BMC Musculoskeletal Disorders最新文献

{"title":"Unilateral biportal endoscopic lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion for single-segment lumbar degenerative disease: a meta-analysis.","authors":"Yanxing He, Qianyue Cheng, Jiang She","doi":"10.1186/s12891-024-08046-0","DOIUrl":"10.1186/s12891-024-08046-0","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive spine surgery has seen rapid development in recent years. The purpose of this study was to evaluate the use of unilateral biportal endoscopic lumbar interbody fusion (ULIF) versus minimally invasive surgery transforaminal interbody fusion (MIS-TLIF) for the treatment of single-segment lumbar degenerative disease (LDD) through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>In collaboration with various search terms, a comprehensive examination of the scientific literature was carried out using PubMed, China National Knowledge Infrastructure (CNKI), Wanfang, and other databases. A total of 9 studies were included retrospective cohort studies.</p><p><strong>Results: </strong>We observed statistically significant differences in intraoperative blood loss, total hospital stay, postoperative hospital stays, and 1-month postoperative Oswestry Disability Index (ODI) scores between the ULIF and MIS-TLIF groups, with the ULIF group being more dominant. MIS-TLIF group was statistically more advantageous in terms of operative time. There were no statistically significant differences in postoperative visual analogue scale (VAS) scores, 3-month postoperative and final ODI scores, excellent and good rate, complications, disc heights, and lumbar lordosis angle between the two groups.</p><p><strong>Conclusions: </strong>Treatment of single-segment LDD with ULIF and MIS-TLIF is both safe and effective. ULIF has the advantage of less intraoperative blood loss, shorter total hospital stay, shorter postoperative hospital stay, and lower ODI scores at 1 month postoperatively compared to MIS-TLIF. There were no significant differences between ULIF and MIS-TLIF in the treatment of LDD in terms of postoperative VAS scores, 3-month postoperative and final ODI scores, satisfaction rates, fusion rates, complications, disc heights, and lumbar lordosis angle. MIS-TLIF has a shorter procedure time than ULIF.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"25 1","pages":"938"},"PeriodicalIF":2.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686063","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":"Assessing potential factors leading to perioperative peri-implant fracture in femoral pertrochanteric fracture osteosynthesis using the proximal femoral nail antirotation 2: A retrospective study.","authors":"Jiun-Jen Yang, Yung-Heng Hsu, Ying-Chao Chou, Ping-Jui Tsai, Chang-Heng Liu, Yi-Hsun Yu","doi":"10.1186/s12891-024-08085-7","DOIUrl":"10.1186/s12891-024-08085-7","url":null,"abstract":"<p><strong>Background: </strong>Perioperative peri-implant fractures (PPIFs) pose infrequent yet significant challenges in orthopedic surgery, particularly in the context of femoral pertrochanteric fractures (FPF) treated with proximal femoral nail antirotation 2 (PFNA-2) nails. PPIFs can lead to prolonged recovery and may necessitate re-osteosynthesis in severe cases. Despite the effectiveness of PFNA-2 in the management of FPFs, our understanding of PPIFs in this specific context remains limited. This study aimed to elucidate the factors contributing to PPIFs in patients with PFNA-2-treated FPF.</p><p><strong>Methods: </strong>In this retrospective analysis spanning from 2019 to 2022, patients with FPF treated with PFNA-2 nails were examined. Demographic data, fracture characteristics, and radiological parameters were collected, along with details of the PPIF management strategies and rehabilitation protocols. Radiological assessments included femoral morphology measurements and reduction and fixation quality evaluation. The area under the curve (AUC) was analyzed in this specific group.</p><p><strong>Results: </strong>Among 157 patients, 3.2% experienced acute PPIFs managed conservatively with successful union without secondary surgical intervention. Younger age and increased femoral isthmus diameter (DI) emerged as significant predictors of PPIFs in the univariate regression analyses (P = 0.01). The AUCs for age (65.5 years) and DI (1.4 cm) were 0.78 and 0.79, respectively, indicating moderate accuracy.