Search Results (1,575)

This prospective case series evaluated the short-term outcomes following percutaneous cementoplasty as the sole palliative treatment for appendicular osteosarcoma in 10 dogs. Synthetic self-hardening calcium phosphate bone substitute was injected into the osseous defect under fluoroscopic guidance after curettage of the bone tumor. Clinician assessment included a numerical rating score for lameness, offloading, and ease of lifting the contralateral limb as well as the 4A-VET postoperative pain scale. Owner assessment was obtained using three descriptive questionnaires, the Helsinki Chronic Pain Index (HCPI), the Canine Brief Pain Inventory (CBPI) and the Canine Symptom Assessment Scale (CSAS). Measures were recorded preoperatively and at 2, 4, 8, and 12 weeks following surgery. Early improvement in the 4A-Vet score was noted at the 2-, 4-, 8-, and 12-week time points for all major pain and function metrics. Similarly, the CBPI pain severity and interference scores demonstrated early postoperative improvement during the 2- and 4-week time points with partial attenuation by 8 and 12 weeks. Panting, difficulty sleeping, whining/moaning, and lack of appetite were significantly reduced when assessed via the CSAS. Cementoplasty as a monotherapy, affording early pain relief and improved structural integrity, supports its role as a palliative limb-preserving option for dogs unable to undergo amputation. Full article

Background/Objectives: Comparative studies evaluating minimally invasive surgery (MIS) and open repair for acute Achilles tendon rupture have predominantly relied on mean-based statistical comparisons, which may not adequately capture whether outcomes are clinically meaningful from the patient perspective. This study aimed to compare 12-month outcomes between MIS using the internal splinting technique and open repair, establish anchor-based minimal clinically important difference (MCID) thresholds, and compare patient-centered responder outcomes between techniques. Methods: This retrospective non-randomized comparative cohort study included 70 patients allocated to MIS (n = 35) or open repair (n = 35). Outcomes were assessed using VAS, AOFAS, ATRS, and Thermann score. Anchor-based MCID thresholds were determined via ROC curve analysis using the Global Rating of Change (GROC) scale as the external anchor. Patient Acceptable Symptom State (PASS) was assessed using a dichotomous anchor question. Results: Both groups demonstrated significant improvements across all outcome measures at 12 months (p < 0.001). No significant between-group differences were observed in mean functional scores, MCID achievement rates, PASS rates, or GROC-defined clinical success (p > 0.05 for all). AUC values ranged from 0.975 to 0.984. The MCID threshold for pain relief was identified as a VAS reduction > 4.8 points (AUC: 0.975, 95% CI: 0.906–0.998), while ROC-derived functional MCID thresholds were identified as an AOFAS increase >38 points (AUC: 0.984, 95% CI: 0.920–0.999), an ATRS increase >38 points (AUC: 0.984, 95% CI: 0.920–0.999), and a Thermann score increase >37 points (AUC: 0.984, 95% CI: 0.920–0.999). These thresholds should be considered exploratory and require validation in larger independent cohorts. MCID achievement rates were 42.9% for VAS in both groups, whereas MCID achievement for functional outcome measures (AOFAS, ATRS, and Thermann scores) was 62.9% in the MIS group and 57.1% in the open repair group. PASS-positive rates were 85.7% and GROC-defined clinical success 71.4% in both groups. Complication rates were low in both groups; however, the small number of events limits the strength of this conclusion, and larger studies are needed to evaluate potential between-group differences. Conclusions: Both techniques were associated with substantial clinically meaningful recovery at 12 months, and neither approach demonstrated a clear clinical advantage in patient-centered outcomes. The population-specific MCID thresholds derived in the present cohort may provide clinically interpretable benchmarks for future research, although external validation is required before broader application. Surgical decision-making may rely on surgeon expertise and patient factors rather than anticipated differences in patient-centered outcomes. Full article

