Effectiveness and safety of robot-assisted versus fluoroscopy-assisted pedicle screw implantation in scoliosis surgery: a systematic review and meta-analysis.

This study aimed to assess the effectiveness and safety of robot-assisted versus fluoroscopy-assisted pedicle screw implantation in scoliosis surgery. The study was registered in the PROSPERO (CRD42023471837). Two independent researchers searched PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure. The outcomes included operation time, pedicle screw implantation time, blood loss, number of fluoroscopic, accuracy of pedicle screw position, hospital stays, postoperative hospital stays, Visual Analog Scale (VAS), Japanese Orthopaedic Association (JOA) score, Scoliosis Research Society-22(SRS-22), cobb angle, cobb angle correction rate, sagittal vertical axis (SVA), and complications. Eight papers involving 473 patients met all the criteria. There was no significant difference between the two groups regarding the reduction in operation time. The effect of reducing the pedicle screw implantation time in the RA group was significant (WMD = -1.28; 95% CI: -1.76 to -0.80; P < 0.00001). The effect of reducing the blood loss in the RA group was significant (WMD=-105.57; 95% CI: -206.84 to -4.31; P = 0.04). The effect of reducing the number of fluoroscopic in the RA group was significant (WMD=-5.93; 95% CI: -8.24 to -3.62; P < ). The pedicle screw position of Grade A was significantly more in the RA group according to both the Gertzbein-Robbins scale and the Rampersaud scale. Compared with the FA group, the difference in the hospital stays in the RA group was not statistically significant, but the effect of reducing the postoperative hospital stays in the RA group was significant (WMD = -2.88; 95% CI: -4.13 to -1.63; P < 0.00001). The difference in the VAS, JOA, SRS-22, Cobb angle and Cobb angle correction rate, SVA, and complications between the two groups was not statistically significant. The robot-assisted technique achieved statistically significant results in terms of pedicle screw placement time, blood loss, number of fluoroscopies, accuracy of pedicle screw position, and postoperative hospital stay.

Risk Factors for New Vertebral Compression Fracture After Percutaneous Vertebral Augmentation: A Retrospective Study.

BACKGROUND Percutaneous vertebral augmentation is the mainstream treatment of osteoporotic vertebral compression fracture (OVCF). New vertebral compression fracture (NVCF) after percutaneous vertebral augmentation may be an issue that cannot be ignored. Nevertheless, the risk factors for NVCF are still uncertain. This research aimed to study the risk factors for NVCF after percutaneous vertebral augmentation. MATERIAL AND METHODS All patients who underwent percutaneous vertebral augmentation for OVCF from January 2019 to December 2020 were enrolled in the study. These patients were divided into NVCF and control groups according to whether they had NVCF. The covariates including sex, age, BMI, diabetes, hypertension, smoking, alcohol, fracture level, surgical method, cement leakage, cement volume, preoperative anterior vertebral height ratio, and Hounsfield unit (HU) value were reviewed. Univariate and multivariate analyses were performed to identify risk factors. RESULTS A total of 279 patients were included in this study, of which 47 had NVCF after percutaneous vertebral augmentation. Univariate analysis demonstrated that there were significant differences in age (OR=1.040, 95% CI=1.003-1.078, P=0.033), BMI (OR=0.844, 95% CI=0.758-0.939, P=0.002) and HU value (OR=0.945, 95% CI=0.929-0.962, P<0.001) between the 2 groups. Multivariate regression analysis revealed that HU value (OR=0.942, 95% CI=0.924-0.960, P<0.001) were independent risk factor for NVCF after percutaneous vertebral augmentation. CONCLUSIONS Hounsfield unit value was an independent risk factor for new vertebral compression fracture after percutaneous vertebral augmentation, whereas age and BMI were not.

microRNA-125b and its downstream Smurf1/KLF2/ATF2 axis as important promoters on neurological function recovery in rats with spinal cord injury.

