Journal of Orthopaedic Surgery and Research最新文献

{"title":"Removable brace is as good as plaster cast after surgically treated distal radius fracture - a randomised controlled study of pain and wrist function.","authors":"Johanna Blomstrand, Irén Sellbrant, Bengt Nellgård, Jon Karlsson, Monika Fagevik Olsén, Gunilla Kjellby Wendt","doi":"10.1186/s13018-025-06097-0","DOIUrl":"10.1186/s13018-025-06097-0","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"691"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682735","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 incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care model.","authors":"XiaoLing Chen, Yixin Huang, Fengxiang Chen, Xiaole Jiang, Dongze Lin, Fengfei Lin","doi":"10.1186/s13018-025-06114-2","DOIUrl":"10.1186/s13018-025-06114-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the incidence of postoperative delirium in elderly patients with hip fractures under the Unaccompanied- Care model and to explore its risk factors.</p><p><strong>Methods: </strong>This retrospective observational study prospectively included elderly patients with hip fractures who were admitted to the Trauma Department of our hospital from November 2024 to May 2025, managed under the Unaccompanied-Care nursing model, and underwent surgical treatment. We retrospectively analyzed the patients' baseline data, blood indicators, and surgery-related data for data analysis. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with delirium in the perioperative period.</p><p><strong>Results: </strong>A total of 138 patients were included, of whom 35 (25.36%) developed delirium. The incidence of delirium was 2.17% (3 cases) preoperatively, 6.52% (9 cases) within 6 h postoperatively, 10.14% (14 cases) within 1 day postoperatively, 4.35% (6 cases) on postoperative day 2, and 2.17% (3 cases) on postoperative day 3. Multivariate analysis showed that mild visual impairment (OR = 15.74, 95% CI: 2.53-97.29, p = 0.003), severe visual impairment (OR = 9.68, 95% CI: 5.20-18.30, p = 0.002); mild hearing impairment (OR = 7.09, 95% CI: 1.23-40.74, p = 0.028), moderate hearing impairment (OR = 6.43, 95% CI: 1.80-51.41, p = 0.031), severe hearing impairment (OR = 16.59, 95% CI: 1.76-156.61, p = 0.014), and hemoglobin (OR = 1.95, 95% CI: 1.91-5.99, p = 0.037) were independent risk factors for delirium.</p><p><strong>Conclusion: </strong>Although the Unaccompanied-Care model shows specific effects in the nursing of elderly patients with hip fractures, the incidence of delirium remains high. Sensory dysfunction and low hemoglobin levels are important risk factors for delirium.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"693"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682738","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":"Lower socioeconomic status is associated with recurrent shoulder instability before surgical shoulder stabilization.","authors":"Mahdi N Mazeh, Joshua P Castle, Johnny Kasto, Brittaney Pratt, Eric X Jiang, Matthew Gasparro, Lawrence Enweze, Jared M Mahylis, Vasilios Moutzouros, Stephanie J Muh","doi":"10.1186/s13018-025-06110-6","DOIUrl":"10.1186/s13018-025-06110-6","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDOH) encompass social and economic factors that influence healthcare access and outcomes. In orthopaedic surgery, disparities in SDOH contribute to unequal access to care and differences in post-surgical recovery. Prior studies indicate that an increased number of preoperative shoulder dislocations raises the likelihood of recurrent instability following stabilization procedures. However, limited research explores the association between SDOH and preoperative dislocation frequency. This study examines how SDOH factors influence the number of shoulder dislocations before surgical intervention.</p><p><strong>Methods: </strong>Patients that underwent shoulder instability surgery at a single center in a large metropolitan area between January 1, 2021, and April 30, 2023, were identified. Patients' demographic and social determinant variables were extracted using the electronic medical record. Socioeconomic status was assessed using the Social Vulnerability Index (SVI) and the Area Deprivation Index (ADI), based on patient zip codes. Statistical analyses, including univariate and multivariate regression models, evaluated predictors of multiple dislocations before surgery, focusing on factors such as age, body mass index (BMI), and socioeconomic indicators.</p><p><strong>Results: </strong>Among 106 patients, 54% identified as White, 29% as Black, and 17% as other. Thirty-eight (35.8%) had a single dislocation before surgery, while 68 (64.2%) experienced multiple instability events. Univariate analysis showed younger age (odds ratio [OR] 0.94, P = 0.02), lower BMI (OR 0.90, P = 0.02), higher SVI (OR 1.21, P = 0.006), and higher ADI (OR 6.04, P = 0.003) were associated with recurrent instability. Multivariate analysis confirmed lower BMI (OR 1.15, P = 0.02) and higher ADI (OR 7.46, P = 0.02) as independent predictors.</p><p><strong>Conclusions: </strong>Lower socioeconomic status, as measured by ADI, is an independent predictor of a higher likelihood of recurrent instability before surgery. Recognizing these relationships can motivate surgeons to create pathways to prevent these treatment disparities among shoulder instability patients.