Journal of Orthopaedic Surgery and Research最新文献

{"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}

{"title":"Performance of artificial intelligence in automated measurement of patellofemoral joint parameters: a systematic review.","authors":"Hongwei Zhan, Zandong Zhao, Qiuzhen Liang, Jiang Zheng, Liang Zhang","doi":"10.1186/s13018-025-06247-4","DOIUrl":"10.1186/s13018-025-06247-4","url":null,"abstract":"<p><strong>Background: </strong>The evaluation of patellofemoral joint parameters is essential for diagnosing patellar dislocation, yet manual measurements exhibit poor reproducibility and demonstrate significant variability dependent on clinician expertise. This systematic review aimed to evaluate the performance of artificial intelligence (AI) models in automatically measuring patellofemoral joint parameters.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed, Web of Science, Cochrane Library, and Embase databases was conducted from database inception through June 15, 2025. Two investigators independently performed study screening and data extraction, with methodological quality assessment based on the modified MINORS checklist. This systematic review is registered with PROSPERO. A narrative review was conducted to summarize the findings of the included studies.</p><p><strong>Results: </strong>A total of 19 studies comprising 10,490 patients met the inclusion and exclusion criteria, with a mean age of 51.3 years and a mean female proportion of 56.8%. Among these, six studies developed AI models based on radiographic series, nine on CT imaging, and four on MRI. The results demonstrated excellent reliability, with intraclass correlation coefficients (ICCs) ranging from 0.900 to 0.940 for femoral anteversion angle, 0.910-0.920 for trochlear groove depth and 0.930-0.950 for tibial tuberosity-trochlear groove distance. Additionally, good reliability was observed for patellar height (ICCs: 0.880-0.985), sulcus angle (ICCs: 0.878-0.980), and patellar tilt angle (ICCs: 0.790-0.990). Notably, the AI system successfully detected trochlear dysplasia, achieving 88% accuracy, 79% sensitivity, 96% specificity, and an AUC of 0.88.</p><p><strong>Conclusion: </strong>AI-based measurement of patellofemoral joint parameters demonstrates methodological robustness and operational efficiency, showing strong agreement with expert manual measurements. To further establish clinical utility, multicenter prospective studies incorporating rigorous external validation protocols are needed. Such validation would strengthen the model's generalizability and facilitate its integration into clinical decision support systems.</p><p><strong>Systematic review registration: </strong>This systematic review was registered in PROSPERO (CRD420251075068).</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"847"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176036","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":"Radical surgical treatment of calcaneal osteomyelitis: clinical characteristics and treatment efficacy based on a synthesis analysis of 364 reported cases.","authors":"Zi-Xian Liu, Peng Chen, Li-Li Qiu, Xiao-Li Zheng, Bin Yu, Nan Jiang","doi":"10.1186/s13018-025-06197-x","DOIUrl":"10.1186/s13018-025-06197-x","url":null,"abstract":"<p><strong>Background: </strong>Calcaneal osteomyelitis (CO) poses substantial therapeutic challenges due to the distinctive anatomy and function of the calcaneus. Although multiple treatment modalities are available, severe cases frequently require radical surgical interventions, such as partial or total calcanectomy, and even amputation. Nevertheless, the clinical profile of these patients is not well characterized. Consequently, this study aimed to examine and elucidate clinical characteristics and treatment outcomes of CO patients who have undergone radical surgical interventions.</p><p><strong>Methods: </strong>A systematic literature search was conducted by two independent authors across the PubMed, Embase, and Cochrane Library databases to identify English-language studies published between January 1, 2000, and December 31, 2021, focusing on patients with CO who had undergone partial or total calcanectomy, as well as limb amputation. Studies were selected based on pre-defined inclusion and exclusion criteria. Quality assessment was performed using the National Institutes of Health (NIH) assessment tool, and effective data were extracted and synthesized for analysis.