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DECT acquisition protocol and image reconstruction/post-processing All DECT scans were conducted using a third-generation dual-source dual-energy CT scanner (Somatom Force, Siemens Healthineers, Munich, Germany) with standard parameters set as follows: tube A operated at 90 kVp with 220 mAs, and tube B operated at 150 kVp with 138 mAs, with an additional tin filter (Selective Photon Shield II, Siemens Healthineers)

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According to the National Institute of Diabetes and Digestive and Kidney Diseases, adults who are overweight or obese should lose 5% to 10% of their body weight within 6 months for weight loss success and better outcomes (12)

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In patients with myelopathy, neuropathy, gait changes, anemia, or low white blood cells, consider: INA Serum copper Ceruloplasmin Serum zinc Complete blood count B12 MMA Homocysteine Folate Vitamin E Copper deficiency can be treatable, but neurological recovery may be incomplete if it is missed too long