</p><p><strong>Conclusions: </strong>Although PFNA-2 nails are reliable in managing FPFs, the persistence of PPIFs emphasizes their complex causes. This study highlights that younger age and increased femoral DI are crucial factors for PPIF occurrence in patients with PFNA-2-treated FPF. Conservative treatment with delayed weight-bearing ambulation may be effective in treating these fractures.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"25 1","pages":"943"},"PeriodicalIF":2.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686054","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":"Association of obstructive sleep apnea with bone metabolism in older adults: a hospital-based study.","authors":"Lihua Deng, Rong Jia, Guangyao Yang, Qian Xue, Yanan Wei, Juan Jiang, Menghan Li, Jie Liu, Jingtong Wang","doi":"10.1186/s12891-024-08070-0","DOIUrl":"10.1186/s12891-024-08070-0","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) significantly affects patients' quality of life; however, the mechanisms, such as its effects on bone mineral density (BMD) and bone turnover marker (BTM) expression, remain unclear. In this study, we investigated the relationships among OSA, BMD, and (BTMs) in older adults.</p><p><strong>Methods: </strong>This retrospective study enrolled 260 participants (114 women; 44.5%). Data of an established system (Alice NightOne) were used to diagnose OSA and analyze nocturnal hypoxia. Participants were divided into four groups according to respiratory event index (REI) (control, < 5 times/hour; mild OSA, 5-15 times/hour; moderate OSA 15-30 times/hour; severe OSA ≥ 30 times/hour). BMD were mesured by dual-energy x-ray absorptiometry. BTMs including bone specific alkaline phosphatase (BALP), tartrate-resistant acid phosphatase 5b (TRAP-5b) were collected.</p><p><strong>Results: </strong>Patients with OSA had higher BMD at first lumbar vertebra, left and right femur than those without (all p < 0.05). REI was positively correlated with BMD at the first lumbar vertebra (r = 0.181, p = 0.006), left femur (r = 0.160, p = 0.014), and right femur (r = 0.243, p < 0.001). In participants with body mass index (BMI) of 18-24 kg/m² (N = 96), the correlation between REI and BMD at the left femur(r = 0.251, p = 0.019) and right femur (r = 0.258, p = 0.018) remained. Multiple regression analysis showed that OSA was significantly associated with osteoporosis (p = 0.034, 95% confidence interval, 0.092-0.100, odds ratio, 0.092). MSaO₂ was positively correlated with TRAP5b (r = 0.560, p = 0.007). In participants with a BMI of ≥ 24 kg/m²(N = 164), MSaO₂ was negatively correlated with BALP (r = -0.331, p = 0.034). No significant association between REI and BMD was observed.</p><p><strong>Conclusions: </strong>OSA and hypoxia were associated with higher BMD in older adults in BMI of 18-24 kg/m² but not in participants with a BMI of ≥ 24 kg/m². This study suggests a negative association between OSA and osteoporosis in non-overweight and obese population. BMI played an important role. The study's findings could help exploration mechanisms of osteoporosis and promoting its treatment.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"25 1","pages":"939"},"PeriodicalIF":2.2,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686055","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":"Axis screw parallel to the sagittal plane versus traditional pedicle screw in the treatment of atlantoaxial fixation: a finite element study.","authors":"Baifang Zeng, Meng Ding, Lang Li, Chao Wu, Bingwei Qin, Danwei Shen, Jiayan Deng, Xiangyu Wang","doi":"10.1186/s12891-024-08047-z","DOIUrl":"10.1186/s12891-024-08047-z","url":null,"abstract":"<p><strong>Background: </strong>This study aims to conduct a finite element analysis (FEA) to assess the bio-mechanical properties of C2 sagittal-parallel pedicle screw (PPS) in fixation for atlantoaxial instability, thereby providing a theoretical foundation for its clinical application.</p><p><strong>Methods: </strong>A total of 5 intact C1-2 finite element models were established. Based on this, instability models were developed and two different fixation methods were applied for each model: C1 lateral mass screw (LMS) combined with C2 sagittal-parallel pedicle screw (C1LMS + C2PPS), and C1 lateral mass screw combined with C2 traditional pedicle screw (C1LMS + C2PS). Under a physiological load of 40 N, a pure moment of 1.5 Nm was used to simulate movements of the cervical spine in flexion, extension, lateral bending, and axial rotation. The von Mises stress of implants and the segment range of motion (ROM) were analyzed and compared statistically.