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28 March 2026, Volume 30 Issue 9 Previous Issue    Next Issue

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Tail anchoring technique of vertebroplasty in treatment of osteoporotic vertebral compression fractures with intravertebral cleft: a finite element analysis Chen Huiting, Zeng Weiquan, Zhou Jianhong, Wang Jie, Zhuang Congying, Chen Peiyou, Liang Zeqian, Deng Weiming 2026, 30 (9):  2145-2152.  doi: 10.12307/2025.873 Abstract ( 225 )   PDF (2904KB) ( 7 )   Save BACKGROUND: Percutaneous vertebroplasty is an effective surgical method for treating osteoporotic vertebral compression fractures. However, for patients with vertebral compression fractures accompanied by intravertebral clefts, how to reduce cement loosening and displacement after vertebroplasty has become one of the difficulties for spinal surgeons. OBJECTIVE: To explore the biomechanical stability of tail anchoring technique in the treatment of vertebral compression fractures with intravertebral cleft.  METHODS: A finite element model of the T10-L2 segment was established using CT scan data from a patient with osteoporotic vertebral compression fractures. On Solidwork software, the intravertebral intravertebral cleft was simulated and five sets of three-dimensional models were constructed: (1) osteoporotic vertebral compression fractures model with intravertebral cleft; (2) percutaneous vertebroplasty model of 2.5 mL bone cement; (3) 2.5 mL bone cement + percutaneous vertebroplasty model with trailing anchoring; (4) percutaneous vertebroplasty model of 4.6 mL bone cement; (5) 4.6 mL bone cement + trailing anchored percutaneous vertebroplasty model. Then, the model was imported into Ansys software, and structures such as ligaments were added and assigned values for finite element analysis. The loading conditions were as follows: a 400 N vertical downward load was applied to the upper surface of T10 vertebral body to simulate the weight of the upper body, and a moment of 7.5 N·m was applied in different directions to simulate movements such as spinal flexion, extension, and rotation. The differences in motion range, deformation degree, maximum equivalent stress, and bone cement stress were compared between different models.  RESULTS AND CONCLUSION: (1) In terms of the range of motion of fractured vertebral bodies, osteoporotic vertebral compression fractures models with intravertebral clefts had the greatest range of motion, reaching 4°-7° in all directions. Although the 2.5 mL bone cement model and the 2.5 mL bone cement + trailing anchor model could partially reduce abnormal movement of fractured vertebrae, their stability was still poor, with a motion range of up to 3°-4° during flexion, extension, and rotation. In the 4.6 mL bone cement + trailing anchor model, the mobility of fractured vertebral bodies was significantly reduced and relatively stable. The motion range of fractured vertebrae decreased by 81%, 83%, 77%, 69%, 76%, and 79% compared with the osteoporotic vertebral compression fractures model with intravertebral cleft, indicating that it had the best biomechanical stability. (2) In terms of the maximum equivalent stress and deformation degree of fractured vertebral bodies, the results were as follows: osteoporotic vertebral compression fractures model with intravertebral cleft > 2.5 mL bone cement model > 2.5 mL bone cement + trailing anchor model > 4.6 mL bone cement model > 4.6 mL bone cement + trailing anchor model, indicating that when there was a small amount of bone cement, the use of only trailing anchoring technology could not effectively stabilize fractured vertebrae. When the amount of bone cement in front of the vertebral body reached 4.6 mL, combined with trailing anchoring technology, it could significantly reduce the maximum equivalent stress and deformation degree of the vertebral body. (3) It is noteworthy that in both sets of tail-anchored models, the maximum equivalent stress of bone cement significantly increased, primarily concentrated in the mid-to-posterior region of the trailing bone cement. (4) In general, with a certain amount of bone cement in the vertebral body, the trailing anchoring technique could significantly enhance the stability of fractured vertebrae and reduce their abnormal movement and stress concentration within the vertebral body. It is a surgical technique worth trying. However, it should be noted that the stress of bone cement in the trailing anchoring part increases significantly. If patients do not pay attention to protection after surgery, there may be a risk of fracture of bone cement at the anchoring site. Figures and Tables | References | Related Articles | Metrics

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Two lumbar rotary manipulation techniques in treating lumbar disc herniation: a finite element analysis of biomechanical differences Zeng Xuan, Weng Rui, Ye Shicheng, Tang Jiadong, Mo Ling, Li Wenchao 2026, 30 (9):  2153-2161.  doi: 10.12307/2026.313 Abstract ( 42 )   PDF (2435KB) ( 11 )   Save 1Third Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510145, Guangdong Province, China; 2School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China; 3Department of Spine Orthopedics, Third Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Institute of Traditional Chinese Medicine and Traumatology), Guangzhou 510145, Guangdong Province, China  Figures and Tables | References | Related Articles | Metrics

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Finite element analysis of novel variable-diameter screws in modified cortical bone trajectory of lumbar vertebrae Cheng Qisheng, Julaiti·Maitirouzi, Xiao Yang, Zhang Chenwei, Paerhati·Rexiti 2026, 30 (9):  2162-2171.  doi: 10.12307/2026.580 Abstract ( 31 )   PDF (4687KB) ( 8 )   Save BACKGROUND: In osteoporotic patients, cancellous bone is insufficient to maintain screw grip and the failure rate of internal spinal fixation is high. Traditional trajectory and cortical bone trajectory screw placement techniques are still insufficient. The modified cortical bone trajectory technique has been proven to have good performance, but requires screws that match its characteristics. OBJECTIVE: To compare the performance of three new variable-diameter all-cortical bone threaded screws with nonvariable-diameter all-cortical bone threaded screws in modified cortical bone track placement technique by finite element analysis. METHODS: Based on the CT data of an adult osteoporosis wet body specimen (male, 63 years old), the L1-L5 lumbar vertebral and sacral model was established, and three new variable-diameter all-cortical bone thread screws (single thread screw, 45 mm in overall length, 5.5 mm in diameter for thicker rods, 4.35 mm in diameter for finer rods, and uniformly variable diameter at two-thirds, one-half, and one-third of the variable-diameter segments of 8 mm in length, respectively), were used in a modified cortical bone-track nailing technique, respectively. With the non-variable diameter full cortical bone threaded screw (single threaded screw, 45 mm in overall length, and 5.5 mm in diameter) in the lumbar spine L4-L5 nailed and modeled. The un-nailed control group and the four nailed model groups received finite element analysis comparison. The mechanical properties of the screws in each group were compared under the modified cortical bone trajectory technique by calculating the range of motion of the lumbar vertebrae, internal fixation system stress, L4-L5 vertebral body stress, and L4-L5 intervertebral disc stress.  RESULTS AND CONCLUSION: Under flexion, extension, lateral bending, and axial rotation working conditions, (1) the overall range of motion of the lumbar vertebrae was reduced by 14.16%, 23.75%, 8.44%, and 7.17% in the two-thirds group compared to the control group. The non-variable-diameter group was reduced by 14.45%, 23.97%, 8.52%, and 7.07%, respectively, compared with the control group. The three new variable-diameter screws had similar levels to the non- variable-diameter screws. (2) In the two-thirds group compared with the non-reducing screw group, the internal fixation system stress decreased by 3.94%, increased by 20.60%, increased by 1.16%, and decreased by 8.59%, respectively. In the one-half group compared with the non-reducing screw group, the internal fixation system stress increased by 2.06%, decreased by 0.05%, 0.14%, and 5.98%, respectively. In the one-third group compared with the non-reducing screw group, the internal fixation system stress increased by 4.16%, 13.96%, 5.07%, and decreased by 4.19%, respectively. (3) The vertebral body stresses in the four nailed model groups were elevated compared with the non-nailed group, and there was no significant increase in the three reducer screws group compared with the non-variable-diameter group. (4) The stress of the fixed segment of the intervertebral disc in the four nailed model groups was significantly reduced compared with the un-nailed group, and was basically the same in the three variable-diameter screw groups compared with the non-variable-diameter group. It is indicated that in the modified cortical bone trajectory technique, the new variable-diameter screws can provide a fixation effect that is not weaker than that of the non-variable-diameter screws.  Figures and Tables | References | Related Articles | Metrics

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Finite element simulation of scoliosis with muscle unit introduction: verification of correction effect under bidirectional load Wu Hongxu, Liu Xuanyu, Wang Taoyu, Wang Shiyao, Cheng Jingyi, Zhang Mingwen, Zhang Yinxia, Liu Zhihua, Wang Xiaojie 2026, 30 (9):  2172-2181.  doi: 10.12307/2026.116 Abstract ( 44 )   PDF (2076KB) ( 9 )   Save BACKGROUND: At present, conservative treatments for scoliosis mainly include physical therapy, brace correction, and traction. In clinical practice, as much traction as possible is usually used within the tolerance range of the patient, and as the tolerance increases, the traction will also increase. OBJECTIVE: To establish a three-dimensional finite element model of scoliosis, incorporating muscle units to enhance realism, and investigate the therapeutic efficacy of a scoliosis correction system with bidirectional (axial and lateral) corrective loads. By analyzing the interaction between axial traction and lateral pushing forces, the study explores how corrective forces influence the Cobb angle, providing a theoretical basis for optimizing individualized treatment plans. METHODS: Spinal CT scan data from a scoliosis patient aged 35 years old were used to construct a 3D finite element model using Mimics, Geomagic Wrap, and HyperMesh software, with muscle units integrated. Finite element analysis was performed via Abaqus. The therapeutic effects of axial traction and lateral pushing loads—applied individually and in combination—were evaluated. Additionally, the impact of periodic lateral loading on treatment efficacy was studied, and a mathematical model of the moments generated by the two loads was developed for computational analysis. RESULTS AND CONCLUSION: (1) When axial traction load combined with lateral push load, the correction rate of scoliosis treatment was 22% in the thoracic segment and 24% in the lumbar segment, respectively, which was better than the two effects alone, and the correction rate was further increased to 27% and 29% with the addition of periodic lateral load. (2) There was a certain relationship between the effect of the two kinds of loads and the Cobb angle. When the Cobb angle was less than 53.13°, the effect of the lateral load was better than that of the axial load. When the Cobb angle was more than 53.13°, the effect of the axial load was better than that of the lateral load, which provided a mechanical theoretical basis for the sequence of application of the two kinds of orthopedic forces. (3) These results provide theoretical support for the development of patient personalized treatment to ensure the safety and effectiveness of orthopedic forces. Figures and Tables | References | Related Articles | Metrics

