Methods: From March 2020 to March 2023, 100 inpatients with DS were classified into groups A, B, C, and D based on the CARDS classification system. Preoperative radiological data were analyzed to measure the severity of central canal stenosis, facet joint arthropathy, intervertebral disc herniation, and spinal epidural lipomatosis, osteophyte formation, range of motion (ROM), and computed tomography value of the vertebral bodies. The radiological characteristics and clinical contraindications for OLIF were compared among the groups. Results: Of the 100 patients, 51% had clinical contraindications for OLIF, which included 85%, 25%, 62.5%, and 20% of patients in groups A, B, C, and D, respectively. Compared with group B, group A demonstrated greater severity of central canal stenosis, whereas group C showed a higher degree of facet joint arthropathy. More patients in groups A and C had severe central canal stenosis. Regarding the ROM results, group A had segmental stiffness, whereas group D presented relatively unstable slip segments. Conclusions Patients with different DS subtypes have varied radiological characteristics. Groups B and D are suitable candidates for OLIF. Most patients in group A are unsuitable for OLIF because of bony hyperplasia, severe spinal stenosis, and segmental stiffness.

With the rising incidence of cervical kyphosis, the clinical understanding of this condition has evolved. Studies have shown that a subset of asymptomatic individuals exhibit cervical kyphosis, indicating that not all cases represent pathological changes. A thorough understanding of the common causes, underlying mechanisms, and imaging criteria for pathological cervical kyphosis is essential for establishing a tiered treatment model. Proficiency in stiffness assessment, clinical classification systems, and cervical osteotomy techniques is crucial for surgical planning and complication prevention. However, several key issues remain unresolved, including the optimal surgical approach for rigid cervical kyphosis, sagittal alignment correction targets, and long-term postoperative outcomes. Addressing these challenges requires high-quality clinical research to refine treatment strategies and improve patient care.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Methods: From March 2020 to March 2023, 100 inpatients with DS were classified into groups A, B, C, and D based on the CARDS classification system. Preoperative radiological data were analyzed to measure the severity of central canal stenosis, facet joint arthropathy, intervertebral disc herniation, and spinal epidural lipomatosis, osteophyte formation, range of motion (ROM), and computed tomography value of the vertebral bodies. The radiological characteristics and clinical contraindications for OLIF were compared among the groups. Results: Of the 100 patients, 51% had clinical contraindications for OLIF, which included 85%, 25%, 62.5%, and 20% of patients in groups A, B, C, and D, respectively. Compared with group B, group A demonstrated greater severity of central canal stenosis, whereas group C showed a higher degree of facet joint arthropathy. More patients in groups A and C had severe central canal stenosis. Regarding the ROM results, group A had segmental stiffness, whereas group D presented relatively unstable slip segments. Conclusions Patients with different DS subtypes have varied radiological characteristics. Groups B and D are suitable candidates for OLIF. Most patients in group A are unsuitable for OLIF because of bony hyperplasia, severe spinal stenosis, and segmental stiffness.

Methods: From March 2020 to March 2023, 100 inpatients with DS were classified into groups A, B, C, and D based on the CARDS classification system. Preoperative radiological data were analyzed to measure the severity of central canal stenosis, facet joint arthropathy, intervertebral disc herniation, and spinal epidural lipomatosis, osteophyte formation, range of motion (ROM), and computed tomography value of the vertebral bodies. The radiological characteristics and clinical contraindications for OLIF were compared among the groups. Results: Of the 100 patients, 51% had clinical contraindications for OLIF, which included 85%, 25%, 62.5%, and 20% of patients in groups A, B, C, and D, respectively. Compared with group B, group A demonstrated greater severity of central canal stenosis, whereas group C showed a higher degree of facet joint arthropathy. More patients in groups A and C had severe central canal stenosis. Regarding the ROM results, group A had segmental stiffness, whereas group D presented relatively unstable slip segments. Conclusions Patients with different DS subtypes have varied radiological characteristics. Groups B and D are suitable candidates for OLIF. Most patients in group A are unsuitable for OLIF because of bony hyperplasia, severe spinal stenosis, and segmental stiffness.

