Background: There are few effective conservative therapies for acute lumbar disc herniation (LDH), and the choice of nonsteroidal anti-inflammatory drugs is not recommended for all patients. The purpose of this study was to compare the effect of Yaobitong capsule with celecoxib capsule, and to further confirm the safety and efficacy of Yaobitong capsule. Methods: This study is a large sample multicenter randomized controlled trial. Eight hospitals served as sub centers to recruit patients. A total of 258 patients are divided into Yaobitong group and celecoxib group according to the ratio of 1:1. Celecoxib or Yaobitong capsule was taken orally for 14 days. Patients will complete the trial after 3 months of follow-up, and independent statisticians who are blinded to random assignment will analyze the data using SAS 9.3 software. The primary outcome was the visual analogue scale (VAS) score after 14 days of treatment, and Japanese Orthopaedic Association (JOA), Oswestry Disability Index (ODI), and SF-12 will be regarded as secondary outcomes. Safety indexes will be recorded before and after treatment, and adverse events (AEs) will be recorded throughout this trial. Discussion: This study will evaluate the efficacy and safety of Yaobitong capsule in treating LDH. The experimental results will provide evidence support to treat LDH with Yaobitong capsule.

Purpose: This study, aimed to report the rates and trends of the prevalence, incidence, and years lived with disability caused by neck pain in the general population of China from 1990 to 2021 and forecast the incidence, prevalence, and disability-adjusted life Years (DALYs) from 2022 to 2042. Methods: We used data from the Global Burden of Diseases Study (GBD) 2021. The annual percentage change (APC) and average APC between 1990 and 2021 were calculated using joinpoint regression analysis. An autoregressive integrated moving average (ARIMA) model was used to forecast the incidence, prevalence, and DALYs rates between 2022 and 2042. Results: From 1990 to 2021, the disease burden of neck pain in China showed a clear upward trend, with age-standardised incidence rate (ASIR), age-standardised prevalence rate (ASPR), and DALYs rates being significantly higher in females than in males. Especially in terms of DALYs, Aging has had the largest impact, contributing 61.88% of the increase, while population growth has accounted for 32.43%. Joinpoint regression analysis showed that the incidence and prevalence of neck pain in China increased gradually from 2000 to 2021. Data from 2021 showed that individuals aged 45– 59 years are the most affected by neck pain, regardless of sex. The prediction results of the ARIMA model indicate that China’s ASIR and ASPR for neck pain are projected to continue increasing over the next 20 years. Conclusion: Neck pain is a serious public health problem in the general Chinese population. This may be related to changes in people’s lifestyles and work patterns due to improvements in societal well-being and technology. Raising awareness of the risk factors for neck pain in the general population could help reduce the future burden of neck disorders, and neck pain should be a priority for future research on prevention and therapy.

C5 nerve root palsy is the most common complication following posterior cervical spinal canal expansion and reconstruction, significantly impacting patients’ quality of life. Although several systematic reviews and meta-analyses have explored the risk factors of C5 nerve root palsy, inconsistencies remain in key conclusions such as the role of age and C4-5 intervertebral foramen stenosis, and new clinical evidence published in recent years has not been integrated. This meta-analysis aims to evaluate the incidence and risk factors of C5 nerve root palsy after posterior cervical spinal canal expansion and reconstruction, providing a more precise and generalizable basis for clinical screening of high-risk patients and formulation of preventive interventions. Case-control trials on C5 nerve root palsy following posterior cervical spinal canal expansion and reconstruction were retrieved from PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases. The search period spanned from each database’s inception to November 2025. Search strategies were tailored to each database’s characteristics. We extracted the basic characteristics of included studies, the incidence of C5 nerve root palsy symptoms, and associated risk factors. Included studies underwent risk of bias assessment and quality evaluation. Meta-analysis was performed using Stata 18.0 to assess the incidence and risk factors of C5 nerve root palsy symptoms. (1) Seventeen studies were included, involving a total sample size of 2,995 cases. The incidence of axial symptoms was 14% (95%CI: 0.10, 0.17), with 15 studies meeting higher quality standards; (2) Meta-analysis results indicated that advanced age (OR = 2.71, 95%CI: 1.53 ~ 3.88)、male gender (OR = 0.36, 95%CI: 0.03 ~ 0.68)、narrowing of the C4-5 intervertebral foramen width (OR=-0.61, 95%CI: -0.84 ~ 0.38)、changes in cervical curvature (OR = 2.88, 95%CI: 1.90 ~ 3.86)、increased spinal cord retraction distance (OR = 0.72, 95%CI: 0.57 ~ 0.87) and high signal intensity on T2-weighted MRI at the C4-5 spinal cord segment (OR = 0.93, 95%CI: 0.16 ~ 1.69) were identified as independent risk factors for C5 nerve root paralysis symptoms. Advanced age, male gender, narrowing of the C4-5 intervertebral foramen width, changes in cervical curvature, increased spinal cord retraction distance, and high signal intensity on T2-weighted MRI at the C4-5 spinal cord segment are independent risk factors for C5 nerve root palsy symptoms. Patients with these high-risk factors require close follow-up and timely intervention to reduce the incidence of C5 nerve root palsy symptoms and improve their quality of life.

This study investigated the association between dietary magnesium intake and all‑cause and cause‑specific mortality among individuals with chronic neck pain (CNP). We enrolled 2955 CNP patients aged ≥20 years from the 1999–2020 NHANES database and used Cox regression, subgroup analysis, and Mendelian randomization‑based mediation analysis to explore relevant associations and mechanisms. During follow‑up, 719 all‑cause deaths, 180 cardiovascular disease (CVD) deaths, and 179 cancer deaths occurred. Multivariable‑adjusted analyses showed that higher dietary magnesium intake was significantly associated with reduced CVD mortality, with each 1 g/day increment linked to a 78% lower risk. A non‑linear association with a threshold of 0.5181 g/day was found for cancer mortality, above which mortality risk dropped significantly. Subgroup analyses confirmed result robustness. Mediation analysis revealed that magnesium lowered all‑cause and CVD mortality directly and indirectly by reducing C‑reactive protein (CRP) levels. These findings indicate that higher dietary magnesium intake predicts lower mortality risk in CNP patients, partly via CRP‑mediated anti‑inflammatory pathways, supporting dietary magnesium optimization from whole‑food sources to improve long‑term prognosis.