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Three-dimensional finite element analysis of cervical spine biomechanical characteristics in a rat model of cervical vertigo Liu Jiafu, Ren Ruxia, Liao Zhouwei, Zhou Xiali, Wu Yihong, Zhang Shaoqun 2026, 30 (9):  2182-2190.  doi: 10.12307/2026.126 Abstract ( 38 )   PDF (2636KB) ( 8 )   Save BACKGROUND: Cervical vertigo is one of the common types of vertigo. Previous studies have mostly simulated cervical vertigo by establishing a rat model of cervical instability, but the specific biomechanical mechanisms leading to cervical vertigo remain unclear. OBJECTIVE: To investigate the biomechanical characteristics of the cervical instability model in cervical vertigo rats and reveal its pathogenic mechanisms. METHODS: Based on the three-dimensional CT data of the cervical spine from 8-week-old healthy rats, a normal three-dimensional geometric model of C2–C7 (including vertebrae, intervertebral discs, and ligaments) was constructed using Mimics software. The cervical vertigo model was created by removing the supraspinous ligament, interspinous ligament, and facet joint cartilage at C5–6. Ansys software was used to analyze the overall stress distribution, overall displacement of the cervical spine, and stress changes in the C5–6 intervertebral disc under various conditions such as loading, flexion, extension, rotation, and lateral bending.                RESULTS AND CONCLUSION: (1) Compared to the normal group, the cervical vertigo group exhibited increased maximum total displacement of the cervical spine across all loading conditions, with the largest increments observed during rotation (left rotation: +84%; right rotation: +233%). (2) Except for flexion, the cervical vertigo group showed elevated maximum stress in the cervical spine under all other conditions, peaking during rotation (left rotation: +102%; right rotation: +165%). (3) The C5–6 intervertebral disc stress in the cervical vertigo group was significantly higher than in the normal group under all conditions, with the most pronounced increases during rotation (left rotation: +312%; right rotation: +323%). (4) It is concluded that current cervical vertigo modeling method effectively reduces cervical stability, leading to abnormal stress concentration across the cervical spine, particularly at the C5–6 intervertebral disc during rotation. This study not only provides critical biomechanical evidence supporting the reliability of the rat cervical vertigo model but also elucidates the potential pathogenesis of “cervical instability–abnormal cervical stress concentration–cervical vertigo episodes.” Figures and Tables | References | Related Articles | Metrics

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Finite element analysis of tibial prosthesis loosening after fixed-bearing unicompartmental knee arthroplasty for osteoporosis Liu Wenlong, Dong Lei, Xiao Zhengzheng, Nie Yu 2026, 30 (9):  2191-2198.  doi: 10.12307/2026.541 Abstract ( 30 )   PDF (1644KB) ( 15 )   Save BACKGROUND: Osteoporosis is generally considered as one of the risk factors for tibial component loosening after unicompartmental knee arthroplasty. However, few finite element studies have investigated tibial component loosening after fixed-bearing unicompartmental knee arthroplasty in osteoporosis patients.  OBJECTIVE: To investigate the slip and stress characteristics around the prosthesis by finite element method after the intervention of cancellous bone slotting and reduction posterior slope under different bone mineral density.  METHODS: The three-dimensional model of the knee joint of a 61-year-old female patient with knee osteoarthritis was reconstructed by computed tomography. Subsequently, fixed-bearing unicompartmental knee arthroplasty surgery was performed on the three-dimensional model in the computer, and the intervention of tibial cancellous bone grooving and reducing the angle of retroversion was implemented. Then, the material parameters were assigned to the osteoporosis and non-osteoporosis, respectively. The finite element analysis method was used to verify whether tibial slotting and changing the tibial posterior tilt angle would affect the aseptic loosening rate of the prosthesis.   RESULTS AND CONCLUSION: (1) In the finite element analysis of fixed-bearing unicompartmental knee arthroplasty, the bone bearing capacity of the osteoporosis knee was weaker than that of the non-osteoporosis knee. (2) The tibial component with different bone mineral density was more prone to the anteroposterior slip than the medial and lateral slip. (3) The degree of cancellous bone slip was reduced after the transverse groove design, which could prevent the loosening of the prosthesis. (4) For the osteoporosis knee, the tibia with reduced posterior slope (6° to 4°) had a stronger ability to bear load, and the possibility of prosthesis loosening was reduced. (5) The scheme of reducing posterior slope and opening transverse groove at the same time had advantages in preventing postoperative prosthesis loosening, and this advantage was more significant in osteoporosis knees.  Figures and Tables | References | Related Articles | Metrics

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Finite element analysis of the force changes of the supraspinatus tendon and glenohumeral joint during the abduction and flexion of the humerus Zheng Wangyang, Fei Ji, Yang Di, Zhao Lang, Wang Lingli, Liu Peng, Li Haiyang 2026, 30 (9):  2199-2207.  doi: 10.12307/2026.098 Abstract ( 32 )   PDF (2053KB) ( 23 )   Save BACKGROUND: The shoulder joint is a complex and highly mobile joint in the human body. Its normal operation is crucial for daily life, but it is also prone to injuries. Diseases such as rotator cuff injuries, labral injuries, and dislocations are relatively common. Understanding the biomechanical characteristics of the shoulder joint is of great significance for the prevention and treatment of related diseases. Finite element analysis provides a powerful tool for such research. OBJECTIVE: To analyze the force changes of the supraspinatus tendon and glenohumeral joint during humeral abduction and flexion using finite element method. METHODS: A three-dimensional finite element model of the shoulder joint was constructed. The three-dimensional models of the humerus and scapula were extracted in Mimics software. They were processed and solidified in Geomagic software. In SolidWorks software, the models were assembled and models at different angles were established, and the supraspinatus tendon and articular cartilage were constructed. In Ansys software, material properties and contact relationships were set, and the stress changes of the supraspinatus tendon and articular cartilage were observed and analyzed. RESULTS AND CONCLUSION: (1) The type I acromion morphology did not induce subacromial impingement syndrome when the humeral abduction angle was ≤ 90°. (2) The stress of the supraspinatus tendon showed a non-linear increasing trend with the humeral abduction angle. (3) There was a significant positive correlation between the stress of the glenohumeral joint cartilage and the abduction/flexion angle. (4) The stress load of the articular cartilage in the abduction state was significantly higher than that in the flexion state (P < 0.01). (5) Through finite element analysis, this study for the first time revealed the biomechanical safety characteristics of the type I acromion within the abduction range of 0°-90°, and quantified the stress-angle dynamic relationship of the supraspinatus tendon and the glenohumeral joint. However, due to model simplification and static analysis, the conclusions need to be verified by multi-modal in vivo experiments. Nevertheless, this study has laid an important theoretical foundation for the intervention strategy of related diseases. Figures and Tables | References | Related Articles | Metrics

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Mechanical effects of Long’s traction orthopedic method on cervical functional units: quantitative analysis of biomechanical model of head and neck Cai Qirui, Dai Xiaowei, Zheng Xiaobin, Jian Sili, Lu Shaoping, Liu Texi, Liu Guoke, Lin Yuanfang 2026, 30 (9):  2208-2216.  doi: 10.12307/2026.535 Abstract ( 34 )   PDF (2642KB) ( 16 )   Save BACKGROUND: Long’s traction orthopedic method has demonstrated clear clinical efficacy in cervical spondylotic radiculopathy and is widely applied; however, its biomechanical mechanism of action has not been clearly reported.  OBJECTIVE: To explore the biomechanical basis for how Long’s traction orthopedic method improves cervical intervertebral foramen deformation using three-dimensional finite element analysis.  METHODS: Based on a previously developed and validated finite element model coupling the musculoskeletal system of the head and neck, the model was imported into LS-DYNA software to simulate classical cervical traction and three manipulative techniques of Long’s traction orthopedic method: the pushing technique, the pulling technique, and the shaking technique. C5 was designated as the target segment, with relevant boundary conditions set under a traction force of 200 N. Forward and downward leftward pulling forces, as well as left axial rotation torque, were sequentially applied to simulate the techniques. The relative displacement, angle, and lateral bending displacement of the cervical intervertebral foramen, direction of intervertebral disc displacement, and strain were recorded and analyzed.  RESULTS AND CONCLUSION: (1) The pushing technique produced the most significant effect on the relative displacement of the intervertebral foramen, with C5 displacement reaching up to 15.6 mm, resulting in an increased intervertebral foramen volume. Additionally, relative angle changes in the foramen were more pronounced, with a peak value of 22.9°. (2) In terms of relative displacement during lateral bending of the overall segment, the shaking technique was 2.4 times more effective than the pulling technique, while pushing technique and classical cervical traction showed minimal changes in lateral bending displacement. (3) In all orthopedic method, the direction of intervertebral disc displacement showed a forward tendency, with Y-axis displacements of 11.56 mm (pushing), 9.94 mm (pulling), and 7.73 mm (shaking), respectively. (4) The orthopedic method induced forward sliding strain in the intervertebral disc, which released the compressed intervertebral foramen volume in the posterior segments. (5) In comparison, classical cervical traction was less effective in achieving these changes and could not reach the same degree of alteration. (6) Therefore, Long’s traction orthopedic method is more effective than classical cervical traction in increasing the cervical intervertebral foramen gap and improving foramen deformation. Biomechanically, this is attributed to the increased relative displacement, angle, and lateral bending displacement of the cervical intervertebral foramen, as well as greater disc displacement and forward strain, thereby relieving nerve compression in the affected segments, alleviating symptoms, and achieving a positive therapeutic effect. Figures and Tables | References | Related Articles | Metrics

