Background:Ganglioneuroma (GN) of the lumbar spine is rare, typically occurring in children and young adults. Its diagnosis in middle-aged patients can be challenging. This paper reports a case of a dumbbell-shaped lumbar GN in a middle-aged woman. Case: A 46-year-old woman presented with low back pain and radiating leg pain. MRI revealed a dumbbell-shaped mass at the L2 level. She underwent posterior microscopic total tumor resection with L2-L3 pedicle screw fixation. Postoperative pathology confirmed GN. Conclusion:At the 1-year follow-up, there was no recurrence. For dumbbell-shaped lumbar GN, a posterior approach combined with internal fixation is an effective strategy. This case suggests that GN should be considered in the differential diagnosis of foraminal masses in middle-aged patients.

Background:Osteoporotic vertebral compression fractures (OVCFs) pose a significant health burden in older adult populations, with postoperative re-fracture (re.fra) complicating recovery. Existing models (e.g., FRAX, QFracture) inadequately address comorbidities and modifiable lifestyle factors. This study aimed to develop and validate a novel nomogram integrating these underrecognized yet critical predictors for personalized risk stratification. Methods:A retrospective cohort of 560 older adult OVCF patients undergoing percutaneous vertebroplasty (PVP) was analyzed. Patients were randomly divided into training (70%, n = 392) and testing (30%, n = 168) cohorts. Univariable and backward stepwise multivariable logistic regression identified independent re.fra predictors. A nomogram was developed and internally validated using area under the curve (AUC), calibration curves (slopes, intercepts), Brier scores, and decision curve analysis (DCA) to assess discrimination, calibration, and clinical utility. Results:Independent predictors included tumor history [adjusted odds ratio (aOR) = 12.29, 95% CI: 2.50-60.35], scoliosis (aOR = 6.46, 95% CI: 2.97-14.03), mental disorders (aOR = 5.91, 95% CI: 2.73-12.82), alcohol use ≥10 years (aOR = 3.69, 95% CI: 1.90-7.17), and chronic kidney disease (aOR = 3.12, 95% CI: 1.61-6.06). Hypertension exhibited a paradoxical protective association (aOR = 0.50, 95% CI: 0.27-0.93). The nomogram demonstrated strong discrimination [AUC:0.886 (training), 0.827 (testing)], excellent calibration in training (slope = 1.000, Brier = 0.118) with slight deviation in testing (slope = 0.697, Brier = 0.162), and superior net benefit over treat-all/none strategies across thresholds (DCA). Conclusion:This validated nomogram integrates often-overlooked comorbidities and lifestyle factors to predict post-PVP re.fra risk, providing a practical tool for personalized management and highlighting the need for multidisciplinary care in high-risk subgroups such as those with scoliosis, mental disorders, or prolonged alcohol use. The intriguing protective association of hypertension, however, requires cautious interpretation and further investigation before clinical application.

Background:Postoperative re-fractures in elderly osteoporotic vertebral compression fracture (OVCF) patients with comorbidities pose a major clinical challenge, with rates up to 52%. Traditional risk models overlook complex underlying diseases interactions in elderly patients. This study pioneers a machine learning (ML) framework for this high-risk group, integrating multidimensional factors to predict re-fractures and identify novel predictors. Methods:We analyzed 560 OVCF patients with comorbidities who underwent percutaneous vertebroplasty (PVP). Fourteen characteristic variables-including scoliosis, chronic kidney disease (CKD), mental disorders, and cardiovascular comorbidities-were selected using feature engineering. Six ML models [Random Forest (RF), XGBoost, support vector machine (SVM), etc.,] were trained and validated. Model performance was rigorously assessed via AUC-ROC, precision-recall curves, and decision curve analysis (DCA). SHapley Additive exPlanations (SHAP) values provided interpretable risk quantification. Results:The RF model achieved superior predictive performance (test AUC = 0.88, sensitivity = 0.77, specificity = 0.87), outperforming conventional approaches. Notably, we identified scoliosis (SHAP = 0.14), mental disorders (0.12), and CKD (0.10) as the three top risk factors, with biomechanical and comorbidity interactions playing pivotal roles. DCA confirmed high clinical utility, with RF providing the greatest net benefit across risk thresholds. Conclusion:This pioneering study establishes ML as a transformative tool for re-fracture prediction in OVCF patients with underlying diseases, uncovering previously underappreciated risk factors. Our findings highlight the critical need for integrated management of spinal deformity, mental health, and renal function in this vulnerable population. This ML framework offers a paradigm shift in personalized risk stratification and postoperative care.

