Numerous screw fixation systems have evolved in clinical practice as a result of advances in screw insertion technology. Currently, pedicle screw (PS) fixation technology is recognized as the gold standard of posterior lumbar fusion, but it can also have some negative complications, such as screw loosening, pullout, and breakage. To address these concerns, cortical bone trajectory (CBT) has been proposed and gradually developed. However, it is still unclear whether cortical bone trajectory can achieve similar mechanical stability to pedicle screw and whether the combination of pedicle screw + cortical bone trajectory fixation can provide a suitable mechanical environment in the intervertebral space. The present study aimed to investigate the biomechanical responses of the lumbar spine with pedicle screw and cortical bone trajectory fixation. Accordingly, finite element analysis (FEA) and in vitro specimen biomechanical experiment (IVE) were performed to analyze the stiffness, range of motion (ROM), and stress distribution of the lumbar spine with various combinations of pedicle screw and cortical bone trajectory screws under single-segment and dual-segment fixation. The results show that dual-segment fixation and hybrid screw placement can provide greater stiffness, which is beneficial for maintaining the biomechanical stability of the spine. Meanwhile, each segment’s range of motion is reduced after fusion, and the loss of adjacent segments’ range of motion is more obvious with longer fusion segments, thereby leading to adjacent-segment disease (ASD). Long-segment internal fixation can equalize total spinal stresses. Additionally, cortical bone trajectory screws perform better in terms of the rotation resistance of fusion segments, while pedicle screw screws perform better in terms of flexion–extension resistance, as well as lateral bending. Moreover, the maximum screw stress of L4 cortical bone trajectory/L5 pedicle screw is the highest, followed by L45 cortical bone trajectory. This biomechanical analysis can accordingly provide inspiration for the choice of intervertebral fusion strategy.

Paratroopers are highly susceptible to lower extremity impact injuries during landing. To reduce the ground reaction force (GRF), inspired by the cat paw pad and triply periodic minimal surface (TPMS), a novel type of bionic cushion sole for paratrooper boots was designed and fabricated by additive manufacturing. A shear thickening fluid (STF) was used to mimic the unique adipose tissue with viscoelastic behavior found in cat paw pads, which is formed by a dermal layer encompassing a subcutaneous layer and acts as the primary energy dissipation mechanism for attenuating ground impact. Based on uniaxial compression tests using four typical types of cubic TPMS specimens, TPMSs with Gyroid and Diamond topologies were chosen to fill the midsole. The quasi-static and dynamic mechanical behaviors of the bionic sole were investigated by quasi-static compression tests and drop hammer tests, respectively. Then, drop landing tests at heights of 40 cm and 80 cm were performed on five kinds of soles to assess the cushioning capacity and compare them with standard paratrooper boots and sports shoes. The results showed that sports shoes had the highest cushioning capacity at a height of 40 cm, whereas at a height of 80 cm, the sole with a 1.5 mm thick Gyroid configuration and STF filling could reduce the maximum peak GRF by 15.5% when compared to standard paratrooper boots. The present work has implications for the design of novel bioinspired soles for reducing impact force.

In recent years, bone tissue engineering (BTE) has played an essential role in the repair of bone tissue defects. Although bioactive factors as one component of BTE have great potential to effectively promote cell differentiation and bone regeneration, they are usually not used alone due to their short effective half-lives, high concentrations, etc. The release rate of bioactive factors could be controlled by loading them into scaffolds, and the scaffold microstructure has been shown to significantly influence release rates of bioactive factors. Therefore, this review attempted to investigate how the scaffold microstructure affected the release rate of bioactive factors, in which the variables included pore size, pore shape and porosity. The loading nature and the releasing mechanism of bioactive factors were also summarized. The main conclusions were achieved as follows: i) The pore shapes in the scaffold may have had no apparent effect on the release of bioactive factors but significantly affected mechanical properties of the scaffolds; ii) The pore size of about 400 μm in the scaffold may be more conducive to controlling the release of bioactive factors to promote bone formation; iii) The porosity of scaffolds may be positively correlated with the release rate, and the porosity of 70%–80% may be better to control the release rate. This review indicates that a slow-release system with proper scaffold microstructure control could be a tremendous inspiration for developing new treatment strategies for bone disease. It is anticipated to eventually be developed into clinical applications to tackle treatment-related issues effectively.