The purpose of this study is to investigate the role of microRNA-125b (miR-125b) and its mechanism in spinal cord injury (SCI) by targeting Smurf1. After loss- and gain-function approaches were conducted in SCI rat models and neural stem cells (NSCs) isolated from foetal rats, the Basso-Beattie-Bresnahan (BBB) score was calculated, and related protein expression was determined by Western blot analysis and cell apoptosis by TUNEL staining. NSC viability was detected by CCK-8, migration abilities by Transwell assay and apoptosis by flow cytometry. The relationship between miR-125b, Smurf1 and KLF2 was evaluated by dual-luciferase reporter gene experiments, Co-IP and in vivo ubiquitin modification assays. Inhibition of miR-125b and KLF2 and the up-regulation of Smurf1 and ATF2 were observed in SCI rats. BBB scores were elevated, the expression of Nestin, NeuN, GFAP, NF-200 and Bcl-2 protein was enhanced but that of Bax protein was reduced, and cell apoptosis was inhibited in SCI rats after up-regulating miR-125b or silencing ATF2. Smurf1 was a target gene of miR-125b, which promoted KLF2 degradation through its E3 ubiquitin ligase function, and KLF2 repressed the expression of ATF2 in NSCs. The results in vivo were replicated in vitro. miR-125b overexpression promotes neurological function recovery after SCI.

A model of acute central cervical spinal cord injury syndrome combined with chronic injury in goats.

PURPOSE: To develop a large animal model for acute central cervical spinal cord injury syndrome (ACCSCIS. METHODS: Twenty-four adult male goats were randomized into four groups including group A with acute compression injury, group B with anterior chronic compression, group C as the test group that received anterior chronic compression by screw and acute compression by posterior balloon insertion, and group D as normal controls that received sham surgery. Neurological function (modified Tarlov motor function), CT, MRI, cortical somatosensory evoked potentials (CSEP), and pathological analysis were evaluated. The data were analyzed statistically. RESULTS: The motor function of the goats in group C was significantly lower than other groups. CSEP before spinal cord compression showed a stable pattern. Spinal cord compression resulted in a gradual decrement in the peak latency and significant increment in the peak amplitude. Cervical spinal canal occupying ratio was significantly lower in group C than the other groups. MRI revealed focal low signal in T1 weighted images and focal high signal in T2 weighted images in group C. Pathological analysis showed more severe lesions in the gray matter than that in the white matter in group C. CONCLUSIONS: The model well simulated the pathogenesis and resembled the clinical characteristics of ACCSCIS. This model seems to have the potential to contribute to the development of effective therapies for ACCSCIS.

Cervicothoracic spinal cord compression caused by IgG4-related sclerosing pachymeningitis: a case report and literature review.

PURPOSE: To report a case of cervicothoracic spinal cord compression caused by IgG4-related sclerosing pachymeningitis (IgG4-RSP). METHODS: A 43-year-old male patient presented with 'neck pain for 15 days, exacerbated accompanying motor and sensory dysfunction of lower limbs with bowel and bladder dysfunction for 4 days' was admitted to our department. Combined with the history of 'acupuncture treatment', MRI results and rapid-developing progression, we considered the great possibilities of spinal cord compression by intradural hematoma and timely performed the emergency operation of cervical double-door laminoplasty and thoracic decompression with internal fixation. RESULTS: After combined therapy of dexamethasone, mannitol and neurotrophic drugs, sensory recovery of lower limbs started at the fifth day after operation and the sensory function became normal at the fourteenth day after operation with still complete loss of muscle strength. Pathological examination strongly suggested the diagnosis of IgG4-related sclerosing pachymeningitis (IgG4-RSP). CONCLUSIONS: IgG4-related sclerosing pachymeningitis (IgG4-RSP) is a newly recognized disease. This case of cervicothoracic spinal cord compression caused by IgG4-related sclerosing pachymeningitis (IgG4-RSP) has never been reported in China with merely three case reports worldwide. Prompt surgical decompression is recommended and pathological examination is essential for diagnosis and comprehensive treatment.