</p><p><strong>Level of evidence: </strong>III retrospective cohort study.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"689"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682716","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 impact of mental and psychological state on metatarsophalangeal joint replacement outcomes in patients with freiberg's infraction.","authors":"Jianmin Qu, Gang Wang, Shihang Cao, Xiaocong Liu, Yi Li, Jun Lu, Junkui Xu","doi":"10.1186/s13018-025-06118-y","DOIUrl":"10.1186/s13018-025-06118-y","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of preoperative psychological factors on outcomes following metatarsophalangeal joint replacement surgery in patients with Freiberg's infraction.</p><p><strong>Methods: </strong>This retrospective study included 127 patients diagnosed with Freiberg's infraction who underwent metatarsophalangeal joint replacement surgery at Xi'an Honghui Hospital's Department of Foot and Ankle Surgery between August 2013 and September 2023. Patients were stratified into two groups based on preoperative psychological status: Group A comprised patients with preoperative anxiety and/or depression symptoms, while Group B included patients without such symptoms. The Hospital Anxiety and Depression Scale (HADS) and visual analogue scale (VAS) were administered preoperatively and at final follow-up to assess psychological status and pain levels. Primary outcome measures included the 0-100 mm VAS for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) functional score.</p><p><strong>Results: </strong>Of 127 patients, 91 (71.7%) completed follow-up. Among these 91 patients, 53 (58.2%) had preoperative anxiety and/or depression symptoms. Both groups demonstrated significant improvements in all measured parameters compared to preoperative values. However, Group A showed significantly worse clinical outcomes than Group B across all assessment measures.</p><p><strong>Conclusion: </strong>Metatarsophalangeal joint replacement surgery significantly improves pain and functional outcomes in patients with Freiberg's infraction. However, preoperative anxiety and depression are associated with inferior postoperative outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"688"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682737","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 moderating role of negative affect on pain in patients with rheumatoid arthritis who have undergone shoulder arthroplasty.","authors":"Lazaridou Asimina, Schneller Tim, Brune Daniela, Edwards Robert, Scheibel Markus","doi":"10.1186/s13018-025-06109-z","DOIUrl":"10.1186/s13018-025-06109-z","url":null,"abstract":"<p><strong>Objective: </strong>Patients with rheumatoid arthritis undergoing shoulder arthroplasty often experience significant pain and functional limitations. Improvements in physical outcomes are well-documented, but psychological factors like negative affect remains underexplored. This study aimed to examine whether changes in negative affect moderate the relationship between functional and pain in rheumatoid arthritis undergoing shoulder arthroplasty.</p><p><strong>Methods: </strong>We analyzed 92 patients with rheumatoid arthritis undergoing shoulder arthroplasty. Baseline and 6-month postoperative outcomes were assessed, including pain, shoulder function (SPADI), and negative affect. Moderation analysis was conducted to examine whether changes in negative affect influenced the relationship between functional improvements and pain reduction.</p><p><strong>Results: </strong>The majority of patients were female (80%) with a mean age of 65 ± 11.1 years. Postoperative assessments showed significant improvements in pain and function. Pain scores decreased from a mean of 5.6 (SD = 2.6) to 1.2 (SD = 1.7) (p <.001), while SPADI scores improved from 63.7 (SD = 18.7) to 24.7 (SD: 15.9), (p <.001). Negative affect showed a reduction from 1.4 (SD = 0.7) to 1.2 (SD: 0.4), (p =.067). Persistent pain was present in 16% of patients postoperatively. Moderation analysis revealed a significant interaction between improvements in function and changes in negative affect on pain (β = 0.16, p =.017), suggesting that patients with concurrent emotional improvement experienced enhanced pain relief.</p><p><strong>Conclusion: </strong>Shoulder arthroplasty in patients with rheumatoid arthritis reduces pain and improves function. Notably, improvements in negative affect may amplify the benefit of functional recovery on pain outcomes. These findings highlight the importance of integrating psychological well-being into postoperative care for this population.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"686"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682749","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":"Why does tension band wiring fail in transverse patellar fractures? Radiographic insights from a 10-years retrospective cohort.","authors":"Eşref Selçuk, Fuat Cihan, Simge Koç, Murat Erem, Savaş Yıldırım","doi":"10.1186/s13018-025-06087-2","DOIUrl":"10.1186/s13018-025-06087-2","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to identify the radiographic parameters associated with failure of tension band wiring (TBW) in the treatment of transverse patellar fractures, with the goal of guiding surgical decision-making.