Thoracic ossification of the ligamentum flavum (TOLF) is the primary cause of thoracic spinal stenosis (TSS). Conventional decompression surgeries require surgical instruments to be inserted into the spinal canal, which is associated with risks such as dural tears, cerebrospinal fluid (CSF) leakage and even spinal cord injury, potentially resulting in devastating neurological deficits. This study introduces a novel surgical technique named midline delta double-door decompression (MDDD), assesses its feasibility and safety and elaborates on its potential advantages. A retrospective analysis was performed on the clinical data of 13 patients with TOLF who underwent MDDD from 2024 to January 2025. All the enrolled patients presented with symptoms of upper motor neuron injury, and some patients experienced complications of intermittent claudication. Centring on the core concept of the midline delta safe zone, a gradient progressive surgical strategy from the safe zone to the lesion boundary was adopted to standardize the surgical procedure. The double-door decompression mode was applied to achieve complete spinal cord decompression without any contact with the spinal cord. All patients received postoperative follow-up for more than 9 months. The modified JOA score for thoracic myelopathy (mJOA) was used to evaluate the improvement in clinical symptoms. Postoperative thoracic CT and MRI were performed to assess lesion resection efficacy and spinal stability. All surgeries were successfully completed without conversion to open surgery. No cases of intraoperative spinal cord injury, CSF leakage or severe postoperative neurological deterioration occurred. The mean operative time was 106.15 ± 8.58 min, with an average intraoperative blood loss of 143.08 ± 24.96 mL. The spinal canal anteroposterior diameter (SCAD) and cross-sectional area significantly increased postoperatively. At the mean 12.8-month follow-up, the mean mJOA score increased from 5.46 ± 0.78 preoperatively to 9.46 ± 0.78, with a mean neurological recovery rate (RR) of 57.72

Neural injuries affecting the peripheral and central nervous systems remain major clinical challenges because primary tissue disruption is followed by injury-specific secondary cascades, inhibitory extracellular environments, and limited circuit reconstruction. Piezoelectric biomaterials can convert physiological micromotion or externally applied ultrasound into localized electrical cues and therefore offer a self-powered route to combine structural repair with neuromodulation. This review critically compares natural, inorganic, organic, and composite piezoelectric systems in terms of piezoelectric coefficients, representative device-level outputs, mechanical compatibility, degradation, and biosafety. We first establish the physiological basis for bioelectric regulation in peripheral nerve injury (PNI), spinal cord injury (SCI), traumatic brain injury (TBI), and ischemic stroke, emphasizing the distinct cellular and electrophysiological requirements of each lesion. We then discuss rational engineering strategies, including structural alignment, compositional modification, interface engineering, and multifunctional integration, and relate these strategies to site-specific scaffold and activation requirements. Particular attention is given to controlling the catalytic activity of multiferroic materials, standardizing electromechanical characterization, and defining translational benchmarks for manufacturing, sterilization, long-term safety, and regulatory evaluation. Overall, piezoelectric materials are promising for neural injury repair, but clinically meaningful progress will require pathology-matched design and quantitative comparison rather than optimization of piezoelectric output alone.

Peripheral nerve injury significantly impacts patients’ quality of life, with poor nerve regeneration and insufficient functional recovery being urgent challenges. Even with early medical and surgical interventions, desired outcomes are often not achieved. Our research focuses on effective surgical and rehabilitation strategies, as well as the development of innovative technologies. Peripheral nerve injury repair is analyzed from three main perspectives: first, improving intrinsic axonal growth capacity, which involves signaling pathways and the regulation of neuromodulatory factors; second, enhancing the injury repair environment, where Schwann cells (SCs) and macrophages play key roles in reducing inhibitory factors, and regulating the immune microenvironment is crucial; and third, ensuring the successful and correct reconnection of the repaired nerve to the innervated tissue, preventing distal tissue degeneration and scar formation. This review explores concepts related to peripheral nerve injury (PNI) and the associated anatomical changes, offering a schematic representation of the various types of nerve damage. We review studies conducted in experimental models of peripheral nerve injury treatment, discussing existing treatment methods—such as surgical interventions, drug-based therapies, and other approaches—and highlight new PNI treatments, particularly for critical lesions, aimed at overcoming existing limitations and achieving better clinical outcomes.

