Osteoporotic vertebral compression fractures (OVCF) are a common complication of osteoporosis, particularly in elderly populations. Percutaneous kyphoplasty (PKP) is a minimally invasive procedure that provides pain relief and spinal stability for patients with OVCF. However, new vertebral compression fractures (NVCF) can occur in 2% to 38% of patients following PKP, posing a significant clinical challenge. Identifying risk factors for NVCF is essential to improve patient outcomes and guide preventive strategies. A retrospective study was conducted on 193 patients aged 60 years or older who underwent PKP for OVCF at a tertiary hospital between January 2017 and December 2023. Patients were divided into 2 groups based on the occurrence of NVCF during follow-up. Preoperative imaging (CT, X-ray, and MRI) and hospital records were analyzed to assess risk factors, including age, gender, bone mineral density, Hounsfield unit (HU) values, paraspinal muscle degeneration, cement volume, and leakage. Statistical analyses were performed using SPSS software, with multivariate regression analysis identifying independent predictors of NVCF. Among the 193 patients, 23.3% (n = 45) developed NVCF during follow-up, while 76.7% (n = 148) did not. Lower HU values (mean 58.1 ± 18.68 vs 79.5 ± 25.44, P = .0001) and increased fatty infiltration of paraspinal muscles were identified as significant independent risk factors for NVCF. Multivariate regression analysis confirmed lower HU values (OR = 0.965, P < .001) and fatty infiltration of the erector spinae muscle (OR = 1.034, P = .038) as predictors. Other factors, such as age, gender, bone mineral density, cement volume, and leakage, were not significantly associated with NVCF. Lower HU values and paraspinal muscle degeneration, particularly reduced functional muscle mass and increased fatty infiltration, are significant predictors of NVCF following PKP. Preoperative evaluations should include HU measurements and paraspinal muscle assessments to identify high-risk patients. Postoperative management should focus on improving bone density and muscle health through targeted therapies and lifestyle modifications to reduce fracture risk.

Background/Objectives: Spontaneous intracranial hemorrhage (sICH) is a life-threatening condition with high in-hospital mortality rates. Prognostic evaluation remains challenging, and biomarkers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), glucose-to-lymphocyte ratio (GLR), and high-sensitivity troponin-I (hs-cTn-I) have been studied for their potential prognostic significance. This study aimed to evaluate the role of hs-cTn-I, NLR, PLR, LMR, and hematoma volume in predicting prognosis in sICH patients. Methods: This retrospective study included 49 adult patients (>18 years) admitted between January 2021 and January 2024 with sICH and hematoma volume >30 mL. All patients underwent surgery within 24 h of admission. Laboratory data, including hs-cTn-I levels and hematological indices, were collected. The hematoma volume was measured using the ABC/2 method. Patients were divided into survival and mortality groups. Statistical analyses were performed using SPSS, with p < 0.05 considered significant. Results: Of the 49 patients, 24 (49%) died. Admission hs-cTn-I levels showed no significant difference between groups, but levels on days 7 and 30 were significantly higher in the mortality group (p < 0.001). ROC analysis revealed hs-cTn-I levels on day 30 had better prognostic performance (AUC: 0.89, cut-off: 46 ng/mL, sensitivity: 76%, specificity: 88%). The hematoma volume and admission hematological indices (NLR, PLR, LMR, SII, and GLR) were not significantly associated with prognosis. Conclusions: Elevated hs-cTn-I levels, particularly on days 7 and 30, were significant predictors of in-hospital mortality in sICH patients. While admission hematological indices and hematoma volume lacked prognostic value, hs-cTn-I may serve as a valuable biomarker for risk stratification in clinical practice. Further multicenter studies with larger cohorts and multivariate analyses are needed to validate these findings.

Objective: To compare tumor growth rate between patients with pituitary microadenomas who had mild to moderate prolactin elevation and symptoms leading to initiation of cabergoline therapy, and asymptomatic microadenomas without prolactin elevation managed with observation. Materials and Methods: In this retrospective cohort study, 139 patients diagnosed with pituitary microadenoma between 2019 and 2024 and with at least 12 months of clinical and radiological follow-up were included. Patients who received cabergoline therapy due to symptoms were classified as the dopamine agonist-positive [DA(+)] group, while those who did not receive treatment were classified as the dopamine agonist-negative [DA(−)] group. Tumor growth rate was calculated as the annual change (mm/year) in maximum tumor diameter on serial magnetic resonance imaging. Between-group comparisons were performed using the Mann–Whitney U test. A mixed-effects linear model was constructed to evaluate the interaction between time and treatment. Results: Of the 139 patients included in the study, 42 were in the DA(+) group and 97 were in the DA(−) group. There were no significant differences between the groups in terms of baseline age, follow-up duration, or tumor size (p > 0.05). The mean tumor growth rate was 0.67 ± 0.80 mm/year in the DA(−) group and 0.36 ± 0.38 mm/year in the DA(+) group (p = 0.0208). In the mixed-effects model analysis, the time × treatment interaction was statistically significant (β = −0.021 mm/month; p = 0.009). Patients receiving cabergoline showed a marked reduction in prolactin levels and improvement in symptoms in 78% of cases. Importantly, no tumor shrinkage was observed in either group; the primary observed effect was a reduction in growth velocity rather than true tumor regression. No serious treatment-related adverse effects were observed. Conclusions: In patients with pituitary microadenomas, cabergoline therapy was associated with a reduced tumor growth rate over time, while no true tumor regression was observed. These findings suggest that cabergoline exposure may influence longitudinal tumor growth dynamics in clinically ambiguous cases encountered in routine practice, without implying definitive tumor subtype classification.