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Biomechanical differences between the new proximal femoral stable intramedullary nail and traditional intramedullary nail#br# Rao Jingcheng, Li Yuwan, Zheng Hongbing, Xu Zhi, Zhu Aixiang, Shi Ce, Wang Bing, Yang Chun, Kong Xiangru, Zhu Dawei 2026, 30 (9):  2217-2225.  doi: 10.12307/2026.620 Abstract ( 33 )   PDF (3116KB) ( 18 )   Save BACKGROUND: Intertrochanteric fractures of the femur are a common type of fracture, especially prevalent among the elderly. Traditional intramedullary nails used in treating such fractures exhibit certain biomechanical inadequacies that can lead to internal fixation failure. Therefore, developing a new type of intramedullary nail to improve fracture healing outcomes and stability is particularly important.  OBJECTIVE: To design and evaluate a novel proximal femoral stable intramedullary nail and compare its biomechanical performance with existing proximal femoral nail antirotation and InterTAN in order to enhance the treatment outcomes of intertrochanteric fractures. METHODS: The study employed computer-simulated experiments using three-dimensional finite element analysis to establish a geometric model of intertrochanteric fractures. Initially, CT scans were utilized to obtain CT data of the femur. Mimics Research and Geomagic Studio software were used to construct a three-dimensional model of the femur. Stable intramedullary nail CrossFix 6°, 7.5°, and 9° were designed and compared with proximal femoral nail antirotation and InterTAN. The biomechanical performance of each model was analyzed under conditions of vertical compression, anterior-posterior bending, and torsion, comparing the von Mises stress, maximum displacement and maximum torsion angle of the intramedullary nail and bone.  RESULTS AND CONCLUSION: (1) Under vertical compression, the stable intramedullary nail series exhibited lower proximal femur stress and femoral head displacement compared to proximal femoral nail antirotation and InterTAN, with stable intramedullary nail CrossFix 9° showing the best performance. (2) In anterior-posterior bending and torsion conditions, the stable intramedullary nail series also demonstrated lower stress and displacement, indicating good stability and anti-rotational properties. (3) The unique cross-screw design of the stable intramedullary nail series effectively distributed stress applied to the fracture site, reducing the risk of fatigue fractures caused by stress concentration. (4) The stable intramedullary nail demonstrates superior biomechanical performance compared to proximal femoral nail antirotation and InterTAN, with excellent structural stability. Although there is preliminary support for its effectiveness, clinical trials are necessary to verify its long-term efficacy and safety, thereby assessing its application value in actual treatments.  Figures and Tables | References | Related Articles | Metrics

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Biomechanical performance of short-segment screw fixation combined with expandable polyetheretherketone vertebral body replacement in osteoporotic vertebrae Chen Long, Wang Xiaozhen, Xi Jintao, Lu Qilin 2026, 30 (9):  2226-2235.  doi: 10.12307/2026.600 Abstract ( 25 )   PDF (1860KB) ( 8 )   Save BACKGROUND: Vertebral replacement can restore the stability of the anterior column of the spine and correct deformity, but the traditional expandable titanium alloy replacement has a large elastic modulus and imaging artifacts, which increases the risk of adjacent segment degeneration. In theory, polyetheretherketone is more suitable for osteoporotic patients because of its similar density to bone, radiolucency and intraoperative adaptability, but there is still a lack of sufficient evidence.   OBJECTIVE: To investigate the biomechanical performance of posterior short-segment screw fixation combined with a novel expandable polyetheretherketone vertebral body replacement in osteoporotic vertebrae using finite element analysis.   METHODS: Four finite element models of T12 vertebral body replacement were developed based on different screw fixation methods and vertebral body replacement materials. Model 1: Conventional pedicle screws through the fractured vertebra combined with an expandable titanium cage (M1). Model 2: Conventional pedicle screws through the fractured vertebra combined with a polyetheretherketone-vertebral body replacement (M2). Model 3: Cement-augmented pedicle screws across the fractured vertebra combined with a polyetheretherketone-vertebral body replacement (M3). Model 4: Cement-augmented pedicle screws through the fractured vertebra combined with a polyetheretherketone-vertebral body replacement (M4). The range of motion, maximum von Mises stress of the fixation system, and adjacent segment endplates in T11-L1 segments were compared among the four models under identical boundary conditions.   RESULTS AND CONCLUSION: (1) Comparing M1 and M2, the range of motion values of M2 under four motion states were higher than those of M1, but the differences were not significant. The maximum stress on the vertebral body replacement in M2 under the four motion states was reduced compared to M1. Additionally, M2 showed a decrease in the maximum stress on the adjacent segment endplates compared to M1. (2) Among M2, M3, and M4, the fixed segment’s maximum range of motion was lowest in M4. The maximum stresses on the screw-rod system and vertebral body replacement under the four motion states were also lowest in M4. The maximum stress on pedicle screws under four motion directions was significantly highest in M3. For the adjacent segment endplates, M4 had the lowest maximum stress across all directions. However, the differences among the three were not statistically significant. (3) In vertebral body replacement for osteoporotic vertebrae, the biomechanical performance of the expandable polyetheretherketone-vertebral body replacement is similar to that of the expandable expandable titanium cage and may perform better in reducing subsidence. Posterior short-segment screw fixation combined with the expandable polyetheretherketone-vertebral body replacement provides good stability, with cement-augmented pedicle screws through the fractured vertebra demonstrating the best biomechanical performance and the least impact on the fixation system and adjacent endplates. Figures and Tables | References | Related Articles | Metrics

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Influence of different depths and loads on knee joint mechanics and peripheral muscle force characteristics during squatting Yan Xiangning, Chen Lei, Chen Yonghuan, Wang Chao, Li Xiaosheng 2026, 30 (9):  2236-2247.  doi: 10.12307/2025.829 Abstract ( 44 )   PDF (1348KB) ( 6 )   Save BACKGROUND: There are many variations and techniques of squatting in sports, and different squatting methods will have different effects on knee mechanics. Existing research results lack a full discussion concerning the effects of different depths and loads on the mechanical changes of the knee joint during squatting.  OBJECTIVE: To investigate the knee biomechanical characteristics of three different depths (shallow, parallel and deep squat) under three loads: 85%, 50%, and 0% of 1 repetition maximum, in order to provide a scientific evidence for choosing a reasonable depth and load for squatting training. METHODS: Kinematic, kinetic, and electromyographic data from 15 male subjects taking squats with different squat depths and loads were synchronously collected using a high-speed video camera (Sony), a three-dimensional force platform (Kistler), and an electromyograph (Noraxon). Inverse kinetics, biomechanical musculoskeletal modeling, and optimization algorithms were used to compute knee joint mechanics and lower limb muscle group force. Lastly, a two-way analysis of variance was employed to analyze the differences between the different depths and load conditions.  RESULTS AND CONCLUSION: (1) The main effect of load on knee joint moment was significant (P < 0.01). The shallow, flat, and deep squats all had the smallest knee moments at 0% load. (2) The main effect of loading on tibiofemoral joint force, patellofemoral joint force, and cruciate ligament force was significant (P < 0.01). With the increase of squat depth, the curves of tibiofemoral joint force, patellofemoral joint force, and cruciate ligament force showed a bimodal trend. (3) The main effect of loading on quadriceps force, hamstring force, and gastrocnemius force was significant (P < 0.01). 50% loading had the greatest quadriceps force, and hamstring and gastrocnemius forces were greatest at 85% loading. With the increase of depth, the change of quadriceps and hamstring muscle force showed a bimodal trend, while the gastrocnemius muscle force showed a trend of decreasing and then increasing. (4) Various mechanical parameters of the knee joint increased with increased loading, but the difference between 50% and 85% loading was small. All three depths of squatting showed maximum patellofemoral joint force and quadriceps force at 50% loading. The posterior cruciate ligament force, hamstring force, and gastrocnemius muscle force all reached their maximum at 85% loading. The increase in squatting in depth had no significant effect on the posterior cruciate ligament force. When the aim was to maximize the development of the muscle strength for the weighted squat, the 50% loaded parallel squat is recommended, but consider that it results in greater joint and ligament forces. Figures and Tables | References | Related Articles | Metrics

