Zhongguo gu shang = China journal of orthopaedics and traumatology最新文献

{"title":"[Clinical and radiological evaluation of sliding positioning and slotting with bone rongeur in posterior cervical laminoplasty].","authors":"Zhenxing Zhu, Bo Yang, Piyaо Ji, Yonggang Ma, Jianghua Ming, Yan Zhou","doi":"10.12200/j.issn.1003-0034.20250991","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250991","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical value and imaging evaluation of bone rongeur sliding positioning technique in precise laminotomy during posterior cervical spinal canal expansion and reconstruction surgery.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 60 patients with cervical spondylotic myelopathy who underwent cervical posterior single-door laminoplasty with spinal canal expansion surgery for cervical spine treatment from October 2020 to December 2023, including 40 males and 20 females;age ranged from 39 to 78 years with a mean of (60.3±9.1)years;disease duration ranged from 1 to 120 months with a mean of (19.6±32.1) months. Among the 30 cases with concurrent ossification of the posterior longitudinal ligament of the cervical spine, 18 were focal-type, 7 were segmental-type, 2 were continuous-type, and 3 were mixed-type. The preoperative Modified Japanese Orthopaedic Association (mJOA) scores ranged from 7 to 14 wit a mean of (11.0±1.8) scores. MRI T2-weighted imaging revealed high signal intensity changes in the spinal cord in 31 cases; hypertension was present in 20 cases, and diabetes in 6 cases. The surgical decompression segments were as follows:C<sub>3</sub>-C<sub>7</sub> in 31 cases, C<sub>3</sub>-C<sub>6</sub> in 11 cases, C<sub>4</sub>-C<sub>7</sub> in 14 cases, C<sub>4</sub>-C<sub>6</sub> in 2 cases, C<sub>3</sub>-C<sub>5</sub> in 1 case, and C<sub>5</sub>-C<sub>7</sub> in 1 case. During the procedure, the bone rongeur sliding positioning technique was consistently employed for laminotomy. Based on CT data, the distance between the apexes of both pedicles, the width of the bilateral slits at the decompression level postoperatively, the distances from the slitting points to the medial wall of the spinal canal, as well as the transverse diameter of the spinal cord and the interlaminar space at the decompression level were measured. Functional assessment was performed using the mJOA classification system.</p><p><strong>Results: </strong>CT measurements showed that the distance between bilateral pedicle peaks progressively increased from C<sub>3</sub> to C<sub>7</sub>. In the postoperative decompression segments of C<sub>3</sub>-C<sub>5</sub>, the width of bilateral slots was greater than the distance between bilateral pedicle peaks(<i>P</i><0.001), whereas in the postoperative decompression segments of C<sub>6</sub>-C<sub>7</sub>, the width of bilateral slots was smaller than the distance between bilateral pedicle peaks(<i>P</i><0.05). The distance from the slotted points on both sides to the medial wall of the spinal canal remains relatively constant, ranging from 4.13 to 5.53 mm. MRI measurements indicate that the transverse diameter of the spinal cord was fairly consistent at the C<sub>3</sub>-C<sub>5</sub> segments, whereas it showed a gradual decrease in the C<sub>6</sub>-C<sub>7</sub> segments. In all MRI measurements, the interlaminal distance at the deco","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"793-801"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Unilateral superior transverse process-extrapedicular approach vertebroplasty for osteoporotic lumbar fractures with small pedicles:a preliminary observation].","authors":"Bangguo Li, Shaochun Huang, Wei Ma, Ziyang Ding","doi":"10.12200/j.issn.1003-0034.20250798","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250798","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of unilateral transtransverse process superior border pedicle external approach vertebral body reconstruction for lumbar fractures associated with osteoporosis in small pedicles.