Background: Thromboangiitis obliterans (TAO) is a nonatherosclerotic inflammatory vascular disorder affecting small- and medium-sized vessels, often leading to critical limb ischemia and a high risk of amputation. Conventional medical and surgical treatments remain limited, particularly for advanced diseases. Tibial transverse bone transport (TTT), based on the principles of distraction osteogenesis, has emerged as a novel technique to promote angiogenesis and improve microcirculation. This systematic review evaluated the clinical efficacy and safety of TTT in the management of TAO. Methods: A systematic review was conducted according to the PRISMA guidelines. A comprehensive search of PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar was performed until December 2025. Eligible studies included clinical investigations that evaluated TTT in patients with TAO. Data on patient characteristics, surgical techniques, clinical outcomes, and complications were extracted and analyzed descriptively because of the heterogeneity in study design and reporting. Results: Ten studies involving 368 patients were included in this review. TTT was consistently associated with significant clinical improvement, including pain relief, increased claudication distance, and ulcer healing, which were typically observed within weeks after the procedure. Limb salvage rates were high, with major amputation rates generally ranging from 3.3% to 13.3%. Objective improvements in perfusion parameters have also been reported in several studies. The most common complication was pin-site infection (up to 30%), while fractures, delayed consolidation, and osteomyelitis were less frequent complications. Conclusions: Current evidence suggests that TTT is a promising limb-salvage strategy for TAO and is associated with favorable clinical and functional outcomes, with an acceptable complication profile. However, the available evidence remains limited, partly because of the rarity of TAO and the specialized nature of the TTT procedure. Most available studies are observational, and further high-quality prospective and randomized trials are required to validate the long-term efficacy of this technique. Full article

Background: Cancer is one of the leading causes of disability in both the United States and worldwide. Its high global prevalence is accompanied not only by the burden of the disease itself but also by the adverse effects of treatment, which can significantly diminish patients’ quality of life (QoL). Osteopathic manipulative treatment (OMT), an emerging complementary therapy, seems to show promise in the improvement in quality of life (QoL) in these patients. The purpose of this systematic review is to evaluate the effectiveness of OMT as a complementary and integrative therapy for the relief of symptoms and improved functional capabilities in cancer patients. Methods: The literature search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed, Scopus, Science Direct and Web of Science databases. A risk of bias analysis was conducted by evaluating the included randomized controlled trials to assess domains, such as randomization, intended intervention, incomplete outcome data, outcome measurement, and selective reporting. Between the 20 randomized controlled trials and observational studies, information regarding OMT in the treatment of general cancers, oral, pediatric, head and neck, gynecological, breast, and gastric cancers was collected. Results: Our analysis displayed a patient-reported increase in QoL, especially through the reduction in pain and lymphedema, as well as an increase in overall functional capabilities. Conclusions: Overall, the findings underscore the potential role of OMT as an adjunctive therapy for patients with a wide range of cancers, contributing to symptomatic management and enhanced QoL. Full article

Background/Objectives: We describe a case series of two patients with non-specific chronic low back pain (CLBP) and measurable decreased quality of life, who showed improvements after a specific multi-modal conservative spine and postural therapy regimen. CLBP is the leading cause of years lived with disability and disability-adjusted life years. This case series adds observational data to the medical literature on conservative treatment of CLBP and potentially improves diagnostic and treatment understanding of how conservative therapies can benefit patients suffering with CLBP. Methods: Two patients (Patient A: 58-year-old female; Patient B: 43-year-old male) presented with severe CLBP who did not find relief with prior traditional chiropractic manipulation. The patients sought treatment at a spine rehabilitation facility closest to their remote locations in Wyoming, USA. The conservative rehabilitation treatment program consisted of multi-modal therapies to strengthen postural muscles, postural spinal manipulation, and specific Mirror Image^® traction. After 36 treatments over 12 weeks in office and home rehabilitation exercises, baseline tests and outcome measures were repeated. Results: Patient-reported objective outcomes, disability indices, and radiographic analysis demonstrated changes at the conclusion of treatment that were maintained at long-term follow-up re-examination. Lumbar lordosis initially changed from −21.8° L1–L5 lordosis to post-treatment −33.6° for patient A and from −22.6° to −42.4° for patient B. Long-term follow-up demonstrated continued resolution of initial symptoms and maintained spine alignment. Conclusions: In these two patients, the described multimodal conservative program was associated with sustained improvements in symptoms, function, and radiographic parameters. This case series adds to prior biomedical literature regarding potential conservative interventions for treating CLBP and abnormal posture. Larger randomized controlled studies are required to evaluate generalizability and relative effectiveness. Full article

