Breast Milk Fatty Acid Shapes Immune Development in Mice

In a new study published in Science titled, “Maternal trans-vaccenic acid shapes neonatal T cell development and early-life immune imprinting,” researchers from the University of Chicago have found that trans-vaccenic acid (TVA), the most abundant trans fatty acid in human breast milk, helps boost immune system development in mice. 

Nursing female mice that were fed a diet enriched with TVA passed the nutrient to their pups, leading to increased production of immune cells during early development. Genetic analyses showed that TVA exposure during breastfeeding reprogrammed immune cells to improve responses to pathogens. Mice that were nursed on TVA-enriched milk responded faster to infections with viruses or common bacteria, even into adulthood. 

“It’s common knowledge that breastfeeding is important for neonatal immune development and overall health, but breast milk is so complex that it seems almost impossible that one single molecule would be sufficient to change a baby’s immune development,” said Jing Chen, PhD, professor of medicine at UChicago and co-corresponding author on the study. “So, it was very surprising to see that during this crucial stage of development, one nutrient derived from the mother’s diet and delivered through breastfeeding has such a tremendous effect.” 

TVA is a long-chain fatty acid found in meat and dairy products from grazing animals such as cows and sheep. The human and mouse body must obtain TVA through diet.  

Pups who were nursed by mothers with a diet enriched with TVA demonstrated a broader and more effective immune cell population, particularly CD4+ T cells that are important for adaptive immunity. Mice raised on TVA-enriched breast milk responded more quickly and had higher survival rates when exposed to the flu virus or Salmonella. 

“We saw that only postnatal exposure to TVA through breastfeeding is important to train the neonatal T cells, and this can have long-lasting imprinting effects,” Chen said. “Even in adulthood, when we challenged the mice with influenza, the ones that were exposed to higher TVA levels during breastfeeding responded better when battling the infection.” 

The team also analyzed TVA levels in breast milk and blood samples from human nursing mothers and infants. They found that higher TVA levels in breast milk were closely linked to higher TVA levels in infants’ blood. In preterm infants, levels of circulating TVA correlated with similar shifts in immune responses seen in mice.

Higher TVA levels in human breast milk were also associated with reduced risk of bronchopulmonary dysplasia, a chronic inflammatory lung disease that affects premature infants with underdeveloped lungs and increased susceptibility to respiratory infection. 

Chen hopes for more research on the possibilities for supplementing diets with TVA during pregnancy and breastfeeding, or infant formula. The team will also investigate additional fatty acids and nutrients found in breast milk to understand their benefits. 

“There are close to 40 fatty acids in total in breast milk, along with hundreds of other components,” Chen said. “So, I think it’s safe for us to say that we believe there could be additional fatty acids and nutrients that can do something similar.” 

The post Breast Milk Fatty Acid Shapes Immune Development in Mice appeared first on GEN – Genetic Engineering and Biotechnology News.

Physical factor therapies for insomnia: a narrative review of mechanisms, clinical evidence, and phenotype-guided applications

Although pharmacological treatments for insomnia remain widely prescribed, their long-term use is constrained by risks of tolerance, dependence, and residual daytime effects. This has prompted growing interest in non-pharmacological interventions that target insomnia’s underlying mechanisms. This narrative review examines five physical factor therapies for insomnia: auditory stimulation, phototherapy, thermotherapy, electrical stimulation, and magnetic stimulation. They are classified according to their primary sites of action into peripheral sensory modulation, central neuromodulation, or systemic autonomic regulation. In each context, research findings about circadian entrainment, thermoregulatory promotion of falling asleep, attenuation of cortical hyperarousal, and restoration of autonomic balance are discussed. Clinical evidence from randomized controlled trials and meta-analyses is critically appraised, with emphasis on therapeutic efficacy, safety, and limitations. Overall, physical factor therapies may constitute promising adjunctive options for selected insomnia phenotypes, but current evidence remains heterogeneous and preliminary for several modalities. Recent advances in portable and home-based technologies support their feasibility, although long-term effectiveness, adherence, and cost-effectiveness remain to be established. Future research should prioritize larger sham-controlled trials, objective sleep and circadian outcomes, standardized protocols, biomarker-guided stratification, and closed-loop intervention systems.