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 13 patients with vertebral fractures accompanied by osteoporotic microarches who underwent unilateral transluminal pedicle approach vertebral body reconstruction between October 2021 and March 2024, including 5 males and 8 females, with an average age of (72.92±5.95) ranging from 65 to 85 years old. The cases included 9 L₁ fractures and 4 L₂ fractures, all with a history of low-energy trauma characterized by lower back pain exacerbated upon sitting up and radiating to both costal regions in 4 cases. The disease duration ranged from 1 to 5 days with a mean of (2.92±1.19) days. Preoperative visual analogue scale (VAS) ranged from 5 to 7 with a mean of (6.31±0.75). MRI findings indicated fresh fractures with bone mineral density T-values <-2.5;axial CT measurements revealed pedicle diameters at their narrowest point ranging from 4.2 to 4.7 mm with a mean of (4.42±0.17) mm, all <5 mm. Individualized puncture planning was performed preoperatively, including measurement of skin-puncture distance on CT cross-sections and head-side deviation distance on lateral X-rays for precise intraoperative positioning. Surgical parameters including operative time, number of fluoroscopic procedures, bone cement volume injected, cement dispersion, and complications were recorded. Efficacy was assessed using VAS and the Oswestry disability index (ODI) at preoperative, postoperative day 1, and postoperative 3-month follow-up.</p><p><strong>Results: </strong>All patients underwent the surgery successfully and received follow-up examinations ranging from 3 months to 1 year. The operative duration ranged from 35 to 46 with a mean of (40.15±3.34) minutes. The number of fluoroscopic procedures was 11 to 17 with a mean of (13.77±2.05). The bone cement volume injected ranged from 4 to 6 with a mean of (4.73±0.70) mL, achieving uniform bilateral distribution throughout the bone cement. One case exhibited asymptomatic intervertebral space cement leakage, with no complications such as nerve injury or hematoma observed. Both VAS and ODI at 1 day and 3 months postoperatively were significantly lower than preoperative levels (<i>P</i><0.05), with better outcomes at 3 months compared to 1 day (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>For osteoporotic lumbar fractures with narrow pedicles, unilateral percutaneous vertebral body formation via an extra-pedicular approach via the superior border of the transverse process is a technically feasible and highly effective treatment modality, offering advantages including shorter operative time, enhanced safety, reduced fluoroscopic requirements, and minimal invasiveness.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"786-92"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Multilevel interpretable modeling and analysis of changes in dual pain dimensions in knee osteoarthritis].","authors":"Jiaxu Han, Yehui Peng, Wei Yang, Mengjie Wu, Xinghua Xiang, Yaxin Tian, Dezhi Tang","doi":"10.12200/j.issn.1003-0034.20260298","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20260298","url":null,"abstract":"<p><strong>Objective: </strong>Based on real-world clinical data, aimed to systematically characterize the key factors, decision-making pathways, and structural relationships influencing pain, and to investigate the differences and associated structural effects of changes across two pain dimensions in patients with knee osteoarthritis(KOA).</p><p><strong>Methods: </strong>Using the visual analog scale (VAS) and Traditional Chinese Medicine(TCM) pain symptom score as bimodal pain dimensions, XGBoost models were constructed under a unified feature system. Multi-layer interpretability analysis was conducted through SHAP, rule extraction, and Bayesian networks to examine the observational data from 187 cases of KOA.</p><p><strong>Results: </strong>The model identified age, disease duration, body mass index (BMI), administration time and local joint symptoms as key factors influencing changes in the TCM pain symptom score, while baseline VAS and medication use were key factors for changes in the VAS. Decision path analysis revealed that the primary pathway for changes in TCM pain symptoms was \"age<69 years, BMI≥23.94 kg·m^-2, and joint swelling score<4, \" while the main pathway for VAS changes was \"baseline VAS≥6 and concurrent use of analgesics.\" Furthermore, the structural relationships between variables and the two pain dimensions were revealed. For example, under the condition of \"age <69 years, BMI≥23.94 kg·m^-2, and joint swelling score<4\", the conditional probability of a \"significant change\" in the TCM pain symptom score was higher than that in the VAS.</p><p><strong>Conclusion: </strong>Under a unified model framework, an analytical approach for examining differential changes in related indicators was explored. Through multi-layered interpretability analysis encompassing \"feature importance assessment-decision rule extraction-Bayesian network inference, \" it was found that the dual pain dimensions share common influencing factors in reflecting pain changes in knee osteoarthritis, yet also exhibit structural association differences. These findings provide a reference basis for identifying pain change characteristics and selecting pain assessment tools in KOA patients, and offer a replicable methodological paradigm for similar analyses.