Introduction:Degenerative lumbar spine diseases significantly affect patients' quality of life. The far-lateral approach (FLA) in uni-portal non-coaxial spinal endoscopic surgery (UNSES) offers a minimally invasive solution for complex lesions; however, a lack of expert consensus exists regarding its use. Research question:This study aimed to establish a consensus definition for the clinical application of FLA in UNSES by aggregating expert opinions through a modified Delphi method, thereby guiding clinical decision-making. Methods:A cross-sectional modified Delphi consensus survey was conducted. Seventy-eight spine endoscopy experts were invited to complete two rounds of anonymous questionnaires. The questionnaire covered six FLA-related categories: indications, advantages, preoperative evaluation, surgical details, complications, and postoperative rehabilitation. The consensus threshold was set at ≥ 70%. Results:The effective response rates for the two survey rounds were 94.87% and 97.44%, respectively. The expert authority coefficients were high (0.88-0.92), and Kendall's coefficients were 0.47 and 0.52, respectively. Grade A and grade B consensus were achieved for 89.5% (17/19) and 10.5% (2/19) of all items, respectively. Discussion and conclusions:This study demonstrates a high degree of agreement among experts on the key aspects of using FLA in UNSES. It provides a framework for standardizing surgery, optimizing patient outcomes, guiding future research, and promoting safe and effective UNSES implementation.

Abstract Axon regeneration in the central nervous system (CNS) remains limited, imposing severe constraints on functional recovery after injury. Here, we reveal that the deubiquitinase OTU deubiquitinase 7 A (OTUD7A) critically regulates CNS regeneration by modulating histidine triad nucleotide-binding protein 1 (HINT1) stability. OTUD7A stabilizes HINT1 protein through specific removal of K63-linked ubiquitin chains at lysine 7. Screening of the small-molecule deubiquitinase inhibitor PR-619 identified HINT1 as a key ubiquitination-regulated target. Notably, genetic knockdown of Hint1 alone was sufficient to improve RGC survival and promote optic nerve regeneration, thereby activating mTOR signaling, while PR-619 administration enhanced tissue preservation and axon repair after spinal cord injury. A multi-gene therapeutic strategy further enhanced optic nerve regeneration in the optic nerve crush (ONC) model. These findings identify the OTUD7A–HINT1–mTOR axis as a potential therapeutic target in CNS regeneration.

This study aims to investigate the associated factors of intercostal neuralgia in patients with osteoporotic vertebral compression fractures (OVCF) of the thoracic spine and to develop a predictive model to assess the likelihood of patients developing intercostal neuralgia following thoracic vertebral fractures. The retrospective study involved 518 patients with thoracic OVCF treated at our hospital, among whom those with and without intercostal neuralgia were matched at a 1:1 ratio.Relevant basic clinical data and imaging parameters of the patients were recorded, t-test was used for continuous variables and chi-square test for categorical variables to determine the factors associated with intercostal neuralgia. Subsequently, the above associated variables were screened using univariate and multivariate logistic regression models to obtain associated factors. Finally, a prediction model for osteoporotic thoracic spine fracture was developed and validated. This study included a total of 104 patients based on the presence or absence of intercostal neuralgia.The results of multifactorial logistic regression analysis showed that injured vertebral intervertebral foraminal area (P = 0.0008, regression coefficient estimate 0.0490, 95

Chromatin domain-binding protein 4 (CHD4), the ATPase core component of the NuRD complex, exerts dual roles in epigenetic regulation—mediating both gene silencing and activation. We report a case of occult breast cancer with extensive bone metastasis harboring a novel somatic truncation mutation in the catalytic SNF2 domain (CHD4 p.Trp736Ter). This mutation, unreported in other cancers to date, abolishes ATPase activity and disrupts NuRD complex assembly. Multimodal analysis (PET/CT, biomarkers, pathology) confirmed the case as luminal-A subtype and revealed a significant response to endocrine therapy. We hypothesize that this CHD4 mutation may alter the protein’s dual regulatory balance, particularly enhancing its potential gene-activating functions, and propose that impaired chromatin remodeling driven by such mutations is associated with metastatic progression of breast cancer.

