Musculoskeletal brucellosis presenting as low back pain and a limp.

Frequent bending movements and injuries in daily life often result in back pain and reduced mobility, making these primary reasons for lumbar spine surgery. Mobilizing patients within 24 hours after lumbar spine surgery is known to help prevent the adverse physiological effects of prolonged bed rest, enhance willingness to mobilize, and minimize the duration of hospitalization. However, a survey in our hospital indicated the achievement rate of mobilization within 24 hours postoperatively in patients with lumbar spondylolisthesis was only 15.2%. The primary reasons for this low rate were identified as patient concerns about drain dislodgement during mobilization, inconsistent health education from nursing staff, lack of explanation about mobilization timing, absence of a standardized mobilization protocol for lumbar spondylolisthesis, and inadequate patient understanding of the timing and importance of mobilization. The project addressed in this study was developed to improve the achievement rate of mobilization within 24 hours postoperatively in patients with lumbar spondylolisthesis and to enhance the accuracy of mobilization steps and completeness of related education for nursing staff. The "Hemovac Strap" and "Escape the Maze" were developed; a "Mobilization Fun Puzzle" was created; an educational video entitled "How Much Do You Know About Post-Lumbar Surgery Mobilization?" was produced; and the "Standardized Postoperative Mobilization Protocol and Training for Lumbar Spondylolisthesis" handbook was implemented. The mobilization achievement rate within 24 hours postoperatively in patients with lumbar spondylolisthesis increased from 15.2% to 95.0%. Patients and their caregivers gained a better understanding of the importance of early mobilization and the correct mobilization steps, facilitating the recovery of daily functional activities. Nursing staff significantly improved the comprehensiveness of educational guidance, enabling patients to receive holistic and high-quality care.

To evaluate the clinical and radiological outcomes of biportal endoscopic lumbar interbody fusion (BE-LIF) using the 30-degree endoscope in patients with lumbar spondylolisthesis and severe disc height loss and to highlight its technical advantages in endplate preparation and contralateral decompression. This retrospective study included 21 patients with single-level Meyerding grade II spondylolisthesis and preoperative disc height <5 mm who underwent BE-LIF combined with percutaneous pedicle screw fixation between February 2023 and February 2025. Clinical outcomes were assessed using the visual analog scale for back and leg pain and the Oswestry Disability Index. Radiographic parameters, including vertebral slip, disc height, and foraminal height, were evaluated on standing lateral x-ray images, while fusion status was assessed using Bridwell grading on 6-month postoperative computed tomography scans. At a mean follow-up of 11.7 ± 2.6 months, all patients demonstrated statistically significant clinical improvement, visual analog scale scores decreased from 7.2 ± 0.6 to 1.5 ± 0.5 for low back pain, from 7.5 ± 0.5 to 1.7 ± 0.6 for leg pain, and the Oswestry Disability Index improved from 42.6 ± 5.7 to 15.7 ± 2.5 (P < 0.001). Radiologically, vertebral slip was reduced from 11.3 ± 1.5 mm to 2.1 ± 0.4 mm. Anterior and posterior disc heights increased from 5.6 ± 0.6 mm and 4.9 ± 0.5 mm to 8.5 ± 1.2 mm and 8.3 ± 1.4 mm, respectively. Foraminal height improved from 9.8 ± 1.7 mm to 14.7 ± 2.8 mm. Fusion was confirmed in all cases (Bridwell grade I: 28.6%, grade II: 71.4%), with no cage subsidence or major complications reported. The use of the 30-degree endoscope in BE-LIF for spondylolisthesis with severe disc collapse provides enhanced visualization, facilitates safe and effective decompression, and results in favorable clinical and radiological outcomes.

Maternal physical health and breastfeeding problems in Croatia: national online survey of new mothers.

The role and mechanism of autophagy-regulated Keap1/Nrf2 pathway in oxidative stress-induced cartilage endplate cell apoptosis.

Ethyl gallate suppresses ferroptosis and alleviates intervertebral disc degeneration through targeting AKT1.

Pelvic and lower limb gait pattern differ between sex but not between chronic low back pain patients and pain-free individuals under strict inclusion criteria.

