BMC Musculoskeletal Disorders最新文献

{"title":"An additional rehabilitation program to improve postoperative outcomes in patients with rotator cuff tear and scapular dyskinesis: a propensity score-matched study.","authors":"Jian-Ning Sun, Qun-Ya Zheng, Rui-Song Wang, Yun-Ru Ma, Peng Chen","doi":"10.1186/s12891-025-08596-x","DOIUrl":"https://doi.org/10.1186/s12891-025-08596-x","url":null,"abstract":"<p><strong>Background: </strong>General scapular exercises have been included in traditional postoperative rehabilitation for rotator cuff tears, but patients with concomitant scapular dyskinesia do not have identical scapular muscle imbalances, and general scapular exercises make it difficult to improve scapular movement. We hypothesized that identifying weak scapular muscle groups and strengthening training would improve scapular movement.</p><p><strong>Methods: </strong>A total of 60 rotator cuff tear patients with scapular dyskinesia were included in the study, 20 in the experimental group and 40 in the control group. Patients in the control group received traditional rehabilitation following rotator cuff repair, while patients in the experimental group performed additional selective scapular muscle rehabilitation exercises. Constant-Murley Score (CMS), shoulder mobility, VAS scores, SF-12 scores, and scapular motion were assessed in both groups at 16 weeks postoperatively.</p><p><strong>Results: </strong>At 16-week follow-up, the experimental group showed better CMS (87.2 ± 4.4 vs. 83.9 ± 4.8) and shoulder anteflexion (137 ± 13.0 vs. 127.9 ± 12.2°) and abduction mobility (133.1 ± 15.4 vs. 121.4 ± 13.8°) compared to the control group. The experimental group had better improvements in scapular upward rotation (42.8 ± 11.7 vs. 35.3 ± 9.6°) and anterior tilt (12.9 ± 4.2 vs. 6.4 ± 2.0°) during shoulder anteflexion versus the control group. During shoulder abduction, the experimental group had better improvements in scapular anterior tilt (12.8 ± 3.3 vs. 9.1 ± 3.0°) versus the control group.</p><p><strong>Conclusions: </strong>This study provides an additional exercise program targeting the scapular muscle groups for postoperative rehabilitation in rotator cuff tear patients with scapular dyskinesis. By identifying imbalanced muscles through electromyographic testing, and performing selective muscle strengthening exercises, better shoulder mobility and scapular motion performance can be achieved.</p><p><strong>Trial registration: </strong>(Chinese Clinical Trial Registry ( https://www.chictr.org.cn ), ChiCTR2400087465, July 29, 2024, prospectively registered.).</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"338"},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of Modic-III change on the osseointegration in cervical disc prosthesis: an experimental study in caprine models.","authors":"Lin Chen, Zhigang Xiu, Xu Hu, Yi Yang, Hao Liu","doi":"10.1186/s12891-025-08567-2","DOIUrl":"https://doi.org/10.1186/s12891-025-08567-2","url":null,"abstract":"<p><strong>Objective: </strong>To quantitatively investigate the effects of Modic-III changes on the porous bone ingrowth at the interface of cervical disc prosthesis using caprine models.</p><p><strong>Methods: </strong>The Modic-III changes were induced at C3-4 level in eight goats by discectomy, followed by the implantation of cervical disc prostheses, while another eight goats served as a control group. Computed tomography (CT) and X-rays of cervical spine were performed intraoperatively and postoperatively at verify implant placement. The vertebral specimens were examined by micro-CT for histomorphometric quantification, including bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th). Methylene-blue/acid fuchsin staining, standard hematoxylin and eosin staining, and Masson staining were used for histologic evaluation. Immunohistochemical staining, including osteocalcin (OCN), alkaline phosphate (ALP), and runt-related transcription factor 2 (RUNX2), were also conducted.</p><p><strong>Results: </strong>All goats were followed for a period of 6 months after prosthesis implantation. The rate of prosthesis complications in experimental group was significantly higher than that in control group (37.5% vs. 12.5%, P = 0.046). The histomorphometric parameters of experimental group, including BV/TV, Tb.N, Tb.Th, and bone ingrowth percentage were significantly lower than those of control group. The histologic sections of control group showed the excellent bone ingrowth and close contact between bone and prosthesis interface. By contrast, in experimental group, plenty of interfacial gaps were filled up with abundant fibrous tissue. The immunohistochemical sections of control group demonstrated the bone trabecula was surrounded by numerous osteoblasts, compared with the clear and smooth bone trabecula margin surrounded by few osteoblasts in experimental group. Moreover, the experimental group had significantly lower integrated optical density values of OCN, ALP, and RUNX2 staining.