Psychological distress and caregiver burden among informal caregivers of patients with earthquake-related and stroke-related dependency: a comparative study

ObjectiveThis study aimed to compare the psychological burden of informal caregivers of patients with earthquake-related dependency and those caring for patients with stroke-related dependency following the 6 February 2023 Türkiye–Syria earthquakes.MethodsA total of 90 informal caregivers of dependent patients were included in this comparative study: 60 caregivers of stroke patients and 30 caregivers of patients with earthquake-related dependency. Participants were assessed using the Beck Depression Inventory, Beck Anxiety Inventory, Beck Hopelessness Scale, Caregiver Burden Scale, and the PTSD Checklist for DSM-5 (PCL-5).ResultsCaregiver burden was significantly higher among male caregivers (p=0.026). Caregivers of patients with earthquake-related dependency more frequently reported receiving external support than caregivers of stroke patients (p=0.004). Overall, caregiving was perceived as a moderate burden in both groups. The distributions of depressive symptoms, anxiety symptoms, and hopelessness levels did not differ significantly between the groups (p=0.172, p=0.172, and p=0.834, respectively). Among caregivers of stroke patients, PTSD symptoms and caregiver burden showed moderate positive correlations with depression, anxiety, and hopelessness (all p<0.05). In caregivers of patients with earthquake-related dependency, caregiver burden was associated only with hopelessness (p=0.045).ConclusionInformal caregivers of patients with earthquake-related and stroke-related dependency experienced comparable levels of psychological distress, despite differences in caregiving context and disaster-related adversity. The higher frequency of external support among caregivers of patients with earthquake-related dependency may be associated with this pattern, suggesting that family and social support may be relevant to caregiver psychological outcomes in post-disaster settings.

Post-marketing safety of lecanemab: a real-world study based on FAERS database, multicenter cohort and network pharmacology

IntroductionLecanemab is a monoclonal antibody targeting amyloid-beta (Aβ) approved for treating Alzheimer’s disease (AD) with mild cognitive impairment or mild dementia. Continuous monitoring of its real-world safety profile remains essential. This study aimed to analyze lecanemab-related adverse events (AEs) using the FDA Adverse Event Reporting System (FAERS) database and a multicenter cohort, and explored mechanisms via network pharmacology.MethodsWe conducted an updated disproportionality analysis of FAERS data from 2023 to 2024 to identify disproportionate reporting signals (SDRs). A multicenter retrospective cohort study was performed, including lecanemab users from June 2024 to February 2025. Data were collected from electronic medical records of five tertiary hospitals. AEs were identified and influencing factors of AE occurrence were analyzed. Additionally, a drug-gene interaction network was constructed to explore potential mechanisms.ResultsIn the FAERS analysis of 2,764 AEs from 1,389 lecanemab users, 12 of 41 positive SDRs were prioritized, with 75% (9/12) being nervous system disorders, primarily amyloid-related imaging abnormalities (ARIA). In the cohort study, 29.05% (43/148) of patients experienced AEs, with infusion-related reactions being most common. Age was identified as a risk factor for AE occurrence [OR (95% CI): 1.109 (1.011–1.215), P = 0.028], while pre-treatment significantly reduced AE incidence. Gene enrichment analysis suggested potential links between lecanemab-related genes and AEs.DiscussionThis study provides real-world evidence on the risk profile of lecanemab, highlighting the importance of continued safety monitoring. These findings may inform discussions about the risks associated with anti-amyloid treatments and warrant further confirmation in large-scale prospective studies.