Background/Objectives: Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) can produce comparable short-term clinical outcomes, but their regional effects on cervical muscle morphology are incompletely characterized. This study compared 12-month clinical outcomes and quantitative magnetic resonance imaging (MRI) changes after single-level C6–7 ACDF and CDA. Methods: This retrospective longitudinal cohort included 100 age-, sex-, and body mass index-matched patients (50 ACDF and 50 CDA). Neck and arm pain were assessed on 0–10 scales, and the Neck Disability Index (NDI) was analyzed as a 0–50-point score. Regional muscle cross-sectional area (CSA) and fatty infiltration (FI) were quantified on standardized preoperative and 12-month axial T2-weighted turbo spin-echo images at C6–7. The primary analysis included four posterior muscles. CSA change was expressed relative to baseline, whereas FI change was expressed in percentage points. Results: Clinical outcomes were statistically indistinguishable at 12 months (neck-pain score, 0.50 vs. 0.36, p = 0.318; NDI, 2.6 vs. 2.2 points, p = 0.479; perfect-outcome rate, 68.0% in both groups). Both groups showed significant regional posterior muscle CSA reduction and FI increase; however, the magnitude was greater after ACDF than after CDA (CSA reduction, −15% to −19% vs. −5% to −9%; absolute FI increase, +5.1 to +8.2 vs. +1.1 to +2.3 percentage points; all between-group q < 0.001). Surgical technique was independently associated with both MRI change metrics. Greater regional CSA reduction was modestly associated with higher concurrent 12-month neck-pain scores (β = −0.26, p = 0.022). This concurrent association does not establish causation or predict outcomes beyond 12 months. Conclusions: ACDF and CDA produced equivalent measured clinical outcomes at 12 months, while CDA showed a more favorable regional posterior muscle MRI profile. Differential device-related artifact was not quantitatively assessed and cannot be completely excluded, although concordant findings across four implant-remote posterior muscles make artifact unlikely to be the sole explanation. The functional and longer-term clinical significance of this imaging difference is not established and requires prospective longitudinal study.

Aim: The relationship between lumbar intervertebral disc degeneration and paraspinal muscle degeneration remains controversial. Although previous studies have reported associations between disc degeneration and muscle atrophy and fatty infiltration, the effect of age on this relationship has not been sufficiently clarified. This study aimed to investigate the associations that cumulative and L4–L5 level-specific disc degeneration have with paraspinal muscle morphology, and to determine whether these associations persisted after adjustment for age. Materials and Methods: This retrospective cross-sectional study included 84 patients who underwent lumbar magnetic resonance imaging (MRI) for low back pain. Disc degeneration was evaluated at all lumbar levels according to the Pfirrmann classification, and the Total Pfirrmann Score was calculated. Relative functional cross-sectional area (rFCSA) and fatty infiltration (FI) measurements of the multifidus, erector spinae, and psoas muscles at the L4–L5 level were performed using ImageJ software. The relationships between variables were examined using Spearman correlation analysis. Multiple linear regression analysis was performed to investigate independent predictors. Age-controlled partial correlation analyses were also performed to evaluate the potential confounding effect of age. Results: Of the 84 patients included in the study, 48 (57.1%) were female and 36 (42.9%) were male, with a mean age of 42.3 ± 8.4 years. The mean Total Pfirrmann Score was 14.3 ± 3.8. A moderate positive correlation was found between age and the Total Pfirrmann Score (rho = 0.519; p < 0.001). Significant positive correlations were observed between the Total Pfirrmann Score and multifidus fatty infiltration (rho = 0.316; p = 0.003) and erector spinae fatty infiltration (rho = 0.300; p = 0.006). A weak negative correlation was detected between psoas rFCSA and the Total Pfirrmann Score (rho = −0.247; p = 0.023). Multifidus and erector spinae rFCSA were not significantly associated with the Total Pfirrmann Score (p = 0.094 and p = 0.095, respectively). At the L4–L5 level, higher Pfirrmann grade was associated with lower multifidus rFCSA (rho = −0.233; p = 0.033) and lower psoas rFCSA (rho = −0.319; p = 0.003), whereas the inverse association with erector spinae rFCSA was borderline (rho = −0.215; p = 0.050). Multiple linear regression analysis showed that age was the only statistically significant predictor of the Total Pfirrmann Score in the multivariable model (p < 0.001). After adjustment for age, the associations of multifidus FI (r = 0.193; p = 0.079) and erector spinae FI (r = 0.194; p = 0.078) with the Total Pfirrmann Score did not reach statistical significance. In the age-adjusted L4–L5 analysis, only the inverse association between Pfirrmann grade and psoas rFCSA remained statistically significant (r = −0.232; p = 0.034). Conclusions: Greater cumulative lumbar disc degeneration was associated with increased fatty infiltration of the multifidus and erector spinae muscles and lower psoas rFCSA, whereas multifidus and erector spinae rFCSA were not associated with the Total Pfirrmann Score. At L4–L5, greater disc degeneration was associated with lower multifidus and psoas rFCSA, while the association with erector spinae rFCSA was borderline. After adjustment for age, the associations of multifidus and erector spinae fatty infiltration with cumulative disc degeneration were attenuated and did not reach statistical significance; however, a weak independent association cannot be excluded.