The relationship between the accumulation of fat in visceral or subcutaneous tissue and bone mineral density (BMD) remains unclear. Our primary objective in this study was to illuminate this relationship by conducting an investigation on a vast scale, encompassing a nationally representative population in the United States. A weighted multiple linear regression model was established to evaluate the relationship between visceral fat, subcutaneous fat, and BMD. Additionally, the exploration of the potential nonlinear relationship was conducted employing the methodology of smooth curve fitting. In order to determine potential inflection points, a two-stage linear regression model was utilized. A total of 10,455 participants between the ages of 20 and 59 were included in this study. Various weighted multiple linear regression models revealed a negative correlation between lumbar BMD and visceral mass index (VMI) and subcutaneous mass index (SMI). However, the association between VMI and lumbar BMD displayed a U-shaped pattern upon employing the smooth curve fitting, and the inflection point of 0.304 kg/m2was determined using a two-stage linear regression model. Our findings indicated a negative association between subcutaneous fat and BMD. A U-shaped relationship was observed between visceral fat and BMD.

Study design: A bibliometric analysis.Objective: To identify and analyze the top 100 cited articles in anterior cervical discectomy and fusion. Summary of Background Data: Anterior cervical discectomy and fusion (ACDF) is one of the most routine surgical procedures in spine surgery. Many surgeons and academics have researched ACDF thoroughly and published numerous articles. However, there is no relevant bibliometric analysis. Therefore, our study aims to identify and analyze the top 100 cited articles in ACDF to identify the research trends. Methods: We searched the Web of Science (WOS) Core Collection database with restrictions and identified the top 100 cited publications in ACDF for analysis. Results:The citation counts of the top 100 cited publications ranged from 37 to 361 (mean 67.42). All studies were published between 2008 and 2019, with 2013 and 2015 the most prolific years. The journals Spine and Journal of Neurosurgery-Spine provided the majority of the articles. Overall, the 100 articles came from 12 countries, with the United States being the top producer, followed by China and South Korea. The most frequent keywords were "spine", "anterior cervical discectomy and fusion", "interbody fusion", 'arthrodesis', "follow-up", "decompression", and "ACDF". Conclusion: ACDF has been regarded as a classical gold standard in anterior cervical surgery, and the emergence of new surgical procedures has not affected its status. Cervical disc arthroplasty still needs further research and development. As the first bibliometric analysis of ACDF, this bibliometric study is meant to provide guidance for clinicians and scholars to research the development trend of this field.

Background Surgical site infection (SSI) is a common complication in spinal surgery that can significantly affect the patient's prognosis. Despite advances in surgical techniques and infection control measures, SSI remains a considerable concern for healthcare providers and patients alike. In recent years, there has been a steady increase in studies related to SSI in spine surgery, leading to the publication of numerous informative articles. However, the current state and trends of research in the field of spinal SSI remain unclear. This study aims to conduct a bibliometric analysis of SSI-related articles in spine surgery to identify research status and trends. Meanwhile, we identify the top 100 most cited articles for further analysis. Methods We searched for all articles related to spinal SSI in the Web of Science Core Collection, recording the publication year, country, journal, institution, keywords, and citation frequency for further analysis. In addition, we identified and analyzed the top 100 most cited articles. Results A total of 307 articles related to spinal SSI were identified. All of these articles were published between 2008 and 2022, with the number of publications showing an increasing trend over the years. The related articles originated from 37 countries, with the USA contributing the most (n = 138). The institution with the highest number of publications and citations was Johns Hopkins University (14 articles; 835 citations). Among the journals, Spine had the highest number of articles (n = 47). The prevention of spinal SSI has been a research hotspot in recent years. Among the top 100 most cited articles, the most common research theme was the risk factors associated with spinal SSI. Conclusions In recent years, research related to spinal SSI has attracted the attention of numerous clinicians and scholars. As the first bibliometric analysis of spinal SSI, our study aims to provide pragmatic guidance for clinicians to learn the research status and trends in this field and improve their vigilance toward SSI.

Objective: The relationship between fat accumulation in visceral or subcutaneous tissue and bone mineral density (BMD) remains unclear. In this study, we aim to shed light on this relationship by examining a large, nationally representative population. Methods: A weighted multiple linear regression model was established to evaluate the relationship between visceral fat, subcutaneous fat and BMD. Additionally, the potential nonlinear relationship was explored using smooth curve fitting method. Results: A total of 10455 participants between the ages of 20 and 59 were included in this study. Various weighted multiple linear regression models revealed a negative correlation between lumbar BMD T-score and visceral mass index (VMI) and subcutaneous mass index (SMI). However, the association between VMI and lumbar BMD T-score was U-shaped when we did smooth curve fitting, and the inflection point of 0.304kg/m² was determined using a two-stage linear regression model. Conclusions: Subcutaneous fat and BMD T-score were found to have a negative association, and visceral fat and BMD T-score were discovered to have a U-shaped connection. It is the significance of taking body composition and weight control into account while treating and preventing osteoporosis.

Objective The association between segmental body composition and bone mineral density (BMD) is unclear. This study analyzed the representative adult sample from the US in order to evaluate the association between segmental body composition and BMD. Method Ten thousand and ninety-six people aged 20–59 from the National Health and Nutrition Examination Survey (NHANES) database participated in this cross-sectional study. Segmental body composition and total BMD were examined using weighted multivariate linear regression analysis. Additionally, a subgroup analysis was performed according to age and gender group. Result The fat proportion of each body region was negatively related to total BMD once confounding variables were taken into account, while the arm and leg showing the most significant negative correlation. Lean mass and BMD were positively correlated in each region. Similar results were observed in all hierarchical analyses. Conclusion In essence, we discovered that BMD in American individuals aged 20 to 59 was inversely linked with the percentage of fat mass in various body locations. The increase of lean mass in each region had a protective effect on bones. Segmental body composition analysis may be used to provide information for predicting the health status of bone.