Journal of Orthopaedic Surgery and Research最新文献

{"title":"The impact of anterior cruciate ligament deficiency severity on the outcomes of fixed-bearing unicompartmental knee arthroplasty: a retrospective study.","authors":"Shuhan Jia, Di Long, Bo Zhang, Mingyang Sun, Fengji Liu, Yixuan Jiao, Guoan Wang, Bin Zhang","doi":"10.1186/s13018-025-05635-0","DOIUrl":"10.1186/s13018-025-05635-0","url":null,"abstract":"<p><strong>Objective: </strong>Anterior cruciate ligament deficiency (ACLD) has traditionally been regarded as a contraindication for unicompartmental knee arthroplasty (UKA). However, advancements in surgical techniques and improvements in prosthetic manufacturing have challenged this notion. Controversy persists regarding whether the anterior cruciate ligament (ACL) influences the postoperative outcomes of fixed-bearing (FB) UKA. This study aimed to evaluate the impact of varying severities of ACLD on the clinical outcomes of FB-UKA.</p><p><strong>Methods: </strong>This retrospective analysis included 81 patients (87 knees) who underwent FB-UKA for anteromedial osteoarthritis (AMOA). Patients were categorised into three groups on the basis of preoperative MRI and intraoperative findings: the intact ACL group (31 knees), the partial ACLD group (39 knees), and the complete ACLD group (17 knees). Patient demographics (age, body mass index [BMI]), preoperative hip-knee-ankle angle (HKA), follow-up duration, and preoperative and last follow-up data, collected more than one year postoperatively, were recorded, including the Hospital for Special Surgery knee score (HSS), Lysholm score, visual analogue scale (VAS) for pain, range of motion (ROM), postoperative X-ray assessment of the position of the femoral component relative to the tibial component, as well as evaluation of radiolucent lines on the postoperative X-rays. Statistical analyses were conducted to determine differences in clinical outcomes, including pre-and postoperative changes, among the three groups. Postoperative complications, such as infection, aseptic loosening, prosthetic dislocation, or periprosthetic fractures requiring revision surgery, were recorded.</p><p><strong>Results: </strong>There were no significant differences among the three groups in terms of age, BMI, follow-up duration, preoperative HKA, baseline Lysholm score, HSS knee score, VAS score, or ROM (P > 0.05). Postoperatively, all three groups showed significant improvements in the Lysholm score, HSS knee score, VAS score, and ROM (P < 0.001), with no significant differences in the extent of improvement among the groups (P > 0.05). The position of the femoral component relative to the tibial component did not differ significantly among the groups (P > 0.05), and no radiolucent lines were observed in any of the patients. No patients experienced complications such as infection, aseptic loosening, periprosthetic fractures, or prosthetic dislocations that required revision surgery at the latest follow-up.</p><p><strong>Conclusion: </strong>FB-UKA is a viable surgical option for the treatment of AMOA. For patients with AMOA and stable anteroposterior knee alignment, ACLD does not adversely affect short- to midterm outcomes following FB-UKA. Even in cases of partial or complete ACLD, careful patient selection and optimised surgical techniques can yield outcomes comparable to those in patients with intact ACLs.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"244"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573289","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":"Performance evolution of the Nano Boron nitride enhanced bone cement composites.","authors":"Hong Wang, Kangrui Zhang, Wenduo Niu, Sicong Min, Fan Lu, Shifeng Zhang, Wensheng Gao, Hua Han, Yayi Xia","doi":"10.1186/s13018-025-05626-1","DOIUrl":"10.1186/s13018-025-05626-1","url":null,"abstract":"<p><p>Bone cement is a research hotspot and has been partially applied in the field of bone repair thanks to the good mechanical, physical and antibacterial properties. However, the easy wear and high temperature during curing characteristics would cause surrounding tissue necrosis, which seriously limits the wider application to some extent. In this work, the hexagonal boron nitride (h-BN) nano flakes were optimized to enhance the bone cement matrix (PMMA) via mechanical doping. The doping of h-BN into PMMA results in an improved mechanical (bending stress increased by 26%), thermal-conductivity (increased by 175% with the loading of 20 wt%), wear-resistance properties, in addition, the h-BN has no significant impact on cell activity. What's more, the co-modification of PMMA with h-BN and Vancomycin (Va) endows the bone cement composites with more persistent drug release characteristics. This comprehensive performance evolution evaluation provides a reference for the innovative application of modified bone cement.