Journal of Orthopaedic Surgery and Research最新文献

{"title":"Regulating osteogenic differentiation of bone marrow mesenchymal stem cells by mTORC1 signaling pathway inhibits bone defect repair in mice.","authors":"Zhuobin Huang, Ziming Zhang, Cheng Yang, Qiguang Mai, Ruanbing Li, Siteng Li, Shicai Fan, Jing Yang","doi":"10.1186/s13018-025-06249-2","DOIUrl":"10.1186/s13018-025-06249-2","url":null,"abstract":"<p><strong>Background: </strong>Bone defects caused by traumatic injuries and orthopedic diseases have emerged as the most common challenges in contemporary orthopedics, characterized by treatment difficulty, long treatment time, and high economic costs. This study aims to demonstrate that the activated mTOR pathway in mesenchymal stromal cells regulates the bone repair process.</p><p><strong>Methods: </strong>Initially, the mammalian target of rapamycin (mTOR) pathway-activated mouse model was constructed by specifically knocking down the tuberous sclerosis complex 1 (TSC1) molecule in bone marrow mesenchymal stem cells (BMMSCs). Then, the differences in bone repair between transgenic mice and littermate control mice in a single-layer cortical bone defect model were evaluated by histological, immunohistochemical, and micro-CT analyses. Further, the effects of the mTOR pathway on the osteoinductive differentiation ability of BMMSCs and its mechanism were mainly verified by cellular osteogenic staining and Western blotting experiments.</p><p><strong>Results: </strong>The activated mTORC1 in mesenchymal stromal cells during bone defect repair in mice inhibited not only the healing rate of bone but also their ability to differentiate into osteoblasts, resulting in a decrease in the number of osteoblasts. The ability of mTORC1 in mesenchymal stromal cells to regulate osteoblastic differentiation might be related to the NOTCH pathway.</p><p><strong>Conclusion: </strong>The activated mTOR pathway during bone defect repair could inhibit the osteogenic ability of BMMSCs and hinder the bone healing process. Accordingly, regulating the activation of the mTOR pathway might promote the repair of bone defects.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"860"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192002","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":"Helical plating yields better outcomes than intramedullary nailing or long straight lateral plating for humeral shaft fractures extending to the proximal humerus.","authors":"Xiaolong Wang, Xin Zhang, Yuxuan Jiang, Haifeng Qiao, Xiaomin Kang, Yangjun Zhu, Yan Zhang, Dongxu Feng","doi":"10.1186/s13018-025-06283-0","DOIUrl":"10.1186/s13018-025-06283-0","url":null,"abstract":"<p><strong>Background: </strong>This study was performed to compare the operative clinical outcomes of helical plating, intramedullary nailing (IMN), and long straight lateral plating in the treatment of humeral shaft fractures extending into the proximal humerus, as well as to identify the optimal fixation strategy for managing such injuries.</p><p><strong>Methods: </strong>In total, 81 patients with humeral shaft fractures extending into the proximal humerus were divided into three groups based on treatment strategy: helical plating (Group A, n = 16), IMN (Group B, n = 12), and long straight lateral plating (Group C, n = 53). Preoperative demographic data and imaging were collected from the medical records. Operative time, blood transfusion, bone reduction quality, bone healing rate, and incidence of complications were recorded. Clinical evaluation included the Constant-Murley score for shoulder function, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire for upper limb function, the visual analogue scale (VAS) for pain, and assessments of shoulder stiffness or instability and patient satisfaction.</p><p><strong>Results: </strong>Compared with Groups A and C, patients in Group B had a longer operative time and lower blood transfusion requirements. More than 80% of patients in each group achieved bone reduction quality rated as \"better than good.\" There were no significant differences among the three groups in operative time, blood transfusion, or shaft angulation. Bone healing rates were 100%, 91.7%, and 94.3% in Groups A, B, and C, respectively. Mean shoulder flexion was 155.0°, 130.0°, and 150.0°, respectively. Functional outcomes, including the Constant-Murley score, DASH score, VAS score, and patient satisfaction, were significantly better in Group A than in Groups B and C. No complications occurred in Group A. One patient in Group B developed nonunion. In Group C, complications were observed in five patients (9.4%).