</p><p><strong>Conclusion: </strong>The Modic-III changes significantly impaired the osseointegration of artificial cervical disc in caprine models by reducing the number of osteoblasts, BV/TV, Tb.N, Tb.Th, bone ingrowth percentage and down-regulating the expression levels of ALP, Osteocalcin, and Runx-2, possibly leading to more occurrence of prosthesis complications.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"335"},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical structure of the medullary cavity of proximal femur with three-dimensional computed tomography.","authors":"Tianhao Shi, Xiaoyang Jia, Kun Zhang, Gengxin Jia, Zhenqi Yang, Minfei Qiang, Yanxi Chen","doi":"10.1186/s12891-025-08588-x","DOIUrl":"https://doi.org/10.1186/s12891-025-08588-x","url":null,"abstract":"<p><strong>Background: </strong>The lateral femoral wall is an important anatomical parameter of the proximal femur, but intramedullary nail fixation for intertrochanteric fractures may cause iatrogenic lateral wall fractures due to population-based design differences. This study aims to measure the anatomical parameters of the proximal femoral medullary cavity and provide data to help design intramedullary nails tailored to the Chinese population to reduce the risk of complications such as lateral wall fractures.</p><p><strong>Methods: </strong>Consecutive patients undergoing full-length or upper half CT scans of the femur were included from January 2010 to December 2021. The anatomical parameters of medullary cavity were defined and measured, including prominence length, canal-shaft angle and proximal minimum diameter. Intraclass Correlation Coefficient (ICC) was used to estimate the inter- and intra-observer agreements.</p><p><strong>Results: </strong>A total of 168 patients, comprising 78 men and 90 women, were included. The mean prominence length was 67.4 ± 4.9 mm (males: 70.8 ± 3.6 mm, females: 64.4 ± 3.9 mm). The mean canal-shaft angle was 5.5° ± 0.7° (males: 5.6 ± 0.8°, females: 5.5 ± 0.7°). The mean proximal minimum diameter was 22.7 ± 1.8 mm (males: 24.0 ± 1.5 mm, females: 21.6 ± 1.4 mm) at the level of 1/3 prominence length from bottom to top. Gender differences were observed in these parameters (p < 0.001) except for the canal-shaft angle (p = 0.45). The mean proximal minimum diameter was significantly larger in the group aged 50 years and older (23.1 ± 1.7 mm) compared to the group younger than 50 years (22.4 ± 1.9 mm) (p = 0.02). Inter- and intra-observer agreement was almost perfect for all the parameters (all ICC values > 0.8).</p><p><strong>Conclusions: </strong>Males have a longer prominence length and larger proximal minimum diameter than females. The proximal minimum diameter is larger in the older population than in the younger population. The measurement results help support the design of intramedullary nails tailored to the Chinese population.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"337"},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological examination for cervical radiculopathy: a scoping review.","authors":"Marzia Stella Yousif, Giuseppe Occhipinti, Filippo Bianchini, Daniel Feller, Annina B Schmid, Firas Mourad","doi":"10.1186/s12891-025-08560-9","DOIUrl":"https://doi.org/10.1186/s12891-025-08560-9","url":null,"abstract":"<p><strong>Background: </strong>To diagnose cervical radiculopathy according to the International Association for the Study of Pain definition, signs of neurological deficits must be examined with the neurological examination. However, the diagnostic accuracy of the standard neurological examination remains unclear, and no clear recommendations exist about standard components. Therefore, the objectives of this review are to map the research about the diagnostic accuracy, components, and performance of the neurological examination for cervical radiculopathy.</p><p><strong>Method: </strong>PubMed, Embase, Scopus, Cinhal, DiTA databases were searched up to February 23rd, 2024. Additional studies were identified through screening reference lists of the included studies. Studies on neurological examination procedures and their diagnostic accuracy for cervical radiculopathy were included.</p><p><strong>Results: </strong>From an initial 12,365 records, 6 articles met the inclusion criteria. All articles were cross-sectional studies and compared the neurological examination with electrodiagnostic tests or magnetic resonance imaging. Reduced tendon reflexes were found to be most specific (81% (95% CI 69-89%) to 99% (95% CI not reported)), while somatosensation testing was least sensitive (25% (95% CI 12-38%; -LR 0.84) to 52% (95% CI 30-74%)). Taking all components into account resulted in higher specificity (98% (95% CI not reported) to 99% (95% CI 95-100%)) but lower sensitivity (7% (95% CI not reported) to 14% (95% CI 5-16%)) compared to electrodiagnostic tests.