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"245"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573187","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":"Diagnosis and treatment of postoperative voice complications following anterior cervical discectomy and fusion: a systematic review.","authors":"Geena Jung, Jorden Xavier, Shaun Wu, Rachel Schwartz, Rachel Kominsky, Mitchell S Fourman","doi":"10.1186/s13018-025-05464-1","DOIUrl":"10.1186/s13018-025-05464-1","url":null,"abstract":"<p><strong>Background: </strong>There is a wide discrepancy in the literature regarding the incidence of postoperative dysphonia following ACDF. How postoperative dysphonia is measured is also inconsistent, with many studies relying on patient-reported outcomes rather than diagnostic laryngoscopy. The purpose of this study was to consolidate information regarding dysphonia after ACDF to improve diagnosis and management.</p><p><strong>Methods: </strong>A comprehensive database search was performed using key terms. Inclusion criteria was as follows: published within 10 years, subjects > 18 years of age, ACDF for treatment of cervical radiculopathy and/or myelopathy, reports of postoperative changes in voice, and at least one postoperative follow-up between one week and six months. Works that included endoscopic surgical techniques and/or subjects with a history of cancer or trauma to the operated region were excluded. Reviews and meta-analyses were also removed from analysis.</p><p><strong>Results: </strong>Twenty-one eligible studies were analyzed. Evaluation methods varied, with incidence rates ranging from 0.3 to 27%. Symptoms typically arose within one week post-op, persisting up to one year. Treatment modalities included steroids, speech therapy, and laryngoplasty. Mechanisms included recurrent laryngeal nerve injury, endotracheal tube pressure, and postoperative edema.</p><p><strong>Conclusions: </strong>Postoperative voice complications following ACDF represent a clinically significant outcome that can impact a patient's quality of life. Patients should be counseled preoperatively about the potential risk, and managed postoperatively to mitigate long-term impairments. Involvement of otolaryngologists may help prevent these complications or allow for early detection and management, underscoring the importance of multidisciplinary care in optimizing surgical outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"239"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567306","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":"Enhanced antibiotic release and biocompatibility with simultaneous addition of N-acetylcysteine and vancomycin to bone cement: a potential replacement for high-dose antibiotic-loaded bone cement.","authors":"Tzu-Hao Tseng, Chih-Hao Chang, Chien-Lin Chen, Hongsen Chiang, Jyh-Horng Wang, Tai-Horng Young","doi":"10.1186/s13018-025-05637-y","DOIUrl":"10.1186/s13018-025-05637-y","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic-loaded bone cement (ALBC) is crucial for treating orthopedic infections, but its use is limited by suboptimal antibiotic release patterns and potential toxicity. This study explores the dual addition of N-acetylcysteine (NAC) and vancomycin to polymethylmethacrylate (PMMA) as a strategy to enhance the antibacterial efficacy and reduce toxicity.</p><p><strong>Methods: </strong>PMMA cement cylinders were loaded with varying combinations of NAC and vancomycin and tested for antibiotic release, cytotoxicity, and antibacterial activity over a 35-day period. Porosity of the cements was also evaluated as a measure of potential antibiotic release enhancement.</p><p><strong>Results: </strong>The addition of NAC improved vancomycin release, particularly after the initial burst release phase, and reduced cytotoxicity compared to high-dose vancomycin alone. The optimal combination was found to be 2 gm vancomycin with either 2 gm or 4 gm of NAC, which maintained effective antibacterial activity over 35 days without the toxicity seen with higher doses of vancomycin alone. Moreover, NAC alone did not demonstrate antibacterial properties, indicating its role primarily as a bioenhancer in this context.</p><p><strong>Conclusion: </strong>Simultaneous inclusion of NAC and vancomycin in PMMA bone cement provides a more favorable release profile and biocompatibility than high-dose vancomycin alone, suggesting a potential strategy for enhancing the therapeutic efficacy of ALBC in treating prosthetic joint infections. This approach allows for lower doses of antibiotics, reducing potential cytotoxicity, systemic toxicity and enhancing the duration of antibacterial activity.</p><p><strong>Level of evidence: </strong>Laboratory study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"246"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573108","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":"Orthopedic frailty risk stratification (OFRS): a systematic review of the frailty indices predicting adverse outcomes in orthopedics.","authors":"Nithin K Gupta, Forrest Dunivin, Hikmat R Chmait, Chase Smitterberg, Azhaan Buttar, Moiz Fazal-Ur-Rehman, Taylor Manes, Morgan Turnow, Tyler K Williamson, Benjamin C Taylor, Jack W Weick, Christian Bowers","doi":"10.1186/s13018-025-05609-2","DOIUrl":"10.1186/s13018-025-05609-2","url":null,"abstract":"<p><strong>Background: </strong>With a growing number of elderly patients requiring elective and non-elective procedures, frailty-based preoperative risk stratification is an emerging tool in orthopedic surgery to minimize adverse postoperative outcomes. This paper sought to understand the current literature regarding preoperative Orthopedic Frailty Risk Stratification (OFRS) and describe the disparate frailty indices and their capabilities for discrimination in predicting adverse postoperative outcomes.