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

{"title":"[Site-specific Hounsfield units predict lumbar cage subsidence using predict].","authors":"Sheng Xu, Yongjian Xu, Lirui Che","doi":"10.12200/j.issn.1003-0034.20250707","DOIUrl":"10.12200/j.issn.1003-0034.20250707","url":null,"abstract":"<p><strong>Objective: </strong>To investigate and validate the utility of site-specific Hounsfield unit(HU) measurements at the posterior endplate (Index-Post) for predicting cage subsidence after lumbar fusion, and to evaluate its performance when combined with the Vertebral Bone Quality (VBQ) score.</p><p><strong>Methods: </strong>A retrospective matched case-control study was conducted. Ninety patients who underwent single-level transforaminal lumbar interbody fusion (TLIF) were allocated into a subsidence group (<i>n</i>=30) and a non-subsidence group (<i>n</i>=60), matched for age, sex, and surgical level. Preoperative CT was used to measure site-specific HU values (Index-Post, Index-Mid, Index-Ant) and traditional sites (L₁ center, L₁-L₄ average). VBQ scores were calculated from preoperative MRI. Receiver operating characteristic(ROC) analysis, logistic regression, and decision curve analysis (DCA) were performed to assess predictive performance.</p><p><strong>Results: </strong>The incidence of cage subsidence was 33.3% (30/90). The Index-Post HU in the subsidence group (96.5±25.8) HU was significantly lower than that in the non-subsidence group (123.4±29.1) HU (<i>P</i><0.001, Cohen's d=0.98). ROC analysis showed that the Index-Post HU had an area under the curve (AUC) of 0.78 [95% <i>CI</i>(0.69, 0.87)], which was superior to the traditional L1 vertebral center HU (AUC=0.65;DeLong test, <i>P</i>=0.012). The optimal cutoff value was 112 HU, yielding a sensitivity of 70.0% and specificity of 68.3%. The composite model (HU+VBQ) achieved an AUC of 0.83. Multivariate logistic regression identified Index-Post HU (<i>OR</i>=0.965, <i>P</i>=0.006) and age (<i>OR</i>=1.045, <i>P</i>=0.015) as independent predictors. Decision curve analysis demonstrated a net benefit within the threshold probability range of 20% to 50%.</p><p><strong>Conclusion: </strong>Site-specific HU measurement at the posterior endplate is superior to traditional methods for predicting cage subsidence following TLIF. Combining this metric with the VBQ score further enhances predictive efficacy. However, standardized measurement protocols and multicenter validation are still required to confirm these findings and establish their clinical utility.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 5","pages":"493-502"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151513","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":"[Treatment of thoracolumbar burst fractures using a self-designed device for intracorporeal autografting combined with osteoinductive materials].","authors":"Zhidong Cui, Dapeng Zhang","doi":"10.12200/j.issn.1003-0034.20250146","DOIUrl":"10.12200/j.issn.1003-0034.20250146","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the clinical significance and efficacy of using a self-designed bone graft device for transpedicular intracorporeal autografting combined with osteoinductive materials in the treatment of thoracolumbar fractures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 40 patients diagnosed with single-level thoracolumbar burst fractures between May 2016 and March 2020. Patients were divided into two groups based on surgical technique:the conventional surgery group (&lt;i&gt;n&lt;/i&gt;=20) underwent open reduction and pedicle screw fixation alone, including 12 males and 8 females with an age of (41.71±8.25) years old;the self-designed device group (&lt;i&gt;n&lt;/i&gt;=20) received additional intracorporeal autografting combined with osteoinductive materials using the self-designed device, including 15 males and 5 females with an age of (40.09±7.59) years old. Preoperative and postoperative follow-up assessments included X-ray and CT scans to measure vertebral compression rate, kyphosis angle (Cobb angle), and correction loss. Clinical outcomes were evaluated using the visual analogue scale (VAS) and Oswestry disability index (ODI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All patients were followed up, and the duration ranged from 12 to 24 months with a mean of (15.51±4.98) months. Both groups began ambulation with brace protection at 2 to 3 weeks postoperatively, with no complications such as infection, implant failure, or neurological deterioration. Postoperative Cobb angles improved significantly in both groups(&lt;i&gt;P&lt;/i&gt;&lt;0.05). At the final follow-up, the Cobb angle in the self-designed device group was (4.1±2.9)°, significantly lower than that in the conventional surgery group (8.2±9.6)°, with a statistically significant difference (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The correction degree loss in the self-designed device group was (1.8±1.5)°, significantly lower than that in the conventional surgery group (7.6±8.4)°, with a statistically significant difference (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Vertebral height restoration was significantly improved in both groups postoperatively (&lt;i&gt;P&lt;/i&gt;&lt;0.05). At the final follow-up, the vertebral height reduction in the self-designed device group was (7.4±1.5)%, significantly lower than that in the conventional surgery group (12.8±6.0)%, with a statistically significant difference (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The loss of corrective height in the self-designed device group was (1.6±0.7)%, also significantly lower than that in the conventional surgery group (7.9±5.4)%, with a statistically significant difference (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Both groups showed significant reductions in VAS and ODI scores at final follow-up (&lt;i&gt;P&lt;/i&gt;&lt;0.05). CT scans in the self-designed device group confirmed complete incorporation of all grafts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The use of a self-designed intracorporeal bone graft device for transpedicular autografting combined with osteoinductive materials and pedicle screw fixation effectively restore","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 5","pages":"473-80"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151528","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":"[Finite element analysis of a combined manipulation technique involving pressing, traction-pressing, and oblique- pulling for lumbar disc herniation].","authors":"Andi Yan, Fanbing Li, Yu Lu, Jubao Li","doi":"10.12200/j.issn.1003-0034.20250130","DOIUrl":"10.12200/j.issn.1003-0034.20250130","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To establish a lumbar spine model using the three-dimensional finite element method, simulate the pressing manipulation and the traction-pressing-oblique-pulling complex manipulation through mechanical simulation, to analyze the mechanical effects of these two manipulations, and compare and discuss their biomechanical mechanisms and the differences in mechanical effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A typical lumbar disc herniation(LDH) patient was selected. Based on the patient's lumbar CT image data, a three-dimensional finite element model of the L&lt;sub&gt;4&lt;/sub&gt;-L&lt;sub&gt;5&lt;/sub&gt; segment was constructed, focusing on in-depth analysis of a single sample. The reliability of the model was verified through mesh convergence analysis and comparison with literature. The stress and strain distribution in various tissue units of the L&lt;sub&gt;4&lt;/sub&gt;-L&lt;sub&gt;5&lt;/sub&gt; segment, as well as the relative displacement distance between the intervertebral disc and the nerve roots, were observed during the application of the pressing manipulation and the traction-pressing-oblique-pulling manipulation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A three-dimensional finite element model of the L&lt;sub&gt;4&lt;/sub&gt;-L&lt;sub&gt;5&lt;/sub&gt; segment based on imaging data from a patient with lumbar disc herniation was successfully constructed, and mechanical simulation analysis of the two manipulations was conducted. After applying the pressing manipulation, the stress was maximum at the anterior part of the intervertebral disc and minimum at the herniated site;the strain was maximum at the herniated site and smaller anteriorly. The intervertebral disc exhibited overall forward strain, but backward strain also occurred at the anterior edge. The strain values were 0.097 for the annulus fibrosus and 0.153 for the nucleus pulposus. The intervertebral disc exhibited overall forward displacement:5.531 mm to the right on the X-axis, 3.707 mm forward for the herniated disc on the Y-axis, and 2.031 mm upward for the herniated disc on the Z-axis. The left nerve root moved forward by 2.453 mm, while the right nerve root moved backward by 0.760 mm. After applying the traction-pressing-oblique-pulling complex manipulation, similar to the pressing manipulation, the stress was maximum at the anterior part of the intervertebral disc and minimum at the herniated site. Regarding disc strain, the posterior part exhibited the maximum strain, with smaller strain anteriorly. The intervertebral disc exhibited overall rightward strain and partial forward strain, with values of 0.751 for the annulus fibrosus and 0.587 for the nucleus pulposus. The intervertebral disc exhibited overall forward and rightward displacement:8.594 mm to the right on the X-axis, 5.409 mm forward for the left side on the Y-axis, while the right side (healthy side) moved backward, and 2.735 mm upward for the herniated part on the Z-axis. The left nerve root moved forward by 2.932 mm, while the right nerve root moved backward","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 