This study aimed to compare the safety and effectiveness between unilateral biportal endoscopy (UBE) technique and microscopic decompression (MD) technique in lumbar spinal stenosis treatment. PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, and other databases were used to conduct extensive literature searches. RevMan ver. 5.3 software was used for the statistical analysis. Eleven studies were included with 930 patients, including 449 patients in the UBE group and 521 in the MD group. Both techniques revealed similar operative times at −1.77 minutes (95% confidence interval [CI], −7.59 to 4.05 minutes; p =0.55), the postoperative dural expansion area at −1.27 (95% CI, −19.30 to 16.77; p =0.89), the postoperative complications at 0.76 (95% CI, 0.47 to 1.22; p =0.26), the preoperative Visual Analog Scale (VAS) for leg pain, and the last follow-up (>12 months) VAS for leg pain at −0.04 (95% CI, −0.14 to 0.06; p =0.47), the preoperative Oswestry Disability Index (ODI), and the last follow-up (>12 months) ODI scores at −0.18 (95% CI, −0.76 to 0.40; p =0.54), and patient satisfaction (the modified MacNab score) at 1.15 (95% CI, 0.54 to 2.42; p =0.72). However, intraoperative bleeding was lower following the UBE technique at −52.78 mL (95% CI, −93.47 to −12.08 mL; p =0.01) and was shorter following the UBE technique at −3.06 (95% CI, −3.84 to −2.28; p <0.01). UBE and MD technology have no significant differences in efficacy or safety in the treatment of patients with lumbar spinal stenosis based on this meta-analysis. However, the UBE technique has less intraoperative bleeding and a shorter hospital stay. It has a slight advantage and is a better surgical option than the MD technique. It can be an alternative minimally invasive spinal surgery method.

This study investigated the effects of plasticizers (phthalates) on the pathogenesis of osteoporosis (OP) and the associated molecular mechanisms, especially the interaction of plasticizers with key pathways. We performed differential expression analysis of different datasets by machine learning to identify target genes associated with OP. And, we also investigated the binding of plasticizers to target proteins using network toxicology and molecular docking techniques. A total of 29 genes are potential targets associated with plasticizer-induced OP. Subsequently, machine learning analysis identified six core target genes as key genes for plasticizer-induced OP. Among them, the up-regulated genes were CKM and SOAT2, and the down-regulated genes were TACR3, SGK1, ERAP2, and MMP12 (P＜0.05). Molecular docking revealed the specific binding effect between plasticizers and target proteins. This study demonstrates that plasticizers may influence the pathogenesis of OP by targeting specific genes and pathways. And the molecular docking simulations indicate a distinct binding specificity between plasticizers and target proteins. These results provide a foundation for further investigation into the mechanisms by which plasticizers affect bone health. Future research should focus on the dose-response relationship between plasticizer exposure and the risk of OP, and explore potential intervention measures to mitigate the adverse effects of plasticizers on bone health.

Objective: To investigate the clinical efficacy of medical ozone injections into the intervertebral disc on relieving lumbosacral pain. through a systematic review and meta-analysis. Methods: A comprehensive literature search was conducted in PubMed, Cochrane Library, and Web of Science for English-language randomized controlled trials (RCTs) published between January 2010 and January 2025. The study was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42023417837). Primary clinical outcomes included pain reduction assessed by Visual Analog Scale (VAS) scores and functional improvement assessed by the Oswestry Disability Index (ODI). Statistical analyses were performed using Review Manager 5.4. Results: Eight RCTs involving 1,744 patients were included. Among them, 903 people received medical ozone injections into the intervertebral discs, while 841 people received other forms of treatment. Meta-analysis showed that medical ozone injections significantly reduced VAS scores (mean difference = −2.13, 95% CI: −2.33 to −1.93, p < 0.05) and improved ODI scores (mean difference = −0.79, 95% CI: −0.95 to −0.63, p < 0.05), indicating superior short-term efficacy compared to conventional treatments. Conclusions: Ozone injection into the intervertebral discs is an effective non-invasive treatment method, which can effectively relieve pain in the lumbar and sacral regions, especially showing significant effects in the short term. However, Further long-term studies are warranted to evaluate the durability of clinical benefits. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023417837 , PROSPERO CRD42023417837.

Objective: This study aims to investigate the predictive value of postoperative serum biomarkers for early surgical site infection (SSI) following single-level posterior lumbar interbody fusion (PLIF) in diabetic patients, and to construct an infection risk prediction model based on key indicators. The goal is to provide a theoretical basis and tool support for precise clinical prevention and control. Methods: A retrospective analysis was conducted on 1,680 diabetic patients who underwent single-level PLIF in our Hospital, from January 2011 to December 2024. Among these, 165 patients developed early SSI. Univariate analysis was performed using–Whitney U -test and the chi-square test. Subsequently, LASSO regression was employed for variable selection and dimensionality reduction, and independent risk factors were determined using multivariate logistic regression. Data were divided into training and validation sets in a 7:3 ratio, and a prediction model was constructed using 10-fold cross-validation. The model's predictive performance and clinical utility were comprehensively evaluated with calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Results: Univariate analysis revealed that patients in the infection group had significantly higher postoperative day 3 fasting blood glucose (FPG pod3: 17.18 vs. 14.13 mmol/L), C-reactive protein (CRP pod3: 281.70 vs. 111.17 mg/L), white blood cell count (WBC pod3: 41.28 vs. 16.90 × 10 ⁹ /L), and 4 other postoperative inflammatory markers compared to the non-infection group (all P < 0.001). Multivariate logistic regression further identified CRP pod3 (OR = 1.025, 95% CI: 1.01–1.04, P < 0.001), WBC pod3 (OR = 1.27, 95% CI: 1.17–1.43, P < 0.001), Erythrocyte Sedimentation Rate (ESR) pod3 (mm/h) (OR = 1.021, 95% CI: 1.01–1.04, P = 0.007), Procalcitonin (PCT) pod3 (ng/mL) (OR = 1.503, 95% CI: 1.24–11.95, P < 0.001), Neutrophil-to-Lymphocyte Ratio (NLR) pod3 (OR = .131, 95% CI: 1.07–1.23, P < 0.001), and Platelet-to-Lymphocyte Ratio (PLR) pod3 (OR = 1.012, 95% CI: 1.01–1.02, P < 0.001) as independent risk factors. The decision tree prediction model, constructed based on these variables, showed excellent discrimination ability with areas under the ROC curve (AUC) of 0.987 (95% CI: 0.972–1.000) for the training set and 0.990 (95% CI: 0.971–1.000) for the validation set. The calibration curve closely followed the ideal reference line, indicating good model fit. DCA demonstrated that the model had high clinical net benefit across all risk thresholds. Conclusion: Postoperative day 3 serum inflammatory markers (e.g., CRP, WBC) have high predictive value in identifying early SSI in diabetic patients undergoing single-level PLIF. The prediction model constructed based on these markers performs excellently in terms of accuracy, stability, and clinical utility, making it an effective tool for early identification of high-risk infection patients and providing scientific evidence for individualized postoperative management strategies and interventions.