Search Results (552)

Objective: Patellofemoral pain syndrome (PFPS) is one of the most common causes of anterior knee pain and is associated with biomechanical, muscular, and functional impairments affecting the extensor mechanism of the knee. Quadriceps muscle dysfunction, altered tendon morphology, and impaired lower extremity biomechanics have been suggested to contribute to patellofemoral joint instability and pain development. The aim of this study was to evaluate the muscle and tendon thicknesses of the extensor mechanism using ultrasonography in individuals with PFPS and to investigate the relationship of these measurements with knee pain, knee function, and physical performance, with particular emphasis on the combined assessment of muscle morphology, tendon morphology, and functional performance parameters. Methods: This cross-sectional study was conducted between 5 November 2019 and 15 December 2019, including 80 individuals aged 18–45 years who presented with anterior knee pain and were clinically diagnosed with patellofemoral pain syndrome (PFPS). Demographic characteristics of the participants were collected. Pain severity was assessed using the Visual Analog Scale (VAS), and functional status was evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Physical performance was assessed using the 6 m walk test and the five-repetition sit-to-stand test. Ultrasonographic examination was used to measure rectus femoris muscle thickness, vastus intermedius muscle thickness, quadriceps tendon thickness, and patellar tendon thickness using a high-frequency linear probe in a standardized supine position with the knee relaxed and the lower extremity muscles at rest. Results: The mean age of the participants was 32.11 ± 7.08 years, and the mean body mass index (BMI) was 25.05 ± 4.11 kg/m². Of the participants, 42 (52.5%) were male and 38 (47.5%) were female; 46 (57.5%) were smokers and 34 (42.5%) were non-smokers. Ultrasonographic measurements showed that rectus femoris muscle thickness was 1.98 ± 0.45 cm, vastus intermedius muscle thickness was 1.75 ± 0.53 cm, quadriceps tendon thickness was 0.54 ± 0.12 cm, and patellar tendon thickness was 0.35 ± 0.08 cm. Rectus femoris, vastus intermedius, and quadriceps tendon thicknesses were significantly higher in males compared to females (p = 0.001). Individuals with BMI > 25 had greater rectus femoris (p = 0.023) and vastus intermedius (p = 0.001) muscle thicknesses. A negative correlation was found between rectus femoris muscle thickness and WOMAC total (r = −0.227, p = 0.042) and WOMAC pain scores (r = −0.233, p = 0.028). Additionally, a significant relationship was observed between quadriceps tendon thickness and the five-repetition sit-to-stand test (r = −0.247, p = 0.044). Conclusions: In patients with PFPS, quadriceps muscle and tendon thicknesses were found to be associated with certain demographic and clinical parameters. Ultrasonographic evaluation of muscle and tendon structures may be a useful, non-invasive, dynamic, and radiation-free method for better understanding the clinical characteristics of PFPS and its relationship with physical performance. Ultrasonographic assessment may also provide complementary information for rehabilitation planning and functional evaluation in individuals with PFPS, although these findings should be interpreted cautiously because of the cross-sectional design and weak correlations observed. Full article

Background: Fibromyalgia is a chronic condition characterised by widespread pain, fatigue, sleep disturbances, and psychological symptoms. Mindfulness-based approaches are increasingly used as complementary interventions for symptom management. This study aimed to investigate the effectiveness of mindfulness-based yoga (MBY) delivered via telerehabilitation in individuals with fibromyalgia. Methods: This trial included 64 women with fibromyalgia who were randomly assigned to an 8-week mindfulness-based yoga program delivered via telerehabilitation or active control group including walking and physiotherapy modalities. Both groups received patient education at the outset. Assessments were conducted before and after the intervention. Outcome measures included fatigue, anxiety, depression, sleep quality, symptoms associated with central sensitization, kinesiophobia, pain intensity, mindfulness level, impact of fibromyalgia on life, biopsychosocial status, and pain catastrophising. Data were analyzed using mixed-design analysis of variance (ANOVA), with additional t-tests and analysis of covariance (ANCOVA) conducted for post hoc analyses. Results: Compared to the control group, the mindfulness-based yoga (MBY) group showed more pronounced improvements in terms of fatigue, anxiety, symptoms associated with central sensitization, biopsychosocial status, symptom severity, catastrophising about pain, ruminative thoughts about pain, and cognitive dimensions of pain. Although no significant differences were found between groups for other variables, intra-group improvements were observed in the MBY group. Conclusions: It was concluded that the MBY intervention administered via telerehabilitation is a viable complementary approach to traditional treatments in reducing the symptom burden of fibromyalgia. It was thought that the effectiveness of the research could be increased by conducting studies involving long-term follow-up assessments and investigating the integration of different mindfulness-based telerehabilitation interventions into the clinical setting. Full article