</p><p><strong>Conclusions: </strong>We found varying operational definitions of radiculopathy, suboptimal reference standards, and great heterogeneity in the neurological examination procedure and its diagnostic accuracy. Future research should address these issues to establish the clinical utility of the neurological examination for cervical radiculopathy.</p><p><strong>Protocol: </strong>https://doi.org/10.1101/2023.05.22.23290194 .</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"334"},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and validation of a prognostic nomogram for periprosthetic femoral fracture after total hip replacement surgery.","authors":"Jie Tang, Ying Hu, Ye Li, Shenghao Zhao, Yong Hu","doi":"10.1186/s12891-025-08575-2","DOIUrl":"https://doi.org/10.1186/s12891-025-08575-2","url":null,"abstract":"<p><strong>Background: </strong>In recent years, with the gaining popularity and wide application of total hip arthroplasty (THA), the incidence rate of periprosthetic femoral fractures (PFF) has increased. The treatment of PFF is difficult and has many related complications. Herein, we aimed to construct a nomogram model to predict occurrence of PFF after THA, in order to identify high-risk populations.</p><p><strong>Methods: </strong>In this retrospective analysis, we selected 2,528 patients who underwent THA at Wuhan Fourth Hospital from January 2014 to August 2022. Patients were randomly divided into a training cohort (n = 1,770) and an internal validation cohort (n = 758) in a 7:3 ratio. Least Absolute Shrinkage and Selection Operator (LASSO) algorithm and logistic regression analysis were used to perform feature analysis and convert them into a nomogram model. The model was externally validated in 1,383 THA patients at Renmin Hospital of Wuhan University.</p><p><strong>Results: </strong>Six independent risk factors for predicting PFF were identified, namely age, female sex, hip revision, non-cemented prosthesis, history of trauma, and osteoporosis. The nomogram demonstrated sufficient predictive accuracy, with area under the curve (AUC) values of 0.798 (95% confidence interval [CI]: 0.725-0.872), 0.877 (0.798-0.957), and 0.804 (0.710-0.897) in the training, internal validation, and external validation cohorts, respectively. The calibration curve showed good consistency between the predicted risk of the model and the actual risk.</p><p><strong>Conclusions: </strong>The nomogram model for postoperative PFF after THA established in this study has good predictive value and helps identify high-risk populations.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"336"},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and validation of hub m7G-related genes and infiltrating immune cells in osteoarthritis based on integrated computational and bioinformatics analysis.","authors":"Zhenhui Huo, Chongyi Fan, Kehan Li, Chenyue Xu, Yingzhen Niu, Fei Wang","doi":"10.1186/s12891-025-08539-6","DOIUrl":"10.1186/s12891-025-08539-6","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is a joint disease closely associated with synovial tissue inflammation, with the severity of synovitis impacting disease progression. m7G RNA methylation is critical in RNA processing, metabolism, and function, but its role in OA synovial tissue is not well understood. This study explores the relationship between m7G methylation and immune infiltration in OA.</p><p><strong>Methods: </strong>Data were obtained from the GEO database. Hub genes related to m7G were identified using differential expression and LASSO-Cox regression analysis, and a diagnostic model was developed. Functional enrichment, drug target prediction, and target gene-related miRNA prediction were performed for these genes. Immune cell infiltration was analyzed using the CIBERSORT algorithm, and unsupervised clustering analysis was conducted to examine immune infiltration patterns. RT-qPCR was used to validate hub gene expression.</p><p><strong>Results: </strong>Seven m7G hub genes (SNUPN, RNMT, NUDT1, LSM1, LARP1, CYFIP2, and CYFIP1) were identified and used to develop a nomogram for OA risk prediction. Functional enrichment indicated involvement in mRNA metabolism and RNA transport. Differences in macrophage and T-cell infiltration were observed between OA and normal groups. Two distinct m7G immune infiltration patterns were identified, with significant microenvironment differences between clusters. RT-qPCR confirmed differential hub gene expression.</p><p><strong>Conclusion: </strong>A diagnostic model based on seven m7G hub genes was developed, highlighting these genes as potential biomarkers and significant players in OA pathogenesis.