Akt-independent GSK3 inactivation downstream of PI3K signaling regulates mammalian axon regeneration.

Inactivation of glycogen synthase kinase 3 (GSK3) has been shown to mediate axon growth during development and regeneration. Phosphorylation of GSK3 by the kinase Akt is well known to be the major mechanism by which GSK3 is inactivated. However, whether such regulatory mechanism of GSK3 inactivation is used in neurons to control axon growth has not been directly studied. Here by using GSK3 mutant mice, in which GSK3 is insensitive to Akt-mediated inactivation, we show that sensory axons regenerate normally in vitro and in vivo after peripheral axotomy. We also find that GSK3 in sensory neurons of the mutant mice is still inactivated in response to peripheral axotomy and such inactivation is required for sensory axon regeneration. Lastly, we provide evidence that GSK3 activity is negatively regulated by PI3K signaling in the mutant mice upon peripheral axotomy, and the PI3K-GSK3 pathway is functionally required for sensory axon regeneration. Together, these results indicate that in response to peripheral nerve injury GSK3 inactivation, regulated by an alternative mechanism independent of Akt-mediated phosphorylation, controls sensory axon regeneration.

Exosome microRNA-22 inhibiting proliferation, migration and invasion through regulating Twist1/CADM1 axis in osteosarcoma.

This study aims to the function of miR-22 original mesenchymal stem cells (MSC) on osteosarcoma (OS) proliferation, migration and invasion. Bio-informatics analysis including GEO2R analysis, Gene Ontology analysis, integration analysis were used to confirmed the target genes (miR-22, Twist1, CADM1) in OS. RT-qPCR and western blotting confirmed the different expression of miR-22, Twist1, CADM1 in OS tissues, MG63 and Saos cell lines. MTS assay, CCK8 assay, colony forming assay, EdU assay were performed to detect the proliferation effect of miR-22 on MG63. Transwell migration assay, transwell invasion assay, wound healing assay were used to verify the migration and invasion effect of miR-22 on MG63. Luciferase reporter assay confirm the binding sites between miR-22 and Twist1. RT-qPCR confirmed miR-22 and CADM1 downregulated and Twist1 upregulated in OS tissues, MG63 and Saos. Exosome original MSC labeled with PKH-26 could be uptake by MG63, which upregulated the expression of miR-22 in MG63. High expression of miR-22 in MG63 inhibited proliferation, migration and invasion, which could be rescued by Twist1. Dual luciferase reporter analysis confirmed Twist1 was a target of miR-22. Exosome modified with miR-22 mimic inhibit proliferation, migration and invasion more efficient than exosome original MSC. miR-22 cargo in exo-MSC could uptake by MG63 and supply MG63 with miR-22, which inhibit MG63 proliferation, migration and invasion through targeting Twist1.

Effectiveness and safety of robot-assisted versus fluoroscopy-assisted cortical bone trajectory screw instrumentation in spinal surgery: a systematic review and meta-analysis.

Robot-assisted (RA) technology has been shown to be a safe aid in spine surgery, this meta-analysis aims to compare surgical parameters and clinical indexes between robot-assisted cortical bone trajectory (CBT) and fluoroscopy-assisted (FA) cortical bone trajectory in spinal surgery. We searched databases such as PubMed, Web of Science, the Cochrane Library, and the China National Knowledge Infrastructure. The study selection process was guided by the PICOS (Patient/Problem, Intervention, Comparison, Outcome, Study Design) strategy. The risk of bias in non-randomized comparative studies was assessed using the risk of bias in non-randomized studies of interventions (ROBINS-I) tool. We performed this meta-analysis using RevMan 5.3 software (Cochrane Collaboration, Copenhagen, Denmark), and the level of statistical significance was set at P < 0.05. Six articles involving 371 patients and 1535 screws were included in this meta-analysis. RA-CBT outperformed FA-CBT in terms of various parameters, such as accuracy of pedicle screw position (both Gertzbein-Robbins scale and Ding scale), avoidance of superior facet joint violation (FJV), and reduction of neurological injury. Our meta-analysis offered a thorough evaluation of the efficacy and safety of RA-CBT in spinal surgery. The findings revealed that RA-CBT produced statistically significant results in terms of pedicle screw position accuracy and superior facet joint violation prevention. In terms of surgical parameters and clinical indexes, future research and clinical practice should investigate the efficacy of RA-CBT further. The study was registered in the PROSPERO (CRD42023466280).