</p><p><strong>Results: </strong>The intact model was validated and showed good consistency with other studies in terms of range of motion (ROM). In flexion and extension, the C1LMS + C2PPS resulted in lower segment ROM (12.4% and 6.3% decrease) and stress concentration (15.9% decrease in flexion) compared to C1LMS + C2PS. However, in lateral bending and axial rotation, the C1LMS + C2PPS exhibited higher segment ROM (42.9% and 5.9% increase) and stress concentration (8.7% and 21.4% increase) compared to C1LMS + C2PS.</p><p><strong>Conclusion: </strong>Both methods were safe and stable for the fixation of atlantoaxial instability. Compared to C1LMS + C2PS, the use of C1LMS + C2PPS may provide better stability and a lower risk of implant failure in flexion and extension. Clinically, it is feasible to utilize the C2 sagittal-parallel pedicle screw in fixing atlantoaxial instability.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"25 1","pages":"931"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675198","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":"Definition of a measurement technique for hexapod circular smart fixators' perioperative assembly parameters and investigation of alignment and correlation with postoperative measurements: a retrospective cohort study.","authors":"Muharrem Kanar, Yusuf Sülek, Tolga Hayrettin Seymenoğlu, Raffi Armağan","doi":"10.1186/s12891-024-08056-y","DOIUrl":"10.1186/s12891-024-08056-y","url":null,"abstract":"<p><strong>Background: </strong>With the assistance of smart fixator technologies, the correction of complex deformities has been facilitated; however, the accurate integration of specialized radiographs and measurements into the system remains the greatest disadvantage, necessitating specialized imaging and an experienced team. When inexperienced technicians and doctors perform these specialized postoperative radiographs, excessive exposure of the patient and team to radioactive rays exacerbates inadequacies in measurements and delays the correction of residual deformities due to angular and translational adjustments. In this study, we compared postoperative measurements with those taken peroperatively via fluoroscopy, hypothesizing that it reduces the exposure of the patient and team to radioactive rays, allows for more accurate and timely correction of deformities and assembly parameters, and reduces time and costs.</p><p><strong>Methods: </strong>Between 2013 and 2022, 84 patients with bone deformities were retrospectively reviewed. All patients had bone deformities and were treated with computer-assisted circular external fixator systems (Ca-CEF). Assembly parameter measurements began to be corrected via artificial neural network software via peroperative fluoroscopy in 37 patients and postoperative radiography in 47 patients. The surgical duration for all patients, peroperative measurement values, and number of radiographs taken on postoperative day 1, week, and month until deformity correction were recorded.</p><p><strong>Results: </strong>The duration until deformity correction was shorter in patients who underwent postoperative measurements (mean 50.24 days) than in those who underwent peroperative measurements (mean 42.31 days), but this difference was not statistically significant (p = 0.102). The surgical duration was significantly shorter in patients with postoperative measurements (mean of 130.37 min) than in those with peroperative measurements (mean of 155.88 min) (p = 0.045). For patients with postoperative measurements, 56.04 postoperative radiographs were taken. In contrast, patients with peroperative measurements had fewer radiographs totaling 28.7. This difference was statistically significant (p < 0.01). There was no statistically significant difference in the fluoroscopy dose between patients with postoperative measurements (mean 18.54 mGy) and those with peroperative measurements (mean 22.22 mGy) (p = 0.105).</p><p><strong>Conclusion: </strong>To achieve accurate assembly parameters, minimizing X-ray exposure is crucial but can pose challenges. Our results showed that despite an average increase of 25 min in surgical duration, the time taken for deformity correction was shorter. Additionally, we obtained fewer postoperative radiographs, indicating reduced radiation exposure.