Purpose
Thoracolumbar vertebral compression fractures (VCFs) are a leading cause of kyphosis and related biomechanical complications, often resulting in chronic back pain and reduced function. Balloon kyphoplasty has been widely used as a minimally invasive intervention to provide pain relief and restore vertebral height. The SpineJack system is a relatively novel technique that introduces mechanical distraction, offering potentially enhanced vertebral restoration. This study aims to compare these two effective treatments for thoracolumbar fractures.
Materials and Methods
This study analyzed 30 patients with thoracolumbar VCFs surgically treated, using the Spine-Jack system (n=10) or balloon kyphoplasty (n=20). Back pain was evaluated as VAS pain score and functional disability was assessed with Oswestry Disability Index (ODI) preoperatively and immediately postoperatively. Radiological outcomes were measured on plain lateral X-rays, including vertebral height restoration, segmental kyphosis angle, and sagittal vertical axis (SVA). Complications, such as cement leakage and adjacent vertebrae fractures, were recorded. Continuous variables – with t-tests and categorical variables- with chi-square tests, were analyzed. P-value less than 0.05 was considered statistically significant.
Results
Both the Spine-Jack system and balloon kyphoplasty were effective in reducing back pain and improving patients’ function, with significant improvements in VAS and ODI scores. However, the Spine-Jack system demonstrated superior vertebral height restoration (85% vs. 72%, p=0.03) and segmental kyphosis angle correction (12° vs. 9°, p=0.032) when compared to balloon kyphoplasty. Complication rates were all low and comparable between the two groups.
Conclusions
Although the Spine-Jack system and balloon kyphoplasty are all effective for thoracolumbar VCFs, the Spine-Jack system offered superior radiological outcomes in selected cases. Further studies may explore their complementary roles in managing thoracolumbar VCFs.

Purpose
The impact of skeletal muscle mass and bone mineral density (BMD) on frailty after osteoporotic vertebral fractures (OVFs) remains unclear. This study aimed to assess the interplay between frailty, skeletal muscle mass, and bone mineral density in OVFs.
Materials and Methods
A total of 66 patients with osteoporotic vertebral compression fractures were enrolled. We collected clinical and radiological data, including age, body mass index (BMI), frailty index, and parameters such as lumbar lordosis, thoracic kyphosis, skeletal muscle mass, and BMD. We then analyzed the relationships between frailty and these variables.
Results
The mean age, BMI, BMD T-score, skeletal muscle mass, and frailty index were 78.0±7.8 years, 22.3±3.3 kg/ m², -3.59±0.96, 37.84±6.24 kg, and 2.59±1.08, respectively. Of the 66 patients, 14 (21.1%) were frail prior to fracture, while 37 (56.1%) were frail after fracture, indicating a worsening frailty status. Specifically, 23 patients (34.8%) transitioned from pre-frail to frail following their fracture and had both lower BMD (T-score: -3.7±0.93) and lower skeletal muscle mass (35.74±3.83 kg). Frailty was negatively correlated with BMD (r=-0.28, p=0.02), while BMD was positively correlated with skeletal muscle mass (r=0.29, p=0.02). OVFs were positively correlated with frailty (r=0.33, p=0.01), especially in terms of fatigue (r=0.31, p=0.01) and ambulation (r=0.21, p=0.01).
Conclusions
In patients with osteoporotic vertebral fractures, decreased muscle mass and low BMD appear to exacerbate frailty. Furthermore, frailty may be both a contributing and a resulting factor in the development of osteoporotic vertebral fractures.

Purpose
This study aimed to compare the clinical effectiveness and potential benefits of ultrasound (US)-guided versus fluoroscopy (FL)-guided cervical retrolaminar block (RLB) in patients with cervical facet joint pain.
Materials and Methods
A total of 27 patients aged 40 years or older who were diagnosed with cervical facet joint syndrome based on physical examination and imaging modalities were included. 12 patients of group I treated with US-guided RLB and 15 patients of group II treated with FL-guided RLB. The position of the needle and the distribution of contrast agent were confirmed using fluoroscopic images, and the changes in numeric rating scale (NRS) and neck disability index (NDI) before and 2 weeks after the procedure were compared in the two groups.
Results
Radiologically, the target agreement of needle placement in group I was 75%. There was no difference in contrast medium spread between the two groups. Clinically, the mean NRS improved from 7.08±0.52 to 3.08±0.90 in group I (p=0.01) and from 7.20±0.56 to 3.33±0.72 in group II (p=0.01). The mean NDI decreased from 41.67±2.27 before the procedure to 20.83±2.33 after the procedure in group I (p=0.01), and from 40.87±2.61 before the procedure to 21.67±2.02 after the procedure in group II (p=0.01), with no difference between the two groups.
Conclusions
US-guided cervical RLB is an effective, radiation-free alternative to FL-guided RLB for managing cervical facet joint pain, offering comparable pain relief and functional improvement.

Advanced imaging technologies have revolutionized the diagnosis and management of spinal pathologies by providing superior precision and efficiency. Modalities such as PET-CT, SPECT, diffusion tensor imaging (DTI), and magnetic resonance spectroscopy (MRS) offer unique insights into the metabolic, structural, and functional aspects of spinal diseases, enabling better differentiation of lesions, improved surgical planning, and early detection of pathological changes. Furthermore, the integration of artificial intelligence (AI) has enhanced imaging workflows by enabling automated analysis, prediction of clinical outcomes, and segmentation of spinal structures. Despite these advancements, challenges such as technical limitations, high costs, and ethical concerns, including issues of data privacy and AI-generated inaccuracies, hinder widespread adoption. This review explores the clinical applications, limitations, and future directions of these emerging technologies, highlighting the need for multidisciplinary collaboration and large-scale research to standardize protocols and optimize patient outcomes. The seamless integration of advanced imaging and AI represents a transformative potential for improving diagnostic accuracy and treatment efficacy in spinal care.