Postoperative refracture of osteoporotic compression fractures in the elderly due to underlying illnesses is a complicated matter involving several variables. A multidisciplinary approach involving orthopedics, geriatrics, endocrinology, and rehabilitation medicine is necessary for an investigation of these issues. investigating the impact of older patients’ underlying medical conditions on the refracture of osteoporotic compression fractures following surgery. A retrospective analysis was conducted on 2383 patients between August 2013 and August 2023. 550 patients with comorbid geriatric underlying diseases were screened, 183 patients underwent refractories, and 367 patients were classified as non-refractories. The patients were then divided into two groups: those undergoing refractories and those not, and the underlying diseases of the patients in both groups were examined using ROC curves and unifactorial and multifactorial logistic regression analyses. Among the patients gathered, the frequency of re-fracture was 33.3

Rationale: Limb dysfunction is not uncommon clinically after intramural tumor surgery. However, there are no relevant literature reports on the recovery of unilateral motor function caused by spinal cord dysfunction after short-term observation and treatment. The report of such cases is of great value for improving the cognition of postoperative complications of meningioma reducing misdiagnosis and providing reference for clinical treatment. Patient concerns: A 73-year-old female patient with numbness and weakness in both lower limbs accompanied by unstable walking for 2 months. Combined with imaging data and postoperative pathological diagnosis, it was diagnosed as thoracic spinal meningioma. The patient experienced transient unilateral limb dysfunction after surgery. Diagnoses: Magnetic resonance imaging and its enhanced magnetic resonance imaging suggest a space occupying lesion on the left side of the spinal canal at the level of the thoracic 3 to 4 vertebral body, possibly a meningioma. The postoperative pathology was grade I meningioma. Intervention: Administer 10 mL of dexamethasone, 1 g of methylprednisolone, and 250 mL of mannitol for treatment. Outcomes: After 3 hours, the patient’s muscle strength gradually recovered, and after 12 hours, it was better than the preoperative level. Conclusion: Spinal cord dysfunction may occur after surgery for intraspinal meningioma in the upper thoracic spine. Unlike spinal cord dysfunction caused by spinal cord injury, this dysfunction is short-term and transient. The use of hormones and diuretics is a feasible solution that can quickly restore patient limb function.

Understanding molecular mechanisms of intervertebral disc degeneration (IDD) and providing a novel target for the treatment of IDD have important implications. We sought to explore a new promising gene target for the treatment of IDD. This study integrated 19,678 genes of 38 IDD patients from two gene datasets. Differentially Expressed Genes (DEGs) of annulus fibrosus were analyzed in groups with mild disc degeneration (MDD) and severe disc degeneration (SDD). We screened the hub gene through biological information technology (bioinformatic) methods. Then, we further validated the hub gene using annulus fibrosus and nucleus pulposus tissues from 12 patients with qRT-PCR. In addition, we explored its underlying molecular mechanism with GO, KEGG and GSEA. Through multiple screening bioinformatics methods, the hub gene CD63 was identified. The qRT-PCR explored that CD63 decreased significantly in SDD group compared to that in MDD group (P < 0.001). The GO, KEGG and GSEA of CD63 explored significant enrichment of the molecular features (P < 0.001), including the cellular component (Extracellular matrix, P < 0.001), the molecular function (collagen binding, P < 0.001), the biological processes (protein targeting, collagen fibril organization and platelet degranulation, P < 0.001) and the signaling pathways. Our research explored and validated a new regulatory gene, CD63 for different degrees of IDD. A new novel form of therapeutic target for IDD may be developed.