5","pages":"445-51"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151491","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":"[Hemostatic efficacy of tranexamic acid combined with absorbable fluid hemostat in single-level transforaminal lumbar interbody fusion during the perioperative period].","authors":"Huanxi Li, Zhimin Tian, Chunnuo He, Xingyu Shan, Hongda Wang, Jie Gao, Haoqiang Zhang","doi":"10.12200/j.issn.1003-0034.20250035","DOIUrl":"10.12200/j.issn.1003-0034.20250035","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the effect of intravenous tranexamic acid (TXA) combined with local application of gelatin sponge versus intravenous TXA combined with absorbable fluid hemostat(SurgifloTM) on perioperative blood loss in patients undergoing single-level transforaminal lumbar interbody fusion (TLIF).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on the clinical data of 64 patients undergoing single-segment TLIF between September 2023 and September 2024. The control group comprised 32 patients who received intravenous TXA infusion combined with local gelatin sponge hemostasis during the perioperative period, including 14 males and 18 females, aged 49 to 70 years with a mean of (60.47±5.93) years. The affected segments were as follows:L&lt;sub&gt;2,3&lt;/sub&gt; in 1 case, L&lt;sub&gt;3,4&lt;/sub&gt; in 6 cases, L&lt;sub&gt;4,5&lt;/sub&gt; in 13 cases, and L&lt;sub&gt;5&lt;/sub&gt;S&lt;sub&gt;1&lt;/sub&gt; in 12 cases. The observation group consisted of 32 patients receiving intravenous TXA infusion combined with local Surgiflo&lt;sup&gt;TM&lt;/sup&gt; hemostasis, including 15 males and 17 females, aged 49 to 69 years with a mean of (59.59±5.35) years. The affected segments were:L&lt;sub&gt;2,3&lt;/sub&gt; in 1 case, L&lt;sub&gt;3,4&lt;/sub&gt; in 7 cases, L&lt;sub&gt;4,5&lt;/sub&gt; in 12 cases, and L&lt;sub&gt;5&lt;/sub&gt;S&lt;sub&gt;1&lt;/sub&gt; in 12 cases. Compare and observe the preoperative and postoperative changes in hematocrit (HCT) and hemoglobin (HGB) levels between the two groups;the total blood volume, intraoperative blood loss, total postoperative drainage volume, perioperative total blood loss, extubation time, and operative duration were compared between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All patients were followed up, and the duration ranged from 2 to 3 months, with a mean of (2.10±0.57) months. The observation group showed significantly higher HCT levels at postoperative days 1 and 3, and higher HGB levels at postoperative day 3 compared to the control group (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). The intraoperative blood loss in the observation group was (230.16±22.98) mL, significantly lower than that in the control group (250.63±22.09) mL, with a statistically significant difference (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The observation group exhibited significantly lower perioperative total blood loss (907.29±270.13) mL and postoperative drainage volume (199.06±19.49) mL compared to the control group (1 166.73±269.13) mL and (211.19±20.75) mL, respectively, with statistically significant differences (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The extubation time (2.56±0.50) days and operative duration (161.25±14.87) minutes in the observation group were significantly shorter than those in the control group (3.03±0.65) days and (172.50±15.24) minutes, respectively, with a statistically significant difference (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Multiple linear regression analysis identified the use of Surgiflo&lt;sup&gt;TM&lt;/sup&gt; as the most significant predictor of reduced total perioperative blood loss (&lt;i&gt;β&lt;/i&gt;=-0.550, &lt;i&gt;P&lt;/i&gt;&lt;0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Compared with","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 5","pages":"466-72"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151563","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":"[Low-temperature plasma radiofrequency ablation of dorsal rami of spinal nerves combined with ozone injection for the treatment of lumbar facet joint disorder].","authors":"Guoxing Ding, Yiheng Zhang, Zhi Li, Weijie Cui, Zhan Wang, Jie Wen, Junxiao Su, Xiangli Luo, Hui Zhang","doi":"10.12200/j.issn.1003-0034.20250247","DOIUrl":"10.12200/j.issn.1003-0034.20250247","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical efficacy of low-temperature plasma radiofrequency ablation of the medial branch of the spinal dorsal ramus combined with ozone injection for the treatment of lumbar facet joint disorders.