Conservative treatment is primarily performed for the treatment of patients with lumbar disc herniation (LDH), but if it does not respond, surgical treatment can be performed. Surgical intervention has a positive effect on the rapid improvement of LDH symptoms. However, the effectiveness of surgical versus conservative treatment for LDH is controversial, especially regarding long-term effects. Recently, a treatment using platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), low-intensity pulsed ultrasound (LIPUS), etc., has been actively conducted as a treatment to avoid side effects of surgery and promote tissue regeneration. In this paper, the literature evaluating the effectiveness of non-surgical treatment options is reviewed with an emphasis on the effectiveness of clinical application. Several clinical studies have shown that PRP, biomaterials, BMAC, and LIPUS treatment promote tissue regeneration and alleviate symptoms. Although PRP-applied studies have suggested disc height changes, cell therapy and LIPUS treatment have many shortcomings in clinical aspects of tissue regeneration. Therefore, it is necessary to establish a unified, safe protocol and standardize the method of presenting results to confirm the clinical effect of the treatment for impaired intervertebral regeneration in patients with intervertebral disc degeneration (IDD), including LDH.

Current clinical applications of mesenchymal stem cell therapy for osteoarthritis lack consistency because there are no established criteria for clinical processes. We aimed to systematically organize stem cell treatment methods by reviewing the literature. The treatment methods used in 27 clinical trials were examined and reviewed. The clinical processes were separated into seven categories: cell donor, cell source, cell preparation, delivery methods, lesion preparation, concomitant procedures, and evaluation. Stem cell donors were sub-classified as autologous and allogeneic, and stem cell sources included bone marrow, adipose tissue, peripheral blood, synovium, placenta, and umbilical cord. Mesenchymal stem cells can be prepared by the expansion or isolation process and attached directly to cartilage defects using matrices or injected into joints under arthroscopic observation. The lesion preparation category can be divided into three subcategories: chondroplasty, microfracture, and subchondral drilling. The concomitant procedure category describes adjuvant surgery, such as high tibial osteotomy. Classification codes were assigned for each subcategory to provide a useful and convenient method for organizing documents associated with stem cell treatment. This classification system will help researchers choose more unified treatment methods, which will facilitate the efficient comparison and verification of future clinical outcomes of stem cell therapy for osteoarthritis.

Background: Fractures of the femur require significant radiation exposure during operations using fluoroscopy (C-arm), posing a high risk of radiation exposure to the medical staff and patients. To address this concern, in this study, we investigated the efficacy of using two fluoroscopy machines simultaneously. Methods: We categorized 30 patients with femoral neck fracture (FNF) into single and double C-arm groups. The operation and radiation exposure times during a closed reduction and internal fixation operation were investigated to evaluate whether the operation and radiation exposure times were effectively audited when the operation was performed using a double C-arm. Results: The total operation times were 93.21 ± 20.70 min and 66.69 ± 13.97 min for the single and double C-arm groups, respectively. Additionally, the total radiation times were 100.43 ± 24.59 s and 83.06 ± 19.53 s for the single and double C-arm groups, respectively. Operation and radiation exposure times in the two groups showed statistically significant differences (p < 0.05). Conclusion: The use of double C-arm in FNF can reduce operation and radiation exposure times. Hence, using the double C-arm in surgical treatment could reduce the risk of radiation exposure to medical staff and patients.

Minimally invasive spine surgery (MISS), supported by advancements in endoscopic systems, tubular retractors, lateral access corridors, image-guided navigation, and robotic assistance, has progressively expanded its role in the management of a broad spectrum of spinal disorders. These approaches were developed to limit muscular disruption and soft tissue damage while maintaining clinical and radiographic outcomes comparable to those of conventional open techniques. Current evidence across multiple surgical procedures indicates reductions in intraoperative blood loss, hospitalization duration, postoperative analgesic requirements, and time to functional recovery. Despite these advantages, MISS remains constrained by technical and procedural limitations. Restricted visualization, reduced working space, and dependence on fluoroscopy for navigation contribute to substantial operative complexity and prolonged learning curves. Procedure-specific risks persist, including increased radiation exposure during minimally invasive transforaminal lumbar interbody fusion, limited haptic feedback in endoscopic spine surgery, and neural or retroperitoneal complications during lateral interbody fusion. Although navigation and robotic platforms improve implant accuracy and the surgeon's radiation safety, high acquisition and maintenance costs, workflow integration challenges, and patients' radiation exposure continue to limit their widespread adoption. Future development will require cost-efficient technological refinement, standardized training pathways, and enhanced intraoperative feedback and decision support systems. Integration of artificial intelligence with robotic platforms is anticipated to further optimize surgical precision and workflow efficiency, supporting the continued evolution of MISS.

Conservative treatment is primarily performed for the treatment of patients with lumbar disc herniation (LDH), but if it does not respond, surgical treatment can be performed. However, surgical treatment is not always superior to non-surgical treatment. Recently, treatment using PRP, BMAC, LIPUS, etc. has been actively conducted as a treatment to avoid side effects of surgery and promote tissue regeneration. In this paper, the literature evaluating the effectiveness of non-surgical treatment options is reviewed with an emphasis on the effectiveness of clinical application. Several clinical studies have shown that PRP, biomaterials, BMAC, and LIPUS treatment promote tissue regeneration and alleviate symptoms. Although PRP-applied studies have suggested disk height changes, cell therapy and LIPUS treatment have many shortcomings in clinical aspects for tissue regeneration. Therefore, it is necessary to establish a unified, safe protocol and standardize the method of presenting results to confirm the clinical effect of the treatment for impaired intervertebral regeneration in patients with intervertebral disc degeneration (IDD) including LDH.

This paper mainly examines the fixation performances of the cephalomedullary nail for the incidence of intertrochanteric (IT) fracture to guide the appropriate fixations with respect to the bone density in terms of a biomechanical perspective. It is substantially important to guide which types of fixation are applied during the operation since it tends to induce the backout or migration of the helical blade and screw according to weight and bone density. Biomedical polyurethane (PUR) foam blocks for simulating human bone are adopted with two grades of densities to simulate a normal person and an elderly person who has osteoporosis. Tensile and compression tests are conducted to analyze the tensile-compression anisotropy of PUR foams. Pull-out performances of screw and helical blades are evaluated from experimental perspectives, which are supported by comparison with the results of finite element method analysis. The clamping force of the screw is higher than the helical blade, about 177% in normal foam density and 198% in low foam density. After physical evaluation of the critical pull-out fixation force of screw and helical blade, we have suggested that stable fixation is guaranteed when the pull-out force is larger than projected force.