During intervertebral disc degeneration (IDD), cartilage endplate (CEP) cells undergo calcification and ossification, relying primarily on glycolysis for energy metabolism. Leptin (LEP) initiates the IDD, while its underlying mechanism related to glycolysis remains elusive in CEP cells. To investigate the underlying mechanism of LEP on IDD, an IDD rat model was established and LEP-added CEP cells were adopted, with a glycolysis inhibitor (2-DG) and sh-HIF-1α. A rat IDD model was successfully established, with the model group exhibiting endplate calcification, ossification, and increased LEP levels. In vitro experiments confirmed that LEP dose-dependently promotes calcification and ossification in CEP cells. LEP also upregulated calcification-related indicators (BMP-2, Sox9) and osteogenesis-related genes (OCN, Runx2), inducing the formation of calcified nodules and increased ALP activity. Mechanistic studies revealed that glycolysis-related proteins and lactic acid content in both IDD rat and LEP-added CEP cells were elevated. This process could be reversed using the glycolysis inhibitor 2-DG. Further experiments demonstrated that LEP promoted glycolysis by upregulating the OCN/HIF-1α axis; knockdown of either OCN or HIF-1α blocked LEP-induced calcification and ossification. LEP is elevated in IDD, and LEP accelerates the calcification and ossification through stimulating glycolysis by the OCN/HIF-1α axis.

Preoperative planning of the surgical approach for cervical spondylotic myelopathy (CSM) is central to precision medicine. This study used supervised machine learning (SML) to build a predictive model for surgical approach selection in CSM and applied unsupervised machine learning (UML) to explore clinical heterogeneity. In this retrospective study, a development cohort of 884 surgically treated patients with CSM was used for model development after exclusion of patients with incomplete perioperative data. Variables showing significant between-group differences were entered into four supervised machine-learning algorithms, including support vector machine (SVM), extreme gradient boosting (XGBoost), random forest (RF), and generalized linear model (GLM), for feature screening and model development. In addition, an exploratory unsupervised clustering analysis was performed in patients undergoing anterior surgery on the basis of perioperative profile variables to characterize clinical heterogeneity. An independent external validation cohort of 200 patients was further used to evaluate the discrimination, calibration, and clinical utility of the final model. The final prediction model for surgical approach incorporated four key variables: American Spinal Injury Association impairment scale (ASIA), eosinophils (EOS), total protein (TP), and albumin (Alb), with an area under the curve (AUC) of 0.811 in the development cohort. Model scores were significantly correlated with perioperative indicators. UML identified two exploratory subgroups among patients receiving anterior surgery, indicating distinct perioperative profiles. In the external validation cohort, the model achieved an AUC of 0.726 (95

Background SCSEH ( Spontaneous cervical spinal epidural hematoma) is a rare yet serious clinical entity characterized by idiopathic, non-traumatic, and non-iatrogenic accumulation of blood in the cervical epidural space. For patients who experience sudden neck pain and nerve root pain symptoms, acute cervical spinal epidural hematoma should be regarded as a possible differential diagnosis cas.In recent years, such cases have been reported globally, yet treatment strategies remain heterogeneous with inconclusive efficacy evidence. While surgical decompression is widely advocated for optimal neurological recovery, conventional protocols lack specificity regarding optimal intervention timing.Over a 13-year period, we surgically managed 36 SCSEH cases. This study analyzes the intervals from symptom onset to hospital admission and admission to surgical intervention, with comparative assessment of postoperative neurological outcomes. Methods A retrospective study was conducted on 36 patients (23 males and 13 females; mean age 48.43 ± 2.17 years) diagnosed with SSCEH between January 2006 and January 2019. All patients presented with varying degrees of neurological deficits upon admission and underwent single-stage surgical intervention comprising cervical spinal canal decompression, epidural hematoma evacuation, and internal fixation. Patients were categorized based on the time interval from symptom onset to surgery.Clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) score, Visual Analog Scale (VAS), and American Spinal Injury Association (ASIA) Impairment Scale. All patients achieved a minimum follow-up of 12 months (mean 16.4 ± 2.17 months). Radiographs, CT(computed tomography ), and MRI(magnetic resonance imaging ) were utilized to evaluate fusion status and spinal stability. Results All 36 patients exhibited statistically significant improvements (P < 0.05) in ASIA grade, VAS score, and JOA score at the final follow-up compared to preoperative assessments. Functional recovery was comparable between patients undergoing surgery within 8 hours of symptom onset and those operated between 8 and 24 hours post-onset, with no statistically significant difference in postoperative functional outcomes (p > 0.05). However, patients receiving surgical intervention within 24 hours demonstrated significantly superior functional recovery compared to those operated beyond 24 hours (P < 0.05). The postoperative follow-up imaging results indicated no rebleeding, no significant loss of cervical curvature, no collapse of the bone graft or no displacement of the implant, and good spinal canal volume. Conclusions Patients with SCSEH undergoing surgery within 8 hours of symptom onset demonstrated comparable postoperative functional recovery to those operated between 8–24 hours. However, subjects receiving intervention within 24 hours collectively showed superior functional outcomes compared to those undergoing surgery beyond 24 hours Trial registration: The studies involving humans were approved by the Ethics Committee of People's Hospital of Guangxi Zhuang Autonomous Regionl. The studies were conducted in accordance with the local legislation and institutional require ments. Written informed consent for participation was not required from the participants or the participants’ legal guardians/next of kin in accordance with the national legislation and institutional requirements.

