Spine – Pubmed Results

Lumbar disk herniation (LDH) is a common cause of low back pain and radiculopathy in athletes, particularly in contact sports. The unique biomechanical demands on the athlete's spine and the pressure for expedited return-to-play (RTP) create distinct challenges in management. This review summarizes the epidemiology, biomechanics, pathophysiology, clinical presentation, diagnosis, treatment options, return-to-play considerations, and outcomes of LDH in athletic populations. Lumbar disk herniation...

With recent advancements and growing literature on the treatment of cervical spine disease in athlete populations, there are new paradigms for treatment, either operatively or nonoperatively, to optimize return to play (RTP) and outcomes while minimizing complications. Although conservative management is effective in many cases, high-level athletes with persistent symptoms may benefit from early surgical intervention. Anterior cervical discectomy and fusion and cervical disc arthroplasty (CDA)...

CONCLUSION: Patients with concurrent ARM and SA represent a high-risk group for long-term bowel and bladder dysfunction, and many require structured bowel and/or bladder management. These findings support anticipatory counselling and multidisciplinary follow-up.

Background and Objectives: Minimally invasive cervical spine surgery (MIS-CSS) relies heavily on intraoperative fluoroscopic imaging, raising concerns about radiation exposure to patients and surgical staff. Unlike lumbar MIS, cervical-specific radiation exposure has not been systematically reviewed, despite distinct anatomical considerations, including proximity to the thyroid gland and lens of the eye. This review aims to quantify intraoperative radiation exposure during MIS cervical spine...

Background and Objectives: Adolescent idiopathic scoliosis (AIS) may influence pelvic orientation and lower-limb alignment; however, data on coronal lower-limb alignment after completion of spinal treatment remain limited. This study aimed to evaluate lower-limb radiographic alignment in AIS patients after spinal treatment and to determine whether these parameters differ according to main curve location. Materials and Methods: In this retrospective study, 70 AIS patients treated surgically (n =...

Background and Objectives: Spondylodiscitis is a severe spinal infection associated with substantial mortality. Standard diagnostic imaging is often limited to the symptomatic spinal segment, which may fail to detect infection foci in other spinal regions. The prevalence and prognostic significance of multifocal spondylodiscitis remain insufficiently characterized. Materials and Methods: A retrospective single-center cohort study was conducted at the University Medical Center Mannheim, Germany....

Intervertebral disc degeneration (IDD) is a fundamental pathological basis of low back pain, yet its pathogenic mechanisms remain incompletely understood. Infection by low-virulence anaerobic bacteria has recently been recognized as a potential etiological factor. In this study, Cutibacterium acnes (C. acnes) was detected in 13.7% of degenerated intervertebral disc (IVD) tissues, and its presence was significantly associated with younger patients and Modic changes. In vitro experiments...

Interbody fusion cages are widely used to restore spinal stability, yet conventional designs often exhibit mechanical mismatch and limited biological integration. Functionally graded spinal cages incorporate spatial variations in composition and structure to better align mechanical properties with the surrounding bone environment. Although these designs have been extensively studied from an engineering perspective, their biological implications remain less clearly defined. This review examines...

Many people suffer from cervical disc herniation, which significantly affects the lives of individuals, causing chronic pain and functional limitations. This paper presents the development and evaluation of an AI-powered inflatable neck collar designed to provide personalized and adaptive support for individuals experiencing neck pain, particularly those with disc herniations. The system seamlessly integrates motion sensors, a robust AI model trained on a dataset of MRI scans, and a...

CONCLUSION: Our findings demonstrate that radiomics derived from routine non-contrast CT, leveraging deep learning for automated bone compartment segmentation, offers a superior and practical tool for Early identification of high-risk individuals for thoracolumbar OVFs. This approach provides valuable, complementary information beyond vBMD, potentially enhancing clinical decision-making and reducing the burden of osteoporosis.

Lumbar degenerative diseases, primarily caused by pathological tissues compressing spinal nerves, typically necessitate surgical intervention-specifically lumbar nerve decompression-to alleviate pain. Although the anterior decompression approach demonstrates notable advantages, such as reduced bleeding and shorter postoperative hospitalization stays, compared with the conventional posterior approach, patients may still experience incomplete decompression because of various instrumental...

Body mass index (BMI) influences bone metabolism; however, its impact on romosozumab treatment response remains unclear. We investigated whether BMI independently predicts bone mineral density (BMD) response to romosozumab and re-examined the role of the outcome metric (absolute vs. percentage change) in generating the apparent BMI signal. This retrospective study analyzed 304 patients (97.4% female, mean age 76.8 years) with high-risk osteoporosis who completed 12-month romosozumab treatment...