</p><p><strong>Methods: </strong>A literature search was conducted in Pubmed, Cochrane, and Scopus for articles published during or prior to February 2024 assessing frailty following surgery for orthopedic pathologies. Qualitative variables including study characteristics and application of frailty were collected and synthesized. Quantitative meta-analysis was performed for pooled odds ratio (OR) and area under the curve (AUC) of frailty for mortality and complications. All methods were performed in accordance with PRISMA guidelines.</p><p><strong>Results: </strong>Of the 81 included articles, over half (52%) addressed traumatic orthopedic pathologies with traumatic hip fractures being the most studied in the OFRS (25 studies). Less common categories included oncology, sports, and foot/ankle. Functional status and independence were the most common frailty domain (25, 96.2%) and component across scales (20, 76.9%), respectively. The 5-Item Modified Frailty Index (mFI-5) was the most common frailty index (28 publications). Meta-analysis demonstrated increasing frailty was an independent predictor of mortality (30-day OR: 2.89, 95% CI: 2.00-4.18; 1 year OR: 1.81, 95% CI: 1.48-2.22, p < 0.001), major complications (OR: 1.63, 95% CI: 1.10-2.41, p = 0.02), and Clavien-Dindo IV complications (OR: 3.26, 95% CI: 2.18-4.87, p < 0.001). Frailty had good discriminatory accuracy for predicting mortality at 30-days (AUC: 0.71, 95% CI: 0.68-0.74, p < 0.001), 3-months (OR: 0.75, 95% CI: 0.65-0.83, p < 0.001), and 1-year (OR:0.74, 95% CI: 0.73-0.75, p < 0.001).</p><p><strong>Conclusions: </strong>The orthopedic surgery frailty literature is extremely heterogeneous, with disparate frailty scales implemented to measure varying outcomes across many orthopedic pathologies. Despite no consensus on exact scales or definitions, various frailty indices have predicted adverse outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"247"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573170","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":"Effects of semaglutide in patients with chronic ankle instability: evidence from a prospective cohort.","authors":"Jieyuan Zhang, Cheng Wang, Jiazheng Wang, Wenqi Gu, Haiqing Wang, Hongyi Zhu, Xin Ma, Zhongmin Shi","doi":"10.1186/s13018-025-05664-9","DOIUrl":"10.1186/s13018-025-05664-9","url":null,"abstract":"<p><strong>Background: </strong>Whether patients with chronic ankle instability (CAI) can benefit from weight loss yielded by using glucagon-like peptide-1 receptor agonists (GLP1-RAs) has remained unclear.</p><p><strong>Methods: </strong>In this observational study, we recruited more than 2000 adults with CAI according to the selection criteria proposed by International Ankle Consortium with at least two-year follow up from three medical centers. The primary endpoint was the change from baseline of the Foot and Ankle Ability Measure (FAAM) sports subscale at the last follow up. Secondary endpoints included the change from baseline of Foot and Ankle Outcome Score (FAOS)/ Cumberland Ankle Instability Tool (CAIT)/ FAAM activities of daily living (ADL) subscale, number of ankle sprains during study period, incident ankle surgery in treatment of CAI.</p><p><strong>Results: </strong>In this study, 71 out of 2018 patients who received semaglutide in purpose of treating type 2 diabetes (T2DM) and/or weight loss during the study period. After controlling baseline characteristics, the adjusted mean difference in change from baseline was 16.3 for FAAM sports subscale and 9.3 for FAAM ADL subscale. Likewise, the adjusted analysis of five subscales of FAOS showed similar results, all consistently favoring semaglutide group. For CAIT, patients in the semaglutide group had achieved statistically significant improvement compared with control group. The association of semaglutide exposure with improvement in FAAM sports and ADL subscales was mediated by the weight loss measured by BMI (mediation proportion: FAAM sports subscale, 31.2% [22.2-41.2%]; FHSQ ADL subscale, 34.1% [24.4-44.8%]). We also observed statistically significant decreases in number of recurrent ankle sprains during study period. For incident ankle surgery, 1 out of 71 patients (1.4%) and 151 out of 1947 patients (7.8%) received ankle surgeries in semaglutide and control groups, respectively (P = 0.047).</p><p><strong>Conclusions: </strong>Semaglutide may show potential benefits as a supplementary intervention in treatment of CAI by improving patient-reported outcomes and preventing recurrent ankle sprains. Further randomized trial is warranted by the current study to further confirm our findings.