</p><p><strong>Results: </strong>Altogether 364 CO patients were enrolled, with a male-to-female ratio of 1.88:1 (188 males and 100 females). The median age at diagnosis was 58.5 years. Diabetic foot ulcers emerged as the predominant cause, and pathogen cultures indicated a high positivity rate of 97.2% (106/109). Staphylococcus aureus was the most commonly isolated strain at 33.3% (20/60), with polymicrobial infection accounting for 24.1% (19/79). The overall infection recurrence rate was 33.1% (105/317), with total calcanectomy and partial calcanectomy being 45% (18/40) and 30.4% (72/237), respectively. Among the 104 patients who underwent amputation procedures, 49 patients were subjected to primary amputations, with the remaining 55 patients receiving secondary amputations following partial or total calcanectomy. The majority of secondary amputations, specifically 78.2% (43/55), occurred after partial calcanectomy, whereas 21.8% (12/55) followed total calcanectomy. The overall mortality rate across all the 345 patients was 5.8%, with no fatalities being directly attributable to CO.</p><p><strong>Conclusions: </strong>In this cohort of patients that received radical surgical interventions, the majority were middle-aged males, and the diabetic foot ulcer was the leading cause. Staphylococcus aureus continued to be the most frequently isolated pathogen. Even among patients who received partial and total calcanectomy, clinical efficacy remained unsatisfactory due to high rates of infection recurrence, leading to a high incidence of secondary limb amputation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"838"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176094","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":"Radiomics-based machine learning model integrating preoperative vertebral computed tomography and clinical features to predict cage subsidence after single-level anterior cervical discectomy and fusion with a zero-profile anchored spacer.","authors":"Bin Zheng, Panfeng Yu, Ke Ma, Zhenqi Zhu, Yan Liang, Haiying Liu","doi":"10.1186/s13018-025-06286-x","DOIUrl":"10.1186/s13018-025-06286-x","url":null,"abstract":"<p><strong>Objective: </strong>To develop machine-learning model that combines pre-operative vertebral-body CT radiomics with clinical data to predict cage subsidence after single-level ACDF with Zero-P.</p><p><strong>Methods: </strong>We retrospectively review 253 patients (2016-2023). Subsidence is defined as ≥ 3 mm loss of fused-segment height at final follow-up. Patients are split 8:2 into a training set (n = 202; 39 subsidence) and an independent test set (n = 51; 14 subsidence). Vertebral bodies adjacent to the target level are segmented on pre-operative CT, and high-throughput radiomic features are extracted with PyRadiomics. Features are z-score-normalized, then reduced by variance, correlation and LASSO. Age, vertebral Hounsfield units (HU) and T1-slope entered a clinical model. Eight classifiers are tuned by cross-validation; performance is assessed by AUC and related metrics, with thresholds optimized on the training cohort.</p><p><strong>Results: </strong>Subsidence patients are older, lower HU and higher T1-slope (all P < 0.05). LASSO retained 11 radiomic features. In the independent test set, the clinical model had limited discrimination (AUC 0.595). The radiomics model improved performance (AUC 0.775; sensitivity 100%; specificity 60%). The combined model is best (AUC 0.813; sensitivity 80%; specificity 80%) and surpassed both single-source models (P < 0.05).</p><p><strong>Conclusion: </strong>A pre-operative model integrating CT-based radiomic signatures with key clinical variables predicts cage subsidence after ACDF with good accuracy. This tool may facilitate individualized risk stratification and guide strategies-such as endplate protection, implant choice and bone-quality optimization-to mitigate subsidence risk. Multicentre prospective validation is warranted.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"851"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176092","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":"A comparative analysis of three distinct approaches for the management of type A1 traumatic thoracolumbar fractures: a retrospective cohort study with a minimum 6-year follow-up.","authors":"Jiangtao Wang, Huiming Yang, Mario Ganau, Yuhang Wang, Junxian Miao, Liang Yan, Biao Wang","doi":"10.1186/s13018-025-06262-5","DOIUrl":"10.1186/s13018-025-06262-5","url":null,"abstract":"<p><strong>Objective: </strong>Comparing the efficacy of conservative treatment, percutaneous pedicle screw fixation and percutaneous balloon kyphoplasty with calcium sulphate particles in the treatment of AO Spine type A1 traumatic thoracolumbar fractures.