Effectiveness and safety of robot-assisted minimally invasive transforaminal lumbar interbody fusion for degenerative lumbar spinal diseases: a systematic review and meta-analysis.

Robot-assisted (RA) technology has been widely used in spine surgery. This analysis aimed to compare the effectiveness and safety of RA minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and fluoroscopy-assisted (FA) MIS-TLIF for degenerative lumbar spinal diseases (DLSD). PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure were systematically searched, and the outcomes included surgical parameters [operation time, blood loss, number of fluoroscopic, accuracy of pedicle screw position, superior facet joint violation (FJV)], and clinical indexes (Visual Analog Scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) score, clinical efficacy, hospital stays, complications). Eleven articles involving 1066 patients were included. RA group produced better results than the FA group in operation time (WMD = - 6.59; 95% CI - 12.79 to - 0.40; P = 0.04), blood loss (WMD = - 34.81; 95% CI - 50.55 to - 19.08; P < 0.0001), number of fluoroscopic (WMD = - 18.24; 95% CI - 30.63 to - 5.85; P = 0.004), accuracy of pedicle screw position: Grade A (OR = 3.16; 95% CI 2.36-4.23; P < 0.00001), Grade B (OR = 0.39; 95% CI 0.28-0.54; P < 0.00001), Grade C (OR = 0.27; 95% CI 0.13-0.54; P = 0.0002), and Grade D (OR = 0.17; 95% CI 0.03-0.98; P = 0.05), FJV: Grade 0 (OR = 3.27; 95% CI 1.34-8.02; P = 0.010), Grade 1 (OR = 0.24; 95% CI 0.16-0.38; P < 0.00001), Grade 2 (OR = 0.24; 95% CI 0.12-0.51; P = 0.0002), and Grade 3 (OR = 0.26; 95% CI 0.07-0.93; P = 0.04). But no significant differences in VAS score, ODI, JOA score, clinical efficacy, hospital stays, and complications. These results demonstrate a significant improvement in the intraoperative course of the RA technique. However, RA-MIS-TLIF has not yet demonstrated significant advantages in terms of postoperative symptom relief and functional improvement. Future research and clinical practice should further explore the efficacy of this technique to optimize outcomes and quality of life for patients with DLSD. The study was registered in the PROSPERO (CRD42023454405).

An anatomic study on the placement of the second sacral screw and its clinical applications.

BACKGROUND: The fixation of lumbosacral and sacral pelvis can be performed on the ilium and the Second Sacrum Vertebrae (S2). Although several studies on the anatomical and biomechanical features of S2 screw fixation have been published, little clinical application has been reported, especially combination of anatomical investigation and clinical study. This study was performed to design and optimize the method of pedicle screw placement for S2. MATERIALS AND METHODS: Fifteen adult dry sacrum specimens were prepared and truncated from the S1-S2 and S2-S3 vertebral fusion remnants, and the morphology of the S2 vertebral body was observed from this section. The intersection of the horizontal line through the lowest point of the inferior edge of the first posterior sacral foramen and the lateral sacral crest was the entry point (Point X). The screws were inserted anterolaterally or anteromedially at Point X in 10 cadavers, with all of the screws penetrating the sacrum. Finally, the S2 sacral screw fixation technique was applied to a total of 13 patients with lumbosacral lesions, and the clinical outcome was evaluated at a minimum follow-up of 1 year. RESULTS: Two S2 sacral screw placement methods were developed, i.e., the anterolateral and anteromedial insertions. Seven patients had complete preoperative, postoperative, and follow-up data. In all cases, the bilateral S2 screws were placed in good position and the fixation was firm. There was no surgical wound infection or internal fixation loosening. All the patients achieved partial bone graft healing, which was verified by computed tomography. CONCLUSIONS: The intersection of the horizontal line through the lowest point of the inferior edge of the first posterior sacral foramen and the lateral sacral crest can be used as the entry point for S2 sacral screw fixation. The S2 pedicle screw fixation shows good clinical effectiveness and safety for stable reconstruction of lumbosacral lesions.