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"25 1","pages":"933"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675202","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":"Cranial reconstruction utilizing polymeric implants in two different designs: finite element investigation.","authors":"Yomna H Shash","doi":"10.1186/s12891-024-08066-w","DOIUrl":"10.1186/s12891-024-08066-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Impact loads applied to the human head can result in skull fractures or other injuries that require a craniectomy. The removed portion is replaced with biological or synthetic materials using cranioplasty surgery. Titanium has been the material of choice for cranial implants due to its superior properties and biocompatibility; however, its issues have prompted the search for substitute materials (e.g., polymers). The issues are related to the requirement for surface modification, casting, radiologic incompatibility and potential allergy risks. Recently, polymeric materials have been used in many fields as alternatives to titanium.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This research aims to conduct a finite element study to evaluate the skull reconstruction process by using PEEK and carbon fiber reinforced PEEK 30 and 60% in the production of cranial implants as alternatives to conventional titanium implants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A three-dimensional model of a defective skull was rehabilitated with a custom-made cranial implant. The implants were stimulated using two designs (plate and mesh), and different polymeric materials (PEEK and carbon fiber reinforced PEEK 30 and 60%) as titanium substitutes, under 2000 N impact force.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The results illustrated that plate implants reduced the stresses on the skull and increased the stresses on brain tissues compared to mesh implants. Titanium, CFR-PEEK 30 & 60% implants (whether mesh or flat) were not prone to fracture, unlike mesh PEEK implants. In addition, CFR-PEEK 60% implants produced the lowest values of stress, strain, and total deformation on the skull and brain compared to titanium implants, unlike PEEK implants. By using the titanium plate implant, the peak tensile and compressive stresses on the skull were 24.99 and 25.88 MPa, respectively. These stresses decreased to 21.6 and 24.24 MPa when using CFR-PEEK 60%, increased to 26.07 and 28.99 MPa with CFR-PEEK 30%, and significantly increased to 41.68 and 87.61 MPa with PEEK. When the titanium mesh implant was used, the peak tensile and compressive stresses on the skull were 29.83 and 33.86 MPa. With CFR-PEEK 60%, these stresses decreased to 27.77 and 30.57 MPa, and with CFR-PEEK 30% and PEEK, the stresses increased to 34.04 and 38.43 MPa, and 44.65 and 125.67 MPa, respectively. For the brain, using the titanium plate implant resulted in peak tensile and compressive stresses of 14.9 and 16.6 Pa. These stresses decreased to 13.7 and 15.2 Pa with CFR-PEEK 60%, and increased to 16.3 and 18.1 Pa, and 73.5 and 80 Pa, with CFR-PEEK 30% and PEEK, respectively. With the titanium mesh implant, the peak tensile and compressive stresses were 12.3 and 13.5 Pa. Using CFR-PEEK 60%, these stresses decreased to 11.2 and 12.4 Pa on the brain, and increased with CFR-PEEK 30% and PEEK to 14.1 and 15.5 Pa, and 53.7 and 62 Pa, respectively. Additionally, the contact area between the PE","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"25 1","pages":"935"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between HDL-c levels and computed tomography-based osteosarcopenia in older adults.","authors":"Rongzhou Wang, Yu Wang, Zicheng Wei, Jiangchuan Wang, Hongye Tang, Xifa Gao, Jianhua Wang, Chao Zhang, Xiao Chen","doi":"10.1186/s12891-024-08059-9","DOIUrl":"10.1186/s12891-024-08059-9","url":null,"abstract":"<p><strong>Objective: </strong>Associations between serum lipid levels and osteoporosis and sarcopenia have been reported. However, few studies have reported a link between serum lipid levels and osteosarcopenia. In the present study, we investigated the association between serum high-density lipoprotein cholesterol (HDL-c) and osteosarcopenia.