Health equity researchers fear unseen level of scrutiny under White House proposal

Deep inside a White House proposal to overhaul how the government awards grants is a short section that health disparities researchers say could disqualify much of their work from federal funding — perhaps the most serious threat yet to the future of their field.

Since it was issued last month, the 412-page proposal has drawn thousands of public comments, in large part because it would diminish the power of peer review in determining which grants are funded, and place that authority with political appointees. Less attention has been given to how the proposed changes could affect efforts to eliminate health disparities research. 

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Birth Characteristics Highlight Early-Onset Colorectal Cancer Risk

U.S. researchers have identified several life factors identifiable at birth that impact on a person’s risk of being diagnosed with colorectal cancer (CRC) at a younger age.

Being a man or having Hispanic ethnicity were potential risk factors for colorectal cancer before the age of 50 years, according to the study in Cancer. Among women, being heavier at birth or having an older father also increased this risk.

Conversely, men and women with a foreign-born mother had a significantly decreased risk of having colorectal cancer at this younger age.

“Evaluating demographic, birth, and parental characteristics is important in understanding what’s causing the rising incidence of early-onset colorectal cancer,” said lead author Sunny Siddique, PhD, MPH, from the Yale School of Public Health.

“Our findings warrant future studies aimed to understand the mechanisms through which factors such as male sex, Hispanic ethnicity, birthweight, maternal birthplace, and paternal age may influence risk of early onset colorectal cancer.”

Colorectal cancer is the second most common cancer in the U.S and, while rates have declined among people 50 years of age in the past few decades, they have steadily increased in younger people.

Compared with colorectal cancer that occurs in later years, early-onset disease presents at an advanced stage, both because of its aggressiveness and delays in diagnosis. It is typically found in the rectum and distal colon, a location associated with Western diets.

Siddique and team compared the characteristics of 1221 people diagnosed with colorectal cancer before age 50 with 61,050 matched individuals without cancer, all living in California.

Multivariable analysis revealed that men had a 34% higher risk of early-onset colorectal cancer compared with women. Hispanic ethnicity was also linked with a 43% higher risk compared with being White.

Among women, every half-kilo increase in birthweight was associated with a 10% increase in early-onset disease, while having a father aged 35 years or older was linked with a 56% increase in risk.

Overall, having a mother born outside the U.S. was associated with a 15% lower risk of early-onset colorectal cancer.

Siddique and co-workers note that more than 60% of foreign-born mothers in their study were born in Mexico and they point to other research suggesting that first-generation, foreign-born Hispanic women tend to have healthier diet and less obesity during pregnancy than their U.S.-born counterparts.

The team speculates that the paternal-age finding may relate to increases in rate of de novo mutations among children born to older fathers.

Referring to the raised Hispanic risk, the researchers note that this ethnic group continues to experience barriers to accessing screening and care, including language and cultural competency, income, and a lack of health insurance.

“Per recent recommendations by the U.S. Preventive Services Task Force to initiate CRC screening among average-risk individuals aged 45 years or older, it is important to note that people younger than age 45 years are not eligible for routine screening,” they pointed out.

“Yet, our finding of Hispanic ethnicity being a risk factor for CRC is particularly relevant to this group of young individuals who are experiencing a high incidence of CRC.”

The post Birth Characteristics Highlight Early-Onset Colorectal Cancer Risk appeared first on Inside Precision Medicine.

QAIAx (AIhealth4U) – AI Public Health Central: Microcity-A (re Quantum AI Agency Aka AI City Hall Project, UPSTO App Nos. 64/074,526, 64/063,557, 63/903,181, 63/729,428