Objective:To analyze the trabecular bone score (TBS) and its association with muscle health in the postmenopausal population.Methods:It was a cross-sectional study. A total of 214 postmenopausal individuals who underwent dual-energy X-ray absorptiometry testing at the Beijing Research Institute of Sports Science between January and December 2023 were consecutively included. The participants were divided into two groups based on the presence or absence of osteoporosis (OP): 62 cases in the OP group and 152 cases in the non-OP group. All subjects completed body composition assessments and scans of bilateral hip and lumbar spine bone mineral density (BMD)(All the BMD in this study were areal BMD). Demographic data, including age, age at menarche, age at menopause, and fracture history, were also collected. TBS was calculated using the TBS iNsight software. Muscle health indicators included upper limb, lower limb, trunk, and total muscle mass, lean body mass, appendicular skeletal muscle mass index (ASMI), and grip strength. The Pearson correlation analysis was used to determine the relationship between TBS and muscle health indicators, as well as between TBS and the BMD of lumbar spine (L 1-4). Further, multiple linear regression analysis was conducted to explore the independent association between TBS and muscle health indicators. Results:TBS, lean body mass, ASMI, grip strength, and muscle mass of the upper limb, lower limb, trunk, whole body in the OP group were all lower than those in the non-OP group [(1.27±0.07) vs (1.35±0.07) score, (36.64±3.45) vs (39.14±3.62) kg, (6.16±0.56) vs (6.44±0.63) kg/m2, (23.87±3.31) vs (25.34±4.33) kg, (3.54±0.47) vs (3.78±0.47) kg, (11.70±1.33) vs (12.68±1.49) kg, (16.57±1.68) vs (17.50±1.69) kg, and (34.91±3.33) vs (37.13±3.47) kg] (all P<0.05). Pearson analysis showed that TBS was positively correlated with lean body mass, ASMI, grip strength, and muscle mass of the upper limb, lower limb, whole body (all P<0.05). TBS was negatively correlated with age ( P<0.01). TBS was positively correlated with the BMD of lumbar spine (L 1-4) ( r=0.660, P<0.01). Multiple regression analysis demonstrated that ASMI was positively correlated with TBS ( β=0.284, P<0.01). Conclusion:In the postmenopausal population, individuals with OP have lower TBS. Furthermore, TBS is closely associated with muscle health.

Objective:To analyze the trabecular bone score (TBS) and its association with muscle health in the postmenopausal population.Methods:It was a cross-sectional study. A total of 214 postmenopausal individuals who underwent dual-energy X-ray absorptiometry testing at the Beijing Research Institute of Sports Science between January and December 2023 were consecutively included. The participants were divided into two groups based on the presence or absence of osteoporosis (OP): 62 cases in the OP group and 152 cases in the non-OP group. All subjects completed body composition assessments and scans of bilateral hip and lumbar spine bone mineral density (BMD)(All the BMD in this study were areal BMD). Demographic data, including age, age at menarche, age at menopause, and fracture history, were also collected. TBS was calculated using the TBS iNsight software. Muscle health indicators included upper limb, lower limb, trunk, and total muscle mass, lean body mass, appendicular skeletal muscle mass index (ASMI), and grip strength. The Pearson correlation analysis was used to determine the relationship between TBS and muscle health indicators, as well as between TBS and the BMD of lumbar spine (L 1-4). Further, multiple linear regression analysis was conducted to explore the independent association between TBS and muscle health indicators. Results:TBS, lean body mass, ASMI, grip strength, and muscle mass of the upper limb, lower limb, trunk, whole body in the OP group were all lower than those in the non-OP group [(1.27±0.07) vs (1.35±0.07) score, (36.64±3.45) vs (39.14±3.62) kg, (6.16±0.56) vs (6.44±0.63) kg/m2, (23.87±3.31) vs (25.34±4.33) kg, (3.54±0.47) vs (3.78±0.47) kg, (11.70±1.33) vs (12.68±1.49) kg, (16.57±1.68) vs (17.50±1.69) kg, and (34.91±3.33) vs (37.13±3.47) kg] (all P<0.05). Pearson analysis showed that TBS was positively correlated with lean body mass, ASMI, grip strength, and muscle mass of the upper limb, lower limb, whole body (all P<0.05). TBS was negatively correlated with age ( P<0.01). TBS was positively correlated with the BMD of lumbar spine (L 1-4) ( r=0.660, P<0.01). Multiple regression analysis demonstrated that ASMI was positively correlated with TBS ( β=0.284, P<0.01). Conclusion:In the postmenopausal population, individuals with OP have lower TBS. Furthermore, TBS is closely associated with muscle health.

With the rising incidence of cervical kyphosis, the clinical understanding of this condition has evolved. Studies have shown that a subset of asymptomatic individuals exhibit cervical kyphosis, indicating that not all cases represent pathological changes. A thorough understanding of the common causes, underlying mechanisms, and imaging criteria for pathological cervical kyphosis is essential for establishing a tiered treatment model. Proficiency in stiffness assessment, clinical classification systems, and cervical osteotomy techniques is crucial for surgical planning and complication prevention. However, several key issues remain unresolved, including the optimal surgical approach for rigid cervical kyphosis, sagittal alignment correction targets, and long-term postoperative outcomes. Addressing these challenges requires high-quality clinical research to refine treatment strategies and improve patient care.