</p><p><strong>Methods: </strong>A total of 1995 participants aged 50 years and above who underwent chest CT physical examinations from 2016 to 2019 were included. Demographic information, including age, sex, and body mass index, and laboratory data, including liver and kidney function, blood lipids (HDL-c, low-density lipoprotein cholesterol (LDL-c), triglyceride (TG), total cholesterol (TC), blood glucose, and serum albumin, were collected from the medical records system. Osteosarcopenia was defined on the basis of the presence of low bone mass (bone CT values < 110 HU) and low muscle mass of bilateral erector spinae (< 25.0 cm² in men and < 20.0 cm² in women). The relationships between HDL-c (continuous data and categorical data) and osteosarcopenia were analyzed via multivariable logistic regression and restricted cubic spline analysis.</p><p><strong>Results: </strong>One hundred forty-one patients with osteosarcopenia (7.7%) were observed. The individuals with osteosarcopenia had significantly greater HDL-c levels than did those without osteosarcopenia (1.65 ± 0.30 vs. 1.49 ± 0.34 mmol/L, P < 0.001). Multivariate logistic regression revealed that HDL-c (odds ratio (OR) = 2.72, 95% confidence interval (CI): 1.30-5.69) was associated with osteosarcopenia. The third and fourth HDL-c quartiles were significantly related to a greater incidence of osteosarcopenia (OR = 3.36, 95% CI: 1.66-6.80; OR = 3.66, 95% CI: 1.67-8.01) than the first quartile was. Similar trends were observed in the male population. For female individuals, the fourth HDL-c quartile was significantly related to a greater incidence of osteosarcopenia than the first quartile was (OR = 2.73, 95% CI: 1.03-7.21). Restricted cubic splines revealed similar relationships between HDL-c and osteosarcopenia.</p><p><strong>Conclusion: </strong>High serum HDL-c levels were associated with the risk of osteosarcopenia in older adults.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"25 1","pages":"932"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675207","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":"Breast size, thoracic kyphosis, and thoracic spine pain: a correlational survey of Nigerian postpartum mothers.","authors":"Ojukwu Chidiebele Petronilla, Edeani Pamela Chinecherem, Ede Stephen Sunday","doi":"10.1186/s12891-024-07978-x","DOIUrl":"10.1186/s12891-024-07978-x","url":null,"abstract":"<p><strong>Background: </strong>Thoracic spine postural dysfunctions are common postpartum-related health problems, compromising breastfeeding efficacy and quality of life among women. Previous studies have particularly associated these conditions with increased breast sizes in several populations. However, such empirical evidence is scarce in the Nigerian population.</p><p><strong>Objectives: </strong>To investigate the relationship among breast size, thoracic-kyphosis, and -spine pain among postpartum Nigerian women.</p><p><strong>Methods: </strong>This correlational survey involved 400 consenting postpartum mothers (between 0 and 24 months of postpartum period). Their breast size, thoracic spine posture, and pain were measured using a measuring tape (cm), inclinometer, and Revised Oswestry thoracic spine pain disability questionnaire, respectively. Data were analyzed using descriptive and relevant inferential statistics at p < 0.05.</p><p><strong>Results: </strong>The majority of the participants fall under the category of breast cup size B (61.75%), have no history of thoracic spine pain (87.4%), and about half of them (50.2%) have normal thoracic spine posture (low category with values ranging between 20⁰ and 35⁰. Breast size was significantly (r = 0.162, p = 0.001) correlated with thoracic spine posture but showed no significant correlation (r = 0.066, p = 0.622) with thoracic spine pain.</p><p><strong>Conclusion: </strong>Increasing breast size is weakly associated with a tendency towards a kyphotic posture of the thoracic spine. Postural education and care around adequate support of the breast with suitable fitting brassieres may help prevent kyphotic deformities. Future research with a randomized control trial and long-term follow-up is recommended to further confirm the causal relationship of these variables.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"25 1","pages":"934"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675199","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":"Spinal navigation with AI-driven 3D-reconstruction of fluoroscopy images: an ex-vivo feasibility study.","authors":"Dietmar Luchmann, Sascha Jecklin, Nicola A Cavalcanti, Christoph J Laux, Aidana Massalimova, Hooman Esfandiari, Mazda Farshad, Philipp Fürnstahl","doi":"10.1186/s12891-024-08052-2","DOIUrl":"10.1186/s12891-024-08052-2","url":null,"abstract":"<p><strong>Background: </strong>With the increasing number of surgeries utilizing spinal instrumentation, three-dimensional surgical navigation aims to improve the accuracy of implant placement. However, its widespread clinical adaption has been hindered by factors such as high radiation exposure and interference with standard surgical workflows.