The role of demethylase AlkB homologs in cancer.

The AlkB family (ALKBH1-8 and FTO), a member of the Fe (II)- and α-ketoglutarate-dependent dioxygenase superfamily, has shown the ability to catalyze the demethylation of a variety of substrates, including DNA, RNA, and histones. Methylation is one of the natural organisms' most prevalent forms of epigenetic modifications. Methylation and demethylation processes on genetic material regulate gene transcription and expression. A wide variety of enzymes are involved in these processes. The methylation levels of DNA, RNA, and histones are highly conserved. Stable methylation levels at different stages can coordinate the regulation of gene expression, DNA repair, and DNA replication. Dynamic methylation changes are essential for the abilities of cell growth, differentiation, and division. In some malignancies, the methylation of DNA, RNA, and histones is frequently altered. To date, nine AlkB homologs as demethylases have been identified in numerous cancers' biological processes. In this review, we summarize the latest advances in the research of the structures, enzymatic activities, and substrates of the AlkB homologs and the role of these nine homologs as demethylases in cancer genesis, progression, metastasis, and invasion. We provide some new directions for the AlkB homologs in cancer research. In addition, the AlkB family is expected to be a new target for tumor diagnosis and treatment.

Efficacy and safety of robot-assisted versus fluoroscopy-assisted PKP or PVP for osteoporotic vertebral compression fractures: a systematic review and meta-analysis.

Percutaneous vertebral augmentation (PVA), which includes percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP). Robot-assisted (RA) and fluoroscopy-assisted (FA) are important methods for treating osteoporotic vertebral compression fractures (OVCFs), though it is still unclear which is superior. This analysis aimed to compare the efficacy and safety of RA and FA. PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure were systematically searched, the outcomes included surgical parameters (leakage rate, operation time, number of fluoroscopic, injection volume, inclination angle), and clinical indexes (hospital stays, Visual Analog Scale (VAS), Oswestry Disability Index (ODI), Cobb angle, the midline height of vertebral). Thirteen articles involving 1094 patients were included. RA group produced better results than the FA group in the leakage rate (OR = 0.27; 95% CI 0.17-0.42; P < 0.00001), number of fluoroscopic (WMD = - 13.88; 95% CI - 18.47 to - 9.30; P < 0.00001), inclination angle (WMD = 5.02; 95% CI 4.42-5.61; P < 0.00001), hospital stays (WMD = - 0.32; 95% CI - 0.58 to - 0.05; P = 0.02), VAS within 3 days (WMD = - 0.19; 95% CI - 0.26 to - 0.12; P < 0.00001), Cobb angle within 3 days (WMD = - 1.35; 95% CI - 2.56 to - 0.14; P = 0.003) and Cobb angle after 1 month (WMD = - 1.02; 95% CI - 1.84 to - 0.20; P = 0.01). But no significant differences in operation time, injection volume, ODI, the midline height of vertebral, and VAS score after 1 month. Our analysis found that the RA group had lower cement leakage rates, number of fluoroscopic and hospital stays, a larger inclination angle, better short-term pain improvement, and Cobb angle improvement. It is worth acknowledging that robotic-assisted surgery holds promise for the development of spine surgery. The study was registered in the PROSPERO (CRD42023393497).

[Research progress of intraspinal solitary fibrous tumor].

