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Background Low back pain (LBP) is a very common condition and leads to serious pain, disability, and price tag all over the world. Intervertebral disk degeneration (IDD) is one of the major reasons that contributed to LBP. The levels of interleukin 1 beta (IL-1β) increase significantly in degenerative disks. IL-1β also accelerates IDD. Sinapic acid (SA) has the effect of anti‐inflammatory, antioxidant and antimicrobial. However, the effect of SA on IDD has never been studied. Therefore, the aim of this study was to figure out whether SA has protective effect on nucleus pulposus (NP) cells and further explore the possible underlying mechanism. Methods The nucleus pulposus (NP) tissues of rats were collected and cultured into NP cells. The NP cells were stimulated by IL-1β and treated with SA. In vitro treatment effects were evaluated by ELISA, Western blot assay, immunofluorescence, TUNEL method and real-time PCR. We conducted percutaneous needle puncture in the rat tail to build intervertebral disk degeneration model and treated rats with SA. In vivo treatment effects were evaluated by hematoxylin and eosin (HE) and safranin O (SO) staining and magnetic resonance imaging (MRI) method. Results Our results showed that SA not only inhibited apoptosis but also suppressed inflammatory mediators including nitric oxide (NO), prostaglandin E2 (PGE2), cyclooxygenase 2 (COX-2), inducible nitric oxide synthase (iNOS) interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) in IL-1β-stimulated NP cells. As to extracellular matrix (ECM), SA could increase collagen II and aggrecan levels and reduce the expression of MMP13 and ADAMTS5 during the stimulation of IL-1β. Furthermore, SA could activate nuclear factor‐erythroid 2‐related factor‐2 (Nrf2) to inhibit nuclear factor κB (NF‐κB) induced by IL‐1β. Nrf2 knockdown partly reduced the protective effect of SA on NP cells. Correspondingly, SA ameliorated IDD by promoting Nrf2 expression. In vivo results also showed that SA could delay the progression of IDD. Conclusion In conclusion, we demonstrated that SA could protect the degeneration of NP cells and revealed the underlying mechanism of SA on Nrf2 activation in NP cells.

Introduction: Neck pain is a common condition that leads to serious pain, disability, and increased healthcare costs worldwide. Pharmacotherapy is one of the most common strategies to reduce neck pain in patients. The aim of this study was to analyze the real-world pattern of drugs prescribed for patients with neck pain in the USA. Methods: Data on individuals who reported current neck pain in the 2009-2010 US National Health and Nutrition Examination Survey (NHANES) and with a history of persistent pain for at least 6 weeks or 3 months were extracted from the NHANES database. Those included in the study were divided into three groups based on the duration of pain: the without neck pain group (Group A); subacute group (Group B) with a history of 6 weeks of neck pain; and the chronic neck pain group (Group C) with a history of 3 months of neck pain. The use and duration of medication Digital Features To view digital features for this article go to

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Background To investigate the morphological changes in the adjacent vertebrae in patients with congenital scoliosis caused by hemivertebra treated by posterior hemivertebra resection with unilateral short segment fixation. Methods A retrospective cohort study was conducted. From 2000 to 2023, 26 pediatric patients with scoliosis caused by a single hemivertebra were included in our institution. They were treated with posterior hemivertebra resection and unilateral short-segment fixation. The preoperative, postoperative, and final follow-up imaging parameters were measured separately, such as the main curve Cobb angle, correction rate, the height of the convex and concave side of the vertebral body, and bilateral pedicle distance (BLPD). All patients had at least 60 months of follow-up. Results The patient was followed up for 68.81 ± 8.11(60–82)months. The preoperative main curve Cobb angle: 36.32°±11.36°, postoperative main curve Cobb angle: 12.29°±7.41°, with a mean correction rate of 66.3%.The main curve Cobb angle at the last follow-up: 12.59°±7.42°, with a loss rate of 2.3%. Preoperative height of proximal vertebral body on convex side: (1.14 ± 0.48) cm,height of proximal vertebral body on concave side: (1.15 ± 0.50) cm, BLPD: (2.58 ± 1.11) cm, height of distal vertebral body in convex side: (1.26 ± 1.89) cm, height of distal vertebral body in concave side: (1.13 ± 0.45) cm, BLPD: (2.83 ± 0.93) cm; Postoperative height of proximal vertebral body in convex side: (1.83 ± 0.49) cm,height of proximal vertebral body in concave side height: (1.58 ± 0.39) cm, BLPD: (2.86 ± 0.77) cm, height of distal vertebral body in convex side: (1.88 ± 0.46) cm,height of distal vertebral body in concave side height: (1.59 ± 0.32) cm, BLPD: (3.31 ± 0.99) cm; At the final follow-up,the height of proximal vertebral body in convex side: (2.01 ± 0.60) cm, height of proximal vertebral body in concave side: (1.89 ± 0.49) cm, BLPD: (3.20 ± 0.78) cm, height of the distal vertebral body in convex side: (2.25 ± 0.50) cm, height of distal vertebral body in concave side: (1.90 ± 0.32) cm, BLPD: (3.58 ± 0.90). The postoperative and final follow-up parameters were significantly difference(P < 0.05) compared with preoperative parameters. No complications such as neurological injury, infection, and internal fixation failure occurred during the follow-up. Conclusion Posterior hemivertebrectomy with unilateral short-segment fixation and fusion can effectively remove the factors leading to deformity and correct the spinal alignment. Morphological changes in the vertebrae adjacent to the hemivertebrae are observed on long-term follow-up, with a tendency to from wedge-shaped or irregular-shaped vertebrae to a typical vertebra. It is a safe and effective treatment for congenital scoliosis caused by hemivertebra.

