The incidence of lumbar spinal stenosis is increasing annually, and with an ever‑aging population and longer life expectancies, this trend will further continue. It is hoped that a more effective treatment can be found so that the patients can be relieved of their pain. The aim of this systematic review and meta‑analysis was to evaluate the effectiveness and safety of unilateral biportal endoscopic surgery (UBE) and microscopic decompression surgery (MD) for the treatment of lumbar spinal stenosis. A literature search of related studies published until April 2022 was performed using PubMed, EMBASE, Cochrane Library, Web of Science, ClinicalTrials.gov, Google Scholar, China National Knowledge Infrastructure (CNKI), and other databases. After filtering of references, 12 eligible studies were identified that compared UBE with MD as a treatment for lumbar spinal stenosis. Data were extracted and analysed using R. A total of 12 articles (four randomized controlled and eight cohort studies) were included, with a total of 1,067 patients: 250 men and 249 women in the UBE group and 290 men and 278 women in the MD group. The meta-analysis showed that the mean intraoperative blood loss in the UBE group [standardized mean difference (SMD)=‑2.10, 95% confidence interval (CI) (‑3.97, ‑0.23), P=0.03] was lower than that in the MD group. The postoperative Visual analogue scale (VAS) score for back pain [SMD=‑0.52, 95% CI (‑0.76, ‑0.27), P<0.01], leg pain [SMD=‑0.30, 95% CI (‑0.51, ‑0.08), P<0.01], postoperative Oswestry disability index [(ODI); SMD=‑0.25, 95% CI (‑0.48, ‑0.03), P=0.03], and postoperative C‑reactive protein [(CRP); odds ratio (OR)=‑0.92, 95% CI (‑1.80, 0.03), P=0.04] were lower than those in the MD group. Complications (OR=0.60, 95% CI (0.37, 0.98), P=0.04) and hospital stay (SMD=‑1.84, 95% CI (‑2.85, 0.83), P <0.01] were also lesser in the UBE group than in the MD group. UBE was preferable to that in the MD group according to the modified MacNab score [OR=2.28, 95% CI (1.28, 4.06), P<0.01]. No significant differences were observed in the operation times between the groups. UBE surgery was found to be a better option for the treatment of lumbar spinal stenosis than MD surgery.

The present study aimed to compare the differences between 3D‑printed porous titanium and polyether ether ketone (PEEK) interbody fusion cages for anterior cervical discectomy and fusion (ACDF). Literature on the application of 3D‑printed porous titanium and PEEK interbody fusion cages for ACDF was searched in the PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang and VIP databases. A total of 1,181 articles were retrieved and 12 were finally included. The Cochrane bias risk assessment criteria and Newcastle‑Ottawa scale were used for quality evaluation and Review Manager 5.4 was used for data analysis. The 3D cage group was superior to the PEEK cage group in terms of operative time [mean difference (MD): ‑7.68; 95% confidence interval (CI): ‑11.08, ‑4.29; P<0.00001], intraoperative blood loss (MD: ‑6.17; 95%CI: ‑10.56, ‑1.78; P=0.006), hospitalization time (MD: ‑0.57; 95%CI: ‑0.86, ‑0.28: P=0.0001), postoperative complications [odds ratio (OR): 0.35; 95%CI: 0.15, 0.80; P=0.01], C2‑7 Cobb angle (MD: 2.85; 95%CI: 1.45, 4.24; P<0.0001), intervertebral space height (MD: 1.20; 95%CI: 0.54, 1.87; P=0.0004), Japanese Orthopaedic Association Assessment of Treatment (MD: 0.69; 95%CI: 0.24, 1.15; P=0.003) and visual analogue scale score (MD: ‑0.43; 95%CI: ‑0.78, ‑0.07; P=0.02). The difference was statistically significant, while there was no significant difference between the two groups in terms of fusion rate (OR: 1.74; 95%CI: 0.71, 4.27; P=0.23). The use of 3D‑printed porous titanium interbody fusion cage in ACDF has the advantages of short operation time, less bleeding loss, shorter hospitalization time and fewer postoperative complications. It can better maintain the cervical curvature and intervertebral height, relieve pain and accelerate postoperative functional recovery.

The present study aimed to compare the differences between minimally invasive transforaminal lumbar fusion (MIS‑TLIF) and open transforaminal lumbar fusion (TLIF) for multi‑segmental lumbar degenerative disease regarding intraoperative indices and postoperative outcomes. PubMed, Web of Science, Embase, CNKI, Wanfang and VIP databases were searched for literature on MIS‑TLIF and open TLIF in treating multi‑segmental lumbar degenerative diseases. Of the 1,608 articles retrieved, 10 were included for final analysis. The Newcastle‑Ottawa Scale and Review Manager 5.4 were used for quality evaluation and data analysis, respectively. The MIS‑TLIF group was superior to the open TLIF group regarding intraoperative blood loss [95% confidence interval (CI): ‑254.33,‑157.86; P<0.00001], postoperative in‑bed time (95%CI: ‑3.49,‑2.76; P<0.00001), hospitalization time (95%CI: ‑5.14,‑1.78; P<0.0001) and postoperative leg pain Visual Analog Scale score (95%CI: ‑0.27,‑0.13; P<0.00001). The fluoroscopy frequency for MIS‑TLIF (95%CI: 2.07,6.12; P<0.0001) was significantly higher than that for open TLIF. The two groups had no significant differences in operation time, postoperative drainage volume, postoperative complications, fusion rate, or Oswestry Disability Index score. In treating multi‑segmental lumbar degenerative diseases, MIS‑TLIF has the advantages of less blood loss, shorter bedtime and hospitalization time and improved early postoperative efficacy; however, open TLIF has a lower fluoroscopy frequency.

