BMC Musculoskeletal Disorders最新文献

{"title":"Best timing of bilateral knee arthroplasty- an analysis of revision and mortality rates from the German Arthroplasty Registry (EPRD).","authors":"Anne Elisabeth Postler, Paula Krull, Yinan Wu, Klaus-Peter Günther, Oliver Melsheimer, Arnd Steinbrück, Jörg Lützner","doi":"10.1186/s12891-025-08548-5","DOIUrl":"10.1186/s12891-025-08548-5","url":null,"abstract":"<p><strong>Background: </strong>The burden of osteoarthritis (OA) in multiple joints is high. For patients with bilateral knee OA there is no clear recommendation when to time the second surgery. The purpose of this study was therefore to compare revision and mortality rate in bilateral unicondylar and bicondylar knee arthroplasties after different strategies of surgical timing in bilateral knee OA from the German Arthroplasty Registry (EPRD).</p><p><strong>Methods: </strong>Data from the German Arthroplasty Registry (EPRD) was used. Since 2012 a total of 15,154 patients had bilateral knee arthroplasty within one year. Patellofemoral arthroplasties and constraint total knee arthroplasties (TKA) were excluded. 1,144 TKA and 682 unicondylar arthroplasties (UKA) were simultaneously performed, 772 TKA and 292 UKA between 1 and 90 days (short interval) and 24,496 TKA and 2,922 UKA between 91 and 365 days (intermediate interval). Revision and mortality rates were analyzed up to 7 years after surgery. Cox regression was performed to evaluate the influence of different patient characteristics on these outcomes.</p><p><strong>Results: </strong>The highest cumulative revision rate for any of the bilateral TKA was found for simultaneous surgery with 3.4% (95% CI 2.1-5.5). Lower risk for revision was seen in two-staged surgery in short interval (HR 0.42; 95% CI 0.20-0.90) and intermediate interval (HR 0.58; 95% CI 0.39-0.85). The cumulative one year mortality rate for TKA was comparable in all three groups with 0.8% for simultaneous TKA, 1.3% for short interval two-staged and 0.7% for intermediate interval. In UKA there were no differences between the groups regarding cumulative revision rate and mortality rate.</p><p><strong>Conclusion: </strong>TKA should be performed simultaneously in selected patients only, the two-staged procedure demonstrated lower revision risks. For UKA we found no differences in timing, simultaneous surgery seems to be a safe option.</p><p><strong>Trial registration: </strong>Clinical trial number not applicable.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"311"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750356","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":"Comparison of the efficacy of ultrasound-guided dextrose 25% hypertonic prolotherapy and intra-articular normal saline injection on pain, functional limitation, and range of motion in patients with knee osteoarthritis; a randomized controlled trial.","authors":"Alireza Teymouri, Nafiseh Birang, Maryamsadat Fakheri, Aref Nasiri","doi":"10.1186/s12891-025-08580-5","DOIUrl":"10.1186/s12891-025-08580-5","url":null,"abstract":"<p><strong>Background and aims: </strong>Knee osteoarthritis (OA) is a debilitating condition that manifests as knee pain and dysfunction. Clinicians prefer non-surgical options such as intra-articular injections for mild to moderate disease. Dextrose prolotherapy (DPTx) has been shown to have a beneficial effect on knee OA in the long-term. In this randomized controlled trial (RCT), we aimed to compare DPTx with intra-articular normal saline injection (IA-NS) to treat knee OA in terms of effectiveness and patient-reported outcomes.</p><p><strong>Methods: </strong>The study was a double-blind RCT with an allocation ratio of 1:1. We used block randomization to assign patients to each treatment arm. Patients with a visual analog scale of at least 4 for pain, and a Kellgren-Lawrence scale of grade 2 or 3 (mild or moderate disease) were selected and assessed according to eligibility criteria. The participants received either 5 ml of 50% dextrose water or 5 ml of 0.9% sodium chloride. The patients were followed up at 2, 4, and 8 weeks. SPSS software was used for statistical analyses. All results were reported with a confidence interval of 95%, and a p-value of less than 0.05 was considered significant.</p><p><strong>Results: </strong>Overall, 55 patients were included in the study, but 50 completed the study process (25 patients in each treatment arm). The mean age of patients with knee OA was 62.98 ± 5.37, ranging from 55 to 74 years. We observed significant improvement in both groups in terms of knee pain, function, and knee extension degree at all follow-up visits (p < 0.001). Although DPTx was associated with better results than IA-NS, the difference was not statistically significant (p > 0.05). The adverse events were limited to injection-site pain and ecchymosis, which resolved by week 4.