting kit-8 (CCK-8), flow cytometry, alizarin red staining assay, and western blot assay. Receiver operating characteristic (ROC) curve was applied to analyse the potential of LINC01123 in the diagnosis of delayed fracture healing.</p><p><strong>Results: </strong>LINC01123 was overexpressed in patients experiencing delayed fractures and was sensitive in predicting the occurrence of delayed healing. As osteoblast differentiation progressed, the expression of LINC01123 and XIAP diminished, while the levels of miR-134-5p and ALP, OCN, RUNX2 mRNA were notably upregulated. Upregulation of LINC01123 reduced the levels of osteogenic biomarkers while suppressing cell viability and accelerating apoptosis, while miR-134-5p mimic partially reversed the inhibitory effect of LINC01123. Knockdown of XIAP partially mitigated the negative impact of silencing miR-134-5p on osteoblast differentiation and proliferation.</p><p><strong>Conclusion: </strong>Elevated LINC01123 expression promotes delayed fracture healing through the miR-134-5p/XIAP pathway, positioning it as a candidate prognostic marker for progression of fracture healing response.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"790"},"PeriodicalIF":2.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957920","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":"Pure platelet-rich plasma delays intervertebral disc degeneration by activating SIRT1-mediated autophagy in nucleus pulposus cells.","authors":"Jiaheng Han, Zhili Ding, Jie Huang, Yan Zhang, Yu Ding","doi":"10.1186/s13018-025-06205-0","DOIUrl":"https://doi.org/10.1186/s13018-025-06205-0","url":null,"abstract":"<p><strong>Background: </strong>Intervertebral disc degeneration (IVDD) is characterized by nucleus pulposus cells (NPCs) apoptosis and extracellular matrix (ECM) degradation. Impaired autophagy and mitochondrial dysfunction further accelerate disc degeneration. Pure platelet-rich plasma (P-PRP), enriched in growth factors and low in pro-inflammatory mediators, has shown regenerative potential. However, its mechanism of action, particularly the role of the autophagy-related SIRT1 pathway and mitochondrial homeostasis, remains unclear.</p><p><strong>Methods: </strong>Rabbit-derived P-PRP was prepared and analyzed for cellular content and cytokine profiling. NPCs were treated with whole blood or P-PRP, and assessed for viability (CCK-8) and migration (Transwell). An IL-1β-induced degeneration model was established, and groups were treated with SIRT1 activator (SRT1720), inhibitor (EX527), P-PRP, or P-PRP + EX527. Mitochondrial membrane potential (JC-1 staining), and apoptosis (Annexin V/PI flow cytometry) were also measured. Western blotting, immunofluorescence, qPCR, and ELISA were conducted to measure the expression of SIRT1, autophagy-related proteins, and ECM-related markers.</p><p><strong>Results: </strong>P-PRP promoted the viability and migration of NPCs, reduced apoptosis, and preserved ECM homeostasis in inflammatory conditions. P-PRP enhanced the expression of SIRT1, improved mitochondrial membrane potential, and reduced apoptosis rates. P-PRP upregulated LC3B-II and Beclin-1 expression, while downregulated p62 expression, indicating autophagy activation. EX-527 abrogated the beneficial effects of P-PRP.</p><p><strong>Conclusion: </strong>P-PRP protected against degenerative NPCs by activating functional autophagic flux and restoring mitochondrial function via the SIRT1 signaling axis. These findings provide novel mechanistic insight into PRP-based therapies and identify SIRT1 as a promising target for the treatment of IVDD.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"786"},"PeriodicalIF":2.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957884","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":"Transverse process-pedicle approach versus conventional transpedicular approach in percutaneous kyphoplasty for osteoporotic vertebral compression fracture.","authors":"Changjia Huang, Fulai Pei, Buyun Li, Xiaolei Tang, Baodi Zha","doi":"10.1186/s13018-025-06173-5","DOIUrl":"https://doi.org/10.1186/s13018-025-06173-5","url":null,"abstract":"<p><strong>Background: </strong>Osteoporotic vertebral compression fracture (OVCF) has been shown to achieve favorable clinical outcomes after percutaneous kyphoplasty (PKP) performed via the transverse process-pedicle approach (TPPA). The aim of this study was to investigate the clinical advantages of PKP via TPPA for the treatment of OVCF, by comparing it with the conventional transpedicular approach (CTPA).</p><p><strong>Methods: </strong>A retrospective study was conducted to analyze data from 124 patients with single-segment OVCF who were treated in our department between January 2019 and December 2022. A 1:1 propensity score matching was performed based on characteristics including sex, age, BMI, injury location, and bone mineral density T-values. The patients were divided into two groups: the TPPA group (62 cases), in which PKP was performed via the TPPA, and the CTPA group (62 cases), in which PKP was performed via the CTPA. Clinical efficacy was evaluated by comparing the two groups in terms of operative time, frequency of intraoperative fluoroscopy, rate of satisfactory bone cement distribution, rate of bone cement leakage, incidence of refractures, and visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores recorded at preoperative, 1-day, 3-month, 6-month, and 12-month postoperative time points. The Beck Index was also evaluated preoperatively, and at 1 day and 12 months postoperatively.