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"333"},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787568","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":"FHL2 deteriorates IL-1β induced inflammation, apoptosis, and extracellular matrix degradation in chondrocyte-like ATDC5 cells by mTOR and NF-ĸB pathways.","authors":"Yicheng Li, Fei Wang, Baochao Ji, Abdusami Amati, Li Cao","doi":"10.1186/s12891-025-08536-9","DOIUrl":"10.1186/s12891-025-08536-9","url":null,"abstract":"<p><strong>Background: </strong>The role of nuclear translocation in osteoarthritis (OA) pathogenesis has garnered increasing attention in recent years. Extensive research has demonstrated that FHL2 acts as a nuclear transmitter through interactions with other nuclear transcription factors. We aimed to investigate the role of FHL2 in an osteoarthritis cell model.</p><p><strong>Methods: </strong>OA cartilage model was established by chondrocyte-like ATDC5 cells induced by 1% insulin-transferrin-selenium and then treated with interleukin-1β (IL-1β, 10 ng/mL). Lentivirus transfection was employed to suppress the expression of FHL2. Immunofluorescence and flow cytometry were used to examine nuclear transcription and apoptosis, respectively. Western blotting was performed to analyze the expression of metabolism-related proteins, autophagy-related proteins, apoptosis-related proteins, as well as proteins associated with the NF-ĸB and mTOR pathways.</p><p><strong>Results: </strong>The elevated expression of FHL2 occurred in both the cytoplasm and the nucleus. Knockdown of FHL2 could inhibit IL-1β-induced phosphorylation of NF-ĸB p65 and stabilize the extracellular matrix (ECM) by decreasing MMP-3 and MMP-13 expression, to suppress COL II degradation in chondrocyte-like ATDC5 cells. Meanwhile, the knockdown of FHL2-activated autophagy in IL-1β-treated chondrocytes through mTOR signaling, characterized by an increased LC3-II/LC3-I ratio and Beclin-1. FHL2 downregulation inhibited IL-1β-induced apoptosis by suppressing BAX and Caspase-3 expression, while enhancing BCL-2 protein levels. This mechanism may involve AKT phosphorylation and decreased expression of p-NF-ĸB p65.</p><p><strong>Conclusions: </strong>FHL2 knockdown activated autophagy while suppressing inflammation, apoptosis, and ECM degradation. The mechanism underlying these processes may involve the inhibition of the mTOR and NF-ĸB signaling pathways.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"331"},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787912","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":"Low frequency physiotherapy on joint health, hemarthrosis, walking, balance and reaction time in hemophilic arthropathy: a controlled trial.","authors":"Ayse Merve Tat, Necati Muhammed Tat, Serbay Sekeroz, Meryem Buke, Kamuran Karaman","doi":"10.1186/s12891-025-08549-4","DOIUrl":"10.1186/s12891-025-08549-4","url":null,"abstract":"<p><strong>Background: </strong>Physiotherapy is recommended for people with hemophilic arthropathy (PwHA) to improve musculoskeletal health and is typically administered in 2 or 3 sessions per week. We aimed to investigate the effects of once a week comprehensive physiotherapy and home exercise on musculoskeletal system of PwHA.</p><p><strong>Methods: </strong>In this study 19 young PwHA with knee and/or ankle were non-randomly divided into two groups: The Home Exercise Group (HEG) and the Comprehensive Physiotherapy Group (CPG). Joint health was evaluated with the Hemophilia Joint Health Score (HJHS), muscle strength (MS) with manual muscle tester, range of motion (ROM) with universal goniometer, pain with Numerical Pain Scale (NPS). The following functional tests were used: 6 min Walking Test (6MWT) for walking capacity, Functional Reach Test (FRT) for dynamic balance and Fitlight^® system for visuomotor reaction time (VMRT). The frequency of hemarthrosis (FoH) in the last 6 weeks was obtained from the self-recorded data. The CPG received comprehensive physiotherapy once a week, including manual therapy, neuromuscular electrical stimulation and supervised exercises, and they performed home exercises for the other two days of the week. The HEG only performed home exercises 3 days a week. All the treatments lasted 6 weeks and evaluations were repeated.</p><p><strong>Results: </strong>Compared with the HEG, the CPG significantly ameliorated for NPS, FoH, HJHS, VMRT (time and mean), 6MWT, all MS and several ROMs. CPG significantly improved in all outcomes except for 1 ROM. The HEG significantly improved in FoH, HJHS, VMRT (time), 6MWT and MS, but not in the ROMs.</p><p><strong>Conclusion: </strong>Comprehensive physiotherapy once a week and continuing home exercise significantly improve joint health, functionality and balance, and reduce pain and hemarthrosis in PwHA.</p><p><strong>Trial registration: </strong>The study was registered at Clinicaltrials.gov (Study ID NCT06331091, retrospectively registered).