</p><p><strong>Conclusion: </strong>Although we achieved slightly better results with DPTx, this treatment technique was not clinically or statistically superior to IA-NS in terms of knee pain and function in the short-term. Therefore, both DPTx and IA-NS are effective and well tolerated treatment options for knee OA. However, more RCTs are needed to confirm these claims.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"313"},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750947","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":"Dual mobility cups reduce dislocation in isolated cup revision.","authors":"Tae Woo Kim, Min Uk Do, Kyeong Baek Kim, Jae Jin Kim, Kuen Tak Suh, Won Chul Shin","doi":"10.1186/s12891-025-08553-8","DOIUrl":"https://doi.org/10.1186/s12891-025-08553-8","url":null,"abstract":"<p><strong>Background: </strong>Dual-mobility cup (DMC) is gaining increasing attention in total hip arthroplasty (THA) revision due to its numerous advantages. However, the prognosis after isolated cup revision with DMC remains unclear. This study aimed to compare complications, focusing on dislocation, and analyze clinical outcomes in patients who underwent isolated cup revision after THA.</p><p><strong>Methods: </strong>This retrospective cohort study included 119 patients who underwent isolated cup revision after THA and were followed up for ≥ 2 years from January 2009 to February 2020. Patient demographics, including age, sex, surgical approach, reasons for previous joint replacement surgery, and postoperative complications, were investigated. The patients were divided into DMC and conventional cup (CC) groups, and operative data and postoperative complications were compared between the two groups. Clinical outcomes were compared using the Harris hip score.</p><p><strong>Results: </strong>Forty-nine patients received DMC, and 70 received CC; the two groups had no difference in preoperative evaluation. Although the implants used significantly differed, there was no difference in the cup position. Six patients in the CC group had dislocations, but none had them in the DMC group (p = 0.042). Aseptic loosening was the most frequent postoperative complication but showed no significant difference between the two groups.</p><p><strong>Conclusions: </strong>DMC in revision THA can prevent dislocation compared to CC. In particular, DMC is considered a good treatment option in isolated cup revision wherein the surgeon can control the limited options.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"308"},"PeriodicalIF":2.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742108","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":"Bilateral non-traumatic multiple calf muscle hernias in a young adult: a rare case report.","authors":"Shihong Li, Zhiqiang Ma, Ruonian Zhai, Junlong Wu, Peng Zhou, Yingchao Tang, Qingyun Xie, Song Chen","doi":"10.1186/s12891-025-08554-7","DOIUrl":"https://doi.org/10.1186/s12891-025-08554-7","url":null,"abstract":"<p><strong>Background: </strong>Muscle hernia refers to the localized protrusion of muscle from a weak point due to fascia defects. Muscle hernias can be classified as structural or traumatic. There are many reasons for the formation of fascia defects. Currently, there are few reports on the causes of muscle hernia in clinical practice. There are not many patients with muscle hernia in clinical practice, and there are fewer patients with multiple muscle hernias. The reasons for their multiple occurrence are worth exploring. Patients usually seek medical advice due to pain, cosmetic reasons or concerns about tumors. This disease is often ignored by doctors, which can easily lead to misdiagnosis and delayed treatment.</p><p><strong>Case presentation: </strong>We report a rare case of multiple muscle hernias in both lower limbs in a 25-year-old adult. The patient has been exercising a lot for a long time. The muscle hernias were more obvious when running and squatting, but were asymptomatic. We used ultrasonography to examine the muscle hernias one by one and found that most of them had a large number of blood vessels. We diagnosed the patient with multiple muscle hernias in both lower legs. Conservative treatment such as wearing elastic stockings and limiting running activities was performed, and regular outpatient follow-up was performed. When the patient was followed up 3 months later, no significant changes were found in the number and morphology of calf muscle hernias.</p><p><strong>Discussion and conclusion: </strong>We reviewed a large number of literatures and found that few of them reported the relationship between muscle hernia and blood vessels. Most of the muscle hernias in this patient had arteries and veins passing through them, which may be the cause of the weak fascia. In addition, he has been running for a long time and is susceptible to chronic fascial syndrome. His muscle fibers have become larger and he has repeatedly directly damaged the fascia. These combined factors may have led to the formation of multiple muscle hernias in both lower limbs. The formation of multiple muscle hernias in the patient's calves may be related to vascular perforation and excessive exercise. The patient was advised to wear elastic stockings and reduce exercise. During follow-up, no obvious changes were found in his muscle hernias. It is hoped that clinicians can have a better understanding of the diagnosis and treatment of muscle hernias through this case.