Retinal ganglion cells (RGCs) generally fail to regenerate axons, resulting in irreversible vision loss after optic nerve injury. While many studies have shown that modulating specific genes can enhance RGCs survival and promote optic nerve regeneration, inducing long-distance axon regeneration in vivo through single-gene manipulation remains challenging. Nevertheless, combined multi-gene therapies have proven effective in significantly enhancing axonal regeneration. At present, research on promoting optic nerve regeneration remains slow, with most studies unable to achieve axonal growth beyond the optic chiasm or reestablish connections with the brain. Future research priorities include directing axonal growth along correct pathways, facilitating synapse formation and myelination, and modifying the inhibitory microenvironment. These strategies are crucial not only for optic nerve regeneration but also for broader applications in central nervous system repair. In this review, we discuss multifactors therapeutic strategies for optic nerve regeneration, offering insights into advancing nerve regeneration research.

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

Abstract Objective: The aim of this study was to identify the feasibility of using palpation of the lowest point of the rib in the posterior axillary line to identify the segment of the spine during spinal surgery. Methods: Three orthopedic surgeons examined 101 patients and determined, by blind palpation, the lowest point of the ribs that could be reached at the posterior axillary line, placed a radiolucent marker, made a plumb line through this point and intersected it at one point C. From this point, a line was made at an angle of 45° to the plumb line and intersected the posterior midline at another point B, where the markers were placed. A posterior anterior lumbar spine X-ray was then taken. Three orthopedic surgeons then identified the spine segment by radiography and assessed the agreement with the spine segment identified by imaging (kappa coefficient). Results: Point B is most commonly found in the T12 and T11 vertebrae, with an accuracy rate of 86% (87/101).Point C, most commonly at the L3 vertebral body, was 79% (80/101) accurate. The greatest proportion of these was in the upper third of L3. High consistency of results between right and left side on palpation. Conclusions: In the prone position, clinicians can use this method as a measurement tool with good reliability for palpating the thoracolumbar vertebrae, but the spinal level estimated by palpation may be inadvertently affected by examiner skill and anatomical variation, as well as by issues of individual variation.

骨质疏松性椎体压缩性骨折(OVCF)是影响老年人生活质量的常见疾病之一.其治疗系统经过数十年的研究探索已经十分成熟,经皮椎体强化术包括经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)是目前最常用也是最有效简便的治疗方案.即便如此,骨水泥渗漏问题一直是困扰着脊柱外科的难题,相对于椎间隙,椎旁,经皮质裂缝等渗漏途径,静脉渗漏是发病率最高且可能引起严重并发症的唯一渗漏途径.既往越来越多的文献已经报导了经椎基底静脉渗漏出现的神经压迫症状,此外,椎旁静脉渗漏引起的医源性静脉压迫及体内脏器的阻塞也不乏少见.对此,国内外学者已经探讨了多种静脉渗漏的危险因素,并提出了一些预防措施.但目前为止,这些危险因素及预防措施较繁杂,存在明显的异质性,尚无系统性综述归纳.本文就既往国内外的相关文献报导进行综述,旨在总结历年研究中骨水泥静脉渗漏的相关危险因素及存在的问题,探讨其预防措施的可信度及临床应用的前景,以期为进一步的研究提供参考.

PurposeHypertrophic pachymeningitis associated with immunoglobulin G4-related disease (IgG4-RD) has been rarely reported, and there is little information and no clear consensus on the management of IgG4-related spinal pachymeningitis (IgG4-RSP). The present study described its possible clinical features, including the symptoms, imaging, treatment and prognosis of patients with IgG4-RSP.MethodsWe report three patients who presented with progressive neurological dysfunction due to spinal cord compression. Relevant articles were searched from the PubMed, Web of Science, and Embase databases, and the resulting literature was reviewed.ResultsThe literature review provided a summary of 45 available cases, which included three cases from our center. Progressive worsening of neurological impairment was observed in 22 patients (48.9%). The lesions involved the thoracic spine (n=28, 62.2%), cervical spine (n=26, 57.8%), lumbar spine (n=9, 20.0%), and sacral spine (n=1, 2.2%). Furthermore, the lesions were located in the dura mater (n=18, 40.0%), epidural space (n=17, 37.8%), intradural-extramedullary space (n=9, 20.0%), and intramedullary space (n=1, 2.2%). On magnetic resonance imaging (MRI), the lesions generally appeared as striated, fusiform, or less often lobulated oval changes, with homogeneous (n=17,44.7%) and dorsal (n=15,39.5%) patterns being the most common. Thirty-five patients had homogeneous T1 gadolinium enhancement. Early surgical decompression, corticosteroid treatment, and steroid-sparing agents offered significant therapeutic advantages. A good therapeutic response to disease recurrence was observed with the medication.ConclusionThe number of reported cases of IgG4-RSP remains limited, and patients often have progressive worsening of their neurological symptoms. The features of masses identified on the MRI should be considered. The prognosis was better with decompression surgery combined with immunosuppressive therapy. Long-term corticosteroid treatment and steroid-sparing agent maintenance therapy should be ensured. A systemic examination is recommended to identify the presence of other pathologies.