Lumbar disc herniation (LDH) is a common cause of lower back and radicular pain. Unilateral biportal endoscopic discectomy (UBE) and percutaneous endoscopic interlaminar discectomy (PEID) are two prevalent minimally invasive techniques, yet their comparative efficacy and safety remain debated. Within the present meta‑analysis, the aim was to compare the efficacy and safety of UBE and PEID in treating LDH. A systematic literature search was conducted using Web of Science, PubMed, Embase and the Cochrane Library up to June 10, 2025, to identify comparative studies evaluating UBE and PEID for single‑level LDH. Extracted data included operative time, blood loss, fluoroscopy frequency, hospital stay, visual analog scale (VAS) score for back and leg pain, Oswestry Disability Index (ODI), MacNab excellent/good rate and complication rate. Study quality was assessed using the Newcastle‑Ottawa Scale. A total of ten studies involving 1,003 patients was included. PEID demonstrated advantages in operative time [mean difference (MD)=7.82 min; P=0.004], blood loss (MD=25.5 ml; P=0.01) and hospital stay (MD=0.56 days; P=0.007). UBE demonstrated ODI improvement at 1 (MD=‑0.93; P=0.01) and 6 months (MD=‑0.85; P=0.01). No significant differences were observed in VAS scores for back and leg pain, MacNab excellent/good rate, fluoroscopy frequency or complication rates. UBE demonstrated improved postoperative functional recovery, instrument maneuverability and visualization, whereas PEID offered shorter operative time, reduced blood loss and shorter hospital stays. The choice of surgical approach should consider these outcome trade‑offs along with patient characteristics and surgeon expertise.

Paget's disease of bone (PDB) is a non-inflammatory, metabolic skeletal disease. It is characterized by excessive bone resorption and irregular bone reconstruction. Its onset is often associated with both genetic and environmental factors. PDB is characterized by a very distinct geographical distribution, being more common in Western countries and rarer in Asia. The most significant susceptibility gene at the moment is SQSTM1. The imbalance between osteoclasts and osteoblasts is the main mechanism of its pathogenesis. The pelvis, spine, skull, femur, and tibia are most commonly involved, with less involvement in the upper limbs, clavicle, ribs, and scapula. It is less common before the age of 40, is predominantly male, and has a positive correlation between age and incidence. Pain and bone deformities are common manifestations of PDB. The diagnosis of PDB depends on imaging and biochemical markers. For the detection of PDBs, radionuclide bone scan is a more accurate test. Bisphosphonates are currently the leading therapeutic agent, and it has been shown that intravenous zoledronate provides remission in most patients and can prevent disease progression. In recent years, the number of related cases in China has gradually increased. The article summarizes relevant literature and analyzes relevant progress in order to provide help in the diagnosis and treatment of PDB.

The present study is a retrospective analysis aimed at evaluating the early clinical efficacy and preliminary safety of full‑endoscopic transforaminal upper facet joint lumbar interbody fusion (TSAP‑LIF) in patients with lumbar degenerative diseases treated at the Department of Orthopaedics at Changzhi Yunfeng Hospital (Changzhi, China). The present study collected clinical follow‑up data and radiological images, which were accessed and collected between January 1, 2021 and December 31, 2022. All surgeries were performed by the same group of experienced surgeons to ensure consistency in surgical technique and its impact on patient outcomes. The study included patients' preoperative baseline characteristics, operative time, intraoperative blood loss, postoperative complications and follow‑up results (with a follow‑up period of 6 months). Clinical outcomes were assessed using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS), and radiological evaluations were conducted using postoperative X‑rays and computed tomography scans to determine the intervertebral fusion rate. Among the 9 patients, there were 4 men and 5 women, with an average age of 47.3±13.1 years (range, 23‑67 years). The average operation time was 113.3±13.9 min, and the average intraoperative blood loss was 101.6±13.8 ml. The postoperative complication rate was 0%. The average hospital stay was 12.7±3.2 days. The average VAS score improved from 7.7±1.4 preoperatively to 2.6±1.2 at 3 months postoperatively and to 1.2±1.1 at 6 months postoperatively. The average ODI score improved from 56.7±8.2 preoperatively to 22.7±5.6 at 1 month postoperatively and to 10.2±4.2 at 6 months postoperatively. Radiological examinations showed an intervertebral fusion rate of 88% at 6 months postoperatively. Retrospective analysis indicates that TSAP‑LIF is a safe and effective method for treating lumbar degenerative diseases. The clinical outcomes are significant, with reduced operation time, marked improvement in patient pain and function and a high intervertebral fusion rate. To further evaluate the clinical efficacy of this procedure, larger sample sizes and longer follow‑up periods are required.