</p><p><strong>Trial registration: </strong>researchregistry10716.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"243"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573096","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":"Percutaneous pedicle screw fixation in the surgical treatment of monosegmental pyogenic spondylodiscitis.","authors":"Zhen-Zhong Chen, Ke-Jun Zhu, Bin Pan, Chao Lou, Wei-Yang Yu, Deng-Wei He","doi":"10.1186/s13018-025-05660-z","DOIUrl":"10.1186/s13018-025-05660-z","url":null,"abstract":"<p><strong>Objective: </strong>The study assessed the efficacy of percutaneous pedicle screw fixation (PPSF) as a treatment approach for monosegmental pyogenic spondylodiscitis (PS), particularly in patients with compromised health conditions that reduce their ability to endure extensive surgical procedures.</p><p><strong>Methods: </strong>From January 2019 and December 2021, a total of 38 patients with PS who underwent PPSF at our hospital were included in the study. Clinical outcomes were assessed using physical examinations, serological tests, Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) scores, and imaging assessments.</p><p><strong>Results: </strong>The mean duration of PPSF among all patients was 73.9 ± 13.9 min, with an average intraoperative blood loss of 52.4 ± 18.4 mL. Pathogenic bacteria were identified in 17 out of 38 cases, representing a detection rate of 44.7%. The mean follow-up period was 21.3 ± 8.3 months. Postoperative assessment of inflammatory markers indicated that infections were effectively controlled in 33 patients, resulting in symptomatic improvement. However, within 2 to 4 weeks postoperatively, 5 patients required a two-stage anterior debridement-fusion following the initial internal fixation. Compared to those who underwent posterior internal fixation alone, these patients had significantly higher Spinal Instability Spondylodiscitis Scores (12.000 ± 1.000 vs. 9.030 ± 2.114, p < 0.05) and a significantly greater prevalence of preoperative epidural abscesses (80% vs. 12.1%, p < 0.01).</p><p><strong>Conclusions: </strong>PPSF may serve as a viable option for patients with monosegmental PS, providing a minimally invasive surgical approach for patients who are unable to tolerate traditional open surgery due to compromised health or advanced age. For patients with significant spinal instability or abscess formation, a two-stage anterior debridement-fusion may be required. However, single-stage posterior internal fixation can effectively relieve pain and improve the overall condition of patients, thereby enhancing their ability to tolerate subsequent anterior surgical interventions.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"241"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573185","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":"LINC00968 accelerates osteogenic differentiation of bone marrow mesenchymal stem cells via the miR-17-5p/STAT3 axis.","authors":"Shanglong Ning, Yang Chen, Hui Zhu","doi":"10.1186/s13018-025-05627-0","DOIUrl":"10.1186/s13018-025-05627-0","url":null,"abstract":"<p><strong>Background: </strong>BMSCs with robust osteogenic differentiation capacity can participate in the repair of osteoporotic (OP) bone. Long non-coding RNAs (LncRNAs) serve as crucial regulators of osteogenic differentiation. This study aims to investigate the clinical implications of LINC00968 in OP and elucidate its molecular mechanisms.</p><p><strong>Methods: </strong>Patients with OP and controls without OP were enrolled. RT-qPCR was utilized the quantify the levels of LINC00968, miR-17-5p, STAT3, and osteogenic differentiation markers. ROC curve was conducted to evaluate the diagnostic significance. Osteogenic differentiation medium (OM) induced hBMSCs. Flow cytometry was used to examine apoptosis. DLR and RIP assay were performed to validate target binding.</p><p><strong>Results: </strong>LINC00968 was notably decreased in the serum and bone tissue of patients with OP, whereas it was markedly elevated during osteogenic differentiation of hBMSCs. LINC00968 has 78.65% sensitivity and 71.95% specificity in identifying OP patients from controls. Silencing of LINC00968 sharply diminished ALP activity and osteogenic differentiation markers levels while promoting apoptosis in hBMSCs under OM induction. However, this reduction was notably reversed by the administration of a miR-17-5p inhibitor. Molecularly, miR-17-5p directly targets LINC00968 and STAT3.</p><p><strong>Conclusions: </strong>Our results indicate that LINC00968 downregulation is a diagnostic biomarker for OP, facilitating osteogenic differentiation and inhibiting apoptosis via miR-17-5p/STAT3 axis, suggesting a new therapeutic target for OP progression.