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

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

临床工作中经常需要确定脊柱的节段,在门诊或其他没有透视条件的环境下,利用骨性标志准确定位椎体水平具有一定的实用价值.不仅可降低患者的就诊费用,在术前准备的定位中能进一步提高切口位置的精确度.为了提高胸腰段脊柱定位的准确性,需要一种简单而可靠的触诊方法来确定脊柱的节段.本研究评估在触诊腋后线处肋骨最低点相对于胸椎、腰椎水平存在的位置关系,并进一步探索这一触诊法对胸腰椎定位是否具有提示作用.

Background Ferroptosis is a novel type of regulated cell death, and there is growing evidence that it is directly associated with the disease. Therefore, this study aimed to investigate the relevance of iron Ferroptosis-related genes to ankylosing spondylitis (AS) to propose a novel targeted therapy for AS patients. Methods AS samples were downloaded from the Gene Expression Omnibus (GEO) database (GSE41038). Ferroptosis-related genes were obtained from the FerrDb database, and differential expression analysis was performed using the GEO2R tool. Additionally, we constructed a protein-protein interaction (PPI) network and identified the central genes using Cytoscape. A neural network model was developed utilizing the data mining software Clementine. cMap technology was used to screen potential pharmacological compounds that target the central gene,and a predictive model was built by machine learning methods. Results We discovered 786 differentially expressed genes in AS samples compared to normal tissue, including 359 up-regulated and 427 down-regulated genes. The intersection of ferroptosis-related genes and differential genes yielded 20 overlapping genes. We constructed a hub gene co-expression network with 20 nodes and 14 edges and obtained the ten most recommended drugs for AS. Conclusion Bioinformatics analysis identified 20 potential genes associated with Ferroptosis in AS. Genes such as CAV1, NOX4, and NQO1 were revealed to influence the development of AS by regulating Ferroptosis. Our study provides new insights into the function of iron Ferroptosis-related genes in AS, suggesting that targeting Ferroptosis may be a potential therapeutic option for AS.

Interpretation of the morphology and characteristics of soft tissues, such as paravertebral muscles and fat, has always been a “relative blind spot” in the spine. The imaging features of the non-bony structures of the spine have been studied and reinterpreted, and changes in the non-bony structure are associated with spinal disease. Soft tissue parameters such as, the “paraspinal muscle cross-sectional area,” “subcutaneous fat thickness,” and the “paraspinal muscle fat infiltration rate” on computed tomography, magnetic resonance imaging and other imaging techniques are reproducible in the diagnosis, treatment and prognosis of spinal disorders and have the potential for clinical application. In addition, focus on the association between sarcopenia and spinal epidural lipomatosis with spinal disorders is increasing. Currently, there is no summary of studies on fat and muscle in the spinal region. Given this, within the context of recent research trends, this article provides a synthesis of research on adipose and muscle tissue in the spine, discusses advances in the study of the imaging manifestations of these structures in spinal disorders, and expands the perspectives.