Background and Clinical Significance: Bone involvement is a common and debilitating manifestation of advanced malignancies, with a substantial negative impact on patients’ functional status, quality of life, and overall prognosis. Management is primarily palliative and may include several locoregional approaches such as radiotherapy, surgical stabilization, cementoplasty, thermal or cryoablation, and high-intensity focused ultrasound. Electrochemotherapy (ECT) is an emerging non-thermal ablative technique that combines limited invasiveness with short procedural times and a favorable safety profile. Case Presentation: We report the case of a patient with oligometastatic lung cancer presenting with a painful rib metastasis refractory to radiotherapy. The patient had previously undergone radiotherapy to the right femoral head and the eighth rib, followed by cryoablation combined with cementoplasty for the femoral lesion and cryoablation of the rib. At one-year follow-up after cryoablation combined with bone cementoplasty, computed tomography demonstrated progression with the appearance of a new symptomatic rib lesion unresponsive to further radiotherapy. Percutaneous ECT was therefore performed under general anesthesia, supplemented with an erector spinae plane block. A total of twelve 18-gauge needle electrodes were accurately positioned under fluoroscopic guidance. Follow-up imaging at three months showed complete local tumor resolution, accompanied by marked and sustained pain relief. Conclusions: This experience supports the role of ECT as an effective salvage locoregional treatment option in selected patients with bone metastases resistant to conventional therapies. Full article

Background: Preoperative anxiety and postoperative pain are prevalent and are frequently associated with poor postoperative functional outcomes. Comprehensive postoperative management, including both pharmacological and psychological components, is essential for proper postoperative care and better recovery. While the analgesic effect of traditional non-pharmacological intervention, such as cognitive behavior therapy, has been investigated by other trial studies, the newer innovative methods for delivering psychological interventions for reducing anxiety and pain are extensively being investigated. Virtual reality (VR) has emerged as a novel and promising technology that offers opportunities to mitigate patient perception and cognitive responses, and has been shown to be associated with lower levels of anxiety and pain. The aim of this randomized clinical trial (RCT) is to determine whether delivering the psychological content through virtual reality (VR) along with the standard preoperative and postoperative care results in better anxiety and pain relief outcomes than standard care in patients undergoing spinal surgery. Methods: This study protocol outlines a parallel-group RCT to be conducted in the Department of Neurosurgery at the University Clinical Hospital of Medical University of Lodz. The objective is to assess the efficacy of immersive VR environments in reducing preoperative anxiety and postoperative pain intensity in the following day after surgery. Adult patients (18–70) will be randomly assigned to either (1) standard care before surgery (control group), (2) VR exposure simulating the hospital environment alongside standard care, or (3) VR-based exposure to calming natural landscapes accompanied by soothing background sound along with standard care. In each group, a minimum of 50 patients will be recruited. The primary outcome is the change in preoperative anxiety measured using the State-Trait Anxiety Inventory-State (STAI-S) scale from baseline to immediately after intervention. Secondary outcomes include postoperative pain measured using the Visual Analogue Scale (VAS), postoperative analgesic consumption, patient satisfaction, and VR-related adverse effects. To facilitate a comprehensive understanding of the VR intervention’s impact, the primary outcome will be complemented with measures of the adverse effects, level of immersion, and level of presence in the VR environment. Secondary outcomes of self-reported satisfaction scores and postoperative analgesics from patients’ medical charts will be assessed. Conclusions: This trial will evaluate whether VR-based interventions may reduce preoperative anxiety and postoperative pain in patients undergoing spine surgery. This study may provide evidence supporting the future implementation of VR as a non-pharmacological adjunct in perioperative care. This intervention may hold significant clinical relevance clinically, particularly in patients with high level of preoperative anxiety, by offering an alternative method to pharmacological anxiolytics in the future. Full article