Background/Objectives: Given the growing need for prenatal care, Nordic Walking (NW) is a promising intervention for maintaining maternal physical activity and quality of life (QoL). We aimed to investigate the influence of NW on gait kinematics, pelvic girdle pain, low back pain (LBP), and QoL during pregnancy. Methods: This is a single-blind randomized controlled trial. A total of 44 pregnant women aged 20 to 40 years with 13–28 weeks of gestation and mild to moderate musculoskeletal pain were included. Participants were randomly assigned to either the study (NW) group or the control group. The study group received the NW program for 12 weeks, three sessions per week, each lasting 45 min. The control group received standard prenatal care plus 30 min of moderate walking three days a week. The GAITRite system was used to measure gait kinematics, and the Visual Analog Scale (VAS) for pain and the SF-36 for QoL were administered at baseline, the fourth week, and the twelfth week. Results: NW significantly improved gait kinematics and reduced musculoskeletal pain (p < 0.001) with improvements in pain and gait speed exceeding the previous reported MCID thresholds. QoL improved across all SF-36 domains in the NW group (p < 0.001) compared with the control group, with large effect sizes observed for the primary outcomes. Conversely, the control group experienced declines in several QoL domains, including energy/fatigue and emotional well-being, despite moderate walking exercise and standard prenatal care over 12 weeks. Conclusions: NW may represent an effective prenatal exercise regimen associated with improved gait, reduced pain, and better overall QoL compared with moderate exercise, consistent with standard prenatal care. Full article

Physical energy-based therapies are non-invasive adjunctive interventions that deliver mechanical, electromagnetic, light, or radiofrequency/thermal energy to tissues with the aim of reducing symptoms and improving tolerance of active rehabilitation. Osteoarthritis (OA) is a heterogeneous whole-joint disorder in which cartilage degeneration, subchondral bone remodeling, synovitis, peri-articular tissue dysfunction, neuromuscular impairment, and pain sensitization may interact to produce pain, stiffness, and activity restriction. As conservative therapy for OA, education, progressive therapeutic exercise, weight management when indicated, and self-management remain the core of care. Nevertheless, some patients cannot fully participate in exercise because of pain, fear of movement, load intolerance, comorbidity, or limited access to supervised rehabilitation. This narrative review synthesizes evidence published mainly between 2016 and 2026 for extracorporeal shock wave therapy (ESWT), photobiomodulation/low-level laser therapy (PBMT/LLLT), pulsed electromagnetic field therapy (PEMF), transfer energy capacitive and resistive/capacitive–resistive electric transfer (TECAR/CRET) therapy, body weight support and aquatic unloading strategies, and mechanosonic vibration therapies. The available literature suggests that ESWT and PBMT/LLLT may provide short- to mid-term pain and function benefits in selected patients with knee OA when parameters are aligned with evidence-supported dosing windows. PEMF and vibration therapies show promising but less consistent effects because protocols, devices, sham conditions, and populations vary. TECAR/CRET and unloading approaches are best interpreted as enabling tools that may reduce guarding, improve walking tolerance, or increase the quality of therapeutic exercise, rather than stand-alone disease-modifying treatments. Current national and society guidelines consistently prioritize exercise, education, and weight management; most of the modalities reviewed here are absent from guidelines or are supported only indirectly, which justifies cautious wording and individualized use. A practical application model is, therefore, time-limited and goal-oriented: identify the barrier to rehabilitation, select a modality with a plausible mechanism and published protocol, monitor pain and functional response, and discontinue the modality if it does not improve participation in active care. Full article