Study Design: Cross-sectional, observational. Objective: To investigate the impact of SBO on sacral morphology and facet tropism in adolescents. Summary of Background Data: Limited information is available on sacral morphology and facet joint changes associated with SBO in adolescents. The association between SBO and sagittal facet tropism is not well described in this age group. Materials and Methods: Lumbosacral computed tomography (CT) was used to assess sacral morphology and facet joint orientation in 100 adolescents with low back pain. Evaluated parameters included the presence of SBO, lumbosacral transitional vertebrae, and spondylolysis. Morphologic features assessed were sacral laminar fusion (graded on a 5-point scale), iliac crest height (classified into 6 types), and facet joint orientation in both the axial and sagittal planes. The patients were divided into SBO-positive (SBO+) and SBO-negative (SBO–) groups and investigated for associations with lumbar spondylolysis, sacral morphology, and facet tropism. Results: SBO was present in 50% of all patients, lumbosacral transitional vertebra in 7%, and lumbar spondylolysis in 42%. Facet tropism was identified in 13% of patients in the axial plane and 21% in the sagittal plane. The SBO+ group contained a significantly higher proportion of men ( P =0.035) and a greater prevalence of spondylolysis ( P =0.013), particularly at L5 ( P =0.044). Sacral laminar fusion grades were significantly lower at the S1/S2 level in the SBO+ group ( P =0.049). Sagittal facet tropism (≥7.1°) was more frequent in the SBO+ group ( P =0.024). Unilateral L5 spondylolysis occurred in 16% of the SBO+ group and 8% of the SBO– group, with vertical facet concordance rates of 50% and 75%. SBO correlated positively with sagittal facet tropism (r=0.307, P =0.002) and lower S1/S2 fusion grades (r=−0.197, P =0.049). Multivariable logistic regression identified sagittal facet tropism as an independent risk factor for SBO (odds ratio: 1.175, 95% CI: 1.002–1.395, P =0.047). Conclusions: Sagittal facet tropism was independently associated with SBO. SBO was also linked with male sex, delayed sacral fusion, and higher rates of spondylolysis, particularly at L5.

Microglial-derived nitric oxide regulates amygdala synaptic plasticity to drive chronic pain and depression induced by lumbar disc herniation.

Introduction: Lumbar disk replacement (LDR) has gained popularity in recent years as a treatment option for low back pain caused by degenerative disk disease (DDD) and as a motion-preserving alternative to lumbar fusion surgery. Modern keeled implant (Prodisc-L) confers higher stability to prevent early migration and improve bony ongrowth. The placement and trajectory of keel cuts are hence vital for the implant’s effectiveness and longevity. Materials and Methods: The authors describe their technique of integrating ExcelsiusGPS robot-arm navigation to improve the accuracy of LDR placement. Results: With this approach, we are able to reliably reproduce the centralised alignment of the LDR keel cut and implant insertion on the coronal and sagittal plane. Discussion: This is the first reported case of robot-arm assistance used in anterior-based lumbar disk replacement. This technique lays the groundwork for future workflow and designs of navigation software and tools specific to LDR. Level of Evidence: IV

The impact of CrossFit on low back pain.

"It's the future, come on!": a think aloud study exploring clinicians' use of knowledge-based AI decision support.

Biomechanical models of lumbar spine degeneration: Methods, challenges, and clinical promise.

Deferoxamine improves intervertebral disc degeneration by activating HIF-1α/BNIP3-mediated mitophagy and inhibiting ferroptosis.

Mechanism of lidocaine-induced ROS generation triggering DNA double-strand breaks and promoting intervertebral disc cell senescence via the MYC-DUSP1-P53 axis.

Crosstalk between reactive oxygen species mediated programmed cell death of nucleus pulposus cells.

Effects of different modes of exercise on sleep quality in adults with chronic low back pain: a randomised controlled trial.

Impact of Movement Pattern Training on Muscular Co-contraction in Patients With Low Back Pain During Walking

Innovative therapeutic strategies used in the regenerative medicine of the intervertebral disc degeneration.

The extent of the incidence of chronic pain in children and young adults has only just begun to be appreciated. In adults, the problem is significant, with back pain being one of the leading causes of disability and loss of work time (Spengler, et al., 1986). The problem in the pediatric age group has not been as well defined, but the few population-based studies that have been published suggest that problems such as headaches, abdominal pain, back pain, and extremity pain are very common (Abu-Arafeh, 1996; Borge, 1994; Kristjansdottir, 1997; Salminen, et al., 1995). For example, the prevalence of back pain in the mid-teenage years is almost as high as the prevalence among adults (Burton, et al.,, 1996). Although the etiologies of the pain may be different, the fact that back pain afflicts teenagers almost as often as it does adults seems astonishing