</p><p><strong>Methods: </strong>X23D is a novel AI-based fluoroscopy reconstruction technique that generates a 3D anatomical model of the spine from only four fluoroscopy images. Based on this technology, we developed a prototype for the surgical navigation of pedicle screws placement of the lumbar spine, visualizing the 3D-reconstructed spine anatomy and the surgical drill position in real-time. An ex-vivo study was conducted to compare the accuracy of the X23D-based navigation approach with fluoroscopy-aided freehand instrumentation. Five board-certified surgeons placed pedicle screws on six human torsi within a realistic surgical environment. Breach rate, site and extent (Gertzbein-Robbins) were evaluated in postoperative CT scans, as well as execution time, radiation dose, and user experience. Specimens, operating side, and surgeon were randomised.</p><p><strong>Results: </strong>Forty-nine pedicle screws (n = 24 × 23D, n = 25 2D-fluoroscopy) were evaluated, with six breaches occurring in the control group, one of which was considered clinically significant (medial breach grade C). Five breaches with one clinically significant breach were observed in the X23D group. Breach rate, execution time for each lumbar level (X23D 167 s vs. control 156 s), radiation dose (X23D 33.26 mGy vs. control 49.5 mGy), and user experience did not reveal significant differences (p > 0.05) between the groups.</p><p><strong>Conclusions: </strong>Spinal navigation using the X23D-based approach shows promise and performs well in a realistic surgical ex-vivo setting. With further refinements, its accuracy is expected to match clinical-grade navigation systems while reducing radiation dose.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"25 1","pages":"925"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667167","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":"Prevalence of valgus and varus foot deformities in 2784 children with cerebral palsy, a register-based cross-sectional study.","authors":"Evgenia Manousaki, Elisabet Rodby-Bousquet, Katina Pettersson, Jenny Hedberg-Graff, Erika Cloodt","doi":"10.1186/s12891-024-08029-1","DOIUrl":"10.1186/s12891-024-08029-1","url":null,"abstract":"<p><strong>Background: </strong>Foot deformities, such as valgus and varus in the coronal plane and equinus in the sagittal plane, are common in children with cerebral palsy (CP). The purpose of this study was to describe the prevalence of coronal plane foot deformities and their association with the Gross Motor Function Classification System (GMFCS) level, age, CP subtype, and equinus in children with CP.</p><p><strong>Methods: </strong>A cross-sectional study was performed of 2784 children (1644 boys, 1140 girls), mean age 10 years, 2 months (standard deviation, 4.83), from the Swedish CP Follow-up Program and registry for 2021-2023. Single and multiple binary regression analyses estimated the association between coronal plane foot deformities (valgus or varus) and sex, age, GMFCS level, CP subtype, and equinus.</p><p><strong>Results: </strong>More than half (58%) the children with CP had valgus feet and 6% had varus feet. Valgus feet were more common in young children with high GMFCS levels, whereas the number of varus feet remained consistently low across all GMFCS levels. The prevalence of valgus feet was lower in older children at GMFCS I and II, but remained high in older children at GMFCS III-V. Coronal plane foot deformities were associated with higher GMFCS levels (odds ratio [OR] 11, 95% confidence interval [CI] 8-15 for GMFCS V), lower age (OR 1.5, 95% CI 1.3-1.7), and equinus (OR 1.9, 95% CI 1.4-2.5).</p><p><strong>Conclusions: </strong>Most children with CP have a coronal plane foot deformity. Valgus is most commonly associated with higher GMFCS levels and lower age. These findings contribute to a mapping of the children with an increased risk of foot deformities and also highlight the need for continuous follow-up of foot deformities in children with CP.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"25 1","pages":"930"},"PeriodicalIF":2.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675206","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}