</p><p><strong>Results: </strong>There were no significant differences in baseline characteristics between the two groups, indicating comparability (P > 0.05). All surgeries were completed successfully without complications such as nerve injury or pedicle fracture. No significant differences were found between the groups in terms of operative time, intraoperative bleeding, or radiation frequency (P > 0.05). However, the amount of bone cement injected was significantly greater in the TPPA group compared to the CTPA group (P < 0.05). At 1 day postoperatively, the VAS score and ODI in the TPPA group were significantly lower than those in the CTPA group (P < 0.05), indicating better immediate pain relief and function. No significant differences in VAS or ODI were observed between the groups at preoperative, 3-month, 6-month, or 12-month time points (P > 0.05). Both VAS and ODI scores showed steady improvement within each group, with significant differences between all consecutive time points (P < 0.05). The Beck Index at both 1 day and 12 months postoperatively was significantly higher in the TPPA group compared to the CTPA group (P < 0.05). Within-group comparisons also showed significant improvement in the Beck Index at both postoperative time points compared with preoperative values (P < 0.05). Additionally, the TPPA group demonstrated a significantly higher rate of satisfactory bone cement distribution than the CTPA group (P < 0.05).</p><p><strong>Conclusions: </strong>In the treatment of OVCF with PKP, the TPPA demonstrated comparable s","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"787"},"PeriodicalIF":2.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957984","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":"Fabrication and evaluation of a host-guest polylactic acid/gelatin-hydroxyapatite-blueberry scaffold for bone regeneration.","authors":"Someyra Sistani, Samira Asgharzade, Samaneh Arab, Marjan Bahraminasab, Elahe Soltani-Fard","doi":"10.1186/s13018-025-06166-4","DOIUrl":"https://doi.org/10.1186/s13018-025-06166-4","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"788"},"PeriodicalIF":2.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957784","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":"Short-term outcomes of percutaneous versus subcutaneous fascial flap fixation in cubital tunnel syndrome surgery: A retrospective cohort study.","authors":"Tianyou Hu, Yujie Bian, Qiankun Wang, Tao Zhou, Hongxiang Zhou","doi":"10.1186/s13018-025-06200-5","DOIUrl":"https://doi.org/10.1186/s13018-025-06200-5","url":null,"abstract":"<p><strong>Objective: </strong>Percutaneous external suturing has been proposed as an alternative approach to fascial flap fixation during anterior subcutaneous transposition for cubital tunnel syndrome (CuTS), with the aim of minimizing deep tissue disruption and reducing postoperative complications. This study compared short-term outcomes between percutaneous external fixation and traditional subcutaneous fixation of fascial flaps in CuTS surgery.</p><p><strong>Methods: </strong>In this retrospective cohort study, 114 patients who underwent anterior ulnar nerve transposition with fascial flap coverage were enrolled between January 2020 and December 2023. Patients were grouped based on the method of fascial flap fixation: subcutaneous (n = 57) or percutaneous (n = 57). Clinical assessments-including Visual Analog Scale (VAS), Patient-Rated Ulnar Nerve Evaluation (PRUNE), and Cubital Tunnel Syndrome Functional Score-along with nerve conduction studies (CMAP, SNCV, MNCV), were performed preoperatively and at 6-month follow-up.</p><p><strong>Results: </strong>Compared to the subcutaneous group, the percutaneous group showed significantly greater improvement in VAS scores (VAS: -2.75 vs. -1.99, p < 0.001), PRUNE scores (PRUNE: -23.78 vs. -17.64, p < 0.001), and functional scores (Score: +3.58 vs. + 2.70, p = 0.0004). Increases in SNCV (16.45 m/s vs. 14.51 m/s, p = 0.035) and MNCV (18.55 m/s vs. 12.13 m/s, p < 0.001) were also more pronounced in the percutaneous group. Although CMAP improved in both groups, postoperative CMAP values were slightly higher in the subcutaneous group (6.02 ± 0.85 mV vs. 5.40 ± 0.51 mV, p = 0.002). No infections or wound complications occurred in either group; two reoperations for recurrent compression were required in the subcutaneous group.</p><p><strong>Conclusion: </strong>Percutaneous external suturing may represent a safe and promising alternative for fascial flap fixation during CuTS surgery, with potential benefits in early postoperative pain relief, nerve conduction, and functional outcomes. However, longer-term studies are needed to assess durability and potential late complications.</p><p><strong>Trial registration: </strong>This study was retrospectively registered with the Institutional Review Board of the First Affiliated Hospital of Anhui Medical University (Approval No. PJ2024-12-17).</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"792"},"PeriodicalIF":2.