Coccygodynia may arise from traumatic or nontraumatic causes and can become refractory to conservative treatments, for which coccygectomy may be required. Providing effective anesthesia for this procedure can be challenging. These case reports describe the use of an ultrasound-guided sacral multifidus plane block (SMPB) as the primary anesthetic technique for coccygectomy in two patients with chronic coccygodynia. SMPB provided adequate surgical conditions and postoperative analgesia without...

CONCLUSIONS: QCT-derived vBMD provides a phantom-calibrated, protocol-standardized metric for preoperative risk stratification of cage subsidence after OLIF.

CONCLUSION: Cervical spine complications following a diagnosis of CD may necessitate opioid therapy, nerve blocks, ablative procedures, and/or surgical interventions. In contrast to prior reports from the predominantly pre-BoNT era, which estimated complication rates of approximately 30%, our cohort, well managed with BoNT therapy, demonstrated a considerably lower risk of cervical spine complications (5.3%). These findings suggest that early initiation of BoNT therapy, by effectively...

Intervertebral disc degeneration (IDD) is characterized by the abnormal synthesis of extracellular matrix (ECM) proteins, increased inflammatory cytokines, and upregulated degradative enzymes. According to the Traditional Chinese Medicine (TCM) concept, the degenerative disease of the intervertebral disc falls under the heading of "stagnation syndrome." Bu-Shen-Huo-Xue-Fang (BSHXF) is commonly applied to the treatment of IDD. In the present study, IDD models were established in rats, and...

CONCLUSION: CDS associated with LMMC and tethered cord represents a rare but clinically significant subset. Even in neurologically intact patients, radiological confirmation of tethering may justify early surgical intervention to prevent future neurological deterioration. Careful radiological assessment and multidisciplinary coordination are essential to optimize long-term functional outcomes.

Pedicle screw fixation is the gold standard for thoracic spine stabilization, but its accuracy is critical due to neurological and vascular complication risks. Robotic-assisted techniques show promise in improving accuracy and reducing radiation, but thoracic-specific evidence is limited. This prospective multicentric observational cohort study involves 6 high-volume centers. 100 adult patients (18-65 years) undergoing robot-assisted thoracic pedicle screw fixation will be recruited. The...

CONCLUSION: These findings identify both thoracolumbar fascia thickness and BMI as potential predictors of low back pain sensitivity and demonstrate significant associations between structural fascial characteristics, body composition, and nociceptive responses. The results are consistent with clinical observations linking higher BMI to increased musculoskeletal pain burden and suggest that fascial structural characteristics may be related to nociceptive sensitivity. Furthermore,...

Airway management can be challenging for patients undergoing cervical spinal surgery. This study aimed to evaluate how the duration of the cervical pathology associated with neck pain and numbness affects airway anatomy and airway management, and to correlate radiological measurements. This was a single-center prospective observational study. Eighty-two patients with American Society of Anesthesiologists I to III were selected from those undergoing surgery for cervical pathology. The patients'...

This study aims to evaluate the efficacy of percutaneous vertebroplasty in treating compression fractures of the thoracolumbar spine in elderly patients and to analyze factors influencing the improvement of postoperative kyphotic deformity. A retrospective review was conducted of 106 patients treated with percutaneous cement injection at our hospital from January to December 2024. Preoperative and 3-month postoperative measurements included anterior/mid-height ratio of the injured vertebra,...

To investigate whether specific morphological parameters of the cervical vertebral lamina and spinous processes are associated with cervical spondylosis (CS) in a northeast Chinese population. This retrospective observational study reviewed cervical computed tomography images acquired between August 2022 and August 2025. Patients were divided into a CS group and a control group according to clinical diagnosis. Seven parameters from C3 to C7 were measured: lamina length, lamina width (LW),...

CONCLUSION: Bilateral pediatric spondylolysis may remain clinically and radiographically stable despite extreme loading. This case highlights the importance of symptom-guided management and the psychosocial consequences of restrictive recommendations when radiographic findings do not correlate with clinical outcomes.

Sacrococcygeal dislocation commonly occurs after trauma and may cause coccydynia. Although most cases of coccydynia after sacrococcygeal dislocation resolve with conservative and medical treatment, surgery is also an option with refractory pain. Sacral erector spinae plane block (SESPB) is a novel approach for sacrococcygeal procedures and may be effective in the postoperative pain of this region. In this article, we present a case of a successful median approach SESPB for postoperative pain...

CONCLUSIONS: In this retrospective study, dedicated spinal x-rays combined with PE reliably excluded >99% of all injuries and 100% of injuries requiring intervention. These findings suggest children can be effectively screened for TLSI with PE and spinal x-rays, reserving cross-sectional imaging for positive x-ray findings and persistent PE findings on repeat exam. (J Trauma Acute Care Surg. 2026;100:915-921.