Background: As the population ages, there is an increasing trend in patients with lumbar degenerative diseases (LDD) complicated by osteoporosis seeking lumbar fusion surgery. However, standardized strategies for minimally invasive surgical procedures among these populations still need improvement in clinical practice. Purpose: This study was to integrate clinical and biomechanical approaches to investigate and demonstrate the effectiveness of oblique lateral interbody fusion combined with bone cement-augmented anterolateral screw (OLIF-BCAAS) in such patients. Study Design: A single-center, retrospective case-controlled clinical study and finite element model (FEM) analysis. Methods: A single-center, retrospective case-controlled clinical study and finite element model (FEM) analysis were conducted. 48 cases were enrolled in the clinical study, then assigned to either OLIF-BCAAS or OLIF combined with posterior internal fixation with pedicle screws (OLIF-PIFPS). Clinical outcomes and radiological parameters were statistically analyzed. The FE models of intact lumbar spine, OLIF-BCAAS, and OLIF-PIFPS were constructed based on computed tomography (CT) scans of a healthy male. These FE models were analyzed under different loading conditions. Results: There were significant differences in the surgical time, blood loss, and lower back score within 1 year postoperatively between the two groups (p < 0.05). Moreover, both OLIF surgical techniques showed significant improvements in disc height (DH) postoperatively; however, the reduction in DH at postoperative 12 months was more pronounced in the OLIF-PIFPS group than in the OLIF-BCAAS group (p < 0.05). Five cases (5/23, 21.74%) of cage subsidence (CS) were detected in the OLIF-BCAAS group, with 4 out of 23 cases (17.39%) considered as mild CS. In contrast, the amount of CS was 12 cases (12/25, 48%) in the OLIF-PIFPS group, which included 3 cases of severe CS. However, there was a trend towards statistical difference in CS between the two groups (p = 0.057). The FEM analysis showed significant reductions in the local range of motion and L3 maximum displacement with respect to L4 under six motion patterns in the two OLIF surgical models. Moreover, stress on the endplate and cage in the OLIF-BCAAS model was higher than that in the OLIF-PIFPS model; however, stress on the supplemental fixation devices was significantly lower than that observed in the OLIF-PIFPS model. Conclusion: Both OLIF surgical techniques for treating LDD with osteoporosis can achieve favorable clinical outcomes. However, OLIF-BCAAS exhibits more significant advantages over OLIF-PIFPS by maximizing the benefits of minimally invasive surgery. Moreover, OLIF-BCAAS is associated with lower postoperative back pain and a reduced incidence of postoperative CS.

Oblique lumbar interbody fusion with anterolateral screw fixation (ASF) has been used to treat lumbar degenerative disease. Cage subsidence, a common OLIF complication, is significantly affected by low bone mineral density. Although MRI-based vertebral bone quality (VBQ) and endplate bone quality (EBQ) scores relate to bone density, their impact on OLIF with ASF remains unstudied. This study reviewed data from patients who underwent OLIF combined with ASF from January 2021 to May 2023. We assessed cage subsidence (CS) by postoperative CT, while VBQ score and EBQ score were derived from MRI scans. Receiver operating characteristic (ROC) curve analysis was employed to assess the predictive accuracy of VBQ score and EBQ score. This study included a total of 219 patients, with 127 in the single-level group and 92 in the double-level group. The overall rate of CS in this study was 30.6