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958021","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":"Correction: Osteonecrosis of the femoral head in post-COVID-19 patients: a retrospective comparative study.","authors":"Jichang Seong, Abduaziz Babakulov, Saodat Asilova, Babamukhamedova Shakhnoza, Makhmudova Nodira, Akbarjon Mirzayev","doi":"10.1186/s13018-025-06107-1","DOIUrl":"https://doi.org/10.1186/s13018-025-06107-1","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"782"},"PeriodicalIF":2.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957546","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":"Early weight-bearing after ankle fracture surgery: a systematic review and meta-analysis of functional outcomes and safety.","authors":"Chengjing Wang, Changqing Li","doi":"10.1186/s13018-025-06216-x","DOIUrl":"https://doi.org/10.1186/s13018-025-06216-x","url":null,"abstract":"<p><strong>Background: </strong>Early weight-bearing (EWB) following ankle fracture surgery represents a paradigm shift from traditional rehabilitation protocols. This systematic review and meta-analysis evaluated the efficacy and safety of early versus delayed weight-bearing following operative treatment of ankle fractures.</p><p><strong>Methods: </strong>We systematically searched six databases (PubMed, EMBASE, Cochrane CENTRAL, Web of Science, CINAHL, PEDro) from January 2015 to February 2025. Twelve studies (1,847 participants) comparing early (≤ 2 weeks) versus delayed weight-bearing protocols were included. Primary outcomes included functional scores, pain, range of motion, and complications. Random-effects meta-analyses used standardized mean differences for continuous outcomes and risk ratios for dichotomous outcomes.</p><p><strong>Results: </strong>Early weight-bearing demonstrated significant advantages in pain reduction (SMD: +0.32, 95% CI: 0.21-0.43) and ankle dorsiflexion (SMD: +0.38, 95% CI: 0.26-0.50). Patients with EWB returned to work 12.3 weeks earlier and achieved clinically significant pain reduction 6 weeks sooner than delayed weight-bearing patients. Complication risk favored EWB (RR: 0.89, 95% CI: 0.69-1.14), with fewer immobilization-related complications (DVT: 2.5% vs. 6.3%; CRPS: 1.8% vs. 4.7%). Weber B fractures, younger age (< 45 years), and absence of syndesmotic injury predicted optimal EWB outcomes. Diabetic patients showed enhanced benefits from early mobilization compared to delayed protocols.</p><p><strong>Conclusions: </strong>Early weight-bearing following ankle fracture surgery results in superior functional outcomes and equivalent safety compared to delayed protocols. Implementation within two weeks post-surgery appears optimal, with benefits most pronounced in Weber B fractures and younger patients. Syndesmotic injuries and diabetes require individualized assessment for optimal rehabilitation timing.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"785"},"PeriodicalIF":2.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957719","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":"Association between metabolism and low back pain: a cross-sectional study.","authors":"XingKun Wang, Long Tian, Qian Xu, Xin Pan, Lingjun Kong, Hua Zhao","doi":"10.1186/s13018-025-06218-9","DOIUrl":"https://doi.org/10.1186/s13018-025-06218-9","url":null,"abstract":"<p><strong>Background: </strong>While pervious studies have identified metabolic imbalance as a key driver of intervertebral disc degeneration, few studies explored the relationship between metabolic and low back pain directly. We aimed to explore the relationships between two critical metabolic factors-insulin resistance and obesity-and low back pain (LBP), thereby providing novel insights for the integrated management of patients with LBP.</p><p><strong>Methods: </strong>We enrolled 41663 participants from four NHANES survey cycles (1999-2004 and 2009-2010). The Metabolic Score for Insulin Resistance (METS-IR) and Body Roundness Index (BRI) were utilized to investigate the associations of insulin resistance and visceral obesity with LBP.Weighted logistic regression models were constructed to evaluate associations between MetS-IR/BRI and LBP, reported as odds ratios (ORs) with 95% confidence intervals (CIs). Using Restricted Cubic Splines (RCS) to assess potential nonlinear relationships. ROC curve analysis quantified diagnostic performance through area under the curve (AUC) estimation. Subgroup analyses and interaction tests were conducted to ensure the robustness of the findings.</p><p><strong>Results: </strong>Multivariable regression analysis revealed significant positive associations between MetS-IR/BRI and LBP after adjusting for all potential confounders (MetS-IR: OR = 1.013, 95% CI: 1.008-1.018; BRI: OR = 1.072, 95% CI: 1.047-1.098) and these associations remained consistent across all subgroups. RCS analysis revealed no significant nonlinear associations between the METS-IR, BRI and LBP. In the ROC analysis, METS-IR showed the highest area under the ROC curve in females, followed by BRI and BMI.</p><p><strong>Conclusions: </strong>In conclusion, within a nationally representative sample of U.S. adults with low back pain, we identified significant positive correlations between METS-IR/BRI and LBP. These findings underscore the importance of maintaining healthy metabolic status, providing valuable insights for further research.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"784"},"PeriodicalIF":2.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958027","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}