</p><p><strong>Conclusion: </strong>In the treatment of humeral shaft fractures extending into the proximal humerus, helical plating was associated with a higher bone union rate, better functional outcomes, and a lower postoperative complication rate compared with IMN or long straight lateral locking plates. Outcomes after nailing and long straight lateral plating were similar.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"858"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191982","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":"Risk factors for scoliosis progression in children with idiopathic short stature on growth hormone therapy.","authors":"Xinkai Zhang, Haiping Ouyang, Xueben Han, Hailun Yao, Yu Zhou, Xing Liu","doi":"10.1186/s13018-025-06224-x","DOIUrl":"10.1186/s13018-025-06224-x","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical characteristics of scoliosis in children with idiopathic short stature after growth hormone treatment, and to explore the influence of growth hormone treatment on the progression of scoliosis and the risk factors for the progression of scoliosis.</p><p><strong>Methods: </strong>A retrospective study of children with scoliosis treated with growth hormone between January 2021 and June 2024 was conducted, analyzing the clinical characteristics of scoliosis and comparing the progression rate of scoliosis between the exposure group and the control group. Independent risk factors for exacerbation of scoliosis were determined by univariate and multifactorial logistic regression analysis.</p><p><strong>Results: </strong>In this study, the average Cobb angle at initial diagnosis of scoliosis during recombinant human growth hormone (rhGH) therapy was 11.86° across all children, with a maximum value not exceeding 20°, consistent with mild scoliosis. Comparative analysis revealed significantly greater Cobb angles in females versus males at both initial angle (11.40 ± 1.72° vs. 12.25 ± 2.64 °, p<0.01) and outcome angle (10.83 ± 1.85° vs. 11.77 ± 2.60°, p < 0.01) And apical vertebrae were distributed in thoracic 10- lumbar 1 (64.17%). The progression rate of scoliosis in the exposure group was significantly higher than that in the control group, and the risk ratio was 4.26. In the exposed group, the scoliosis progression rate was 17.02% (8/39) in males versus 20.00% (13/52) in females (p = 0.69). Within controls, progression rates were 4.35% (2/44) in males and 4.44% (2/43) in females (p = 1.00). Univariate and multivariate logistic regression analyses showed that continued growth hormone treatment and the initial Cobb Angle were independent risk factors for scoliosis progression.</p><p><strong>Conclusion: </strong>(1) Scoliosis developing in children with idiopathic short stature (ISS) receiving growth hormone (GH) therapy predominantly manifests as mild curvature. (2) If scoliosis develops during GH therapy, continued treatment may increase the risk of scoliosis progression. (3) Patients with smaller initial Cobb Angles are at higher risk of progression, necessitating closer clinical monitoring for this subgroup.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"859"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192016","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":"Effect of postoperative ankle pump exercises on the prevention of deep vein thrombosis and venous hemodynamics following lower limb orthopedic surgery: a meta-analysis of randomized controlled trials.","authors":"Xike Liu, Hong Hu, Ling Jin, Qian Lin, Pengfei Liu, Neng Li, Ziyuan Chen","doi":"10.1186/s13018-025-06236-7","DOIUrl":"10.1186/s13018-025-06236-7","url":null,"abstract":"<p><strong>Background: </strong>Deep vein thrombosis (DVT) is a common and serious complication following lower limb orthopaedic surgery. Early ankle pump exercises may promote venous return, reduce limb swelling, and lower the incidence of postoperative DVT. However, the efficacy of such interventions remains inconsistently reported. The aim of this meta-analysis is to evaluate the effects of preoperative and postoperative ankle pump training on DVT incidence and venous haemodynamic parameters, such as maximum venous outflow (MVO) and maximum venous capacity (MVC).