Objectives:To analyze the epidemiological characteristics of osteoporosis and osteopenia in patients with lumbar degenerative diseases,and to evaluate the predictive values of Osteoporosis Self-Assess-ment Screening Tool for Asians(OSTA)score and body mass index(BMI)for osteoporosis in this population.Methods:The clinical data of 432 patients with lumbar degenerative diseases admitted to the Department of Orthopedics of Huashan Hospital from January 2020 to December 2022 were analyzed retrospectively,including 120 males with an average age of 72.0±5.4 years and 312 females with an average age of 67.2±31.1 years old.All the patients underwent dual-energy X-ray absorptiometry(DXA)examination and lumbar CT scan in our hospital within 3 months before admission or after admission.OSTA score and BMI were calculated based on patient's age,height,and weight.Chi-square test was used to compare the incidence rates of osteoporosis and osteopenia in patients of different ages and genders.Receiver operating characteristics(ROC)curve was constructed and the area under the curve(AUC)was calculated.After determining the optimal cutoff value,the sensitivity,specificity,positive predictive value,and negative predictive value were calculated at this cutoff value.Results:According to the DXA examination results,the prevalence rates of osteoporosis in male patients over 65 years old and female patients over 50 years old were 14.17％and 37.50％respectively,and the prevalence rates of osteopenia were 52.50％and 48.08％respectively.The diagnostic compliance rate of lumbar and total hip DXA was 60.2％.In female patients of different age groups,the prevalence of osteoporosis or osteopenia increased in older age group,but the difference was not statistically significant.The prevalence of osteoporosis in women over 65 years old was greater than in men over 65 years old(P=0.000).Among the 297 patients diagnosed with osteopenia or normal bone mass by DXA,11.78％of them met the diagnostic criteria for osteoporosis in CT examination.The sensitivity of the OSTA score in predicting osteoporosis in male and female patients with lumbar degenerative disease was both 55.56％,and the negative predictive values were 89.04％and 79.19％,respectively,indicating limited predictive value for osteoporosis.The AUC of BMI in male and female patients with lumbar degenerative disease were 0.672 and 0.668 respectively,with sensitivities of 77.78％and 73.50％,and the negative predictive values of 93.10％and 76.69％respectively.The BMI had certain predictive value for osteoporosis.After correcting the diagnosis of osteoporosis with lumbar CT examination,the screening efficacy of OSTA score and BMI improved in both male and female patient populations.Conclusions:The epidemiological characteristics of osteoporosis in patients with lumbar degenerative diseases are high prevalence and low treatment rate.The prevalence of osteoporosis in women is significantly higher than that in men.The OSTA score has limited value in predicting osteoporosis,while BMI can be used as one of the initial screening tools for osteoporosis in this population.

Methods: The median sagittal diameter and transverse diameter of the spinal canal from C2 to C7 were measured on CT images. The ratio of the median sagittal diameter to the transverse diameter was calculated. Accordingly, the spinal canal shape of each segment was classified into four, and the specific criteria of lunar phase classification were determined through linear discriminant analysis based on the ratio of the median sagittal diameter to the transverse diameter. The inter-rater reliability of the classification was explored using Kappa coefficients. Finally, the morphology of the different segments of the cervical spinal canal in healthy volunteers was revised and compared. Results: According to the ratio of the median sagittal diameter and the transverse diameter of the cervical spinal canal, the lunar phase classification of the cervical bony spinal canal was determined as follows: full-moon >0.65, 0.55< convex-moon ≤0.65, 0.46≤ quarter-moon ≤0.55, and residual-moon <0.46. The Kappa values of C2–C7 were 0.851, 0.958, 0.823, 0.927, 0.793, and 0.946, and the Kappa value of all C2–C7 segments was 0.854 that mainly presented two forms of full-moon (76.5%) and convex-moon (23.0%). A quarter-moon spinal canal was mainly distributed in C3, C4, C5, and C6; a residual-moon spinal canal was mainly distributed in C4 and C5; and the morphological distribution of C4 and C5 were similar (p>0.05). The frequency of the spinal canal of the residual-moon type was the highest, and the full-moon (6.5%) and residual-moon (7.5%) types of C7 were rare. Conclusions The morphological classification of the cervical spinal canal was established to present anatomical variations. The classification showed good inter-rater reliability.