Lumbar discectomy is a common and effective treatment for symptomatic disk herniation. It has been suggested that lumbar discectomy in older patients may result in poorer clinical outcomes and lesser satisfaction. The purpose of this study was to assess age-related difference in patient reported outcomes of patients undergoing lumbar discectomy for chronic low back and radicular pain. Patients with chronic lumbar radiculopathy without neurological deficit underwent non-urgent single level lumbar discectomy in our institution between 2014 and 2017. Pain level (using VAS score), Oswestry Disability Index, and SF-12 scores were retrospectively reviewed and compared between younger patients (60 years, group 2). Seventy-three patients, aged between 34–76 years participated in this study. VAS, ODI, and SF-12 scores improved significantly after the surgery for each group (P < .01). When comparing between the groups, no significant differences in the outcomes measured were found after the surgery in both early post-operative follow-up and late post-operative follow-up (P > .05). Elderly patients undergoing lumbar discectomy report a significant reduction in VAS, ODI, and SF-12 scores justifying the procedure. Lumbar discectomy improved function and decreased pain level to similar extent in both younger and older patients suffering from radicular symptoms related to lumbar disc herniation.

Background: Disc herniation following decompression of lumbar spinal stenosis is a less familiar surgical complication. Previous studies suggested that open lumbar decompression techniques, associated with relative segmental instability especially in the presence of degenerated disc in older patients, are more likely to result in disc herniation compared to minimally invasive techniques. The current study compares the incidence of acute disc herniation following mini-open and minimally invasive decompression of lumbar spinal stenosis. Methods: This was a retrospective study reviewing 563 patients who underwent spinal decompression for symptomatic lumbar stenosis by mini-open bilateral partial laminectomy technique or minimally invasive laminotomy utilizing a tubular system. Demographic and clinical data were collected and compared between the groups. Results: Postoperative disc herniation rate was significantly lower in the minimally invasive group with 2 of 237 cases (0.8%) versus 19 of 326 cases (5.8%) in the mini-open group (p = 0.002). This finding was more noticeable following multi-level procedures with no case of postdecompression disc herniation in the minimally invasive group compared to 8 of 39 cases (20.5%) in the mini-open group (p = 0.003). Conclusion: The incidence of postoperative disc herniation following spinal decompression for symptomatic lumbar stenosis was 5.8% following mini-open bilateral partial laminectomy compared to only 0.8% after minimally invasive laminotomy (p = 0.002). These findings highlight the more extensive nature of mini-open surgery associated with relative segmental instability that poses a greater risk for postoperative disc herniation.

Motivation: Differential network analysis, designed to highlight interaction changes between conditions, is an important paradigm in network biology. However, network analysis methods have been typically designed to compare between few conditions, were rarely applied to protein interaction networks (interactomes). Moreover, large-scale benchmarks for their evaluation have been lacking. Results: Here, we assess five network analysis methods by applying them to 34 human tissues interactomes. For this, we created a manually-curated benchmark of 6,499 tissue-specific, gene ontology biological processes, and analyzed the ability of each method to expose these tissue-process associations. The four differential network analysis methods outperformed the non-differential, expression-based method (AUCs of 0.82-0.9 versus 0.69, respectively). We then created another benchmark, of 1,527 tissue-specific disease cases, and analyzed the ability of differential network analysis methods to highlight additional disease-related genes. Compared to a non-differential subnetworks surrounding a known disease-causing gene, the extremely-differential subnetwork (top 1%) was significantly enriched for additional disease-causing genes in 18.6% of the cases (p≤10e-3). In 5/10 tissues tested, including Muscle, nerve and heart tissues (p = 2.54E-05, 2.71E-04, 3.63E-19), such enrichments were highly significant. Summary: Altogether, our study demonstrates that differential network analysis of human tissue interactomes is a powerful tool for highlighting processes and genes with tissue-selective functionality and clinical impact. Moreover, it offers expansive manually-curated datasets of tissue-selective processes and diseases that could serve for benchmark and for analyses in many other studies. Contact: estiyl@bgu.ac.il