</p><p><strong>Methods: </strong>A systematic Literature search was performed across multiple databases up to July 2025 to identify randomized controlled trials (RCTs) that compared ankle pump exercises with standard care in patients undergoing lower limb orthopaedic surgery. Data were pooled using a fixed-effects model. The outcomes included the incidence of DVT (odds ratio (OR)), MVO, and MVC (standardized mean difference (SMD)). Heterogeneity was assessed using the I² statistic, and the risk of bias was evaluated using the Cochrane Risk of Bias Tool.</p><p><strong>Results: </strong>A total of 16 RCTs involving 1,704 patients (intervention: n = 889; control: n = 815) were included. Compared with routine care, ankle pump exercises significantly reduced the incidence of DVT (OR = 0.27, 95% CI: 0.20-0.37, p < 0.001; I² = 0.0%, p = 0.523). For MVO, the pooled results from 6 studies revealed a significant improvement in the intervention group (SMD = 0.50, 95% CI: 0.34-0.66, p < 0.001; I² = 7.8%, p = 0.366). MVC also significantly increased following ankle training (SMD = 0.47, 95% CI: 0.31-0.63, p < 0.001; I² = 0.0%, p = 0.915). The risk of bias was low to moderate across the included studies. The funnel plots revealed no significant publication bias.</p><p><strong>Conclusions: </strong>This meta-analysis provides Level I evidence that ankle pump exercises significantly reduce the incidence of deep vein thrombosis (DVT) and increase venous haemodynamic parameters-specifically maximum venous outflow (MVO) and maximum venous capacity (MVC)-in patients undergoing lower limb orthopaedic surgery. These findings support the integration of ankle pump exercises into routine postoperative care as an effective, noninvasive strategy to mitigate DVT risk and promote venous return.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"863"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192040","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":"Impact on lower limb length following proximal femoral varus osteotomy for perthes disease.","authors":"Zhihong Qin, Xiaolin Luo, Jiahao Yu, Jianwei Hu, Jianhong Liu, Jinkao Li, ShiJie Liao, XiaoFei Ding","doi":"10.1186/s13018-025-06230-z","DOIUrl":"10.1186/s13018-025-06230-z","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"866"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191989","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: Reduced opioids after total joint replacement surgery (REPAIRS): a pilot randomized controlled trial.","authors":"Zhiwei Yang","doi":"10.1186/s13018-025-06314-w","DOIUrl":"10.1186/s13018-025-06314-w","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"857"},"PeriodicalIF":2.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182071","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":"Analysis of the anti-subsidence mechanical properties of novel 3D-printed titanium cages compared to conventional titanium cages.","authors":"Huiming Yang, Yuhang Wang, Junxian Miao, Jiangtao Wang, Hao Li, Yang Zhang, Liang Yan, Biao Wang","doi":"10.1186/s13018-025-06237-6","DOIUrl":"10.1186/s13018-025-06237-6","url":null,"abstract":"<p><strong>Background: </strong>Titanium cage subsidence remains a common complication following anterior cervical corpectomy and fusion. 3D printing technology can optimize titanium cages, including high geometric matching and unique porous graded structures, providing a better option for improving titanium cage subsidence. This study aims to evaluate the mechanical properties of 3D-printed titanium cages and compare them with those of conventional titanium cages, providing preclinical data for future clinical trials.</p><p><strong>Methods: </strong>The samples were divided into a 3D-printed titanium cage group and a conventional titanium cage group, with 5 samples in each group. A static compression test was conducted using the American Society for Testing and Materials (ASTM) F2077-14 standard to evaluate the stiffness of the titanium cages. A static subsidence test was conducted using the ASTM F2267-04 standard to evaluate the stiffness (K_p) of the test blocks in different groups of Sawbone. The larger the K_p value, the smaller the tendency of titanium cage subsidence.</p><p><strong>Results: </strong>In the static compression test, the stiffness of the 3D-printed titanium cage and the conventional titanium cage were (6562.60 ± 390.72) N/mm and (10252.40 ± 704.07) N/mm, respectively, with a statistically significant difference (P < 0.05). In the static subsidence test, the stiffness of the 3D-printed titanium cage system and the conventional titanium cage system were (258.60 ± 7.99) N/mm and (221.00 ± 20.36) N/mm, respectively, with a statistically significant difference (P < 0.05). Additionally, the stiffness (K_p value) of the test block for the 3D-printed titanium cage in the static subsidence test was 270 N/mm, while the K_p value of the test block in the conventional titanium cage static subsidence test was 226 N/mm, indicating a 19.5% increase in anti-subsidence capability.