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 90 patients diagnosed with lumbar facet joint disorders between January 2024 and December 2024. Patients were divided into three groups based on the treatment received. The radiofrequency group comprised 30 cases underwent coblation radiofrequency ablation alone including 12 males and 18 females, with an age of (59.37±3.85) years and a disease duration of (14.37±1.25) months. The ozone group comprosed 30 cases received ozone injection alone including 11 males and 19 females, with an age of (59.89±3.96) years and a disease duration of (14.44±1.36) months. The combination group consisted of 30 cases received coblation radiofrequency ablation combined with ozone injection including 15 males and 15 females, with an age of (59.12±2.15) years and a disease duration of (14.23±3.25) months. Outcome measures included the numerical rating scale (NRS) for pain at preoperative and postoperative time points and the modified MacNab criteria at 12 months postoperatively.</p><p><strong>Results: </strong>All patients were successfully followed up for 12 months. The NRS scores in all three groups decreased significantly compared to preoperative levels (<i>P</i><0.05). Notably, the combination group exhibited significantly lower NRS scores at 1 day, 2 weeks, 1 month, 3 months, 6 months, and 12 months postoperatively compared to the radiofrequency and ozone groups(<i>P</i><0.05). At the 12-month follow-up, the excellent/good rate in the combination group was 86.67% (26/30), which was significantly higher than that in the radiofrequency group(70.0%, 21/30) and the ozone group(60.0%, 18/30) (<i>χ</i>²=5.277, <i>P</i><0.05). No complications such as hematoma, nerve injury, or infection occurred in any of the groups during the follow-up period.</p><p><strong>Conclusion: </strong>For lumbar facet joint disorders, coblation radiofrequency ablation combined with ozone injection demonstrates superior efficacy to monotherapy, providing more effective pain relief, higher excellent/good rates, and excellent safety.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 5","pages":"481-5"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151520","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 efficacy of low-dose bone cement with different distribution patterns in the treatment of osteoporotic vertebral compression fractures].","authors":"Yubo Ma, Fei Zhou, Yun Ma, Dacheng Liu","doi":"10.12200/j.issn.1003-0034.20250777","DOIUrl":"10.12200/j.issn.1003-0034.20250777","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the difference in clinical efficacy between different distribution patterns of low-dose bone cement in percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fractures (OVCFs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 80 patients with OVCFs treated between March 2022 and March 2024. Based on postoperative imaging evaluation of bone cement distribution, patients were divided into a fused pattern group (fused group, &lt;i&gt;n&lt;/i&gt;=40) and a separated pattern group (separated group, &lt;i&gt;n&lt;/i&gt;=40). All cases received a single-level injection of 2 to 3 mL of bone cement. The fused group included 14 males and 26 females, aged 60 to 88 years with a mean of (75.4±4.8) years, with a cement volume of 2.0 to 3.0 mL (2.65±0.18) mL. The separated group included 15 males and 25 females, aged 60 to 86 years with a mean fo (75.3±4.8) years, with a cement volume of 2.0 to 3.0 mL (2.63±0.20) mL. Operative time, number of fluoroscopic exposures, and blood loss were recorded. The anterior height ratio and anterior-posterior height ratio of the injured vertebra, as well as the sagittal Cobb angle, were measured preoperatively and at 3 months and 1 year postoperatively. Functional disability was assessed using the Oswestry disability index(ODI), and pain was evaluated using the visual analogue scale (VAS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All patients were followed up for at least one year. There were no significant differences between the two groups regarding operative time, fluoroscopic exposures, or blood loss(&lt;i&gt;P&lt;/i&gt;&gt;0.05). Preoperative anterior height ratio, anterior-posterior height ratio, and Cobb angle were comparable between the groups (&lt;i&gt;P&lt;/i&gt;&gt;0.05). At 3 months and 1 year postoperatively, both groups showed significantly increased height ratios and decreased Cobb angles compared to preoperative values (&lt;i&gt;P&lt;/i&gt;&lt;0.05). However, at these time points, the separated group exhibited significantly higher anterior and anterior-posterior height ratios and a smaller Cobb angle compared to the fused group (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Both groups showed significant improvements in VAS and ODI scores at 3 months and 1 year compared to preoperative levels (&lt;i&gt;P&lt;/i&gt;&lt;0.001). Notably, the separated group demonstrated significantly lower VAS and ODI scores than the fused group at both 3 months and 1 year (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Furthermore, the incidence of adjacent vertebral fractures was significantly higher in the fused group than in the separated group (&lt;i&gt;P&lt;/i&gt;&lt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In OVCF patients treated with low-dose (2 to 3 mL) PVP, a separated bone