Objective: To review the research progress of intraspinal solitary fibrous tumor (SFT). Methods: The domestic and foreign researches on intraspinal SFT were extensively reviewed and analyzed from four aspects, including disease origin, pathological and radiological characteristics, diagnosis and differential diagnosis, and treatment and prognosis. Results: SFT is an interstitial fibroblastic tumor with a low probability of occurrence in the central nervous system, especially in the spinal canal. In 2016, the World Health Organization (WHO) used the joint diagnostic term "SFT/hemangiopericytoma" according to the pathological characteristics of mesenchymal fibroblasts, which can be divided into three levels according to specific characteristics. The diagnosis process of intraspinal SFT is complex and tedious. It has relatively variable imaging manifestations and specific pathological changes of NAB2-STAT6 fusion gene, which often requires differential diagnosis with neurinoma, meningioma, etc. The treatment of SFT is mainly resection, which can be assisted by radiotherapy to improve the prognosis. Conclusion: Intraspinal SFT is a rare disease. Surgery is still the main treatment. It is recommended to combine preoperative or postoperative radiotherapy. The efficacy of chemotherapy is still unclear. In the future, more studies are expected to establish a systematic diagnosis and treatment strategy for intraspinal SFT.

Research progress on black phosphorus hybrids hydrogel platforms for biomedical applications.

Hydrogels, also known as three-dimensional, flexible, and polymer networks, are composed of natural and/or synthetic polymers with exceptional properties such as hydrophilicity, biocompatibility, biofunctionality, and elasticity. Researchers in biomedicine, biosensing, pharmaceuticals, energy and environment, agriculture, and cosmetics are interested in hydrogels. Hydrogels have limited adaptability for complicated biological information transfer in biomedical applications due to their lack of electrical conductivity and low mechanical strength, despite significant advances in the development and use of hydrogels. The nano-filler-hydrogel hybrid system based on supramolecular interaction between host and guest has emerged as one of the potential solutions to the aforementioned issues. Black phosphorus, as one of the representatives of novel two-dimensional materials, has gained a great deal of interest in recent years owing to its exceptional physical and chemical properties, among other nanoscale fillers. However, a few numbers of publications have elaborated on the scientific development of black phosphorus hybrid hydrogels extensively. In this review, this review thus summarized the benefits of black phosphorus hybrid hydrogels and highlighted the most recent biological uses of black phosphorus hybrid hydrogels. Finally, the difficulties and future possibilities of the development of black phosphorus hybrid hydrogels are reviewed in an effort to serve as a guide for the application and manufacture of black phosphorus -based hydrogels. Recent applications of black phosphorus hybrid hydrogels in biomedicine.

[Retracted] MicroRNA­132 inhibits cell growth and metastasis in osteosarcoma cell lines possibly by targeting Sox4.

Following the publication of this paper, it was drawn to the Editor's attention by a concerned reader that the flow cytometric data shown in Fig. 2D on p. 1675 had already been submitted in different form in the following paper written by different authors at different research institutes: Tian R, Li Y and Gao M: Shikonin causes cell­cycle arrest and induces apoptosis by regulating the EGFR­NF­κB signalling pathway in human epidermoid carcinoma A431 cells. Biosci Rep 28: e00189, 2015. After having conducted an independent review of the data in this figure in the Editorial Office, the concerns of the reader were found to be validated. Therefore, since the contentious data in the above article had already been submitted for publication prior to its submission to International Journal of Oncology, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive any reply. The Editor apologizes to the readership for any inconvenience caused. [International Journal of Oncology 47: 1672­1684, 2015; DOI: 10.3892/ijo.2015.3147].

High expression of integrin-binding sialoprotein (IBSP) is associated with poor prognosis of osteosarcoma.

