<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Thoracolumbar spine fr...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Thoracolumbar spine fracture-dislocations are very unstable and usually secondary to high energy trauma. Due to disruption of the entire vertebrae columns, the absence of neurological deficit is exceptional. </span><b><span style="font-family:Verdana;">Aim: </span></b><span style="font-family:Verdana;">The purpose of this work is to report our experience in the management of this entity in a context of limited resources and to make a review of the literature. </span><b><span style="font-family:Verdana;">Case presentation: </span></b><span style="font-family:Verdana;">A 30-year-old man was admitted with a severe low back pain after a traffic accident. Neurological functions were intact after examination. Radiological assessments revealed a complete L3-L4 fracture-dislocation.</span></span><span style="font-family:""><span style="font-family:Verdana;"> The patient underwent an open posterior reduction and internal long segment fixation. The post-operative was marked by a surgical site infection treated with surgical debridement and targeted antibiotic therapy. The neurological functions were preserved. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Fracture-dislocations of the thoracolumbar spine</span><span style="color:red;"> </span></span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> caused by high energy trauma and are remarkably unstable lesions. When they are associated with intact neurorological functions, reduction and stabilization of these fractures are a challenge.展开更多
Since the first electron micrograph of“lace-like structures”over 75 years ago,the endoplasmic reticulum(ER)is now viewed as a highly dynamic,constantly remodeling,continuous network of tubules and cisternae that pla...Since the first electron micrograph of“lace-like structures”over 75 years ago,the endoplasmic reticulum(ER)is now viewed as a highly dynamic,constantly remodeling,continuous network of tubules and cisternae that plays an important role in a broad range of cellular activities from calcium regulation to protein synthesis and trafficking.In neurons,the ER extends from the soma through the axon to presynaptic terminals,and throughout the dendritic arbor into as many as half of all postsynaptic dendritic spines at any given time(Falahati et al.,2022).展开更多
Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglio...Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglion cells and their axons,leading to axonal transport dysfuntion,subsequently causing secondary damage to anterior or posterior ends of the visual system.Accordingly,recent evidence indicates that glaucoma is a degenerative disease of the central nervous system that causes damage throughout the visual pathway.However,the effects of glaucoma on synaptic plasticity in the primary visual cortex remain unclear.In this study,we established a mouse model of unilateral chronic ocular hypertension by injecting magnetic microbeads into the anterior chamber of one eye.We found that,after 4 weeks of chronic ocular hypertension,the neuronal somas were smaller in the superior colliculus and lateral geniculate body regions of the brain contralateral to the affected eye.This was accompanied by glial cell activation and increased expression of inflammatory factors.After 8 weeks of ocular hypertension,we observed a reduction in the number of excitatory and inhibitory synapses,dendritic spines,and activation of glial cells in the primary visual cortex contralateral to the affected eye.These findings suggest that glaucoma not only directly damages the retina but also induces alterations in synapses and dendritic spines in the primary visual cortex,providing new insights into the pathogenesis of glaucoma.展开更多
Dendritic spines are small protrusions along dendrites that contain most of the excitatory synapses in principal neurons,playing a crucial role in neuronal function by creating a compartmentalized environment for sign...Dendritic spines are small protrusions along dendrites that contain most of the excitatory synapses in principal neurons,playing a crucial role in neuronal function by creating a compartmentalized environment for signal transduction.The plasticity of spine morphologies provides a tunable handle to regulate calcium signal dynamics,allowing rapid regulation of protein expression necessary to establish and maintain synapses(Cornejo et al.,2022).If excitatory inputs were to be located primarily on dendritic shafts,dendrites would frequently short-circuit,preventing voltage signals from propagating(Cornejo et al.,2022).It is thus not surprising that the structural plasticity of dendritic spines is closely linked to synaptic plasticity and memory formation(Berry and Nedivi,2017).While comprehensive in vitro studies have been conducted,in vivo studies that directly tackle the mechanism of dendritic transport and translation in regulating spine plasticity spatiotemporally are limited.展开更多
BACKGROUND Cervical spine fracture-dislocations in patients with ankylosing spondylitis(AS)are mostly unstable and require surgery.However,osteoporosis,one of the comorbidities for AS,could lead to detrimental prognos...BACKGROUND Cervical spine fracture-dislocations in patients with ankylosing spondylitis(AS)are mostly unstable and require surgery.However,osteoporosis,one of the comorbidities for AS,could lead to detrimental prognoses.There are few accurate assessments of bone mineral density in AS patients.AIM To analyze Hounsfield units(HUs)for assessing bone mineral density in AS patients with cervical fracture-dislocation.METHODS The HUs from C2 to C7 of 51 patients obtained from computed tomography(CT)scans and three-dimensional reconstruction of the cervical spine were independently assessed by two trained spinal surgeons and statistically analyzed.Inter-reader reliability and agreement were assessed by interclass correlation coefficient.RESULTS The HUs decreased gradually from C2 to C7.The mean values of the left and right levels were significantly higher than those in the middle.Among the 51 patients,25 patients(49.02%)may be diagnosed with osteoporosis,and 16 patients(31.37%)may be diagnosed with osteopenia.CONCLUSION The HUs obtained by cervical spine CT are feasible for assessing bone mineral density with excellent agreement in AS patients with cervical fracture-dislocation.展开更多
The lumbar spine is the most common sites for fractures because of the high mobility of the lumbar spine. A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates ver...The lumbar spine is the most common sites for fractures because of the high mobility of the lumbar spine. A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. A 32-year-old man presented to us after traffic accident. In our patient, unstable fracture-dislocation of the lumbar spine at the L2-L3 level due to traffic accident occurred. The vertebral bodies were fractured and the anterior dislocation happened without spinal cord injury. The patient was a candidate for an open reduction and internal fixation surgery. The posterolateral approach was performed. After insertion of all the pedicle screws, the rods were transversally placed on L2-L3-L4 vertebral bodies and tightened. The reduction of the dislocations was carried out by pushing downwards (foreside) L2 and L4 vertebras and upwards (backside) L3 vertebrae, simultaneously. After securing the reduction of the dislocations, the rods were opened and placed along the spinal column and tightened. This technique is more effective when the pedicle of fractured vertebrae is intact.展开更多