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"825-32"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Preliminary study on the learning curve of ultrasonic measurement of lumbar spinous process distance change rate].","authors":"Yantao Song, Xu Wei, Xu Wang, Chen Zhang, Guanghui Liu, Na An, Xiaoqi Zhao","doi":"10.12200/j.issn.1003-0034.20250956","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250956","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the learning curve associated with ultrasound measurement of the change rate of lumbar spinous process distance in patients with lumbar disc herniation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 90 patients with lumbar disc herniation who underwent ultrasound measurement of the change rate of lumbar spinous process distance from October 2018 to October 2020. Patients were sequentially numbered from 1 to 90 according to their visit order. All ultrasound measurements were performed by the same physician. Examination time was recorded for each patient. The cumulative sum analysis (CUSUM) method was used to plot the learning curve scatter diagram, which was then fitted with a polynomial function to calculate the inflection point (turning point) of the curve. Based on this turning point, patients were divided into a learning exploration group and a learning stability group. Intergroup comparisons of various indicators were performed to verify the existence of the learning curve.</p><p><strong>Results: </strong>(1)The best-fit simulation function for the learning curve was Y=8.75+1.86X-0.05X²+0.000 3X³(<i>R</i>²=0.951, <i>P</i><0.05), with the turning point identified at the 27th case. (2)There were no statistically significant differences between the learning exploration group and the learning stability group regarding age, sex, body mass index (BMI), disease duration, Oswestry disability index(ODI) scores, or the change rate of lumbar spinous process distance(<i>P</i>>0.05). However, the mean examination time was significantly longer in the learning exploration group(3.88±1.30) min compared to the learning stability group(2.21±0.32) min(<i>P</i><0.05).</p><p><strong>Conclusion: </strong>Ultrasound measurement of the change rate of lumbar spinous process distance exhibits a distinct learning curve. The turning point occurs at the 27th case. Once the stable phase is reached, the average examination time stabilizes at approximately (2.21±0.32) min.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"801-5"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evolution and prospect of treatment decision-making systems for spinal metastases:from traditional frameworks to the era of precision medicine].","authors":"Xuyong Cao, Yaosheng Liu","doi":"10.12200/j.issn.1003-0034.20250293","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250293","url":null,"abstract":"<p><p>The treatment of spinal metastases is highly dependent on multidisciplinary collaboration. This study systematically reviews the evolution of clinical decision-making systems for spinal metastases, from traditional frameworks to the era of precision medicine. The neurologic, oncologic, mechanical, systemic(NOMS) framework, introduced in 2006, focused on surgical and radiotherapeutic interventions;however, it had notable deficiencies in its neurologic assessment grading and, in terms of oncologic management, largely overlooked the role of systemic therapy in achieving local control of bony metastatic lesions. The LMNOP (location, mechanical, neurologic, oncologic, patient) framework, proposed in 2011, attempted to explore individualized surgical approaches, but its accuracy in determining optimal strategies remained suboptimal, and it still fell short in adequately incorporating systemic therapeutic factors. In 2017, the International Spinal Oncology Consortium introduced the MNOP(mechanical, neurologic, oncologic, patient) system, which placed greater emphasis on patient survival assessment. In 2018, the Dutch guidelines standardized surgical timing and radiotherapy strategies, and in the same year, the MOSS (medical/mental, oncological, stenosis, stability) framework achieved innovations in systematic evaluation, non-surgical interventions, and the integration of psychological status. In 2021, the Department of Orthopedics at the Chinese PLA General Hospital proposed the SENO framework for spinal metastases, which encompasses four major elements:systemic conditions, effectiveness of systemic treatment of tumors, neurology, and oncology. Built upon the foundation of the ESCC Twelve-Point Grading System developed by the Chinese PLA General Hospital, the SENO