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"242"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573159","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":"Anatomical variability, morphofunctional characteristics, and clinical relevance of accessory ossicles of the back: implications for spinal pathophysiology and differential diagnosis.","authors":"Eren Ogut","doi":"10.1186/s13018-024-05407-2","DOIUrl":"10.1186/s13018-024-05407-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored the anatomical variations and clinical implications of accessory ossicles in the spine, which are often identified incidentally but can significantly impact the differential diagnosis of spinal disorders.</p><p><strong>Methods: </strong>A comprehensive review of the literature from MEDLINE, the Cochrane Library, ScienceDirect, and Google Scholar up to April 2024 was conducted. Statistical analyses emphasized distinct patterns in prevalence, location, and correlation with symptoms, reinforcing the importance of accurate identification and appropriate patient management.</p><p><strong>Results: </strong>Limbus Vertebra (LV) was observed in 2.5% of the cases, predominantly in the lumbar spine (70%). Ossicles of the nuchal ligament were identified in approximately 5.6% of cases, with a higher prevalence in males than in females.Correlation analysis indicated a weak positive correlation between LV and symptom severity (r = 0.25, p = 0.05) and a strong positive correlation between the ossicles of the nuchal ligament and male predominance (r = 0.75, p < 0.01). Additional accessory ossicles, including Oppenheimer's ossicles, accessory ossicles of the atlas, persistent ossiculum terminale, and os odontoideum, exhibited lower prevalence rates (< 2%), emphasizing their infrequency.</p><p><strong>Conclusions: </strong>Accessory ossicles of the spine exhibit varied prevalence and clinical significance, with some presenting minor associations with symptoms and others linked to specific syndromes or spinal disorders. The prevalence of different ossicles shows notable heterogeneity, highlighting the need for careful differential diagnosis to prevent the misinterpretation of fractures or other spinal pathologies.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"240"},"PeriodicalIF":2.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573095","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":"Percutaneous endoscopic unilateral laminotomy and bilateral decompression improves gait quality and stance balance in patients with lumbar spinal stenosis: a retrospective cohort study.","authors":"Penghui Ke, Liuhu Han, Wenfeng Xu, Yang Song, Benfan Zhu, Likui Wang","doi":"10.1186/s13018-025-05631-4","DOIUrl":"10.1186/s13018-025-05631-4","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous endoscopic unilateral laminotomy and bilateral decompression (Endo-ULBD) has been applied to patients with lumbar spinal canal stenosis (LSS). However, it remains unclear whether gait and postural balance in LSS patients fully recover to normal levels following ULBD surgery.</p><p><strong>Methods: </strong>This retrospective study included 60 symptomatic LSS patients (LSS group) and 60 healthy age-matched adults (control group). The LSS group was assessed at four time points: preoperatively, 3, 6, and 12 months postoperatively. Evaluations included the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores, as well as assessments of gait and balance. The control group underwent gait and balance evaluations on the day of recruitment.</p><p><strong>Results: </strong>The LSS group showed significant improvement in VAS and ODI at 3, 6, and 12 months after ULBD surgery (p < 0.05). Cadence improved at 3 months postoperatively, while walking speed, stride length, and double support duration improved at 6 months postoperatively. At 12 months postoperatively, there was no significant difference in gait spatiotemporal parameters between the LSS group and the healthy control group (p > 0.05). Preoperatively, the LSS group exhibited differences in COP path length and 90% COP postural sway area compared to the control group. Postoperatively, there was no significant improvement in COP path length at any time point. However, there were differences in 90% COP postural sway area at 12 months after surgery compared to the preoperative and control groups.</p><p><strong>Conclusion: </strong>LSS patients showed significant improvement in gait after ULBD surgery, with gait parameters comparable to those of healthy controls at 12 months. While balance stability improved at 12 months, it remained inferior to that of age-matched healthy controls, indicating that postoperative balance training is necessary for full recovery.</p><p><strong>Trial registration: </strong>This study was a single-center retrospective cohort study, approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University (Ethical Application Reference: PJ2023-07-13 Anhui, China) and was registered at the Chinese Clinical Trial Registry at 20/06/2023 (ChiCTR2300072649). The research was conducted in accordance with the Declaration of Helsinki and clinical practice guidelines.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"238"},"PeriodicalIF":2.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567327","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}