</p><p><strong>Conclusion: </strong>The optimized 3D-printed titanium cage, featuring anatomical conformity and a 70% porous structure, demonstrates 19.5% improved anti-subsidence performance compared to conventional designs, addressing limitations in prior 3D-printed solutions, providing a promising and feasible solution for reducing the subsidence of titanium cages.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"854"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175511","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 clinical application potential of miR-1287-5p in spinal cord injury resulting from spinal trauma and its involvement in modulating the inflammatory response.","authors":"Runze Du, Yingnan Li, Gang-Gang Wang, Weicheng Lin","doi":"10.1186/s13018-025-06240-x","DOIUrl":"10.1186/s13018-025-06240-x","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) is a severe nervous trauma and the underlying mechanism of miR-1287-5p in its pathogenesis remains incompletely elucidated.</p><p><strong>Objective: </strong>This research seeks to elucidate the molecular mechanism of miR-1287-5p in regulating inflammatory responses following SCI.</p><p><strong>Methods: </strong>The expression levels of miR-1287-5p and MAP3K9 were measured using qRT-PCR. Pearson correlation tests scrutinised their associations with clinical indices. ROC curve analysis was conducted to evaluate it diagnostic value for SCI. CCK-8 and ELISA assays were employed to evaluate cell viability and protein expression levels, respectively. The direct interaction between miR-1287-5p and MAP3K9 was confirmed through dual-luciferase reporter assays.</p><p><strong>Results: </strong>miR-1287-5p was markedly down-regulated in SCI patients and correlated with pain scores, LEMS, and ASIA grade.ROC curve analysis indicated that miR-1287-5p has potential as a diagnostic biomarker for SCI. Overexpression of miR-1287-5p enhances cell viability, reduces the production of inflammatory cytokines, and specifically binds to MAP3K9, thereby inhibiting its expression.</p><p><strong>Conclusion: </strong>miR-1287-5p serves as a potential diagnostic biomarker for SCI and modulates the inflammatory response in SCI through direct targeting of MAP3K9.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"852"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176102","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":"Personalized musculoskeletal modeling for gait analysis and decision-making in femoral derotational osteotomy for children with cerebral palsy.","authors":"Jehyun Yoo, Kun-Bo Park, Juntaek Hong, Junmin Cha, Jeuhee Lee, Yebin Cho, Dong-Wook Rha","doi":"10.1186/s13018-025-06287-w","DOIUrl":"10.1186/s13018-025-06287-w","url":null,"abstract":"<p><strong>Background: </strong>Preoperative gait analysis plays a crucial role in determining the necessity and correction angle for femoral derotational osteotomy (FDO). However, conventional musculoskeletal models used in gait analysis often fail to reflect patient-specific musculoskeletal characteristics, such as femoral and tibial deformities. This study evaluates the impact of a personalized musculoskeletal model incorporating these deformities on gait analysis and investigates the surgical outcomes of FDO based on kinematic changes derived from this personalized musculoskeletal model.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 254 limbs from 127 children with cerebral palsy (CP) who presented with increased femoral anteversion and underwent pre- and postoperative gait analyses. Kinematic data were generated using general and personalized musculoskeletal models developed in OpenSim. Patients were classified according to FDO status and the presence of excessive hip internal rotation (IR). Surgical outcomes were assessed based on postoperative changes in hip rotation. Subgroup analyses were performed to evaluate the model's impact on surgical outcomes.