Neuropathic pain is a debilitating condition lacking objective and quantitative assessment tools, as current evaluations rely largely on subjective reports. Hyperspectral imaging (HSI) is a non-invasive technology that quantifies spatial and spectral tissue characteristics and has been applied in rheumatologic and metabolic disorders. This study investigated whether HSI-detected paw skin alterations correlate with graded nerve injury severity in a chronic constriction injury (CCI) model. Sprague–Dawley rats were assigned to sham or CCI groups with one to four sciatic nerve ligatures. Behavioral assessments (CatWalk XT gait analysis, thermal hyperalgesia, and mechanical allodynia) and paw HSI measurements were performed longitudinally. Histological and molecular analyses were conducted from paw skin to dorsal spinal cord tissues. At 1100 nm, HSI demonstrated progressive and significant spectral deviations proportional to injury severity across all CCI groups, whereas 1300 nm changes were only detected in severe injuries. Histology revealed increased fibrosis, NGF, TNF-α, synaptophysin, and microglial activation with greater injury severity, alongside reduced PGP9.5, neurofilament, AChR, Desmin, GAP-43, Pax3, and BDNF expression. These molecular findings were supported by electrophysiological and behavioral impairments, which correlated with injury grade by HSI. In conclusion, HSI at 1100 nm provides a sensitive and objective indicator of neuropathic pain severity and holds promise as a quantitative translational tool. Full article

Background: Walking a dog on-leash is a common activity for a large portion of our society. Many dogs consistently pull on the leash, which transmits potentially dangerous forces to the human body. The purpose of this in silico study was to determine the effects of dog-leash tension and human posture on lumbar compression, and how comparable the effects of dog walking on lumbar compression are to lifting, an activity known to contribute to low back pain. Methods: Dog-leash simulations were performed with 50–300 N directed along the arm segment of a static three-dimensional musculoskeletal model across a range of trunk segment and shoulder joint angles. Lifting simulations were performed across a range of test postures with the model holding a 50–300 N weight close to the ground. Lumbar compression was computed for each simulation using McGill’s polynomial equation and compared with the 3400 N cutoff used to develop occupational safety guidelines. Results: Lumbar compression increased as trunk segment flexion increased for all simulation conditions. With 200 N of leash tension, lumbar compression exceeded 3400 N for all postures with 25° or more of trunk segment flexion. When lifting 150 N, lumbar compression exceeded 3400 N for all postures with shank segment angle of 80° or greater and knee flexion angle of 100° or less. Conclusions: Our in silico results suggest that dog owners should seek intervention if their dog routinely pulls on the leash with a force of 200 N or greater and should attempt to lean backward when resisting leash pulling to reduce lumbar compression and injury risk. Full article

Objective: This study aimed to evaluate the clinical and radiological efficacy of percutaneous laser disc decompression (PLDD) in patients with disc-related lumbar spinal stenosis. Methods: Data from 96 patients who underwent PLDD between January 2023 and January 2025 were reviewed retrospectively. Pain intensity (visual analogue scale [VAS]), functional capacity (pain-free walking distance), patient satisfaction (global patient evaluation), and radiological canal diameter were assessed before the procedure and at 1, 3, and 6 months postoperatively. Treatment response was determined based on a ≥2-point decrease in the VAS score, which is the minimal clinically important difference (MCID) criterion. Results: A marked improvement in VAS scores was observed from the early period following PLDD, with the mean VAS score decreasing from 8.02 to 5.02 ± 1.99 at 6 months (p < 0.001). The pain-free walking distance increased from 212.7 m to 345.8 m, resulting in a significant improvement in functional capacity (p < 0.001). A significant increase in the anteroposterior diameter of the spinal canal from 7.1 ± 1.7 mm to 7.9 ± 1.8 mm (p < 0.001) was observed, corresponding to a mean increase of 0.8 mm; however, the magnitude of this radiological change was modest and should be interpreted cautiously. A moderate correlation was found between radiological expansion and VAS change (r = 0.52). At 6 months, 72.9% of patients met the MCID criterion. Although ODI improved significantly over follow-up, the mean reduction remained below commonly accepted MCID thresholds, suggesting that the functional benefit may be modest. No major complications were observed; only short-term transient radicular irritation (2.1%) was seen. Conclusions: PLDD was associated with improvements in pain control, functional capacity, and modest radiological canal enlargement in this cohort of carefully selected patients with single-level, predominantly disc-driven lumbar spinal stenosis. However, because of the retrospective design and absence of a control group, no conclusions regarding comparative effectiveness can be drawn. PLDD should therefore be viewed as a selectively applicable minimally invasive option rather than a general treatment for all forms of lumbar spinal stenosis. The observed clinical benefit was limited to the 6-month follow-up available in this cohort, and its durability beyond this period remains uncertain. Prospective and comparative studies are required to better define its long-term role and its position relative to conservative treatment and surgery. Full article