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"307"},"PeriodicalIF":2.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742356","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":"Biomechanical effects of fascial hydrorelease: a cadaveric study.","authors":"Kousuke Shiwaku, Hidenori Otsubo, Daisuke Suzuki, Calmero Pirri, Taiki Kodesyo, Tomoaki Kamiya, Keigo Taniguchi, Hirofumi Ohnishi, Atsushi Teramoto, Carla Stecco","doi":"10.1186/s12891-025-08533-y","DOIUrl":"https://doi.org/10.1186/s12891-025-08533-y","url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate the influence of hydrorelease (HR) on the gliding resistance force between the aponeurotic fascia and epimysial fascia of tibialis anterior and between two epimysial fasciae of tibialis posterior and flexor digitorum longus using a biomechanical testing system.</p><p><strong>Methods: </strong>In this cadaveric comparative study, 12 paired legs amputated above the knee joint from six fresh-frozen specimens were divided into two groups. The distal insertions of the target tendons of the tibialis anterior and posterior were detached and sutured to a force gauge for tension measurement during tendon pull. These tendons were representatives of the layer between the aponeurotic and epimysial fasciae of the tibialis anterior and between the epimysial fasciae of the tibialis posterior and flexor digitorum longus. For the baseline, the position where the tension of the target tendon was approximately 15 N was determined to eliminate creep. In the HR group, the baseline test position was replicated, and force was measured. The intervention was an HR injection between the specified fascial layers. The main outcome was the gliding resistance force between the aponeurotic and epimysial fasciae and between two epimysial fasciae.</p><p><strong>Results: </strong>The resistance force between the aponeurotic and epimysial fasciae in the HR group was 6.4% lower than that in the control group (P = 0.02). The resistance force between two epimysial fasciae in the HR group was 4.3% lower than that in the control group (P < 0.01).</p><p><strong>Conclusions: </strong>The gliding resistance force significantly decreased after HR in the layer between the aponeurotic and epimysial fasciae and between two epimysial fasciae in this cadaveric study.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"306"},"PeriodicalIF":2.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742366","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":"Cerebrospinal fluid leakage complicated by intracranial hematoma and cervical infection following resection of dumbbell schwannoma in the cervical canal: a case report and literature review.","authors":"Zhen-Shan Yuan, Lian-Song Lu, Yong Hu","doi":"10.1186/s12891-025-08484-4","DOIUrl":"https://doi.org/10.1186/s12891-025-08484-4","url":null,"abstract":"<p><strong>Background: </strong>Haemorrhagic cerebral infarction with cervical infection is a severe and complex complication in spinal surgery. This paper report a case of intracranial hematoma secondary to cerebrospinal fluid leakage after surgery for dumbbell tumor of cervical spine.</p><p><strong>Case presentations: </strong>The patient suffered from postoperative cerebrospinal fluid leakage followed by hemorrhagic cerebral infarction, unilateral limb sensorimotor dysfunction and language dysfunction, and was treated conservatively. Combined with cervical infection, the treatment was anti-inflammatory and lumbar puncture drainage. The infection of the patient was cured, and the symptoms related to hemorrhagic cerebral infarction were better than before.</p><p><strong>Results: </strong>The case showed cerebrospinal fluid leakage after the operation of dumbbell tumor of cervical spine, which caused hemorrhagic cerebral infarction with typical clinical symptoms.</p><p><strong>Conclusions: </strong>The risk complications of intracranial hemorrhage and cervical infection should be paid attention to when cerebrospinal fluid loss occurs in patients with cervical dumbbell tumor after surgery.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"305"},"PeriodicalIF":2.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741810","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":"Construction and evaluation of a prognostic model based on the expression of the metabolism-related signatures in patients with osteosarcoma.","authors":"Tieli Wu, Xingyi Wu","doi":"10.1186/s12891-025-08439-9","DOIUrl":"10.1186/s12891-025-08439-9","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to screen three major substance metabolism-related genes and establish a prognostic model for osteosarcoma.