Intervertebral disc degeneration (IVDD) is the primary cause of spinal degenerative diseases. Nucleus pulposus (NP) cell senescence is a significant pathological manifestation of IVDD. Here, we constructed a hypoxia-induced NP cell model to clarify the mechanisms by which S-palmitoylation is involved in NPC senescence. The IP3R S-palmitoylation of NP cells was significantly reduced under hypoxic conditions, contributing to abnormalities in mitochondria-associated membranes (MAMs). The study...

BACKGROUND Cervical spinal epidural abscesses are uncommon; ventral lesions are rare, often arising from contiguous spondylodiscitis. Atypical presentations without cranial nerve involvement or altered consciousness are easily misattributed to intracranial diseases, delaying care. CASE REPORT We report the case of a 51-year-old man with poorly controlled hypertension and recent heroin use who developed progressive back and neck pain along with 3 days of fever, followed by rapidly progressive...

CONCLUSION: These findings suggest that sacral elongation and remodeling of the auricular surface may occur independently of lumbar vertebral number. This highlights the importance of individualized morphometric assessment in clinical procedures such as sacroiliac joint fusion and caudal epidural anesthesia. Conventional definitions based solely on L5-S1 fusion may not adequately capture the complexity of sacral structure. Consideration of both sacral segmentation patterns and lumbar vertebral...

Ultrasound-mediated drug delivery holds promise for treating spinal cord diseases, but the spinal canal is a challenging focused ultrasound target. This in silico study explores Tikhonov-regularized anti-focus (AF) driving to improve transspinal focal quality when focusing with a 256-element, 400-kHz spine-specific array. Three focusing methods were simulated for 80 targets in an ex vivo human spine: (1) uncorrected (water-case) phases and amplitudes, (2) simulation-derived phases and inverse...

CONCLUSION: Perioperative nefopam did not reduce acute morphine use, pain scores, hospital stay, or drug-related adverse events in spine surgery, though most studies used doses below the median effective dose, limiting conclusions on its efficacy and safety.

Intervertebral disc (IVD) degeneration (IDD) involves nucleus pulposus (NP) cell death, but its mechanisms are unclear. PANoptosis is a novel cell death pattern whose role in IDD remains elusive. This study investigates whether PANoptosis contributes to mechanical overloading-induced NP cell death and explores its underlying mechanisms. We evaluated PANoptosis in NP cells from human degenerated IVD tissues, aged mice, lumbar spine instability model, and an in vitro mechanical compression system....

CONCLUSIONS: This pilot study demonstrated a nonsignificant overall effect on the primary outcome, with significant effects on nonopioid-naive patients. Further research with a larger trial is needed to validate these findings.

» Traditional metallic implants used in spinal surgery, such as stainless steel, cobalt chrome, and titanium (Ti), can generate artifacts during magnetic resonance imaging and computed tomography, impeding visualization of the adjacent anatomy and impacting clinical decision-making. » Carbon fiber-reinforced polyether ether ketone (CFR-PEEK) spinal instrumentation is now commercially available. The reported benefits include minimal artifact with radiographic imaging while providing similar...

CONCLUSIONS: Neck pain was not found to be associated with craniovertebral angle, neck rotation and deep neck flexor endurance. However, cervical flexion, extension, left flexion and right flexion were found associated with neck pain. The association of neck pain with age and body mass index was not significant.

The risk of fractures and osteoporosis is higher in patients on hemodialysis than in the general population. We examined the association between computed tomography (CT)-measured trabecular attenuation at the first lumbar vertebra (L1 CT-attenuation), bone mineral density (BMD), and osteoporosis in patients on hemodialysis. We retrospectively included Japanese patients on hemodialysis who underwent non-enhanced abdominal CT and dual-energy X-ray absorptiometry (DEXA) analyses as part of a...

To examine implementation approaches and effectiveness of preoperative cognitive behavioral therapy (CBT) on patient-reported outcomes following lumbar fusion. We systematically searched PubMed/Medline, Cochrane Database of Systematic Reviews, and Epistemonikos (inception to December 15, 2024) for studies investigating preoperative CBT in patients scheduled for lumbar fusion. Primary and secondary outcomes were postoperative disability (Oswestry Disability Index, ODI) and health-related quality...

Degenerative spondylolisthesis (DS) involves vertebral translation over a lower vertebra, often linked to degenerative changes. Risk factors include age, gender, body mass index, and sagittal facet orientation. Surgical options like posterolateral and interbody fusion exist, but the benefits of interbody fusion remain debated. This study aims to compare the efficacy of posterolateral fusion (PLF) versus interbody fusion in single-level DS. It evaluates both clinical outcomes, such as pain relief...