</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"332"},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787569","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":"Predictors for vertebral height deterioration in fractured vertebrae operated by percutaneous vertebroplasty.","authors":"Benqiang Tang, Xueming Chen, Libin Cui, Yanhui Wang, Xin Yuan, Yadong Liu, Liang Liu","doi":"10.1186/s12891-025-08574-3","DOIUrl":"10.1186/s12891-025-08574-3","url":null,"abstract":"<p><strong>Background: </strong>Vertebral height loss of fractured vertebrae treated by percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fracture (OVCFs) during follow-up had been reported. Mostly, vertebral height loss and its relevant terms (e.g., \"recompression\", \"recollapse\" and \"refracture\") were defined according to immediate postoperative vertebral height as the baseline in published studies. By contrast, vertebral height deterioration (VHD) was defined according to preoperative vertebral height as the baseline in the present study. The aim of the study was to reveal predictors for VHD in fractured vertebrae operated by percutaneous vertebroplasty (PVP), with a specific focus on surgical factors.</p><p><strong>Methods: </strong>All patients with OVCFs treated by PVP between April 2016 and September 2018 were retrospectively reviewed. Patients were followed up for at least 12 months after procedure according to treatment protocol. VHD was defined as the presence of a decrease of vertebral height at final follow-up compared to preoperative. Clinical, radiological and surgical factors that might affect occurrence of VHD were assessed using univariate and multivariate analyses.</p><p><strong>Results: </strong>A total of 543 patients (females 80%, age 73.2 ± 8.1 years) with 681 fractured vertebrae who underwent PVP were enrolled. Mean follow-up time was 28.9 ± 13.4 months (range, 12-59 months). Incidence of VHD in fractured vertebrae was 48.9% (333/681). One clinical factor and four radiological factors, including fracture age (OR = 0.513, 95% CI 0.385-0.683, p = 0.000), fracture location (OR = 2.878, 95% CI 1.994-4.152, p = 0.000), fracture severity (OR = 0.521, 95% CI 0.386-0.703, p = 0.000), cortical defect on lateral wall (OR = 2.535, 95% CI 1.351-4.758, p = 0.004) and intravertebral cleft (OR = 2.362, 95% CI 1.488-3.750, p = 0.000), were independent predictors for VHD. However, all the surgical factors evaluated were not significant in final model analysis.</p><p><strong>Conclusions: </strong>Surgical factors might play a negligible effect on VHD. VHD might be due to natural course of fracture/osteoporosis.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"327"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779145","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":"Higher incidence of delayed bone fusion for atlantoaxial fusion versus occipitocervical fusion with navigation system.","authors":"Masashi Uehara, Shota Ikegami, Hiroki Oba, Terue Hatakenaka, Daisuke Kurogochi, Takuma Fukuzawa, Shinji Sasao, Tetsuhiko Mimura, Jun Takahashi","doi":"10.1186/s12891-025-08582-3","DOIUrl":"10.1186/s12891-025-08582-3","url":null,"abstract":"<p><strong>Background: </strong>Due to the high stresses placed on the upper cervical spinal region, achieving firm fixation and solid bony fusion is essential for good surgical outcomes. However, few reports have addressed bony fusion in procedures involving this region. The present investigation evaluated bony union in fusion procedures for surgical treatment of the upper cervical spinal region and searched for factors associated with fusion failure.</p><p><strong>Methods: </strong>The medical data of 84 consecutive patients (38 male and 46 female; mean age: 68.7 years) who underwent upper cervical spinal fusion surgery were retrospectively examined. The surgical techniques used were occipitocervical (O-C) fusion in 45 patients and atlantoaxial fusion with trans-articular screws in 39 patients. To determine the incidence of bony union, the cohort was divided into O-C fusion and atlantoaxial fusion groups and examined for the presence of delayed bony union. Logistic regression models were employed to analyze the prevalence, characteristics, and risk factors of delayed bony union.</p><p><strong>Results: </strong>Overall, 20.2% of upper cervical spinal fusion surgery patients experienced delayed bony union. In comparisons of the O-C fusion and atlantoaxial fusion groups, we observed no remarkable differences for age, gender, or steroid use, although rheumatoid arthritis was significantly more common in the O-C fusion group (p < 0.001). Bony fusion rates tended to be higher in the O-C fusion group (86.6%) than in the atlantoaxial fusion group (71.7%). Multivariate analysis identified atlantoaxial fusion to be more strongly associated with delayed bony union (odds ratio: 2.6).</p><p><strong>Conclusion: </strong>Approximately 20% of patients undergoing upper cervical spinal fusion surgery experienced delayed bony union. With an odds ratio of 2.6, atlantoaxial fusion was strongly related to this complication.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"328"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779144","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}