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Fracture mapping and imaging analysis of triplane fracture of distal tibia in adolescents Wang Bokai, Wang Zhiqiang, Zhou Hongyan, Li Junran, Wu Yiheng, Zhao Hongbo 2026, 30 (9):  2248-2254.  doi: 10.12307/2025.984 Abstract ( 26 )   PDF (1816KB) ( 4 )   Save BACKGROUND: Because of its complex and unique spatial structure, the triplane fracture of the distal tibia only occurs in adolescents with epiphyseal closure, which is a great test for clinicians’ experience and understanding in the treatment. In recent years, fracture mapping technology has developed rapidly and has been widely used in trauma orthopedics.  OBJECTIVE: To draw a triplane fracture map of the distal tibia in adolescents by using fracture mapping technology, observe the shape, location, and frequency of the cross-sectional fracture line, and analyze the characteristics of the triplane fracture of the distal tibia.  METHODS: The medical records of 79 patients with triplane fractures of the distal tibia were retrospectively studied. The original CT image data were collected. The required two cross-sectional images were obtained by Mimics 21.0 software. The patient’s CT images were reset and fitted to the standard template in Photoshop 24.0 software, and all fracture lines were depicted and superimposed to generate a fracture map. The Matlab (r2023b) software was used to create a heat map to show the high-density and low-density fracture areas, and the distribution of fracture lines was analyzed. RESULTS AND CONCLUSION: (1) Among the 79 adolescent patients included in this study, 73% were male and 27% were female, with an average age of 12.8±1.5 years (range, 10-15 years). (2) The fracture line of metaphysis mainly concentrated in the posterior side. The fracture line of the articular surface showed obvious “Y” type characteristics. The fracture line of this plane could be subdivided into “Y” type (18%), transverse type (32%), anteromedial notch type (33%) and other types (17%). The zonal fracture map showed that there were significant differences in the number of fracture lines passing through different regions (P < 0.01). (3) The formation of the “Y” shaped fracture line on the articular surface may be related to the anterior and posterior ligaments of the lower tibiofibula. The results show that the fracture map can provide an intuitive visual framework for the triplane fracture of the distal tibia, and provide references for further image classification, internal fixation design, and screw placement. Figures and Tables | References | Related Articles | Metrics

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Biomechanical characteristics of volar locking plate only versus combined dorsal mini-plate fixation of distal radius fractures with dorsal ulnar fragment  Zhou Daobin, Wang Kehao, Xie Yang, Ning Rende 2026, 30 (9):  2255-2261.  doi: 10.12307/2026.503 Abstract ( 32 )   PDF (1024KB) ( 8 )   Save BACKGROUND: For many years, surgical treatment for intra-articular fractures of the distal radius has been widely recognized, but there is still controversy over which surgical approach can achieve better efficacy and maximize joint function recovery. Regardless of the chosen treatment method, the goal is anatomical reduction and stable internal fixation. Although palmar locking plate fixation has recently become the most commonly used surgical method, one of the main limitations of this fixation method is the inability to achieve sufficient stability of the ulnar dorsal fracture fragment. OBJECTIVE: To analyze the biomechanical characteristics of treating distal radius fractures with dorsal ulnar fragment with only volar locking plate fixation and combined dorsal mini-plate fixation, and to explore the optimal internal fixation methods for different fracture patterns of distal radius fractures with dorsal ulnar fragment. METHODS: Thirty radial bone specimens were produced using 3D printing technology to establish distal radius fracture models with dorsal ulnar fragment and divided into three groups. Group 1 established distal radius fracture models with a dorsal ulnar fragment not exceeding the Lister tubercle. Group 2 established distal radius fracture models with a dorsal ulnar fragment exceeding the Lister tubercle. Group 3 established distal radius fracture models with comminuted fractures with dorsal ulnar fragment. Each group of models was randomly fixed with either a simple palmar locking steel plate or a palmar locking steel plate combined with a dorsal mini steel plate. The prepared model was installed into a customized biomechanical fixture. Cyclic loading and failure loading experiments were conducted on each model in sequence. Biomechanical stability was observed.  RESULTS AND CONCLUSION: (1) In the cyclic loading experiment, all test models did not fail. Comparison of stiffness among different models: There was no significant difference in fixing method at the initial stage of group 1 (P > 0.05), but there was a significant difference in fixing method values at the 1 000th, 2 000th, and 3 000th cycles (P < 0.05). There was no significant difference in fixing method between each stage of group 2 (P > 0.05). There were significant differences in each stage of group 3 (P < 0.05). (2) In the failure load experiment, the elastic limits of each group of models were compared: there was a significant difference between group 1 and group 3 (P < 0.05). There was no significant difference in group 2 (P > 0.05). Comparison of failure loads among different models: There was a significant difference between group 1 and group 3 (P < 0.05). There was no significant difference in various fixing methods in group 2 (P > 0.05). (3) It is concluded that for comminuted distal radius fractures or distal radius fractures with a relatively small dorsal ulnar fragment not exceeding the Lister tubercle, the stiffness and axial compressive strength of volar locking plate combined with dorsal mini-plate fixation are superior to only volar locking plate fixation, which can provide stronger fixation in the early stages of fracture healing. For distal radius fractures with a larger dorsal ulnar fragment exceeding the Lister tubercle, the biomechanical stability of the two fixation methods is basically the same. Figures and Tables | References | Related Articles | Metrics

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MRI evaluation of nerve root subsidence sign affecting efficacy of percutaneous endoscopic decompression in lumbar spinal stenosis Wang Nan, Chen Shuang, Xi Zhipeng, Qian Yuzhang, Zhang Xiaoyu, Gu Jun, Kang Ran, Xie Lin 2026, 30 (9):  2262-2268.  doi: 10.12307/2026.502 Abstract ( 28 )   PDF (1214KB) ( 4 )   Save BACKGROUND: The nerve root sedimentation sign has improved the imaging understanding of lumbar spinal stenosis as a new assessment index for it, but controversy still exists as to whether the nerve root sedimentation sign affects the prognostic efficacy of total endoscopic lumbar spinal decompression surgery. OBJECTIVE: To investigate the effect of nerve root sedimentation sign on the efficacy of lumbar spinal stenosis treated by full endoscopic techniques.  METHODS: Clinical data of 69 patients with lumbar spinal stenosis who underwent full endoscopic lumbar decompression from September 2018 to September 2022 in Jiangsu Provincial Hospital of Integrated Traditional Chinese and Western Medicine were retrospectively analyzed. The patients were divided into positive group (n=45) and negative group (n=24) according to whether the cauda equina was sedated under MRI. The general data, visual analog scale scores for low back pain and leg pain, Oswestry disability index scores and Macnab efficacy ratings of the two groups were compared, and the changes in the sagittal diameter of the lumbar spinal canal, transverse diameter of the spinal canal, the area of the spinal canal, and the angle of anterior convexity of the lumbar spine were compared between the pre- and post-treatment periods. RESULTS AND CONCLUSION: (1) Postoperative visual analog scale scores and Oswestry disability index scores of the two groups were reduced compared with those of the preoperative period, and the differences were statistically significant (P < 0.05). Comparing the two groups, the scores of the positive group in terms of low back pain were significantly lower than those of the negative group in both the 1-week and the 1-year periods after treatment, and the differences were statistically significant (P < 0.05). (2) The area of the spinal canal, the sagittal diameter of the spinal canal, and the transverse diameter of the spinal canal were significantly enlarged after the operation in both groups compared with the preoperative period, and the difference was statistically significant (P < 0.05). (3) The lumbar anterior convexity angle was not significantly affected in both groups after surgery, and the difference was not statistically significant compared with the preoperative and postoperative periods (P > 0.05). (4) The 1-year postoperative efficacy of the patients was evaluated by MacNab: positive group: 30 cases were excellent, 11 cases were good, 3 cases were average, and 1 case was poor, with an excellent and good rate of 91%; negative group: 16 cases were excellent, 4 cases were good, 4 cases were average, with an excellent and good rate of 83%. No significant difference was detected between the two groups (P > 0.05). (5) The above results show that total endoscopic lumbar spinal canal decompression in the treatment of lumbar spinal stenosis has outstanding efficacy, which can achieve accurate decompression and can be well reflected on MRI, while the presence or absence of nerve root sedimentation sign has no obvious effect on the postoperative efficacy.  Figures and Tables | References | Related Articles | Metrics

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Establishment and validation of a prediction model for axial symptoms after laminectomy with lateral mass screw fixation Shi Yaozhou, Jia Fanglin, Zhang Heling, Song Hanlin, Gao Haoran, Gao Xiao, Sun Wei, Feng Hu 2026, 30 (9):  2269-2277.  doi: 10.12307/2026.105 Abstract ( 29 )   PDF (1634KB) ( 5 )   Save BACKGROUND: Current research on axial symptoms following posterior cervical surgery predominantly focuses on pathological mechanisms, while a clinically applicable risk prediction model remains lacking.  OBJECTIVE: To investigate the factors influencing the occurrence of axial symptoms following laminectomy with lateral mass screw fixation for cervical compressive myelopathy and to develop and validate a predictive model for postoperative axial symptoms, and design a dynamic web calculator to achieve real-time evaluation and visualization of the risk of postoperative complications. METHODS: A retrospective analysis was conducted on medical records of 127 patients who underwent laminectomy with lateral mass screw fixation for cervical compressive myelopathy at Affiliated Hospital of Xuzhou Medical University between February 2021 and April 2024. Patients were categorized into an axial symptom group and a non-axial symptom group based on the presence of axial symptoms within six months postoperatively. To handle missing data, the K-Nearest Neighbors Algorithm was employed for multiple imputation, and Synthetic Minority Over-sampling Technique was used to address class imbalance. Combining the results of univariate and multivariate binary Logistic regression analysis, the influencing factors that jointly affected the incidence of postoperative axial symptoms were screened out, that is, the predictive factors included in the prediction model. The dataset was stratified into a training set and a testing set in a 7:3 ratio. A nomogram prediction system was constructed based on the multivariate regression results, and its performance was evaluated using the receiver operating characteristic curve, calibration curve, and decision curve analysis. The reliability of the model was verified in three dimensions. A web-based calculator was developed to enable real-time individualized risk assessment and facilitate clinical decision-making through visualized results. RESULTS AND CONCLUSION: (1) A total of 52 patients (40.9%) developed axial symptoms postoperatively. (2) Univariate analysis indicated significant differences between the two groups in age, operation time, intraoperative blood loss, early postoperative functional exercise, cervical collar wearing duration, preoperative Japanese Orthopaedic Association score, best postoperative Japanese Orthopaedic Association score, C2-C7 Cobb angle in neutral and flexion positions, and cervical lordosis loss (P < 0.1). (3) Multivariate logistic regression analysis using the forward stepwise selection method identified age, early postoperative functional exercise, cervical collar wearing duration, best postoperative Japanese Orthopaedic Association score, and cervical lordosis loss as independent predictors of axial symptoms. Among them, age, cervical collar wearing duration, and cervical lordosis loss were risk factors, whereas early postoperative functional exercise and best postoperative Japanese Orthopaedic Association score were protective factors. (4) A nomogram prediction model and a web-based calculator were established based on the analysis (available at http://121.40.90.248:8080/). The areas under the receiver operating characteristic curve values for the training and testing sets were 0.877 (95%CI: 0.798-0.955) and 0.834 (95%CI: 0.705-0.964), respectively, indicating excellent predictive performance. The calibration curve demonstrated strong agreement between predicted and observed outcomes. (5) It is indicated that age, cervical collar wearing duration, cervical lordosis loss, early postoperative functional exercise, and best postoperative Japanese Orthopaedic Association score are the key factors influencing the occurrence of axial symptoms following laminectomy with lateral mass screw fixation. Based on these findings, we developed a highly accurate nomogram prediction model and implemented a web-based calculator.  Figures and Tables | References | Related Articles | Metrics