Background: Several primary fracture classification systems (FCSs) have been widely used for intra-articular calcaneal fractures. The purpose of this study was to measure the inter-and intra-observer variations as well as integrality of the Zwipp, Crosby-Fitzgibbons, Sanders, and Eastwood-Atkins classification systems based on more accurate CT scans.Methods: 549 patients with intra-articular calcaneal fractures taken from a database in our level-I trauma centre (3 affiliated hospitals) were included from January 2018 to December 2019. For each case, normative CT (1 mm slices) scans were available.Four different observers reviewed all CT scans two times according to these 4 most prevalent FCSs within a 2-month interval. For these four FCSs, the kappa [κ] coefficient was used to evaluate interobserver reliability and intraobserver reproducibility, and the percentage that can be classified was used to indicate integrality. Results:The κ values were measured for Zwipp (κ= 0.38 interobserver, κ= 0.61 intraobserver), Crosby-Fitzgibbons (κ= 0.48 interobserver, κ= 0.79 intraobserver), Sanders (κ= 0.40 interobserver, κ= 0.57 intraobserver), and Eastwood-Atkins (κ= 0.44 interobserver, κ= 0.72 intraobserver). Furthermore, the integrality were calculated for Zwipp (100 %), Crosby-Fitzgibbons (100 %), Sanders (92 %) as well as Eastwood-Atkins (89.6 %). Conclusion:Compared with previous literatures, CT scanning with higher accuracy can significantly improve intraobserver reproducibility of Zwipp and Eastwood-Atkins FCSs, but it has no positive effect on variability of Sanders FCS and interobserver reliability of Crosby-Fitzgibbons FCS. While in terms of integrality, Zwipp and Crosby-Fitzgibbons FCSs appear to be superior to the other two FCSs.

Background: Several primary fracture classification systems (FCSs) have been widely used for intra-articular calcaneal fractures. The purpose of this study was to measure the inter- and intra-observer variations as well as integrality of the Zwipp, Crosby-Fitzgibbons, Sanders, and Eastwood-Atkins classification systems based on more accurate CT scans. Methods: 549 patients with intra-articular calcaneal fractures taken from a database in our level-I trauma centre (3 affiliated hospitals) were included from January 2018 to December 2019. For each case, normative CT (1 mm slices) scans were available. Four different observers reviewed all CT scans two times according to these 4 most prevalent FCSs within a 2-month interval. For these four FCSs, the kappa [κ] coefficient was used to evaluate interobserver reliability and intraobserver reproducibility, and the percentage that can be classified was used to indicate integrality. Results: The κ values were measured for Zwipp (κ= 0.38 interobserver, κ= 0.61 intraobserver), Crosby-Fitzgibbons (κ= 0.48 interobserver, κ= 0.79 intraobserver), Sanders (κ= 0.40 interobserver, κ= 0.57 intraobserver), and Eastwood-Atkins (κ= 0.44 interobserver, κ= 0.72 intraobserver). Furthermore, the integrality were calculated for Zwipp (100 %), Crosby-Fitzgibbons (100 %), Sanders (92 %) as well as Eastwood-Atkins (89.6 %). Conclusion: Compared with previous literatures, CT scanning with higher accuracy can significantly improve intraobserver reproducibility of Zwipp and Eastwood-Atkins FCSs, but it has no positive effect on variability of Sanders FCS and interobserver reliability of Crosby-Fitzgibbons FCS. While in terms of integrality, Zwipp and Crosby-Fitzgibbons FCSs appear to be superior to the other two FCSs.