Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

BACKGROUND:The transplanted bone marrow stem cells (BMSCs) survive,migrate to the injury site and differentiate into neurons and astrocytes.Transplantation of BMSCs following spinal cord injury (SCI) may improve the recovery of spinal function and may be an effect way for treating spinal cord injury.The treatment of spinal cord injury by autologous BMSCs mobilization and surgical transplantation has a wide prospect of clinic application.However,it is still unclear whether outcomes and mechanisms of them are different.OBJECTIVE:To compare the efficacy of treating SCI in rats by mobilization and surgical transplantation of autologous BMSCs,and assess the two methods by qualitative indexes.DESIGN,TIME AND SETTING:A randomized controlled animal experiment was conducted at the Henan Province People's Hospital from June 2007 to April 2008.MATERIALS:A total of 90 healthy Sprague Dawley rats aged 10 wees old,half male and half female,weighing (240±10) g,were subjected to make spinal cord injury models.MATHODS:After 3 days injection with bromodeoxyuridine 50 mg/kg per day,BMSCs were isolated from bone marrow of healthy rats.All the rats were underwent spinal cord injury by NYU impactor.All 90 rats were randomly divided into 3 groups,with 30 for each group.Rats in the mobilization group were subcutaneously injected with grenulocyte-colony stimulating factor for 7 days,20 mg/kg per day.In surgical transplantation group,a total of 0.3 mL (1×10~(10)/L) BMSCs were transplanted into injured area of spinal cord.Rats in control group were given the same volume of saline (0.3 mL) into injured area of spinal cord.All the rats were injected with 50 mg/kg bromodeoxyuridine daily at day 3 before surgery for 10 days in each group.MAIN OUTCOME MEASURES:The Basso-Beattie-Brasnahan (BBB) locomotor score was used to evaluate functional recovery in rat hindlima at 3 days,1,2,4 and 8 weeks after SCI.Motion evoked potential (MEP) and somatosensory evoked potential (SEP) tests were performed to defect the neural pathway so as to evaluate recovery of injured spinal cord.The cell structural changes and the expression and distribution of Brdu,glial fibrillary acidic protein (GFAP),and neuron specific enolase (NSE) were observed by pathological and immunohistochemical methods.and 8 weeks after injury (P ＜ 0.05),but there was no significant difference between the mobilization group and surgical was increased in the mobilization group and surgical transplantation group compared with the control group (P ＜ 0.05-0.01),but Histopathology showed that there were less empty,necrosis and GFAP-positive glial scar tissue,more Brdu-positive cells and NSE-positive cells in the mobilization group and surgical transplantation group than in the control group.CONCLUSION:Autologous BMSCs mobilization transplantation and surgery transplantation could significantly reduce the degree of SCI,and promote the recovery of the spinal cord function after injury for treating SCI.Compared between the two,mobilization of autologous BMSCs are more convenient,non-invasive,more likely to seize the opportunity to treatment.

Objective GAP-43 protein is a marker of peripheral nerve regeneration,To report the regeneration of rat proximal sciatic nerve were observed labeled by GAP-43 in two types of surgical repair model. Methods Right side of sciatic nerves of 64 SPF-class healthy adult male SD rats were cut at 5cm above the branch,32 rats were subjected to small gap(2mm)bridging repair with chitin conduit;others were subjected to traditionary epineurium suture.The general conditions of local tissue,sciatic nerve growth state and regenerative patterns of peripheral nerve fiber were observed at 1 d,3 d,7 d and 14 d respectively.Results The small gap bridging group had less local adhesion,immunofluorescencc staining showed that new axons Was in conic-sharp and homogeneously tidy.Local adhesion of traditionary epineurium suture group was more serious,distal new regenerated axons were irregular compared to the small gap bridging group.Immunofluorescence image analysis results showed that: early after the repair of rat sciatic nerve injury.the number of new axons of traditionary epineurium suture group was more compared with small gap bridging group(P<0.01);around 14 days after operation,the number of small gap bridging group was significantly higher than the traditionary epineurium suture group(P<0.05). Conclusion The small gap bridging group has less focal adhesion, better shape of nerve fibers and more regenerating axons than the traditionary epineurium suture group.The regenerative law of peripheral nerve fibers may further give us an explanation why regeneration results of small gap bridging group is better than traditionary epineurium suture group.