</p><p><strong>Materials and methods: </strong>A total of 76 patients underwent surgical treatment for patellar fractures at Trakya University between January 2013 and December 2022. We retrospectively analyzed 32 patients who met the study's inclusion criteria for transverse fractures (AO Type 34- C1) treated with TBW. Radiographic parameters assessed included patellar width, inter-K-wire distance, K-wire-to-patella ratios, knot configuration, and K-wire length, all evaluated for their potential association with fixation failure. Failure was defined as cerclage wire slippage or breakage. Statistical analyses were conducted using SPSS and Jamovi software. Descriptive statistics, t-tests, chi-square or Fisher's exact tests, logistic regression, and ROC analysis were performed. A p-value < 0.05 was considered significant.</p><p><strong>Results: </strong>The mean age was 50 years ± 15.8 (range 26-80), with 8 women (25%) and 24 men (75%). Nine patients (28.1%) experienced TBW failure. Notably, single-knot constructs had significantly higher failure rates (66.7% vs. 19.2%; OR = 0.119, 95% CI [0.017-0.843], p = 0.038). Increased K-wire length was associated with failure (p = 0.008; cutoff 69.1 mm, AUC = 0.785). Patella-K-wire length ratio was higher in failures (p = 0.035). Lateral K-wire to articular distance and lateral K-wire to articular distance surface to patella thickness ratio were also significant predictors in slippage group (p = 0.046 and p = 0.031).</p><p><strong>Conclusion: </strong>The number of knots, K-wire length, and specific radiographic parameters are important predictors of TBW failure. Attention to construct configuration and K-wire placement is crucial to minimize failure risk.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"685"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682750","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":"Comprehensive workflow with optical navigation in minimally invasive transforaminal lumbar interbody fusion: a retrospective study.","authors":"Kangheng Niu, Zhenzhen Tao, Le Cheng, Zhong Wei, Hui Kang, Tanjun Wei, Biwang Huang, Feng Xu, Chengjie Xiong","doi":"10.1186/s13018-025-06111-5","DOIUrl":"10.1186/s13018-025-06111-5","url":null,"abstract":"","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"694"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682714","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":"miR-340-5p alleviates the damage effect of LPS on nucleus pulposus cells by negatively regulating the expression of SOX4.","authors":"Yuhang Liu, Lina Huang, Zhengtian Gao, Yingnuo Hou, Fanlei Kong, Shibin Hou, Zheng Li","doi":"10.1186/s13018-025-06069-4","DOIUrl":"10.1186/s13018-025-06069-4","url":null,"abstract":"<p><strong>Background: </strong>Previous studies show that about 80% of lumbar disc degeneration (LDD) patients experience back or leg pain, affecting their quality of life. However, the causes of LDD are not fully understood. This study focused on exploring the expression level of miR-340-5p and SRY-related high-mobility-group box 4 (SOX4) in LDD and attempts to clarify its potential mechanism in the pathological process of LDD.</p><p><strong>Methods: </strong>A total of 88 patients with LDD and 80 non-LDD patients were continuously included in this study. The miR-340-5p levels in nucleus pulposus (NP) tissues were measured using Reverse Transcription Quantitative Polymerase Chain Reaction (RT-qPCR). The potential diagnostic significance of miR-340-5p for LDD was evaluated by generating a Receiver Operating Characteristic (ROC) curve. The impacts of miR-340-5p on Lipopolysaccharide (LPS)-stimulated NP cells were analyzed through the Cell Counting Kit-8 (CCK-8) method, and apoptosis levels were quantified using flow cytometry. Additionally, the concentrations of inflammatory cytokines and extracellular matrix (ECM) remodeling markers were assessed with Enzyme-Linked Immunosorbent Assay (ELISA) kits.</p><p><strong>Results: </strong>miR-340-5p was abnormally down-regulated in LDD patients and the ROC curve showed that miR-340-5p has diagnostic value for LDD (AUC = 0.909, sensitivity = 81.8%, specificity = 85.0%, cutoff value = 0.815). Additionally, the enforced expression of miR-340-5p promoted proliferation and ECM remodeling and inhibited the level of apoptosis and pro-inflammatory factors in LPS-damaged NP cells. However, overexpression of SOX4 counteracted the effects of miR-340-5p overexpression on LPS-induced NP cells.</p><p><strong>Conclusions: </strong>miR-340-5p alleviates the damage effect of LPS on NP cells by negatively regulating the SOX4, and miR-340-5p may be a potential therapeutic target for LDD.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"690"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682734","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 stratification and clinical classification for postoperative neurological complications in post-tuberculosis kyphosis: a retrospective cohort study.","authors":"Jianqiang Wang, Yong Hai, Haoshuang Geng, Zhangfu Li, Yuzeng Liu, Yangpu Zhang, Lijin Zhou","doi":"10.1186/s13018-025-06112-4","DOIUrl":"10.1186/s13018-025-06112-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify risk factors for postoperative neurological complications in patients with post-tuberculosis kyphosis undergoing posterior corrective surgery and to develop a classification system for preoperative risk stratification.