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One-hole split endoscope surgery with the aid of digital 3D technology for highly migrated lumbar disc herniation#br# Zhao Jiaqing, Liu Dong, Lu Suni, Wang Dawei, Geng Xiaopeng, Ning Huaxiu 2026, 30 (9):  2278-2285.  doi: 10.12307/2025.851 Abstract ( 26 )   PDF (1835KB) ( 2 )   Save BACKGROUND: The use of one-hole split endoscope technique for highly mobile lumbar intervertebral disc herniation is a feasible treatment option, but there are few reports comparing one-hole split endoscope with traditional methods using 3D digital technique. OBJECTIVE: To compare clinical effects of 3D digital technique assisted one-hole split endoscope surgery and traditional one-hole split endoscope surgery in the treatment of highly migrated lumbar disc herniation.  METHODS: A retrospective analysis was performed on 52 patients with highly migrated lumbar disc herniation who underwent one-hole split endoscope surgery from June 2022 to June 2023, including 22 patients with 3D digital technology assisted one-hole split endoscope (observation group) and 30 patients with traditional one-hole split endoscope (control group). Operation time, intraoperative blood loss, retention rates of lateral facet, visual analog score and Oswestry Disability Index of lower limb pain and efficacy at the last follow-up (modified MacNab criteria) were used as the main indicators of clinical efficacy to evaluate the clinical effects of the two methods. RESULTS AND CONCLUSION: (1) All 52 patients completed the operation successfully. There were two cases of calf intermuscular vein thrombosis in the observation group and three cases in the control group. All patients were given anticoagulant therapy and symptomatic treatment such as delayed ambulation. No other complications such as dural tear or infection occurred. (2) There was no significant difference in operation time, intraoperative blood loss, and modified MacNab criteria between the two groups (P > 0.05). (3) The lateral articular surface preservation rate of the observation group was (88.9%±7.8)%, which was significantly higher than that of the control group (83.8±8.0)%, and the differences were significant (P < 0.05). (4) The visual analog scale score and Oswestry disability index of lower limb pain in both groups were significantly improved 3 and 6 months after surgery compared with those before surgery (P < 0.05), but there was no significant difference between the two groups (P > 0.05). (5) It is indicated that one-hole split endoscope is a safe and effective treatment for highly migrated lumbar disc herniation. As an auxiliary tool, 3D digital technique can help surgeons better protect facet joints and provide possibilities for reducing complications.  Figures and Tables | References | Related Articles | Metrics

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Cervical motion characteristics in patients with cervical spondylotic radiculopathy based on motion capture technology Li Zhifei, Han Bin, Liu Qiuli, Zhang Zhanming, Wei Haokai, Zuo Kuangshi, Zhang Yisheng 2026, 30 (9):  2286-2293.  doi: 10.12307/2026.543 Abstract ( 44 )   PDF (1305KB) ( 10 )   Save BACKGROUND: Motion capture technology can comprehensively and accurately analyze the three-dimensional structure angle of the cervical spine and obtain accurate data, which is helpful to understand the movement characteristics of the cervical spine in patients with cervical radiculopathy. It is of vital significance for guiding the prevention of cervical spondylotic radiculopathy, assisting cervical spondylotic radiculopathy diagnosis, formulating personalized treatment plans, and guiding rehabilitation training.  OBJECTIVE: To explore the cervical motion characteristics of patients with cervical spondylotic radiculopathy and reveal the pathogenesis of cervical spondylotic radiculopathy through motion capture technology.  METHODS: Five cervical spondylotic radiculopathy patients who visited the Orthopedics Department of First Affiliated Hospital of Guangxi University of Chinese Medicine from October 1, 2023 to March 1, 2024 were analyzed as the cervical spondylotic radiculopathy group. Five healthy individuals were selected as the healthy control group. The gender, age, head circumference, and body mass index of all subjects were recorded. The angle change process (trajectory) and motion range were captured during the six degrees of freedom of neck flexion, extension, left flexion, right flexion, left rotation, and right rotation of the research subjects using Inertial Measurement Unit sensors.  RESULTS AND CONCLUSION: (1) The cervical spondylotic radiculopathy group had significantly smaller changes in C2-C7 relative angles during forward flexion than the healthy control group (P < 0.01). The range of neck motion error in cervical spondylotic radiculopathy group was significantly larger than that in the healthy control group during right rotation (P < 0.01). The time for the cervical spine to reach its maximum range of flexion during forward flexion was longer than the time to return to normal position (P < 0.01). (2) The range of motion of the cervical spondylotic radiculopathy group was significantly lower than that of the healthy control group in terms of forward flexion and right rotation (P < 0.001). These findings indicate that patients with cervical spondylotic radiculopathy have degeneration of the muscles and nerves on the affected side during vertebral body movement, muscle strength and coordination abilities are reduced. The muscles and nerves on the healthy side will compensate for the deficiency of the affected side and overcontrol, which is consistent with the concept of “musculoskeletal imbalance.”  Figures and Tables | References | Related Articles | Metrics

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Evaluation parameters and specific region of C6 nerve oppression by uncinate process degeneration Li Sa, Sun Ning, Sun Zhaozhong, Feng Zhimeng, Li Xuedong 2026, 30 (9):  2294-2302.  doi: 10.12307/2026.064 Abstract ( 27 )   PDF (2296KB) ( 5 )   Save BACKGROUND: Degeneration of the uncinate process and the development of osteophytes are recognized as prevalent factors contributing to cervical intervertebral foramen stenosis in individuals suffering from cervical spondylotic radiculopathy. Nonetheless, there is a notable scarcity of research data, both domestically and internationally, regarding C6 cervical spondylotic radiculopathy induced by mutations in the C6 uncinate process. Furthermore, the current body of imaging data is insufficient to establish a definitive diagnostic protocol for identifying the specific region affected by cervical spondylotic radiculopathy due to uncinate process degeneration. OBJECTIVE: To delineate the spatial relationships between the uncinate process and adjacent anatomical structures using three-dimensional CT image reconstruction, to identify specific diagnostic regions within CT images for C6 nerve entrapment associated with uncinate process degeneration, and to guide key-hole surgical procedures aimed at decompressing the C6 nerve root canals. METHODS: A cohort of 56 patients presenting with C5/6 unilateral cervical spondylotic radiculopathy, each patient fulfilled the predefined inclusion criteria, was enrolled in the study. This group comprised 29 males and 27 females, ranging in age from 35 to 71 years. Cervical spine CT data were imported into Mimics 21.0 software to construct a three-dimensional model of the cervical spine. The following parameters at the C5/6 level were measured: (1) Measurement on the sagittal plane of the uncinate process situated within the most constricted segment of the cervical intervertebral foramen: The vertical distance from the uncinate process situated within the most constricted segment of the cervical intervertebral foramen to the transverse section of the lower edge of the C5 pedicle and the upper edge of the C6 pedicle (a, b); (2) measurement on the cross section of the uncinate process situated within the most constricted segment of the cervical intervertebral foramen: The horizontal distance from the uncinate process situated within the most constricted segment of the cervical intervertebral foramen to the sagittal plane where the lowest point of the posterior edge of the upper endplate is located (c); (3) the horizontal distance from the uncinate process situated within the most constricted segment of the cervical intervertebral foramen to the sagittal plane of the medial and lateral margin of the pedicle of C6 (d, e); (4) the narrowest distance of intervertebral foramen (f); (5) measurement on the cross section of the lowest point of the posterior edge of the C6 upper endplate: the left and right distance from the upper endplate to the sagittal plane of the medial edge of the left and right pedicle of C6 (g, h); (6) on the median sagittal plane, the line connecting the anterior and inferior edge of the C5 inferior endplate (the line of inferior edge of the vertebral body ) was established, and the parallel line of the line of inferior edge of the vertebral body (the inferior endplate line) was established through the highest point of the C5 lower endplate. The parallel line (uncinate process line) of the line of inferior edge of the vertebral body was established through the uncinate process situated within the most constricted segment of the cervical intervertebral foramen, and the location between the line of inferior edge of the vertebral body, the inferior endplate line and the uncinate process line was observed on the median sagittal plane; (7) observation of the morphological characteristics of intervertebral foramen on the sagittal plane of the uncinate process situated within the most constricted segment of the cervical intervertebral foramen. All patients underwent single-port split endoscopic key-hole surgery on the cervical spine under the guidance of the above imaging data. The clinical efficacy was evaluated by visual analog scale and Japanese Orthopaedic Association scores before operation and 1 month, 6 months and the last follow-up after operation. RESULTS AND CONCLUSION: (1) There was no significant difference in the related parameters between the two genders (P > 0.05). (2) There was no significant difference between the left side and the right side of a, b, c, d, e, f, g, and h (P > 0.05), and there was also no significant difference between g and h in the total sample (P > 0.05). (3) Visual analog scale score and Japanese Orthopaedic Association scores were improved at 1 month, 6 months, and the last follow-up after operation, and the difference was statistically significant (P < 0.05). (4) The region between the line of inferior edge of the vertebral body and the inferior endplate line was the absolute region and above the inferior endplate line was the region of above the inferior endplate line. The uncinate process region composed of the two regions was the specific region for the diagnosis of uncinate process degeneration by CT. (5) The intervertebral foramen region between the inner and outer edges of the sagittal pedicle included by the uncinate process region was a specific region in the diagnosis of cervical spondylotic radiculopathy. The uncinate process region with clinical symptoms and signs was accurate and reliable in the diagnosis of cervical spondylotic radiculopathy caused by uncinate process degeneration. (6) The uncinate process situated within the most constricted segment of the cervical intervertebral foramen was only the narrowest point of the intervertebral foramen, and the compression of the nerve root was often caused by the stenosis of the intervertebral foramen with the uncinate process at the uncinate process situated within the most constricted segment of the cervical intervertebral foramen as the center. (7) Different pathomorphological types of intervertebral foramen could be observed in the sagittal plane where the uncinate process situated within the most constricted segment of the cervical intervertebral foramen was located, and different types oppressed cervical nerve in different parts of intervertebral foramen. (8) Additional resection of uncinate process could be considered for grade 2 cervical intervertebral foramen stenosis; during the operation, the inferior margin of C5 pedicle and the upper, medial and lateral margin of C6 pedicle could be located and the uncinate process that was severely compressed cervical nerve can be removed. (9) Cervical spondylotic radiculopathy resulting from uncinate process degeneration warrants careful attention. The uncinate process region is particularly useful for CT diagnosis. Diagnosing cervical spondylotic radiculopathy caused by uncinate process degeneration using CT scans focused on this area, along with clinical signs and symptoms, is accurate and dependable, reducing the chance of missed or incorrect diagnoses. In cases of severe cervical nerve compression due to uncinate process degeneration, key-hole uncinate process resection may be considered. Figures and Tables | References | Related Articles | Metrics