Bilateral anterior dislocations of the shoulder are rare lesions. They are even rarer when combined with a bilateral fracture of major tubercles. We report the case of a 28-year-old patient admitted to trauma emergenc...Bilateral anterior dislocations of the shoulder are rare lesions. They are even rarer when combined with a bilateral fracture of major tubercles. We report the case of a 28-year-old patient admitted to trauma emergencies after trauma by falling from the top of a stool. Clinical and radiographic findings revealed bilateral anterior shoulder dislocation associated with bilateral fracture of major tubercles. The patient was treated orthopedically by a reduction of dislocations under General Anesthesia, immobilization of the shoulders for 6 weeks followed by reeducation. The functional result after 12 months was satisfactory with a UCLA score of 30 points.展开更多
BACKGROUND We report a case with the displacement of an articular fracture fragment of the base of the second metacarpal from the ulnar to the volar side,treated via the dorsal approach.The dorsal approach can be a go...BACKGROUND We report a case with the displacement of an articular fracture fragment of the base of the second metacarpal from the ulnar to the volar side,treated via the dorsal approach.The dorsal approach can be a good option not only because it allows direct observation of ligament damage and fixation of bone fragments but also because the thin subcutaneous tissue makes the approach easier.CASE SUMMARY A 45-year-old man with a right hand injury visited the hospital.A small bone fragment was identified using plain radiography.Lateral radiography revealed the fragment as lying over the volar aspect of the carpometacarpal(CMC)joint.Computed tomography revealed that approximately one-third of the CMC joint surface of the second metacarpal was damaged.We provisionally diagnosed an intra-articular fracture with significant CMC joint instability and performed open reduction and internal fixation.We made a dorsal longitudinal incision over the CMC joint between the second and third metacarpals.The dorsal ligament of the third CMC joint was torn.We thought it had been dislocated to the volar side and spontaneously reduced to that position.There are only few reports of volar dislocation of CMC joint fractures,particularly of the second and third metacarpals;our report is unique as our patient had an intact interosseous ligament between the second and third metacarpals.CONCLUSION Although past reports have used a palmar approach,the dorsal approach is a good option for these cases.展开更多
Chronic pain after spine surgery(CPSS)is a complex disorder characterized by multifactorial pathogenesis that occurs in 8%–40%of patients undergoing lumbar spine surgery.We aimed to develop a rat model that mimics cl...Chronic pain after spine surgery(CPSS)is a complex disorder characterized by multifactorial pathogenesis that occurs in 8%–40%of patients undergoing lumbar spine surgery.We aimed to develop a rat model that mimics clinical CPSS conditions by taking two sequential surgical procedures.Step 1:A plastic rod was inserted into the left L5 intervertebral foramen to produce a steady compression on the dorsal root ganglion(DRG)and the spinal nerve,a common cause of low back pain(LBP).Step 2:The rod was removed after 7 days when rats exhibited mechanical and heat hypersensitivity in the ipsilateral hindpaw,followed by a full L5 laminectomy to mimic spine decompression surgery in LBP patients.The retention of the rod induced a prolonged LBP-like behavior but was quickly resolved after rod removal without laminectomy.However,rats that received laminectomy after rod removal developed heightened mechanical and heat sensitivity in the hindpaw,impaired gait,and reduced spontaneous exploration activity,indicating CPSS.Patch clamp recording revealed a significant augmentation in the intrinsic excitability of smalldiameter DRG neurons in CPSS rats.Administration of Dermorphin[D-Arg2,Lys4](1–4)amide(DALDA,5mg/kg,i.p.),a peripherally acting mu-opioid receptor(MOR)-preferred agonist,attenuated pain hypersensitivity,capsaicin-induced[Ca^(2+)]i rising and the increased intrinsic excitability of DRG neurons from CPSS rats.Our findings suggest that this new model,which mirrors the nature of CPSS developed in patients,may be useful for future studies of the underlying mechanisms.展开更多
Artificial intelligence(AI)and machine learning(ML)are transforming spine care by addressing diagnostics,treatment planning,and rehabilitation challenges.This study highlights advancements in precision medicine for sp...Artificial intelligence(AI)and machine learning(ML)are transforming spine care by addressing diagnostics,treatment planning,and rehabilitation challenges.This study highlights advancements in precision medicine for spinal pathologies,leveraging AI and ML to enhance diagnostic accuracy through deep learning algorithms,enabling faster and more accurate detection of abnormalities.AIpowered robotics and surgical navigation systems improve implant placement precision and reduce complications in complex spine surgeries.Wearable devices and virtual platforms,designed with AI,offer personalized,adaptive therapies that improve treatment adherence and recovery outcomes.AI also enables preventive interventions by assessing spine condition risks early.Despite progress,challenges remain,including limited healthcare datasets,algorithmic biases,ethical concerns,and integration into existing systems.Interdisciplinary collaboration and explainable AI frameworks are essential to unlock AI’s full potential in spine care.Future developments include multimodal AI systems integrating imaging,clinical,and genetic data for holistic treatment approaches.AI and ML promise significant improvements in diagnostic accuracy,treatment personalization,service accessibility,and cost efficiency,paving the way for more streamlined and effective spine care,ultimately enhancing patient outcomes.展开更多
BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a ...BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.展开更多
BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgica...BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.展开更多