Trigeminal neuralgia (TN) ranks among the most excruciating neuropathic pain syndromes, characterized clinically by multiple daily episodes of unilateral, paroxysmal, electric shock-like facial pain. The daily activities and quality of life of affected patients are profoundly diminished. First-line pharmacological agents, such as carbamazepine and oxcarbazepine, provide initial relief for many patients. However, a significant proportion eventually develops refractory symptoms or experience intolerable adverse effects, leading to the discontinuation of traditional oral medications. For these patients with complex clinical phenotypes who fail to respond or are intolerant to these therapies, alternative pharmacological strategies are required before considering invasive surgical procedures. Over the past two decades, botulinumtoxin type-A (BoNTA) has become an effective and safe, minimally invasive therapeutic option for refractory TN. This review provides a practical framework for BoNTA use in the clinical setting of refractory TN. To connect the pathophysiological background with clinical patient care, we summarize the current understanding of TN pathophysiology, the proposed mechanisms by which BoNTA exerts its antinociceptive effects and the evolving clinical evidence supporting its efficacy and safety. We also critically examine dosing protocols, injection techniques, long-term outcomes and the integration of BoNTA into the management algorithm of refractory TN. Full article

Sciatic neuropathy is most commonly attributed to spinal or muscular causes, whereas vascular-related compression remains underrecognized. We report a case of sciatic nerve entrapment caused by an anomalous inferior gluteal artery in the deep gluteal region, who presented with persistent right gluteal and posterior thigh pain for more than two years, refractory to multiple conservative treatments. Physical examination demonstrated marked allodynia and a well-defined Tinel-like sign, with radiating symptoms extending to the lower limb, suggesting a peripheral etiology. High-resolution ultrasonography identified an aberrant inferior gluteal artery, which crossed over and compressed the sciatic nerve, forming an accompanying artery of the sciatic nerve. Doppler imaging confirmed the vascular nature of the structure, while long-axis views demonstrated focal nerve compression with segmental swelling. Magnetic resonance imaging further corroborated the diagnosis. Ultrasound-guided hydrodissection using 5% dextrose and lidocaine was performed, resulting in significant symptom relief. Pain scores improved from 7 to 3 after treatment, with resolution of symptoms at two-month follow-up. This case highlights a rare neurovascular cause of sciatic nerve entrapment and underscores the importance of ultrasonography in identifying anatomical variations. Recognition of vascular contributions to deep gluteal syndrome may improve diagnostic accuracy and guide targeted interventions. Full article

Background/Objectives: Lysophosphatidic acid (LPA) is a bioactive lipid mediator implicated in neuropathic pain (NP). Depressive symptoms frequently accompany NP and adversely affect outcomes, yet objective biomarkers remain limited. This study aimed to identify cerebrospinal fluid (CSF) LPA molecular species associated with depressive symptoms in patients with NP. Methods: CSF samples were obtained from 48 patients, and LPA species, including positional isomers (sn-1 and sn-2), were quantified using liquid chromatography–tandem mass spectrometry. Depressive symptoms were assessed using the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Statistical analyses were performed to evaluate associations among depressive symptoms, clinical variables, and LPA species. Results: CSF LPA18:0 was significantly associated with HADS-D scores (r = 0.380, p = 0.010), with the strongest association observed for the sn-1 isoform (r = 0.385, p = 0.009). In multivariable analysis, LPA18:0 sn-1 remained independently associated with depressive symptoms, alongside pain intensity and pain catastrophizing (R² = 0.386). Structural equation modeling supported an association between LPA18:0 sn-1 and depressive symptoms independent of pain-related factors. Conclusions: These findings suggest that CSF LPA18:0 sn-1 may be associated with a biological dimension of depressive distress and may represent a candidate biomarker of depressive distress in NP. However, these findings should be interpreted cautiously, as the analyses were exploratory, and further validation in independent and longitudinal cohorts is warranted. Full article

Background: Neurovascular compression syndromes (NVCS) represent a spectrum of disabling neurologic disorders caused by vascular or structural compression of cranial nerves, most commonly at the root entry zone. Conditions such as trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GN) are associated with significant pain, functional impairment, and reduced quality of life. This review provides a multidisciplinary, anatomically grounded overview of the pathophysiology, diagnosis, imaging, and contemporary management strategies for NVCS. Methods: A narrative review of the literature was conducted, synthesizing historical perspectives, neuroanatomy of the cerebellopontine angle, mechanisms of neurovascular conflict, advances in imaging and neuromonitoring, and current treatment modalities. Medical, percutaneous, surgical, radiosurgical, and neuromodulatory approaches were evaluated, with emphasis on patient selection and outcome considerations. Results: Neurovascular compression, most frequently arterial compression at the root entry zone, leads to focal demyelination, ephaptic transmission, and neuronal hyperexcitability. High-resolution Magnetic resonance imagin (MRI) remains the diagnostic gold standard. First-line management for TN and related syndromes typically includes pharmacotherapy, particularly sodium channel blockers. Refractory cases may benefit from percutaneous rhizotomy, balloon compression, stereotactic radiosurgery, or microvascular decompression (MVD), which offers the most durable relief in appropriately selected patients. Emerging technologies, including endoscopic visualization, advanced neuromodulation, and virtual reality-assisted surgical planning, continue to refine treatment precision and safety. Conclusions: Effective management of NVCS requires a comprehensive understanding of neuroanatomy, pathogenesis, and individualized risk–benefit profiles. A multidisciplinary, stepwise approach optimizes outcomes and improves quality of life in patients with these complex disorders. Full article