骨质疏松症是一种进行性的全身骨骼疾病,其发病机制极为复杂.多糖是广泛存在于中药材中的生物大分子,具有多种药理活性.从基因、蛋白、体内外实验等多维度研究综述了中药多糖防治骨质疏松症的作用和机制,总结发现,中药多糖能够通过激活或/和抑制Wnt、磷脂酰肌醇3-激酶(phosphatidylinositol 3-kinase,PI3K)/蛋白激酶B(protein kinase B,Akt)、丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)、活化 T 细胞核因子(nuclear factor-activated T cell 1,NFATc1)、内质网应激(endoplasmic reticulum stress,ERS)、骨保护素(osteoprotegerin,OPG)/核因子-κB 受体活化因子(receptor activator of NF-κB,RANK)/RANK 配体(RANK ligand,RANKL)、Hippo(Hpo)、细胞外调节蛋白激酶(extracellular regulated protein kinases,ERK)/糖原合成酶激酶 3β(glycogen synthase kinase 3β,GSK3β)/β-连环蛋白(β-catenin)、骨形态发生蛋白-2(bone morphogenetic protein-2,BMP-2)/Smads、细胞周期素 D1 蛋白(Cyclin D1)、核因子 E2 相关因子 2(nuclear factorNF-E2-relatedfactor 2,Nrf2)等多种信号通路,进而调节成骨细胞与破骨细胞之间的动态平衡,最终达到维持骨稳态、发挥防治骨质疏松症的目的.中药多糖因具有多靶点、不良反应小、来源广泛等优势,为骨质疏松症的预防和治疗带来了更多的可能.

N6-methyladenosine (m6A) is the most prevalent modification in mRNA in biological processes and associated with various malignant tumor initiation and progression. The present study aimed to construct a prognostic risk model based on m6A-related genes (the downstream genes influenced by m6A modulators) for LUSC. Based on TCGA, we stratified LUSC patients with and without genetic alteration of m6A modulators into altered and unaltered groups. Using univariate Cox and Lasso regression analyses, we identified prognostic m6A-related genes to construct a prognostic risk model. We then applied a multivariate Cox proportional regression model and the survival analysis to evaluate the risk model. Moreover, we performed the Receiver operating characteristic curve to assess the efficiency of the prognostic model based on TCGA and GSE43131. We analyzed the characteristics of tumor-associated immune cell infiltration in LUSC through the CIBERSORT method. Three m6A-related genes (FAM71F1, MT1E, and MYEOV) were identified as prognostic genes for LUSC. A novel prognostic risk model based on the three m6A-related genes was constructed. The multivariate Cox analysis showed that the prognostic risk model was an independent risk factor (HR = 2.44, 95% CI = 1.21~3.56, p = 0.029). Patients with a high-risk group had worse overall survival both in TCGA (p = 0.018) and GSE43131 (p = 0.00017). The 1, 2, and 3-year AUC value in TCGA was 0.662, 0.662, and 0.655, respectively; The 1, 2, and 3-year AUC value in GSE43131 was 0.724, 0.724, and 0.722, respectively. The proportion of infiltrated neutrophils in the high-risk group was higher than that in the low-risk group (p = 0.028), whereas that of resting NK cells (p = 0.002) was lower. A novel prognostic risk model based on three m6A-related genes for LUSC was generated in this study.

- BACKGROUND: The role of tranexamic acid (TXA) in controlling blood loss during spine surgery remains unclear. With the publication of new randomized controlled trials (RCTs), we conducted a meta-analysis to determine the safetyMETHODS: PubMed, Embase, Web of Science, and Cochrane databases were searched for relevant studies through 2022. Only RCTs were eligible for this study. The extracted data were analyzed using RevMan 5.3 software for metaanalysis.RESULTS: Twenty RCTs including 1497 patients undergoing spine surgery were included in this systematic evaluation. Compared with the control group, TXA significantly reduced total blood loss (mean difference [MD] = - 218.96, 95% confidence interval [CI] = - 309.77 to - 128.14, P < 0.00001), perioperative blood loss (MD = - 90.54, 95% CI = - 139.33 to - 41.75, P = 0.0003), postoperative drainage (MD = - 102.60, 95% CI = - 139.51 to - 65.70, P < 0.00001),reduced hospital stay (MD = - 1.42, 95% CI = - 2.71 to - 0.14, P = 0.03), reduced total blood transfusion volume (MD = - 551.06, 95% CI = - 755.90 to - 346.22, P < 0.00001), and international normalized ratio (MD = -0.03, 95% CI = -0.04 to -0.02, P < 0.00001).CONCLUSIONS: Based on the meta-analysis of 20 RCTs, we demonstrated that TXA reduces blood loss in open spine surgery, decreases transfusion rates, and shortens hospital stays. The TXA administration during the perioperative period does not increase the incidence of postoperative complications.