Neurofibromatosis type 1(NF1)is a genetic disorder affecting 1 in 3000 people due to heterozygous mutations in the NF1 gene.Patients with NF1 can develop multiple symptoms,such as neurofibromas,skin hyperpigmentation,...Neurofibromatosis type 1(NF1)is a genetic disorder affecting 1 in 3000 people due to heterozygous mutations in the NF1 gene.Patients with NF1 can develop multiple symptoms,such as neurofibromas,skin hyperpigmentation,and bone abnormalities,including tibial pseudarthrosis and spine deformity.Here,we aimed to elucidate the cellular origin and pathogenic mechanism of NF1 spine deformity.We explored the Prss56-Nf1 knockout(KO)mouse model that recapitulates neurofibromas and pseudarthrosis by carrying Nf1 gene inactivation in Prss56-expressing boundary cap cells,a neural crest subset,and their derivatives.Micro-CT analyses showed that Prss56-Nf1 KO mice exhibit spine deformity from 12 months of age,associated with vertebral anomalies reminiscent of patients with NF1.Fate mapping revealed a significant increase in OSX^(+)osteoblasts of the Prss56 lineage in vertebrae of Prss56-Nf1 KO mice.Increased traced Nf1-deficient cells correlated with increased vertebral bone volume and kyphosis spine curvature.Finally,we showed that treating Prss56-Nf1 KO mice with RAS-MAPK pathway inhibitors prevented spine deformity.Overall,the Prss56-Nf1 KO mouse model unravels the role of osteoblasts from the Prss56 lineage as the cellular origin of NF1 spine deformity and highlights RAS-MAPK pathway inhibition as a promising therapeutic strategy for preventing NF1 spine deformity.展开更多
Spinal cord injury and non-traumatic myelopathies are major causes of lifelong disability,yet conventional magnetic resonance imaging(MRI)can underestimate microstructural damage.Diffusion tensor imaging(DTI)and tract...Spinal cord injury and non-traumatic myelopathies are major causes of lifelong disability,yet conventional magnetic resonance imaging(MRI)can underestimate microstructural damage.Diffusion tensor imaging(DTI)and tractography map white-matter integrity by measuring fractional anisotropy(FA)and mean diffusivity(MD),but their adoption in spine imaging has been limited by long scan times and complex post-processing.Supsupin et al report a two-minute cervical DTI sequence integrated into routine MRI and applied to four representative pathologies–spinal cord contusion,metastatic compression,degenerative myelopathy,and multiple sclerosis–compared with five controls.Each lesion showed distinctive tractographic and quantitative patterns:For example,reduced FA with preserved MD in contusion and combined FA decrease and MD elevation in metastatic compression.These findings highlight the potential of tractography to improve diagnosis,guide surgical planning,and monitor treatment,while maintaining clinical feasibility.Remaining challenges include limited angular resolution,motion artifacts,and the need for multicenter validation and advanced reconstruction methods.This manuscript places the study in the context of current spinal diffusion imaging and outlines future directions toward routine,precision care.展开更多
Fruit spine density is an important commercial trait for cucumber(Cucumis sativus L.).Most North China-type cucumbers that are grown over large areas have a dense-spine phenotype,which directly affects the appearance ...Fruit spine density is an important commercial trait for cucumber(Cucumis sativus L.).Most North China-type cucumbers that are grown over large areas have a dense-spine phenotype,which directly affects the appearance quality,storage,and transportation of the fruits.Here,we isolated a novel few spines mutant(fs2)from the wild-type(WT)inbred line WD1,a North China-type cucumber with high density fruit spines,by an ethyl methanesulfonate(EMS)mutagenesis treatment.Genetic analysis revealed that the phenotype of fs2 is controlled by a single recessive nuclear gene.We fine-mapped the fs2 locus using F_(2) and BC_(1) populations(1,802 and 420 individuals,respectively),which showed that the candidate gene of FS2(Csa4G652850)encodes an ARID-HMG transcription factor containing an AT-rich interaction domain(ARID)and a high mobility group box domain(HMG).One SNP(C to T)and one InDel(a 40-bp deletion)in the coding region of FS2 result in amino acid variation and premature translation termination in the fs2 mutant,respectively.FS2 was found to be highly expressed in the apical buds and young ovaries.In addition,experiments suggest that FS2 participates in the regulation of fruit spine initiation by activating the expression of the Tril gene in cucumber.This work provides not only an important reference for understanding the molecular mechanisms of fruit spine development but also an important resource for fruit appearance quality breeding in cucumber.展开更多
Fins are extensively utilized in heat exchangers and various industrial applications as they are lightweight and can benefit in various systems,including electronic cooling devices and automotive components,owing to t...Fins are extensively utilized in heat exchangers and various industrial applications as they are lightweight and can benefit in various systems,including electronic cooling devices and automotive components,owing to their adaptable design.Furthermore,spine fins are introduced to improve performance in applications such as automotive radiators.They can be shaped in different ways and constructed from a collection of materials.Inspired by this,the present model examines the effects of internal heat generation and radiation-convection on the thermal distribution in a wetted convex-shaped spine fin.Using dimensionless terms,the proposed fin model involving a governing nonlinear ordinary differential equation(ODE)is transformed into a dimensionless form.The study uses the operational matrix with the Charlier polynomial collocation method(OMCCM)to ensure precise and computationally efficient numerical solutions for the dimensionless equation.In order to aid in the analysis of thermal performance,the importance of major parameters on the temperature profile is graphically illustrated.The main outcome of the study reveals that as the radiation-conductive,wet,and convective-conductive parameters increase,the heat transfer rate progressively improves.Conversely,the ambient temperature and internal heat generation parameters show an inverse relationship.展开更多
Objective:To investigate the diagnostic value of magnetic resonance imaging(MRI)in patients with Modic changes and endplate sclerosis of the lumbar spine.Methods:A total of 66 patients with lumbar spine diseases who u...Objective:To investigate the diagnostic value of magnetic resonance imaging(MRI)in patients with Modic changes and endplate sclerosis of the lumbar spine.Methods:A total of 66 patients with lumbar spine diseases who underwent MRI and CT diagnostic examinations at the hospital from May 2024 to April 2025 were included in this study.The MRI findings of Modic changes were compared between Type I and Type II patients,and the presence or absence of endplate sclerosis signals and the HU value ratio on CT were analyzed.The pathological characteristics of Modic changes in Type I and Type II patients were observed.The imaging features of Modic changes in patients with lumbar spine diseases were analyzed.Results:Modic changes were present in 34 patients,with a total of 204 endplates evaluated,of which 74 were affected.MRI classification showed:Type I in 8 cases(10.81%),Type I/II mixed in 10 cases(13.51%),Type II in 51 cases(68.92%),and Type II/III mixed in 5 cases(6.76%).In CT reconstruction images,26 endplates with Modic changes on MRI showed sclerosis in the vertebral body,presenting high-density sclerotic features.These sclerotic areas did not exhibit distinct signal characteristics on MRI but pathologically demonstrated Type II Modic changes concurrently with fatty degeneration and sclerosis;In patients with Modic changes of Type I and Type II,regardless of the presence or absence of endplate sclerosis,the sagittal T1/T2 signal intensity ratio showed no statistically significant difference(P>0.05).However,the HU value ratio in Type II changes with sclerotic regions(2.74±0.61)was significantly higher than that in regions without sclerosis(1.16±0.23),with a statistically significant difference(P<0.05).Conclusion:CT reconstruction images of patients with lumbar Modic changes clearly demonstrate endplate sclerosis,a phenomenon closely associated with the bone marrow repair process.MRI has limited sensitivity for detecting sclerosis,potentially due to the following factors:first,differences in the radiographic characterization of endplate mineral content;second,the specific influence of different Modic types on signal intensity.This suggests that MRI classification should be combined with CT features for comprehensive interpretation.展开更多