</p><p><strong>Methods: </strong>The 220 patients with type A1 thoracolumbar fractures were divided into group A (n = 63, conservative treatment), group B (n = 85, percutaneous pedicle screw fixation), and group C (n = 72, percutaneous balloon kyphoplasty with calcium sulphate particle). Before treatment, 1 months and 2 years after treatment, and at the final follow-up, the efficacy was measured and compared between the three groups. Calcium sulphate particles ossification was assessed in patients from group C at 9 and 12 months postoperatively using computed tomography scans.</p><p><strong>Results: </strong>At the corresponding time points, the anterior vertebral body height ratio and Cobb angle were significantly better in groups B and C than in group A (all P < 0.05). At 1-month follow-up, visual analogue scale and oswestry disability index scores were significantly lower in groups B and C than in group A (P < 0.05), but the difference was not significant between the three groups at the subsequent follow-up (P > 0.05). Group C had significantly shorter operation time, less intraoperative blood loss, and shorter incision length compared to group B (all P < 0.05). At 12 months after surgery, computed tomography scan showed that the calcium sulphate particle disappeared and was replaced by autologous newly formed bone in patients of group C.</p><p><strong>Conclusion: </strong>For the management of type A1 thoracolumbar fractures, all three treatment methods demonstrated satisfactory clinical efficacy. After interim follow-up, similar levels of pain relief and functional improvement were observed across the three methods. Both percutaneous pedicle screw fixation and kyphoplasty with calcium sulphate particle exhibited similar efficacy in correcting kyphotic Cobb angle and restoring vertebral body height, with both being superior to conservative treatment. Notably, percutaneous balloon kyphoplasty with calcium sulphate particle exhibited a more minimally invasive profile compared with percutaneous pedicle screw fixation.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"856"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176082","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 related factors affecting the postoperative clinical outcome of cervical ossification of the posterior longitudinal ligament.","authors":"Shuqing Chen, Changlin Lv, Xuanyu Dong, Ziang Zhang, Jianyi Li, Tianyu Bai, Xiaofan Du, Guodong Zhang, Jianwei Guo, Jiale Shao, Jiayan Li, Yukun Du, Jun Dong, Yongming Xi","doi":"10.1186/s13018-025-06276-z","DOIUrl":"10.1186/s13018-025-06276-z","url":null,"abstract":"<p><strong>Purpose: </strong>To establish a risk prediction model for postoperative outcomes in patients with ossification of the posterior longitudinal ligament (OPLL), identify key risk factors, and provide a theoretical basis for personalized treatment.</p><p><strong>Methods: </strong>Clinical data of 384 OPLL patients undergoing cervical spine surgery were retrospectively analyzed. Potential predictors were screened using univariate analysis, and independent risk factors were determined through multivariate logistic regression. A dynamic nomogram was constructed, and its performance was evaluated with the concordance index (C-index), receiver operating characteristic (ROC) curve, Hosmer-Lemeshow test, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Four independent risk factors were identified and incorporated into the prediction model. The model demonstrated high accuracy and stability, with C-index values of 0.880 (training cohort) and 0.915 (validation cohort). ROC curve analysis confirmed excellent discrimination, while calibration and DCA showed good clinical applicability.</p><p><strong>Conclusion: </strong>Advanced age, history of trauma, surgical approach, and spinal cord T2 hyperintensity on imaging are independent predictors of postoperative outcomes in OPLL patients. The developed nomogram provides a reliable tool for individualized risk assessment and clinical decision-making. These findings warrant further validation in multicenter cohorts.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"849"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176143","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}