Background: Opioid dependence is prevalent among patients undergoing lumbar spinal fusion and has been linked to poor postoperative outcomes. However, its specific impact on surgical complications and hospital resource utilization remains unclear. This study evaluates the association between opioid dependence and postoperative complications, length of stay (LOS), and hospital charges in lumbar fusion patients. Methods: A retrospective analysis was conducted using the National Inpatient Sample (NIS) database from 2016 to 2021. Adult patients (aged > 18 years) who underwent lumbar fusion surgery were identified and categorized based on opioid dependence using ICD-10 codes. Propensity score weighting (PSW) was employed to balance baseline characteristics. Primary outcomes included inpatient mortality, LOS, hospital charges, and postoperative complications. Statistical analyses were performed using survey-weighted generalized linear models. Results: Among 597,455 lumbar fusion patients, 7715 (1.3%) had documented opioid dependence. After PSW, opioid-dependent patients had significantly increased odds of blood loss anemia (OR 1.79, p < 0.001), respiratory complications (OR 2.17, p < 0.001), surgical site infections (OR 3.94, p = 0.001), and cardiac complications (OR 1.53, p = 0.002). They also had higher hospital charges (mean difference USD 17,739.2, p < 0.001) and prolonged LOS (mean difference 0.83 days, p < 0.001). Differences in urinary tract infections, acute renal failure, and stroke were not statistically significant after PSW. Conclusions: Opioid dependence is associated with increased postoperative complications, longer hospital stays, and higher healthcare costs in lumbar fusion patients. These findings highlight the need for improved perioperative pain management and opioid stewardship strategies to optimize surgical outcomes.

Background: Chronic wrist pain is becoming increasingly recognized among athletes engaging in wrist-loading activities such as handstands. However, its prevalence and associated risk factors in handstand practitioners have not been systematically studied. This study aimed to investigate the prevalence of chronic wrist pain and to explore associated factors such as discipline, training habits, and pain management strategies. Methods: This cross-sectional study aimed to investigate the prevalence and associated factors of chronic wrist pain among handstand practitioners. Eligible participants were individuals aged 18 years or older, of any gender, who practiced handstands regularly (defined as at least once per week). Participants were recruited via a combination of open invitations on social media (Facebook, WhatsApp, Instagram) and direct outreach to movement studios and training communities. The survey was administered online using Google Forms and remained open for two months. Participation was voluntary and anonymous. Descriptive statistics were used to present sociodemographic characteristics, including age group, gender, sport discipline, and weekly training hours. Participants reported training habits, equipment use, pain history, and management strategies via a self-developed questionnaire designed for this study. Chronic pain was defined as recurring or persistent wrist pain. Descriptive statistics were used to summarize responses. Associations between chronic wrist pain and survey variables were analyzed using Chi-square or Fisher’s exact tests for nominal data, and Chi-square test for trend for ordinal data. A p-value < 0.05 was considered statistically significant. Results: A total of 321 participants were included in the study. The most represented age group was 25–34 years, comprising 123 (38.3%) of the participants. Gender distribution was 174 (54.2%) males and 147 (45.8%) females. The most common sport disciplines were Yoga (88, 27.4%), Capoeira (60, 18.7%), and Movement (52, 16.2%). Chronic wrist pain was reported by 182 (56.7%) of participants. Younger age was significantly associated with higher pain prevalence (p = 0.042). No significant associations were observed between chronic pain and weekly training hours, warm-up routines, brace use, or grip device use. Female participants demonstrated more proactive pain management behaviors (p = 0.016). Sport discipline and training practices showed non-significant trends toward pain differences. Conclusions: Chronic wrist pain is common among handstand practitioners, particularly among younger athletes. These findings suggest that injury risk may relate more to training intensity and biomechanics than to simple training volume. Further research incorporating objective diagnostics and standardized intervention protocols is warranted.