Effective therapy options for pneumoconiosis are lacking. Traditional Chinese medicine (TCM) presents a favorable prospect in the treatment of pneumoconiosis. A pilot study on TCM syndrome differentiation can evaluate the clinical efficacy and safety of TCM and lay a foundation for further clinical research. A double-blind, randomized, and placebo-controlled trial was conducted for 24 weeks, in which 96 patients with pneumoconiosis were randomly divided into the control and treatment groups. Symptomatic treatment was conducted for the two groups. The treatment group was treated with TCM syndrome differentiation, and the control group was treated with placebo. The primary outcomes were the six-minute walking distance (6MWD) and the St. George Respiratory Questionnaire (SGRQ) score. The secondary outcomes were the modified British Medical Research Council Dyspnea Scale (mMRC), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), Hospital Anxiety and Depression Scale (HADS), and pulmonary function. Only 83 patients from the 96 patients with pneumoconiosis finished the study. For the primary outcome, compared with the control groups, the treatment group showed a significantly increased 6MWD (407.90 m vs. 499.51 m; 95% confidence interval (CI) 47.25 to 135.97; P <0.001) and improved SGRQ total score (44.48 vs. 25.67; 95% CI −27.87 to −9.74; P <0.001). The treatment group also significantly improved compared with the control group on mMRC score (1.4 vs. 0.74; 95% CI −1.08 to −0.23; P =0.003), CAT score (18.40 vs. 14.65; 95% CI −7.07 to −0.43; P =0.027), and the total symptom score (7.90 vs. 5.14; 95% CI −4.40 to −1.12; P <0.001). No serious adverse events occurred. This study showed that TCM syndrome differentiation and treatment had a favorable impact on the exercise endurance and quality of life of patients with pneumoconiosis.

Objective: To investigate the roles of the L2 and L5 sympathetic nerve branches in the conduction pathway of discogenic low back pain. Methods: One-hundred and twenty Sprague-Dawley rats were divided into the following groups: A, A-L-2, A-L-5, A-L-2-L-5, B (posterior intervertebral disc control), B-L-2, B-L-5, and B-L-2-L-5. The numbers of fluoro-gold (FG) and Substance P (SP) double-labeled cells in the DRGs of the T13, L1, L2, L3, L4, L5, and L6 segments were recorded. Results: The numbers of double-labeled DRG cells in the L2 segment were significantly lower in the A-L-2 and A-L-2-L-5 groups than in the group A (P < 0.01). Compared to the B group, the B-L-2 group had significantly fewer double-labeled DRG cells in the L2 segment (P < 0.01); the B-L-5 group had significantly fewer double-labeled DRG cells in the T13, L1, and L2 segments (P < 0.01) and the B-L-2-L-5 group had significantly fewer double-labeled DRG cells in the T13, L1, and L2 segments (P < 0.01). The numbers of double-labeled DRG cells in the L2 segment in the B-L-2-L-5 group were significantly lower than those in the B-L-2 and B-L-5 groups (P < 0.01). Conclusions: In the rat, the L2 sympathetic nerve branch participates in pain information conduction from the L5-6 intervertebral disc to the L2 DRG, while pain information from the posterior L5-6 intervertebral disc is conducted to the upper and lower lumbar vertebrae DRGs through two different pathways. The L5 sympathetic nerve branch is involved in the conduction pathway of the upper lumbar vertebra DRG.

The role of AMP-activated protein kinase (AMPK) in the regulation of energy metabolism and the control of skeletal muscle regeneration post injury has been described previously. It remains unknown whether this metabolic sensor plays a role in the mechanism of axonal regeneration post injury. In this study, we used a sciatic nerve crushed mouse model to detect the expression of AMPK in sciatic nerve and spinal motor neurons at 1 week, 2 weeks and 3 weeks after injury by immunofluorescence staining. Electrophysiological and histopathological studies were used to confirm the nerve injury and regeneration. Our results showed that frequency of AMPK-positive spinal motor neurons was significantly higher on day 7 after sciatic nerve crush (SNC) and peaked on day 14. No expression of AMPK was detected in axons of the sciatic nerve before and after the injury. Taken together, our study suggested a possible role of AMPK in the mechanism of motor nerve regeneration after injury.