Conditions: Asperger’s Disorder; Asperger Disorder; Autism Disorder; Autism; ADHD – Attention Deficit Disorder With Hyperactivity; ADHD; ASD; Alcohol Abuse/Dependence; Alcohol Addiction; Alcohol and Other Drug Use Disorders; Alcohol and Other Substance Use Prevention; Gambling Addiction; Gambling Disorder; Sex Abuse; Sex Behavior; Sex Crimes; Sex Disorder; Sex Disorders; Gender Dysphoria, Adult; Eating Behavior Disorders; Narcotic-Related Disorders; Narcotic Addiction; Narcissism; Psychiatric Disorder; Psychedelic Effects in Healthy Volunteers; Psychedelic Experiences; Psychedelic Drug Dependence; Marijuana Use Disorder; Marijuana Abuse and Dependence; Smoking (Tobacco) Addiction; Smoking Among Youth; Smoking Abstinence; Abstinence, Sex; Opiate Substitution Treatment; Opioid Abuse (Disorder); Opioid Abuse and Addiction; Cocaine Abuse; MDMA (‘Ecstasy’); Addiction Disorders; Homeless and Low Incomes People, Refugees; Homelessness; Reliability and Validity; Anger Problems; Child Abuse, Sexual

Interventions: Behavioral: AI City Hall Project (AIhealth4u – Public Health Central); Behavioral: AI City Hall Project (QAIAx Microcity A – AI Public Health Central)

Sponsors: Veterans Recovery Network Inc.; U.S. Special Operations Command; Central Virginia VA Health Care System; AI-119 Vulcan Project Research & Educational Technology Company (fka Henry Nanpei Academy Project)

Not yet recruiting

StockWatch: Positive Phase III Data Sells Investors on Intellia

A second positive Phase III data readout in two months is a major reason why Intellia Therapeutics (Nasdaq: NTLA) shares have soared more than 76% over the past six months—including a 29% surge this past week that followed the CRISPR gene editing therapy developer’s lead pipeline candidate lonvoguran ziclumeran (lonvo-z) meeting three key secondary endpoints in a pivotal study in patients with hereditary angioedema (HAE).

Lonvo-z met the Phase III HAELO trial’s (NCT06634420) primary endpoint, Intellia announced back in April, by showing an 87% reduction (p<0.0001) in mean monthly attacks in the lonvo-z arm vs. the placebo arm during the efficacy evaluation period (weeks 5-28). Lonvo-z also aced the trial’s key secondary endpoint by showing that 62% of the 52 patients in the lonvo-z arm were entirely attack-free and therapy-free for the six-month efficacy evaluation period, vs. just 11% of the 28 patients in the placebo arm (p<0.0001).

On June 13, Intellia presented and published additional data showing lonvo-z to have achieved positive results on three other key secondary endpoints:

  • Monthly rate of attacks requiring on-demand treatment, Weeks 5–28, mean (0.19 vs. 1.79, 95% CI).
  • Monthly rate of moderate/severe attacks, Weeks 5–28, mean (0.11 vs. 1.23, 95% CI).
  • Change from baseline to Week 28 in AE-QoL total score, mean ( — 23.51 vs. — 6.47, 95% CI).

Intellia presented the data at the European Academy of Allergy & Clinical Immunology (EAACI) Annual Congress 2026 in Istanbul, Türkiye, and published the results in The New England Journal of Medicine.

The data was strong enough for Intellia to continue the rolling Biologics License Application (BLA) submission that it began in April. The company expects to complete the BLA filing by year’s end and hopes to gain FDA approval and launch lonvo-z in the first half of 2027.

“Super pleased”

“We were super pleased with the results that we saw,” John Leonard, MD, Intellia’s president and CEO, told GEN. “We’re essentially replicating what we’ve seen throughout the program, where most of the patients reached a status of no attacks, no therapies over the course of this extended observation period. For those patients who didn’t, they appeared to be on their way to reaching that kind of a state. And critically important was that every single patient who got the drug was off long-term prophylaxis.”

“Across the board, and across all subgroups, the drug performed extremely well. So, we think it speaks to physicians, it’s going to speak to payers in terms of how they think about the drug and its ultimate, excellent utility,” Leonard said.