framework has successfully established a novel precision comprehensive treatment model characterized by \"minimally invasive intervention first, followed by systemic therapy\". Clinical practice has demonstrated that the SENO framework offers significant advantages in therapeutic outcomes compared with traditional decision-making approaches. The continuous evolution of clinical decision-making systems for spinal metastases profoundly reflects the broader transformation of oncology from experience-based medicine to evidence-based medicine. Looking ahead, with the deep integration of artificial intelligence and multi-omics technologies, decision-making systems for spinal metastases are poised to advance toward a comprehensive, intelligent \"prevention-intervention-rehabilitation\" continuum, bringing new promise for improving patient prognosis.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"836-42"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Preliminary construction and validation of an auxiliary diagnosis model for cervical instability based on multimodal deep learning].","authors":"Guangyi Yang, Changxiao Han, Minshan Feng, Haibao Wen, Jing Li, Bochen Peng, Liguo Zhu","doi":"10.12200/j.issn.1003-0034.20251185","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20251185","url":null,"abstract":"<p><strong>Objective: </strong>To preliminarily construct and validate a diagnostic model for Cervical Spine Instability (CSI) based on multimodal deep learning, and to develop an open-access, web-based prototype platform tailored for clinical scenarios.</p><p><strong>Methods: </strong>Clinical data from 122 subjects were included, integrating three-position X-ray images and nine structured clinical variables. The model architecture featured an imaging branch built on ResNeXt50 and a clinical branch based on a Fully Connected Neural Network(FCNN), with cross-modal fusion performed at the feature level(ResNeXt50-FCNN). Modality ablation studies were conducted using two control groups:\"Imaging-only\"(ResNeXt50) and \"Clinical-only\"(FCNN). Evaluation metrics included Area Under the Receiver Operating Characteristic Curve(AUC), Average Precision(AP), Accuracy, Precision, Recall, F1-score, and Specificity. Grad-CAM was employed for attention visualization of the imaging branch, while SHAP(SHapley Additive exPlanations) was used to interpretglobal and individual feature contributions of the clinical branch. Finally, the optimal model was deployed via the Streamlit framework to create an interactive, clinically usable platform.</p><p><strong>Results: </strong>The multimodal model achieved superior comprehensive performance on the validation set compared to the control groups, yielding an AUC of 0.964, AP of 0.973, Accuracy of 0.919, Precision of 0.875, F1-score of 0.933, and Specificity of 0.813. Ablation studies demonstrated that the fusion strategy significantly compensated for the insufficient sensitivity of the \"Imaging-only\" model and the low specificity of the \"Clinical-only\" model. Grad-CAM visualizations revealed that the model consistently focused on suspected abnormal structures across all three positions, effectively suppressing background interference. SHAP analysis identified age, limitation of flexion-extension, tenderness, gender, and headache as the primary contributing variables. The developed AI platform(https://cervical-instability-classifier.streamlit.app/) provides real-time outputs of diagnostic probabilities and visualizations of feature contributions.</p><p><strong>Conclusion: </strong>This study successfully constructed and preliminarily validated a CSI discrimination model based on multimodal deep learning, demonstrating promising diagnostic performance, interpretability, and potential for clinical application. However, given the limited sample size of this study, further external validation is required to confirm the model's generalizability and ultimate clinical utility.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"806-14"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on correction methods of rotational deformity in closed reduction and intramedullary nail internal fixation of femoral shaft fracture].","authors":"Junjin Zhang, Shixing Luo, Chun Lu, Yeqiang Chen, Huasheng Sun, Jinrong Zhu","doi":"10.12200/j.issn.1003-0034.20241241","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20241241","url":null,"abstract":"<p><p>Femoral shaft fracture (FSF) is a common fracture in orthopedic practice. Closed reduction and intramedullary nailing, due to their minimally invasive nature and ability to promote fracture healing, have become the mainstream treatment for FSF. However, accurately