INTRODUCTION: Osteosarcoma is a malignant tumor, accounting for 20% of primary malignant bone tumors worldwide. However, the role of IBSP as a biomarker in osteosarcoma progression has not been studied yet. METHODS: 85 cases of IBSP expression and clinical characteristics were obtained from TARGET database. Through the Kaplan-Meier curve, subgroup analysis, and univariate and multivariate Cox analysis, we further assessed the independent predictive capacity of IBSP expression for overall survival (OS) and relapse-free survival (RFS). RESULTS: The mRNA expression of IBSP was higher in osteosarcoma than normal tissue (P < 0.0001). IBSP expression grouped by vital status showed statistical differences (P = 0.042). The race (P = 0.0183), vital status (P = 0.0034), and sample type (P = 0.0020) showed significant differences. IBSP expression exhibited satisfied diagnostic ability for osteosarcoma. The univariate and multivariate analysis confirmed that IBSP expression was an independent risk factor for OS (HR = 3.425, 95% CI: 1.604-7.313, P = 0.002) and RFS (HR = 3.377, 95% CI: 1.775-6.424, P < 0.001) in osteosarcoma patients. High IBSP expression was significantly associated with poor OS and RFS (P < 0.0001). The higher IBSP expression was observed in osteosarcoma (P < 0.001), confirmed by the IHC staining. The CCK-8 and colony formation assay showed that IBSP knockdown inhibits cell proliferation while overexpression promotes cell proliferation (P < 0.05). CONCLUSION: High expression of IBSP was associated with poor OS and RFS. IBSP could serve as a potential biomarker for osteosarcoma, which could aid in early detection and disease monitoring.

Analysis of Potential Risk Factors for Cement Leakage into Paraspinal Veins after Vertebroplasty for Acute Osteoporotic Vertebral Fractures Based on a 3D Reconstruction Technique: A Retrospective Matched Case-Control Study.

OBJECTIVE: Pulmonary embolism, cardiac embolism, and even cerebral embolism due to paraspinal vein leakage (PVL) are increasingly reported, and their risk factors need to be adequately investigated for prevention. To this end, this study investigated the correlation of the distribution and morphological characteristics of fracture lines with the occurrence of PVL after percutaneous vertebroplasty (PVP), which has not been previously reported. METHODS: Patients with acute single-segment thoracolumbar osteoporotic vertebral compression fractures (OVCFs) treated with PVP at our institution from January 2019 to July 2022 were selected for a matched case-control study. The case and control groups included those with and without PVL, respectively, matched at a 1:1 ratio based on general clinical characteristics. Additionally, fracture map and heatmap analysis was performed in both groups. In addition to the general clinical characteristics, the vertebral height ratio, puncture angle, delivery rate, and indexes were assessed via the three-dimensional CT reconstruction fracture line mapping technique, namely, the distribution of fracture lines, fracture line length, main fracture line shape, location of fracture line involvement, and number of fracture line branches, were compared between the two groups. The Wilcoxon rank-sum test, t tests, analysis of variance, and conditional logistic regression were used for statistical analysis. RESULTS: Among 658 patients with OVCFs, 54 who did and 54 who did not develop PVL were included in this study. Significant differences in the puncture angle, fracture line distribution (MR-1, ML-2, MM-2, MR-2, ML-3, MM-3, LL-1, LM-1, LL-2, LM-2), fracture line involvement of the posterior wall, total fracture line length, and main fracture line length were found between the two groups (p < 0.05). Logistic univariate analysis showed significant differences in the puncture angle, fracture line distribution (MR-1, ML-2, MM-2, MR-2, ML-3, MM-3, LL-1, LL-2, LM-2, LL-3), total fracture line length, main fracture line length, and fracture line involvement of the posterior wall between the two groups (p < 0.05). Logistic multifactorial analysis showed that the fracture line distribution (UR-3, ML-3, LM-2, LR-2) and main fracture line length were independent risk factors for the development of PVL in both groups. In addition, the fracture maps and heatmaps showed a greater degree of fracture line encapsulation and more extensive involvement in the middle and lower regions of the vertebral body in the PVL group than in the control group. CONCLUSIONS: Through a three-dimensional computed tomography reconstruction-based fracture line mapping technique, this study revealed for the first time that the distribution of fracture lines (UR-3, ML-3, LM-2, LR-2) and main fracture line length were independent risk factors for PVL after PVP in patients with acute single-segment thoracolumbar OVCFs. In addition, we hypothesized that the fracture line-vein traffic branch that may appear within 2 weeks after injury in acute OVCF patients may be one of the mechanisms influencing the above potential independent risk factors associated with PVL.