BACKGROUND Epithelioid angiosarcoma(EA)is an aggressive,malignant endothelial-cell tumor of vascular or lymphatic origin.EA often arises from deep soft tissues such as pleura,breast,bone and gastrointestinal tract.It ...BACKGROUND Epithelioid angiosarcoma(EA)is an aggressive,malignant endothelial-cell tumor of vascular or lymphatic origin.EA often arises from deep soft tissues such as pleura,breast,bone and gastrointestinal tract.It usually affects patients aged 60-70 years and is associated with high recurrence and metastasis rates with surgical resection as the primary treatment of choice.Overall survivals are generally poor,ranging from 6 to 16 months.More than 50%of patients died of disease within 2 to 3 years of diagnosis.CASE SUMMARY We present a rare case of EA of the cervical spine causing a C6 pathological fracture complicated by severe kyphosis.The patient received C4-7 posterior laminectomy and C2/3/4/7/T1 transpedicular screw fixation,followed by anterior C5-6 corpectomy with allograft bone fusion and cervical plate fixation.Postoperative radiotherapy was administered without delay.However,the patient died of rapidly progressive acute respiratory distress syndrome 3 weeks after the second surgery.CONCLUSION EA with spinal involvement is extremely rare.Early detection and cord decompression may prevent neurological deterioration and preserve better quality of life.展开更多
The dynamic response characteristics of scoliosis and kyphosis to vibration are currently unclear.The finite element method(FEM)was employed to study the vibration response of patients with idiopathic scoliosis and ky...The dynamic response characteristics of scoliosis and kyphosis to vibration are currently unclear.The finite element method(FEM)was employed to study the vibration response of patients with idiopathic scoliosis and kyphosis.The objective is to analyze the dynamic characteristics of idiopathic scoliosis and kyphosis using FEM.The finite element model of T1—S1 segments was established and verified using the CT scanning images.The established scoliosis and kyphosis models were verified statistically and dynamically.The finite element software Abaqus was utilized to analyze the mode,harmonic response,and transient dynamics of scoliosis and kyphosis.The first four natural frequencies extracted from modal analysis were 1.34,2.26,4.49 and 17.69 Hz respectively.Notably,the first three natural frequencies decreased with the increase of upper body mass.In harmonic response analysis,the frequency corresponding to the maximum amplitude in x direction was the first order natural frequency,and the frequency corresponding to the maximum amplitude in y and z directions was the second order natural frequency.At the same resonance frequency,the amplitude of the thoracic spine was larger relative to that of the lumbar spine.The time domain results of transient analysis showed that the displacement dynamic response of each segment presented cyclic response characteristics over time.Under 2.26 Hz excitation,the dynamic response of the research object appeared as resonance.The higher the degree of spinal deformity,the greater the fundamental frequency.The first three natural modes of scoliosis and kyphosis contain vibration components in the vertical direction.The second order natural frequency was the most harmful to patients with scoliosis and kyphosis.Under cyclic loading,the deformation of the thoracic cone exceeds that of the lumbar cone.展开更多
In this article,we comment on the article by Oommen et al.Oommen et al provided a comprehensive overview of the management of hip centre restoration in total hip arthroplasty(THA)for childhood hip disorder sequelae.Gi...In this article,we comment on the article by Oommen et al.Oommen et al provided a comprehensive overview of the management of hip centre restoration in total hip arthroplasty(THA)for childhood hip disorder sequelae.Given the developmental disparity in this population,specific preoperative planning is an essential prerequisite for the success of THA procedures.In the review by Oommen et al,assessments of acetabular and femoral anatomic variations were fully described.However,spinal malalignment and stiffness are common in physical and radiological examinations and should be taken into careful consideration when planning surgical procedures.Poor outcomes of THA for patients with comorbid hip and spinopelvic pathologies have been widely reported,especially for hips with childhood disorder sequelae.Therefore,in this editorial,we would like to emphasize the need for a thorough hip-spine evaluation of patients with childhood hip disorder sequelae before THA.展开更多
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:""><span style="font-family:Verdana;"> Thoracolumbar spine fracture-dislocations are very unstable and usually secondary to high energy trauma. Due to disruption of the entire vertebrae columns, the absence of neurological deficit is exceptional. </span><b><span style="font-family:Verdana;">Aim: </span></b><span style="font-family:Verdana;">The purpose of this work is to report our experience in the management of this entity in a context of limited resources and to make a review of the literature. </span><b><span style="font-family:Verdana;">Case presentation: </span></b><span style="font-family:Verdana;">A 30-year-old man was admitted with a severe low back pain after a traffic accident. Neurological functions were intact after examination. Radiological assessments revealed a complete L3-L4 fracture-dislocation.</span></span><span style="font-family:""><span style="font-family:Verdana;"> The patient underwent an open posterior reduction and internal long segment fixation. The post-operative was marked by a surgical site infection treated with surgical debridement and targeted antibiotic therapy. The neurological functions were preserved. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Fracture-dislocations of the thoracolumbar spine</span><span style="color:red;"> </span></span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> caused by high energy trauma and are remarkably unstable lesions. When they are associated with intact neurorological functions, reduction and stabilization of these fractures are a challenge.
