Background: Patients suffering from degenerative scoliosis (DS) were commonly associated with coronal and sagittal imbalance which made deformity correction surgery necessary. The study aimed to explore the efficacy and feasibility of the limited correction of lumbar lordosis (LL) in the treatment of patients with DS. Methods: This was a retrospective study including 58 DS patients who underwent spinal deformity correction surgery and were followed up at least 2 years between January 2013 and January 2017. According to the difference of postoperative LL, the patients were divided into 2 groups: the limited correction group: Pelvic incidence(PI)–18°≤ LL<PI–9° and the control group: PI–9°≤ LL .05). In terms of surgery, the limited group had less intra-operative blood loss and operation time (P < .05). At the last follow-up, significant differences were found in terms of LL(−38.2 ± 4.7° and -46.9 ± 4.7°), PT (18.8 ± 5.2° and 11.1 ± 3.6°), sacrum slope (33.7 ± 7.0° and 41.4 ± 6.1°) (P < .05), while there were no significant differences in terms of lumbar Cobb angle (10.5 ± 9.3°and 8.3 ± 6.7°), Oswestry Disability Index scores (25.6 ± 10.2 and 26.4 ± 12.1), and JOA scores (23.6 ± 5.2 and 22.3 ± 5.7) (P > .05). Conclusion: Limited correction of LL in the treatment of DS patients can achieve favorable clinical outcomes including effective Cobb angle correction with less blood loss and operative time.

Study design: A retrospective analysis was conducted to analyze the position of the aorta by MRI in patients with adult degenerative scoliosis. Objective: This study aimed to investigate the relative anatomic positions of the aorta and spine in patients with adult degenerative scoliosis (ADS). Summary of background data: Aorta injury is a rare complication of spinal surgeries. However, there would be a disastrous consequence once it happened. Therefore, knowing about the position of aorta is of great importance. Methods: A retrospective analysis was performed in 90 patients with ADS and 132 participants without spine deformity. ADS patients were divided into several groups such as left scoliosis, left scoliosis with thoracolumbar kyphosis, right scoliosis, and right scoliosis with thoracolumbar kyphosis. The aorta-vertebrae angle (α) and aorta-vertebrae distance (d) in each level of T12–L4 were measured by using a Cartesian coordinate system. t test of independent samples was performed, α and d were compared, and Pearson correlation analysis was employed for α, d, and X-ray radiographic measurements. Result: The changes of α were not statistically significant (P > 0.05) in LS and LKS groups but d (P < 0.05) was longer in LKS group compared with the control group. In the right malformed group, there was no significant change in the angle (P > 0.05) in the abdominal aorta but longer d (P < 0.05) than the normal group. There was longer d in the RKS group compared with the RS group (P < 0.05). Pearson correlation analysis showed that there was a positive correlation between d and TLK (r = 0.439, P < 0.05). Conclusion: In patients with ADS, a relative normal position is maintained between the aorta and vertebrae. While the aorta is slightly away from the left pedicle in RS patients and farther away in patients with kyphosis, the angle of kyphosis would become bigger and d becomes longer. Therefore, the surgeons should be aware of the changes of the aorta position to avoid the disastrous vessel injuries.

Assessing the invasiveness of thyroid nodules, particularly whether they have metastasized to lymph nodes, is crucial for guiding treatment decisions. Current diagnostic methods, including ultrasound imaging, are limited by operator dependence and interpretative variability, complicating accurate evaluation of nodule invasiveness. To address these limitations, this study introduces the UTV-ST Swin Transformer, a deep learning model that combines ultrasound video data with standardized clinical information to predict the invasiveness of thyroid nodules. The model classifies nodules into three categories: non-invasive, central lymph node metastasis (CLNM), and central plus lateral lymph node metastasis (CLNM+LLNM). By analyzing ultrasound video features using the Video Swin Transformer and clinical data using a text analysis module based on the KAN network, and then fusing these features, the model achieves a classification accuracy of 82.1% and an average AUC of 94.2%. These results surpass the performance of traditional methods, particularly in distinguishing different degrees of invasiveness, even under noisy conditions. This study highlights the potential of the UTV-ST Swin Transformer model in improving the accuracy of thyroid nodule assessment, reducing reliance on operator expertise, and providing a more consistent and automated method for evaluating nodule invasiveness.

To decrease postoperative complications in patients with adult lumbar degenerative scoliosis (ALDS), short-segment fusion surgery was used in this study. However, the incidence of adjacent segment disease was found to be remarkable. Therefore, we applied the hybrid treatment (short-segment fusion for responsibility levels plus nonfusion stabilization of lumbar segments, which was called the Wallis system, for the proximal level) to patients enrolled into this study. The purpose of this study was to investigate the feasibility of a novel hybrid therapeutic approach for treating patients with ALDS. From January 2011 to January 2017, a retrospective study was conducted consisting of 16 patients with ALDS who were treated with hybrid treatment. All patients were treated with short-segment decompression and fusion for responsibility levels and nonfusion stabilization of lumbar segments for the proximal levels. The imaging outcomes were evaluated preoperatively and at the time of follow-up. The mean visual analog score for back pain decreased from 6.1 +/- 2.0 preoperatively to 2.1 +/- 0.7 at 2-year follow-up (P < .05), and the mean visual analog score for leg pain reduced from 8.1 +/- 0.6 preoperatively to 1.3 +/- 0.8 at 2-year follow-up (P < .05). The Oswestry disability index scores improved from 65.4 +/- 16.3% preoperatively to 18.3 +/- 5.6% at 2-year follow-up (P < .05). The mean Cobb angle was 22.1 +/- 6.2 degrees preoperatively, and 13.8 +/- 6.8 degrees at 2-year follow-up (P < .05). The lumbar lordosis changed from -40.4 +/- 14.8 degrees to -43.5 +/- 11.2 degrees at 2-year follow-up (P < .05). Solid fusion was achieved in all the patients, and no incidence of adjacent segment disease was noted as well. The proposed hybrid treatment for patients with ALDS can achieve favorable clinical outcomes and a lower incidence of ALDS. However, the correction of deformity is still limited that highlights the necessity of further study.