The Dual Effect of 3D-Printed Biological Scaffolds Composed of Diverse Biomaterials in the Treatment of Bone Tumors.

Bone tumors, including primary bone tumors, invasive bone tumors, metastatic bone tumors, and others, are one of the most clinical difficulties in orthopedics. Once these tumors have grown and developed in the bone system, they will interact with osteocytes and other environmental cells in the bone system's microenvironment, leading to the eventual damage of the bone's physical structure. Surgical procedures for bone tumors may result in permanent defects. The dual-efficacy of tissue regeneration and tumor treatment has made biomaterial scaffolds frequently used in treating bone tumors. 3D printing technology, also known as additive manufacturing or rapid printing prototype, is the transformation of 3D computer models into physical models through deposition, curing, and material fusion of successive layers. Adjustable shape, porosity/pore size, and other mechanical properties are an advantage of 3D-printed objects, unlike natural and synthetic material with fixed qualities. Researchers have demonstrated the significant role of diverse 3D-printed biological scaffolds in the treatment for bone tumors and the regeneration of bone tissue, and that they enhanced various performance of the products. Based on the characteristics of bone tumors, this review synthesized the findings of current researchers on the application of various 3D-printed biological scaffolds including bioceramic scaffold, metal alloy scaffold and nano-scaffold, in bone tumors and discussed the advantages, disadvantages, and future application prospects of various types of 3D-printed biological scaffolds. Finally, the future development trend of 3D-printed biological scaffolds in bone tumor is summarized, providing a theoretical foundation and a larger outlook for the use of biological scaffolds in the treatment of patients with bone tumors.

Co-delivery of vitamin D3 and Lkb1 siRNA by cationic lipid-assisted PEG-PLGA nanoparticles to effectively remodel the immune system in vivo.

The imbalance of the immune system can lead to the occurrence of autoimmune diseases. Controlling and regulating the proliferation and function of effector T (Teff) cells and regulatory T (Treg) cells becomes the key to treating these diseases. Dendritic cells (DCs), as dedicated antigen-presenting cells, play a key role in inducing the differentiation of naive CD4+ T cells. In this study, we designed a cationic lipid-assisted PEG-PLGA nanoparticle (NPs/VD3/siLkb1) to deliver 1,25-dihydroxyvitamin D3 (VD3) and small interfering RNA (siRNA) to DC cells in the draining lymph nodes. By modulating the phenotypic changes of DC cells, this approach expands Treg cells and reduces the occurrence of autoimmune diseases. Thus, this study provides a novel approach to alleviating the occurrence and development of autoimmune diseases while also minimizing the risk of unwanted complications.

[Application progress of implantation in surgical treatment of cervical tuberculosis].

OBJECTIVE: To review the characteristics and applications of different implantation in cervical tuberculosis surgery and the research progress of the new implantation. METHODS: By consulting relevant domestic and foreign research literature on cervical tuberculosis, the classification, advantages, disadvantages, and prospects of implantations were analyzed and summarized. RESULTS: The incidence of cervical tuberculosis has increased recently and has a high disability rate. Currently, the implantation in the surgical treatment of cervical tuberculosis are mainly divided into bone materials, metal materials, and bioactive materials; the above materials have their own advantages and disadvantages, for example, the amount of autologous bone is limited, the complications of allogeneic bone are common, and the bone fusion effect of metal materials is poor. With the development of science and technology, the implantation are also more diverse. CONCLUSION: The choice of the implantation affects the bone fusion directly, furthermore, it affects the effectiveness of cervical tuberculosis, the development of new implantation provides a variety of options for the treatment of cervical tuberculosis.