</p><p><strong>Methods: </strong>RNA-seq expression data for osteosarcoma were downloaded from The Cancer Genome Atlas (TCGA) and GEO databases. Differentially expressed (DE) RNAs were selected, followed by the selection of metabolic-related DE mRNAs. Using Cox regression analysis, prognostic DE RNAs were identified to construct a prognostic model. Subsequently, independent prognostic clinical factors were screened, and the functions of the long non-coding RNAs (lncRNAs) were analyzed. Finally, the expression of signature genes was further tested in osteosarcoma cells using quantitative reverse transcription quantitative real-time polymerase chain reaction (qRT-PCR) and western blotting.</p><p><strong>Results: </strong>A total of 432 DE RNAs, comprising 79 DE lncRNAs and 353 DE mRNAs were obtained, and then 107 metabolic-related DE mRNAs. Afterwards signature genes (LINC00545, LINC01537, FOXC2-AS1, CYP27B1, PFKFB4, PHKG1, PHYKPL, PXMP2, and XYLB) served as optimal combinations, and a prognostic score model was successfully proposed. Three verification datasets (GSE16091, GSE21257, and GSE39055) showed that the model had high specificity and sensitivity. In addition, two independent prognostic clinical factors (age and tumor metastasis) were identified. Finally, the concordance rate between the in silico analysis, qRT-PCR, and western blotting analysis was 88.89% (8/9), suggesting the robustness of our analysis.</p><p><strong>Conclusions: </strong>The prognostic model based on the nine signature genes accurately predicted the prognosis of patients with osteosarcoma; CYP27B1, PFKFB4, PHKG1, PHYKPL, PXMP2, and XYLB may serve as metabolism-related biomarkers in osteosarcoma.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"303"},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728610","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":"Finite element analysis of the stability of tibiofibular fractures treated with various combinations of external fixators.","authors":"Xubiao Ye, Jinling Luo, Pu Chen, Xiaohua Wei, Shifeng Liu","doi":"10.1186/s12891-025-08530-1","DOIUrl":"10.1186/s12891-025-08530-1","url":null,"abstract":"<p><strong>Background: </strong>External fixators have been extensively applied in the treatment of open tibiofibular fractures and have yielded positive outcomes. The stability of an external fixator primarily hinges on its structure. Employing additional external fixation components can undoubtedly enhance stability. However, there is scant research on the topic of achieving superior stability with fewer external fixation components.</p><p><strong>Methods: </strong>Utilizing 3D modeling software, constructed three different external fixation models in middle tibial fractures in Group A, constructed four external fixation models in proximal tibial fractures in Group B, and constructed four external fixation models in distal tibial fractures in Group C.Simulate the load under the assistance of a walker to stand up, obtain the displacement of fractures and the stress of the external fixator for each group. Analyze and compare the results of each model.</p><p><strong>Results: </strong>In a mid-tibial fracture, the stability of the crossbar increases by 21% with each 2 cm closer to the tibia. Model B3 achieves superior stability with the use of more fixed clamps and connecting rods in the \"H\" shaped model. Although the triangular cross-bar structure used in Model B4 is less stable than that of Model B3, it has achieved 83.2% of the stability of Model B3, despite using fewer components. The stability of Model C4 has increased by 73.44% compared to Model C3.</p><p><strong>Conclusions: </strong>The external fixator should be configured to keep the crossbar as close to the skin as possible. For proximal tibial fractures, to minimize the use of external fixation components, the triangular cross-bar structure of Model B4 can be employed. In the case of distal tibial fractures, while the triangular cross-bar structure of Model C4 offers good stability, the risk of displacement is greater. Therefore, it is advisable to use an H-shaped fixation method with additional external fixation components, such as those found in Model C3.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"304"},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728611","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":"How do different standing positions affect trunk muscle activation in LBP-developers during prolonged standing?","authors":"Saeedeh Abbasi, Hooman Minoonejad, Hamed Abbasi, Seyed Hamed Mousavi","doi":"10.1186/s12891-025-08525-y","DOIUrl":"10.1186/s12891-025-08525-y","url":null,"abstract":"<p><strong>Background: </strong>Low back pain developers (PDs) are individuals at a high risk of developing low back pain (LBP), especially during prolonged standing. Understanding their characteristics is essential for devising effective preventive strategies. Prolonged standing has been associated with increased co-contraction of trunk muscles and elevated activity of the trunk extensor muscles. This study aims to examine the effects of using a normalized footrest height and altering arm positions on muscle activity in PDs.