Yong Hai

Objectives: Accurate nutritional assessment in children with early‐onset scoliosis (EOS) is challenging because spinal deformity reduces measured standing height and may distort BMI‐for‐age classification. This study aimed to evaluate, using a longitudinal design, height‐adjusted nutritional status before each growing‐rod procedure throughout the treatment course and to investigate its association with postoperative complications in patients with EOS. Methods: A retrospective cohort study included 53 patients with EOS who underwent 86 growing‐rod procedures between January 2016 and January 2023, with each procedure serving as the unit of analysis. Nutritional status was reassessed before each analyzed procedure using BMI calculated from height corrected by the Ylikoski formula and was linked to the postoperative outcome of the corresponding procedure. Generalized estimating equations (GEE) were used to evaluate factors associated with postoperative complications while accounting for within‐patient clustering. Results: A total of 14 procedures resulted in postoperative complications, yielding an overall complication rate of 16.3% (14/86), with 15 specific complication events recorded. After height‐adjusted BMI correction, 46 procedures were classified into the malnourished group and 40 into the normal nutrition group. The complication rate was significantly higher in the postadjusted malnourished group than in the normal nutrition group (23.9% vs. 7.5%, p = 0.042). Multivariable analysis using GEE revealed that undergoing ≥ 3 surgeries (OR = 4.614, 95% CI: 1.133–18.786, p = 0.033), and postadjusted malnutrition (OR = 3.701, 95% CI: 1.006–13.613, p = 0.049) were associated with increased risk of postoperative complications. However, after the Mancl–DeRouen small‐sample correction, the association between height‐adjusted malnutrition and complications was no longer statistically significant (OR = 4.21, 95% CI: 0.38–46.12, p = 0.239). Conclusions: Height‐adjusted malnutrition and repeated surgeries (≥ 3) were associated with increased postoperative complications after growing‐rod surgery in EOS patients. However, larger cohorts are needed to confirm these findings. The procedure‐specific application of height‐adjusted BMI provides an alternative approach to longitudinal nutritional assessment during repeated growing‐rod treatment. Timely intervention should be implemented for patients with poorer nutritional status.

Study Design: Retrospective cohort study.Purpose: To evaluate the clinical efficacy and advantages of integrated optical and electromagnetic navigation-guided biportal endoscopic unilateral laminotomy for bilateral decompression (navigation-guided BE-ULBD, Ng-BE-ULBD) in patients with lumbar spinal stenosis (LSS).Overview of Literature: The use of surgical navigation improves procedural precision and contributes to reduced operative time and fluoroscopy exposure. However, currently available navigation systems have notable limitations: optical navigation is influenced by lineof- sight obstruction, while electromagnetic navigation is easily affected by interference from metallic instruments.Methods: A retrospective analysis was performed on patients who underwent BE-ULBD for LSS at Beijing Chaoyang Hospital between August 2023 and June 2025. Patients treated using an integrated optical and electromagnetic surgical navigation system were categorized into the Ng-BE-ULBD group (n=84), whereas those treated under conventional C-arm fluoroscopy guidance were included in the Carm- guided BE-ULBD (C-BE-ULBD) group. Baseline demographic and clinical characteristics, operative time, number of fluoroscopy shots, clinical outcomes, and postoperative complications were recorded and compared between the two groups.Results: The total operative time for both single- and two-level decompressions was significantly shorter in the Ng-BE-ULBD group (81.40 minutes and 144.56 minutes, respectively) than in the C-BE-ULBD group (88.79 minutes and 159.53 minutes, respectively; p <0.05), with the most substantial difference observed in catheter placement time. The total number of fluoroscopy shots was also significantly lower in the Ng-BE-ULBD group (p 0.05).Conclusions: The integrated optical and electromagnetic surgical navigation system effectively reduces radiation exposure and shortens operative time, thereby improving surgical efficiency and safety. These findings demonstrate strong clinical potential for this technology in minimally invasive spine surgery.

