Advances in basic and preclinical spine research: Highlights from the Chinese Spine Research Community

The establishment of the Chinese Orthopaedic Association (COA) was initiated in 1978 and has been pushed to become true in 1980 when the first Orthopaedic Congress of Chinese Medical Association was held in Tianjin, China. With more than 40 years of development, COA has made great achievements in many aspects, especially in basic orthopedic research, new diagnostic methods and treatments, and orthopedic surgeon training. A branch of COA, the Chinese Orthopaedic Research Society (CORS), was set up during the second Orthopaedic Congress in 1985. CORS' members are composed of basic orthopedic researchers and clinical experts who are engaged in basic research from the Mainland, Hong Kong, Macao, and Taiwan, focusing on organizing academic events and promoting and integrating basic and clinical research activities. CORS also plays an active role in the development and clinical translation of new orthopedic techniques and materials. After the unremitting efforts and cooperation of CORS members over years, the level of orthopedic research in China has significantly improved, and CORS has become one of the most supported branches of COA. In recent years, CORS has devoted special attention on spine health, which is also a hot area in musculoskeletal research worldwide. In the past 10 years, publications on spine research have accounted for about 40% of musculoskeletal research publications. Since 2014, assembled of spine researchers, the basic research group of Spine and Spinal Cord Committee of the Chinese Association of Rehabilitation Medicine was also active in spine research and produced impressive achievements. With the funding support from the National Natural Science Foundation of China and the Ministry of Science and Technology of China, a large number of spine research teams in China have grown and matured into worldwide leaders. The research topics include spinal development, deformity, degeneration and repair, aging, biological therapies, biomaterials, tissue engineering, and biomechanics. This current special issue represents a collected series of articles from the Chinese Spine Research Community on their recent research. Highlights are summarized below. Recent technological advances have brought new tools to spine clinicians for surgical assistance or prognosis of surgical outcomes. Chaofan Han et al.1 measured the changes of the spinal canal length (SCL) of scoliotic patients after corrective surgeries for spine deformity. They demonstrated that 3D analysis of the spinal canal is a valuable method for evaluating the SCL changes of scoliotic patients before and after corrective surgeries, which could be instrumental for future improvements to corrective surgeries with the aim to maximize the correction of the spine deformity and to minimize the negative effect on spinal cord to prevent neurological complications. Mengze Zhang et al.2 developed models utilizing radiomics, advanced objective and quantitative indicators, and machine learning for predicting the postoperative prognosis of cervical spondylotic myelopathy. Nan Ru et al.3 found that the specific lumbar shape can be affected by the sacral morphology. They provided predictive models of lumbopelvic parameters, which demonstrate constant sacral anatomical parameters could serve as a good supplementary index of pelvic incidence to predict ideal lumbar parameters. Yang Xiong et al.4 established a cobweb classification system, which can provide detailed and objective descriptions of the location, extent, and severity of neurological compressions in cervical degenerative disease with satisfactory reliability. Development of novel biological therapeutics for intervertebral disc degeneration treatment is another hot research area in China. Lei Yue et al.5 investigated the effect of H2S on rat nucleus pulposus (NP) cells under hypoxia conditions. Their results showed that H2S played a cytoprotective role on NP cells via induction of autophagy. Hao Hu et al.6 described a new therapeutic strategy for intervertebral disc degeneration. They showed that Panax notoginseng saponins, a traditional Chinese patent drug with antiosteoclast differentiation effects, could alleviate intervertebral disc degeneration by inhibiting aberrant osteoclast activation in the porous cartilage endplate of a lumbar spine instability model in the mouse. Recent technology developments are leading to new tools for the precise management of tissue diseases. One example is single-cell RNA sequencing (scRNA-seq), which examines the sequence information from individual cells, providing a higher resolution of cellular differences and a better understanding of the function of individual cells in the context of their microenvironment. Yilin Yang et al.7 compared the single-cell-level cellular landscapes of spinal cancellous bone tissues between adolescent idiopathic scoliosis (AIS) patients and healthy subjects using high-throughput scRNA-seq. The AIS patients and healthy subjects showed differences in the cellular states. The differentiation disruption of specific mesenchymal stem cell clusters was discovered in AIS. Cell communication analysis provided the possible pathogenesis of osteoblast and chondrocyte differentiation dysfunction in AIS. The authors declare that they have no conflicts of interest to disclose.