Investors and analysts appeared to share that enthusiasm this past week, as Intellia’s stock price rose over three of the four trading sessions following the release of data on the secondary endpoints. Intellia shares jumped 23% on June 15, the first trading day since the news, rising from $12.11 to $14.92. After a day of profit-taking that saw shares dip 2.5%, to $14.55, Intellia’s stock resumed its upward trajectory, rising nearly 4.5% to $15.20 on Wednesday, then another 3% Thursday, closing the week at $15.67. Markets were closed on Friday for the Juneteenth holiday.

Since December 18, 2025, when Intellia shares closed at $8.88, the stock has soared nearly 76.5%, accounting for most of its one-year gain of 62%. Lonvo-z accounted for three of Intellia’s four stock price peaks in 2026: The dosing of the first patient in HAELO, announced January 22, led the stock to climb 13%, from $14.03 to $15.90.

Shares surged 12% March 2, from $13.78 to $15.44, when the FDA lifted a clinical hold on the company’s Phase III MAGNITUDE trial (NCT06128629) assessing nexiguran ziclumeran (nex-z) in transthyretin amyloidosis with cardiomyopathy (ATTR-CM). The FDA imposed the hold after an elderly patient died during a study of Nex-z, an in vivo CRISPR-based therapy developed in partnership with Regeneron Pharmaceuticals (Nasdaq: REGN) to treat ATTR-CM by inactivating the TTR gene.

The third peak, an 8% gain from $15.31 to $16.57 on April 22, followed Intellia reporting positive data for lonvo-z, showing that it met HAELO’s primary endpoint, while the fourth peak followed the secondary endpoint announcement.

Misperceived market

“Hereditary angioedema has, in the last 10 to 15 years, had a variety of therapies arrive that are better than the ones that were there 20 years ago. Twenty years ago, circumstances were pretty grim for patients with HAE,” Leonard recalled. “I think some investors have looked at this incorrectly as a satisfied market, only because there are other therapies available.”

Among those therapies are three that won FDA approval last year. Last August, the agency approved Dawnzera® (donidalorsen), a prekallikrein-directed antisense oligonucleotide designed to prevent HAE attacks in patients ages 12+, marketed by Ionis Pharmaceuticals (Nasdaq: IONS). A month earlier, the FDA authorized Ekterly® (sebetralstat), a plasma kallikrein inhibitor indicated for the treatment of acute attacks of HAE in patients ages 12+, marketed in the United States by KalVista Pharmaceuticals (Nasdaq: KALV).

And in June 2025, the FDA approved Andembry® (garadacimab-gxii), an activated Factor XII (FXIIa) inhibitor (monoclonal antibody) and the first long-term prophylactic HAE treatment designed to target Factor XIIa, administered as a once-monthly subcutaneous injection for patients ages 12+, marketed by CSL Behring, the largest business unit of Australian-owned CSL (ASX: CSL).

“What we’re showing is that a lot of efficacy and a lot of utility has been left on the table, and that it’s possible for patients to get pretty close to something resembling a normal person who does not have HAE and all of the things, benefits that come with that,” Leonard said. “As people have looked at the data more completely, I think they’re seeing more and more that that’s the case, and maybe some of those original premises that they had are not quite correct.”

In research notes, three analysts said Intellia’s latest data strengthened the company’s future case to regulators for pursuing approval of lonvo-z as a one-time HAE treatment.

“We view these data as furthering Intellia’s case for regulatory approval following its expected completion of a rolling BLA,” Myles R. Minter, PhD, a partner and biotechnology analyst with William Blair, wrote June 15.

A day earlier, Jefferies equity analyst Maury Raycroft, PhD, commented that Intellia’s latest data will help lonvo-z gain more than a foothold in the HAE market.

“Positive implications”

“Big picture, we believe total HAE data have positive implications for commercial positioning” of lonvo-z, Raycroft wrote. “Editing is expected to be durable (we have seen longer term ph.I/II data out to 3-yrs); therefore, NTLA’s approach could eliminate need for lifelong chronic tx [therapy], justifying the value proposition of a 1X tx, despite competition in a crowded HAE space.”