cement distribution pattern yields superior clinical outcomes. It provides better restoration and maintenance of vertebral height and alignment, more effective pain relief, improved functional recovery, and a lower risk of adjacent vertebral fractures compared to a fused pattern. This technique holds significant","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 5","pages":"503-9"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151433","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":"[Mechanism of traditional Chinese medicine manipulation in the treatment of lumbar disc herniation:a new perspective of mechanics and biochemistry].","authors":"Hualong Xie, He Yin, Ning Liu, Guojun Wang, Kai Sun, Xu Wang, Ming Huo, Liguo Zhu, Xu Wei","doi":"10.12200/j.issn.1003-0034.20251045","DOIUrl":"10.12200/j.issn.1003-0034.20251045","url":null,"abstract":"<p><p>Lumbar disc herniation (LDH) is a prevalent spinal disorder. As a non-pharmacological therapy in traditional Chinese medicine (TCM), manipulation is widely employed in the conservative management of LDH and has garnered considerable attention due to its notable clinical efficacy. This paper aims to review the mechanism of TCM manipulation in the treatment of LDH, and analyze the existing evidence from the multi-dimensional integration of \"biomechanical stimulation, cell signal transduction, system physiological response\". At the biomechanical level, TCM manipulation can adjust the spinal force line, improve the relative position relationship between nerve roots and protrusions, and relieve mechanical compression by applying precise tensile, rotational and shear forces. At the level of cell signal transduction, mechanical stimulation is sensed by mechanoreceptors such as integrins and Piezo1/2 channels on the membrane of nucleus pulposus and annulus fibrosus, and starts Ca²⁺ influx and intracellular cascade reaction. By regulating Hippo/Yes-associated protein, etracellular signal-regulated kinase1/2 and other key pathways, mechanical signals are transformed into chemical signals, thereby inhibiting cell apoptosis, promoting extracellular matrix synthesis, and regulating inflammatory response. At the level of system physiological response, TCM manipulation intervention can regulate the nerve immune two-way network and alleviate chemical nerve root inflammation;At the same time, by reducing peripheral noxious input, it can reverse the structural and functional remodeling of the central nervous system in patients with LDH, thus breaking the vicious circle of \"pain-dysfunction\". In conclusion, TCM manipulation exerts therapeutic effects through a multi-level integrated mechanism involving mechanical decompression, regulation of cellular signal transduction, modulation of neuroimmune inflammation, and central functional remodeling. This paper also points out the existing problems and challenges in this research field, and provides suggestions for future research directions. This review provides a richer scientific basis for the clinical application of TCM manipulation and promotes its popularization and application.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 5","pages":"459-65"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151522","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":"[Effects of tendon-regulating and bone-setting manipulation on clinical outcomes and lumbopelvic sagittal parameters in patients with lumbar disc herniation after transforaminal lumbar interbody fusion].","authors":"Qi Zhang, Qing Liu, Nengfeng Guo, Xiaolong Zhao, Yu Jiang, Xiaoyun Hu, Zhaohui Chen","doi":"10.12200/j.issn.1003-0034.20251101","DOIUrl":"10.12200/j.issn.1003-0034.20251101","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the effects of tendon-regulating and bone-setting manipulation on clinical outcomes and lumbopelvic sagittal alignment in patients with lumbar disc herniation (LDH) after undergoing transforaminal lumbar interbody fusion (TLIF).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From May 2024 to May 2025, 60 patients with lumbar disc herniation (LDH) who underwent transforaminal lumbar interbody fusion (TLIF) were randomly assigned to either the treatment group or the control group, with 30 cases in each group. One patient was lost to follow-up in the treatment group and one patient was lost to follow-up and one patients was excluded from the control group. The treatment group comprised 29 cases, including 12 males and 17 females, with an age of (61.1±7.2) years, and received conventional rehabilitation therapy;the control group consisted of 28 cases, including 10 males and 18 females, with an age of (57.8±10.1) years, and received conventional rehabilitation therapy supplemented with tendon-releasing and bone-setting manual techniques. Before surgery and at 1, 3, and 6 months postoperatively, pain was assessed using the visual analogue scale(VAS), while function was evaluated with the Oswestry