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Background/Objectives: This study investigated whether decompression surgery for lumbar spinal stenosis can effectively improve sagittal alignment in elderly patients. With the growing focus on sagittal balance in spinal surgery, this study aimed to evaluate post-decompression alignment changes and identify the factors influencing these changes using the EOS imaging system. Methods: A retrospective analysis was conducted on 49 elderly patients who underwent decompression surgery alone for lumbar spinal stenosis. Radiologic parameters, measured using the EOS system, and clinical outcomes were assessed preoperatively, at two weeks postoperatively, and at one year postoperatively. Patients were grouped based on the improvement of the sagittal vertical axis (SVA) by 25 mm or more. A multivariate analysis was performed to identify factors affecting sagittal alignment changes. Results: Significant sagittal alignment improvements were observed postoperatively, including a notable increase in thoracic kyphosis and a decrease in SVA observed at one year. Clinical outcomes, such as the Oswestry disability index (ODI) and EQ-5D, significantly improved at both two weeks and one year postoperatively compared to preoperative values (all p-values < 0.05). Multivariate analysis revealed that greater preoperative SVA and higher ODI were significant predictors of sagittal alignment changes (odds ratio [OR] for SVA = 1.014, OR for ODI = 1.034). Conclusions: Decompression surgery for lumbar spinal stenosis in elderly patients can result in significant improvements in sagittal alignment and clinical outcomes. The study suggests that decompression alone is a viable surgical option for elderly patients, particularly those with a greater preoperative sagittal imbalance and disability, even in the absence of major deformities.

(1) Background: Recently, Escherichia coli-derived recombinant human bone morphogenetic protein-2 (E. coli-derived rhBMP-2) has been increasingly applied to different types of spinal surgeries and reported to achieve successful fusion. This pilot study aimed to evaluate the clinical efficacy and safety of rhBMP-2 in patients undergoing posterior instrumented fusions for unstable spinal fractures. (2) Methods: This study included ten consecutive patients undergoing spinal surgery using E. coli-derived rhBMP-2 with more than one year of follow-up. Radiologic outcomes were compared, including the average fracture healing period, local kyphosis correction, and clinical outcomes between preoperative and the last follow-up. (3) Results: The average time of radiographic union was 99.9 ± 45.4 (62–192) days, with an average use of 5.2 ± 3.9 months of anabolic agents. Radiologic parameters such as anterior vertebral height and vertebral wedge angle were significantly corrected postoperatively and at the last follow-up. Clinical outcomes other than leg pain were significantly improved after the surgery. In addition, four patients with preoperative neurologic deficits showed improved neurologic status. (4) Conclusions: Combined with the anabolic agents, applying E. coli-derived rhBMP-2 to the fractured vertebral body could be an effective surgical treatment for unstable spinal fractures. Further trials are needed to validate this result.

To fabricate high‐performance organic solar cells (OSCs) by green solvent processing, it is essential to control the aggregation behavior and processability of constituent small‐molecule acceptors (SMAs). Herein, a series of SMAs (A1–A4) with enhanced aggregation behavior and processability is developed by replacing the linear alkyl outer side chains of BTP‐eC9 with 2D functional groups. The PM6:A1 SMA blend exhibits appropriate crystallinity, favorable blend morphology, superior electrical properties, and affords an OSC with a high power conversion efficiency (PCE) of 16.8%. Importantly, the OSC is fabricated using a nonhalogenated solvent (ortho‐xylene), annealing‐free process. In contrast, the reference PM6:BTP‐eC9‐based OSC exhibits a lower PCE of 15.3%. Structural analyses reveal that the 2D outer side chains of A1 induce steric hindrance between its dithienothiophen[3,2‐b]‐pyrrolobenzothiadiazole (BTP) core and the 2‐(3‐oxo‐2,3‐dihydroinden‐1‐ylidene)malononitrile end groups, optimizing its molecular planarity and aggregation property. It is further found that the SMAs with chlorinated IC end groups afford OSCs with higher PCEs than SMAs with fluorinated end groups.

For the realization of highly efficient and thermally stable polymer solar cells (PSCs), we develop a new series of polymer donors (PDs) containing carbazole (Cz)-based units, N-dodecyl-carbazole[3,4-c:5,6-c]bis [1,2,5]-thiadiazole (CBT). The coplanar penta-fused-ring structures of the CBT units coupled with pconjugated bridges (thiophene (T) or thienothiophene (TT)) exhibit highly planar PD conformations that are non-covalently locked by secondary interactions. As a result, the series of PDs (i.e., P1, P2, and P3) exhibit superior electrical and photovoltaic properties. In particular, the TT-p-bridged PDs, P2 and P3, achieve high power conversion efficiencies (PCEs) of 13.17 and 14.58% when paired with Y6 acceptor, respectively, which outperform the T-p-bridged PD, P1 (10.78%). This result is attributed to the compact intermolecular packing, enhanced crystallinity, and extended conjugation of the PDs featuring TT. Furthermore, an even higher PCE of 15.54% is achieved by a P3-based ternary (P3:Y6:PC71BM) blend system. This PCE represents the highest among the PCEs of previously reported PSCs featuring Czbased PDs. In addition, the P3:Y6 blend shows excellent thermal stability by maintaining 90% of its initial PCE after 144 h at 120 -C. Therefore, this study provides important molecular design rules for developing Cz-based PDs and realizing high-performance and thermally stable PSCs. [ABSTRACT FROM AUTHOR]