</p><p><strong>Methods: </strong>We retrospectively analyzed 51 patients with post-tuberculosis kyphosis who underwent single-stage posterior osteotomy and correction at our institution. Radiographic parameters, including the kyphotic angle, cross-sectional area ratio of the spinal cord (CSAR), and spinal cord angle (SCA), alongside surgical factors such as intraoperative blood loss and osteotomy grade, were evaluated. Postoperative neurological complications were recorded. Univariate and multivariate logistic regression analyses were employed to identify potential influencing factors. Based on the interaction between these factors, a clinical classification system for post-tuberculosis kyphosis was established to stratify the risk of postoperative neurological complications.</p><p><strong>Results: </strong>A minimum 2-year follow-up was conducted for the 51 patients with post-tuberculosis kyphosis. Multivariate logistic regression analysis revealed that the Baltalimani sign, spinal cord MRI type, Rajasekaran classification, three-column osteotomy, C-reactive protein (CRP), and SCA were significant risk factors for postoperative neurological complications. Two risk prediction models were developed accordingly. Synergistic interactions were identified between spinal cord MRI type and Rajasekaran classification, as well as between CRP and SCA. These findings informed the development of two clinical classification systems: the Mechanical Classification (AUC = 0.751) and the Imaging-Biomarker Classification (AUC = 0.883). The area under the curve (AUC) for both classifications demonstrated good predictive performance, with the DeLong test indicating superior efficacy for the Imaging-Biomarker Classification (P = 0.039).</p><p><strong>Conclusion: </strong>Spinal structural instability, spinal cord compression, osteotomy grade, and elevated CRP levels may all contribute to an increased risk of postoperative neurological complications in patients with post-tuberculosis kyphosis. The clinical classification systems established herein facilitate precise risk stratification, enabling targeted preoperative interventions to mitigate surgical risks and enhance surgical outcomes.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"692"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682736","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":"Comparison of posterior trans-intervertebral osteotomy and pedicle Subtraction osteotomy for the correction of thoracolumbar kyphotic deformity secondary to ankylosing spondylitis.","authors":"Lijin Zhou, Honghao Yang, Jie Wang, Yiqi Zhang, Yunsheng Wang, Yong Hai","doi":"10.1186/s13018-025-06074-7","DOIUrl":"10.1186/s13018-025-06074-7","url":null,"abstract":"<p><strong>Background: </strong>Ankylosing spondylitis (AS) often leads to severe thoracolumbar kyphotic deformity, requiring surgical correction. Pedicle subtraction osteotomy (PSO) is the gold standard but carries risks of significant blood loss and neurological complications. Posterior trans-intervertebral osteotomy (PTIO) has emerged as a less invasive alternative, but its comparative efficacy and safety remain unclear. This study aimed to compare radiographic outcomes, surgical parameters, and complications between PTIO and PSO in AS-related kyphosis.</p><p><strong>Methods: </strong>A single-center retrospective cohort study included 45 AS patients with thoracolumbar kyphosis (19 PTIO, 26 PSO) who underwent posterior spinal correction. Radiographic parameters (global kyphosis GK, sagittal vertical axis SVA, etc.), surgical data (operative time, blood loss), health-related quality of life (SRS-22), and complications were analyzed. Statistical comparisons were performed using independent t-tests or Mann-Whitney U tests for continuous variables and chi-square/Fisher's tests for categorical variables.</p><p><strong>Results: </strong>Both groups achieved significant kyphosis correction, with no differences in postoperative GK (PTIO: 51.4° ± 13.3° vs. PSO: 47.4° ± 13.0°, P > 0.05) or SVA (PTIO: 59.1 ± 50.3 mm vs. PSO: 49.0 ± 47.1 mm, P > 0.05). PTIO showed lower intraoperative blood loss (600.9 ± 264.6 mL vs. 1088.7 ± 287.9 mL, P = 0.009) and fewer neurological complications (5.3% vs. 15.4%, P = 0.003). Health-related quality of life improved similarly in both groups (P > 0.05).</p><p><strong>Conclusion: </strong>PTIO provides comparable radiographic correction to PSO while reducing blood loss and neurological risks. It represents a viable, less invasive alternative for AS-related kyphosis, particularly when anterior column support is achievable. Further studies with long-term follow-up are warranted to validate these findings.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"679"},"PeriodicalIF":2.8,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667825","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}