disability index(ODI) and the Japanese Orthopaedic Association (JOA) scoring system. Sagittal plane parameters such as pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL) were measured preoperatively and at 6 months postoperatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All patients were followed up, and the duration ranged from 6.0 to 7.0 months, with a mean of (6.2±0.3) months. In both groups, the VAS at 1, 3, and 6 months postoperatively were significantly lower than those before surgery, with statistically significant differences (&lt;i&gt;P&lt;/i&gt;&lt;0.05). No significant intergroup difference in VAS was found preoperatively or at 1 month postoperatively (&lt;i&gt;P&lt;/i&gt;&gt;0.05). However, the treatment group showed significantly lower VAS than the control group at 3 and 6 months postoperatively (&lt;i&gt;P&lt;/i&gt;&lt;0.05). ODI scores significantly improved at all postoperative time points in both groups (&lt;i&gt;P&lt;/i&gt;&lt;0.05). While no significant intergroup difference in ODI was observed preoperatively or at 1 month, the treatment group had significantly lower ODI scores at 3 and 6 months (&lt;i&gt;P&lt;/i&gt;&lt;0.05). JOA scores increased significantly at all postoperative time points in both groups (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The treatment group demonstrated significantly higher JOA scores than the control group at 3 and 6 months postoperatively (&lt;i&gt;P&lt;/i&gt;&lt;0.05). At 6 months, the JOA improvement rate was significantly higher in the treatment group (83.95±10.62)% compared to the control group (64.55±14.31)%(&lt;i&gt;t&lt;/i&gt;=5.795, &lt;i&gt;P&lt;/i&gt;&lt;0.001). Regarding sagittal alignment at 6 months, the treatment group showed significantly greater improvement in PT, SS, LL, and PI-LL match compared to the control group (all &lt;i&gt;P&lt;/i&gt;&lt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The a","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 5","pages":"437-44"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151539","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":"[Study on the influencing factors of vitamin D level in female patients with knee osteoarthritis].","authors":"Xuezong Wang, Hengzhi Wang, Daofang Ding, Yuxin Zheng, Yuelong Cao","doi":"10.12200/j.issn.1003-0034.20240861","DOIUrl":"10.12200/j.issn.1003-0034.20240861","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the characteristics of vitamin D (Vit D) and identify factors influencing Vit D deficiency in patients with knee osteoarthritis (KOA).</p><p><strong>Methods: </strong>Patients diagnosed with KOA between January 2018 and December 2023 were enrolled as study subjects. A total of 260 KOA patients with available Vit D test records were included, consisting of 214 females and 46 males, with a mean age of (71.95±8.35) years and a median disease duration of 5 (4.00, 9.00) years. Differences in the severity of Vit D deficiency between the general population and KOA patients, as well as changes in Vit D levels at different stages of KOA progression, were compared. Multivariate Logistic regression and nested analysis were used to investigate the influencing factors of Vit D in female patients with KOA.</p><p><strong>Results: </strong>A total of 260 KOA patients were included. The median Vit D level was 17.31 (12.45, 25.91) ng·mL-1. The numbers of patients with normal, insufficient, and deficient Vit D were 35, 74, and 151, respectively. Multivariate Logistic regression analysis showed that Vit D levels in KOA patients were influenced by female sex (<i>OR</i>=3.909, 95% <i>CI</i>(0.490, 2.236), <i>P</i>=0.002), imaging grading(<i>OR</i>=17.486, 95%<i>CI</i>(0.220, 5.503), <i>P</i>=0.034), and osteoporosis (<i>OR</i>=0.134, 95% <i>CI</i>(3.381, -0.635), <i>P</i>=0.004). Nested analysis demonstrated that osteoporosis with Vit D supplementation reduced the risk of Vit D deficiency (<i>OR</i>=0.094, <i>P</i>=0.014), while a history of fracture increased the risk of Vit D deficiency (<i>OR</i>=5.750, <i>P</i>=0.015).</p><p><strong>Conclusion: </strong>Female patients with KOA are susceptible to Vit D deficiency, with Vit D levels influenced by imaging grading, osteoporosis status, and fracture history. Regular monitoring and supplementation of Vit D in female KOA patients may delay the progression of the disease.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 4","pages":"343-8"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843599","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":"[Advances and development trends in non-surgical treatment of knee osteoarthritis].","authors":"Rui He","doi":"10.12200/j.issn.1003-0034.20260382","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20260382","url":null,"abstract":"","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 4","pages":"325-8"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843579","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}