The turtle carapace has a high level of protection, due to its unique biological structure, and there is great potential to use the turtle carapace structure to improve the impact resistance of composite materials using bionic theory. In this paper, the chemical elements of the turtle carapace structure, as well as its mechanical properties, were investigated by studying the composition of the compounds in each part. In addition, the bionic sandwich structure, composed of the plate, core, and backplate, was designed using modeling software based on the microstructure of the keratin scutes, spongy bone, and the spine of the turtle carapace. Additionally, finite element analysis and drop-weight experiments were utilized to validate the impact-resistant performance of the bionic structures. The numerical results show that all of the bionic structures had improved impact resistance to varying degrees when compared with the control group. The experimental results show that the split plate, the core with changing pore gradients, and the backplate with stiffener all have a considerable effect on the impact-resistance performance of overall composite structures. This preliminary study provides theoretical support for composite material optimization.

Study Design: Retrospective observational study. Objectives: Scoliosis is commonly observed in adolescents, with a world0wide prevalence of 0.5%. It is prone to be overlooked by parents during its early stages, as it often lacks overt characteristics. As a result, many individuals are not aware that they may have scoliosis until the symptoms become quite severe, significantly affecting the physical and mental well-being of patients. Traditional screening methods for scoliosis demand significant physician effort and require unnecessary radiography exposure; thus, implementing large-scale screening is challenging. The application of deep learning algorithms has the potential to reduce unnecessary radiation risks as well as the costs of scoliosis screening. Methods: The data of 247 scoliosis patients observed between 2008 and 2021 were used for training. The dataset included frontal, lateral, and back upright images as well as X-ray images obtained during the same period. We proposed and validated deep learning algorithms for automated scoliosis screening using upright back images. The overall process involved the localization of the back region of interest (ROI), spinal region segmentation, and Cobb angle measurements. Results: The results indicated that the accuracy of the Cobb angle measurement was superior to that of the traditional human visual recognition method, providing a concise and convenient scoliosis screening capability without causing any harm to the human body. Conclusions: The method was automated, accurate, concise, and convenient. It is potentially applicable to a wide range of screening methods for the detection of early scoliosis.

Periodical and consecutive distraction is an effective treatment for severe early onset scoliosis (EOS), which enables the spinal coronal and sagittal plane deformity correction. However, the rate of rod fractures and postoperative complications was still high mainly related to the distraction process. Previous studies have primarily investigated the maximum safe distraction force without a rod broken, neglecting the spinal re-imbalance and distraction energy consumption, which is equally vital to evaluate the operative value. This study aimed to reveal the kinematic and biomechanical responses occurring after spinal distraction surgery, which were affected by traditional bilateral fixation. The spinal models (C6-S1) before four distractions were reconstructed based on CT images and the growing rods were applied with the upward displacement load of 0–25 mm at an interval of 5 mm. Relationships between the distraction distance, the distraction force and the thoracic and lumbar Cobb angle were revealed, and the spinal displacement and rotation in three-dimensional directions were measured. The spinal overall imbalance would also happen during the distraction process even under the safe force, which was characterized by unexpected cervical lordosis and lateral displacement. Additionally, the law of diminishing return has been confirmed by comparing the distraction energy consumption in different distraction distances, which suggests that more attention paid to the spinal kinematic and biomechanical changes is better than to the distraction force. Notably, the selection of fixed segments significantly impacts the distraction force at the same distraction distance. Accordingly, some results could provide a better understanding of spinal distraction surgery.