Numerous studies have manifested that cellular senescence involves in the pathogenesis of intervertebral disc degeneration (IDD). Here, we constructed a novel senescence-related genes (SRGs) signature for IDD. Three data sets were derived from Gene Expression Omnibus (GEO) database and 370 SRGs were collected from cellAge database. Key module genes related to senescence in IDD were screened using “WGCNA” package. The “limma” package was employed to filter differentially expressed genes (DEGs) between control and IDD groups, and candidate genes were identified by intersecting up-regulated DEGs and module genes. Hub genes were screened by randomForest and LASSO regression analysis. Diagnosis performance of hub genes was assessed and verified by receiver operating characteristic (ROC) curve. Diagnosis biomarkers of IDD were identified based on AUC > 0.7. Signaling pathway enrichment analysis of biomarkers was performed using “clusterProfiler” package. Immune cells infiltration was evaluated by “MCP-counter” and “GSVA” packages. A total of 625 module genes and 384 DEGs were obtained, then 28 candidate genes related to senescence in IDD were screened. By machine learning, 4 hub genes were identified with good diagnostic performance, which were highly expressed in IDD samples. Furthermore, 3 biomarkers (BID, KANK2, and SMIM3) were screened with AUC > 0.7 in external datasets. Three biomarkers were mainly involved in nuclear factor (NF)-kappa B, TNF, IL-17, and NOD-like receptor signaling pathway, etc. Besides, BID, KANK2, and SMIM3 exhibited positive association with most immune cell infiltration. We identified 3 diagnostic biomarkers related to senescence in IDD, hoping to improve the treatment of IDD.

This study aims to assess the outcomes of combining oblique lumbar interbody fusion (OLIF) with anterolateral screw fixation (ASF) and stress endplate augmentation (SEA) in comparison to OLIF combined with pedicle screw fixation (PSF) for the treatment of degenerative lumbar spinal stenosis (DLSS) in patients with osteoporosis (OP). We performed a retrospective analysis of patients diagnosed with DLSS who underwent OLIF in conjunction with either SEA and ASF (SEA-ASF group) or PSF (PSF group). Clinical outcomes, including the visual analog scale (VAS) scores for lumbar and leg pain, as well as the Oswestry Disability Index (ODI), were assessed at various postoperative intervals and compared to preoperative values. Additionally, radiographic outcomes such as disc height (DH), lumbar lordosis (LL), segmental lordosis (SL), cage subsidence (CS), and fusion rate were evaluated at different postoperative intervals and compared to their preoperative measurements. A total of 65 patients were enrolled in the study, comprising 30 individuals in the SEA-ASF group and 35 in the PSF group. No statistically significant differences were observed in surgery-related complications between the groups. While VAS and ODI scores did not differ significantly at the 24-month follow-up, the SEA-ASF group exhibited superior scores at both 1 day and 1 month post-surgery (P < 0.05). Significant differences were observed in DH, LL, and SL at both 12 and 24 months postoperatively between the two groups (P < 0.05). At the 24-month postoperative follow-up, the incidence of CS was observed to be 16.67

To systematically analyze the effectiveness of lumbar braces in patients after lumbar spine surgery. The databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), were searched to identify the randomized controlled trials (RCTs), case-series or case–control studies on the use of lumbar braces after lumbar spine surgery. The two authors independently assessed the quality of the included study and extracted the data. The statistical analysis was performed using Revman 5.4 software. 9 English papers and 1 Chinese paper were included in the present work, involving a total of 2646 patients (2181 in the experimental group and 465 in the control group). The differences in preoperative VAS, postoperative VAS, preoperative ODI, postoperative ODI, length of hospital stay, postoperative complications, and surgical comparison were not statistically significant (p > 0.05). However, postoperative surgical site infection incidence was lower in the lumbar brace group than those without lumbar brace (p < 0.05). Whether or not the use of lumbar braces after lumbar fixation has a negligible impact on clinical outcomes was studied. Subsequent studies could further demonstrate whether the use of lumbar braces after lumbar surgery could reduce the incidence of surgical site infections.

椎间盘退变(IDD)引起的腰背痛是致残率较高的疾病之一,其发病往往呈慢性进行性发展,并且具有不可逆性.因此,如何延缓或逆转IDD成为一个新的研究热点,比如基因疗法、干细胞疗法和细胞因子疗法.如今随着转录因子在椎间盘发育过程中的相继发现,将为开发出一种新的椎间盘疗法提供可能.该文就椎间盘发育过程中相关转录因子的作用进行综述.