Congenital NAD deficiency (CNDD) is a rare autosomal recessive disorder characterized by multiple congenital anomalies, frequently affecting the spine, kidneys, heart and nervous system. NADSYN1 is one of the genes of the NAD pathway that is mutated in CNDD. Here, we report a 5-year-old boy from a consanguineous family presenting with multiple vertebral segmentation defects, developmental delay and intellectual and speech impairment. To identify the disease-causing variant, whole-exome...

CONCLUSION: SIJ variations are common, predominantly bilateral, and more frequently observed in females, supporting a mechanical rather than inflammatory origin. The high prevalence of accessory SIJ highlights its importance as a potential source of diagnostic confusion in SIJ imaging. Combined evaluation of sacral morphology and SIJ variations provides an integrated anatomical framework that improve radiological interpretation and reduce diagnostic uncertainty in clinical practice.

RATIONALE: While epidural steroid injections (ESI) are a routine component of lumbar disc herniation management, the procedure carries inherent risks. Certain clinical presentations may signal an elevated risk for catastrophic complications, such as cauda equina syndrome. This report examines the significance of severe positional pain as a pre-procedural warning sign.

To investigate the independent risk factors of significant intraoperative blood loss (SIBL) in cervical spondylotic myelopathy (CSM) patients who receive unilateral expansive open-door cervical laminoplasty (UEOCL) treatment. UEOCL is a representative method for surgically treating CSM, while SIBL (with an IBL ≥ 500 mL) cannot be completely avoided. The 341 patients who received UEOCL for CSM treatment at our hospital from 2013 to 2019 fell into the SIBL group (n = 37) and the non-SIBL group (n...

CONCLUSION: Current evidence suggests that AR may reduce intraoperative radiation exposure without compromising workflow or surgical precision, available studies are limited by small sample sizes, heterogenous methodologies, and a paucity of direct staff-dosimetry data. Larger, high-quality multicenter studies are needed to clarify the magnitude of AR's radiation-sparing benefits and to define its role in modern spine surgery.

Lumbar degenerative disease is one of the most common indications for spinal surgery, and lumbar interbody fusion (LIF) remains a central technique in its management. The performance of an interbody fusion cage largely depends on its material composition and structural design, which influence segmental stability and the quality of bony fusion. This review summarizes the material characteristics, biomechanical rationale, biological behavior, and clinical applications of three-dimensional-printed...

CONCLUSION: Compared to traditional laminoplasty, laminoplasty with preservation of the unilateral spinous process-ligament complex demonstrates comparable results in terms of surgical safety, short-term neurological recovery, and complication control. However, its advantage lies in better maintaining dynamic spinal stability and significantly alleviating pain at the surgical site during spinal hyperflexion and hyperextension.

CONCLUSION: For patients with multilevel cervical OPLL with symptom-ossification mismatch, UODL provides similar improvement in clinical symptoms regardless of whether the opening side is directed toward the side with more severe ossification or toward the more symptomatic side. However, opening toward the side with more severe ossification may lead to more pronounced spinal cord morphological recovery and posterior shift, although the impact of this radiological advantage on long-term clinical...

CONCLUSION: Cervical sagittal imbalance (characterized by reduced lordosis and segmental mobility) and disc base expansion are significantly associated with LOP coexistence in single-level cervical disc herniation patients. These imaging markers may aid early identification of high-risk populations in clinical settings.

CONCLUSION: Patient-specific 3D-printed drill guides can reduce geometric deviations in C (2) pedicle screw placement in basilar invagination and decrease the number of fluoroscopic exposures. They show a potential advantage in improving the GR grade 0/1 acceptability rate; however, further clinical studies with larger samples are needed for verification.

CONCLUSIONS: Reduced affected-side LBR was strongly associated with residual PO following THA in patients with DHOA presenting with downward PO. An affected-side LBR cutoff value of 4.5° is helpful in predicting residual PO and assist in coronal compensatory capacity before THA.

CONCLUSION: Reduced preoperative global spinopelvic coronal flexibility, particularly diminished ΔSPA, was associated with the perception of leg length discrepancy following THA. Assessment of coronal spinopelvic flexibility may provide additional insight for preoperative evaluation and patient counseling. Further studies are warranted to better understand whether perioperative rehabilitation aimed at improving coronal spinopelvic mobility may help to mitigate pLLD after THA.

This study evaluated the potential of Colombian silk fibroin hydrogels functionalized with recombinant LSECtin (rLSECtin) for intervertebral disc tissue engineering. In silico analysis indicated that rLSECtin may interact with glycans similar to those found in human adipose-derived stem cells (ADSCs) through residues Asn105, Asp106, Glu93, Asn87, and Glu85, which coordinate calcium to form hydrogen bonds with GlcNAc hydroxyl groups. rLSECtin was successfully produced, purified, and incorporated...