</p><p><strong>Methods: </strong>Twenty-four female PDs, identified by a > 10 mm increase on the visual analog scale (VAS) during prolonged standing, were recruited. They were randomly divided into two groups: Group A used a footrest intermittently, while Group B used a footrest combined with changes in arm positions (shoulder flexion and hands crossed on the clavicles). Muscle activity was monitored using electromyography (EMG) over a one-hour standing protocol.</p><p><strong>Results: </strong>Both interventions significantly reduced lumbar erector spinae (LES) muscle activity, as well as co-contraction of the trunk flexor and extensor muscles (p < 0.05). The group that adjusted their arm positions (Group B) experienced a greater reduction in muscle activity (p = 0.05). Additionally, transversus abdominis (TrA) muscle activity slightly increased in both groups, with a more notable increase in Group B (p > 0.05). Although lumbar spine muscle activity decreased, thoracic spine extensor (TES) activity increased in Group B. This increase is attributed to the engagement of the thoracic spine during upper limb movement, compensating for the reduced lumbar muscle activity, which may help alleviate back pain.</p><p><strong>Conclusions: </strong>Using footrests cyclically and adjusting arm positions can help prevent back pain during prolonged standing by promoting muscle relaxation, reducing fatigue, and improving posture. These findings offer practical strategies for enhancing workplace ergonomics, particularly for occupations involving prolonged standing.</p><p><strong>Trial registration: </strong>This study is registered in the Clinical Trial Registry ( http://www.irct.ir/ ) with Trial ID 71,648 and IRCT ID IRCT20230628058610N1, dated January 20, 2024.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"299"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718048","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":"Is screw position a greater contributor to adjacent segment disease than plate-to-disc distance following anterior cervical discectomy and fusion?","authors":"Feng Wang, Jiawei Lu, Bijun Wang, Ziqi Zhu, Beiduo Shen, Kai Guo, Zhaoyu Ba, Yufeng Huang, Desheng Wu","doi":"10.1186/s12891-025-08285-9","DOIUrl":"10.1186/s12891-025-08285-9","url":null,"abstract":"<p><strong>Background: </strong>To investigate the risk factors for radiographic adjacent segment disease (RASD), with a focus on the impact of screw position, following anterior cervical discectomy and fusion with plate fixation (ACDF-P).</p><p><strong>Methods: </strong>We conducted a comprehensive analysis on 126 patients who underwent ACDF-P for degenerative cervical spinal disease, evaluating various factors such as demographics, cervical sagittal parameters, the number of fused segments, sagittal screw angle, plate to disc distance (PDD), and screw position score (SPS). Based on MRI findings, we classified patients into ASD and Non-ASD groups. Logistic regression analysis was used to evaluate risk factors, and the model's discrimination was assessed using the receiver operating characteristic (ROC) curve. Additionally, we evaluated the predictive value of SPS for RASD using ROC curves. To further investigate the relationship between screw position and RASD, we reanalyzed the data of patients with PDD of less than 5 mm to eliminate the effect of PDD.</p><p><strong>Results: </strong>Among the 126 patients, 57 developed RASD after a minimum follow-up period of 5 years. No significant differences were observed in demographics, cervical sagittal parameters, number of fused segments, or sagittal screw angle between the two groups (p > 0.05). However, PDD and SPS showed significant differences between the two groups (p < 0.05). Multivariate binary logistic models revealed that PDD (OR: 3.238; 95% CI:1.191-8.807; p < 0.021) and SPS (OR: 1.309 95% CI: 1.092-1.568; p = 0.004) were risk factor for RASD. The models exhibited excellent discrimination and calibration. The area under the curve (AUC) for RASD identified by SPS were 0.674. Among patients with PDD less than 5 mm, SPS was significantly higher in the ASD group compared to the Non-ASD group (p < 0.05). After grouping by screw position, it was determined that both the incidence of RASD (70.5% vs. 34.6%, p < 0.05) and the percentage of long-segment fusion (3-4 levels) (38.6% vs. 7.7%, p < 0.05) were significantly higher in the group with a score greater than 6 compared to the group with a score of 6 or lower.</p><p><strong>Conclusions: </strong>Our findings indicate that a PDD of less than 5 mm and a higher SPS are related with RASD following ACDF-P. Secondary analysis indicates that screw position, as indicated by the SPS, may be a primary contributor to ASD, rather than PDD.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9189,"journal":{"name":"BMC Musculoskeletal Disorders","volume":"26 1","pages":"297"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718051","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}