Objective:To explore the relationship between the osteosarcopenia and depressive symptom in the elderly in community,and the moderating effect of physical activity in the interrelationship.Methods:Using strati-fied random sampling,1 051 elderly people from 20 communities in Shihezi were selected for the study,and sur-veyed using the Strength,Assistance with walking,Rise from a chair,Climb stairs,Falls and Calf circumference(SARC-Cal F),grip strength measurements,previous fragility fracture,or osteoporosis risk one-minute test,and the Osteoporosis Self-Screening Tool for Asians(OSTA)to screen for osteoporosis,the short version of the Geriatric Depression Scale(GDS-15)and the Physical Activity Scale for the Elderly(PASE)were used to assess depressive symptoms and physical activity.Results:Osteosarcopenia were positively correlated with GDS-15 scores(r=0.54,P＜0.01),PASE scores were negatively correlated with both osteosarcopenia and GDS-15 scores(r=-0.45,-0.55,Ps＜0.01).Physical activity negatively moderated the association between osteosarcopenia anddepressive symptom in community elderly people(β=-0.01,P＜0.05).Conclusion:Osteosarcopenia associated with de-pressive symptoms,and physical activity moderates the association between osteosarcopenia and depressive symp-tom in community elderly people.

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.

Objective:To explore the relationship between the osteosarcopenia and depressive symptom in the elderly in community,and the moderating effect of physical activity in the interrelationship.Methods:Using strati-fied random sampling,1 051 elderly people from 20 communities in Shihezi were selected for the study,and sur-veyed using the Strength,Assistance with walking,Rise from a chair,Climb stairs,Falls and Calf circumference(SARC-Cal F),grip strength measurements,previous fragility fracture,or osteoporosis risk one-minute test,and the Osteoporosis Self-Screening Tool for Asians(OSTA)to screen for osteoporosis,the short version of the Geriatric Depression Scale(GDS-15)and the Physical Activity Scale for the Elderly(PASE)were used to assess depressive symptoms and physical activity.Results:Osteosarcopenia were positively correlated with GDS-15 scores(r=0.54,P＜0.01),PASE scores were negatively correlated with both osteosarcopenia and GDS-15 scores(r=-0.45,-0.55,Ps＜0.01).Physical activity negatively moderated the association between osteosarcopenia anddepressive symptom in community elderly people(β=-0.01,P＜0.05).Conclusion:Osteosarcopenia associated with de-pressive symptoms,and physical activity moderates the association between osteosarcopenia and depressive symp-tom in community elderly people.

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.

Objective:To explore the relationship between the life satisfaction of family caregivers and the de-gree of disability of disabled elderly people in Xinjiang Uygur and Kazak nationality,and the role of family mem-bers'participation in the relationship.Methods:A total of 431 elderly people with disabilities at home and their fam-ily caregivers(247 without family members and 184 with family members)were selected from Xinjiang Uygur and Kazak ethnic groups,and the survey was conducted with the Activity of Daily Living Scale(ADL)and Life Satis-faction Index B(LSIB).Results:The LSIB scores in family caregivers were negatively correlated with the ADL scores in the disabled elderly(r=-0.19,P＜0.01),and the family members'participation in care was positively correlated with the LSIB scores of family caregivers(r=0.52,P＜0.01).Family members'participation in care could moderate the negative effect of the ADL scores in the disabled elderly on the LSIB scores in family caregivers(β=0.08,P＜0.05).Conclusion:The involvement of family members in care has a moderating effect on the life satisfaction of Uyghur and Kazak family caregivers and the degree of disability of disabled elderly people.

Lumbar spondylolysis refers to the bone injury between the upper and lower articular processes and the transition zone of the transverse process of the unilateral or bilateral pedicle of the lumbar spine, being a common cause of low back pain in patients that seriously affects their quality of life. The mechanism of the occurrence and development of lumbar spondylolysis is complex, and long-term stress wear and sudden damage with an external force are the main causes. At the same time, risk factors related to spinal anatomy are important causes of lumbar spondylolysis. A full understanding of the pathogenesis of lumbar spondylolysis, early identification of high-risk groups, and active preventive measures can reduce its incidence. For this purpose, the authors reviewed the research progress in risk factors related to the spinal anatomy of lumbar spondylolysis from three aspects including genetical susceptibility, local anatomy and overall spine-pelvic sequence, so as to provide references for the prevention and treatment of spondylolysis.

Objective:To introduce a novel risk factor for lumbar spondylolysis, the pedicle isthmus angle (PIA), and to explore its underlying mechanism and clinical relevance.Methods:A retrospective analysis of CT imaging data from young male patients with lumbar spondylolysis, admitted to the 960th Hospital of the Joint Logistic Support Force of the PLA between January 2018 and August 2023, was conducted. The study included 119 cases of unilateral spondylolysis and 339 cases of bilateral spondylolysis, with a mean age of 22.8±3.4 years (range 18-30 years). A control group of 458 patients with normal lumbar CT scans, presenting with low back pain, was also analyzed. Their mean age was 22.9±3.5 years (range 18-30 years). The PIA of the left and right sides of the L 3, L 4, and L 5 vertebrae in both the spondylolysis and control groups were measured using CT imaging. Differences in PIA measurements between the left and right sides, as well as between groups, were compared. Binary logistic regression analysis identified risk factors for lumbar spondylolysis. The receiver operating characteristic (ROC) curve and Youden index were used to determine the critical risk threshold for lumbar spondylolysis. Results:No significant differences were found between the spondylolysis and control groups in terms of gender, age, height, weight, or body mass index (BMI) ( P>0.05). Similarly, there was no significant difference in the left and right PIA measurements for the L 3, L 4, and L 5 vertebrae in either group ( P>0.05). The PIA of the L 3 and L 4 vertebrae was not significantly different between the groups (107.2°±3.5° vs. 107.1°±3.5°, t=0.270, P=0.787; 110.6°±3.5° vs. 110.5°±4.0°, t=0.441, P=0.659). However, the PIA of the L 5 vertebra was significantly larger in the spondylolysis group (117.7°±4.7°) compared to the control group (114.0°±4.9°) ( t=11.654, P<0.001). Logistic regression analysis identified an increased PIA at L 5 ( β=0.159, OR=1.172, P<0.001) as a risk factor for lumbar spondylolysis. According to the ROC curve and Youden index, the risk of lumbar spondylolysis increased substantially when the L 5 PIA exceeded 115.8°. The area under the curve (AUC) was 0.709, with a sensitivity of 0.670 and a specificity of 0.644. Conclusion:PIA is an objective and effective imaging parameter for predicting lumbar spondylolysis. It aids in understanding the pathophysiology of spondylolysis, identifying high-risk individuals, and informing prevention and treatment strategies for lumbar spondylolysis.