基金supported by AHA Career Development Award 938683 (to PJD)NIH grant R01MH123700 (to MLD)
文摘Since the first electron micrograph of“lace-like structures”over 75 years ago,the endoplasmic reticulum(ER)is now viewed as a highly dynamic,constantly remodeling,continuous network of tubules and cisternae that plays an important role in a broad range of cellular activities from calcium regulation to protein synthesis and trafficking.In neurons,the ER extends from the soma through the axon to presynaptic terminals,and throughout the dendritic arbor into as many as half of all postsynaptic dendritic spines at any given time(Falahati et al.,2022).
基金supported by the National Natural Science Foundation of China,No.82271115(to MY).
文摘Synaptic plasticity is essential for maintaining neuronal function in the central nervous system and serves as a critical indicator of the effects of neurodegenerative disease.Glaucoma directly impairs retinal ganglion cells and their axons,leading to axonal transport dysfuntion,subsequently causing secondary damage to anterior or posterior ends of the visual system.Accordingly,recent evidence indicates that glaucoma is a degenerative disease of the central nervous system that causes damage throughout the visual pathway.However,the effects of glaucoma on synaptic plasticity in the primary visual cortex remain unclear.In this study,we established a mouse model of unilateral chronic ocular hypertension by injecting magnetic microbeads into the anterior chamber of one eye.We found that,after 4 weeks of chronic ocular hypertension,the neuronal somas were smaller in the superior colliculus and lateral geniculate body regions of the brain contralateral to the affected eye.This was accompanied by glial cell activation and increased expression of inflammatory factors.After 8 weeks of ocular hypertension,we observed a reduction in the number of excitatory and inhibitory synapses,dendritic spines,and activation of glial cells in the primary visual cortex contralateral to the affected eye.These findings suggest that glaucoma not only directly damages the retina but also induces alterations in synapses and dendritic spines in the primary visual cortex,providing new insights into the pathogenesis of glaucoma.
基金supported by the National Natural Science Foundation of China(NSFC/RGC/JRF N_HKU735/21)Research Grant Council of Hong Kong,China(17102120,17108821,17103922,C1024-22GF,C7074-21G)+1 种基金Health and Medical Research Fund(HMRF 09200966)(to CSWL)FRQS Postdoctoral Fellowship(to AHKF).
文摘Dendritic spines are small protrusions along dendrites that contain most of the excitatory synapses in principal neurons,playing a crucial role in neuronal function by creating a compartmentalized environment for signal transduction.The plasticity of spine morphologies provides a tunable handle to regulate calcium signal dynamics,allowing rapid regulation of protein expression necessary to establish and maintain synapses(Cornejo et al.,2022).If excitatory inputs were to be located primarily on dendritic shafts,dendrites would frequently short-circuit,preventing voltage signals from propagating(Cornejo et al.,2022).It is thus not surprising that the structural plasticity of dendritic spines is closely linked to synaptic plasticity and memory formation(Berry and Nedivi,2017).While comprehensive in vitro studies have been conducted,in vivo studies that directly tackle the mechanism of dendritic transport and translation in regulating spine plasticity spatiotemporally are limited.
文摘BACKGROUND Cervical spine fracture-dislocations in patients with ankylosing spondylitis(AS)are mostly unstable and require surgery.However,osteoporosis,one of the comorbidities for AS,could lead to detrimental prognoses.There are few accurate assessments of bone mineral density in AS patients.AIM To analyze Hounsfield units(HUs)for assessing bone mineral density in AS patients with cervical fracture-dislocation.METHODS The HUs from C2 to C7 of 51 patients obtained from computed tomography(CT)scans and three-dimensional reconstruction of the cervical spine were independently assessed by two trained spinal surgeons and statistically analyzed.Inter-reader reliability and agreement were assessed by interclass correlation coefficient.RESULTS The HUs decreased gradually from C2 to C7.The mean values of the left and right levels were significantly higher than those in the middle.Among the 51 patients,25 patients(49.02%)may be diagnosed with osteoporosis,and 16 patients(31.37%)may be diagnosed with osteopenia.CONCLUSION The HUs obtained by cervical spine CT are feasible for assessing bone mineral density with excellent agreement in AS patients with cervical fracture-dislocation.