OBJECTIVE: The aim of this study was to compare the efficacy and safety of ultrasonic bone curette (UBC) and conven-tional surgical instruments in thoracic laminec-tomy decompression (TLD) for the treatment of thoracic spinal stenosis (TSS) by meta-analysis. MATERIALS AND METHODS: Two authors independently searched Medline via PubMed, Embase, Cochrane Library, Web of Science, Wanfang Database, and China National Knowl-edge Infrastructure for the period from the es-tablishment of the database until January 2023 to identify the studies on the safety and effica-cy of UBC vs. conventional instruments for TSS. Data extraction and quality assessment were performed by two researchers independently. We used RevMan 5.4 software (Review Manager Web, The Cochrane Collaboration, Copenhagen, Denmark) to analyze the data. RESULTS: Eight retrospective studies were included in the present work. This meta -anal-ysis revealed that no significant differences in the preoperative JOA scores, the JOA scores at the last follow-up, the improvement rate of JOA scores, and the incidence of cerebrospinal fluid leakage/dura injury were detected between the two groups (p>0.05). However, there were sig-nificant differences in the operative time and in-traoperative blood loss during single-level TLD [operative time: MD=-1.47, 95% CI (-1.86,-1.09), p<0.001; intraoperative blood loss: MD=-46.62, 95% CI (-53.83,-39.40), p<0.001], total opera-tive time [MD=-56.88, 95% CI (-69.66,-44.10), p<0.001], total intraoperative blood loss [MD= -143.52, 95% CI (-212.49,-74.54), p<0.001], the in-cidence of neurological deterioration/nerve root injury [RR= 0.29, 95% CI (0.09, 0.91), p=0.03] be-tween the groups. CONCLUSIONS: The application of UBC in TLD to treat TSS is safe and effective. UBC can significantly shorten operation time and reduce intraoperative blood loss compared to tradition-al surgical instruments. Moreover, it has the ad-vantage of reducing perioperative nerve injury.

At present, the impact of cuproptosis-related genes in the study of osteosarcoma is largely unknown. Genome-wide data of osteosarcoma and controls were downloaded from 3 different databases, and specific diagnostic models associated with cuproptosis in osteosarcoma were constructed by support vector machines with artificial intelligence, random forest trees and LASSO regression. Differential analysis of immune cell infiltration was examined using routine blood data from 25,665 cases. Differential expression was examined using immunohistochemistry and PCR. PDHA1 and CDKN2A were obtained as specific cuproptosis-related biomarkers for osteosarcoma after artificial intelligence analysis. PDHA1, CDKN2A and neutrophils were differentially expressed in OS and control groups. PDHA1 and CDKN2A are significantly dysregulated in OS and are able to serve as biomarkers of OS.

OBJECTIVE:The aim of this study was to evaluate and aggregate the evidence from the published studies to determine the effectiveness of intradiscal steroid injection (ISI) in patients with symptomatic Modic type I change (MCI). MATERIALS AND METHODS:A systematic literature search was independently performed by two authors. The electronic database, including PubMed, Embase, the Cochrane Library, and Web of Science, were searched with the given search terms but without language restriction. The studies that met the inclusion criteria were included. The relevant data were extracted, and two authors independently assessed the quality of the included studies. We performed the present study using the STATA software package. RESULTS:The present work included seven studies with 434 patients with chronic low back pain (CLBP). The risk of bias in the included randomized controlled trials (RCTs) was rated from low to unclear, and all the included observational studies were rated as high quality. The result of the meta-analysis revealed that there were significant differences in pain intensity [standardized mean difference (SMD): 3.09, 95% confidence interval (CI): 1.60-4.58; p<0.01] and self-assessed improvement/satisfaction [odds ratio (OR): 11.41, 95% CI: 3.39-38.41; p=0.05] after ISI compared to before treatment. However, no significant differences in the proportion of patients with full or part-time employment (OR: 1.03, 95% CI: 0.55-1.91; p>0.05), receiving additional care for CLBP (OR: 0.78, 95% CI: 0.36-1.71; p>0.05), and serious adverse events (OR: 1.09, 95% CI: 0.58 to 2.05; p>0.05) were detected between the groups. CONCLUSIONS:Among CLBP patients with MCI, the use of ISI was significantly associated with a reduction in pain intensity in the short term.

