Aims: The development of lumbar lordosis has been traditionally examined using angular measurements of the spine to reflect its shape. While studies agree regarding the increase in the angles during growth, the growth rate is understudied, and sexual dimorphism is debated. In this study, we used a novel method to estimate the shape of the lumbar curve (LC) using the landmark-based geometric morphometric method to explore changes in LC during growth, examine the effect of size and sex on LC shape, and examine the associations between angular measurements and shape.Methods: The study population included 258 children aged between 0 and 20 years (divided into five age groups) who underwent a CT scan between the years 2009 and 2019. The landmark-based geometric morphometric method was used to capture the LC shape in a sagittal view. Additionally, the lordosis was measured via Cobb and sacral slope angles. Multivariate and univariate statistical analyses were carried out to examine differences in shape between males and females and between the age groups.Results: The overall shape of the LC overlapped between males and females in most age groups, except for the nine- to 12-year age group. However, size did not affect LC shape. LC shape changed significantly during growth from straight to curved, reaching its mature shape earlier in females. This corresponded with the results obtained by the lordosis and sacral slope angles. A significant positive correlation was found between the LC shape and angles, although the angles demonstrated poor distinction between age groups, as opposed to the LC shape.Conclusion: New insights into LC shape development were achieved using the geometrical morphometric method. The LC shape was sex-independent in most age groups. However, the LC reached its mature shape earlier in females than males. The method and data of this study are beneficial for future studies examining aetiological factors for spinal pathologies and maldevelopment.Cite this article: Bone Joint Res 2025;14(1):58–68.

Vertebral osteoporotic fractures (VOF) are among the most frequent fractures in the elderly, often leading to an impaired lifestyle and a high economic burden. Although a reduced bone mass density is considered one of the main risk factors for VOF, its role in determining the fracture type, using the AO spine‐DGOU classification for osteoporotic thoracolumbar fractures, as well as its progression, is unknown. The current study aimed to: (1) reveal whether the bone density of the vertebral bodies of fractured and non‐fractured vertebrae predicts the type of fracture, (2) examine whether bone density is associated with the initial and progressive collapse of the vertebral body, and (3) provide predictive measures for fracture progression. The study sample included 124 patients (40 males and 84 females) with an acute osteoporotic vertebral fracture who underwent a computerized tomography scan at the time of diagnosis and an x‐ray at least 3 months later. The bone density of the fractured and adjacent (non‐fractured) vertebrae was measured at diagnosis. The magnitude of the collapse and the progression of the fracture over time were calculated from height measurements of the vertebral bodies at diagnosis and follow‐up. Age was a significant factor in predicting the fracture type and magnitude of collapse, whereas sex and bone density were not. The severity of the fracture was involved in predicting its progression, demonstrating that severe‐type fractures tended to continue to collapse after diagnosis. However, when each type was examined independently, the density of the fractured vertebra had a protective effect on fracture progression. To conclude, identifying the type of fracture is beneficial in determining patient prognosis. Furthermore, the density of the fractured vertebra, the magnitude of collapse, and patient age are valuable predictors of fracture progression.

Background: The therapeutic effect of neurodynamic mobilization (NM) of the median nerve in mild to moderate carpal tunnel syndrome (CTS) remains inconclusive based on subjective reports and nerve conduction studies. Sonographic measurement of cross-sectional area (CSA) of the median nerve provides an objective method to evaluate treatment outcomes. Objective: To compare the effect of carpal bones and flexor retinaculum mobilization (CBFRM) vs. NM using various subjective outcome measures and a single objective measure: sonographic measurement of the median nerve CSA. Methods: Fifty-one individuals with mild to moderate CTS were randomly assigned to three groups:(1) CBFRM (n=17) (2) NM (n= 17) and (3) a control group awaiting surgery (n=17). Outcomes were assessed pre and post intervention and consisted of included median nerve CSA, pain severity rating using a visual analogue scale (VAS) and functional status using the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. Pain improvement was also evaluated using the Pain Relief Scale (PRS). The intervention consisted of eight sessions over four weeks. Results: Both NM and CBFRB interventions significantly reduced pain and improved function compared with the control group. While both groups showed reduced median nerve CSA, post-hoc analysis revealed that this reduction was primarily driven by the NM group, with the CBFRB group not differing significantly from either condition. Conclusions: NM appears to be an effective conservative intervention for patients with mild to moderate CTS, demonstrating meaningful clinical and functional improvements. In addition, sonographic assessment of median nerve CSA may serve as a valuable complementary objective measure for evaluating treatment response and monitoring clinical status.