文摘The lumbar spine is the most common sites for fractures because of the high mobility of the lumbar spine. A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. A 32-year-old man presented to us after traffic accident. In our patient, unstable fracture-dislocation of the lumbar spine at the L2-L3 level due to traffic accident occurred. The vertebral bodies were fractured and the anterior dislocation happened without spinal cord injury. The patient was a candidate for an open reduction and internal fixation surgery. The posterolateral approach was performed. After insertion of all the pedicle screws, the rods were transversally placed on L2-L3-L4 vertebral bodies and tightened. The reduction of the dislocations was carried out by pushing downwards (foreside) L2 and L4 vertebras and upwards (backside) L3 vertebrae, simultaneously. After securing the reduction of the dislocations, the rods were opened and placed along the spinal column and tightened. This technique is more effective when the pedicle of fractured vertebrae is intact.
文摘Bilateral anterior dislocations of the shoulder are rare lesions. They are even rarer when combined with a bilateral fracture of major tubercles. We report the case of a 28-year-old patient admitted to trauma emergencies after trauma by falling from the top of a stool. Clinical and radiographic findings revealed bilateral anterior shoulder dislocation associated with bilateral fracture of major tubercles. The patient was treated orthopedically by a reduction of dislocations under General Anesthesia, immobilization of the shoulders for 6 weeks followed by reeducation. The functional result after 12 months was satisfactory with a UCLA score of 30 points.
文摘BACKGROUND We report a case with the displacement of an articular fracture fragment of the base of the second metacarpal from the ulnar to the volar side,treated via the dorsal approach.The dorsal approach can be a good option not only because it allows direct observation of ligament damage and fixation of bone fragments but also because the thin subcutaneous tissue makes the approach easier.CASE SUMMARY A 45-year-old man with a right hand injury visited the hospital.A small bone fragment was identified using plain radiography.Lateral radiography revealed the fragment as lying over the volar aspect of the carpometacarpal(CMC)joint.Computed tomography revealed that approximately one-third of the CMC joint surface of the second metacarpal was damaged.We provisionally diagnosed an intra-articular fracture with significant CMC joint instability and performed open reduction and internal fixation.We made a dorsal longitudinal incision over the CMC joint between the second and third metacarpals.The dorsal ligament of the third CMC joint was torn.We thought it had been dislocated to the volar side and spontaneously reduced to that position.There are only few reports of volar dislocation of CMC joint fractures,particularly of the second and third metacarpals;our report is unique as our patient had an intact interosseous ligament between the second and third metacarpals.CONCLUSION Although past reports have used a palmar approach,the dorsal approach is a good option for these cases.
基金supported by the Neurosurgery Pain Research Institute at Johns Hopkins University and by the Lehner Family Foundation.
文摘Chronic pain after spine surgery(CPSS)is a complex disorder characterized by multifactorial pathogenesis that occurs in 8%–40%of patients undergoing lumbar spine surgery.We aimed to develop a rat model that mimics clinical CPSS conditions by taking two sequential surgical procedures.Step 1:A plastic rod was inserted into the left L5 intervertebral foramen to produce a steady compression on the dorsal root ganglion(DRG)and the spinal nerve,a common cause of low back pain(LBP).Step 2:The rod was removed after 7 days when rats exhibited mechanical and heat hypersensitivity in the ipsilateral hindpaw,followed by a full L5 laminectomy to mimic spine decompression surgery in LBP patients.The retention of the rod induced a prolonged LBP-like behavior but was quickly resolved after rod removal without laminectomy.However,rats that received laminectomy after rod removal developed heightened mechanical and heat sensitivity in the hindpaw,impaired gait,and reduced spontaneous exploration activity,indicating CPSS.Patch clamp recording revealed a significant augmentation in the intrinsic excitability of smalldiameter DRG neurons in CPSS rats.Administration of Dermorphin[D-Arg2,Lys4](1–4)amide(DALDA,5mg/kg,i.p.),a peripherally acting mu-opioid receptor(MOR)-preferred agonist,attenuated pain hypersensitivity,capsaicin-induced[Ca^(2+)]i rising and the increased intrinsic excitability of DRG neurons from CPSS rats.Our findings suggest that this new model,which mirrors the nature of CPSS developed in patients,may be useful for future studies of the underlying mechanisms.
文摘Artificial intelligence(AI)and machine learning(ML)are transforming spine care by addressing diagnostics,treatment planning,and rehabilitation challenges.This study highlights advancements in precision medicine for spinal pathologies,leveraging AI and ML to enhance diagnostic accuracy through deep learning algorithms,enabling faster and more accurate detection of abnormalities.AIpowered robotics and surgical navigation systems improve implant placement precision and reduce complications in complex spine surgeries.Wearable devices and virtual platforms,designed with AI,offer personalized,adaptive therapies that improve treatment adherence and recovery outcomes.AI also enables preventive interventions by assessing spine condition risks early.Despite progress,challenges remain,including limited healthcare datasets,algorithmic biases,ethical concerns,and integration into existing systems.Interdisciplinary collaboration and explainable AI frameworks are essential to unlock AI’s full potential in spine care.Future developments include multimodal AI systems integrating imaging,clinical,and genetic data for holistic treatment approaches.AI and ML promise significant improvements in diagnostic accuracy,treatment personalization,service accessibility,and cost efficiency,paving the way for more streamlined and effective spine care,ultimately enhancing patient outcomes.
基金Supported by Natural Science Foundation of Shandong Province,No.ZR2023MH331.
文摘BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.
文摘BACKGROUND Cauda equina syndrome(CES)is characterized by a group of symptoms that may be caused by inflammation,spinal cord compression,venous congestion,or ischemia.This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.CASE SUMMARY To report the case of a 54-year-old male patient who had CES following spinal surgery,with no obvious compression lesions found during re-exploration,suggesting that vascular insufficiency may have contributed to the condition.Furthermore,a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.CONCLUSION Postoperative CES requires urgent imaging and exploration to rule out compression;noncompressive cases,including vascular insufficiency may performed conservative management.