Background: Chronic pain affects approximately 30% of older adults and is strongly associated with social isolation and loneliness, which impact an estimated 25% of the global older adult population. A substantial proportion of chronic pain in this population is classified as primary chronic pain (non-specific), characterized by persistent pain with no underlying disease or structural damage. Pharmacotherapy has limited efficacy in treating primary chronic pain and presents significant polypharmacy risks, highlighting a critical need for sustainable, non-pharmacologic interventions. Among these, Tai Chi has emerged as a promising multimodal therapy, it is a mind–body exercise that integrates gentle movement and focused breathing with social engagement, offering participants both physical relief and opportunities for meaningful human connection. Gentle movement for flexibility, balance, and strength, combined with deep breathing may also improve self-reported symptoms of chronic pain, in addition to inflammatory biomarkers such as CRP, IL-6 and TNFα. The purpose of this narrative review is to investigate the literature on Tai Chi as a method for promoting socialization and reducing self-rated chronic pain among community-dwelling, socially isolated older adults. Methods: Following librarian-assisted concept map development, we searched six electronic databases (PubMed, CINAHL, Scopus, Cochrane, ProQuest, and PsycINFO) for studies published between January 2016 and February 2026. Search strings included terms for “older adults,” “chronic pain,” “social isolation/loneliness,” and “Tai Chi.” Two reviewers independently screened results and extracted data for relevance. Results: Of the 1098 records identified, 25 studies met the inclusion criteria. Eleven studies evaluated Tai Chi or related mind–body interventions. Among these, approximately six studies reported improvements in pain-related outcomes, while five studies reported improvements in loneliness or social isolation. However, only two to three studies simultaneously evaluated both chronic pain and social isolation/loneliness outcomes within Tai Chi interventions. Overall, most studies supported Tai Chi as a safe and potentially effective intervention for older adults, with evidence suggesting benefits for both pain and social well-being. However, the limited number of studies examining combined outcomes restricts conclusions regarding the integrated effects of Tai Chi on chronic pain and social isolation. Discussion: Tai Chi is a safe, inexpensive behavioral strategy for improving social connectedness and reducing self-rated chronic pain among older adults. However, the evidence base remains fragmented, as pain and social isolation are rarely assessed together within the same trial. Future research should address this gap by considering both social isolation and chronic pain in the same study, with more standardized Tai Chi forms as the single independent variable. Full article

Background/Objectives: Pain is one of the most disabling symptoms in patients with unresectable pancreatic ductal adenocarcinoma (PDAC), having a major impact on quality of life, functional status, and tolerance to oncologic treatment. Percutaneous computed tomography (CT)-guided cryoablation may provide tumor-directed pain palliation in selected patients. This study aimed to evaluate the safety and palliative clinical benefit of percutaneous CT-guided cryoablation in patients with painful unresectable PDAC. Methods: This retrospective single-center pilot case series included 11 consecutive patients with painful unresectable PDAC treated with percutaneous CT-guided cryoablation between January 2022 and May 2024. Primary endpoints were change in visual analogue scale (VAS) score and reduction in analgesic requirement. Secondary endpoints included technical success, adverse events, supportive clinical outcomes, imaging evolution, progression status, and survival. Results: Technical success was achieved in all procedures (11/11, 100%). No major procedure-related complications occurred; minor adverse events were observed in 3/11 patients (27.3%). Mean VAS score decreased from 6.72 ± 1.56 at baseline to 3.45 ± 1.44 at 1 month, 2.54 ± 1.29 at 3 months, 2.27 ± 1.43 at 6 months, and 1.60 ± 1.07 at 12 months. At 1 month, all patients showed a reduction of at least 3 VAS points. A reduction in analgesic requirement was documented in all patients during early follow-up, with complete opioid discontinuation in 5/11 patients (45.5%). At 1-month CT, residual enhancement was present in 9/11 patients (81.8%), although with an estimated 50–80% reduction in enhancing tumor burden. Observed survival proportions at 6 and 12 months were 90.9% and 72.7%, respectively. Conclusions: Percutaneous CT-guided cryoablation appears to be a feasible palliative option for selected patients with painful unresectable PDAC, with meaningful pain relief, opioid sparing, acceptable short-term safety, and exploratory imaging evidence of local cytoreductive effect. Further prospective studies are warranted. Full article