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Peri-knee osteotomy for treatment of knee osteoarthritis: optimization of treatment strategies Chen Qiuhan, Yang Long, Yuan Daizhu, Wu Zhanyu, Zou Zihao, Ye Chuan 2026, 30 (9):  2303-2312.  doi: 10.12307/2026.586 Abstract ( 43 )   PDF (941KB) ( 7 )   Save BACKGROUND: With the rise of knee-preserving concepts, peri-knee osteotomy has gradually become an important method for treating early- to mid-stage knee osteoarthritis due to its advantages in correcting lower limb alignment, reducing joint load, and delaying the need for joint replacement. OBJECTIVE: To summarize the advantages, disadvantages, and clinical outcomes of various knee osteotomy techniques, providing a reference for developing appropriate surgical strategies in clinical practice. METHODS: The PubMed and CNKI from 2014 to 2024 were searched for relevant literature on peri-knee osteotomy for the treatment of knee osteoarthritis. The Chinese and English search terms included “knee osteoarthritis, high tibial osteotomy, distal femur osteotomy, proximal fibula osteotomy, tibial condylar valgus osteotomy, dome shaped high tibial osteotomy, limb alignment correction, joint-preserving surgery.” Following inclusion and exclusion criteria, 108 articles were ultimately included for this review.  RESULTS AND CONCLUSION: (1) The effectiveness of peri-knee osteotomy in the treatment of knee osteoarthritis has been widely recognized. In recent years, the clinical outcomes have significantly improved through the optimization of various surgical techniques, including high tibial osteotomy, distal femoral osteotomy, proximal fibular osteotomy, and the innovative popliteus anterior high tibial tubercle osteotomy. (2) These procedures effectively alleviate pain and improve functional activity by correcting lower limb alignment and optimizing weight distribution across the knee joint. However, postoperative complications such as lateral hinge fractures, patella baja, and insufficient correction remain concerns. With the development of personalized osteotomy plans, the precision and safety of the surgery have been further enhanced through comprehensive assessment of the patient’s age, deformity origin, and underlying conditions. In conclusion, peri-knee osteotomy plays a crucial role in improving knee function and enhancing patients’ quality of life.  Figures and Tables | References | Related Articles | Metrics

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Application value of finite element analysis on unicompartmental knee arthroplasty for medial knee compartmental osteoarthritis Zhang Zizheng, Luo Wang, Liu Changlu 2026, 30 (9):  2313-2322.  doi: 10.12307/2026.652 Abstract ( 33 )   PDF (942KB) ( 2 )   Save BACKGROUND: Unicompartmental knee arthroplasty is a minimally invasive surgery for end-stage medial knee osteoarthritis and is increasingly used in the field of joint surgery. As an advanced biomechanical research method, finite element analysis can simulate the real human body, reveal the biomechanical characteristics of the knee joint, and provide strong support for optimizing surgical plans and developing new implant materials. OBJECTIVE: To review the advancements of finite element analysis in unicompartmental knee arthroplasty for medial compartment osteoarthritis and forecast future trends. METHODS: The first author searched the PubMed and CNKI for literature published from the inception of the database to December 2024, using “finite element analysis, medial compartment osteoarthritis of the knee, unicompartmental knee arthroplasty, prosthesis alignment, joint line, prosthesis design, fracture risk factors” as English search terms; “finite element analysis, knee joint, unicompartmental knee arthroplasty, prosthesis alignment, joint line, prosthesis design, fracture risk factors” as Chinese search terms. Finally, 53 articles were included for analysis. RESULTS AND CONCLUSION: (1) Tibial prosthesis arrangement: Fixed platform unicompartmental knee arthroplasty recommends a coronal surface of 0°, posterior inclination of 5°-7°, while for movable platform unicompartmental knee arthroplasty, it suggests a coronal surface of varus 4° to valgus 4°, posterior inclination of 3°-7°, and axial rotation of 0° to external rotation 3°. (2) Femoral prosthesis alignment: Fixed-bearing unicompartmental knee arthroplasty: Coronal alignment at 0° (neutral) distal femoral center; sagittal alignment 9°–12° posterior tilt. Mobile-bearing unicompartmental knee arthroplasty: Coronal alignment 4° varus to 4° valgus; axial rotation 0° (neutral) to 6° internal rotation. (3) The joint line should maintain the original height. (4) Prosthesis design: Fixed platform unicompartmental knee arthroplasty should use a liner with a flat or anatomical simulation design, while movable platform unicompartmental knee arthroplasty benefits from an anatomical simulation pad or one with increased anatomical consistency. Moreover, the tibial tray design preferably features two straight columns with fin bone or small keel combinations, with a recommended tibial prosthesis column length of 33 mm.  Figures and Tables | References | Related Articles | Metrics

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Risk factors and coping strategies of internal fixation failure in treatment of intertrochanteric fracture with proximal femoral nail antirotation Zhao Feifan, Cao Yujing 2026, 30 (9):  2323-2333.  doi: 10.12307/2025.868 Abstract ( 37 )   PDF (1122KB) ( 6 )   Save BACKGROUND: Proximal femoral nail antirotation is the most widely used operation method for treating intertrochanteric fractures. It possesses advantages such as minimal invasion, reliable fixation, simple operation, and rapid rehabilitation. However, there is still a certain risk of internal fixation failure, and there are many controversies regarding the related risk factors. OBJECTIVE: To summarize and collate the risk factors related to the failure of internal fixation of proximal femoral nail antirotation, thereby providing some references for reducing the risk and formulating the corresponding surgical plan.  METHODS: Using “intertrochanteric fracture, proximal femoral nail antirotation, PFNA, internal fixation failure, risk factors” as the Chinese and English search terms, relevant literature was collected from databases such as CNKI, WanFang Data, VIP, PubMed, Springer, ScienceDirect, and Elsevier by computer search. The search period was from January 2014 to September 2024, and a small number of classic long-term literature were included. By reading the titles and abstracts, 113 articles were included in the review, including 45 in Chinese and 68 in English. RESULTS AND CONCLUSION: (1) Intertrochanteric fracture of femur is a common fracture that causes greater harm to the elderly, significantly increasing the risk of disability and death in elderly patients. Proximal femoral nail antirotation remains an effective internal fixation method for intertrochanteric fracture. (2) With the advancement of research on proximal femoral nail antirotation treatment of intertrochanteric fracture, many risk factors leading to internal fixation failure have been discovered. Previous studies focused more on osteoporosis, complicated medical diseases, fracture types, apex distance, etc. However, the conclusions on anteromedial cortical support reduction, wedge splitting effect, guide needle insertion point, spiral blade position, distal locking nail implantation, etc., were not comprehensive, and the specific mechanism analysis of each risk factor was also limited. (3) The results indicated that the internal fixation of proximal femoral nail antirotation failure was associated with poor reduction quality (including poor alignment of the fracture, negative alignment of the anteromedial cortex), external wall risk or fracture type, poor guide needle entry point, improper selection of staple length, small staple diameter or excessive reaming, cortical impingement of the medullary nail, excessive wedge splitting effect, poor placement of the spiral blade (screw), and non-implantation of the distal locking nail. The probability of internal fixation failure can be effectively reduced through good reduction and reasonable placement of intramedullary nails. Figures and Tables | References | Related Articles | Metrics

