Background/Objectives: Osteoporosis is a systemic skeletal disorder characterized by reduced bone mass and microarchitectural deterioration, resulting in an increased risk of fragility fractures, particularly vertebral fractures. Genetic factors are considered important in osteoporotic fracture susceptibility, and polymorphisms of the vitamin D receptor (VDR) gene have been widely studied because of their role in bone metabolism. To evaluate the distribution of VDR gene polymorphisms (FokI, BsmI, ApaI, and TaqI) in patients with osteoporotic vertebral fractures and to assess their association with fracture susceptibility. Methods: This case–control study included 86 individuals: 43 patients who underwent vertebroplasty for osteoporotic vertebral fractures and 43 osteoporotic individuals without vertebral fractures serving as controls. VDR gene polymorphisms ApaI, TaqI, BsmI and FokI were analyzed using real-time polymerase chain reaction. Genotype distributions were compared using Fisher’s exact test, and Hardy–Weinberg equilibrium was evaluated. Results: A significant difference between groups was observed only for the ApaI polymorphism (p = 0.002). The GG genotype was more frequent in patients, whereas the variant genotypes (GT and TT) were more prevalent in controls. The GG genotype was associated with an increased risk of vertebral fractures, while the presence of variant genotypes may be associated with reduced fracture susceptibility. No significant associations were found for TaqI, BsmI, or FokI polymorphisms. Conclusions: The ApaI polymorphism of the VDR gene may represent a protective genetic factor against osteoporotic vertebral fractures. In contrast, no associations were identified for the TaqI, BsmI, or FokI polymorphisms in this cohort. Larger studies in diverse populations are required to confirm these findings and to clarify the role of VDR gene variants in fracture susceptibility.

Background and Objectives: Chronic spontaneous lumbar epidural hematoma (CSLEH) is a rare condition that may mimic a lumbar synovial cyst clinically and radiologically, making accurate preoperative diagnosis challenging. This study aimed to compare the clinical and magnetic resonance imaging (MRI) characteristics of CSLEHs and lumbar synovial cysts and to identify features that may facilitate their preoperative differentiation. Materials and Methods: This retrospective single-center study included 16 adult patients who underwent surgical decompression for symptomatic extradural lesions located between T12 and S1 and were ultimately diagnosed with either CSLEH or lumbar synovial cyst. Based on definitive intraoperative findings with histopathological confirmation when applicable, patients were classified into a CSLEH group (n = 6) or a lumbar synovial cyst group (n = 10). Demographic characteristics, clinical presentation, MRI findings, lesion localization, neurological deficits, pain severity assessed using the Visual Analog Scale (VAS), and postoperative outcomes were compared between the groups. Results: Patients with CSLEHs had a significantly shorter symptom duration (p = 0.001), more frequent anticoagulant use (p = 0.008), and a higher prevalence of motor weakness (p < 0.001) and sensory deficits (p = 0.001) than those with lumbar synovial cysts. Preoperative pain severity was significantly greater in the CSLEH group (p < 0.001). No significant differences were observed in MRI signal characteristics or lesion distribution between the groups. Surgical decompression was associated with marked postoperative pain improvement in both groups, with a greater reduction in VAS scores (ΔVAS) in the CSLEH group (p = 0.007). No postoperative complications were observed. Conclusions: CSLEH should be considered in the differential diagnosis of lumbar synovial cyst, particularly in patients with a relatively short symptom duration, anticoagulant use, and progressive neurological deficits. Although conventional MRI remains essential for preoperative evaluation, substantial overlap in MRI characteristics may limit reliable differentiation between these entities. Integration of clinical and radiological findings may improve preoperative diagnostic suspicion, while surgical exploration can provide both definitive diagnosis and effective neural decompression.

Background: Medulloblastoma is the most common malignant pediatric central nervous system tumor and exhibits marked molecular and clinical heterogeneity. Immune evasion pathways may contribute to tumor aggressiveness and represent potential prognostic and therapeutic targets. We investigated the clinicopathological and prognostic relevance of the immune checkpoint molecules B7-H3 (CD276) and CD47 in medulloblastoma. Methods: We screened 77 patients treated between April 2015 and December 2025; in total, 32 patients with pathologically confirmed medulloblastoma and complete data were included. Tumor B7-H3 and CD47 expression was assessed using immunohistochemistry and an immunoreactivity score (IRS); patients were categorized as having negative/low (IRS < 4) or high (IRS ≥ 4) expression. We analyzed the associations with clinicopathological and molecular features. Overall survival (OS) and disease-free survival (DFS) were evaluated using Kaplan–Meier and log-rank tests. Prognostic factors were examined using univariate and multivariate Cox regression. Results: High B7-H3 expression was associated with shorter OS (median 46 vs. 85 months; p = 0.024) and markedly reduced DFS (median 21 vs. 102 months; p < 0.001). High CD47 expression was also associated with shorter OS (median 56 vs. 102 months; p = 0.025), whereas DFS did not significantly differ by CD47 status (p = 0.200). B7-H3 and CD47 expression levels were not correlated (Spearman’s rho = 0.071; p = 0.699). In the univariate analysis, high B7-H3 expression predicted mortality (HR = 25.79; p = 0.002) and recurrence risk (HR = 136.23; p = 0.045), and high CD47 expression predicted mortality (HR = 4.82; p = 0.042). In the multivariate analysis, high B7-H3 expression remained an independent predictor of poor OS (HR = 31.01; p = 0.004), whereas radiotherapy independently reduced the recurrence risk (HR = 0.197; p = 0.024). Conclusions: B7-H3 is a strong independent adverse prognostic biomarker for OS and is associated with profoundly shorter DFS in medulloblastoma, supporting its relevance as a candidate target for immune-directed strategies.