Raycroft cited market research from Intellia showing that 64% of surveyed patients on LTPs [long-term prophylaxis drugs] are extremely likely to transition to a one-time therapy, while 54% surveyed docs expressed intent to prescribe such a treatment.

Mani Foroohar, MD, senior managing director, genetic medicines, and a senior research analyst with Leerink Partners, said Intellia’s latest results “again demonstrate lonvo-z’s clean safety and best-in-class efficacy and convenience.”

Writing in NEJM, the team of HAELO investigators reported no serious adverse events in patients treated with lonvo-z: “The most common adverse reactions were infusion-related reactions, which were generally transient and resolved without intervention. Elevated levels of serum aspartate aminotransferase and alanine aminotransferase, which occurred in approximately 10 to 15% of patients treated with lonvo-z, were transient, asymptomatic, and resolved without intervention.”

Foroohar sided with optimistic investors over their pessimistic counterparts in arguing that patients will warm up to a one-time treatment, though it will likely be costlier than current therapies.

Bears and bulls

“Bears argue limited patient demand to move up the innovation curve in a market with several approved treatments. We take the other side of this and see onetime therapy (vs lifetime chronic dosing) and patient desire to be attack-free as potent tailwinds to adoption,” Foroohar wrote. “Longer follow-up and crossover data (caveat – small n [number of patients studied]) provide an early glimpse at the improving profile of lonvo-z over time. We look to more data ahead of 1H27 launch to further educate physicians/patients.

“Subgroup analyses demonstrate clear benefit across all patient populations (prior LTP use, historical attack severity/frequency, etc.), supporting broad uptake as SoC [standard of care] across HAE—recognizing this will take time to play out as physicians gain comfort with this (likely) first approved in vivo gene editing therapy,” Foroohar added.

Intellia has not set a price for lonvo-z.

“We have said publicly we’re not going to set any new records beyond prices that have been precedented,” Leonard said.

HAE patients, he continued, “are some of the most costly patients that payers have. They’re small in number, but high in cost, with the therapies they take and their healthcare resource utilization exceeding $1 million a year.

“When you consider that these are patients that are oftentimes treated, or first diagnosed in adolescence or young adulthood, the lifetime costs are frighteningly high,” Leonard explained. “We are confident that, and we have this as an intended outcome, that we will save lifetime health, resources in very, very substantial terms, in a way that payers see and can recognize. We want to make it easy for patients to get onto the therapy, and we want to make it very competitive, cost-competitive for physicians taking care of them.”