In recent years, there has been an unprecedented upsurge in opioid prescriptions for pain management. Consequently, the widespread availability of these medicines has led to an increase in misuse and abuse. This has led to a greater number of overdose-related deaths. The high prevalence of drug misuse was born of multiple and complex societal factors. However, from a medical perspective, critical contributors to the dire consequences of the crisis have been the need for chronic pain relief, as well as mental health issues within communities. Chronic pain coupled with psychological distress exacerbates patients’ predicaments and thus further fuels the crisis. Anxiety and depression have bidirectional and complex relationships with pain. The somatic symptoms associated with anxiety potentially worsen pain, whilst pain emanating from a chronic condition worsens anxiety. The same relational dynamic applies to depression and pain. Thus, these psychopathological states may be major contributors to the opioid abuse epidemic. Thus, psychosocial management as a first-line treatment instead of starting with drug treatments seems an enlightened approach to this problem. Cognitive behavioral therapy (CBT) has been proven to be effective in managing specific symptoms associated with chronic pain. Similarly, patient education has been shown to be a viable alternative to drugs for certain aspects of chronic pain treatment. We consider that the opioid crisis could be addressed with a greater reliance and emphasis on non-pharmacological approaches to managing chronic pain patients. This mini-review examines non-pharmaceutical and monitoring-based interventions to reduce opioid misuse risk among adults prescribed opioids for chronic non-cancer pain. Studies were identified through PubMed/MEDLINE, Scopus, and Google Scholar using terms related to chronic pain, prescription opioid misuse, opioid use disorder, cognitive behavioral therapy, patient education, prescription drug monitoring programs, digital health, telehealth, and non-pharmacological interventions. Studies were included if they focused on adults with chronic pain who were prescribed opioids or at risk of misuse, and evaluated interventions aimed at reducing unsafe opioid use, misuse risk, or opioid-related harm. Evidence was synthesized narratively to identify key intervention approaches, limitations, and clinical implications. Full article

Background: Hindfoot arthrodesis is commonly used to treat rigid flatfoot. While traditionally performed as a triple arthrodesis, recent evidence supports medial double arthrodesis, involving only the talonavicular and talocalcaneal joints and sparing the calcaneocuboid (CC) joint. This study aims to evaluate the long-term condition of the spared CC joint more than 10 years after double arthrodesis. Methods: We retrospectively reviewed 17 feet in 13 patients (8 women, 5 men; mean age 43.8 ± 16.5 years) who underwent double arthrodesis for rigid flatfoot. Clinical outcomes were assessed using the AOFAS score and a visual analog pain scale. Radiographic evaluation of the CC joint was based on Graves’ four-stage classification, preoperatively and at final follow-up (minimum 10 years). Results: The mean follow-up was 154.6 ± 20.4 months. No patient required additional CC arthrodesis, and all CC joints remained asymptomatic. Radiographically, degeneration improved in 9 cases, was stable in 6, and worsened in 2. The mean AOFAS score significantly improved from 23.7 ± 9.3 preoperatively to 70.1 ± 9.3 at the longest follow-up (p < 0.0001). Similarly, the mean VAS pain score decreased from 6.4 ± 1.3 preoperatively to 2.1 ± 1.2 at follow-up (p < 0.0001). Conclusions: Double medial arthrodesis spares the CC joint, enabling arthrodiastasis and subchondral remodeling over time. This contributes to long-term pain relief and improved radiographic outcomes. Preserving minimal motion at the CC joint may enhance foot adaptability to uneven terrain and reduce the need for further surgical intervention. Full article