assessing and correcting rotational deformities during surgery remains a major challenge for this technique. This article reviews the research progress on the assessment and correction of rotational deformities in closed reduction and intramedullary nailing of FSF. Current assessment methods involve the wire-drawing method, femoral neck anteversion angle method, lesser trochanter-femoral shaft tangent method, cortical \"step-sign\" method, lesser trochanter morphology comparison method, greater trochanter inclination index quantification method, and computer-assisted navigation for reduction. These methods all have their own advantages and disadvantages, and the choice depends on fracture type, hospital resources, and surgical skill. Methods for correcting rotational deformities are mainly divided into two types:closed reduction under traction and percutaneous device-assisted reduction. Closed reduction under traction is easy to perform and suitable for patients with mild shortening deformities. However, it's less effective for patients with extensive shortening, and may cause iatrogenic fractures and nerve injuries. Percutaneous device-assisted reduction can effectively reduce surgical time, blood loss, and radiation exposure. However, it still has limitations when dealing with complex fractures. In recent years, the application of computer-assisted navigation for reduction has offered new possibilities for the precise correction of rotational deformities. However, it's operationally complex and demands high technical skills from surgeons. This article, through a review of existing methods, aims to provide clinicians with more references. It is expected to achieve more accurate rotational deformity correction in the treatment of FSF, thereby improving patients' prognosis.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"842-8"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Spontaneous resolution of an acute epidural hematoma after vertebroplasty:a case report].","authors":"Xinzhou Xie, Chaoliang Lyu, Cunxin Zhang","doi":"10.12200/j.issn.1003-0034.20250295","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250295","url":null,"abstract":"","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"833-5"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical effects of lumbar brace on bone mineral density and screw stability after lumbar spinal surgery].","authors":"Bolin Sun, Weicheng Chen, Xu Xiong, Yu Liu, Liuxue Du, Xuanyin Chen, Rongping Zhou, Shanhu Huang, Zhili Liu, Jiaming Liu","doi":"10.12200/j.issn.1003-0034.20250391","DOIUrl":"10.12200/j.issn.1003-0034.20250391","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To analyze the effect of wearing a lumbar corset after internal fixation surgery for lumbar degenerative diseases on patients' vertebral bone mineral density (BMD) and screw stability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 123 patients with lumbar degenerative diseases who underwent posterior lumbar decompression, bone grafting, fusion, and internal fixation from January 1, 2021 to December 31, 2023 were prospectively enrolled. Using a random number table method, patients were divided into two groups according to the postoperative lumbar corset wearing time:70 cases in the 1-month wearing group 70 cases, including 20 males and 50 females, aged (63.4±7.9) years;and 50 cases in the 3-month wearing group, including 18 males and 35 females, aged (64.3±7.5) years. To deeply analyze the impact of osteoporosis status on outcomes, all patients were further divided into an osteoporosis subgroup (54 cases) and a non-osteoporosis subgroup (69 cases) based on preoperative bone mineral density results following the initial randomization. All patients underwent plain lumbar CT scans preoperatively and at 1, 3, and 6 months postoperatively. Bone's FRAX V1.0 software was used to quantitatively measure vertebral bone mineral density and assess screw stability, aiming to compare the temporal changes under different wearing durations and different bone mineral density states. Preoperatively and at the final follow-up, the visual analogue scale (VAS) was used for pain scoring, and the Oswestry disability index (ODI) was used for dysfunction evaluation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All patients were followed up for 6 months. Regardless of whether they were osteoporotic or non-osteoporotic, the vertebral BMD of patients in the 1-month group was significantly higher than that of patients in the 3-month group at the 3rd and 6th months postoperatively (&lt;i&gt;P&lt;/i&gt;&lt;0.05);the BMD loss in the 3-month group was greater than that in the 1-month group at 3 and 6 months