Leaders and laggards

  • Elicio Therapeutics (Nasdaq: ELTX) shares plunged 72.5% from $14.85 to $4.08 on June 15 after the developer of immunotherapies to treat high-prevalence cancers said it was evaluating multiple strategic financing and partnership opportunities to advance its planned Phase III adjuvant pancreatic cancer immunotherapies program and broader AMP platform. The action came after ELI-002 7P, a 7-peptide formulation of its lead candidate ELI-002, failed the Phase II AMPLIFY-7P trial (NCT05726864) in patients with mKRAS-driven pancreatic ductal adenocarcinoma (PDAC). ELI-002 7P missed the pre-specified primary endpoint of disease-free survival (DFS) in the intent-to-treat population. Elicio said the ELI-002 7P arm had a higher proportion of R1 resected (higher residual disease) patients vs. the observation arm (19% vs. 10%), and that post-hoc analyses showed significant DFS improvement (R0: HR 0.65, p=0.048) in the 121 lower residual disease (R0 completely resected) patients, a subgroup representing approximately 84% of enrolled patients. Elicio said the trial results will shape a Phase III strategy focused on a defined R0 resected population and additional ELI-002 7P dosing.
  • Neumora Therapeutics (Nasdaq: NMRA) shares plummeted 49% from $1.78 to 91 cents on June 15 after the brain disease drug developer said it was chopping its workforce by approximately 35% or about 34 jobs, ending development of its major depressive disorder (MDD) candidate navacaprant, and refocusing on advancing the rest of its pipeline. The actions came after navacaprant missed statistical significance on the primary and key secondary endpoints of the Phase III KOASTAL-2 trial (NCT06058013) and KOASTAL-3 trial (NCT06058039) in MDD. The primary endpoint was the change from baseline to week 6 on the Montgomery-Åsberg Depression Rating Scale (MADRS).  Neumora projected the job cuts would save it approximately $10 million annually, to be partially offset this year by approximately $2 million in one-time restructuring costs. Neumora said current cash and cash equivalents are expected to provide runway into Q3 2027, including multiple expected key clinical milestones. Neumora’s pipeline includes NMRA-511 in Alzheimer’s disease agitation, NMRA-898 in schizophrenia, and NMRA-215 in cardiometabolic disease.
  • uniQure (Nasdaq: QURE) shares zoomed 78% from $26.99 to $48.16 Wednesday after the gene therapy developer announced the FDA’s revised position that a three-year analysis from its two-trial, Phase I/II study (United States, NCT04120493, and Europe (NCT05243017) of AMT-130 in Huntington’s disease was now acceptable as the primary basis of a Biologics License Application (BLA) for accelerated approval of the gene therapy. Researchers hailed “game-changing” data last year showing significant slowing of Huntington’s disease (HD) progression, but the FDA disagreed while its Center for Biologics Evaluation and Research (CBER) was headed by Vinayak (Vinay) Prasad, MD, who resigned in April. uniQure said the FDA seeks to align on the confirmatory study design prior to the BLA submission, including considering allowing concurrent control on standard-of-care therapy instead of a sham procedure. “FDA communicated that they would work as expeditiously as possible with uniQure on this effort. The company is committed to conducting the confirmatory study without delay and expects to further align with the FDA on the details of such a study prior to BLA submission,” uniQure stated.

The post StockWatch: Positive Phase III Data Sells Investors on Intellia appeared first on GEN – Genetic Engineering and Biotechnology News.

Can preoperative spino-cranial angle predict cervical sagittal imbalance after laminoplasty?

ObjectiveThis study aimed to determine whether the preoperative spino-cranial angle (SCA) predicts cervical sagittal imbalance (CSI) after laminoplasty (LP).MethodsWe retrospectively screened 298 consecutive patients with degenerative cervical myelopathy (DCM) who underwent LP at our hospital from January 2018 to June 2021. Of these, 116 met the inclusion criteria and were analyzed. Radiographic and clinical parameters were collected preoperatively and at the last follow-up. Patients were stratified based on the change in cervical sagittal vertical axis (cSVA), calculated as ΔcSVA = postoperative−preoperative, into three categories: improvement (ΔcSVA≤ − 10 mm), stability (−10 mm < ΔcSVA≤10 mm), and deterioration (ΔcSVA>10 mm). Group comparisons were conducted using the χ2 test, t-test, analysis of variance, or non-parametric equivalents, as appropriate. Multivariable logistic regression was used to identify factors associated with postoperative CSI (ΔcSVA>10 mm). Receiver operating characteristic (ROC) analysis was performed to determine the SCA cutoff.ResultsPatients in the deterioration group exhibited the lowest preoperative SCA, along with poorer JOA recovery and worse postoperative neck pain compared to the improvement group. In the adjusted model, a lower SCA independently predicted postoperative cSVA deterioration (OR = 0.575, 95%CI: 0.372–0.808, p = 0.012), while other preoperative variables were not significant. The ROC analysis showed fair discrimination (AUC = 0.662), and an SCA threshold of 81.8° yielded 62.6% sensitivity and 96.0% specificity.ConclusionThe preoperative SCA influences postoperative cervical alignment after LP. Patients with a low SCA are at increased risk for CSI and may benefit from enhanced preoperative counseling and strategies that preserve alignment during LP.