</p><p><strong>Results: </strong>Of the 254 limbs, 92 underwent FDO. Patients with increased hip IR in the general model (Group A) had a higher good responder rate (88.2%) than those without (Group B, 17.2%). All limbs in Groups A1 and B1 (increased hip IR using personalized musculoskeletal models) had 100% favorable outcomes, whereas Groups A2 and B2 (not increased hip IR using personalized musculoskeletal models) showed favorable outcomes in 20% and 13.5%, respectively. Increased hip IR was more frequent in patients with external tibial rotation (p < 0.05). Surgical outcomes differed significantly between patients with and without increased hip IR in the personalized musculoskeletal model (χ² = 4.90, p = 0.027).</p><p><strong>Conclusion: </strong>Gait analysis using personalized musculoskeletal models improved surgical decision-making for FDO, leading to better outcomes in children with CP. Personalized musculoskeletal models better identified suitable FDO candidates and more accurately predict surgical outcomes than general models.</p><p><strong>Trial registration: </strong>Retrospectively registered.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"855"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176107","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":"Comparative analysis of the efficacy of UBE-PLIF versus conventional PLIF in the treatment of L4-5 degenerative spondylolisthesis.","authors":"Xinkai Luo, Yixi Wang, Yiqing Wu, Qiuyuan Huang, Zexi Wang, Zhen Wu, Xiaoyu Cai, Hailong Guo","doi":"10.1186/s13018-025-06266-1","DOIUrl":"10.1186/s13018-025-06266-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;L4-5 lumbar degenerative spondylolisthesis is a common spinal disease in the middle-aged and elderly population, often accompanied by spinal stenosis and nerve root compression, which seriously affects the quality of life. Traditional posterior lumbar interbody fusion (PLIF) has been widely used in the treatment of such diseases, but it is more traumatic, has a longer recovery period, and has more complications. In recent years, Unilateral biportal endoscopic posterior lumbar Interbody Fusion (UBE-PLIF) has received attention as a minimally invasive treatment. However, the difference in efficacy between UBE-PLIF and PLIF remains to be further explored. This study aimed to compare the clinical outcomes and postoperative imaging changes between the two in the treatment of L4-5 degenerative spondylolisthesis and to provide a basis for clinical decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fifty-nine patients with L4-5 degenerative lumbar spondylolisthesis admitted between January 2021 and January 2024 were retrospectively analyzed in this study, including 28 in the UBE-PLIF group and 31 in the PLIF group. Baseline data (gender, age, history of hypertension/diabetes, BMI), major operative parameters (operative time, number of intraoperative fluoroscopies, postoperative drainage volume) and clinical assessments (low back pain/leg pain VAS score, ODI, SF-36) were collected, and a modified MacNab score was used for final follow-up. Imaging assessments included disc height, (DH), L4-5 segmental lumbar lordosis (SLL), lumbar lordosis (LL), and sagittal slip distance (SSD) preoperatively, at 3 days postoperatively, and the final follow-up, and were compared with the paravertebral muscle cross-sectional area (CSA), the paravertebral muscle fat infiltration (FI), Adjacent segment Pfirrmann grades, and vertebral fusion rate at the final follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Surgery was completed in both groups, with comparable baseline characteristics and significant postoperative symptom relief. The UBE-PLIF group had significantly less drainage but slightly longer operative time and more fluoroscopic exposures (p &lt; 0.05). Both groups showed significant improvement in leg pain VAS, ODI, and SF-36 scores; however, low back pain VAS at 1 month was significantly lower in the UBE-PLIF group (p &lt; 0.05). Final follow-up revealed no difference in modified MacNab \"Excellent \"or \"Good \"Rate (92.9% vs. 90.3%, p &gt; 0.05). Radiologically, both groups demonstrated improved DH, SLL, LL, and SSD, with greater gains in SLL, LL, and SSD in the PLIF group (p &lt; 0.05). Adjacent segment Pfirrmann grades showed no significant difference (p &gt; 0.05). Although the proportion of Grade I fusion was higher in the UBE-PLIF group (64.3% vs. 54.8%), the difference was not statistically significant (p = 0.682). Notably, the UBE-PLIF group had superior paravertebral muscle CSA preservation and lower fat infiltration (p &lt; 0.05). Complication rates were ","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"846"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175480","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}