postoperatively (&lt;i&gt;P&lt;/i&gt;&lt;0.05). In addition, although the imaging-observed screw loosening rates were relatively high in both the 1-month and 3-month groups, no clinical symptoms occurred. Whether in osteoporotic or non-osteoporotic patients, there was no statistically significant difference in screw loosening rates between the 1-month and 3-month groups (&lt;i&gt;P&lt;/i&gt;&gt;0.05). At the final follow-up, the VAS for low back pain in the 1-month group decreased from (7.05±1.08) preoperatively to (2.90±1.02), while that in the 3-month group decreased from (7.19±0.91) preoperatively to (2.83±0.95), with no statistically significant difference between the two groups at the final follow-up (&lt;i&gt;P&lt;/i&gt;=0.699). At the final follow-up, the ODI in the 1-month group decreased from (39.69±15.12) preoperatively to (13.08±8.06), while that in the 3-month group decreased from (37.78±14.62) preoperatively to (12.79±8.02), with no statistically significant difference between the two groups at the final ","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"778-85"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Modified <i>Shaoyao Gancao</i> decoction()alleviates post-spinal cord injury muscle spasticity by regulating the lncRNA H19/miR-185-5p/Tph1 axis].","authors":"Yihang Qiao, Wenlong Ma, Yingjie Zhou, Yan Xie","doi":"10.12200/j.issn.1003-0034.20250453","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250453","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the biological mechanisms underlying the therapeutic effect of modified &lt;i&gt;Shaoyao Gancao&lt;/i&gt; decoction () in alleviating muscle spasms following spinal cord injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;①Extract and modify the active components from the original &lt;i&gt;Shaoyao Gancao&lt;/i&gt; decoction (), determined their concentrations using chromatography-mass spectrometry (HPLC-MS), and compared the differences between the two formulations.②Forty SD rats were randomly divided into four groups: normal control group, model group, treatment group, and positive control group, with 10 rats in each group. With the exception of the normal control group, all other rats were subjected to a spinal cord injury model via semi-transverse sectioning of the T&lt;sub&gt;9&lt;/sub&gt;-T&lt;sub&gt;10&lt;/sub&gt; segments. Three days post-surgery, the normal control group and the model group received oral administration of deionized water;the drug-treated group received oral administration of modified &lt;i&gt;Shaoyao Gancao&lt;/i&gt; decoction (), Shaoyao∶Gancao=3∶1, 3.3 g of crude drugs per kg body weight;the positive control group received oral administration of Standard Shaoyao Gancao Decoction(Shaoyao∶Gancao=1∶1, 3.3 g of crude drugs per kg body weight). The total treatment duration was 2 weeks.The drug efficacy was evaluated using the BBB scale(Basso, Beattie & Bresnahanlocomotor rating scale, BBB scale), and 5-hydroxytryptamine(5-HT) levels in spinal cord tissue were measured. The expression of long noncoding RNA H19 (lncRNA H19, hereinafter referred to as H19) and microRNA 185-5p (miR-185-5p) in spinal cord tissues was examined using polymerase chain reaction (RT-qPCR) in both the model group and the treatment group. Furthermore, a dual-fluorescein enzyme reporter assay was employed to verify that H19 regulates the expression of miR-185-5p and that miR-185-5p, in turn, regulates the expression of tryptophan hydroxylase 1 (Tph1).③In vitro culture of spinal cord nerve cells was conducted, where modified &lt;i&gt;Shaoyao Gancao&lt;/i&gt; decoction (), H19 inhibitor, and miR-185-5p inhibitor were administered to investigate the effects of these agents as well as H19 and miR-185-5p on Tph1 expression.④Twelve SD rats were randomly divided into four groups:the model group, the drug administration group, the H19 inhibitor group, and the positive control group, with three rats in each group. Rats in the H19 inhibitor group received intravenous injection of H19 inhibitor at a dose of 50 mg·kg&lt;sup&gt;-1&lt;/sup&gt; via the tail vein, while all other groups were treated as described in step ①. The expression levels of 5-HT were determined using enzyme-linked immunosorbent assay (ELISA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;①The overall ion current profile showed no significant differences;however, in the modified &lt;i&gt;Shaoyao Gancao&lt;/i&gt; decoction (), compounds related to Paeonia exhibited higher responses, while those related to Glycyrrhiza demonstrated reduced responses. ②At 2 weeks post-adminis","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"815-24"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}