基金Association Neurofibromatoses et Recklinghausen(C.C)Agence Nationale de la Recherche-18-CE14-0033(C.C.,P.T.)+2 种基金Agence Nationale de la Recherche-21-CE18-007-01(C.C.,P.T.)US Department of the Army NF220019(C.C.)supported by a PhD fellowship from the University Paris-Est Créteil and the Fondation pour la Recherche Médicale(FRM)(FDT202304016600 to FK and ECO202306017399 to CG)。
文摘Neurofibromatosis type 1(NF1)is a genetic disorder affecting 1 in 3000 people due to heterozygous mutations in the NF1 gene.Patients with NF1 can develop multiple symptoms,such as neurofibromas,skin hyperpigmentation,and bone abnormalities,including tibial pseudarthrosis and spine deformity.Here,we aimed to elucidate the cellular origin and pathogenic mechanism of NF1 spine deformity.We explored the Prss56-Nf1 knockout(KO)mouse model that recapitulates neurofibromas and pseudarthrosis by carrying Nf1 gene inactivation in Prss56-expressing boundary cap cells,a neural crest subset,and their derivatives.Micro-CT analyses showed that Prss56-Nf1 KO mice exhibit spine deformity from 12 months of age,associated with vertebral anomalies reminiscent of patients with NF1.Fate mapping revealed a significant increase in OSX^(+)osteoblasts of the Prss56 lineage in vertebrae of Prss56-Nf1 KO mice.Increased traced Nf1-deficient cells correlated with increased vertebral bone volume and kyphosis spine curvature.Finally,we showed that treating Prss56-Nf1 KO mice with RAS-MAPK pathway inhibitors prevented spine deformity.Overall,the Prss56-Nf1 KO mouse model unravels the role of osteoblasts from the Prss56 lineage as the cellular origin of NF1 spine deformity and highlights RAS-MAPK pathway inhibition as a promising therapeutic strategy for preventing NF1 spine deformity.
文摘Spinal cord injury and non-traumatic myelopathies are major causes of lifelong disability,yet conventional magnetic resonance imaging(MRI)can underestimate microstructural damage.Diffusion tensor imaging(DTI)and tractography map white-matter integrity by measuring fractional anisotropy(FA)and mean diffusivity(MD),but their adoption in spine imaging has been limited by long scan times and complex post-processing.Supsupin et al report a two-minute cervical DTI sequence integrated into routine MRI and applied to four representative pathologies–spinal cord contusion,metastatic compression,degenerative myelopathy,and multiple sclerosis–compared with five controls.Each lesion showed distinctive tractographic and quantitative patterns:For example,reduced FA with preserved MD in contusion and combined FA decrease and MD elevation in metastatic compression.These findings highlight the potential of tractography to improve diagnosis,guide surgical planning,and monitor treatment,while maintaining clinical feasibility.Remaining challenges include limited angular resolution,motion artifacts,and the need for multicenter validation and advanced reconstruction methods.This manuscript places the study in the context of current spinal diffusion imaging and outlines future directions toward routine,precision care.
基金supported by the National Natural Science Foundation of China(31972425)the Shanghai Agriculture Applied Technology Development Program,China(2020-02-08-00-08-F0148)。
文摘Fruit spine density is an important commercial trait for cucumber(Cucumis sativus L.).Most North China-type cucumbers that are grown over large areas have a dense-spine phenotype,which directly affects the appearance quality,storage,and transportation of the fruits.Here,we isolated a novel few spines mutant(fs2)from the wild-type(WT)inbred line WD1,a North China-type cucumber with high density fruit spines,by an ethyl methanesulfonate(EMS)mutagenesis treatment.Genetic analysis revealed that the phenotype of fs2 is controlled by a single recessive nuclear gene.We fine-mapped the fs2 locus using F_(2) and BC_(1) populations(1,802 and 420 individuals,respectively),which showed that the candidate gene of FS2(Csa4G652850)encodes an ARID-HMG transcription factor containing an AT-rich interaction domain(ARID)and a high mobility group box domain(HMG).One SNP(C to T)and one InDel(a 40-bp deletion)in the coding region of FS2 result in amino acid variation and premature translation termination in the fs2 mutant,respectively.FS2 was found to be highly expressed in the apical buds and young ovaries.In addition,experiments suggest that FS2 participates in the regulation of fruit spine initiation by activating the expression of the Tril gene in cucumber.This work provides not only an important reference for understanding the molecular mechanisms of fruit spine development but also an important resource for fruit appearance quality breeding in cucumber.
基金the Deanship of Research and Graduate Studies at King Khalid University for funding this work through Large Research Project under grant number RGP2/308/46。
文摘Fins are extensively utilized in heat exchangers and various industrial applications as they are lightweight and can benefit in various systems,including electronic cooling devices and automotive components,owing to their adaptable design.Furthermore,spine fins are introduced to improve performance in applications such as automotive radiators.They can be shaped in different ways and constructed from a collection of materials.Inspired by this,the present model examines the effects of internal heat generation and radiation-convection on the thermal distribution in a wetted convex-shaped spine fin.Using dimensionless terms,the proposed fin model involving a governing nonlinear ordinary differential equation(ODE)is transformed into a dimensionless form.The study uses the operational matrix with the Charlier polynomial collocation method(OMCCM)to ensure precise and computationally efficient numerical solutions for the dimensionless equation.In order to aid in the analysis of thermal performance,the importance of major parameters on the temperature profile is graphically illustrated.The main outcome of the study reveals that as the radiation-conductive,wet,and convective-conductive parameters increase,the heat transfer rate progressively improves.Conversely,the ambient temperature and internal heat generation parameters show an inverse relationship.