Background Which types of Modic changes (MCs) and whether or how specific factors associated to MCs work on lumbar instability have yet to be well understood. The purpose of this study was to investigate the influences of the types of MCs, the extent of MCs lesion involvement, and different lumbar levels involved by MCs on lumbar instability. Methods This retrospective study included 263 adult subjects with MCs who underwent lumbar X-ray examinations in the neutral, flexion, and extension positions. All patients who met our inclusion criteria were examined with 1.5 Tesla magnetic resonance units. Two experienced authors with more than three-year clinical experience independently evaluated and measured the subjects’ radiographic images. The subgroup analysis was performed to detect the differences in subjects’ baseline characteristics and lumbar segmental motions among three types of MCs, the extent of MCs lesion involvement and different lumbar levels involved by MCs. Results There was a statistical difference in body mass index (BMI) between different involvement extent of MCs ( p < 0.01), indicating that the subjects with high BMI are more likely to develop severe MCs. The subjects with Modic type 1 change (MC1) had a significant increase in lumbar angular motion than those with Modic type 2 change (MC2) and Modic type 3 change (MC3) ( p < 0.01) and compared with MC3, a significant increase in lumbar translation motion was detected in subjects with MC1 and MC2 ( p < 0.01). While, angular motion decreased, translation motion increased significantly as the extent of MCs lesion involvement aggravated ( p < 0.01). However, there were no statistical differences in lumbar angular and translation motions between different lumbar levels involved by MCs ( p > 0.05). Conclusions Higher BMI might be a risk factor for the development of severe MCs. MC1 and MC2 significantly contribute to lumbar instability. The extents of MCs lesion involvement are strongly associated with lumbar instability. However, different lumbar levels involved by MCs have little effect on lumbar stability.

Background: In absence of uniform therapeutic recommendations, knowledge of the available treatment options for Modic changes (MCs) patients and their safety and effectiveness would be crucial and significant for clinicians and such patients. Objectives: The aim of this study was to provide a systematic review of available studies on non-surgical treatments of MCs. Methods: We performed a systematic review of multiple electronic databases including PubMed, Web of Science, Embase, Cochrane Library, and China National Knowledge Infrastructure for the period until 31st August 2021 to search for studies on non-surgical treatments for MCs in accordance with the guidance of the Cochrane Handbook. Potential studies were screened by their titles and abstracts. The methodological quality of the included studies was independently evaluated by two authors. Final recommendations for the included interventions were developed based on grades of recommendations. The narrative format was adopted to synthesize the findings of the present work. Results: Fifth studies involving a total of 1147 patients were identified for this systematic review. The results of this review demonstrated that spinal manipulation has been suggested as an alternative option for patients with MCs. However, there was insufficient evidence to support that patients with MCs can benefit from the medication and wearing the rigid lumbar brace. Moreover, the rationale and safety for the use of antibiotics in such patients remain highly controversial. Low evidence revealed that exercise therapy might decrease pain intensity only for special subgroups of MCs patients. Conclusions: There is not yet enough evidence to suggest that non-surgical treatments are useful for patients with MCs. Further high-quality, multicenter trials are required to validate the effectiveness of these non-surgical treatments.

Intervertebral disc degeneration (IDD) is considered the basis of serious clinical symptoms, especially for low back pain (LBP). Therefore, it is essential to explore the regulatory role and diagnostic performance of dysregulated genes and potential drugs in IDD. Through WGCNA co-expression analysis, 36 co-expression modules were obtained. Among them, MidnightBlue and Red modules were the most related to IDD. Functional enrichment analysis showed that the Red module was mainly related to neutrophil activation and regulation of cytokine-mediated signaling pathway and apoptosis, whereas the MidnightBlue module was mainly related to extracellular matrix organization, bone development, extracellular matrix, extracellular matrix component, and other extracellular matrices. Furthermore, 356 genes highly related to the module were screened to construct a protein interaction network. Network degree distribution analysis showed that the known IDD-related genes had a higher degree of distribution. Enrichment analysis demonstrated that these genes were enriched in MAPK_SIGNALING_PATHWAY (FDR = 0.012), CHEMOKINE_SIGNALING_PATHWAY, and some other pathways. By constructing a disease-gene interaction network, three disease-specific genes were finally identified. Through combining with the drug-target gene interaction network, two potential therapeutic drugs, entrectinib and larotrectinib, were determined. Finally, based on these genes, the diagnostic model in the training dataset, test dataset, and verification dataset all showed a high diagnostic performance. The findings of this study contributed to the diagnosis of IDD and personalized treatment of IDD.

