Posterior lumbar spinal fusion has been widely used in degenerative lumbar stenosis, but adjacent segment degeneration (ASD) was common. Researchers have found many risk factors for ASD after one or two levels of surgery, but few clinical studies focused on multi-level surgery. The purpose of this study was to clarify risk factors for upper ASD after multi-level posterior lumbar spinal fusion. A retrospective study was performed on the clinical data of 71 patients with degenerative lumbar stenosis who underwent multi-level (at least 3 levels) posterior lumbar spinal fusion from January 2013 to December 2016. Two groups were divided according to lamina and posterior ligamentous complex (PLC) maintenance of proximal fixed vertebrae in surgery. In the 22 patients of group A, the proximal fixed vertebral lamina and PLC were not resected, and in the 49 patients of group B, the proximal fixed vertebral lamina and PLC were resected completely. Age, sex, body mass index (BMI), number of fixed vertebrae and fused levels, spinopelvic parameters, coronal Cobb angle, and modified Pfirrmann grading system were measured for each patient. A Cox proportional hazards model was used to analyze risk factors for upper ASD. No symptomatic ASD was found during the follow-up period. Patients who underwent proximal fixed vertebral lamina and PLC resection had a significantly higher percentage of radiographic ASD (P = 0.042). The Cox proportional hazards model showed that age, sex, BMI, preoperative lumbar lordosis, sacral slope, pelvic tilt, coronal Cobb angle, number of fixed vertebrae, and interbody fusion levels had no significant differences for radiographic ASD. But a preoperative modified Pfirrmann grade higher than 3, a high degree of preoperative pelvic incidence, and more decompressed levels had statistical significance (P = 0.024, 0.041, and 0.008, respectively). A preoperative modified Pfirrmann grade higher than 3, a high degree of preoperative pelvic incidence, and more decompressed levels might be risk factors for upper radiographic ASD after multi-level posterior lumbar spinal fusion surgery.

Thyroid cancer affects 1.3 percent of the population, with rates of occurrence rising in recent years (approximately 2 percent per year). Thyroid cancer is a common endocrine cancer with an annual increase in occurrence. Although the general prognosis for differentiated subtypes is favorable, the rate of mortality linked with thyroid cancer has been steadily progressing. The presence of suspicious thyroid nodules necessitates more diagnostic testing, including laboratory evaluation, additional imaging, and biopsy. For clinical staging and appropriate patient therapy design, accurate diagnosis is necessary. In this paper, we examined the application value of ultrasound imaging diagnosis in the clinical staging of thyroid tumor in this research. The benefit of early diagnosis is determined in this article using ultrasonography reports from Chinese patients. Images of benign and malignant thyroid nodules were collected and annotated in this work, and deep learning-based image recognition and diagnostic system was built utilizing the adaptive wavelet transform-based AdaBoost algorithm (AWT-AA). The system’s efficacy in diagnosing thyroid nodules was assessed, and the use of ultrasound imaging in clinical practice was studied. The variables that had a significant impact on malignant nodules were studied using logistic multiple regression analysis. The sensitivity and specificity of ultrasonography thyroid imaging reporting and data system (TI-RADS) categorization outcomes for benign and malignant tumors were also calculated.

Lumbar disc herniation (LDH) is a prevalent spinal disorder affecting 20–40% of the population. This study compared the clinical efficacy of two minimally invasive techniques, one-hole split endoscopy (OSE) and unilateral biportal endoscopy (UBE), for treating single-level LDH. A retrospective analysis of 217 patients (OSE: 118; UBE: 99) treated between April 2021 and January 2025 demonstrated that while both techniques were effective, OSE offered several advantages. Incision lengths were shorter in the OSE group (2.20 ± 0.33 cm vs. 2.91 ± 0.33 cm; p < 0.001), and fewer intraoperative fluoroscopy sessions were required (2.05 ± 0.21 vs. 2.59 ± 0.59; p < 0.001). Postoperative assessments revealed lower Oswestry Disability Index(ODI) scores (19.40 ± 2.81 vs. 20.87 ± 2.88; p = 0.003) and reduced visual analog scale(VAS) scores for low back pain (1.87 ± 0.68 vs. 2.24 ± 0.58; p = 0.002) in the OSE group at 7 days. The cross-sectional area of the multifidus muscle decreased less in OSE (104.71 ± 36.10) compared to UBE (268.85 ± 40.00; p < 0.001). Complication rates were similar, with no major adverse events such as infections or nerve injuries. The minimally invasive nature of OSE may contribute to improved patient outcomes and satisfaction. Further large-scale, long-term studies are warranted to validate these findings and assess the long-term efficacy of OSE in spinal surgery. Clinical trial number: Not applicable.