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Radiologic and Clinical Predictors of Reoperation Following Unilateral Biportal Endoscopic Spine Surgery: A Retrospective Cohort Study

2026-03-26T01:58:40Z

Title: Radiologic and Clinical Predictors of Reoperation Following Unilateral Biportal Endoscopic Spine Surgery: A Retrospective Cohort Study Authors: Shin, Jun Jae; Kim, Keonhee; Park, Se Jun; Jeong, Won Joo; Yoo, Sun Joon; Shin, Dong Ah; Shin, Joongkyum; Jang, Hyun Jun; Chin, Dong Kyu Abstract: Purpose Unilateral biportal endoscopic discectomy (UBE) is an effective and minimally invasive technique for the treatment of degenerative lumbar diseases. However, reoperation may be required, and evidence on how risk factors vary according to the timing of reoperation remains limited. This study aimed to identify the clinical and radiologic factors associated with short-term (<6 months) and long-term (>= 6 months) reoperations following UBE. Materials and Methods This retrospective study included 80 patients who underwent reoperation after UBE between January 2016 and December 2023 with a minimum 24-month follow-up. The patients were classified into short-term and long-term reoperation groups. Clinical and radiologic parameters, including disc degeneration grade, facet joint osteoarthritis grade, and comorbidities, were compared between groups. Multivariable logistic regression was used to evaluate preoperative factors predicting postoperative functional improvement. Results Reoperations were performed for incomplete decompression (27.5%), facet cysts (10.0%), recurrent herniation (8.8%), restenosis (8.0%), and postoperative instability (43.7%). Long-term reoperation was associated with greater disc degeneration, a higher grade of facet joint osteoarthritis, and a higher prevalence of diabetes mellitus (DM). Short-term reoperation was mainly due to inadequate decompression, whereas long-term reoperation was largely attributable to postoperative instability. Multivariable analysis identified a higher preoperative grade of facet joint osteoarthritis as a predictor of postoperative functional improvement. Conclusion Short-term reoperation after UBE is primarily related to inadequate decompression, whereas long-term reoperation is linked to advanced disc degeneration, severe facet joint osteoarthritis, postoperative instability, and DM. These findings highlight the importance of thorough preoperative assessment of facet arthropathy and disc degeneration, ensuring adequate initial decompression, and careful postoperative management, particularly in patients with DM.

Effects of Trunk Extension-Based Inspiratory Muscle Strengthening on Respiratory Function, Balance, and Gait in Patients with Stroke: A Randomized Controlled Trial

2026-03-31T01:29:50Z

Title: Effects of Trunk Extension-Based Inspiratory Muscle Strengthening on Respiratory Function, Balance, and Gait in Patients with Stroke: A Randomized Controlled Trial Authors: An, Kwang-Bin; Jeon, Hye-Joo; Choi, Yu-Sik; Lee, Soo-Yong; Chang, Woo-Nam Abstract: Objectives: This study investigated the effects of trunk extension-based inspiratory muscle strengthening on respiratory function, balance, and gait in patients with stroke. Methods: Thirty stroke patients were randomly assigned to the study group (n = 15) or control group (n = 15). The study group performed inspiratory muscle strengthening exercises in a trunk extension posture, while the control group received conventional inspiratory muscle training. Both groups trained five times per week for six weeks. Outcome measures included maximal inspiratory pressure (MIP), maximal inspiratory flow rate (MIFR), maximal inspiratory volume (MIV), peak expiratory flow (PEF), forced expiratory volume in 1 s (FEV1), Berg Balance Scale (BBS), weight distribution ratio (WDR), limits of stability (LOSs), Timed Up and Go (TUG), gait velocity, cadence, and stride length. Results: The study group showed significantly greater improvements in respiratory parameters (MIP, MIFR, MIV, PEF, FEV1) and functional outcomes (WDR, LOS, BBS, TUG, gait velocity, cadence, stride length) compared to the control group. Conclusions: Trunk extension-based inspiratory muscle strengthening effectively improves respiratory function, balance, and gait in stroke patients, and may serve as a valuable addition to stroke rehabilitation programs.

Effect of Manganese Exposure on Multi-Finger Coordination with Asymptomatic Welder

2026-04-13T00:25:27Z

Title: Effect of Manganese Exposure on Multi-Finger Coordination with Asymptomatic Welder Authors: Lee, Jiseop; Song, Junkyung; Park, Jaebum Abstract: Chronic exposure to manganese in occupational settings such as welding is known to accumulate in the basal ganglia and disrupt motor control. Although clinical symptoms emerge only after considerable neural damage, subtle motor deficits may exist in asymptomatic individuals. This study aimed to identify such subclinical motor alterations by examining multi-finger coordination in professional welders. Nine professional welders with more than 20 years of welding experience and ten age-matched healthy controls participated in the study. Participants performed three isometric finger force tasks: a maximal voluntary contraction task to assess maximal finger forces, a single-finger ramp task to evaluate finger enslaving, and a multi-finger quick pulse task to analyze motor synergies and anticipatory synergy adjustments (ASA). Surface electromyogram was recorded to quantify muscle co-contraction. Compared to controls, welders exhibited reduced motor synergy strength, delayed and decreased ASA, and increased antagonist muscle co-contraction. These findings suggest that long-term occupational welding exposure, which involves manganese as a major component, is associated with subtle but measurable alterations in motor coordination and neural control strategies, even in the absence of clinical symptoms. Multi-finger synergy analysis and co-contraction metrics may serve as sensitive markers for detecting early motor dysfunction in populations occupationally exposed to neurotoxic substances.

Association Between CDH13 rs12596316 and Adiponectin Levels According to Fasting Glucose Status in a Korean Population

2026-04-14T00:15:15Z

Title: Association Between CDH13 rs12596316 and Adiponectin Levels According to Fasting Glucose Status in a Korean Population Authors: Kim, Gitae; Kim, Eun Bi; Kim, Dae Hyun; Sull, Jae Woong Abstract: Background: Adiponectin is a key adipokine involved in glucose and lipid metabolism. Variants in the CDH13 gene have been consistently associated with circulating adiponectin levels. However, limited evidence is available regarding whether these associations differ according to glucose status. We examined the association between CDH13 rs12596316 and adiponectin levels across fasting blood glucose (FBS) categories in a Korean population. Methods: A total of 4865 participants from the Korean Genome and Epidemiology Study were included. Linear regression under an additive genetic model was used to evaluate the association between rs12596316 and adiponectin levels. Logistic regression under a dominant model was used to assess the association with hypoadiponectinemia. Stratified analyses were performed according to BMI and FBS categories. Results: CDH13 rs12596316 was strongly associated with adiponectin levels (beta = -0.59, p = 3.30 & times; 10-31). Carriers of the TC/CC genotype had a 1.74-fold higher risk of hypoadiponectinemia compared with TT homozygotes after adjustment for age, sex, and BMI. In stratified analyses, the magnitude of association differed across FBS categories, with a stronger association observed in men with FBS >= 126 mg/dL (OR = 3.62, p = 0.009) compared with lower FBS groups. However, formal interaction analyses between genotype and fasting glucose categories were not statistically significant. Conclusions: CDH13 rs12596316 is strongly associated with adiponectin levels in this Korean cohort. The strength of association varied across fasting glucose categories, suggesting that the observed association may differ across metabolic subgroups.