Background/Objectives: Continuous subcutaneous foslevodopa/foscarbidopa infusion (CSFLI) improves motor fluctuations in advanced Parkinson’s disease (PD), but some patients continue to experience residual motor and non-motor fluctuations despite optimized infusion parameters. We describe two patients receiving CSFLI in whom the addition or reintroduction of opicapone was associated with improvement in persistent fluctuations. In one patient, clinical findings were further explored using wearable sensor monitoring. Methods: Two patients with advanced PD treated with CSFLI and residual fluctuations received add-on opicapone. Clinical evaluation included neurological examination, assessment of motor fluctuations, and documentation of antiparkinsonian therapy before and after opicapone introduction. In one patient, motor performance was additionally evaluated with wearable sensor monitoring during the Timed Up and Go test and the 6-minute walk test before (T0) and three months after opicapone introduction (T1). Results: In both cases, opicapone 50 mg once daily was associated with rapid improvement in residual motor and non-motor fluctuations during CSFLI therapy. In the first patient, freezing episodes and unpredictable akinesia resolved. In the second patient, the reintroduction of opicapone improved morning slowness, axial symptoms, and dorsal pain. Wearable sensor analysis showed increased walking distance during the 6-minute walk test, higher walking speed, reduced Timed Up and Go duration, increased step length, and reduced step length variability. Conclusions: These preliminary observations suggest that opicapone may deserve further investigation as a potential adjunctive strategy in selected patients receiving CSFLI who continue to experience residual fluctuations despite optimized infusion therapy. Wearable sensor monitoring may provide objective support for treatment assessment in this setting. Full article

Background and Objectives: Knee osteoarthritis (KOA) is a degenerative joint disease that affects quality of life through pain, impaired functional performance, and altered gait patterns. Hydrotherapy is a well-tolerated form of physical rehabilitation, especially suitable for patients with severe pain, as water’s properties support movement while reducing joint load. Its effects have been widely studied, primarily focusing on patient-reported outcomes, with limited synthesis of functional performance and gait-related outcomes. Materials and Methods: A systematic search was conducted in PubMed, Web of Science, Cochrane, PEDro, SpringerLink, ScienceDirect, and Google Scholar, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search strategy included a combination of Medical Subject Headings (MeSH) terms and keywords. For example, the PubMed search strategy was as follows: (“knee osteoarthritis” OR “knee OA”) AND (“hydrotherapy” OR “aquatic therapy” OR “water-based exercise”) AND (“gait” OR “walking” OR “functional performance”). Randomized controlled trials (RCTs) from the last 10 years involving patients with KOA undergoing aquatic therapy were included. Primary outcomes included functional performance assessed by measures such as the 6 min walking test (6MWT), the Timed Up and Go (TUG) test, the five sit-to-stand (5 STS) and stair climb (SC) tests, and by using gait-related parameters (e.g., speed, cadence, and step length) assessed clinically or using technology. Patient-reported outcomes, including the Visual Analog Scale (VAS), Western Ontario and McMaster University’s Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Score (KOOS), were analyzed as a secondary objective. Results: A total of 479 studies were identified, of which 13 met the eligibility criteria. The results revealed improvements in functional performance, with increases in 6MWT in five studies, the TUG test in four trials, and better performance in the 5-STS and SC tests in five studies. Benefits in gait parameters were noted in four studies. Additionally, one of the articles reported improvements in static and dynamic balance, another showed enhanced proprioception, and a third described more efficient muscle activation during gait following hydrotherapy. Consistent benefits in pain reduction, joint stiffness, and activities of daily living, as reflected by VAS, WOMAC, and KOOS, were also noted immediately and maintained at follow-up. The variability in outcome measures and intervention characteristics limited the possibility of data integration and the calculation of effect sizes. Conclusions: Hydrotherapy as a rehabilitation intervention may be associated with improvements in functional capacity, mobility, and self-reported physical ability in patients with KOA, with some evidence supporting a beneficial effect on gait; however, the certainty of evidence remains low to moderate due to heterogeneity among studies and limited sample sizes. These findings should be interpreted in light of the methodological limitations identified across the included trials. Full article