骨质疏松症(osteoporosis,OP)是强直性脊柱炎(ankylosing spondylitis,AS)患者常见的合并症.OP的发生严重影响着AS患者的治疗效果及生活质量,因此,AS患者应进行OP的预防及常规治疗.目前治疗OP的主要药物有双膦酸盐、钙及维生素D等,相关研究发现,治疗AS的常规药物,如肿瘤坏死因子抑制剂(tumor necrosis factor inhibitor,TNFi)、甲状旁腺素(parathyroid hormone,PTH)、非甾体抗炎药、IL-17(interleckin-17,IL-17)阻断剂等,在OP的治疗中也发挥一定的作用,当合并骨折时,手术是首要的治疗方式.目前的研究主要集中在AS的发病机制,对合并OP的AS患者的治疗研究较少,因此,笔者综述了AS患者合并OP的相关治疗方式,并对其存在的问题和未来发展方向进行探讨.

Objectives The purpose of this study was to examine the biomechanical effects of fixation on range of motion (ROM) in the upper and lower adjacent segments of different lumbar spine segments in a goat spine model. Methods Fifteen goat spine specimens (vertebrae T12–S1) were randomly divided into three groups: A (single-segment fixation), B (double-segment fixation), and C (triple-segment fixation). Motion in different directions was tested using a spinal motion simulation test system with five external loading forces. Transverse, forward–backward, and vertical displacement of the upper and lower adjacent segments were measured. Results As the external load increased, the upper and lower adjacent segment ROM increased. A significantly greater ROM in group C compared with group A was found when the applied external force was greater than 75 N. The upper adjacent segment showed a significantly greater ROM than the lower adjacent segment ROM within each group. Conclusions Adjacent segment ROM increased with an increasing number of fixed lumbar segments. The upper adjacent segment ROM was greater than that of the lower adjacent segments. Adjacent segment stability after lumbar internal fixation worsened with an increasing number of fixed segments.

Purpose The main aim of this retrospective study was to analyze lumbopelvic sagittal parameters among the three different types of Modic changes (MCs). Furthermore, correlations between the sizes of MCs and the number of involved lumbar levels with lumbopelvic parameters are investigated. Methods A total of 263 adult subjects with MCs at a single institution from September 2015 to October 2020 who underwent lumbar x-ray examinations and magnetic resonance imaging were included in this retrospective study. Types of MCs, sizes of MCs, lumbar levels involved by MCs as well as lumbopelvic sagittal parameters from each subject were evaluated by two authors. Results Lumbar lordosis (LL), sacral slope (SS), and pelvic incidence (PI) in subjects with MC grade 1 were significantly smaller than in those with MC grade 2 and grade 3 (p<0.05). Lumbopelvic sagittal parameters decreased significantly as the sizes aggravated (p<0.01). Triple lumbar levels with MCs showed a significant increase in PI-LL (p<0.05) and decrease in LL (p<0.01), SS (p<0.01), and PI (p<0.01) when compared to MCs at single and double lumbar levels. Conclusion MC grade 1, severe MCs, and lumbar multi-segmental MCs were significantly linked to lumbar sagittal imbalance.

脊柱嗜酸性肉芽肿(EG)占所有骨肿瘤＜1％,是自限性疾病,患者临床表现缺乏特异性,常表现为涉及椎体的溶骨性改变,多见于儿童,成人发病较少见.其首发症状多表现为局部疼痛,若累及颈椎可伴斜颈和活动受限,若病变累及脊髓或神经根时可导致神经功能损伤的表现,其特征性影像学表现是扁平椎,病理学特点为病变组织中有大量朗格汉斯细胞增生伴嗜酸性粒细胞、淋巴细胞浸润.而颈椎是脊柱EG的罕见位置,成人颈椎EG大多涉及单个椎体,少部分涉及多个椎体,颈部疼痛、四肢无力和运动受限是成人颈椎EG最常见的症状.随着对该病研究的不断深入,成人颈椎EG治疗方法也在不断更新,而手术通常用于严重神经功能缺损和骨骼不稳定的患者.