基金Key Laboratory of Spinal Degenerative Diseases,Xianyang City(Project No.:L2023-CXNL-CXPT-ZDSYS-010)Key Technology Innovation Team Project for Minimally Invasive Spinal Surgery,Xianyang City(Grant No.:L2022CXNLTD002)University-level Scientific Research Project,Shaanxi University of Traditional Chinese Medicine(Project No.:2020FS06).
文摘Objective:To investigate the diagnostic value of magnetic resonance imaging(MRI)in patients with Modic changes and endplate sclerosis of the lumbar spine.Methods:A total of 66 patients with lumbar spine diseases who underwent MRI and CT diagnostic examinations at the hospital from May 2024 to April 2025 were included in this study.The MRI findings of Modic changes were compared between Type I and Type II patients,and the presence or absence of endplate sclerosis signals and the HU value ratio on CT were analyzed.The pathological characteristics of Modic changes in Type I and Type II patients were observed.The imaging features of Modic changes in patients with lumbar spine diseases were analyzed.Results:Modic changes were present in 34 patients,with a total of 204 endplates evaluated,of which 74 were affected.MRI classification showed:Type I in 8 cases(10.81%),Type I/II mixed in 10 cases(13.51%),Type II in 51 cases(68.92%),and Type II/III mixed in 5 cases(6.76%).In CT reconstruction images,26 endplates with Modic changes on MRI showed sclerosis in the vertebral body,presenting high-density sclerotic features.These sclerotic areas did not exhibit distinct signal characteristics on MRI but pathologically demonstrated Type II Modic changes concurrently with fatty degeneration and sclerosis;In patients with Modic changes of Type I and Type II,regardless of the presence or absence of endplate sclerosis,the sagittal T1/T2 signal intensity ratio showed no statistically significant difference(P>0.05).However,the HU value ratio in Type II changes with sclerotic regions(2.74±0.61)was significantly higher than that in regions without sclerosis(1.16±0.23),with a statistically significant difference(P<0.05).Conclusion:CT reconstruction images of patients with lumbar Modic changes clearly demonstrate endplate sclerosis,a phenomenon closely associated with the bone marrow repair process.MRI has limited sensitivity for detecting sclerosis,potentially due to the following factors:first,differences in the radiographic characterization of endplate mineral content;second,the specific influence of different Modic types on signal intensity.This suggests that MRI classification should be combined with CT features for comprehensive interpretation.
文摘BACKGROUND Epithelioid angiosarcoma(EA)is an aggressive,malignant endothelial-cell tumor of vascular or lymphatic origin.EA often arises from deep soft tissues such as pleura,breast,bone and gastrointestinal tract.It usually affects patients aged 60-70 years and is associated with high recurrence and metastasis rates with surgical resection as the primary treatment of choice.Overall survivals are generally poor,ranging from 6 to 16 months.More than 50%of patients died of disease within 2 to 3 years of diagnosis.CASE SUMMARY We present a rare case of EA of the cervical spine causing a C6 pathological fracture complicated by severe kyphosis.The patient received C4-7 posterior laminectomy and C2/3/4/7/T1 transpedicular screw fixation,followed by anterior C5-6 corpectomy with allograft bone fusion and cervical plate fixation.Postoperative radiotherapy was administered without delay.However,the patient died of rapidly progressive acute respiratory distress syndrome 3 weeks after the second surgery.CONCLUSION EA with spinal involvement is extremely rare.Early detection and cord decompression may prevent neurological deterioration and preserve better quality of life.
基金the National Natural Science Foundation of China(No.32260235)。
文摘The dynamic response characteristics of scoliosis and kyphosis to vibration are currently unclear.The finite element method(FEM)was employed to study the vibration response of patients with idiopathic scoliosis and kyphosis.The objective is to analyze the dynamic characteristics of idiopathic scoliosis and kyphosis using FEM.The finite element model of T1—S1 segments was established and verified using the CT scanning images.The established scoliosis and kyphosis models were verified statistically and dynamically.The finite element software Abaqus was utilized to analyze the mode,harmonic response,and transient dynamics of scoliosis and kyphosis.The first four natural frequencies extracted from modal analysis were 1.34,2.26,4.49 and 17.69 Hz respectively.Notably,the first three natural frequencies decreased with the increase of upper body mass.In harmonic response analysis,the frequency corresponding to the maximum amplitude in x direction was the first order natural frequency,and the frequency corresponding to the maximum amplitude in y and z directions was the second order natural frequency.At the same resonance frequency,the amplitude of the thoracic spine was larger relative to that of the lumbar spine.The time domain results of transient analysis showed that the displacement dynamic response of each segment presented cyclic response characteristics over time.Under 2.26 Hz excitation,the dynamic response of the research object appeared as resonance.The higher the degree of spinal deformity,the greater the fundamental frequency.The first three natural modes of scoliosis and kyphosis contain vibration components in the vertical direction.The second order natural frequency was the most harmful to patients with scoliosis and kyphosis.Under cyclic loading,the deformation of the thoracic cone exceeds that of the lumbar cone.
文摘In this article,we comment on the article by Oommen et al.Oommen et al provided a comprehensive overview of the management of hip centre restoration in total hip arthroplasty(THA)for childhood hip disorder sequelae.Given the developmental disparity in this population,specific preoperative planning is an essential prerequisite for the success of THA procedures.In the review by Oommen et al,assessments of acetabular and femoral anatomic variations were fully described.However,spinal malalignment and stiffness are common in physical and radiological examinations and should be taken into careful consideration when planning surgical procedures.Poor outcomes of THA for patients with comorbid hip and spinopelvic pathologies have been widely reported,especially for hips with childhood disorder sequelae.Therefore,in this editorial,we would like to emphasize the need for a thorough hip-spine evaluation of patients with childhood hip disorder sequelae before THA.