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Lumbar fusion combined with unilateral fixation for lumbar degenerative diseases: biomechanics, technical evolution, and clinical applications  Zhang Xianxu, Ma Zhong, Liu Xin, Huang Lei, Shen Wenxiang, Luo Zhiqiang 2026, 30 (9):  2334-2342.  doi: 10.12307/2026.645 Abstract ( 34 )   PDF (1214KB) ( 11 )   Save BACKGROUND: Lumbar degenerative disease is common in middle-aged and elderly individuals, often presenting as low back pain and lower limb dysfunction. Traditional lumbar fusion combined with bilateral pedicle screw fixation is associated with large surgical trauma, many complications, and other issues. Unilateral pedicle screw fixation combined with lumbar fusion, as a minimally invasive treatment approach, offers smaller trauma and a lower risk of complications, gradually becoming a new choice for the treatment of lumbar degenerative disease. OBJECTIVE: To review the effect and advantages of lumbar fusion surgery combined with unilateral pedicle screw fixation in the treatment of lumbar degenerative disease. METHODS: A literature review was conducted by searching PubMed and CNKI databases from January 2021 to January 2025 to summarize clinical studies and biomechanical characteristics of lumbar fusion combined with unilateral pedicle screw fixation. The search terms included “lumbar fusion, unilateral fixation, bilateral fixation, biomechanics, degenerative disease of the lumbar spine.” Ultimately, 70 articles were included for review. RESULTS AND CONCLUSION: (1) Lumbar fusion surgery combined with unilateral pedicle screw fixation effectively reduces surgical trauma and intraoperative blood loss, provides biomechanical stability similar to bilateral pedicle screw fixation, and lowers the risk of adjacent segment degeneration. (2) Unilateral pedicle screw fixation has been widely recognized in the treatment of single-segment and two-segment lumbar degenerative disease, although its application in multi-segment lumbar degenerative disease still requires further research. (3) Lumbar fusion combined with unilateral pedicle screw fixation provides a minimally invasive and safe option for the treatment of lumbar degenerative disease. More high-quality studies are needed in the future to validate its application and long-term efficacy in complex cases and further optimize its clinical use. Figures and Tables | References | Related Articles | Metrics

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Characteristics and clinical application of ankle joint finite element models Zhang Nan, Meng Qinghua, Bao Chunyu 2026, 30 (9):  2343-2349.  doi: 10.12307/2025.191 Abstract ( 30 )   PDF (865KB) ( 4 )   Save BACKGROUND: The ankle joint is one of the most complex joints in the human body, including bony structures such as fibula, tibia, and talus, as well as soft tissues such as ligaments, muscles, and tendons. Finite element modeling, as an important engineering analysis technique, has been widely used in various fields of bioengineering research. However, there is little literature on what material properties should be selected for each anatomical structure of the ankle joint finite element model for different research purposes. OBJECTIVE: To summarize the ankle joint finite element model modeling methods, material properties, model validation, and clinical and rehabilitation applications based on previous finite element studies of the ankle joint. METHODS: PubMed and CNKI were searched for articles published from 2000 to 2024. The English and Chinese search terms were “ankle joint, finite elements, material selection, ligament injury, osteoarthritis.” The 71 selected articles were summarized.  RESULTS AND CONCLUSION: (1) The ankle joint has a complex structure, and accurate anatomical structure and materials are the basis for establishing simulation models. (2) The finite element modeling of ankle joint is useful to gain a deeper understanding of the biomechanical properties of the ankle joint, to develop new implant materials, to predict ankle joint diseases, to improve surgical techniques, and to guide rehabilitation exercises. (3) Most of the previous studies did not consider the influence of body temperature and joint fluid on the model, which needs to be solved in the future. In addition, ankle joint, as an important weight-bearing joint of lower limbs, can also perform flexion, extension, and rotation activities. The finite element model of ankle joint to simulate complex movements will be the focus of future research.  Figures and Tables | References | Related Articles | Metrics

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Application effects and mechanisms of low-frequency pulsed electromagnetic fields in muscle repair and growth Jiang Xianglong, Li Zhongshan, Che Tongtong 2026, 30 (9):  2350-2360.  doi: 10.12307/2026.067 Abstract ( 32 )   PDF (1691KB) ( 1 )   Save BACKGROUND: Low-frequency pulsed electromagnetic fields, as a non-invasive therapeutic modality, have not only achieved remarkable results in the treatment of bone fractures and arthritis, but have also shown substantial potential in promoting muscle repair and growth.  OBJECTIVE: To review the application effects and mechanisms of low-frequency pulsed electromagnetic fields in promoting muscle repair and growth. METHODS: The first author searched the CNKI and PubMed databases from 2000 to 2024 for relevant literature, and the search terms were “low-frequency pulsed electromagnetic fields, muscle repair, muscle growth, electromagnetic biological effects” in Chinese and English, respectively. The preliminary search yielded 527 papers. According to the inclusion and exclusion criteria, 89 papers were finally included for review. RESULTS AND CONCLUSION: Although research on low-frequency pulsed electromagnetic fields has matured in recent years, the specific effects and mechanisms of low-frequency pulsed electromagnetic fields on muscle repair and growth remain to be fully elucidated. While low-frequency pulsed electromagnetic fields have shown positive effects on increasing muscle mass and strength, enhancing aerobic capacity, preventing disuse-induced muscle atrophy, and accelerating postoperative recovery, significant challenges still exist regarding the elucidation of their underlying mechanisms, optimization of treatment parameters, and comprehensive validation of clinical outcomes. Furthermore, understanding the mechanisms of low-frequency pulsed electromagnetic fields could provide novel insights into the biological processes underlying muscle repair and growth, thereby contributing to advances in sports medicine and regenerative medicine. Figures and Tables | References | Related Articles | Metrics

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Effectiveness and safety of tranexamic acid versus epsilon-aminocaproic acid in total hip and knee arthroplasties: a meta-analysis He Yixiang, Qiao Wanjia, Wang Wenji 2026, 30 (9):  2361-2369.  doi: 10.12307/2026.587 Abstract ( 33 )   PDF (4211KB) ( 1 )   Save OBJECTIVE: Tranexamic acid and epsilon-aminocaproic acid have been extensively utilized for hemostasis in orthopedic surgery; however, comparative studies focusing on the hemostatic efficacy of the two drugs in total joint arthroplasty remain relatively scarce. The present article was conducted to systematically assess the effectiveness and safety of two drugs in total hip arthroplasty and total knee arthroplasty.  METHODS: Published studies on the perioperative application of tranexamic acid and epsilon-aminocaproic acid in total knee arthroplasty or total hip arthroplasty were identified from the following electronic databases: PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang, VIP, and SinoMed from inception until November 1, 2024. After removing duplicate references, two researchers conducted literature screening and data extraction based on predefined inclusion and exclusion criteria. Statistical analysis of total blood loss, transfusion rate, incidence of deep venous thrombosis, and other relevant indicators was performed using Review Manager 5.3 software.  RESULTS: This meta-analysis finally included 7 randomized controlled trials and 5 non-randomized controlled trials involving 4 101 patients. During total hip arthroplasty and total knee arthroplasty, compared with epsilon-aminocaproic acid, tranexamic acid could significantly reduce total blood loss (MD=−109.58, 95%CI: −169.08 to −50.07, P < 0.001), postoperative drainage volume (MD=−35.66, 95%CI: −64.99 to −6.33, P=0.02), and hemoglobin loss (MD=−0.25, 95%CI: −0.40 to −0.09, P=0.002), and the differences were significant. However, there were no significant differences in intraoperative blood loss, operation time, hospital stay, transfusion rate, blood transfusion unit per patient, and deep vein thrombosis incidence between the two groups (P > 0.05).  CONCLUSION: Meta-analysis results show that compared with epsilon-aminocaproic acid, tranexamic acid can effectively reduce the perioperative total blood loss, postoperative drainage volume, and hemoglobin loss of patients, but it does not show obvious advantages in terms of blood transfusion rate, hospital stay, and deep vein thrombosis incidence. Tranexamic acid has better hemostatic effect during joint arthroplasty. Therefore, tranexamic acid is still recommended as the first choice hemostatic drug during total hip and total knee arthroplasties.   Figures and Tables | References | Related Articles | Metrics

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Efficacy of different nonsurgical treatments for adolescent idiopathic scoliosis: a systematic review and network meta-analysis Liu Jinlong, Abuduwupuer·Haibier, Bai Zhen, Su Danyang, Miao Xin, Li Fei, Yang Xiaopeng 2026, 30 (9):  2370-2379.  doi: 10.12307/2026.651 Abstract ( 36 )   PDF (1638KB) ( 8 )   Save OBJECTIVE: There is an increasing number of intervention modalities for the conservative treatment of adolescent idiopathic scoliosis, and a comprehensive assessment of the comparative efficacy between different non-surgical intervention modalities is lacking. The authors compared the effectiveness of different nonsurgical therapies to intervene in adolescent idiopathic scoliosis by network meta-analysis, with the aim of providing clinicians with an evidence-based medical reference for the nonsurgical treatment of adolescent idiopathic scoliosis.  METHODS: Two researchers independently searched for randomized controlled trials on non-surgical interventions for adolescent idiopathic scoliosis published from January 2014 to August 2024 in Web of Science, PubMed, Embase, and Cochrane Library. The Cochrane Risk of Bias tool in Review Manager 5.4 was applied to evaluate the quality of the literature. GRADEPro software was used for evidence assessment, and R Studio was used for pairwise analysis as well as network meta-analysis. The outcome indicators were ranked by surface under the cumulative ranking curve to compare the clinical efficacy of different non-surgical therapeutic interventions.  RESULTS: (1) A total of 26 randomized controlled trials were included, with 1 212 patients who were randomly assigned to receive one of 19 different treatment options. (2) Risk of bias assessment showed that most of the included studies had a low risk of bias. (3) The order of probability of surface under the cumulative ranking curve in terms of cobb angle intervention (the smaller the probability, the better the intervention effect) showed that Schroth exercise and Hippotherapy training (5.5%) > Pelvic rotation correction and Schroth exercise (9.1%) > Schroth exercise and Sling exercise (19.3%). The surface under the cumulative ranking curve probability ranking in terms of angle of trunk rotation intervention (the smaller the probability, the better the intervention effect) showed Schroth exercise and Hippotherapy training (8.1%) > Schroth exercise and Sling exercise (12.7%) > Schroth exercise and Balance training (17.1%). The ranking of the probability of improvement in quality of life after treatment for surface under the cumulative ranking curve (the larger the probability, the better the effect) showed Lyon exercise (99.2%) > Schroth exercise and Sling exercise (84.8%) > Pelvic rotation correction and Schroth exercise (82.4%).  CONCLUSION: Based on the surface under the cumulative ranking curve and network meta-analysis results, Schroth exercise combined with Hippotherapy training showed the best efficacy in reducing cobb angle and angle of trunk rotation in patients with adolescent idiopathic scoliosis, and Lyon exercise was more effective in improving quality of life. Due to the limited number of included studies, more high-quality literature should be introduced in the future to assess the durability of efficacy and provide more accurate clinical guidance. Figures and Tables | References | Related Articles | Metrics