Low back pain (LBP) is one of the most frequently encountered conditions in orthopedics, physical therapy and rehabilitation, and pain medicine. Its etiology is multifactorial and its management options are diverse. However, a unified, standardized, and evidence-based clinical pathway for LBP remains lacking, leading to substantial variation in diagnostic reasoning, treatment selection, outcome assessment, and long-term care across healthcare settings and professional disciplines. To address this gap, Chinese Society for the Study of the Lumbar Spine, Chinese Association of Spine initiated this multidisciplinary expert consensus. The project was organized and implemented by Xijing Hospital of Fourth Military Medical University and Beijing Chaoyang Hospital of Capital Medical University, in collaboration with a national multicenter panel of clinical experts and methodologists. Using rigorous evidence-based methodology, the panel developed an expert consensus on recommendation levels for clinical diagnosis and treatment pathways in LBP. Comprehensive searches of multiple databases and guideline sources were performed from 1991 to December 2025 in this consensus. A total of 4 703 publications were initially retrieved, and 653 publications were ultimately selected to inform the development of the consensus statements, including 70 systematic reviews and 145 original studies that directly supported the formulation and grading of recommendations. Centered on key elements across the entire care continuum, including precise diagnostic assessment, stepwise treatment selection, multimodal comprehensive interventions, long-term outcome management, recurrence prevention, patient education, and self-management, this consensus provides a structured set of recommendations. It clarifies the core diagnostic criteria and intervention strategies for patients with low back pain caused by different etiologies, and classifies interventions as “strong recommendation”, “weak recommendation”, “weak recommendation against”, or “strong recommendation against”. The recommendations emphasize individualized and stepwise decision-making tailored to patient-specific circumstances, reaffirm the foundational role of conservative management, and define strict indications for surgery and other invasive interventions. In addition, the consensus evaluates the potential synergistic effects of combined treatment strategies and highlights the importance of recurrence prevention and functional rehabilitation in long-term care. It also provides guidance on multidisciplinary collaboration and referral criteria within the clinical pathway. Overall, this consensus aims to provide clinicians at all levels of healthcare with a clear and authoritative decision-making framework. By promoting a shift from experience-based and fragmented practice toward systematic, standardized, and evidence-based management, this consensus is expected to improve clinical outcomes, enhance patients’ quality of life, and support more efficient use and distribution of healthcare resources.

Background: This study systematically present the overall landscape and evolutionary trends of international research in the field of scoliosis rehabilitation over the past 30 years. Methods: This study used the Science Citation Index Expanded (SCI-E) database of the Web of Science Core Collection as the data source. Target literature was screened according to pre-set criteria, and bibliometric analysis platforms, VOSviewer 1.6.11 and CiteSpace software 6.1.R6 were employed to conduct a quantitative analysis and visual presentation of annual publication volume, citation frequency, core authors, institutions, countries, research directions, funding sources, and journal distribution. Results: The results showed that the United States and China were the major contributing countries in this field. A total of 308 valid documents were included, with 4,333 total citations, 14.07 citations per paper on average, and an H-index of 35. Negrini S, Italian Spine Science Institute, the United States, Orthopedics, National Natural Science Foundation of China, and Spine ranked first in terms of publication output, citations, core research directions, funding, and journals, respectively. Conclusions: Keyword clustering analysis indicated that adolescent idiopathic scoliosis, Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) guidelines, and Asian adolescent idiopathic scoliosis were core topics in the field, representing future research hotspots. Meanwhile, the burst intensity of keywords such as Cobb angle, posterior spinal fusion, and risk factors increased significantly, suggesting that surgical treatment and its safety are becoming frontier research trends.

Background:Distractive spinal cord injury (DSCI), a severe complication of spinal deformity correction surgery, is characterized by rapid neuronal loss. However, the molecular mechanisms linking mechanical distraction to apoptosis remain unclear. Here, we tested whether sodium rutin (NaR), a water-soluble rutin derivative with improved oral bioavailability, mitigates DSCI.Methods:We employed an in vivo rat DSCI model and an in vitro mechanical distraction (DIS) model using neuronal cells. The therapeutic efficacy of NaR was evaluated using locomotor function assessments (Basso–Beattie–Bresnahan score and footprint analysis), histopathology, and transmission electron microscopy. Molecular docking simulations were performed to predict the binding affinity of NaR to Erb-B2 receptor tyrosine kinase 4 (ErbB4). Mechanistic investigations targeting the ErbB4/protein kinase B (Akt) axis, reactive oxygen species (ROS), and apoptotic pathways were conducted using western blot analysis and immunofluorescence.Results:DIS suppressed ErbB4 phosphorylation and downstream Akt signaling, accompanied by the activation of B-cell lymphoma 2/Bcl-2-associated X protein/Caspase-3 (Bcl-2/Bax/Caspase-3) apoptotic pathways after DSCI. Simultaneously, DIS induced a decrease in the mitochondrial membrane potential (ΔΨm) and accumulation of mitochondrial ROS, along with a significant reduction in superoxide dismutase 2 (SOD2) and glutathione peroxidase 4 (GPX4) levels. NaR treatment engaged ErbB4 to restore ErbB4/Akt signaling, inhibited mitochondrial ROS signaling, ameliorated ΔΨm, and reduced the number of terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)-positive apoptotic neurons, thereby inhibiting neuronal apoptosis. However, the inhibition of ErbB4 phosphorylation along with NaR treatment significantly reversed these therapeutic effects. Furthermore, the pharmacological administration of NaR ameliorated histopathological and neuronal ultrastructural damage in the spinal cord tissues, increased the number of surviving neurons, and facilitated locomotor recovery after DSCI.Conclusions:These findings identify ErbB4 and ROS signaling as key regulators of neuronal survival during DSCI and establish NaR as a candidate therapeutic strategy for DSCI associated with spinal deformity correction surgery.