Objective
To investigate stiffness-related disability (SRD) following surgical treatment in adolescent idiopathic scoliosis (AIS) patients particularly with respect to the lowest instrumented vertebra (LIV).
Summary of Background
Extensive spinal fusion inevitably results in loss of mobility which may induce SRD during activities of daily living. Few studies have examined SRD after surgical correction for AIS.
Methods
Patients who underwent surgical correction for AIS between 2014 and 2021 and were followed up for two years were included. The degree of SRD was evaluated using the Stiffness-Related Disability Index (SRDI) which consists of four categories, each containing three questions, giving a total of 12 components of the questionnaire. The SRDI scores were compared according to the (LIV) levels. Correlation analysis was performed to examine the relationship between the SRDI and legacy health-related quality of life (HRQOL) measurements.
Results
This study included 174 patients (47 males, 127 females) with a mean age of 13.8 years. Among the 12 items of the SRDI, the scores of nine items showed a significant increase after surgery. The total sum of the SRDI scores also significantly increased after surgery. Pearson correlation analysis showed that the SRDI scores were significantly correlated with ODI (Oswestry disability index), nearly all domains, and the total sum of SRS-22 (Scoliosis Research Society-22 questionnaire), and SF-36 (Short Form 36 health questionnaire). No differences in the SRDI score were found among cases with the LIV between T12 and L3. However, The SRDI scores of patients with LIV at L4 were significantly higher than those of patients with other LIV levels. .
Conclusions
Various degree of SRD occurred after spinal fusion for AIS. The SRDI significantly correlated with the HRQOL measures. The SRDI score was highest in patients with the LIV at L4 compared to those with other LIV levels.

Purpose
Few studies have assessed the prevalence of cervical and thoracic and lumbar (thoracolumbar) intervertebral disc disorders, respectively, using data from the Korean National Health Insurance Service (KNHIS). The aim is to show the changing prevalence of cervical and thoracolumbar intervertebral disc disorder over the last decade.
Methods
Data spanning 2012 to 2021 were collected from the KNHIS, encompassing primary diagnoses related to cervical and thoracolumbar intervertebral disc disorder (ICD 10 code: M50.x and M51.x except M51.4). The agestandardized prevalence was computed using the estimated Korean population in 2020 as a reference. Additionally, age-standardized number of general spinal operations per year was illustrated using the Statistical Yearbook of Major Surgeries in 2021.
Results
In 2012, the age-standardized prevalence of cervical intervertebral disc disorder was 11,383 persons per 100,000 decreasing to 8,860 persons per 100,000 persons in 2021. This decline was observed in both male (from 10,101 to 8,012) and female (from 12,690 to 9,709). For thoracolumbar intervertebral disc disorders, the agestandardized prevalence decreased from 27,506 to 18,903 persons per 100,000 persons from 2012 to 2021. Notably, the age-standardized prevalence showed a greater increase in individuals aged 60 or older compared to those aged 50, for both sexes. However, there was an increase in the number of general spinal operation from 2012 to 2021.
Conclusions
While the overall age-standardized prevalence of cervical and thoracolumbar intervertebral disc disorders decreased between 2012 and 2021 across all age groups, the number of general spinal operations increased during the same period.

Spinal cord injury (SCI) distinguishes itself from peripheral nerve injury by causing devastating and irreversible damage to the spine, resulting in profound motor, sensory, and autonomic dysfunction. The ensuing complex microenvironment of SCI, characterized by hemorrhage, inflammation, and scar formation, poses substantial challenges to regeneration and complicates numerous transplantation strategies. Recent research has shifted its focus towards manipulating the intricate SCI microenvironment to enhance regeneration, with some approaches demonstrating significant therapeutic efficacy. Consequently, the reconstruction of an appropriate microenvironment post-transplantation emerges as a potential therapeutic solution for SCI. This review aims to provide a comprehensive overview, firstly summarizing the influential compositions of the microenvironment and their diverse effects on regeneration. Secondly, we highlight recent research employing various transplantation strategies to modulate distinct microenvironments induced by SCI, aiming to facilitate regeneration. Lastly, we discuss prospective transplantation strategies for SCI, emphasizing the importance of addressing the complex microenvironment for successful therapeutic outcomes.

The standard method for treating posterior pelvic ring injuries involves sacroiliac joint cannulated lag screw fixation, necessitating repeated fluoroscopy and leading to radiation exposure. The O-arm navigation system, designed for spine screw fixation, is applied in pelvic injuries to enhance precision. A successful case involved a 39-year-old male with a complex pelvic injury, where sacroiliac screw fixation was performed in the prone position using the O-arm guide. The patient, injured at a construction site, showed fractures and widening of the symphysis pubis and right sacroiliac joint. Surgery was planned for both lumbar and pelvic regions due to an L3 burst fracture. The O-arm system demonstrated efficacy in precise screw placement, reducing surgical duration, and minimizing complications. The discussion emphasizes early pelvic fixation benefits, with percutaneous iliosacral screws standing out. Conventional fluoroscopy-guided methods pose challenges, and the O-arm system proves advantageous, especially for less experienced surgeons. Future advancements may enable pelvic surgery using the O-arm without C-arm guidance if instrumentation for pelvis fixation is developed.