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Unilateral biportal endoscopic technology for treatment of lumbar degenerative diseases: global research status and changing trends Wen Fayan, Li Yan, Qiang Tianming, Yang Chen, Shen Linming, Li Yadong, Liu Yongming 2026, 30 (9):  2380-2390.  doi: 10.12307/2026.578 Abstract ( 34 )   PDF (3366KB) ( 2 )   Save BACKGROUND: As a new minimally invasive spine technique, unilateral biportal endoscopic technology has been successfully applied to the treatment of various lumbar diseases. OBJECTIVE: From the perspective of bibliometrics, this paper was to intuitively analyze the hotspots and research trends of unilateral biportal endoscopic technology in the treatment of lumbar diseases in the world, in order to provide new insights for future research.  METHODS: Web of Science Core Collection database was used to retrieve and download the publications on the application of unilateral biportal endoscopic technology in the treatment of lumbar diseases from January 1, 2015 to December 31, 2024. VOSviewer, CiteSpace, and Microsoft Excel were used to conduct this bibliometric analysis. The publication volume, countries/regions, institutions, authors, journals, references, and keywords were analyzed to identify significant features, providing new insights and scientific research ideas for the future use of unilateral biportal endoscopic technology in the treatment of lumbar degenerative diseases.   RESULTS AND CONCLUSION: (1) A total of 265 articles were included, and the number of annual publications increased steadily. These documents mainly come from 706 institutions in 56 countries/regions headed by China. Hallym University in Korea has the most publications. Dong Hwa Heo is the author who has published the most articles. WORLD NEUROSURGERY is the most published periodical. (2) The analysis results of highly cited and strong sudden references show the superiority of unilateral biportal endoscopic technology, which is considered as an alternative treatment for lumbar degenerative diseases. (3) Keyword analysis showed that decompression was the most frequent keyword. Key words are mainly divided into eight clusters: endoscopic spinal surgery, bilateral decompression, back muscle injury, minimally invasive surgery, foraminal stenosis, unilateral biportal endoscopic technology, research trends, and endoscopic surgical procedure. (4) The research on the treatment of lumbar diseases by unilateral biportal endoscopic technology has shown an upward trend in recent years. Unilateral biportal endoscopic technology is mainly used in decompression, discectomy and laminectomy, and its main diseases are lumbar spinal stenosis and lumbar disc herniation. The research in this field is still in its infancy, and scholars are constantly exploring the adaptation of unilateral biportal endoscopic technology to surgery and clinical effects, while its complications have attracted much attention. (5) In recent years, the research focus in this field has focused on unilateral biportal endoscopic technology in the treatment of adjacent segmental degenerative diseases. The popularization rate of unilateral biportal endoscopic technology in the world is still low, and the national conditions and the training of high-level technicians may be the limiting reasons. In the future, China should strengthen international academic cooperation and technology introduction, slow down the pace of technology expansion, improve the quality of research, standardize operations and formulate expert consensus. A large number of prospective randomized controlled trials are needed.  Figures and Tables | References | Related Articles | Metrics

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Visualization analysis of research hotspots and cutting-edge information in the field of intervertebral disc regeneration and repair Zhu Xiaolong, Zhang Wei, Yang Yang 2026, 30 (9):  2391-2402.  doi: 10.12307/2026.063 Abstract ( 39 )   PDF (4601KB) ( 2 )   Save BACKGROUND: In recent years, the rapid development of emerging technologies such as stem cells, exosomes, and biomaterials has provided diversified approaches and feasibility for the realization of intervertebral disc regeneration therapies. OBJECTIVE: To conduct a bibliometric visualization analysis of research hotspots in the field of intervertebral disc regeneration and repair, summarize the developmental trajectory, current status, and research hotspots in this domain, thereby providing a reference for future research. METHODS: By selecting the Web of Science Core Collection database and utilizing Citespace 6.4.R1 and VOSviewer 1.6.20 software, a comprehensive analysis was performed on relevant countries, institutions, keyword co-occurrence, clustering analysis, burst analysis, timeline analysis, document co-citation analysis, citation burst analysis, and scientific collaboration networks. Visualization techniques were employed to reveal the knowledge structure, academic communities, and technological evolution trends in this research field, thereby forming a comprehensive and objective understanding of the research status and frontier dynamics in intervertebral disc repair and regeneration. RESULTS AND CONCLUSION: (1) A total of 1 229 articles were included, and the number of publications related to this field has shown an overall increasing trend over the past 15 years. The annual number of publications reaches a peak of 163 in 2023. China is the country with the highest number of publications, contributing 687 articles, while Shanghai Jiao Tong University is the leading institution with 61 publications. Author collaboration analysis reveals that James C. Iatridis from the Icahn School of Medicine at Mount Sinai in the United States ranks first in both publication volume and citation count, with 33 publications, averaging 50.54 citations per article. The author collaboration network indicates that despite regional differences in intervertebral disc regeneration and repair research, the number of international collaborations is significant. (2) Co-citation analysis identified the most cited article as one by Nebojsa Nick Knezevic published in Lancet in 2021, which was cited 61 times. Among the top 10 most co-cited articles, six focus on stem cells, endogenous repair cells, and tissue engineering. In the top 10 articles ranked by citation burst strength, three concentrate on stem cell therapy for intervertebral disc degeneration, while four focus on tissue engineering biomaterials, including hydrogels and biological scaffolds. (3) Keyword co-occurrence and cluster analysis revealed four main research directions: Intervertebral disc structure and tissue engineering (15 items), mechanisms of intervertebral disc degeneration (13 items), establishment of research models and treatment strategies for intervertebral disc degeneration (5 items), and stem cells and regenerative medicine (5 items). The analysis suggests that current research in intervertebral disc repair primarily focuses on treatments aimed at delaying or reversing the progression of disc degeneration. (4) In the top 20 keywords ranked by burst strength, “oxidative stress” exhibited the highest burst intensity. Keywords such as “pathway,” “stress,” “nucleus pulposus cells,” “oxidative stress,” “inflammation,” and “extracellular vesicles” continue to show active bursts, indicating that these areas remain recent research hotspots. Timeline analysis of keywords shows that “oxidative stress” has long been a focal point in intervertebral disc repair and regeneration research. In contrast, “exosomes” have emerged as a new research direction only in recent years. Research on “mesenchymal stem cells,” “annulus fibrosus repair,” and “tissue engineering” has been established earlier and remains a key focus in the field. (5) Through visualization analysis, the field of intervertebral disc repair and regeneration has shown rapid global development. Current technological advancements are primarily reflected in the diversified exploration of regeneration and repair methods. Additionally, researchers have proposed various innovative approaches targeting the mechanisms of intervertebral disc degeneration, demonstrating the broad prospects for future therapeutic methods in this field.  Figures and Tables | References | Related Articles | Metrics

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Expert consensus on diagnosis and treatment of brucellar osteoarthritis Xinjiang Branch of China Trauma Rescue & Treatment Association 2026, 30 (9):  2403-2412.  doi: 10.12307/2026.127 Abstract ( 29 )   PDF (1148KB) ( 4 )   Save BACKGROUND: In recent years, China has seen a progressive increase in the annual incidence of brucellosis. As a significant complication, brucellar osteoarticular infections pose considerable challenges in diagnosis and treatment. They can also lead to severe health consequences, making the development of effective management strategies an urgent clinical priority. OBJECTIVE: To establish diagnostic and treatment guidelines to reduce impaired motor function caused by brucellosis-induced osteoarthritis. METHODS: To diminish motor function impairment caused by brucellosis-induced osteoarthritis, the Xinjiang Branch of China Trauma Rescue & Treatment Association, Infectious Diseases Committee of Xinjiang Medical Association, and Orthopedics Committee of Xinjiang Medical Association organized domestic medical experts from orthopedics, infectious diseases, radiology, and related fields. This expert consensus was developed through discussions, referencing domestic and international guidelines, and incorporating China's clinical circumstances to guide practice. The consensus comprehensively addresses pathogen characteristics, epidemiology, clinical manifestations, diagnostic approaches, and therapeutic strategies. It was finalized after extensive deliberation. RESULTS AND CONCLUSION: The definitive diagnosis of brucellar osteoarthritis necessitates a systematic and integrated evaluation framework, comprising retrospective epidemiological investigation, clinical manifestation analysis, laboratory and imaging verification, to prevent diagnostic errors and ensure timely, precise medical intervention. A personalized patient-centric strategy should be employed to determine the optimal therapeutic regimen. Figures and Tables | References | Related Articles | Metrics