Background and Objectives: Breast cancer survivors often experience long-term physical and psychological impairments that negatively affect quality of life. Exercise-based rehabilitation strategies are increasingly recommended in this population. This study aimed to analyze the physical and psychological benefits of Nordic walking (NW) in breast cancer survivors. Materials and Methods: A systematic review (registered in PROSPERO ref: CRD42024613292) was conducted in accordance with PRISMA guidelines. SPORTDiscus, CINAHL, Cochrane, Embase, Medline Ovid and PubMed were searched from database inception to 30 December 2025, with no restrictions applied regarding the language of the included studies, using the terms “breast cancer”, “walking poles”, “pole walking” and “Nordic walking”. Studies involving adult women (≥18 years) with breast cancer were included. Data on study design, participant characteristics, intervention protocols and outcomes were extracted. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Results: From 281 records identified, 17 studies were included that evaluated NW alone or in combination with other exercise. Improvements in cardiovascular capacity were reported in five studies (four out of five reported significant improvement after NW), while gains in shoulder range of motion were observed in three out of four studies assessing this outcome, mainly after standalone NW interventions. Positive changes in body posture were significantly reported after NW in all three studies investigating this parameter. Improvements in strength were reported in five studies, while gains in flexibility were observed in one study, within multimodal interventions combining NW with other exercise. Among seven studies evaluating lymphedema, sustained reductions were primarily reported after multiweek programs, especially when NW was combined with the ISA method. Several studies also reported improvements in pain, psychological alterations, and quality of life. Conclusions: NW appears to be an effective, holistic exercise modality for enhancing both physical and psychological aspects for breast cancer survivors. Full article

Osteoarthritis is a leading cause of lower-limb arthroplasty, and although total hip arthroplasty (THA) and total knee arthroplasty (TKA) reduce pain and improve quality of life, gait impairments often persist after surgery. This study aimed to analyze gait patterns in individuals following THA and TKA using the wearable RunScribe™ sensor system and to examine its sensitivity to short-term changes during rehabilitation. Thirty-seven patients (19 THA, 18 TKA) attending a two-week inpatient rehabilitation program were assessed twice, on the first and final day of rehabilitation. Gait was measured during a 2 min circular walk test, and both global spatiotemporal variables and limb-specific loading-related variables were analyzed. A significant main effect of time was observed for walking speed (p = 0.001, ηp² = 0.284), with improvements of approximately 10% in both groups, as well as for step cadence (p < 0.001, ηp² = 0.429) and contact time (p < 0.001, ηp² = 0.380). Loading-related variables also changed significantly over time, including impact acceleration (p = 0.004, ηp² = 0.226), braking acceleration (p < 0.001, ηp² = 0.419), and rate of force development (p < 0.001, ηp² = 0.412). No statistically significant between-group differences were observed for global gait variables, although participants following THA showed a tendency toward better walking performance (e.g., higher cadence, p = 0.065). These findings suggest that early rehabilitation is associated with measurable improvements in gait after arthroplasty and support the potential of affordable wearable sensors as practical tools for objective gait assessment in clinical settings. Full article

Prolonged standing and repetitive lifting are routine occupational stressors that elevate plantar pressures across workers. In those with diabetes, these demands represent additional risk factors for diabetic foot pathology, highlighting the need for ergonomic interventions beyond standard safety footwear. This study evaluated the perceived ergonomic performance of the MoonWalking^® insole, a novel adaptive pneumatic system designed for real-time pressure stabilization and offloading when integrated into safety footwear. A comparative experimental protocol tested two conditions: safety footwear with the manufacturer’s original insole and the same footwear with the MoonWalking prototype. Twenty participants assessed perceived comfort using a VAS and binary ergonomic questionnaires. The results showed statistically significant improvements in perceived cushioning, foot fit, and overall comfort when using the MoonWalking insole. Participants consistently identified pressure-stabilizing and offloading functions across all plantar regions, indicating that adaptive pressure control was clearly perceptible. No pain or movement restrictions were reported. Although perceived fatigue did not reach statistical significance, a decreasing trend was observed. A slight reduction in intention to reuse the footwear occurred with the prototype, possibly due to its increased weight. These findings provide evidence that integrating an adaptive pneumatic insole into safety footwear may improve plantar pressure redistribution and user comfort. Full article

Introduction: Although gait alterations associated with excess body weight have been widely studied, most available evidence comes from laboratory-based analyses, which limit ecological validity and the translation of findings into clinical practice. This study addresses this gap by examining gait biomechanics across BMI categories using portable sensor-based insoles that allow gait assessment in real-world conditions. Methods: A cross-sectional study including 96 adults categorized as normal weight (NW), overweight (OW), or obese (OB) was conducted. Gait biomechanics were recorded using PODOSmart^® intelligent insoles, which capture spatiotemporal and angular parameters during natural walking. Foot health, quality of life and comorbildities were evaluated throught valeted questionnarires. Differences between groups were analyzed using ANOVA and chi-square tests. Age and sex, known to influence gait, were comparable across BMI groups and were considered in the interpretation of the results. Results: Overall, the participants in the OB group exhibited reduced stride length, gait speed, and swing time, increased double-support time, and greater pronation–supination and progression angles than OW and NW participants. Partial eta-squared values (η²p) were predominantly medium to large, reinforcing the robustness of these between-group differences (e.g., double-support time, p > 0.001; η²p = 0.19). Individuals with obesity reported poorer general and foot health and more difficulty finding suitable footwear. BMI was also significantly associated with hypertension, dyslipidemia, arthritis, and depression (all p <0.05), whereas diabetes, cardiopathies, knee pain, and fatigue andwalking or social activity limitations showed no significant differences. Conclusions: By using portable gait analysis technology in ecological conditions, this study provides novel evidence of clinically meaningful gait impairments across BMI groups. Higher BMI is associated with clinically relevant gait impairments, poorer perceptions of foot and general health, and a higher prevalence of several comorbidities. Full article

Background: The etiology and diagnosis of heel pain are complex and multifactorial, and it has been reported that Baxter’s entrapment is responsible for up to 20% of foot disorders. The most conservative treatment of Baxter’s entrapment has been the use of custom insoles. Electromyography was considered an effective test to assess muscle activity. The aim of this study was to test the use of insoles of different hardness on muscle activity of the abductor hallucis muscle in subjects with entrapment of the lateral branch of the external plantar nerve. Methods: 18 subjects (7 women and 11 men) diagnosed with nerve entrapment of the first branch of the lateral plantar nerve were recruited. Muscle activity of the adductor hallucis muscle was analyzed with insoles of different hardness in static and dynamic situations using electromyographic evaluation. Results: The statistical analysis did not show statistically significant differences in the muscle activity of the abductor hallucis muscle in the static position, with and without plantar orthoses (p>0.05), in contrast, in dynamic situations statistically significant differences were found between groups (p<0.01). Conclusions: The use of a hard insole decreases the maximum peak muscular activity of the abductor hallucis muscle in subjects with Baxter’s nerve entrapment in walking conditions. Full article

Background: Achondroplasia, the most common genetic dwarfism caused by the FGFR3 mutation (autosomal dominant, 80% de novo), results in a disproportionately short stature. Thoracolumbar kyphosis (TLK), combined with characteristic spinal canal stenosis, increases the risk of symptomatic compression, yet the literature lacks clear thresholds for symptom onset or progressive deformity angles. Methods: A 16-year-old female with achondroplasia presented with rapidly progressive kyphosis despite conservative management (bracing and therapy). Over six months, she developed neurogenic claudication; bilateral leg pain; weakness; and paresthesia that worsened with standing/walking, which was relieved by flexion/sitting. Imaging demonstrated surgical-threshold kyphosis with progressive spinal misalignment. Her symptoms indicated compressive myeloradiculopathy from lumbar stenosis, critical given achondroplasia’s congenitally narrowed canal and heightened neurologic vulnerability. Results: Staged surgery planned: Posterior fusion T6-L4 with pedicle screws and then extensive decompression (laminectomy/foraminotomy T11-L3), L1 corpectomy with expandable titanium cage, and Ponte osteotomies. Intraoperative complications included a malpositioned left T10 screw breaching the anterior/lateral cortex near the aorta, requiring urgent revision. Postoperatively: Neurogenic bladder, wound leakage, and E. coli urinary tract infection (UTI) with fever (treated with IV antibiotics). After infection resolution, definitive surgery removed the malpositioned screw and completed decompression, corpectomy, cage placement, bone grafting, and osteotomies, successfully resolving neurological symptoms. However, 13 cm trunk lengthening caused severe functional impairment—disproportionately short arms prevented independent toileting and dressing. Left arm lengthening via external fixation restored partial function. At 2.5-year follow-up, there was solid fusion, no neurological deficits, and improved quality of life. Conclusions: Surgery addresses severe TLK, vertebral wedging, and neurogenic claudication in achondroplasia. Vertebral column resection effectively corrects TLK and neurological deficits but carries a high complication risk. This should be reserved for severe TLK with hypoplastic vertebrae, performed by experienced surgeons. Critically, correction magnitude must preserve limb–trunk proportions to prevent functional disability, as excessive lengthening may necessitate additional limb procedures for independence restoration. Full article